Celiac disease is a common autoimmune disease triggered by gluten-containing foods (wheat, barley and rye) in genetically predisposed individuals. We present a patient with celiac disease complicated by severe aphthous stomatitis resulting in impairing swallowing, chewing and speaking. This led to weight loss, psychosocial problems as well as inability to perform her work. A variety of topical and systemic medications used resulted in either no improvement or only partial alleviation of the patient's symptoms. After informed consent, etanercept was initiated and resulted in complete remission of aphthous stomatitis, decrease in arthralgia and fatigue and considerable improvement in her quality of life. The use of newer biological agents for selected and severe manifestations of celiac disease may lead to improved morbidity in these patients, but more studies are needed to determine long-term efficacy as well as safety of these drugs in the mucosal and/or systemic complications of this disease.

Celiac disease is a common autoimmune disease triggered by gluten-containing foods (wheat, barley and rye) in genetically predisposed individuals. We present a patient with celiac disease complicated by severe aphthous stomatitis resulting in impairing swallowing, chewing and speaking. This led to weight loss, psychosocial problems as well as inability to perform her work. A variety of topical and systemic medications used resulted in either no improvement or only partial alleviation of the patient's symptoms. After informed consent, etanercept was initiated and resulted in complete remission of aphthous stomatitis, decrease in arthralgia and fatigue and considerable improvement in her quality of life. The use of newer biological agents for selected and severe manifestations of celiac disease may lead to improved morbidity in these patients, but more studies are needed to determine long-term efficacy as well as safety of these drugs in the mucosal and/or systemic complications of this disease.

INTRODUÇÃO: A Estomatite Aftóide Recorrente (EAR) é uma doença oral com incidência em 20% da população mundial, caracterizada por úlceras mucosas de caráter recidivante. O seu diagnóstico baseia-se principalmente na história clínica do paciente. Hereditariedade pode ser um fator de risco para a doença. Entretanto, os estudos disponíveis não são conclusivos quanto aos resultados obtidos, variando segundo a população estudada. OBJETIVOS: Neste trabalho tipificamos moléculas HLA de classe I e de classe II e avaliamos a freqüência destas moléculas em 31 pacientes, da cidade de São Paulo, portadores de Estomatite Aftóide Recorrente bem como em seus subgrupos (minor, major e herpetiforme), comparando com grupo controle, composto de 961 pacientes saudáveis. CASUÍSTICA E MÉTODOS: Prospectivamente, 58 pacientes com suspeita diagnóstica de Estomatite Aftóide Recorrente no período de fevereiro de 2004 a maio de 2006, foram estudados. Estes pacientes foram submetidos a protocolo de exames e, daqueles que obedeceram os critérios de inclusão, foi extraído o Ácido Desoxi Ribonucléico (DNA), por meio de amostra de 10 ml de sangue total periférico, com o fim de proceder a tipificação HLA por Reação de Polimerização em Cadeia. RESULTADO: Nos pacientes portadores de Estomatite Aftóide Recorrente do tipo minor encontramos as freqüências HLA A33 e B35, estatisticamente significantes quando comparadas com o grupo controle. CONCLUSÃO: As freqüências HLA-A33 e HLA-B35 podem estar associadas à Estomatite Aftóide Recorrente minor na população brasileira. / INTRODUCTION: Recurent aphthous stomatits (RAS) is a common oral mucosa disorders and affects 20% of the world\'s population, this disease is characterized by recurring painful ulcers of the mouth. The diagnosis is base on the clinic and the lesion\'s history. Hereditary may be involved in the morbidity of Recurent aphthous stomatits. Despite extensive investigations of etiology\'s Recurent aphthous stomatits, they are not conclusive and variety by different ethnic backgrounds. OBJECTIVES: In this work HLA class I and class II was typing from 31 subjects affected by Recurent aphthous stomatits, and compared with 961 healthy controls. CASUISTIC and METHOD: Fifty eight patients with diagnostic hypothesis of Recurent aphthous stomatits were treated, in the period of February of 2004 to May of 2006. A protocol of exams were obtained from those that obeyed the inclusion criteria. To obtain the DNA, 10 ml venous blood sample was collected to type HLA using Polymerase Chain Reaction - Sequence Specific Oligonucleotide (PCR-SSO). RESULTS: The investigation revealed that HLA-A33 and HLA-B35 were more frequent in minor Recurent aphthous stomatits patient, when compared with control group. CONCLUSION: HLA-A33 and HLA-B35 may be associated with Recurent aphthous stomatits type minor in the Brazilian\'s population.

