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Genetic Predisposition to Recurrent Aphthous Stomatitis
(Review)


Authors: P. Bořilová Linhartová 1,2;  S. Valová 1,2;  L. Izakovičová Hollá 1,2
Authors‘ workplace: Stomatologická klinika LF MU a FN u sv. Anny, Brno 1;  Ústav patologické fyziologie LF MU, Brno 2
Published in: Česká stomatologie / Praktické zubní lékařství, ročník 117, 2017, 2, s. 27-34
Category: Review Article

Overview

Background:
Recurrent aphthous stomatitis (RAS), one of the most common diseases of the oral mucosa, is characterized by the formation of painful oral erosions or even ulcers. RAS diagnosis is based on anamnestical data and appearance of lesions; no laboratory tests to confirm the diagnosis are available. Treatment of this condition is only symptomatic and less effective. The disease etiopathogenesis is unknown, but risk factors associated with the origin and development of the disease have been described in the literature. Besides local trauma, food allergens, oral microbial dysbiosis, infectious agents, nutritious factors (deficiency of B12 vitamin, iron, and folic acid), stress and hormonal changes, the immunological profile of the patient and his/her genetic predispositions to this multifactorial disease play a role. The effect of heredity on the disease origin and development was previously confirmed by studies of twins and families. Genetic variability of the selected genes in patients with RAS compared with healthy controls (case-control study) conducted in different populations have been published. The main candidates for RAS are the genes associated with the immune system, response of the organism to oxidative stress, metabolism of mucosal tissues, vitamins, and minerals.

The aim of these studies was to find risk, or on the contrary protective, gene variants in the interleukin-1 (IL) and its receptor antagonist (IL-1RN), IL-4, IL-6, IL-10, tumor necrosis factor alpha (TNFalpha), NOD-like receptor 3 (NLRP3), Toll-like receptor 4 (TLR4), E- and L-selectin (SEL), angiotensin converting enzym (ACE), gene for Mediterranean fever (MEFV), serotonin transporter (SLC6A4), matrix metalloproteinase 9 (MMP9), methylenetetrahydrofolate reductase (MTHFR) and nitric oxide syntase 2 (NOS2), which may together with other factors influence the individual susceptibility to the disease development. In the present review, we summarize and discuss findings of genetic association studies.

Conclusion:
We assume that further research into RAS on the molecular level may lead to better understanding of this disease etiopathogenesis and improve prevention, diagnosis and treatment of the affected patients.

Keywords:
aphthous stomatitis – oral mucosa diseases – genetic study – gene variability – hereditary predisposition


Sources

1. Akintoye, S. O., Greenberg, M. S.: Recurrent aphthous stomatitis. Dental clinics of North America, roč. 58, 2014, č. 2, s. 281–297.

2. Akman, A., et al.: Relationship between periodontal findings and specific polymorphisms of interleukin-1a and-1ß in Turkish patients with Behçet‘s disease. Arch. Dermatol. Res., roč. 300, 2008, č. 1, s. 19–26.

3. Albanidou-Farmaki, E., et al.: HLA-A, B, C, and DR antigens in recurrent oral ulcers. Ann. Dentistry, roč. 47, 1988, č. 1, s. 5–8.

4. Albanidou-Farmaki, E., et al.: Detection, enumeration and characterization of T helper cells secreting type 1 and type 2 cytokines in patients with recurrent aphthous stomatitis. Tohoku J. experiment. Med., roč. 212, 2007, č. 2, s. 101–105.

5. Albanidou-Farmaki, E., et al.: HLA haplotypes in recurrent aphthous stomatitis: a mode of inheritance? Intern. J. Immunogenet., roč. 35, 2008, č. 6, s. 427–432.

6. Ali, K., et al.: Apolipoprotein E suppresses the type I inflammatory response in vivo. Circulation Res., roč. 97, 2005, č. 9, s. 922–927.

7. Alkhateeb, A., et al.: Association of cell adhesion molecule gene polymorphisms with recurrent aphthous stomatitis. J. Oral Pathol. Med., roč. 42, 2013, č. 10, s. 741–746.

