Levamisole can modulate the serum tumor necrosis factor-α level in patients with recurrent aphthous ulcerations
Journal
Journal of Oral Pathology and Medicine
Journal Volume
35
Journal Issue
2
Pages
111-116
Date Issued
2006
Author(s)
Abstract
BACKGROUND: Recurrent aphthous ulcerations (RAU) are common oral inflammatory lesions. Tumor necrosis factor (TNF)-α is an important inflammatory mediator and a critical cytokine for adequate host defense. Our previous studies have shown that 14-43% and 59-63% of patients in the ulcerative stage of major, minor or herpetiform RAU have significantly higher than normal serum levels of interleukin (IL)-6 and IL-8, respectively. In this study, we examined whether RAU patients in the ulcerative stage had a significantly higher than normal serum level of TNF-α and assessed whether treatment with levamisole can modulate serum TNF-α levels in RAU patients. METHODS: This study used a solid phase, two-site sequential chemiluminescent immunometric assay to determine the baseline serum levels of TNF-α in 146 patients with RAU, nine patients with traumatic ulcers (TU), and 54 normal control subjects. Fifty-five RAU patients with serum TNF-α levels higher than 5.0 pg/ml were treated with levamisole for 0.5-4 months and their serum TNF-α levels were measured after treatment. RESULTS: We found that 29% (42 of 146) RAU patients as well as 39% (24 of 61) major type, 20% (14 of 69) minor type, and 25% (four of 16) herpetiform type RAU patients had a serum level of TNF-α greater than the upper normal limit of 7.4 pg/ml. The mean serum level of TNF-α in patients with RAU (9.1 ± 1.0 pg/ml, P < 0.001), major type RAU (11.6 ± 1.9 pg/ml, P < 0.001), minor type RAU (6.9 ± 0.9 pg/ml, P < 0.005), or herpetiform type RAU (9.6 ± 2.7 pg/ml, P < 0.001) was higher than that (3.8 ± 0.2 pg/ml) in normal control subjects. The mean serum TNF-α level was significantly higher in patients with major type RAU than in patients with minor type RAU (P < 0.05) and was significantly higher in major type RAU patients in the exacerbation stage than in the post-exacerbation stage (P < 0.05). In 55 RAU patients with serum TNF-α levels higher than 5.0 pg/ml, treatment with levamisole for a period of 0.5-4 months could significantly reduce the serum TNF-α level from 16.4 ± 1.9 to 5.8 ± 0.6 pg/ml (P < 0.001). CONCLUSIONS: We conclude that a significantly higher than normal serum level of TNF-α can be detected in 20-39% of patients in the ulcerative stage of major, minor or herpetiform RAU. The serum TNF-α level may be associated with the severity and the stage of RAU. Levamisole can modulate serum TNF-α levels in RAU patients. ? Blackwell Munksgaard 2006. All rights reserved.
Subjects
Levamisole; Recurrent aphthous ulcerations; Tumor necrosis factor-α
SDGs
Other Subjects
cytokine; interleukin 6; interleukin 8; levamisole; tumor necrosis factor alpha; adult; aged; aphthous ulcer; article; chemoluminescence; controlled study; disease association; disease classification; disease exacerbation; disease severity; female; host resistance; human; injury; major clinical study; male; priority journal; school child; staging; Adjuvants, Immunologic; Adolescent; Adult; Aged; Child; Female; Follow-Up Studies; Humans; Inflammation Mediators; Levamisole; Male; Middle Aged; Mouth Mucosa; Oral Ulcer; Recurrence; Stomatitis, Aphthous; Stomatitis, Herpetic; Tumor Necrosis Factor-alpha
Type
journal article