INTRODUÇÃO: A Estomatite Aftóide Recorrente (EAR) é uma doença oral com incidência em 20% da população mundial, caracterizada por úlceras mucosas de caráter recidivante. O seu diagnóstico baseia-se principalmente na história clínica do paciente. Hereditariedade pode ser um fator de risco para a doença. Entretanto, os estudos disponíveis não são conclusivos quanto aos resultados obtidos, variando segundo a população estudada. OBJETIVOS: Neste trabalho tipificamos moléculas HLA de classe I e de classe II e avaliamos a freqüência destas moléculas em 31 pacientes, da cidade de São Paulo, portadores de Estomatite Aftóide Recorrente bem como em seus subgrupos (minor, major e herpetiforme), comparando com grupo controle, composto de 961 pacientes saudáveis. CASUÍSTICA E MÉTODOS: Prospectivamente, 58 pacientes com suspeita diagnóstica de Estomatite Aftóide Recorrente no período de fevereiro de 2004 a maio de 2006, foram estudados. Estes pacientes foram submetidos a protocolo de exames e, daqueles que obedeceram os critérios de inclusão, foi extraído o Ácido Desoxi Ribonucléico (DNA), por meio de amostra de 10 ml de sangue total periférico, com o fim de proceder a tipificação HLA por Reação de Polimerização em Cadeia. RESULTADO: Nos pacientes portadores de Estomatite Aftóide Recorrente do tipo minor encontramos as freqüências HLA A33 e B35, estatisticamente significantes quando comparadas com o grupo controle. CONCLUSÃO: As freqüências HLA-A33 e HLA-B35 podem estar associadas à Estomatite Aftóide Recorrente minor na população brasileira. / INTRODUCTION: Recurent aphthous stomatits (RAS) is a common oral mucosa disorders and affects 20% of the world\'s population, this disease is characterized by recurring painful ulcers of the mouth. The diagnosis is base on the clinic and the lesion\'s history. Hereditary may be involved in the morbidity of Recurent aphthous stomatits. Despite extensive investigations of etiology\'s Recurent aphthous stomatits, they are not conclusive and variety by different ethnic backgrounds. OBJECTIVES: In this work HLA class I and class II was typing from 31 subjects affected by Recurent aphthous stomatits, and compared with 961 healthy controls. CASUISTIC and METHOD: Fifty eight patients with diagnostic hypothesis of Recurent aphthous stomatits were treated, in the period of February of 2004 to May of 2006. A protocol of exams were obtained from those that obeyed the inclusion criteria. To obtain the DNA, 10 ml venous blood sample was collected to type HLA using Polymerase Chain Reaction - Sequence Specific Oligonucleotide (PCR-SSO). RESULTS: The investigation revealed that HLA-A33 and HLA-B35 were more frequent in minor Recurent aphthous stomatits patient, when compared with control group. CONCLUSION: HLA-A33 and HLA-B35 may be associated with Recurent aphthous stomatits type minor in the Brazilian\'s population.

