Oral Health and Its Aetiological Role in Behçet's Disease

Mumcu, Gonca; Fortune, Farida

doi:10.3389/fmed.2021.613419

Cited by 20 publications

(18 citation statements)

References 78 publications

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“…Studies, including our own, have concluded that the oral health of BD patients is impaired ( 14 , 55 – 57 ) while clinical treatment of oral symptoms results in better outcomes of systemic disease ( 38 ). Furthermore, the importance of dental and periodontal treatment for controlling oral ulceration activity and systemic disease has been reported ( 54 ) and highlighted in several studies, however its importance in the preventative management of BD has remained largely unrecognised ( 58 ).…”

Section: Introductionmentioning

confidence: 99%

Saliva and Serum Cytokine Profiles During Oral Ulceration in Behçet’s Disease

et al. 2021

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Behçet’s disease (BD) is a chronic, multi-systemic disorder of unknown aetiology typified by recurrent oral and genital mucocutaneous lesions, uveitis and vasculitis. Innate and adaptive immune system dysregulation has been implicated in pathogenesis with alterations in serum cytokine profiles. Few studies have investigated salivary cytokines in BD, despite more than 90% of BD patients first presenting with oral ulceration. The aim of this pilot study was twofold; firstly to investigate whether cytokine levels in matched serum and saliva samples show a differential profile in BD (with and without oral ulcers), recurrent aphthous stomatitis (RAS) and healthy controls (HCs), and secondly, to explore if any differential profiles in serum and/or saliva could provide a panel of cytokines with diagnostic and therapeutic potential for BD. Concentrations of 12 cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IFN-γ, TNF-α, TNF-β) were measured using the Human Th1/Th2 11-Plex FlowCytomix™ kit with IL-17A, in BD (N=20), RAS (N=6) and HCs (N=10). A differential range of cytokines was detected in serum and saliva with the majority of cytokine levels higher in saliva. The most prevalent salivary cytokines were IL-1β, IL-2, IL-8, IL-10 and TNF-α present in all samples in contrast to serum where the most prevalent cytokine detected was IL-8 (91.9%). The least abundant cytokine was IFN-γ in both saliva (43.2%) and serum (2.7%). After normalizing saliva for protein content, BD patients with oral ulcers (BD-MA) had significantly higher levels of salivary IL-1β (p=0.01), IL-8 (p=0.02), TNF-α (p=0.004) and IL-6 (p=0.01) than HCs. Notably, BD patients without oral ulcers (BD-MQ) also had significantly higher salivary IL-1β, IL-8 and TNF-α (p ≤ 0.05) than HCs. During relapsed (BD-RE) and quiet (BD-Q) systemic episodes, salivary IL-β and TNF-α were also significantly increased with IL-8 significantly higher only in BD-Q (p=0.02). BD oral ulcers signify a potential reactivation of systemic inflammation. Identifying cytokines released during asymptomatic episodes and oral ulceration might lead to targeted drug therapy to prevent recurrent oral ulcers and possible disease relapse. This is the first study to report salivary cytokine levels in BD. The detectable levels suggests cytokine profiling of BD saliva may provide an alternative, less invasive, sensitive procedure for frequent monitoring of disease activity and progression.

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Section: Introductionmentioning

confidence: 99%

Saliva and Serum Cytokine Profiles During Oral Ulceration in Behçet’s Disease

et al. 2021

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“…Moreover, male gender was identi ed as an independent risk factor for oral health in healthy controls. Immunosuppressive therapy was found to be effective in reducing the number of oral ulcers in severe BD patients compared to those with moderate and milder symptoms, which may help improve oral health (7,30,31).…”

Section: Discussionmentioning

confidence: 99%

Oral health in Behçet's disease and its association with disease severity: cross-sectional and case-control study

