Evaluation of salivary tumour necrosis factor–alpha in patients with recurrent aphthous stomatitis

Abstract

DOI: 10.26650/eor.2018.543

Purpose

Present study was undertaken to evaluate and compare the salivary levels of tumour necrosis factor alpha (TNF-α) in subjects with RAS, traumatic ulcers (TUs) in the oral mucosa and in healthy controls.

Materials and Methods

Present study involved 90 participants of which 30 subjects were diagnosed with RAS, 30 subjects with TUs and 30 healthy controls grouped as group 1, group 2 and group 3 respectively. Unstimulated saliva was collected from the subjects through ‘Spit Technique’ and the estimation of TNF-α was done by enzyme linked immunosorbent assay.  The data collected was statistically analysed.

Results

Salivary level of TNF-α was significantly higher in RAS patients than in patients with TUs and healthy controls. Difference between the Salivary TNF-α level in our study groups were statistically significant (p<0.001).

Conclusion

Present study suggests that saliva is a convenient and ideal medium for the detection of TNF-α.  Statistically significant difference in the level of salivary TNF-α between the RAS and TUs subjects as well as controls suggests the significant contribution of TNF-α in pathogenesis of RAS.

Keywords

• Recurrent aphthous stomatitis; tumour necrosis factor-alpha; saliva; oral mucosa; traumatic ulcer

References

1. 1. Natah SS, Konttinen YT, Enattah NS, Ashammakhi N, Sharkey KA, Häyrinen-Immonen R. Recurrent apthous ulcers today: a review of growing knowledge. Int J Oral Maxillofac Surg 2004; 33: 221-34. 2. Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. Crit Rev Oral Biol Med 1998; 9: 306-21. 3. Jurge S, Kuffer R, Scully C, Porter SR. Mucosal disease series: Number VI. Recurrent aphthous stomatitis. Oral Dis 2006; 12: 1-21. 4. Sawair FA. Recurrent apthousstomatitis: Do we know what patients are using to treat the ulcers? . J Altern Complement Med 2010; 16: 651-5. 5. Eisenberg E. Diagnosis and treatment of recurrent aphthous stomatitis. Oral Maxillofacial Surg Clin N Am 2003; 15: 111-22. 6. Akintoye SO, Greenberg MS. Recurrent aphthous stomatitis. Dent Clin North Am 2014; 58: 281-97. 7. Kutcher MJ, Ludlow JB, Samuelson AD, Campbell T, Pusek SN. Evaluation of a bioadhesive device for the management of aphthous ulcers. J Am Dent Assoc 2011; 32: 368-76. 8. Eguia-del Valle A, Martinez-Conde-Llamosas R, López-Vicente J, Uribarri- Etxebarria A, Aguirre-Urizar JM. Salivary levels of Tumour Necrosis Factor-alpha in patients with recurrent aphthous stomatitis. Med Oral Patol Oral Cir Bucal 2011; 16: e33-6. 9. Rivera-Hidalgo F, Shulman JD, Beach MM. The association of tobacco and other factors with recurrent aphthous stomatitis in an US adult population. Oral Dis 2004; 10: 335-45. 10. Boras VV, Lukac J, Brailo V, Picek P, Kordić D, Zilić IA. Salivary interleukin-6 and tumor necrosis factor-alpha in patients with recurrent aphthous ulceration. J Oral Pathol Med 2006; 35: 241-3. 11. Natah SS, Häyrinen-Immonen R, Hietanen J, Malmström M, Konttinen YT. Immunolocalization of tumor necrosis factor-alpha expressing cells in recurrent aphthous ulcer lesions (RAU). J Oral Pathol Med 2000; 29: 19-25. 12. Sun A, Wang JT, Chia JS , Chiang CP. Levamisole can modulate the serum tumor necrosis factor-a level in patients with recurrent aphthous ulcerations. J Oral Pathol Med 2006; 35: 111-6. 13. Al-Ghurabei BH, Saliah MM. Role of salivary tumor necrosis factor-alpha and immunoglobulin- a in recurrent aphthous stomatitis. J Fac Med Baghdad 2011; 53: 207-10. 14. Slebioda Z, Szponar EZ, Kowalska A. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Arch Immunol Ther Exp 2014; 62: 205-15. 15. Beutler B, Cerami A. Cachectin: more than a tumor necrosis factor. N Engl J Med 1987; 316: 379-85. 16. Hegde S, Harini K, Ajila V, Babu S, Shetty SR. Prevalence of recurrent aphthous stomatitis: An institutional study. Cumhuriyet Dent J 2015; 18: 228-34. 17. Byahatti SM. Incidence of Recurrent Apthous ulcers in a group of student population in Libya: A Questionnaire Study. Arch Cran Oro Fac Sc 2013; 1: 26-30. 18. Atai Z, Ansari M, Torabi N. Efficacy of Olive Leaf Extract in the Treatment of Minor Oral Aphthous Ulcers. Am J Infect Diseas 2007; 3: 24-6. 19. Belenguer-Guallar I, Jiménez-Soriano, Claramunt-Lozano A. Treatment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent 2014; 6: e168-74. 20. Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, Walsh T, Riley P, Yates JM. Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev 2012; 9: CD005411. 21. Ship JA, Chavez EM, Doerr PA, Henson BS, Sarmadi M. Recurrent aphthous stomatitis. Quintessence Int 2000; 31: 95-112. 22. Scully C, Gorsky M, Lozada-Nur F. The diagnosis and management of recurrent aphthous stomatitis: a consensus approach. J Am Dent Assoc 2003; 134: 200-7. 23. Avci E, Akarslan ZZ, Erten H, Coskun-Cevher S. Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers. Brazilian Journal of Medical and Biological Research 2014; 47: 355-60. 24. O’Neill ID, Scully C. Biologics in oral medicine: ulcerative disorders. Oral Dis 2013: 19: 37-45.