Research progress on the pathogenesis and clinical treatment of recurrent aphthous ulcer

Liyang Jiang^1#, Huanhuan Wang^1#, Huayan Sun¹, Fenghua Xu^1*, Rui Xiao^2*

¹Department of Pharmacy, Medical Supplies Center of PLA General Hospital, Beijing 100853, China.

²Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing 100853, China.

#co-first author:These authors contributed equally to this work.

F.X. and R.X. were co-corresponding authors.

*Correspondence:

Fenghua Xu; Email: xufh@301hospital.com.cn

Rui Xiao; Email: xiao_rui0809@163.com

Abstract

Recurrent aphthous ulcer (RAU) is the most common oral mucosal disease with the highest incidence rate worldwide, accounting for 20%–50% of the population. RAU has a large effect on the daily diet, language communication, and quality of life of patients. With the rapid development of biotechnology in recent years, research on the pathogenesis of RAU has made breakthrough progress in the past 5 years. This review systematically summarizes the latest achievements of understanding RAU in the field of cellular and molecular biology in recent years. This review focuses on the new discoveries at the levels of immune cell subset dysfunction, cytokine network imbalance, abnormal proteomics of epigenetic regulation, microorganisms, and signaling pathways. This article also discusses in detail the efficacy characteristics and applicable symptoms of innovative drugs used in clinical practice in the past 5 years. These drugs include the new Class 1.1 innovativetraditional Chinese medicine (TCM) Catechu Shangqing pill, the targeted preparation apremilast, the natural product cannabidiol gel, and a new drug delivery carrier. Studies have shown that the breakthrough of basic research is promoting transformation of the clinical treatment mode of RAU from traditional symptomatic intervention to precision and individualization. The clinical implementation of biomarker detection, targeted therapy, immune regulation, and other technologies provides a new direction for the diagnosis and treatment of RAU. This review aims to provide researchers and clinicians in the field of stomatology with cutting-edge developments in the pathogenesis and treatment of RAU, and to help further improve research in this field.

Keywords: recurrent aphthous ulcer, pathogenesis, clinical medication