Role of genetic polymorphisms in recurrent aphthous stomatitis: A systematic review and meta-analysis

Yousefi, Hadi; Gholami, Morteza; Zoughi, Marziyeh; Rezaei, Nima; Chuppani, Aria; Nikfar, Shekoufeh; Amoli, Mahsa M.

doi:10.1016/j.cyto.2022.155864

Cited by 3 publications

(10 citation statements)

References 49 publications

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“…Recurrent aphthous stomatitis, also known as aphthous ulcers or canker sores, is characterized by recurring episodes of 1 or more round, shallow, and painful oral ulcers. [50][51][52] It is the most prevalent acute oral mucosal condition across all geographic areas, with an estimated lifetime prevalence of 39% to 50%. 50,53 Recurrent aphthous stomatitis affects females slightly more commonly than males and usually has its onset between the ages of 10 and 19 years, with the frequency decreasing with age.…”

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

“…54 The frequency of recurrent aphthous stomatitis episodes varies significantly between individuals, ranging from 1 to 2 episodes per year to more than 1 episode per month. [50][51][52] Aphthous stomatitis can be categorized into 3 distinct forms based on the size and number of ulcers: minor, major, and herpetiform aphthous stomatitis. 55 Minor aphthous stomatitis, which constitutes approximately 80% of all recurrent aphthous stomatitis ulcers, is typically found on the nonkeratinized oral mucosa, such as the labial mucosa, buccal mucosa, ventral surface of the tongue, and the floor of the mouth.…”

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

“…Although the precise cause of recurrent aphthous stomatitis is unclear, abnormal multifunctional cytokines might play a role in its development by promoting an increased cell-mediated immune reaction against the nonkeratinized oral mucosa. 52,57 A variety of contributing factors, such as genetic, immunological, nutritional, allergic, and systemic disease, have been proposed as potential triggers for the development of aphthous stomatitis. 51,52,[57][58][59][60][61][62][63][64][65] A microbial origin of recurrent aphthous stomatitis has also been explored, but an infectious causation has not been proven.…”

Section: Pathophysiologymentioning

confidence: 99%

“…52,57 A variety of contributing factors, such as genetic, immunological, nutritional, allergic, and systemic disease, have been proposed as potential triggers for the development of aphthous stomatitis. 51,52,[57][58][59][60][61][62][63][64][65] A microbial origin of recurrent aphthous stomatitis has also been explored, but an infectious causation has not been proven. 58,59 Genetic factors contributing to recurrent aphthous stomatitis have been investigated due to the possible hereditary nature of the condition.…”

Section: Pathophysiologymentioning

confidence: 99%

“…58,59 Genetic factors contributing to recurrent aphthous stomatitis have been investigated due to the possible hereditary nature of the condition. 51,52,57 A linkage-based genome-wide association study of 16 families with recurrent aphthous stomatitis reported that it was more likely to be associated with multiple host genes rather than being monogenic. 66 Moreover, a meta-analysis that included 23 studies found that certain cytokines, such as IL-10, 819 (T allele), and IL-6-174 (G allele), were associated with a higher incidence of recurrent aphthous stomatitis.…”

Section: Pathophysiologymentioning

confidence: 99%

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Common Oral Conditions

Stoopler,

Villa,

Bindakhil

et al. 2024

JAMA

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ImportanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are 3 of the most common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity.ObservationsIn a meta-analysis of 26 population-based cohort and cross-sectional studies, the global prevalence of dry mouth symptoms was 23% (95% CI, 18% to 28%), placing individuals at risk of oral candidiasis, dental caries, dysgeusia, masticatory/speech impairment, and oropharyngeal dysphagia. Dry mouth is associated with using more than 3 oral medications per day (odds ratio [OR], 2.9 [95% CI, 1.4 to 6.2]), head and neck radiation, and Sjögren disease. Symptoms may include difficulty swallowing and speaking, thirst, and halitosis. Dry mouth is associated with an 11.5% (95% CI, 3.6% to 27%) higher risk of oral candidiasis, based on a meta-analysis of 6 observational cohorts. Management of dry mouth includes mechanical salivary stimulants, oral moisturizers, and/or systemic sialagogues. Oral candidiasis is an opportunistic fungal infection caused by overgrowth of the Candida genus with C albicans, which accounts for 76.8% of infections. The prevalence of oral candidiasis is higher in patients who are immunosuppressed, for example, those with HIV (35% [95% CI, 28% to 42%]) and those with salivary gland hypofunction (OR, 3.02 [95% CI, 1.73 to 5.28]). Common risk factors associated with oral candidiasis include use of antibiotics (P = .04) and oral mucosal disorders such as lichen planus. Oral burning and dysgeusia are common symptoms of oral candidiasis. Treatment includes addressing risk factors and use of topical and/or systemic antifungal medications. Recurrent aphthous stomatitis is characterized by symptomatic round or oval oral ulcers, which are covered by a gray-white fibrin layer and encircled by an erythematous ring. A meta-analysis of 10 case-controlled studies revealed an increased risk of recurrent aphthous stomatitis associated with polymorphism of IL-1β (+3954C/T) (OR, 1.52 [95% CI, 1.07 to 2.17]) and IL-1β (−511C/T) (OR, 1.35 [95% CI, 1.09 to 1.67]). Another meta-analysis of 9 case-control studies reported that patients with recurrent aphthous stomatitis had a higher frequency of nutritional deficiencies, including vitamin B12 (OR, 3.75 [95% CI, 2.38 to 5.94]), folic acid (OR, 7.55 [95% CI, 3.91 to 14.60]), and ferritin (OR, 2.62 [95% CI, 1.69 to 4.06]). Recurrent aphthous stomatitis can be associated with systemic diseases. A meta-analysis of 21 case-control studies revealed that celiac disease is associated with a higher incidence of recurrent aphthous stomatitis (25% vs 11%; OR, 3.79 [95% CI, 2.67 to 5.39]; P &lt;.001). Topical corticosteroids are first-line agents to manage recurrent aphthous stomatitis; however, systemic medications may be necessary in more severe cases.Conclusions and RelevanceDry mouth, oral candidiasis, and recurrent aphthous ulcers are common oral conditions that may be associated with patient discomfort, decreased quality of life, and morbidity. First-line treatment includes over-the-counter sialagogues for dry mouth, topical antifungals for oral candidiasis, and topical corticosteroids for aphthous ulcers. Oral conditions that do not improve with first-line treatment may require treatment with systemic medications.

