Human cytomegalovirus as a potential etiologic agent in recurrent aphthous ulcers and Behçet's disease

Abstract

In a preliminary study on anti-human cytomegalovirus (HCMV) antibody (Ab) by ELISA, the serum anti-HCMV/IgG Ab concentrations in 22 patients with recurrent aphthous ulcers (RAU) in the remission stage were found to be significantly higher than in 22 control subjects (121 +/- 42 vs 100 +/- 27, P < 0.05) and in 39 patients with RAU in the active stage (121 +/- 42 vs 88 +/- 45, P < 0.01). Therefore, the potential of HCMV as an etiologic agent in RAU was proposed and studies using the polymerase chain reaction (PCR) and in situ hybridization (ISH) have been performed to investigate the possible presence of HCMV DNA in pre-ulcerative oral aphthous lesions in patients with RAU or Behçet's disease (BD) of the mucocutaneous type. For this purpose, formalin-fixed biopsy specimens were obtained from 13 pre-ulcerative oral aphthous lesions, 2 samples of normal oral mucosa and 1 ileal mucosal lesion from 9 RAU patients and 4 BD patients. Five specimens of normal oral mucosa from 5 normal control subjects and 12 specimens of oral erosive or ulcerative lesions from 12 patients with erosive lichen planus (ELP) were also included. By PCR, HCMV DNA was detected in 5 of the 13 (38.5%) pre-ulcerative oral aphthous lesions, 3 from RAU patients and 2 from BD patients. The ileal mucosa specimen was also HCMV DNA-positive, whereas HCMV DNA was not demonstrated in any of the 7 specimens of normal oral mucosa from RAU patients and normal control subjects; 12 specimens of oral lesions from ELP patients were similarly negative. ISH did not detect HCMV DNA in any of the biopsy specimens from RAU patients and control subjects. Our findings suggest that HCMV may be an etiologic agent in some cases of RAU and BD.

The efficacy of the bioadhesive patches containing licorice extract in the management of recurrent aphthous stomatitis

“…An overall prevalence of 10-20% has been reported for the general population (Rennie et al, 1985;Scully et al, 2003), with a higher prevalence of RAS (56%) in selected groups, such as university students (Donatsky, 1973). Although hereditary (Ship, 1965;Shohat-Zabarski et al, 1992), dietary (Eversole, 1994), hematologic (Burgan et al, 2006), infectious (Barile et al, 1963;Sun et al, 1996), allergic (Boulinguez et al, 2003) and immunologic (Natah et al, 2000) factors have been implicated, their role as the main etiological factors in the pathogenesis remains to be elucidated. Furthermore, with the dramatic worldwide increase in patients with immuno-suppression caused by medical treatments, systemic diseases, or both, the prevalence of these conditions may be increasing.…”

Association between recurrent aphthous stomatitis and salivary thiocyanate levels

“…Recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease characterized by painful recurring ulcers of the oral mucosa of unknown etiology (1,2). RAS is one of the least understood diseases of the oral cavity, and the difficulty in determining its exact nature is due in part to the non-specific histopathologic features of the ulcers and to the lack of any reproducibly identifiable endogenous or exogenous cause (3).…”

Reccurent aphthous stomatitis

“…U aftoznim ulceracijama dokazana je i prisutnost citomegalovirusa (CMV), međutim nije bilo moguće dokazati je li on uzročnik RAS-a ili je došlo do superinfekcije s CMV-om. Daljnjim istraživanjima u 'preulcerativnom tkivu' dokazana je prisunost CMV DNK pomoću PCR metode 65 . Na sličan način predočena je i prisutnost Epstein Barr virusa u aftoznim ulceracijama, no zasad ne postoje čvrsti dokazi o virusnoj etiologiji RAS-a 66 .…”