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Larsen KR, Johansen JD, Reibel J, Zachariae C, Rosing K, Pedersen AML. Filaggrin gene mutations and the distribution of filaggrin in oral mucosa of patients with oral lichen planus and healthy controls. J Eur Acad Dermatol Venereol 2017; 31:887-893. [PMID: 28000306 DOI: 10.1111/jdv.14098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/02/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disease of unknown aetiology affecting the skin and oral mucosa. Oral lichenoid lesions (OLLs), like oral contact reactions, may resemble oral lichen planus (OLP) both clinically and histopathologically. As OLP and OLL are hyperkeratotic diseases and filaggrin is essential to keratinization, the distribution of filaggrin may be altered in these lesions. OBJECTIVES To investigate whether patients with OLP/OLL have (i) altered distribution of filaggrin in the oral mucosa; (ii) a higher incidence of mutations in the filaggrin gene (FLG); (iii) active dermatoses, apart from cutaneous LP, than healthy controls; and (iv) patients with OLP/OLL and a defect in the FLG have more widespread oral lesions and report more symptoms than OLP/OLL patients without a concomitant defect in the FLG. METHODS Forty-nine Caucasian patients (42 women and 7 men, mean age 61.0 ± 10.3 years), with symptomatic OLP, OLL or stomatitis, and 29 matched healthy controls underwent a clinical oral and dermatological examination, oral mucosal biopsy and filaggrin genotyping (testing for R2447X, R501X, 2282del4). Smear tests for Candida spp. were performed in all patients to exclude oral candidiasis. Immunohistochemistry were performed using poly- and monoclonal filaggrin antibodies. RESULTS The immunoreactivity for filaggrin was significantly more intense in the oral mucosa in the patients with OLP/OLL compared with healthy controls (P = 0.000025). No difference was noted in the incidence of defects in the FLG and active dermatoses between patients and healthy controls. No difference was noted in extension and number of symptoms reported by patients with OLP/OLL with or without a concomitant defect in the FLG. CONCLUSION OLP/OLL is associated with an altered distribution of filaggrin in the oral mucosa independently of defects in the FLG. Patients with OLP/OLL did not display more active dermatoses other than cutaneous LP when compared to healthy controls.
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Affiliation(s)
- K R Larsen
- Department of Odontology, Oral Pathology and Oral Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - J D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Gentofte University Hospital, Hellerup, Denmark
| | - J Reibel
- Department of Odontology, Oral Pathology and Oral Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - C Zachariae
- Department of Dermatology and Allergy, Gentofte University Hospital, Hellerup, Denmark
| | - K Rosing
- Department of Odontology, Faculty of Health and Medical Sciences, Community Dentistry, University of Copenhagen, Copenhagen N, Denmark
| | - A M L Pedersen
- Department of Odontology, Oral Pathology and Oral Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
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Kluger N. Radiation-associated lichen planus: a case report and literature review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2017; 26:105-108. [DOI: 10.15570/actaapa.2017.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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103
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RIMKEVIČIUS A, ALEKSEJŪNIENĖ J, PŪRIENĖ A, ŠEININ D, RASTENIENĖ R. Oral lichen planus: a 4-year clinical follow-up study. Turk J Med Sci 2017; 47:514-522. [DOI: 10.3906/sag-1511-94] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 09/11/2016] [Indexed: 11/03/2022] Open
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Cao T, Zhang H, Zhou L, Wang Y, Du G, Yao H, Wang Y, Luo Q, Chen F, Wang W, Tang G. In vitrocell culture system optimization of keratinocytes from oral lichen planus (OLP) patients. Oral Dis 2016; 23:225-232. [PMID: 27763705 DOI: 10.1111/odi.12599] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 09/24/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
Affiliation(s)
- T Cao
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
- Department of Endodontics and Oral Medicine; Nantong Stomatological Hospital; Nantong China
| | - H Zhang
- Department of Clinical Immunology; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - L Zhou
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Y Wang
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - G Du
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - H Yao
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Y Wang
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Q Luo
- Department of Clinical Immunology; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - F Chen
- Department of Clinical Immunology; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - W Wang
- Department of Periodontology and Oral Medicine; Qingdao Stomatological Hospital; Qingdao China
| | - G Tang
- Department of Oral Medicine; Shanghai Ninth People's Hospital; Shanghai Jiao Tong University School of Medicine; Shanghai China
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105
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Shen Z, Zhang C, Zhou Z, Liu W, Shi L, Shen X. Altered expression of interleukin-17A and its targeting microRNAs in oral lichen planus: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:619-624.e1. [PMID: 27765331 DOI: 10.1016/j.oooo.2016.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/14/2016] [Accepted: 07/08/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To investigate the potential role of interleukin (IL)-17A and its targeting microRNAs (miRNAs) in oral lichen planus (OLP). STUDY DESIGN We compared the IL-17A expression levels in biopsies from patients with OLP (n = 50) against normal controls (n = 19) by using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blot analyses, identified the targeting miRNAs of IL-17A, and examined the miRNA expression levels in OLP. RESULTS IL-17A expression was significantly increased in patients with OLP compared with controls. The dual-luciferase reporter assay system demonstrated that miR-635 and miR-578 were the target miRNAs of IL-17A in human embryonic kidney 293 cells, which was consistent with predictions from bioinformatics software analyses. In contrast with IL-17A, the expression levels of miR-635 and miR-578 in OLP were significantly decreased compared with controls. CONCLUSIONS This pilot study found that low levels of miR-635 and miR-578 expression were associated with high expression of IL-17A, suggesting that IL-17A and its targeting miRNAs contribute to the pathogenesis of OLP.
