Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.

摘要 越来越多的证据表明，灼口综合征（burning mouth syndrome, BMS）的发病机制中存在与外周神经纤维（peripheral nerve fibers, NF）及肥大细胞（mast cells）分泌的神经肽相关的分子串扰。本研究旨在探究BMS患者与健康个体口腔黏膜中，外周神经纤维的S-100蛋白（S-100）阳性密度、蛋白基因产物9.5（PGP 9.5）阳性完整性，以及类胰蛋白酶阳性（tryptase+）肥大细胞的密度。本研究共评估23份口腔黏膜标本，其中BMS患者组12份，健康对照组11份。BMS的临床诊断需经细致检查，排除其他局部及全身性致病因素。有症状的BMS患者样本取自舌黏膜的切开活检组织，而非肿瘤性舌活检的边缘组织则作为健康个体的对照样本。采用免疫组织化学染色法，检测S-100阳性、PGP 9.5阳性外周神经纤维及类胰蛋白酶阳性肥大细胞的密度（单位：个/mm²）。结果显示，BMS患者组与健康对照组的S-100阳性、PGP 9.5阳性外周神经纤维及类胰蛋白酶阳性肥大细胞密度均无显著差异：BMS组的中位数分别为3.70、0.70和29.24个/mm²，对照组则分别为2.60、0.80和26.01个/mm²（P>0.05）。此外，两组中外周神经纤维的S-100阳性与PGP 9.5阳性之间的相关性均无统计学差异（P=0.70）。本研究证实，有症状的BMS患者舌部外周神经纤维的密度与完整性均未出现异常改变。但该疾病中外周神经纤维的致敏作用可能并不依赖于肥大细胞的密度。