Salivary Biomarkers and Their Correlation with Pain and Stress in Patients with Burning Mouth Syndrome.

Pia Lopez-Jornet,Jose J Ceron,Candela Castillo Felipe,Asta Tvarijonaviciute,Luis Pardo-Marin,Eduardo Pons-Fuster

doi:10.3390/jcm9040929

Pia Lopez-Jornet, Jose J Ceron + Show 4 more

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https://doi.org/10.3390/jcm9040929

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Abstract

Objective: To evaluate a panel of salivary analytes involving biomarkers of inflammation, stress, immune system and antioxidant status in patients with burning mouth syndrome (BMS) and to study their relationship with clinical variables. Materials and Methods: A total of 51 patients with BMS and 31 controls were consecutively enrolled in the study, with the recording of oral habits, the severity of pain using a visual analogue scale (VAS), the Hospital Anxiety and Depression (HAD) score and the Oral Health Impact Profile-14 (OHIP14) score. Resting whole saliva was collected with the drainage technique, followed by the measurement of 11 biomarkers. Results: The salivary flow was higher in patients with BMS. Among all the biomarkers studied, significantly higher levels of alpha-amylase, immunoglobulin A (IgA), and macrophage inflammatory protein-4 (MIP4) and lower levels of uric acid and ferric reducing activity of plasma (FRAP) were observed in the saliva of patients with BMS as compared to the controls (p < 0.05 in all cases). Positive correlations were found between pain, oral quality of life and anxiety scores and salivary biomarkers. Conclusions: BMS is associated with changes in salivary biomarkers of inflammation, oxidative stress and stress, being related to the degree of pain and anxiety.

Highlights

The International Association for the Study of Pain (IASP) defines burning mouth syndrome (BMS) as an intraoral burning or dysesthetic sensation that manifests daily for more than two hours over three months, with no evidence of clinical lesions [1]
All the patients were informed about the study and gave consent to participation in the trial, which was approved by the local Clinical Research Ethics Committee (Ref.: 2203/2018)
In this study we aimed to evaluate the results without any adjustment, and we corrected salivary flow or total protein content to gain knowledge about the possible effect that these corrections can have in this particular disease

Summary

Introduction

The International Association for the Study of Pain (IASP) defines burning mouth syndrome (BMS) as an intraoral burning or dysesthetic sensation that manifests daily for more than two hours over three months, with no evidence of clinical lesions [1]. BMS is estimated to affect 4% of the general population and 18–33% of all postmenopausal women [2,3,4,5,6]. Much has been published about BMS, its underlying etiopathogenesis is largely unknown, and complex interactions among local, systemic and psychogenic factors are believed to be involved [2,7,8]. For these reasons, BMS is poorly diagnosed, and in many cases management is deficient, a situation that causes frustration for both physicians and patients [3,5]. Changes in personality and mood state, anxiety and depression, are a typical finding in patients with BMS [2,9]

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