Significantly Higher Salivary Opiorphin Concentrations Linked to Burning Mouth Syndrome, Study Reveals

Burning Mouth Syndrome is a chronic intraoral burning sensation lasting over 2 hours daily for at least 3 months, often accompanied by oral dryness, taste changes, and dysesthesia. Its global prevalence is 1.73%, rising to 8% among clinical patients, predominantly affecting middle-aged and elderly women. Psychological factors, anxiety, depression, and neuropathy are linked to BMS, though its exact cause remains unclear. Misdiagnosis and improper treatment can worsen symptoms, highlighting the need for multidisciplinary care.

No specific paraclinical parameters exist for diagnosing Burning Mouth Syndrome, which relies solely on clinical findings. Recent studies suggest that opiorphin, a natural analgesic in saliva, may influence BMS by modulating pain perception and exhibiting antidepressant effects. Considering this, Maryam Amirchaghmaghi, Mashhad University of Medical Sciences, Mashhad, Iran, and colleagues examined the association between salivary opiorphin levels, pain severity, and psychiatric scores to explore its role in BMS pathogenesis and treatment response.

For this purpose, the researchers conducted a cross-sectional study involving 28 BMS patients and 40 healthy individuals referred to the Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad, between September 2018 and August 2019. Participants with confirmed BMS, based on clinical and psychiatric evaluations, were included. Unstimulated salivary opiorphin levels were measured using ELISA, and statistical analysis was performed with SPSS version 24.

The investigation revealed the following findings:

• Salivary opiorphin levels were significantly higher in BMS patients (2.16 ± 0.30 ng/mL) compared to healthy subjects (1.80 ± 0.36 ng/mL).
• Opiorphin levels in BMS patients showed no significant change after psychiatric therapy.
• There was no significant association between opiorphin levels and variables such as age, gender, menopause, burning severity, anxiety, and depression status.

The study investigated salivary opiorphin concentrations in BMS patients and their association with anxiety and depression levels. The findings revealed that most BMS patients exhibited some degree of anxiety and depression. Initial opiorphin levels were significantly higher in the BMS group compared to controls. Although opiorphin levels showed only a slight, insignificant increase four weeks after treatment, there was a significant reduction in burning sensation intensity, anxiety, and depression.

The authors acknowledge a limitation in their study due to the small number of patients available for post-treatment assessment, which limited the ability to evaluate the effectiveness of psychiatric treatment.

"Further research is needed to confirm the link between opiorphin concentration and burning sensation severity in BMS patients. Salivary opiorphin levels may serve as a noninvasive tool for monitoring treatment outcomes and assessing BMS symptoms, depression, and anxiety during long-term follow-up," the researchers concluded.

Reference:

Dalirsani, Z., Amirchaghmaghi, M., Semnani, M. M., Talebi, M., Hashemy, S. I., Shakeri, M. T., & Taghizadeh, A. (2024). Comparison of Salivary Opiorphin in Burning Mouth Syndrome and Healthy Subjects and Its Correlation With Psychiatric Disorders. Clinical and Experimental Dental Research, 10(6), e934. https://doi.org/10.1002/cre2.934