Gülsün Hazan TABAK, Ayşen KARADUMAN, Burçin ŞENER
Turkish Journal of Dermatology - 2026;20(1):33-38
Aim: Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa. Recently, it has been emphasized that an impaired intestinal barrier is involved in the development of inflammatory diseases. Zonulin, which reversibly increases intestinal permeability, may be involved in this process. We aimed to reveal the potential effect of intestinal permeability on the etiopathogenesis of RAS by measuring serum levels of zonulin. Materials and Methods: This prospective case-control study included patients aged 18 to 65 years who were diagnosed with RAS, and a healthy control group. Serum zonulin levels in the groups were evaluated using the enzyme-linked immunosorbent assay. Results: A total of 78 individuals were included: 27 diagnosed with RAS who had active ulcers, 25 diagnosed with RAS without ulcers, and 26 healthy controls. In the patient groups, serum zonulin levels were significantly higher than that in the healthy control group (127.32 +/- 61.52 ng/mL, 121.04 +/- 62.88 ng/mL, 89.22 +/- 49.51 ng/mL, respectively; P < 0.05). Conclusion: This study has demonstrated that serum zonulin levels are increased in patients with RAS. Increased serum zonulin levels suggest that leaky gut may be an etiological factor in the pathophysiology of RAS.
