A Link Between Dietary Modifications Focused on Unsaturated Fatty Acids and the Course of Oral Autoimmune Diseases: A Systematic Review.

Background/

Objectives

The aim of this systematic review was to analyze the impact of dietary modifications on unsaturated fatty acids (UFAs) intake on the course of three oral autoimmune conditions: oral lichen planus (OLP), recurrent aphthous stomatitis (RAS), and pemphigus. These acids serve a structural function as key components of cell membrane phospholipids, influencing their fluidity and membrane receptor activity. The proper ratio of these acids in the diet may be crucial for maintaining normal functioning of the human immune system.

Methods

The following bases were searched with no time restrictions: PUMS Library, Embase/Elsevier, PubMed/MEDLINE, Scopus, and Web of Science. Of the 247 results identified in pre-screening, 6 studies that met all search criteria were included in the final systematic review. The risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for randomized trials and the Newcastle-Ottawa Scale for non-randomized studies.

Results

The outcome measures included: proportions of LA-derived oxylipins (9-HODE, 13-HODE), ulcer size (mm), monthly number of ulcers, average pain (VAS), duration of episodes, and quality of life (OHIP-14), healing time, and fatty acid analysis of total plasma phospholipid fraction, Pemphigus Disease Area Index (PDAI) for disease severity (mild ≤ 15, severe > 15); AHEI-2010 score (9-90 points) for diet quality. In all studies, improvements in clinical parameters and subjective complaints were observed after implementing a dietary intervention.

Conclusions

Dietary modification may be a valuable component of adjunctive therapy. Nutritional optimization offers a genuine opportunity to reduce reliance on conventional pharmaceuticals, thereby limiting the risk of systemic adverse effects associated with long-term pharmacotherapy.