Salivary levels of TNF-α in patients with recurrent aphthous stomatitis: A cross-sectional study

Abstract

Background. Recurrent aphthous stomatitis (RAS) is a disorder characterized by recurring ulcers involving the oral mucosa in patients with no other signs of disease. The current concept of etiopathogenesis is that RAS is a clinical syndrome with several possible etiologies. The process seen in RAS is probably initiated through an as yet unidentified antigenic stimulation of the mucosal keratinocytes, which stimulates secretion of T-cell activation cytokines ‒ interleukins and tumor necrosis factor alpha (TNF-α). TNF-α causes inflammation by its effect on endothelial cell adhesion and neutrophil chemotaxis. The rele-vance of TNF-α to the pathogenesis of RAS has stemmed from the observations that anti- TNF-α drugs such as thalidomide and pentoxifylline have been found to be effective in the treatment of RAS. Therefore, the present study was an attempt to measure the levels of salivary TNF-α in patients with RAS, which will reflect the local production of cytokines at the site of the disease. The aim was to evaluate the salivary levels of TNF-α in patients with recurrent aphthous stomatitis. Methods. The study comprised of 60 subjects, of whom 30 clinically proven RAS patients of either sex were selected as cases and 30 healthy, age- and gender- matched subjects were selected as controls. After taking informed consent, 5 mL of unstimulated saliva were collected from both the study and control group subjects. Determination of salivary TNF-α levels was carried out by Enzyme-Linked Immunosorbent Assay (ELISA) and expressed in pg/mL. Statistical analysis of the RAS and control groups was carried out using unpaired t-test. Gender-wise comparison of salivary TNF-α levels in the study and control groups was carried out using one-way ANOVA. Results. Mean salivary TNF-α levels were significantly higher in the RAS group compared to the control group (P<0.001). It was also revealed that the mean salivary TNF-α levels in females were significantly higher than in males in the study group (PP<0.05). Conclusion. It is fair to suggest that TNF-α plays a very important mediatory role in the pathogenesis of RAS and may play an important role in the search for a definitive treatment for the disease.

Serum interleukin‐6, interleukin‐17A, and tumor necrosis factor‐alpha in patients with recurrent aphthous stomatitis

“…Different cells including macrophages, CD4+ T cells, mast cells, and NK cells stimulate the production of TNF‐α by producing lipopolysaccharides, viruses, and parasites. The TNF‐α immune response had been detected in macrophages and lymphocytes infiltrated by mononuclear inflammation in oral ulcer lesions 13,24‐27 . In this study, the serum level of TNF‐α was within normal limits, which was same to the Yamamo's research 12 .…”

Investigation of tumour necrosis factor-alpha role in development of recurrent aphthous stomatitis

“…The levels of salivary tumour necrosis factor-alpha in recurrent aphthous stomatitis patients were no significantly increased. Considering that serum TNF-α was mostly within the normal range, its role in the pathology of RAS needed to be further explored (Chaudhuri et al, 2018). Some studies indicates that TNF-α has important effects on the RAS development.…”

Risk of cancer in patients with recurrent aphthous stomatitis in Korea

“…In RAS, when mucosal keratinocytes induce stimulation of T lymphocytes, they secrete cytokines such as TNF-a and IL. [ 17 ] TNF-a is known to induce activation of NF-κB , a transcription factor, to convert tumor suppressors to tumor promotors and substances such as IL-6 to induce pancreatic intraepithelial neoplasia. [ 18 ] In a previous nationwide population-based cohort study of the association between candidiasis and cancer, there was a significant association between candidiasis groups and pancreatic cancer.…”