{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:26:16Z","timestamp":1793039176517,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,1,20]],"date-time":"2006-01-20T00:00:00Z","timestamp":1137715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Oral Pathology Medicine"],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Recurrent aphthous ulcerations (RAU) are common oral inflammatory lesions. Tumor necrosis factor (TNF)\u2010<jats:italic>\u03b1<\/jats:italic> is an important inflammatory mediator and a critical cytokine for adequate host defense. Our previous studies have shown that 14\u201343% and 59\u201363% of patients in the ulcerative stage of major, minor or herpetiform RAU have significantly higher than normal serum levels of interleukin (IL)\u20106 and IL\u20108, respectively. In this study, we examined whether RAU patients in the ulcerative stage had a significantly higher than normal serum level of TNF\u2010<jats:italic>\u03b1<\/jats:italic> and assessed whether treatment with levamisole can modulate serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> levels in RAU patients.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> This study used a solid phase, two\u2010site sequential chemiluminescent immunometric assay to determine the baseline serum levels of TNF\u2010<jats:italic>\u03b1<\/jats:italic> in 146 patients with RAU, nine patients with traumatic ulcers (TU), and 54 normal control subjects. Fifty\u2010five RAU patients with serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> levels higher than 5.0\u2003pg\/ml were treated with levamisole for 0.5\u20134\u2003months and their serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> levels were measured after treatment.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> We found that 29% (42 of 146) RAU patients as well as 39% (24 of 61) major type, 20% (14 of 69) minor type, and 25% (four of 16) herpetiform type RAU patients had a serum level of TNF\u2010<jats:italic>\u03b1<\/jats:italic> greater than the upper normal limit of 7.4\u2003pg\/ml. The mean serum level of TNF\u2010<jats:italic>\u03b1<\/jats:italic> in patients with RAU (9.1\u2003\u00b1\u20031.0\u2003pg\/ml, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001), major type RAU (11.6\u2003\u00b1\u20031.9\u2003pg\/ml, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001), minor type RAU (6.9\u2003\u00b1\u20030.9\u2003pg\/ml, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.005), or herpetiform type RAU (9.6\u2003\u00b1\u20032.7\u2003pg\/ml, <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001) was higher than that (3.8\u2003\u00b1\u20030.2\u2003pg\/ml) in normal control subjects. The mean serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> level was significantly higher in patients with major type RAU than in patients with minor type RAU (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05) and was significantly higher in major type RAU patients in the exacerbation stage than in the post\u2010exacerbation stage (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05). In 55 RAU patients with serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> levels higher than 5.0\u2003pg\/ml, treatment with levamisole for a period of 0.5\u20134\u2003months could significantly reduce the serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> level from 16.4\u2003\u00b1\u20031.9 to 5.8\u2003\u00b1\u20030.6\u2003pg\/ml (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001).<\/jats:p><jats:p><jats:bold>Conclusions:\u2002<\/jats:bold> We conclude that a significantly higher than normal serum level of TNF\u2010<jats:italic>\u03b1<\/jats:italic> can be detected in 20\u201339% of patients in the ulcerative stage of major, minor or herpetiform RAU. The serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> level may be associated with the severity and the stage of RAU. Levamisole can modulate serum TNF\u2010<jats:italic>\u03b1<\/jats:italic> levels in RAU patients.<\/jats:p>","DOI":"10.1111\/j.1600-0714.2006.00383.x","type":"journal-article","created":{"date-parts":[[2006,1,20]],"date-time":"2006-01-20T14:16:08Z","timestamp":1137766568000},"page":"111-116","source":"Crossref","is-referenced-by-count":30,"title":["Levamisole can modulate the serum tumor necrosis factor\u2010<i>\u03b1<\/i> level in patients with recurrent aphthous 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