8. Andrew, P. J., Mayer, B.: Enzymatic function of nitric oxide synthases. Cardiovascular Res., roč. 43, 1999, č. 3, s. 521–531.

9. Avci, E., et al.: Oxidative stress and cellular immunity in patients with recurrent aphthous ulcers. Brazil. J. med. biol. Res., roč. 47, 2014, č. 5, s. 355–360.

10. Baek, J. O., et al.: Methylenetetrahydrofolate reductase gene C677T mutation and apolipoprotein E gene mutation in recurrent aphthous stomatitis. Korean J. Dermatol., roč. 46, 2008, č. 2, s. 209–215.

11. Bazrafshani, M. R., et al.: IL-1B and IL-6 gene polymorphisms encode significant risk for the development of recurrent aphthous stomatitis (RAS). Genes Immunity, roč. 3, 2002, č. 5, s. 302–305.

12. Bazrafshani, M. R., et al.: Recurrent aphthous stomatitis and gene polymorphisms for the inflammatory markers TNF-α, TNF-ß and the vitamin D receptor: no association detected. Oral Dis., roč. 8, 2002, č. 6, s. 303–307.

13. Bazrafshani, M. R., et al.: Polymorphisms in the IL-10 and IL-12 gene cluster and risk of developing recurrent aphthous stomatitis. Oral Dis., roč. 9, 2003, č. 6, s. 287–291.

14. Bidoki, A. Z., et al.: NLRP3 gene polymorphisms in Iranian patients with recurrent aphthous stomatitis. J. Oral Pathol. Med., roč. 45, 2016, č. 2, s. 136–140.

15. Borra, R. C., et al.: The Th1/Th2 immune-type response of the recurrent aphthous ulceration analyzed by cDNA microarray. J. Oral Pathol. Med., roč. 33, 2004, č. 3, s. 140–146.

16. Brozovic, S., et al.: Salivary levels of vascular endothelial growth factor (VEGF) in recurrent aphthous ulceration. J. Oral Pathol. Med., roč. 31, 2002, č. 2, s. 106–108.

17. Buno, I. J., et al.: Elevated levels of interferon gamma, tumor necrosis factor α, interleukins 2, 4, and 5, but not interleukin 10, are present in recurrent aphthous stomatitis. Arch. Dermatol., roč. 134, 1998, č. 7, s. 827–831.

18. Dalghous, A. M., Freysdottir, J., Fortune, F.: Expression of cytokines, chemokines, and chemokine receptors in oral ulcers of patients with Behcet‘s disease (BD) and recurrent aphthous stomatitis is Th1-associated, although Th2-association is also observed in patients with BD. Scand. J. Rheumatol., roč. 35, 2006, č. 6, s. 472–475.

19. Feng, J., et al.: Prevalence and distribution of oral mucosal lesions: a cross-sectional study in Shanghai, China. J. Oral Pathol. Med., roč. 44, 2015, č. 7, s. 490–494.

20. Gallina, G., et al.: HLA-A, B, C, Dr, MT, and MB antigens in recurrent aphthous stomatitis. Oral Surg. Oral Med. Oral Pathol., roč. 59, 1985, č. 4, s. 364–370.

21. Gallo, C. de Barros, Mimura, M. A. M., Sugaya, N. N.: Psychological stress and recurrent aphthous stomatitis. Clinics, roč. 64, 2009, č. 7, s. 645–648.

22. Gavic, L., et al.: The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus. J.Oral Pathol. Med., roč. 43, 2014, č. 6, s. 410–417.

23. Ghanaei, F. M., et al.: Prevalence of oral mucosal lesions in an adult Iranian population. Iranian Red crescent Med. J., roč. 15, 2013, č. 7, s. 600–604.

24. Guimarães, A. L. S., et al.: Investigation of functional gene polymorphisms IL-1β, IL-6, IL-10 and TNF-α in individuals with recurrent aphthous stomatitis. Arch. Oral Biol., roč. 52, 2007, č. 3, s. 268–272.