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Affiliation(s)
- Zhengyu Shen
- Department of Dermatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenping Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Alves de Medeiros AK, Speeckaert R, Desmet E, Van Gele M, De Schepper S, Lambert J. JAK3 as an Emerging Target for Topical Treatment of Inflammatory Skin Diseases. PLoS One 2016; 11:e0164080. [PMID: 27711196 PMCID: PMC5053514 DOI: 10.1371/journal.pone.0164080] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/19/2016] [Indexed: 12/19/2022] Open
Abstract
The recent interest and elucidation of the JAK/STAT signaling pathway created new targets for the treatment of inflammatory skin diseases (ISDs). JAK inhibitors in oral and topical formulations have shown beneficial results in psoriasis and alopecia areata. Patients suffering from other ISDs might also benefit from JAK inhibition. Given the development of specific JAK inhibitors, the expression patterns of JAKs in different ISDs needs to be clarified. We aimed to analyze the expression of JAK/STAT family members in a set of prevalent ISDs: psoriasis, lichen planus (LP), cutaneous lupus erythematosus (CLE), atopic dermatitis (AD), pyoderma gangrenosum (PG) and alopecia areata (AA) versus healthy controls for (p)JAK1, (p)JAK2, (p)JAK3, (p)TYK2, pSTAT1, pSTAT2 and pSTAT3. The epidermis carried in all ISDs, except for CLE, a strong JAK3 signature. The dermal infiltrate showed a more diverse expression pattern. JAK1, JAK2 and JAK3 were significantly overexpressed in PG and AD suggesting the need for pan-JAK inhibitors. In contrast, psoriasis and LP showed only JAK1 and JAK3 upregulation, while AA and CLE were characterized by a single dermal JAK signal (pJAK3 and pJAK1, respectively). This indicates that the latter diseases may benefit from more targeted JAK inhibitors. Our in vitro keratinocyte psoriasis model displayed reversal of the psoriatic JAK profile following tofacitinib treatment. This direct interaction with keratinocytes may decrease the need for deep skin penetration of topical JAK inhibitors in order to exert its effects on dermal immune cells. In conclusion, these results point to the important contribution of the JAK/STAT pathway in several ISDs. Considering the epidermal JAK3 expression levels, great interest should go to the investigation of topical JAK3 inhibitors as therapeutic option of ISDs.
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Affiliation(s)
- Ana Karina Alves de Medeiros
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
- Department of Dermatology, Ghent University, Ghent, Belgium
- * E-mail:
| | - Reinhart Speeckaert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
- Department of Dermatology, Ghent University, Ghent, Belgium
| | - Eline Desmet
- Department of Dermatology, Ghent University, Ghent, Belgium
| | | | - Sofie De Schepper
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
- Department of Dermatology, Ghent University, Ghent, Belgium
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107
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Ma J, Zhang J, Zhang Y, Lv T, Liu J. The Magnitude of the Association between Human Papillomavirus and Oral Lichen Planus: A Meta-Analysis. PLoS One 2016; 11:e0161339. [PMID: 27571417 PMCID: PMC5003373 DOI: 10.1371/journal.pone.0161339] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 08/03/2016] [Indexed: 12/03/2022] Open
Abstract
Background The role of human papilloma virus (HPV) in oral lichen planus (OLP) is controversial. Objectives The primary aim of the current study is to calculate the pooled risk estimates of HPV infection in OLP when compared with healthy controls. Methods Bibliographic searches were conducted in three electronic databases. Articles on the association between HPV and OLP were selected from case-control studies or cross-sectional studies, following predefined criteria. Pooled data were analyzed by calculating odds ratios (OR) and 95% confidence interval (CI). Results Of the 233 publications identified, 22 case-control studies met the inclusion criteria. Collectively, 835 cases and 734 controls were available for analysis. The summary estimate showed that OLP patients have significantly higher HPV prevalence (OR: 6.83; 95% CI: 4.15–11.27) than healthy controls. In subgroup analyses, the association of HPV and OLP varied significantly by geographic populations. The ORs ranged from 2.43 to 132.04. The correlation of HPV and erosive-atrophic oral lichen planus (EA-OLP) (OR: 9.34) was comparable and well above that of HPV and non-EA-OLP (OR: 4.32). Among HPV genotypes, HPV 16 showed an extremely strong association with OLP (OR: 11.27), and HPV 18 showed a relatively strong one (OR: 6.54). Conclusion In conclusion, a significant association was found between HPV and OLP. The strength of the association varied across geographic populations, clinical types of OLP, and HPV genotypes. The results suggest that HPV might play an important causal role in OLP and in its malignant to progression.