A ulceração aftosa recorrente (UAR) é considerada a doença ulcerativa mais frequente da cavidade bucal. Sua etiopatogenia ainda não está plenamente esclarecida, embora inúmeros fatores locais e sistêmicos já tenham sido a ela associados. Recentemente, a resposta imune anormal do tipo celular tem sido considerada a responsável pela lesão bucal na UAR, favorecendo uma resposta imunológica pró-inflamatória do tipo Th1, em conjunto com alterações em linfócitos T regulatórios. Sendo assim, o objetivo do presente estudo foi realizar análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 em pacientes com ulceração aftosa recorrente, por meio de estudo caso-controle. Os pacientes do grupo caso apresentavam quadros frequentes de UAR com pelo menos um ano de manifestação de surtos ulcerativos e história negativa de condições sistêmicas ou locais interferentes com a expressão das UAR. Estes foram submetidos a biópsia de lesão ulcerativa recente para a análise molecular. Os pacientes do grupo controle apresentavam história negativa de UAR, mucosa clinicamente saudável, e doaram voluntariamente fragmento de mucosa saudável para análise molecular, quando submetidos a procedimentos cirúrgicos como exodontia de terceiros molares ou biópsias ósseas. Todos os pacientes foram incluídos no grupo de pesquisa apenas após anuência com termo de consentimento livre e esclarecido. Submeteram-se a exame clínico, realizaram exames complementares para controle da saúde geral e suporte diagnóstico. Onze pacientes UAR e três controles voluntários compuseram a casuística estudada, sendo submetidos a biópsia de lesões de UAR ou de mucosa de revestimento sadia. As amostras de tecido bucal foram submetidas aos procedimentos laboratoriais de extração do RNA e análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 por meio da técnica de RT-PCR em tempo real. Não houve diferença significativa na expressão dos genes estudados entre as amostras de portadores de UAR e controles sadios. Concluímos que os genes aqui avaliados não parecem desempenhar papel distintivo na fase ulcerativa inicial das UAR, entretanto estudos adicionais são recomendados a fim de se verificar a real participação desses agentes da inflamação na expressão da doença. / Recurrent aphthous ulcers (RAU) is the most common ulcerative disease of the oral cavity. Its pathogenesis is poorly understood yet, although numerous local and systemic factors have been associated with it. Recently, abnormal immune response of cellular type has been considered responsible for the RAU oral lesions, promoting a pro-inflammatory immune response Th1-type, in conjunction with changes in regulatory T cells. Thus, the aim of this study was to analyze the gene expression of FOXP3, MIP-3? and interleukins 2, 10 and 35 in patients with recurrent aphthous ulceration through a case-control study. The case group of patients presented frequent RAU bouts with at least one year of manifestation of ulcerative outbreaks and negative history of local or systemic conditions interfering with the RAU expression. These patients were submitted to a biopsy procedure of a recent ulcerative lesion for molecular analysis. Patients in the control group presented no history of RAU, and agreed with a donation of a healthy mucosa fragment for molecular analysis when undergoing surgical procedures such as extraction of third molars or bone biopsies. All patients were included in the research group only after agreement with an informed consent. All subjects underwent clinical examination and were submitted to additional lab tests to check overall health and support diagnosis. Eleven RAU patients and three control volunteers composed the sample size and undergone biopsy of RAU lesions or healthy mucosal lining. The oral tissue samples were submitted to the laboratory procedures of RNA extraction and analysis of gene expression of FOXP3, MIP-3? and interleukins 2, 10, 35 by real time RT-PCR. There was no significant difference in gene expression between the studied samples of patients with RAU and healthy controls. It was concluded that the genes evaluated do not seem to play distinctive role in the initial ulcerative phase of RAU, however further studies are recommended in order to verify the actual participation of these inflammation agents in RAU expression.

A ulceração aftosa recorrente (UAR) é uma das lesões mais freqüentes da cavidade bucal, comprometendo a qualidade de vida de seus portadores muitas vezes de maneira importante. Embora sua etiopatogenia ainda não esteja esclarecida, vários fatores têm sido consistentemente relacionados ao surgimento da UAR, especialmente alterações imunológicas e genéticas, conduzindo grande parte da investigação científica para esses campos do conhecimento. Os receptores Toll-Like (TLR) reconhecem produtos moleculares derivados, principalmente, de microrganismos, desencadeando a resposta inflamatória protetora. Entretanto, anormalidades em sua função podem estar relacionadas ao desenvolvimento de doenças, pela ativação aberrante do sistema imunológico. A proposta desta investigação foi a de se avaliar a expressão dos receptores TLR-2, TLR-4 e TLR-7 através do RT-PCR em tempo real, a partir de amostras de sangue periférico e da mucosa bucal de população portadora de UAR e indivíduos controles sadios. Cinco pacientes UAR e quatro controles voluntários compuseram a casuística estudada, sendo submetidos à biópsia de lesões de UAR ou de mucosa de revestimento sadia. Na mesma sessão os pacientes tiveram sangue coletado por venopunção. Posteriormente, ambos os materiais foram submetidos aos procedimentos laboratoriais de extração do RNA e análise de expressão dos receptores TLR por meio da técnica de RT-PCR real time. Não houve diferença significativa na expressão destes receptores entre portadores de UAR e controles sadios, nos dois tipos de amostra. Estudos mais aprofundados são necessários a fim de se verificar a real participação destes receptores na UAR, visto que não há outros estudos nesta área e a amostra analisada foi pequena. / Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases which may cause serious impairment on patients quality of life. Despite its still unknown pathogenesis, several factors have been consistently associated with RAS, especially genetic and immunological changes, which has driven a lot of research effort towards these issues. Toll-Like receptors (TLR) recognize molecular products, mainly derived from microorganisms, triggering the inflammatory response. However, abnormalities in their function may give rise to the development of diseases, through abnormal activation of the immune system. The purpose of this investigation was to evaluate the expression of receptors TLR-2, TLR-4 and TLR-7 in peripheral blood and tissue samples of RAS and healthy controls, through real time RT-PCR technique. Five UAR patients and four healthy volunteers with no RAS history composed the casuistic and were submitted to biopsy of their UAR lesions or normal oral mucosa. On that same session patients had a blood sample taken through venopuncture. Both samples (tissue and blood) were, afterwards, submitted to lab procedures of RNA extraction and toll-like receptors expression through real time RT-PCR. There were no significant differences in the expression of these receptors between RAS and healthy controls in the two sample types. Further studies are necessary to allow sound conclusions on the actual participation of these receptors in RAS, since the sample followed were small and there are no similar studies published.