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Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Section: Recurrent Aphthous Stomatitismentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

See 3 more Smart Citations

Common Oral Conditions

Stoopler,

Villa,

Bindakhil

et al. 2024

JAMA

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Salivary microbiota and metabolic phenotype of patients with recurrent aphthous ulcers

Dong,

Lou,

Yan

et al. 2024

Oral Diseases

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ObjectivesRecurrent aphthous ulcer (RAU) is a prevalent oral mucosal disease, affecting around 20% of the global population. It can greatly impair the quality of life for affected individuals. However, the exact etiology of RAU remains unknown.Subjects and Methods16S rRNA sequencing (16S rRNA‐seq) and non‐targeted liquid chromatography‐mass spectrometry (LC–MS) were employed to investigate the salivary microbiota and metabolic phenotype between RAU patients (N = 61) and healthy controls (HCs) (N = 105).ResultsFindings from 16S rRNA ‐seq indicated reduced oral microbial diversity in RAU patients compared to HCs, but increased interactions. Clinical variables did not show any significant association with the overall diversity of oral microbiota in RAU patients. However, significant correlations were observed between specific microorganisms and clinical variables. LC–MS results revealed dysregulation of amino acid, lipid, nucleotide, and caffeine metabolism in RAU patients. Furthermore, correlation analysis of 16S rRNA‐seq and LC–MS data revealed a significant association between salivary microbiota and metabolites in RAU patients.ConclusionsOur study revealed notable differences in salivary microbiota and metabolic profiles between RAU patients and HCs, indicating a strong link between oral microbiota dysbiosis, metabolic disturbances, and the onset and progression of RAU.

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Recurrent Aphthous Stomatitis and Sleep Quality Factors: A Comprehensive Analysis

Bazmi,

Mohammadi,

Tabrizi

et al. 2024

Oral Diseases

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BackgroundDue to the unclear etiology of recurrent aphthous stomatitis (RAS), a painful and distressing condition with a high prevalence, the researchers have hypothesized a connection between sleep quality and RAS.MethodsThe cross‐sectional study enrolled 10,138 Fasa Cohort Study participants aged 35–70 years. Various sleep quality factors were calculated and categorized based on the Pittsburgh Sleep Questionnaire.ResultsAmong 9030 subjects finally included with RAS prevalence of 20.2%, adjusted logistic regression showed significant odds ratios (ORs) in subjects who sleep < 5 h (OR = 1.44, 95%CI 1.25, 1.66), have sleep latencies of more than 60 min (OR = 1.37, 95%CI 1.11, 1.69), have sleep efficiencies of 65%–75% (OR = 1.55, 95%CI 1.21, 1.98), or regularly go to bed after 11 p.m. (OR = 1.23, 95%CI 1.11, 1.37). Subgroup analyses indicated no significant associations between RAS and various sleep factors in individuals who worked night shifts, and stronger associations were observed in men than women.ConclusionThe study found a significant positive association between RAS and sleep quality factors such as shorter duration, lower efficiency, longer latency, later bedtime, and regular sleeping pill use. Establishing early and sufficient sleep and addressing sleep onset disturbances by adhering to sleep hygiene principles should be prioritized in individuals with RAS.

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Role of genetic polymorphisms in recurrent aphthous stomatitis: A systematic review and meta-analysis

Cited by 3 publications

References 49 publications

Common Oral Conditions

Common Oral Conditions

Salivary microbiota and metabolic phenotype of patients with recurrent aphthous ulcers

Recurrent Aphthous Stomatitis and Sleep Quality Factors: A Comprehensive Analysis

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