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Affiliation(s)
- Junxian Ma
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
| | - Jinshan Zhang
- Department of Human Anatomy and Histology and Embryology, The Fourth Military Medical University, Xi'an, China
| | - Yan Zhang
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
- * E-mail:
| | - Tingting Lv
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
| | - Jie Liu
- Department of Rheumatology and Immunology, Tangdu hospital, The Fourth Military Medical University, Xi'an, China
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108
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Shen Z, Du G, Zhou Z, Liu W, Shi L, Xu H. Aberrant expression of interleukin-22 and its targeting microRNAs in oral lichen planus: a preliminary study. J Oral Pathol Med 2016; 45:523-7. [PMID: 26711064 DOI: 10.1111/jop.12404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a T cell-mediated autoimmune disease involving oral mucosa. Interleukin-22 (IL-22) as the signature cytokine of T helper 22 cells is increasingly recognized as a key regulator in various autoimmune diseases. Our previous study reported that IL-22 immunoexpression in OLP was significantly increased compared with the normal controls. METHODS The objective of this preliminary study was to compare the IL-22 expression levels in oral biopsies from patients with OLP (n = 50) against normal oral mucosa (n = 19) using RT-qPCR and Western blot, identify the potential targeting miRNAs of IL-22, and examine the miRNA expression levels in OLP. RESULTS Interleukin-22 expression level in OLP was significantly increased compared with the normal controls. The Dual-Luciferase reporter assay system in human embryonic kidney 293 (HEK293) cells demonstrated that miR-562 and miR-203 were the target miRNAs of IL-22, which was consistent with predictions from bioinformatics software analyses. Interestingly, miR-562 expression in OLP was significantly decreased, but miR-203 expression in OLP was significantly increased compared with the normal controls. CONCLUSION This preliminary study for the first time reported that aberrant expression levels of miR-562 and miR-203 were associated with high expression of IL-22 and demonstrated the target relationship between miRNAs and IL-22 in HEK293 cells. Our data indicated that IL-22 and its targeting miRNAs contribute to the pathogenesis of OLP. Further studies are required to investigate the regulatory pathways of IL-22 and miR-562 and miR-203 in OLP.
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Affiliation(s)
- Zhengyu Shen
- Department of Dermatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanhuan Du
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Key Laboratory of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Xu
- Department of Dermatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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109
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Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:332-54. [PMID: 27401683 DOI: 10.1016/j.oooo.2016.05.004] [Citation(s) in RCA: 277] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/26/2022]
Abstract
Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA.
| | - Alan Gould
- Louisville Oral Pathology Laboratory, Louisville, KY, USA
| | - Zoya Kurago
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Augusta University, Augusta, GA, USA
| | - John Fantasia
- Department of Dental Medicine, Hofstra North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA
| | - Susan Muller
- Professor Emeritus, Emory University School of Medicine, Atlanta, GA; Atlanta Oral Pathology, Decatur, GA, USA
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110
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The presence of bacteria within tissue provides insights into the pathogenesis of oral lichen planus. Sci Rep 2016; 6:29186. [PMID: 27383402 PMCID: PMC4935860 DOI: 10.1038/srep29186] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/16/2016] [Indexed: 12/14/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic T cell-mediated mucocutaneous disease of unknown etiopathogenesis. Although various antigens have been considered, what actually triggers the inflammatory response of T cells is unknown. In the present study, we propose that intracellular bacteria present within tissues trigger T cell infiltration and provide target antigens. Sections of OLP (n = 36) and normal (n = 10) oral mucosal tissues were subjected to in situ hybridization using a universal probe targeting the bacterial 16S rRNA gene and immunohistochemistry with anti-CD3, anti-CD4, anti-CD8, and anti-macrophage-specific antibodies. Bacteria were abundant throughout the epithelium and the lamina propria of OLP tissues, which exhibited positive correlations with the levels of infiltrated CD3(+), CD4(+), and CD8(+) cells. Furthermore, bacteria were detected within the infiltrated T cells. Pyrosequencing analysis of the mucosal microbiota from OLP patients (n = 13) and control subjects (n = 11) revealed a decrease in Streptococcus and increases in gingivitis/periodontitis-associated bacteria in OLP lesions. Using the selected bacterial species, we demonstrated that certain oral bacteria damage the epithelial physical barrier, are internalized into epithelial cells or T cells, and induce production of T cell chemokines CXCL10 and CCL5. Our findings provide insights into the pathogenesis of OLP.
