Topical immunomodulators for management of oral mucosal conditions, a systematic review; Part II: miscellaneous agents.
BACKGROUND
Topical immunomodulating preparations have utility in inflammatory/immune-mediated oral mucosal disease resistant to topical steroids, in immunologically mediated systemic disease with primary oral involvement or more severe lesions primarily involving the oral mucosa.


METHODS
This paper is the second part of a systematic review of a variety of topical immunomodulators for management of immune/inflammatory oral mucosal conditions. The literature search revealed studies of azathioprine, benzydamine, GM-CSF and G-CSF, tetracyclines, retinoids, imiquimod, amlexanox, sirolimus and bacillus Calmette-Guerin polysaccharide nucleic acid. Weighted conclusions are provided for the topical use of each of the immunomodulators reviewed in the management of these oral diseases.


CONCLUSIONS
Topical immunomodulators may be useful as second line treatment in several oral diseases, particularly oral lichen planus and recurrent aphthous stomatitis. Benzydamine was found to be preventive in radiotherapy-induced mucositis; however, it is unclear if this outcome is related to its immunomodulating effects or other mechanisms of action. Topical application of tetracyclines and retinoic acid also shows potential anti-inflammatory actions.
Hebrew University - Hadassah School of Dental Medicine, Department of Oral Medicine, POB 12272, Jerusalem 91120, Israel. eladhome@md.huiji.ac.il
Sharon
S
Elad
Joel B
JB
Epstein
Inger
I
von Bültzingslöwen
Scott
S
Drucker
Rinat
R
Tzach
Noam
N
Yarom
D000287:Administration, Topical; D002986:Clinical Trials as Topic; D055808:Drug Discovery / Q000379:methods*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017676:Lichen Planus, Oral / Q000188:drug therapy / Q000276:immunology; D009059:Mouth Diseases / Q000188:drug therapy* / Q000276:immunology; D009061:Mouth Mucosa / Q000187:drug effects* / Q000276:immunology; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D013281:Stomatitis, Aphthous / Q000188:drug therapy / Q000276:immunology; D013754:Tetracyclines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D007155:Immunologic Factors; D012176:Retinoids; D013754:Tetracyclines