Mansourian Arash, Bahar Babak, Moosavi Mahdieh Sadat, Amanlou Massoud, Babaeifard Shahabodin
Associate Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Assistant Professor, Hematology and Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
J Dent (Tehran). 2017 Nov;14(6):313-320.
Graft-versus-host disease (GVHD) is among the most frequent complications of allogeneic hematopoietic stem cell transplantation (HSCT). GVHD has several clinical manifestations in the oral cavity, including painful desquamative erythema, ulcerative mucosal lesions, and lichenoid lesions. The patients presenting with oral GVHD complain of oral sensitivity, pain, dysgeusia, and xerostomia. The treatment of oral GVHD includes a proper systemic therapy combined with a good oral hygiene and the use of local and topical steroids. Corticosteroids and immunosuppressants are used for the treatment of chronic oral GVHD; however, they are associated with different complications. Evidence shows that curcumin has anti-inflammatory and antioxidative properties. The treatment of lichen planus and oral mucositis with curcumin has been successful. This study aimed to compare the efficacy of topical curcumin in Orabase and triamcinolone in Orabase in the patients affected by oral GVHD.
Twenty-six patients presenting with oral GVHD were randomly divided into two groups of 13 using block randomization. The control group used triamcinolone in Orabase, and the case group received curcumin in Orabase.
The two groups were not significantly different in terms of the alleviated severity of the lesions at the end of the treatment (P=0.052). The comparison of the pain score via the visual analog scale (VAS) at the onset of the treatment and at days 14 and 28 (completion of the treatment) showed no significant difference between the two groups (P>0.05).
Curcumin has comparable efficacy to that of triamcinolone and may be prescribed for the patients presenting with oral GVHD.
移植物抗宿主病(GVHD)是异基因造血干细胞移植(HSCT)最常见的并发症之一。GVHD在口腔有多种临床表现,包括疼痛性脱屑性红斑、溃疡性黏膜病变和苔藓样病变。出现口腔GVHD的患者会抱怨口腔敏感、疼痛、味觉障碍和口干。口腔GVHD的治疗包括适当的全身治疗、良好的口腔卫生以及局部和外用类固醇的使用。皮质类固醇和免疫抑制剂用于治疗慢性口腔GVHD;然而,它们会引发不同的并发症。有证据表明姜黄素具有抗炎和抗氧化特性。用姜黄素治疗扁平苔藓和口腔黏膜炎已取得成功。本研究旨在比较局部用姜黄素糊剂和曲安奈德糊剂治疗口腔GVHD患者的疗效。
26例口腔GVHD患者采用区组随机化方法随机分为两组,每组13例。对照组使用曲安奈德糊剂,病例组使用姜黄素糊剂。
治疗结束时,两组病变严重程度减轻情况无显著差异(P = 0.052)。治疗开始时以及第14天和第28天(治疗结束时)通过视觉模拟量表(VAS)比较疼痛评分,两组之间无显著差异(P>0.05)。
姜黄素与曲安奈德疗效相当,可用于口腔GVHD患者。