A ulceração aftosa recorrente (UAR) é uma das lesões mais freqüentes da cavidade bucal, comprometendo a qualidade de vida de seus portadores muitas vezes de maneira importante. Embora sua etiopatogenia ainda não esteja esclarecida, vários fatores têm sido consistentemente relacionados ao surgimento da UAR, especialmente alterações imunológicas e genéticas, conduzindo grande parte da investigação científica para esses campos do conhecimento. Os receptores Toll-Like (TLR) reconhecem produtos moleculares derivados, principalmente, de microrganismos, desencadeando a resposta inflamatória protetora. Entretanto, anormalidades em sua função podem estar relacionadas ao desenvolvimento de doenças, pela ativação aberrante do sistema imunológico. A proposta desta investigação foi a de se avaliar a expressão dos receptores TLR-2, TLR-4 e TLR-7 através do RT-PCR em tempo real, a partir de amostras de sangue periférico e da mucosa bucal de população portadora de UAR e indivíduos controles sadios. Cinco pacientes UAR e quatro controles voluntários compuseram a casuística estudada, sendo submetidos à biópsia de lesões de UAR ou de mucosa de revestimento sadia. Na mesma sessão os pacientes tiveram sangue coletado por venopunção. Posteriormente, ambos os materiais foram submetidos aos procedimentos laboratoriais de extração do RNA e análise de expressão dos receptores TLR por meio da técnica de RT-PCR real time. Não houve diferença significativa na expressão destes receptores entre portadores de UAR e controles sadios, nos dois tipos de amostra. Estudos mais aprofundados são necessários a fim de se verificar a real participação destes receptores na UAR, visto que não há outros estudos nesta área e a amostra analisada foi pequena. / Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases which may cause serious impairment on patients quality of life. Despite its still unknown pathogenesis, several factors have been consistently associated with RAS, especially genetic and immunological changes, which has driven a lot of research effort towards these issues. Toll-Like receptors (TLR) recognize molecular products, mainly derived from microorganisms, triggering the inflammatory response. However, abnormalities in their function may give rise to the development of diseases, through abnormal activation of the immune system. The purpose of this investigation was to evaluate the expression of receptors TLR-2, TLR-4 and TLR-7 in peripheral blood and tissue samples of RAS and healthy controls, through real time RT-PCR technique. Five UAR patients and four healthy volunteers with no RAS history composed the casuistic and were submitted to biopsy of their UAR lesions or normal oral mucosa. On that same session patients had a blood sample taken through venopuncture. Both samples (tissue and blood) were, afterwards, submitted to lab procedures of RNA extraction and toll-like receptors expression through real time RT-PCR. There were no significant differences in the expression of these receptors between RAS and healthy controls in the two sample types. Further studies are necessary to allow sound conclusions on the actual participation of these receptors in RAS, since the sample followed were small and there are no similar studies published.