25. Han, M., et al.: Effectiveness of laser therapy in the management of recurrent aphthous stomatitis: a systematic review. Scientifica, 2016, 2016, 9062430.

26. Hazzaa, H. H. A., Rashwan, W. A. M., Attia, E. A. S.: IL-18 gene polymorphisms in aphthous stomatitis vs. Behçet‘s disease in a cohort of Egyptian patients. J. Oral Pathol. Med., roč. 43, 2014, č. 10, s. 746–753.

27. Hosová, K.: Volně prodejné produkty pro léčbu chorob v dutině ústní. Dermatol. praxi, roč. 5, 2011, č. 1, s. 40–42.

28. Jing, C., Zhang, J. Q.: Association between interleukin gene polymorphisms and risk of recurrent oral ulceration. Genet. Molecul. Res., roč. 14, 2015, č. 2, s. 6838–6843.

29. Kalkan, G., et al.: Association between interleukin 4 gene intron 3 VNTR polymorphism and recurrent aphthous stomatitis in a cohort of Turkish patients. Gene, roč. 527, 2013, č. 1, s. 207–210.

30. Kalkan, G., et al.: Association between MEFV gene mutations and recurrent aphthous stomatitis in a cohort of Turkish patients. J. Dermatol., roč. 40, 2013, č. 7, s. 516–521

31. Kalkan, G., Karakus, N., Yigit, S.: Association of MTHFR gene C677T mutation with recurrent aphthous stomatitis and number of oral ulcers. Clin. Oral Investigations, roč. 18, 2014, č. 2, s. 437–441.

32. Karakus, N., et al.: High association of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with recurrent aphthous stomatitis. Arch. Dermatol. Res., roč. 305, 2013, č. 6, s. 513–517.

33. Karakus, N., et al.: Effects of interleukin (IL)-6 gene polymorphisms on recurrent aphthous stomatitis. Arch. Dermatol. Res., roč. 306, 2014, č. 2, s. 173–180.

34. Karasneh, J. A., et al.: Endothelial nitric oxide synthase gene polymorphisms are not associated with recurrent aphthous stomatitis. Arch. Oral Biol., roč. 54, 2009, č. 6, s. 583–587.

35. Karasneh, J. A., et al.: Association between recurrent aphthous stomatitis and inheritance of a single-nucleotide polymorphism of the NOS2 gene encoding inducible nitric oxide synthase. J. Oral Pathol. Med., roč. 40, 2011, č. 9, s. 715–720.

36. Karasneh, J. A., et al.: Association of MMP but not TIMP-1 gene polymorphisms with recurrent aphthous stomatitis. Oral Dis., roč. 20, 2014, č. 7, s. 693–699.

37. Karasneh, J., et al.: TLR2, TLR4 and CD86 gene polymorphisms in recurrent aphthous stomatitis. J. Oral Pathol. Med, roč. 44, 2015, č. 10, s. 857–863.

38. Karasneh, J., et al.: Investigation of SLC6A4 gene polymorphisms in jordanian RAS patients. Oral Surg. Oral Med. Oral Pathol. Oral Radiol., roč. 120, 2015, č. 3, s. 141–142.

39. Kim, Y., et al.: Mucosal and salivary microbiota associated with recurrent aphthous stomatitis. BMC Microbiol., roč. 16, 2016, č. 1, s. 57.

40. Koybasi, S., et al.: Recurrent aphthous stomatitis: investigation of possible etiologic factors. Amer. J. Otolaryngol., roč. 27, 2006, č. 4, s. 229–232.

41. Landová, H., et al.: Oral mucosa and therapy of recurrent aphthous stomatitis. Ces. Slov. Farm., roč. 62, 2013, č. 1, s. 12–18.

42. Lehner, T., Welsh, K. I., Batchelor, J. R.: The relationship of HLA-B and DR phenotypes to Behcet‘s syndrome, recurrent oral ulceration and the class of immune complexes. Immunology, roč. 47, 1982, č. 4, s. 581–587.

