Salivary Interleukins-19 and Interleukins-21 as Diagnostic Biomarkers in Recurrent Aphthous Stomatitis: A Case-Control Study
Recurrent aphthous stomatitis, IL-19, IL-21, salivary biomarkers, Roc analysis
AuthorsABSTRACTBackground: Recurrent aphthous stomatitis (RAS) is a prevalent oral mucosa disorder characterized by recurrent ulceration and immune dysregulation with C interleukins implicated in its pathogenesis. Objective: To evaluate salivary interleukin-19 (IL-19) and interleukin-21 (IL21) as diagnostic biomarkers in patients with RAS. Methods: This case-control study enrolled 90 participants (45 RAS patients and 45 healthy controls). Unstimulated salivary IL-19 and IL-21 levels were quantified by ELISA. Data were analyzed using independent t-test, ANOVA, and ROC curve analysis (SPSS v. 22) Results: Salivary Il-19 and IL-21 were significantly elevated in RAS patients versus controls (P=0.001). No significant differences were observed across ulcer subtypes; however, IL-19 was significantly higher in buccal mucosal lesions (P=0.042). ROC analysis demonstrated excellent diagnostic performance: Il-19 achieved an AUC of 0.928 (95% CI: 0.854-0972; p< 0.001), sensitivity 88.89%, specificity 88.89% (cut-off> 88.90 pg/mL); IL-21 achieved an AUC 0.930, (95% CI: 0.856-0.973; p< 0.001), (95% CI: 0.856-0.973; p< 0.001), sensitivity 86.67%, specificity of 95.56% (cut-off > 56.50 pg/mL) Conclusions: salivary IL-19 and IL-21 are significantly elevated in RAS and exhibited high diagnostic accuracy, supporting their values as non-invasive biomarkers and implicating cytokine dysregulation in RAS immunopathogenesis.
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