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Association between the Concentration of Cortisol, α-amylase, Interleukin-6 in Saliva with the Psychological Profile of Patients with Oral Lichen Planus and Burning Mouth Syndrome

Given the field of psychoneuroimmunology of skin diseases is better researched and documented than oral diseases, further studies on oral diseases in this field are needed. Oral lichen planus (OLP) and primary burning mouth syndrome (BMS) are diseases of unkonown etiology, but are possible connected to psychological stress. Therefore, determining the concentrations of salivary biomarkers (cortisol, α-amylase, interleukin (IL)-6) and the psychological profile (depression, anxiety, stress) of patients with OLP and primary BMS could improve our understanding of their etiopathogenetic mechanisms. Cortisol is called the „stress hormone“ and reflects the activity of the hypothalamic-pituitary-adrenal axis. Salivary α-amylase shows sensitivity to changes in catecholamine concentration in the blood, i. e. it is regulated by the sympathetic nervous system. Interleukin (IL)-6 is an important proinflammatory cytokine involved in the pathogenesis of all inflammatory diseases. Studies have shown that with the advancement of technology, the benefit of determining the concentration of salivary biomarkers is highly correlated with serum values. The results of studies on salivary cortisol concentrations in patients with OLP and primary BMS are contradictory. However, most studies have found a positive correlation between higher concentrations of salivary cortisol and depression, anxiety and stress. The association of OLP and primary BMS with mental disorders has been confirmed in numerous studies. Whether mental disorders precede these diseases or are their consequences, remains unclear. Previous studies have shown that patients with OLP (erosive form) have higher concentration of salivary IL-6 compared to healthy control subjects. The results of salivary IL-6 in patients with primary BMS are contradictory. Elevated concentrations of the most relevant salivary stress biomarkers in patients with OLP and primary BMS may indicate poorer mental health, a longer course, and a more severe clinical picture of the disease. A multidisciplinary therapeutic approach is important in order to provide patients with a higher quality of life, based on the possible effect on the psychological aspects of their disease.

oral lichen planus ; burning mouth syndrome ; saliva ; biomarkers ; cortisol

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