Classification of Oral Ulcers and its Treatment by focusing on Exosome Loaded Hydrogel: A Comprehensive Review
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Abstract
Background: Oral ulcers significantly impact patient quality of life, manifesting as acute or chronic lesions that can cause considerable discomfort and pain. These ulcers arise from a variety of etiological factors and disrupt daily activities due to the painful loss of mucosal tissue.
Objective: This review aims to elucidate the etiology and management of oral ulcers, with a focus on innovative treatment modalities involving hydrogels and exosomes.
Methods: We reviewed current literature on the pathology and treatment of oral ulcers. Special attention was given to the properties of hydrogels and exosomes, their biomedical applications, and their roles in new therapeutic strategies for oral ulcers.
Results: Hydrogels, due to their biocompatibility, biodegradation, and controlled release properties, have emerged as effective drug delivery systems. Exosomes, loaded within these hydrogels, enhance treatment outcomes due to their high cellular communication capacity and anti-inflammatory properties.
Conclusion: Innovative treatments utilizing hydrogels and exosomes offer promising alternatives for the management of oral ulcers, potentially improving drug delivery efficiency and patient compliance.
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References
Wen, S.D., et al., Effects of natural extracts in the treatment of oral ulcers: A systematic review of evidence from experimental studies in animals. Journal of clinical and experimental dentistry, 2021. 13(10): p. e1038.
Edgar, N.R., D. Saleh, and R.A. Miller, Recurrent aphthous stomatitis: a review. The Journal of clinical and aesthetic dermatology, 2017. 10(3): p. 26.
Vigata, M., et al., Hydrogels as drug delivery systems: A review of current characterization and evaluation techniques. Pharmaceutics, 2020. 12(12): p. 1188.
Hade, M.D., C.N. Suire, and Z. Suo, Mesenchymal stem cell-derived exosomes: applications in regenerative medicine. Cells, 2021. 10(8): p. 1959.
Antimisiaris, S.G., S. Mourtas, and A. Marazioti, Exosomes and exosome-inspired vesicles for targeted drug delivery. Pharmaceutics, 2018. 10(4): p. 218.
Akbari, A., et al., Free and hydrogel encapsulated exosome-based therapies in regenerative medicine. Life sciences, 2020. 249: p. 117447.
Salamat-Miller, N., M. Chittchang, and T.P. Johnston, The use of mucoadhesive polymers in buccal drug delivery. Advanced drug delivery reviews, 2005. 57(11): p. 1666-1691.
Sudhakar, Y., K. Kuotsu, and A. Bandyopadhyay, Buccal bioadhesive drug delivery—a promising option for orally less efficient drugs. Journal of controlled release, 2006. 114(1): p. 15-40.
Fitzpatrick, S.G., D.M. Cohen, and A.N. Clark, Ulcerated lesions of the oral mucosa: clinical and histologic review. Head and neck pathology, 2019. 13(1): p. 91-102.
Zeng, X., et al., Difficult and complicated oral ulceration: an expert consensus guideline for diagnosis. International Journal of Oral Science, 2022. 14(1): p. 28.
Alrouji, M., et al., A story of the potential effect of non-steroidal anti-inflammatory drugs (NSAIDs) in Parkinson’s disease: beneficial or detrimental effects. Inflammopharmacology, 2023. 31(2): p. 673-688.
Pärssinen, M., et al., Oral mucosal pellicle as an immune protection against micro-organisms in patients with recurrent aphthous stomatitis: A hypothesis. Medical Hypotheses, 2021. 146: p. 110449.
Mortazavi, H., et al., Diagnostic features of common oral ulcerative lesions: an updated decision tree. International journal of dentistry, 2016. 2016.
Paleri, V., et al., Evaluation of oral ulceration in primary care. BmJ, 2010. 340.
Chateaubriand, S.L., et al., Necrotizing sialometaplasia: a diagnostic challenge. Oral Oncology, 2021. 118: p. 105349.
Chen, J.-Y., et al., A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan. Journal of Applied Oral Science, 2010. 18: p. 5-9.