Khalayli,

Ataya,

Darwish

et al. 2023

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Background: Behçet's disease is a chronic autoimmune disorder that affects various organs, including oral aphte, genital ulceration, cutaneous manifestation, ocular involvement, and positive pathergy test according to International Study Group for Behçet’s Disease criteria. This study aimed to investigate the oral health condition of patients with Behçet's disease and to assess how it correlates with the patients' gender, clinical symptoms, and severity of the disease. Methods: A total of 92 participants, including 42 patients with Behçet's disease and 50 healthy controls, were enrolled in this cross-sectional study. The periodontal indices were measured and compared between the two groups. Logistic regression analysis was used to identify potential risk factors for disease severity. Results: This study assessed the periodontal health of patients with Behçet's disease and found that they had significantly higher plaque, gingival, bleeding, and probing depth scores compared to healthy controls (P<0.05). Logistic regression analysis revealed that plaque accumulation was a significant risk factor for higher severity scores in Behçet's disease. Gender-specific approaches may be necessary in the management and treatment of periodontal disease in Behçet's disease patients. Conclusions: The findings of this study suggest that patients with Behçet's disease are at increased risk for periodontal disease and its associated symptoms. Specifically, plaque accumulation appears to be a significant risk factor for more severe periodontal health issues in these patients. Therefore, it is important for clinicians to be aware of this increased risk and to develop tailored treatment plans that address both the underlying Behçet's disease and the associated periodontal disease.

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“…Topical interventions range from oral health promotion to inert barriers to active treatments such as sprays, mouth rinses, locally dissolving tablets, pastes, or gels. Discomfort and pain linked to mucosal lesions may contribute to a poor oral hygiene practice, which in turn induces infective foci, worsening of local inflammation, and dysbiosis, and may contribute to increase systemic disease activity [ 87 ]. Dental plaque accumulation is associated with a more severe disease course [ 88 ].…”

Section: Treatmentmentioning

confidence: 99%

Treatment Options in Pediatric Behçet’s Disease

2023

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Behçet’s disease is a rare and poorly understood vasculitis affecting blood vessels of all types and sizes. Uveitis and oral and genital ulcers represent the typical clinical triad. Populations along the ancient trading route connecting the Mediterranean basin with the Middle and Far East are most affected. Up to a quarter of the cases has a pediatric onset, typically around puberty. The aim of the treatment is early intervention to control inflammation, with symptom relief and prevention of relapses, damage, and complications. The heterogeneous clinical presentation often requires a multidisciplinary and tailored approach. Ocular, neurological, gastrointestinal, and vascular involvement is associated with a worse prognosis and needs more aggressive treatments. In young patients with expected prolonged disease, treatment should also focus on preventive measures and lifestyle advice. In recent years, the pharmacological armamentarium has grown progressively, although only a limited number of drugs are currently authorized for pediatric use. Most evidence for these drugs still derives from adult studies and experience; these are prescribed as off-label medications and are only available as adult formulations. Corticosteroids frequently represent the mainstay for the management of the initial acute phases, but their potential serious adverse effects limit their use to short periods. Different conventional disease-modifying anti-rheumatic drugs have long been used. Many other biologic drugs targeting different cytokines such as interleukin-1, interleukin-6, and interleukin-17 and treatments with small molecules including the phosphodiesterase 4 and Janus kinase inhibitors are emerging as novel promising therapeutic agents. In recent years, a growing interest has developed around anti-tumor necrosis factor agents that have often proven to be effective in severe cases, especially in those with a gastrointestinal and ocular involvement.

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Oral Health and Its Aetiological Role in Behçet's Disease

Cited by 20 publications

References 78 publications

Saliva and Serum Cytokine Profiles During Oral Ulceration in Behçet’s Disease

Saliva and Serum Cytokine Profiles During Oral Ulceration in Behçet’s Disease

Oral health in Behçet's disease and its association with disease severity: cross-sectional and case-control study

Treatment Options in Pediatric Behçet’s Disease

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