Characterization of burning mouth syndrome profiles based on response to a local anaesthetic lozenge.
OBJECTIVE
Burning mouth syndrome (BMS) is a chronic oral pain condition with unknown aetiology but assumed to involve peripheral/central neuropathological and immune-mediated inflammatory factors. We aimed at characterizing inflammatory and neurogenic profiles and oral symptomatology of patients with BMS based on response to a local anaesthetic lozenge.


METHODS
Patients with BMS were divided into an Effect (n = 13), No effect (n = 8) or Unspecified (n = 2) group according to their response to a local anaesthetic lozenge on oral pain. Inflammation was assessed in blood plasma and saliva by analyses of IL-6, IL-8, IL-17A, IL-23 and TNF-α levels. The degree of inflammation and distribution of oestrogen receptor, NGF, NGF-receptor, TRPV-1 and IL-17F in buccal mucosal tissue were investigated by immunohistochemistry.


RESULTS
Immunoreactivity to the oestrogen receptor was most intense in the Effect group, whereas the No effect group tended to have higher plasma levels of the pro-inflammatory cytokines.


CONCLUSIONS
Our findings indicate that the response to treatment with local anaesthesia enables subgrouping of patients with BMS according to the potential pathogenic mechanisms. Effect of local anaesthesia indicates a peripheral neuropathology involving lack of oestrogen and upregulation of oestrogen receptors, and no effect indicates a systemic inflammation-induced mechanism leading to increased levels of plasma cytokines.
['Treldal|Charlotte|C|https://orcid.org/0000-0001-5921-807X', 'Petersen|Janne|J|', 'Mogensen|Stine|S|', 'Therkildsen|Christina|C|', 'Jacobsen|Jette|J|', 'Andersen|Ove|O|', 'Pedersen|Anne Marie Lynge|AML|https://orcid.org/0000-0002-6424-5803']
D000284:Administration, Oral D000779:Anesthetics, Local D002054:Burning Mouth Syndrome D016207:Cytokines D006801:Humans D011960:Receptors, Estrogen D012463:Saliva
burning mouth syndrome local anaesthetic lozenge oestrogen receptor cytokines