Probiotics Can Cure Oral Aphthous-Like Ulcers in Inflammatory Bowel Disease Patients: A Review of the Literature and a Working Hypothesis

Cappello, Francesco; Rappa, Francesca; Canepa, Federica; Cetta, Francesco; Mazzola, Marco; Tomasello, Giovanni; Bonaventura, Giuseppe; Giuliana, G; Leone, Angelo; Saguto, Dario; Scalia, Federica; Bucchieri, Fabio; Fucarino, Alberto; Campisi, Giuseppina

doi:10.3390/ijms20205026

Cited by 20 publications

(22 citation statements)

References 46 publications

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“…In 2012, RAS was successfully managed by Lactobacillus brevis CD2 in an immunocompromised hemophilic patient after the failed attempt to use antiviral agents and topical steroids; the condition did not recur for 6 months 19 . And probiotics were proposed as a treatment for oral aphthous stomatitis in patients with inflammatory bowel disease 21 .…”

Section: Introductionmentioning

confidence: 99%

The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

Cheng

Zeng

Liu

et al. 2020

Sci Rep

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There is currently a lack of effective drugs to cure recurrent aphthous stomatitis. This study aimed to evaluate the efficacy of probiotics alone or as an adjunct in recurrent aphthous stomatitis (RAS) patients. Seven randomized controlled trials (RCTs) were included, of which three were included in quantitative analysis. Of five studies evaluating the efficacy of probiotics alone compared with placebo or Oracure gel, two reported no significant difference in relieving oral pain, while probiotics exhibited a higher capacity for decreasing oral pain in the other three. A significant decrease in ulcer severity was found in one, while no significant difference was found in the other four. The remaining two studies demonstrated that probiotics, as an adjunct to steroids or anaesthetic antiseptic gel, significantly reduced the ulcer severity and oral pain. The meta-analysis showed a significant decrease in oral pain (− 1.72, P = 0.0001) with probiotics compared with placebo. In conclusion, probiotics alone were capable of relieving oral pain but not effective in reducing ulcer severity. A combination of probiotics and steroids or anaesthetic antiseptic gel was more effective than steroids or anaesthetic antiseptic gel alone in RAS patients. Probiotics are promising for the treatment of recurrent aphthous stomatitis.

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Section: Introductionmentioning

confidence: 99%

The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

Cheng

Zeng

Liu

et al. 2020

Sci Rep

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“…Aplastic anaemia associated with iron deficiency results in painful angular cheilitis and depapillation of the tongue, as well as erosive and crusty lesions in the perioral area and lip commissures. 14 An aphthous-like ulcer is similar to recurrent aphthous stomatitis (RAS). If the occurrence of aphthae is associated with a compromised systemic condition, the term aphthouslike ulcer is more appropriate, since aphthae are considered a secondary manifestation of systemic disease and have a different clinical history, as well as require different management strategies from RAS.…”

Section: Discussionmentioning

confidence: 99%

“…Usually, the lesions appear suddenly and are accompanied by systemic symptoms. 14 The aphthous-like ulcer can be determined based on the patient's medical history, the presence of lesions affecting the skin, mucosa other than the oral cavity (eye mucosa or genital mucosa), and the digestive and respiratory tract. In addition, a complete blood count can also confirm the diagnosis of an aphthous-like ulcer and relate it to the systemic condition.…”

Section: Discussionmentioning

confidence: 99%

Management of patients with aphthous-like ulcers related to aplastic anaemia in the COVID-19 pandemic era through teledentistry: A case report

et al. 2022

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Background: Aplastic anaemia is a disease that occurs when the body fails to produce enough blood cells. Oral lesions, such as canker sores, are often used as an early marker of this disease condition. In the COVID-19 pandemic era, a teledentistry method is expected to assist in the management of patients with various diseases including aplastic anaemia. Purpose: This case report discusses the management of patients with aphthous-like ulcers related to aplastic anaemia in a 34-year-old woman, based on history, clinical examination, and blood tests through teledentistry. Case: The patient complained of a bleeding wound on the inner left cheek and corner of the left lip that appeared one month ago. There was an ulcer lesion that was bleeding easily in the buccal mucosa sinistra and the angular sinistra, as well as macules lesion on her hand and foot. The complete blood count test exhibits a low platelet level. Case management: The diagnosis was an aphthous-like ulcer related to aplastic anaemia. Patient was treated with topical antiseptic and anti-inflammatory mouthwashes for the oral lesions, as well as collaboration with the medical team. The lesions improved after the patient received a blood transfusion and drug therapy from the internist while she was hospitalized, but the lesions reappeared in other locations in the oral cavity when the platelet level dropped. Conclusion: Management of oral manifestations in patients with aphthous-like ulcers related to aplastic anaemia in the COVID-19 pandemic era can be done through teledentistry. However, this requires sensitivity from the dentist, patient compliance in following instructions, and the involvement of a multidisciplinary approach, such as collaboration with internists to achieve recovery. Delay in detecting and treating aplastic anaemia will lead to death, as in this case.

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“…However, after the administration of specific probiotics, this compromise improves through several mechanisms, one of which is the synthesis of tight junction proteins through the activation of the aryl hydrocarbon receptor, leading to the increase in the synthesis of ZO-1 (zonula occludens-1), improving the functionality of the epithelial barrier, as shown in Figure 3. Although there are several mechanisms involved in IBD's pathophysiology, the use of probiotics has beneficial effects due to different mechanisms of action [29,30]. In Table 1 we show the studies included in this review.…”

Section: Use Of Probiotics On Ibdmentioning

confidence: 99%

Effects of probiotics on inflammatory bowel disease: A systematic review

Lopes¹,

Campanari²,

Barbalho³

et al. 2021

Japanese J Gastroenterol Res

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Inflammatory Bowel Disease (IBD) is a chronic idiopathic inflammation of the gastrointestinal tract, characterized by periods of exacerbation and remission, which includes two primary forms: Ulcerative Colitis (UC) and Crohn's Disease (CD). IBD is an autoimmune disorder influenced by genetics, hereditary, environment, and infection. Alternative treatments with fewer side effects have been searched. Thus, the use of probiotics stands out due to several beneficial effects. For this reason, the objective of this systematic review is to evaluate the effects of the use of probiotics in patients diagnosed with IBD. This review included studies available in the MEDLINE databases - PubMed, EMBASE, and Cochrane, and the final selection included thirteen randomized clinical trials. The results showed that the oral use of probiotics and, mainly for a prolonged period, can help in the improvement of reducing symptoms related to IBD. In endoscopic analyzes, a reduction in intestinal inflammation was noted, in addition to a reduction in proinflammatory cytokines. Although there are positive effects, there is a need for further studies to define the best composition of probiotics and time of use since there are many variations in this treatment.

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Probiotics Can Cure Oral Aphthous-Like Ulcers in Inflammatory Bowel Disease Patients: A Review of the Literature and a Working Hypothesis

Cited by 20 publications

References 46 publications

The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

Management of patients with aphthous-like ulcers related to aplastic anaemia in the COVID-19 pandemic era through teledentistry: A case report

Effects of probiotics on inflammatory bowel disease: A systematic review

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