以乳鐵蛋白輔助治療貓淋巴球漿細胞性口炎

Abstract

貓淋巴球漿細胞性口炎 (feline lymphoplasmacytic stomatitis, FLPS) 是一種會造成口腔黏膜具疼痛的糜爛與增生的炎症疾病。罹患FLPS的患貓可能在年幼時就發病，難以痊癒會需要終生依賴藥物的治療。本實驗試驗一種合併乳鐵蛋白口腔噴劑 (bovine lactoferrin oral spray)與piroxicam 的新療法。以隨機雙盲對照實驗 (randomized double-blinded clinical trial)方式進行，對象為13隻罹患FLPS的貓。實驗中以口腔病灶嚴重程度與臨床症狀評分的變化進行藥物療效的評估。全血球計數與血清生化學檢查用於進行麻醉安全性與肝腎功能評估。一系列的口腔黏膜組織採樣，用於檢查在治療前、中、後，組織學下的變化。結果中指出，77 % 的患貓在本實驗的治療下，臨床症狀得到良好的改善。在短期評估中，piroxicam可以在兩週內快速的緩解臨床症狀。而長期評估中，乳鐵蛋白口腔噴劑合併piroxicam可進一步提升治療效果，於12週的治療後，有效緩解口腔病灶(P=0.059)，顯著改善臨床症狀(P<0.05)、提升生活品質(P<0.05)、與增加體重(P<0.05)。口腔病灶的改善與黏膜中巨噬細胞數量的減少有顯著相關 (OR 4.719, P<0.05)。此外在12週治療期間，並沒有發現明顯的臨床副作用，或是對肝腎功能的任何影響。總結而言，合併乳鐵蛋白口腔噴劑與piroxicam是安全有效的治療方法，可以作為FLPS的第一線選擇。

Feline lymphoplasmacytic stomatitis (FLPS) is an inflammatory disease that led to painfully erosive lesions and proliferations of the oral mucosa. The FLPS patients may be affected in early age, difficult to be cured, and probably needed a lifetime therapy. In this study, a novel therapeutic modality that combined with bovine lactoferrin (bLf) oral spray and piroxicam was investigated by a randomized double-blinded clinical trial in 13 FLPS patients. The oral lesion grading and symptomatic scoring were performed to assess the clinical outcome during and after the therapy. A CBC and serum chemistry profiles were conducted for the anesthetic safety assessment and the functional evaluation of liver and kidneys. A series of oral mucosa biopsies were used for evaluating the histological changes during, before, and after the treatment. Results indicated that clinical symptoms were well improved in 77 % of FLPS patients. In the short-term (4 weeks) study, the clinical symptoms were significantly ameliorated by oral piroxicam within 2 weeks. In the long- term (12 weeks) study, the combined bLf oral spray and piroxicam could further reinforce the previous effect and lead to a visible amelioration of oral lesions (P=0.059), and a significant improvement of clinical symptoms (P<0.05), quality of life (P<0.05), and weight gain (P<0.05). The remission of oral inflammation was significantly correlated with the decreased number of macrophages in oral mucosa (OR = 4.719, P<0.05). Furthermore, there was neither clinical side-effects nor detectable liver or kidney influence in a 12-week assessment. In conclusion, the combined oral bLf spray and piroxicam was a safe therapeutic method and was suggested as a primary choice of treatment modality for the FLPS patients.