Burning Mouth Syndrome May Essentially Be Related To Psychoneuroimmunology: Mechanism Hypothesis

Burning mouth syndrome (BMS) is a chronic intraoral dysesthesia with elusive aetiology, only few studies have been carried out on immune function in BMS patients. We aimed to investigate the role immune function paly in the pathogenesis of BMS by psychoneuroimmunology (PNI).

We recruited 44 BMS patients and 31 controls. We measured the anxiety and depression levels by the Zung' Self-rating Anxiety Scale (SAS) and Zung' Self-rating Depression Scale (SDS), respectively. Serological immunity included cellular immunity, humoral immunity and autoantibody. Visual analogue scale (VAS) was used to quantify pain levels. We used the Pearson correlation analysis to analyse the relationship between pain, psychology and immune function.

BMS exhibited higher levels of anxiety and depression (***p < 0.001 for both). In BMS, the CD3⁺ cells, CD4⁺ cells were lower (*p = 0.028, 0.046 and 0.033, respectively), IgE and antinuclear antibody (ANA) was higher (*p = 0.035). The average VAS score among BMS was approximately 3.7. Pearson correlation analysis revealed positive correlations between VAS, SAS and SDS; negative correlations between these scores of VAS, SAS, SDS and the levels of CD3⁺ cells, CD4⁺ cells, CD8⁺ cells.

BMS were more painful, anxious, depressive, and immunity dysfunction than controls. We proposed a mechanism hypothesis that the BMS may essentially be an immunological disease.