Topical immunomodulators for management of oral mucosal conditions, a systematic review; Part II: Miscellaneous agents

Sharon Elad*, Joel B. Epstein, Inger Von Bltzingslöwen, Scott Drucker, Rinat TzaC.H., Noam Yarom

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: 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. Areas covered: 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. Expert opinion: 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.

Original languageEnglish
Pages (from-to)183-202
Number of pages20
JournalExpert Opinion on Emerging Drugs
Volume16
Issue number1
DOIs
StatePublished - Mar 2011

Keywords

  • G-CSF
  • GM-CSF
  • azathioprine
  • bacillus Calmette-Guerin polysaccharide nucleic acid
  • benzydamine
  • evidence-based
  • imiquimod
  • mechanism
  • mucosal
  • oral
  • retinoids
  • tetracyclines
  • therapy
  • topical

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