Reviews
ALARMINS TSLP, IL-25, IL-33 AS A TARGET FOR THE DIAGNOSIS AND TREATMENT OF CHRONIC RECURRENT HERPETIC STOMATITIS
Published
2026-06-30
Authors:
SZ
AM
OS
IK
- Abstract:
-
Chronic recurrent herpetic stomatitis is one of the most prevalent viral diseases of the oral mucosa, with incompletely understood pathogenesis. This review systematizes current evidence on the role of epithelial alarmins – thymic stromal lymphopoietin, interleukin-33, and interleukin-25 – in the pathogenesis of chronic reccurent herpetic stomatitis. A concept of a self-perpetuating alarmin-driven pathogenetic cycle is proposed, along with immunological rationale for optimizing CRHS treatment by combining antiviral therapy with zinc supplementation and diode laser photobiomodulation.
- Keywords:
-
herpes simplex virus infection herpetic stomatitis interleukin-33 interleukin-25 alarmins thymic stromal lymphopoietin
- References:
-
- Al-Hallak MAG, Karkoutly M, Hsaian JA, Aljoujou AA. Effect of combined antimicrobial photodynamic therapy and photobiomodulation therapy in the management of recurrent herpes labialis: a randomized controlled trial. Sci Rep. 2025;15(1):16264. doi:10.1038/s41598-025-01331-5.
- Al Balah OF, Rafie M, Osama AR. Immunomodulatory effects of photobiomodulation: a comprehensive review. Lasers Med Sci. 2025;40(1):187. doi:10.1007/s10103-025-04417-8.
- Antony F, Kinha D, Nowińska A, Rouse BT, Suryawanshi A. The immunobiology of corneal HSV-1 infection and herpetic stromal keratitis. Clin Microbiol Rev. 2024;37(3):e0000624. doi:10.1128/cmr.00006-24.
- Bao Y, Chen Q, Shi B, Zhu X. The epithelial barrier: a Janus-faced regulator in allergic airway diseases from defense to inflammation. Front Allergy. 2025;6:1693611. doi:10.3389/falgy.2025.1693611.
- Boland H, Endres A, Kinscherf R. Protective effect of interferon type I on barrier function of human airway epithelium during rhinovirus infections in vitro. Sci Rep. 2024;14:30510. doi:10.1038/s41598-024-82516-2.
- Borowczyk J, Shutova M, Brembilla NC, Boehncke WH. IL-25 (IL-17E) in epithelial immunology and pathophysiology. J Allergy Clin Immunol. 2021;148(1):40–52. doi:10.1016/j.jaci.2020.12.628.
- Carmona-Rivera C, Carlucci PM, Moore E. NETs decorated with bioactive IL-33 infiltrate inflamed tissues and induce IFN-α production in patients with SLE. JCI Insight. 2021;6(23):e147937. doi:10.1172/jci.insight.147937.
- Chen KW, Broz P. Gasdermins as evolutionarily conserved executors of inflammation and cell death. Nat Cell Biol. 2024;26:1394–1406. doi:10.1038/s41556-024-01474-z.
- Chafe SC, Raby KL, Bhatt DL, Bhatt PM, Hughes MR, McNagny KM. Regulation of airway epithelial-derived alarmins in asthma: perspectives for therapeutic targets. Int J Mol Sci. 2024;25(20):11302. doi:10.3390/ijms252011302
- Coppola N, Cantile T, Adamo D. Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review. Clin Oral Invest. 2023;27:6333–6344. doi:10.1007/s00784-023-05250-5.
- Danga AK, Rath PC. Human buccal epithelial cells as a model system for molecular analysis of DNA, RNA and protein. Tissue Cell. 2024;87:102322. doi:10.1016/j.tice.2024.102322.
- Fang R, Jiang Q, Zhou X, Wang C, Guan Y, Tao J, et al. The race between host antiviral innate immunity and the immune evasion strategies of herpes simplex virus 1. Microbiol Mol Biol Rev. 2023;87(4):e00099-23. doi:10.1128/mmbr.00099-23.
