New mouthwash: an efficacious intervention for oral ulceration associated with Behçet's disease

Senusi, Amal; Kang, Angray S.; Buchanan, John; Adesanya, Adebowale; Aloraini, Ghfren; Stanford, Miles; Fortune, Farida

doi:10.1016/j.bjoms.2020.07.027

Cited by 12 publications

(13 citation statements)

References 16 publications

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“…These BS surveys have allowed the gathering of data to assist in providing evidence-based advice to patients and patient advocates, as well-moderating use of medication used to alleviate their symptoms. For example, the use of mouthwashes (TMW and subsequently Triorasol) ( 15 ) are proven to be beneficial in reducing BS oral symptoms. TMW is readily available to all our BS patient at an affordable price (given that many patients might be unemployed, receiving benefits or both other definitions on restricted financial means).…”

Section: Discussionmentioning

confidence: 99%

The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years

et al. 2022

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ObjectiveThis study analyses the 2020 survey and reviews the 2009, 2014 surveys to ascertain which Behçet's symptoms, personal and family status, patients' lifestyle, and work-related outcomes impacted on Health-Related Quality of Life (HRQoL).MethodsFour hundred and fifty-nine Behçet's patients submitted an online survey/questionnaire. Patients provided information on socio-demographic characteristics, disease duration, historical and current symptoms, systemic and topical medication, health related lifestyle, work-related outcomes regarding employment status and claiming benefits and Quality of Life (QoL) measured by EQ-5D index.ResultsFour hundred and nineteen patients met the inclusion criteria, and 371 who had full data (Males: Females: Others = 84:285:2, mean–age = 41.1 ± 23.3:38 ± 13.2:40 ± 5). The main symptoms associated with patients seeking medical care were mouth ulcers 30% and genital ulcers 23%, joint 14%, and eye problems 9%. The EQ-5D index for 2009, 2014, 2020 was (mean ± SD); 0.47 ± 0.38, 0.42 ± 0.37, 0.34 ± 0.40, respectively, p < 0.05. 2020 patients had the worst values of the five domains compared to 2014 and 2009. Interestingly, mobility value was the same over the 10 years of monitoring patients. Behçet's syndrome (BS) symptoms that had significant negative impact on QoL were; 2009 (arthropathy, neurological problems, pathergy reaction, and stomach/bowel symptoms), 2014 (arthropathy, headache, neurological problems, pathergy reaction, and skin lesions), 2020 (arthropathy, neurological problems, and stomach/bowel symptoms). The 2014 and 2020 surveys reported the QoL is significantly better in patients on immunosuppressant, who did sport, continued in employment and not receiving benefits.ConclusionJoints and neurological symptoms are the main symptoms which had negative impact on BS patients over the 10 years, sociodemographic (gender, age, marital, and education status), lifestyle (medication, cannabis, drinking wine, and regular exercise), employment status (employee and no career change), and accessing benefits (never claim benefit) had significant influence on patients' HRQoL.

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Section: Discussionmentioning

confidence: 99%

The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years

et al. 2022

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“…In the genital area, Lactobacillus and Gardnerella were more abundant in females than males; the Gardnerella,Lactobacillus, Atopobium were higher in females than males with genital ulcers, while Peptoniphilus and Corynebacterium were signi cantly increased in males than females with genital ulcers. Clinically, Triorasol mouthwash (TMW) shows effective managements to mucosal diseases including BD which presents with mucosal ulceration [39].…”