Abstract Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a syndrome characterized by regular, high-fever episodes with healthy periods in between. In a classic phenotype of the syndrome, the fevers begin in childhood before the age of five, and fever flares are accompanied by aphthous stomatitis, pharyngitis, and/or cervical adenitis. The etiology of the syndrome is unknown, but tonsillectomy (TE) has been shown to be an effective treatment for the disease. The purposes of this study were as follows: (1) to assess the long-term outcome of PFAPA patients treated by TE with either the classic or incomplete phenotype (later onset of the disease and/or missing oropharyngeal symptoms), (2) to compare the health and growth of PFAPA patients with healthy controls, and (3) to compare the histological and microbiological findings of the tonsils of PFAPA patients with controls via conventional and modern sequencing technologies. In this approximately 9-year follow up, 97% (n = 56) of patients with the classic phenotype and all patients (n = 50) with the incomplete phenotype achieved a prompt and constant response after TE. There were no differences in either the length of fever episodes or flares between patients with both the classic and incomplete phenotypes. The health and growth of 119 PFAPA patients was compared to that of sex- and age-matched controls (n = 230), and no differences in prevalence of chronic diseases or growth were found between the groups. Infections, oral thrush, and pollen allergy were more common in the history of the PFAPA patients than in the controls. Microbiological and histological findings of the tonsils of PFAPA patients (n = 31) were compared with the findings of the controls (n = 24) who had undergone TE for other reasons. Biofilm formation and Candida albicans were more frequently found among PFAPA patients than the controls, but Staphylococcus aureus, varicella zoster, and herpes simplex viruses were more common in the controls. While comparing the bacterial microbiota between the groups, we found significant differences in the presence and relative abundance of many bacteria. For example, Cyanobacteria were more common and abundant in the case samples than in the controls. Because the long-term outcome after TE was excellent, both in classic and incomplete PFAPA patients; a new diagnostic criteria for the syndrome is proposed. The microbes of the tonsils in PFAPA patients differ from that of the controls, which may play an important role in triggering the inflammatory processes that lead to symptoms of PFAPA. / Tiivistelmä Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrooma, on oireyhtymä, jossa potilaat kärsivät hyvin säännöllisesti ilmaantuvista, toistuvista kuumejaksoista, joiden välillä potilaat ovat terveitä. Klassisessa tautimuodossa kuumeilut alkavat lapsuudessa ennen viiden vuoden ikää ja kuumevaiheeseen liittyy liitännäisoireita: suun limakalvojen rakkuloita, nielutulehdusta ja/tai kaulan imusolmukkeiden suurentumista. Oireyhtymän syytä ei tiedetä, mutta nielurisaleikkaus (TE) on osoittautunut tehokkaaksi hoidoksi. Tutkimuksen tarkoituksena oli (1) arvioida PFAPA potilaiden vointia pitkäaikaisseurannassa TE:n jälkeen ja vertailla taudinkuvaa niiden PFAPA potilaiden välillä, joilla oli klassinen PFAPA tai epätyypillinen PFAPA. (2) Lisäksi tutkimme myös TE:lla hoidettujen PFAPA potilaiden sairastuvuutta, yleistä terveydentilaa ja kasvua vertaamalla näitä sukupuoli- ja ikävakioituihin kontrolleihin ja (3) selvitimme mikrobiologisia ja histologisia löydöksiä PFAPA potilaiden nielurisoissa verrattuna muista syistä TE:ssa käyneiden lasten nielurisoihin. Tässä noin yhdeksän vuoden seurannassa TE:n jälkeen oli täysin parantunut 97% (n = 56) potilaista, joilla oli klassinen PFAPA, ja kaikki (n = 50) potilaat, joilla oli epätyypillinen PFAPA (tauti oli alkanut viiden ikävuoden jälkeen ja/tai klassiset liitännäisoireet puuttuivat). Kuumeprofiilit eivät muilta osin eronneet ennen nielurisaleikkausta näissä ryhmissä. PFAPA potilaiden (n = 119) kasvu ja yleinen terveydentila eivät eronneet väestökontrolleista (n = 230). Krooniset ja autoimmuunisairaudet olivat yhtä harvinaisia molemmissa ryhmissä. Potilaat raportoivat sairastaneensa enemmän infektioita ja sammasta lapsuudessa ja heillä oli enemmän siitepölyallergioita. PFAPA potilaiden (n = 31) ja muista syistä TE:ssa käyneiden lasten (n = 24) nielurisojen mikrobiologiaa ja histologiaa tutkittiin ja vertailtiin. Biofilmimuodostusta nielurisan pinnalla ja Candida albicansia löytyi enemmän tapauksilta kuin kontrolleilta, kun taas Staphylococcus aureusta, varicella zoster- ja herpes simplex -viruksia tavattiin enemmän kontrolleilla. Myös mikrobiomi erosi ryhmien välillä, esimerkiksi syanobakteerit olivat yleisempiä PFAPA risoissa kuin kontrolleilla. Klassisten ja epätyypillisten PFAPA potilaiden terveydentila TE:n jälkeen oli pitkäaikaisseurannassamme erinomainen ja siksi ehdotamme, että PFAPA –syndrooman diagnostisia kriteereitä tulisi muuttaa. Nielurisojen mikrobisto on erilainen kontrolleihin verrattuna ja tällä voi olla merkitystä PFAPA syndrooman inflammatorisessa prosessissa.

