Recent Views on Etiological Factors in Recurrent Aphtous Ulcer

Overview

With the objective to contribute to the problem of etiology of diseases withrecurrent oral ulcers the authors made an immunological examination of 10 patients with thediagnosis of stomatitis aphthosa minor which was supplemented by examination of galvanicphenomena in the oral cavity. The authors assessed serum IgA levels, levels of secretory IgAin saliva, levels of complement serum components and the formation of IFN-g and IL-4 insupernatants of lymphocyte tissue cultures. The results were compared with values of a controlgroup of 16 healthy volunteers of corresponding age. In patients with recurrent aphtous ulcerin 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 complementcomponents were most probably used for the formation of immune complexes, by the classicalas 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. Duringthe remission period a gradual increase of the number of Th1 clones occurs. This is evidence ofthe fact that recurrent aphtae ulcer are probably genetically conditioned with a congenital typeof regulation of the immune reaction, and relapses of acute exacerbations may be caused byvarious factors which cause an increased number of Th2 at the expense of Th1 clones. Basedon our results we assume that it is useful to include among triggering mechanisms of acuteexacerbation also galvanic phenomena which may have an negative impact on the developmentof aphthous lesions as well as on the process of their healing. We recommend therefore t o assessin patients galvanic currents and the strain in the mouth and to eliminate as a possibletherapeutic tool their causes.

Key words:
recurrent aphthae ulcer – etiology – immunology – galvanism