43. Lewkowicz, N., et al.: Predominance of production of Th1 type cytokines in recurrent aphthous ulceration. Dental medical Problems, roč. 42, 2004, s. 655–660.

44. Lewkowicz, N., et al.: Expression of Th1/Th2/Th3/Th17-related genes in recurrent aphthous ulcers. Arch. Immunol. Ther. Experiment., roč. 59, 2011, č. 5, s. 399–406.

45. Lopez-Jornet, P., Camacho-Alonso, F., Martos, N.: Hematological study of patients with aphthous stomatitis. Intern. J. Dermatol., roč. 53, 2014, č. 2, s. 159–163.

46. Manchanda, A., Iyengar, A. R., Patil, S.: Association between serotonin transporter gene polymorphism and recurrent aphthous stomatitis. Dental Res. J., roč. 13, 2016, č. 3, s. 206–210.

47. Mantegazza, C., et al.: Oral manifestations of gastrointestinal diseases in children. Part 4: Coeliac disease. Eur. J. paed. Dentistry, roč. 17, 2016, č. 4, s. 248–250.

48. Mays, J. W., Sarmadi, M., Moutsopoulos, N. M.: Oral manifestations of systemic autoimmune and inflammatory diseases: diagnosis and clinical management. J. evidence based dental Pract., roč. 12, 2012, č. 3, s. 265–282.

49. Mccullough, M. J., Abdel-Hafeth, S., Scully, C.: Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices? J. Oral Pathol. Med., roč. 36, 2007, č. 10, s. 615–620.

50. Miller, M. F., et al.: Inheritance patterns in recurrent aphthous ulcers: twin and pedigree data. Oral Surg. oral Med. oral Pathol., roč. 43, 1977, č. 6, s. 886–891.

51. Miyamoto J. R., et al.: Immune-expression of HSP27 and IL-10 in recurrent aphthous ulceration. J. Oral Pathol. Med., roč. 37, 2008, č. 8, s. 462–467.

52. Moqadam, I. F., et al.: Lack of association between interleukin-12 gene polymorphisms and recurrent aphthous stomatitis. Avicenna J. med. Biotechnol., roč. 8, 2016, č. 4. s. 200–201.

53. Najafi, S., et al.: Interleukin-10 gene polymorphisms in recurrent aphthous stomatitis. Immunological Investigations, roč. 43, 2014, č. 4, s. 405–409.

54. Najafi, S., et al.: Association study of interleukin-1 family and interleukin-6 gene single nucleotide polymorphisms in recurrent aphthous stomatitis. Intern. J. Immunogenet., roč. 42, 2015, č.. 6. s. 428–431.

55. Najafi, S., et al.: HLA-DRB and HLA-DQB allele and haplotype frequencies in Iranian patients with recurrent aphthous stomatitis. Iranian J. Allergy Asthma Immunol., roč. 15, 2016, č. 4, s. 289–295.

56. Natah, S. S., et al.: Recurrent aphthous ulcers today: a review of the growing knowledge. Intern. J. Oral maxillofacial Surg., roč. 33, 2004, č. 3, s. 221–234.

57. Özdemir, M., et al.: HLA-B* 51 in patients with recurrent aphthous stomatitis. Acta derma-venereolog., roč. 89, 2009, č. 2, s. 202–203.

58. Özler, G. S.: Zinc deficiency in patients with recurrent aphthous stomatitis: a pilot study. J. Laryngol. Otol., roč. 128, 2014, č. 6, s. 531–533.

59. Ozyurt, K., et al.: Serum Th1, Th2 and Th17 cytokine profiles and alpha-enolase levels in recurrent aphthous stomatitis. J. Oral Pathol. Med., roč. 43, 2014, č. 9, s. 691–695.

60. Pammer, J., et al. Vascular endothelial growth factor is constitutively expressed in normal human salivary glands and is secreted in the saliva of healthy individuals. J. Pathol., roč. 186, 1998, č. 2, s. 186–191.