- Feng X, Andersson T, Gschwend J. Tuft cell IL-17RB restrains IL-25 bioavailability and reveals context-dependent ILC2 hypoproliferation. Nat Immunol. 2025;26(4):567–581. doi:10.1038/s41590-025-02104-y.
- Gopinath D, Koe KH, Maharajan MK, Panda S. A comprehensive overview of epidemiology, pathogenesis and the management of herpes labialis. Viruses. 2023;15(1):225. doi:10.3390/v15010225.
- Guo Q. Dual immune regulatory roles of interleukin-33 in pathological conditions. Front Immunol. 2022;13:1016629. doi:10.3389/fimmu.2022.1016629.
- Guo X, An Y, Tan W. Cathelicidin-derived antiviral peptide inhibits herpes simplex virus 1 infection. Front Microbiol. 2023;14:1201505. doi:10.3389/fmicb.2023.1201505.
- Hassoun D, Malard O, Barbarot S, Magnan A, Colas L. Type 2 immunity-driven diseases: towards a multidisciplinary approach. Clin Exp Allergy. 2021;51(12):1538–1552. doi:10.1111/cea.14029.
- He Y, Liu Y, Ouyang J, Wang C, Liu J, Wu C, et al. IL-33-driven macrophage reprogramming as a potential immunometabolic strategy for herpes simplex keratitis. Pharmaceuticals (Basel). 2026;19(2):285. doi:10.3390/ph19020285.
- Hendel SK, Kellermann L, Hausmann A, Bindslev N, Jensen KB, Nielsen OH. Tuft cells and their role in intestinal diseases. Front Immunol. 2022;13:822867. doi:10.3389/fimmu.2022.822867.
- Hou J, Bao X, Zhang X, Feng J, Zhu Y, Zhou W, et al. Protective effect of zinc gluconate on intestinal mucosal barrier injury in antibiotics and LPS-induced mice. Front Microbiol. 2024;15:1407091. doi:10.3389/fmicb.2024.1407091.
- Liu J, Li B, Zhao B, Liu W, Yang F, Yang J, et al. IL-33 alleviates corneal nerve damage in herpes simplex keratitis. Int Immunopharmacol. 2025;159:114833. doi:10.1016/j.intimp.2025.114833.
- Nedeva D, Kowal K, Mihaicuta S, Guidos Fogelbach G, Steiropoulos P, Jose Chong-Neto H, et al. Epithelial alarmins: a new target to treat chronic respiratory diseases. Expert Rev Respir Med. 2023;17(9):773–786. doi:10.1080/17476348.2023.2262920.
- Piperi E, Papadopoulou E, Georgaki M, Dovrat S, Bar Illan M, Nikitakis NG, Yarom N. Management of oral herpes simplex virus infections: the problem of resistance. A narrative review. Oral Dis. 2024;30(3):877–894. doi:10.1111/odi.14635.
- Salvati L, Maggi L, Annunziato F, Cosmi L. Thymic stromal lymphopoietin and alarmins as possible therapeutical targets for asthma. Curr Opin Allergy Clin Immunol. 2021;21(6):590–596. doi:10.1097/ACI.0000000000000793
- Saran A, Nishizaki D, Lippman SM, Kato S, Kurzrock R. Interleukin-17: a pleiotropic cytokine implicated in inflammatory, infectious, and malignant disorders. Cytokine Growth Factor Rev. 2025;83:35–44. doi:10.1016/j.cytogfr.2025.01.002.
- Savchenko L, Mykytiuk M, Cinato M, Tronchere H, Kunduzova O, Kaidashev I. IL-26 in the induced sputum is associated with the level of systemic inflammation, lung functions and body weight in COPD patients. Int J Chron Obstruct Pulmon Dis. 2018;13:2569–2575. doi:10.2147/COPD.S164833.
- Smith JB, Herbert JJ, Truong NR, Cunningham AL. Cytokines and chemokines: the vital role they play in herpes simplex virus mucosal immunology. Front Immunol. 2022;13:936235. doi:10.3389/fimmu.2022.936235.
