Evaluation of topical human platelet lysate versus topical clobetasol in management of methotrexate-induced oral ulceration in rheumatoid arthritis patients: Randomized-controlled clinical trial.

BACKGROUND: There is no mainstay protocol for management of Methotrexate-induced oral ulcers; commonly used protocols are cessation of Methotrexate, folic acid treatment, corticosteroids or combination. A new era of oral ulcers management is represented by platelet concentrates. The current study assessed the effect of topical human platelet lysate compared to topical Clobetasol Propionate in management of methotrexate-induced oral ulceration in rheumatoid arthritis patients. METHODS: This randomized controlled clinical trial include 30 patients in two parallel groups (intervention - human platelet lysate, control - Clobetasol Propionate), with allocation ratio 1:1. Outcome measures were pain intensity using numerical rating scale, WHO scale for oral mucositis, measuring size of the largest ulcer and total number of oral ulcers. RESULTS: A statistically significant difference was detected between HPL and Clobetasol groups on comparing numerical rating scale, WHO mucositis scale, size and total number of oral ulcers throughout all visits. A considerable quick pain reduction and clinical improvement were noticed in HPL group compared to Clobetasol. CONCLUSION: Human platelet lysate has superior effect when compared to one of the most potent topical corticosteroids, Clobetasol Propionate, in reducing pain and clinical signs of Methotrexate-induced oral ulcers in patients with rheumatoid arthritis.

Evaluating the accuracy of microRNA27b and microRNA137 as biomarkers of activity and potential malignant transformation in oral lichen planus patients.

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease with a potential malignant transformation, characterized by cytotoxic T cells against basal epithelial cells. MicroRNAs (MiRNAs) are short non-coding RNA that plays critical role in gene expression at post-transcriptional levels. Much evidence showed that miRNAs play an important role in regulating immune response and cancer development. The purpose of the present study was to compare the expression of miRNA 27b and miRNA 137 in tissues and saliva between OLP patients and controls by using RT-qPCR and to evaluate their use as biomarkers of disease activity and potential malignant transformation. Our results showed down expression of miRNA 27b and miRNA 137 in tissue and saliva of OLP patients compared to controls; among OLP subgroups, erosive-type miRNA 137 revealed the lowest level in tissue and saliva. In conclusion, alteration of miRNA 27b and miRNA 137 gene expression signify their use as biomarkers for diseases activity and tendency of malignant transformation, and down expression of miRNA 137 especially in erosive-type favors the use of saliva sample as a noninvasive method for monitoring a potential malignant transformation of OLP.