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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Prakt. zub. Lék., 49, 2001, No. 5, p. 162-174 |
Recent Views on Etiological Factors in Recurrent Aphtous Ulcer Procházková J., Bártová J., Benetková K., Krátká Z., Kučerová H., Rožcová L. Výzkumný ústav stomatologický VFN, Praha, přednosta doc. MUDr. O. Krejsa, CSc. Parodontologie, soukromá zubní ordinace, Praha, MUDr. L. Rožcová |
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Summary: With the objective to contribute to the problem of etiology of diseases with
recurrent oral ulcers the authors made an immunological examination of 10 patients with the
diagnosis of stomatitis aphthosa minor which was supplemented by examination of galvanic
phenomena in the oral cavity. The authors assessed serum IgA levels, levels of secretory IgA
in saliva, levels of complement serum components and the formation of IFN-g and IL-4 in
supernatants of lymphocyte tissue cultures. The results were compared with values of a control
group of 16 healthy volunteers of corresponding age. In patients with recurrent aphtous ulcer
in the acute stage lower serum IgA levels were found and higher levels of secretory IgA in saliva.
The authors found also low levels of C3 and C4 components of complement. These complement
components were most probably used for the formation of immune complexes, by the classical
as well as alternative pathway. The results of IFN-g and IL-4 formation suggest that the greatest amount of Th2 clones was found in patients in the acute stage of the disease. During
the remission period a gradual increase of the number of Th1 clones occurs. This is evidence of
the fact that recurrent aphtae ulcer are probably genetically conditioned with a congenital type
of regulation of the immune reaction, and relapses of acute exacerbations may be caused by
various factors which cause an increased number of Th2 at the expense of Th1 clones. Based
on our results we assume that it is useful to include among triggering mechanisms of acute
exacerbation also galvanic phenomena which may have an negative impact on the development
of aphthous lesions as well as on the process of their healing. We recommend therefore t o assess
in patients galvanic currents and the strain in the mouth and to eliminate as a possible
therapeutic tool their causes.
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