- Smolinska S, Antolín-Amérigo D, Popescu FD, Jutel M. Thymic stromal lymphopoietin (TSLP), its isoforms and the interplay with the epithelium in allergy and asthma. Int J Mol Sci. 2023;24(16):12725. doi:10.3390/ijms241612725.
- Spirito F, Sovereto D, Dioguardi M, et al. Topical and systemic therapeutic approaches in the treatment of oral herpes simplex virus infection: a systematic review. Int J Mol Sci. 2025;26(17):8490. doi:10.3390/ijms26178490
- Stanbery AG, Smita S, von Moltke J, Tait Wojno ED, Ziegler SF. TSLP, IL-33, and IL-25: not just for allergy and helminth infection. J Allergy Clin Immunol. 2022;150(6):1302–1313. doi:10.1016/j.jaci.2022.07.003.
- Su D, Han L, Shi C, Li Y, Qian S, Feng Z, Yu L. An updated review of HSV-1 infection-associated diseases and treatment, vaccine development, and vector therapy application. Virulence. 2024;15(1):2425744. doi:10.1080/21505594.2024.2425744.
- Traidl S, Roesner L, Zeitvogel J, Werfel T. Eczema herpeticum in atopic dermatitis. Allergy. 2021;76(10):3017–3027. doi:10.1111/all.14853.
- Widjaja AA, Chothani S, Viswanathan S, Goh JWT, Lim WW, Cook SA. IL11 stimulates IL33 expression and proinflammatory fibroblast activation across tissues. Int J Mol Sci. 2022;23(16):8900. doi:10.3390/ijms23168900.
- Williams TC, Loo SL, Nichol KS, Reid AT, Veerati PC, Esneau C, et al. IL-25 blockade augments antiviral immunity during respiratory virus infection. Commun Biol. 2022;5(1):415. doi:10.1038/s42003-022-03367-z.
- Wu J, Zhang F, Tao H, Nawaz W, Chen D, Wu Z. The potential roles of interleukin-25 in infectious diseases. Front Immunol. 2022;13:986118. doi:10.3389/fimmu.2022.986118.
- Yamanishi K, Imai Y. Alarmins/stressorins and immune dysregulation in intractable skin disorders. Allergol Int. 2021;70(4):421–429. doi:10.1016/j.alit.2021.05.005.
- Zeitvogel J, Döhner K, Klug I, Richardo T, Sodeik B, Werfel T. Short-form thymic stromal lymphopoietin (sfTSLP) restricts herpes simplex virus infection of human primary keratinocytes. J Med Virol. 2024;96(9):e29865. doi:10.1002/jmv.29865.
- Zhang Y, Lo K, Wang C, Zhou G, Feng X, Ni J, Chen X. Herpes simplex virus-induced upregulation of inflammatory cytokines in human gingival fibroblasts. Virol J. 2024;21(1):323. doi:10.1186/s12985-024-02595-5.
- Zhang Y, Lo KL, Wang CM, Feng XP, Ni J, Chen X. Inflammatory cytokine changes in herpes simplex virus infected periodontium: an in vitro proteomic study. Oral Dis. 2025. doi:10.1111/odi.70167.
- Zhao J, Wei K, Chang C, et al. Role of IL-33-ST2 pathway in regulating inflammation: current evidence and future perspectives. J Transl Med. 2023;21(1):902. doi:10.1186/s12967-023-04782-4.
- Publication:
-
«World of Medicine and Biology»
Vol. 22 No. 96 (2026)
, с. 211-220
УДК 616.31-002:616.523-07-08
How to Cite
1.
Zadorozhna S, Marchenko A, Shlykova O, Kaidashev I. ALARMINS TSLP, IL-25, IL-33 AS A TARGET FOR THE DIAGNOSIS AND TREATMENT OF CHRONIC RECURRENT HERPETIC STOMATITIS. СМБ [Internet]. 2026 Jun. 30 [cited 2026 Jul. 4];22(96):211-20. Available from: https://womab.com.ua/article/view/4134
Share

English
Ukrainian