A ulceração aftosa recorrente (UAR) é considerada a doença ulcerativa mais frequente da cavidade bucal. Sua etiopatogenia ainda não está plenamente esclarecida, embora inúmeros fatores locais e sistêmicos já tenham sido a ela associados. Recentemente, a resposta imune anormal do tipo celular tem sido considerada a responsável pela lesão bucal na UAR, favorecendo uma resposta imunológica pró-inflamatória do tipo Th1, em conjunto com alterações em linfócitos T regulatórios. Sendo assim, o objetivo do presente estudo foi realizar análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 em pacientes com ulceração aftosa recorrente, por meio de estudo caso-controle. Os pacientes do grupo caso apresentavam quadros frequentes de UAR com pelo menos um ano de manifestação de surtos ulcerativos e história negativa de condições sistêmicas ou locais interferentes com a expressão das UAR. Estes foram submetidos a biópsia de lesão ulcerativa recente para a análise molecular. Os pacientes do grupo controle apresentavam história negativa de UAR, mucosa clinicamente saudável, e doaram voluntariamente fragmento de mucosa saudável para análise molecular, quando submetidos a procedimentos cirúrgicos como exodontia de terceiros molares ou biópsias ósseas. Todos os pacientes foram incluídos no grupo de pesquisa apenas após anuência com termo de consentimento livre e esclarecido. Submeteram-se a exame clínico, realizaram exames complementares para controle da saúde geral e suporte diagnóstico. Onze pacientes UAR e três controles voluntários compuseram a casuística estudada, sendo submetidos a biópsia de lesões de UAR ou de mucosa de revestimento sadia. As amostras de tecido bucal foram submetidas aos procedimentos laboratoriais de extração do RNA e análise da expressão gênica da FOXP3, MIP-3? e Interleucinas 2, 10 e 35 por meio da técnica de RT-PCR em tempo real. Não houve diferença significativa na expressão dos genes estudados entre as amostras de portadores de UAR e controles sadios. Concluímos que os genes aqui avaliados não parecem desempenhar papel distintivo na fase ulcerativa inicial das UAR, entretanto estudos adicionais são recomendados a fim de se verificar a real participação desses agentes da inflamação na expressão da doença. / Recurrent aphthous ulcers (RAU) is the most common ulcerative disease of the oral cavity. Its pathogenesis is poorly understood yet, although numerous local and systemic factors have been associated with it. Recently, abnormal immune response of cellular type has been considered responsible for the RAU oral lesions, promoting a pro-inflammatory immune response Th1-type, in conjunction with changes in regulatory T cells. Thus, the aim of this study was to analyze the gene expression of FOXP3, MIP-3? and interleukins 2, 10 and 35 in patients with recurrent aphthous ulceration through a case-control study. The case group of patients presented frequent RAU bouts with at least one year of manifestation of ulcerative outbreaks and negative history of local or systemic conditions interfering with the RAU expression. These patients were submitted to a biopsy procedure of a recent ulcerative lesion for molecular analysis. Patients in the control group presented no history of RAU, and agreed with a donation of a healthy mucosa fragment for molecular analysis when undergoing surgical procedures such as extraction of third molars or bone biopsies. All patients were included in the research group only after agreement with an informed consent. All subjects underwent clinical examination and were submitted to additional lab tests to check overall health and support diagnosis. Eleven RAU patients and three control volunteers composed the sample size and undergone biopsy of RAU lesions or healthy mucosal lining. The oral tissue samples were submitted to the laboratory procedures of RNA extraction and analysis of gene expression of FOXP3, MIP-3? and interleukins 2, 10, 35 by real time RT-PCR. There was no significant difference in gene expression between the studied samples of patients with RAU and healthy controls. It was concluded that the genes evaluated do not seem to play distinctive role in the initial ulcerative phase of RAU, however further studies are recommended in order to verify the actual participation of these inflammation agents in RAU expression.