61. Pekiner, F. N., et al.: HLA-A, B (Class I) and HLA-DR, DQ (Class II) antigens in Turkish patients with recurrent aphthous ulceration and Behcet‘s disease. Medical principles practice, roč. 22, 2013, č. 5, s. 464–468.

62. Pentenero, M., et al.: The prevalence of oral mucosal lesions in adults from the Turin area. Oral Dis., roč. 14, 2008, č. 4, s. 356–366.

63. Reddy Gaddam, R., Chambers, S., Bhatia, M.: ACE and ACE2 in inflammation: a tale of two enzymes. Inflammation & allergy-drug targets (formerly current drug targets-inflammation & allergy), roč. 13, 2014, č. 4, s. 224–234.

64. Reichart, P. A.: Oral mucosal lesions in a representative cross-sectional study of aging Germans. Community dentistry and oral epidemiology, roč. 28, 2000, č. 5, s. 390–398.

65. Schuff-Werner, P., et al.: Serotonin acts as a radical scavenger and is oxidized to a dimer during the respiratory burst of human mononuclear and polymorphonuclear phagocytes. Eur. J. clin. Investigation, roč. 25, 1995, č. 7, s. 477–484.

66. Ślebioda, Z., Szponar, E., Kowalska, A.: Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: literature review. Archivum immunologiae et therapiae experimentalis, roč. 62, 2014, č. 3, s. 205–215.

67. Ślebioda, Z., et al.: Clinical phenotype of recurrent aphthous stomatitis and interleukin-1b genotype in a Polish cohort of patients. J. Oral Pathol. Med., 2016.

68. Scully, C., Hodgson, T., Lachmann, H.: Auto-inflammatory syndromes and oral health. Oral Dis., roč. 14, 2008, č. 8, s. 690–699.

69. Ship, I. I.: Inheritance of aphthous ulcers of the mouth. J. dental Res., roč. 44, 1965, č. 5, s. 837–844.

70. Ship, I. I.: Epidemiologic aspects of recurrent aphthous ulcerations. Oral Surg. oral Med. Oral Pathol., roč. 33, 1972, č. 3, s. 400–406.

71. Ship, J. A., et al.: Recurrent aphthous stomatitis. Quintessence inter., roč. 31, 2000, č. 2, s. 95–112.

72. Sun, M., et al.: Inflammatory factors gene polymorphism in recurrent oral ulceration. J. Oral Pathol. Med., roč. 42, 2013, č. 7, s. 528–534.

73. Sun, A., et al.: Significant association of deficiencies of hemoglobin, iron, vitamin B12, and folic acid and high homocysteine level with recurrent aphthous stomatitis. J. oral Pathol. Med., roč. 44, 2015, č. 4, s. 300–305.

74, Tappuni, A. R., et al.: Clinical assessment of disease severity in recurrent aphthous stomatitis. J. Oral Pathol. Med., roč. 42, 2013, č. 8, s. 635–641.

75. Theodoropoulou, K., Vanoni, F., Hofer, M.: Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: a review of the pathogenesis. Current Rheumatol. Reports, roč. 18, 2016, č. 4, s. 1–7.

76. Victoria, J. M. N., et al.: Serotonin transporter gene polymorphism (5-HTTLPR) in patients with recurrent aphthous stomatitis. J.Oral Pathol. Med., roč. 34, 2005, č. 8. s. 494–497.

77. Wilhelmsen, N. S. W., et al.: Correlation between histocompatibility antigens and recurrent aphthous stomatitis in the Brazilian population. Brazilian J. Otorhinolaryngol., roč. 75, 2009, č. 3, s. 426–431.

78. Yakar, T., et al.: The relationship of recurrent aphthous stomatitis and Helicobacter pylori, cytokine gene polymorphism and cobalamin. Turkish J. Gastroenterol., roč. 26, 2015, č. 4. s. 304–308.

79. Yigit, S., et al.: Investigation of CD40 gene rs4810485 and rs1883832 mutations in patients with recurrent aphthous stomatitis. Arch. Oral Biol., roč. 74, 2017, s. 51–54.

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