Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Dentistry, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia; Centre of Forensic and Legal Medicine and Dentistry, School of Dentistry, University of Dundee, Dundee, United Kingdom.
Cytokine. 2022 Sep;157:155946. doi: 10.1016/j.cyto.2022.155946. Epub 2022 Jun 18.
The pathogenesis of recurrent aphthous stomatitis (RAS) is related to an increase of pro-inflammatory cytokine, namely tumor necrosis factor α (TNF-α). This cytokine plays an important role in the development of ulcer lesions, both in saliva, tissues and blood. This systematic review analyzed the differences of TNF-α in lesions, salivary and blood and can be used as a reliable method of diagnosis for RAS.
A comprehensive search of PubMed, Scopus databases, Web of Science, Scielo, Google Scholar and Embase with keywords. The inclusion criteria were studies that assessed the saliva, serum, and RAS lesion, with the outcome reporting the mean of saliva, serum and tissue expression of TNF-α. The risk of bias was also assessed.
Healthy individuals showed significantly lower TNF-α than RAS (SMD = -1.517, 95% CI [-2.25, -0.78]). Although there is a significant difference between sample (i.e., saliva, serum) and detection type (i.e., cytometry bead array, ELISA), both methods can detect a significant difference in TNF-α between healthy individuals and RAS patients.
The TNF-α is a useful diagnostic marker for RAS. We encourage saliva to detect changes in TNF-α during ulceration as it provides accuracy, reliability, and non-invasive procedure compared to a blood draw.
复发性阿弗他口炎（RAS）的发病机制与促炎细胞因子，即肿瘤坏死因子 α（TNF-α）的增加有关。这种细胞因子在溃疡病变的发展中起着重要作用，无论是在唾液、组织还是血液中。本系统评价分析了病变、唾液和血液中 TNF-α 的差异，可作为 RAS 的可靠诊断方法。
通过关键词在 PubMed、Scopus 数据库、Web of Science、Scielo、Google Scholar 和 Embase 上进行全面检索。纳入标准为评估唾液、血清和 RAS 病变中 TNF-α 的研究，其结果报告唾液、血清和组织中 TNF-α 的平均表达。还评估了偏倚风险。
健康个体的 TNF-α 明显低于 RAS（SMD=-1.517，95%CI[-2.25，-0.78]）。尽管样本（即唾液、血清）和检测类型（即细胞仪珠阵列、ELISA）之间存在显著差异，但两种方法都可以检测到健康个体和 RAS 患者之间 TNF-α 的显著差异。
TNF-α 是 RAS 的有用诊断标志物。我们鼓励在溃疡期间通过唾液检测 TNF-α 的变化，因为与抽血相比，它提供了准确性、可靠性和非侵入性程序。
