INFLUENCE OF SOMATIC STATUS ON THE APPEARANCE OF RECURRENT APHTHOSIS STOMATITIS

Alona A. Komova, E. G. Borisova, V. A. Zheleznyak, Georgiy B. Gorshunov, H. Yagmurov
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Abstract

Recurrent aphthous stomatitis is a polyetiological inflammatory disease of the oral mucosa, characterized by the appearance of aphthous ulcers. The etiology and pathogenesis of this disease have not been finally revealed. There is an imbalance of immunity observed in patients who are suffering from recurrent aphthous stomatitis caused by the influence of certain trigger factors. The purpose is to summarize the literature data on the relationship of somatic status with the occurrence of recurrent aphthous stomatitis. The review considers the pathogenesis of recurrent aphthous stomatitis, as well as possible trigger factors: genetic predisposition, infections, somatic diseases, allergies, stress, and hypovitaminosis. An obligatory link in the pathogenesis of recurrent aphthous stomatitis is an imbalance of immunity - cellular (the production of pro-inflammatory cytokines increases, and the synthesis of anti-inflammatory heat shock proteins decreases) and humoral (an increase in the number of neutrophils and B-lymphocytes, activation of the complement system). Genetic predisposition, some somatic diseases (Behcet's disease) and viral infections (in particular, COVID-19) lead to an imbalance in the immune system. Provoke the occurrence of recurrent aphthous stomatitis infections, diseases of the gastrointestinal tract, stress and insufficiency of B vitamins and trace elements. The indirect effect of trigger circumstances is due to a decrease in the trophism of the oral mucosa, which leads to a local decrease in the number of factors of cellular and humoral immunity and to hyposalivation and a decrease in the pH of the oral fluid, which provokes the reproduction of opportunistic microflora. Based on the analyzed literature data, it can be concluded that the somatic status influences the development of recurrent aphthous stomatitis. Accordingly, patients suffering from recurrent aphthous stomatitis should be referred to a general doctor for evaluation.
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体质对复发性口腔炎出现的影响
复发性阿弗他口腔炎是一种以出现阿弗他溃疡为特征的多病原性口腔粘膜炎症性疾病。这种疾病的病因和发病机制尚未最终揭示。在某些诱发因素的影响下,反复发作的口腔炎患者会出现免疫失衡。本文旨在总结有关体质与复发性口腔炎发生关系的文献资料。综述考虑了复发性口腔炎的发病机制,以及可能的诱发因素:遗传易感性、感染、躯体疾病、过敏、压力和维生素缺乏。复发性口腔炎发病机制的一个必然环节是免疫失衡--细胞免疫(促炎细胞因子的产生增加,抗炎热休克蛋白的合成减少)和体液免疫(中性粒细胞和 B 淋巴细胞数量增加,补体系统启动)。遗传易感性、某些体质性疾病(白塞氏病)和病毒感染(尤其是 COVID-19)会导致免疫系统失衡。诱发复发性口腔炎感染、胃肠道疾病、压力、B 族维生素和微量元素不足。诱发因素的间接影响是由于口腔黏膜滋养度下降,导致局部细胞免疫和体液免疫因子数量减少,以及唾液分泌减少和口腔液 pH 值下降,从而引发机会性微生物菌群的繁殖。根据所分析的文献数据,可以得出结论:体质状况会影响复发性口腔炎的发展。因此,患有复发性口腔炎的患者应转诊至全科医生进行评估。
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