Section: Discussionmentioning

confidence: 99%

Genital and Oral Microbiome and Behçet’s Disease Activity

Senusi

Ogunkolade

Sandionigi

et al. 2022

Preprint

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BackgroundThe aetiopathogeneses of Behçet’s Disease (BD) remains elusive with multifactorial genetic and epigenetic factors resulting in multisystemic disease. Oral and genital ulceration are common and influences disease outcome. We hypothesised that dysregulation of genital and oral microbial communities contributes to BD disease activity. 153 BD patients’ samples, 70 matched oral and genital (Female: Male, 58:12; mean age, 42±13.9: 39.3±10.3), 12 unmatched samples; 16s rRNA sequencing utilised and V1/V2 and V3/V4 regions analysed. BD outcomes: oral and genital ulcer severity and BD activity scores, Psychological and Social Well-being scales, Headache Impact Test-6 (HIT-6) were included. All the analyses were performed with R software. ResultsThe alpha and beta diversity had anatomical specificity, with significant differences between genital and oral samples; p values<0.05 irrespective of presence or absence of ulcers. Interestingly, in the genital area Bacteroidota were present (G_U: 29% - 10%) and (G_nU: 27% - 14%) compared to less than 1% oral area of V1/V2 and V3/V4. Proteobacteria were uniquely present with (O_U: 9%) and (O_nU: 12%) in oral, and less than 0.01% in genital area for V3/V4 region. Gender anatomical specific communities were noted: females with genital ulcers Gardnerella, Lactobacillus, Atopobium were significantly increased compared to than males, with V3/V4 analysis indicating that Lactobacillus and Gardnerella were significantly increased by 20 times in females than males (p-adj <0.05). In contrast Peptoniphilus and Corynebacterium were significantly increased in males than females. Streptococcus was significantly increased with oral ulceration, while Veillonella was significantly decreased in patients without oral ulceration. Colchicine had a significant effect on the bacterial abundance irrespective of the presence or absence of ulceration. In this cohort, the WSAS (Work and Social Adjustment Scale) values were higher in active disease. ConclusionOur results suggest that dysregulated microbial communities occur in BD. V1/V2 demonstrates that during episodes of ulceration the pathogenic bacteria genus Escherichia-Shigella appear in both oral and genital ulcers. V3/V4 outcomes show that ulceration in both regions is assigned to genus; Lachnospiraceae, Saccharimonidales, Coriobacteriales. Streptococcus is related to the presence of oral ulcers, while Veillonella is presence when patients are ulcers free may be a useful marker of disease regression.

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“…An additional benefit is that it reduces oral and oropharyngeal scarring commonly seen in BD. The efficacy of this mouthwash is found to be high compared to betamethasone mouthwash in BD ( 85 ). In addition, immunosuppressive medications for the elimination of oral ulcers in resistant mucocutaneous cases can improve outcomes in a multidisciplinary setting ( 5 , 84 , 86 – 88 ).…”

Section: Oral Ulcer and Treatment Protocolsmentioning

confidence: 99%

Oral Health and Its Aetiological Role in Behçet's Disease

Mumcu

Fortune

2021

Front. Med.

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Behçet's disease (BD) is a chronic multi-systemic inflammatory disorder characterised by oro-genital ulcers, cutaneous manifestations, ocular, vascular, neurologic and gastrointestinal involvement. Complex interactions operating on the genetic background e.g.(HLA51), of infectious and other environmental agents, together with immune dysregulation impacts on the pathogenesis of BD. This suggests that the environmental factors triggering immune responses may activate clinical manifestations in genetically susceptible individuals. Since oral health forms the basis of all general health both dental and systemic, it is an important component of both Dentistry and Medicine. Oral ulcers are the most common clinical manifestation of oral mucosal health. Changes in the oral environment consequently acts as an infective and immune trigger. In this review, complex interactions between the oral ulcers, the oral microbiome and immune responses together with the course of oral and systemic disease manifestations in BD are discussed in the context of the aetiologic role of oral health.

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New mouthwash: an efficacious intervention for oral ulceration associated with Behçet's disease

Cited by 12 publications

References 16 publications

The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years

The impact of multifactorial factors on the Quality of Life of Behçet's patients over 10 years

Genital and Oral Microbiome and Behçet’s Disease Activity

Oral Health and Its Aetiological Role in Behçet's Disease

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