Neville, B.W., D.D. Damm, and C. Allen, dan Bouquot JE. Squamous Cell Carcinoma in Oral and Maxillofacial Pathology. 2nd ed. Philadelphia, PA, Pennsylvania: Saunders, 2002.
Yıldırımyan, N., Ulcerative Lesions of the Oral Cavity. 2021.
Trayes, K.P., G. Love, and J. Studdiford, Erythema multiforme: recognition and management.
American family physician, 2019. 100(2): p. 82-88.
Reinhart, J.P., E.T. Stoopler, and G.H. Crawford, Oral hypersensitivity reactions. Dermatologic Clinics, 2020. 38(4): p. 467-476.
Bilodeau, E.A. and R.V. Lalla, Recurrent oral ulceration: Etiology, classification, management, and diagnostic algorithm. Periodontology 2000, 2019. 80(1): p. 49-60.
Mohan, R.P.S., et al., Acute primary herpetic gingivostomatitis. Case Reports, 2013. 2013: p. bcr2013200074.
González‐Moles, M.Á., et al., Worldwide prevalence of oral lichen planus: A systematic review and meta‐analysis. Oral diseases, 2021. 27(4): p. 813-828.
Carey, B. and J. Setterfield, Mucous membrane pemphigoid and oral blistering diseases.
Clinical and Experimental Dermatology, 2019. 44(7): p. 732-739.
Di Lernia, V., et al., Pemphigus vulgaris and bullous pemphigoid: update on diagnosis and treatment. Dermatology practical & conceptual, 2020. 10(3).
Mutalik, V.S., et al., Unique oral presentations of deep fungal infections: a report of four cases. Head and Neck Pathology, 2021. 15: p. 682-690.
Rajendra Santosh, A.B., K. Muddana, and S.R. Bakki, Fungal infections of oral cavity: diagnosis, management, and association with COVID-19. SN comprehensive clinical medicine, 2021. 3(6): p. 1373-1384.
Almangush, A., et al., Staging and grading of oral squamous cell carcinoma: An update. Oral oncology, 2020. 107: p. 104799.
Liu, L., et al., Progress in targeted therapeutic drugs for oral squamous cell carcinoma. Surg Oncol, 2019. 31: p. 90-97.
Boch, K., et al., Lichen planus. Frontiers in Medicine, 2021. 8: p. 737813.
Lau, C.B. and G.P. Smith, Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options. Dermatologic Therapy, 2022. 35(6): p. e15500.
Manfredini, M., et al., Recurrent Aphthous Stomatitis: Treatment and Management.
Dermatol Pract Concept, 2021. 11(4): p. e2021099.
Tong, B., et al., Immunopathogenesis of Behcet's disease. Frontiers in immunology, 2019. 10: p. 665.
Alpsoy, E., B.C. Bozca, and A. Bilgic, Behcet Disease: An Update for Dermatologists. Am J Clin Dermatol, 2021. 22(4): p. 477-502.
Alpsoy, E., B.C. Bozca, and A. Bilgic, Behçet disease: an update for dermatologists. American Journal of Clinical Dermatology, 2021. 22(4): p. 477-502.
Vaishnavi, V., Management of Recurrent Apthous stomatitis-A Review. Research Journal of Pharmacy and Technology, 2014. 7(10): p. 1193-1195.
Zhang, W., et al., Promoting oral mucosal wound healing with a hydrogel adhesive based on a phototriggered S‐nitrosylation coupling reaction. Advanced Materials, 2021. 33(48): p. 2105667.
Schmidt, T., et al., A Paradigm Shift in Tissue Engineering: From a Top–Down to a Bottom–Up Strategy. Processes, 2021. 9(6): p. 935.
Chapekar, M.S., Tissue engineering: challenges and opportunities. Journal of Biomedical Materials Research: An Official Journal of The Society for Biomaterials, The Japanese Society for Biomaterials, and The Australian Society for Biomaterials and the Korean Society for Biomaterials, 2000. 53(6): p. 617-620.
Koons, G.L., M. Diba, and A.G. Mikos, Materials design for bone-tissue engineering. Nature Reviews Materials, 2020. 5(8): p. 584-603.
