The expression of TNF-α in recurrent aphthous stomatitis: A systematic review and meta-analysis

• Published in: Cytokine (Philadelphia, Pa.) Vol. 157; p. 155946
• Main Authors: Surboyo, Meircurius Dwi Condro, Boedi, Rizky Merdietio, Hariyani, Ninuk, Santosh, Arvind Babu Rajendra, Manuaba, Ida Bagus Pramana Putra, Cecilia, Pamela Handy, Ambarawati, I Gusti Agung Dyah, Parmadiati, Adiastuti Endah, Ernawati, Diah Savitri
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2022
• Subjects: Recurrent aphthous stomatitis; Saliva; Serum; Tissue expression; TNF-α; Recurrent aphthous stomatitis; Serum; TNF-α; Saliva; Tissue expression
• ISSN: 1043-4666; 1096-0023
• DOI: 10.1016/j.cyto.2022.155946

[Display omitted] •Healthy individuals showed significantly lower TNF-α than RAS.•TNF-α is a useful diagnostic marker for RAS.•Significant TNF-α differences in RAS patients can be detected through saliva or blood serum.•Saliva provides good accuracy, reliability, and non-invasive procedures for detecting changes in TNF-α during ulceration.•Detection using ELISA or CBA was sensitive enough to detect the TNF-α. 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.