THE PLACE OF THE HELICOBACTER PYLORI ON THE ETIOPATHOGENESIS OF IDIOPATHIC RECURRENT APHTHOUS STOMATITIS (RAS)

The most frequent cause of oral mucosal diseases is idiopathic recurrent aphthous stomatitis (RAS). RAS is a disease characterized by painful and recurrent ulcerations localized on oral mucosa and is affecting up to 10-25% of the population on the world. Local and systemic conditions, genetic, immunological and microbial factors may play a role in the pathogenesis of RAS. Although the etiopathogenesis of the disease is not known, the recent investigations have been focused on Helicobacter pylori (H. pylori) as a causative agent. Aphthous ulcers and H. pylori lesions are similar in histopathological examination. In this study, we aimed to investigate the role of the H.pylori infections on the pathogenesis of IRAS. We were included 36 patients diagnosed with RAS admitted to our clinics between 2011 and 2012. Behcet's disease and patients who underwent H. pylori eradication therapy was not included. Aphthous lesions in the oral cavity of patients swab samples were taken with a brush. Twenty two adult patients were included as a control group who they scheduled for tonsillectomy with various reasons. Detection of H. pylori DNA by PCR on their swab and tissue samples was planned. In addition, H. pylori IgA and IgG serum antibody levels were measured by ELISA in the study and control groups. H.pylori DNA was found a positive by PCR in 9 (25%) of 36 cases with RAS but was not detected in the control group. H.pylori IgG seropositivity was found 55% (n: 20) and IgA was detected in 66.6% (n=24) of patients group. In the control group, IgG positivity was found 40.9% (n=9) and IgA was detected in 81.8% (n=18). The mean average of IgG and IgA titer were found 39.4 (+/- 2.6) and 38.4 (+/- 3.1) arbIU/mL on RAS patients, respectively. For control group, the mean average of IgG and IgA titer were found 165 (+/- 0.6) and 18.5 (+/- 3.3) arbIU/mL, respectively. IgG and IgA values were compared with control group, it was found as a statistically significant in patient group (p<0.05). As a result, H.pylori PCR was detected of 25% of RAS patients and H. pylori IgA and IgG mean titer rates were found as high titers on RAS patients. According to these results, we thought that H.pylori may be play a role in the pathogenesis of RAS.