Mandal, A., et al., Hydrogels in the clinic. Bioengineering & Translational Medicine, 2020.
(2): p. e10158.
Ullah, F., et al., Classification, processing and application of hydrogels: A review. Materials Science and Engineering: C, 2015. 57: p. 414-433.
Caló, E. and V.V. Khutoryanskiy, Biomedical applications of hydrogels: A review of patents and commercial products. European polymer journal, 2015. 65: p. 252-267.
Bashir, S., et al., Fundamental concepts of hydrogels: Synthesis, properties, and their applications. Polymers, 2020. 12(11): p. 2702.
Ahmad, Z., et al., Versatility of hydrogels: from synthetic strategies, classification, and properties to biomedical applications. Gels, 2022. 8(3): p. 167.
Feksa, L.R., et al., Chapter 11 - Hydrogels for biomedical applications, in Nanostructures for the Engineering of Cells, Tissues and Organs, A.M. Grumezescu, Editor. 2018, William Andrew Publishing. p. 403-438.
Aswathy, S., U. Narendrakumar, and I. Manjubala, Commercial hydrogels for biomedical applications. Heliyon, 2020. 6(4): p. e03719.
Zeng, D., S. Shen, and D. Fan, Molecular design, synthesis strategies and recent advances of hydrogels for wound dressing applications. Chinese Journal of Chemical Engineering, 2021. 30: p. 308-320.
Mantha, S., et al., Smart hydrogels in tissue engineering and regenerative medicine.
Materials, 2019. 12(20): p. 3323.
Zhao, H., et al., Nanocomposite hydrogels for tissue engineering applications. Nanoscale, 2020. 12(28): p. 14976-14995.
Al-Sabah, A., et al., Structural and mechanical characterization of crosslinked and sterilised nanocellulose-based hydrogels for cartilage tissue engineering. Carbohydrate Polymers, 2019. 212: p. 242-251.
Wu, X., et al., Eggshell particle-reinforced hydrogels for bone tissue engineering: An orthogonal approach. Biomaterials science, 2019. 7(7): p. 2675-2685.
Ahsan, A., et al., An overview of hydrogels and their role in transdermal drug delivery. International Journal of Polymeric Materials and Polymeric Biomaterials, 2021. 70(8): p. 574- 584.
Hanafy, N.A., S. Leporatti, and M.A. El-Kemary, Mucoadhesive hydrogel nanoparticles as smart biomedical drug delivery system. Applied Sciences, 2019. 9(5): p. 825.
Brannigan, R.P. and V.V. Khutoryanskiy, Progress and current trends in the synthesis of novel polymers with enhanced mucoadhesive properties. Macromolecular Bioscience, 2019. 19(10): p. 1900194.
Xie, S., Q. Zhang, and L. Jiang, Current knowledge on exosome biogenesis, cargo-sorting mechanism and therapeutic implications. Membranes, 2022. 12(5): p. 498.
Hessvik, N.P. and A. Llorente, Current knowledge on exosome biogenesis and release.
Cellular and Molecular Life Sciences, 2018. 75: p. 193-208.
Chen, J., et al., Review on strategies and technologies for exosome isolation and purification.
Frontiers in Bioengineering and Biotechnology, 2022. 9: p. 811971.
Shi, Q., et al., GMSC-derived exosomes combined with a chitosan/silk hydrogel sponge accelerates wound healing in a diabetic rat skin defect model. Frontiers in physiology, 2017. 8: p. 904.
Zheng, D., et al., The role of exosomes and exosomal microRNA in cardiovascular disease.
Frontiers in cell and developmental biology, 2021. 8: p. 616161.
Yu, D., et al., Exosomes as a new frontier of cancer liquid biopsy. Molecular Cancer, 2022.
(1): p. 56.
Xing, X., et al., Emerging role of exosomes in craniofacial and dental applications.
Theranostics, 2020. 10(19): p. 8648.
Safari, B., et al., Exosome-loaded hydrogels: a new cell-free therapeutic approach for skin regeneration. European Journal of Pharmaceutics and Biopharmaceutics, 2022. 171: p. 50- 59.