A comprehensive view of the etiology of ChRAS, taking into account potential risk factors

Abstract

Summary. Chronic recurrent aphthous stomatitis (ChRAS) is currently one of the most common diseases affecting the oral mucosa, affecting 5 to 66 % of the population in different countries worldwide. The pathogenesis of ChRAS is unknown, and it is considered a multifactorial disease associated with local and systemic factors. Further research can be valuable for the prevention and treatment of ChRAS. The aim of the study – to analyze data from scientific literature sources regarding potential risk factors, mechanisms of pathogenesis, including the immune response of mucous membranes and mechanisms of its modification to optimize the diagnosis and treatment of ChRAS. Materials and Methods. The bibliosemantic method was applied to clarify the state of the problem, study the analysis of results of previous scientific research based on literature sources and electronic resources. Results and Discussion. Clinical characteristics of ChRAS are well-defined, but its etiology and pathogenesis remain unresolved. The comprehensive investigation of the occurrence and recurrence of the disease is crucial for understanding the fundamental pathogenetic links, which would be valuable for the prevention and treatment of ChRAS. Potential risk factors for ChRAS, such as a family history, psychological stress, hormonal changes, food allergies, nutritional deficiencies, vitamins and minerals deficiencies, gastrointestinal disorders, certain viral and bacterial infections, medication use, and mechanical trauma to the oral mucosa, are reported. Genetic predisposition and genetic risk factors altering individual susceptibility to ChRAS play a significant role. Various DNA polymorphisms, widespread throughout the human genome, especially those associated with changes in interleukin metabolism, are involved. The unbalanced composition of the oral microbiota may play a key role, although no specific causative agents have been conclusively proven. Food markers related to vitamin and micro- and macroelement deficiencies are also reported, and these are more common in patients with ChRAS. These findings preliminarily explain the main mechanisms through which the oral mucosa is a potential high-risk site for ChRAS, providing evidence for future prevention and treatment strategies. Conclusions. The results of the processed literature sources show that ChRAS is considered a multifactorial disease, but little is known about the mechanisms of pathogenesis and the possibilities of influencing its main links. Therefore, a comprehensive approach and the development and organization of complex rehabilitation plans are extremely important and decisive for assessing the condition of patients suffering from ChRAS.