مجله دانشکده دندانپزشکی اصفهان (Jan 2010)
A study on salivary cortisol level in patients with recurrent aphthous stomatitis during both ulceration and ulcer free periods
Abstract
Introduction: Recurrent Aphthous Stomatitis (RAS) is one of the most common oral mucosal disorders. RAS patients show a decline in oral tolerance which leads to epithelial damage. Cortisol secretion in such patients may not be enough to suppress cytotoxic reactions against oral epithelium. The aim of this study was to measure salivary cortisol level during both ulceration and ulcer free phases of the disease. Materials and Methods: In this analytic-descriptive study, a total of 20 patients having minor oral aphthi with a history of at least three times oral ulceration in one year were included.Saliva samples were collected through spitting. The salivary concentration level of cortisol was measured on the first and 7th days from the appearance of aphthous ulcers, every patient was considered as both case and control. Sampling was repeated when ulcers were completely healed. The saliva samples were collected between 9 and 10 am and were analyzed via Enzyme-Linked Immunosorbent Assay (ELISA). The collected data were statistically analyzed on a computer through repeated measurement ANOVA and paired t-tests using SPSS software.(α = 0.05)Results: The mean concentration of salivary cortisol on the first day of aphthous appearance was 2.72 . However after complete healing of the ulcers, it rose to 3.37 . The difference these values were shown to be statistically significant (p value=0.002). The mean concentration level of salivary cortisol on the 7th day from aphthous appearance (2.6 ) was also significantly different from the aphthous Free State. (p value = 0.001). Mean cortisol concentration level on the first and 7th days from the appearance of aphthous ulcer did not show a significant difference (p value = 0.304).Conclusion: The results showed that the mean salivary cortisol level at the beginning of the disease as well as during its active ulcerative period (acute phase) were significantly lower than in aphthous free periods. It seems that cortisol plays a key role in reducing aphthous ulcer inflammation. Impaired cortisol secretion in RAS patients may cause an increased rate of incidence and severity of aphthous ulcers. Key words: Recurrent aphthous ulcer, Saliva, Hydrocortisone