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111
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Wang Y, Zhang H, Du G, Wang Y, Cao T, Luo Q, Chen J, Chen F, Tang G. Total glucosides of paeony (TGP) inhibits the production of inflammatory cytokines in oral lichen planus by suppressing the NF-κB signaling pathway. Int Immunopharmacol 2016; 36:67-72. [DOI: 10.1016/j.intimp.2016.04.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 03/14/2016] [Accepted: 04/07/2016] [Indexed: 01/15/2023]
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112
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Zhou L, Cao T, Wang Y, Yao H, Du G, Tian Z, Tang G. Clinical observation on the treatment of oral lichen planus with total glucosides of paeony capsule combined with corticosteroids. Int Immunopharmacol 2016; 36:106-110. [DOI: 10.1016/j.intimp.2016.03.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/25/2016] [Accepted: 03/29/2016] [Indexed: 01/09/2023]
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113
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Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res 2016; 308:539-51. [PMID: 27349424 DOI: 10.1007/s00403-016-1667-2] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/16/2016] [Accepted: 06/17/2016] [Indexed: 12/22/2022]
Abstract
Lichen planus (LP) is a common chronic inflammatory condition that can affect skin and mucous membranes, including the oral mucosa. Because of the anatomic, physiologic and functional peculiarities of the oral cavity, the oral variant of LP (OLP) requires specific evaluations in terms of diagnosis and management. In this comprehensive review, we discuss the current developments in the understanding of the etiopathogenesis, clinical-pathologic presentation, and treatment of OLP, and provide follow-up recommendations informed by recent data on the malignant potential of the disease as well as health economics evaluations.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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114
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Suter VGA, Negoias S, Friedrich H, Landis BN, Caversaccio MD, Bornstein MM. Gustatory function and taste perception in patients with oral lichen planus and tongue involvement. Clin Oral Investig 2016; 21:957-964. [DOI: 10.1007/s00784-016-1860-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/23/2016] [Indexed: 12/21/2022]
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115
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Siponen M, Bitu CC, Al-Samadi A, Nieminen P, Salo T. Cathepsin K expression is increased in oral lichen planus. J Oral Pathol Med 2016; 45:758-765. [PMID: 27152719 DOI: 10.1111/jop.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Oral lichen planus (OLP) is an idiopathic T-cell-mediated mucosal inflammatory disease. Cathepsin K (Cat K) is one of the lysosomal cysteine proteases. It is involved in many pathological conditions, including osteoporosis and cancer. The expression and role of Cat K in OLP are unknown. METHODS Twenty-five oral mucosal specimens diagnosed histopathologically as OLP and fourteen healthy controls (HC) were used to study the immunohistochemical (IHC) expression of Cat K. Colocalization of Cat K with CD1a, Melan-A, CD68, CD45, mast cell tryptase (MCT), and Toll-like receptors (TLRs) 4 and 9 were studied using double IHC and/or immunofluorescence (IF) staining. Expression of Cat K was also evaluated in OLP tissue samples before and after topical tacrolimus treatment. RESULTS Cat K was expressed in a higher percentage of cells in the epithelial zone, and the staining intensity was stronger in the stroma in OLP compared to controls (P < 0.001). In OLP, Cat K was present mostly in melanocytes and macrophages and sporadically in basal keratinocytes, endothelial cells, and extracellularly. Cat K was found also in some fibroblasts in HC and OLP samples. Coexpression of Cat K and TLRs 4 and 9 was seen in some dendritic cells (presumably melanocytes) and macrophages. In OLP, tacrolimus treatment reduced the expression of Cat K in the epithelium but increased it in the stroma. CONCLUSIONS These results suggest that Cat K is involved in the pathogenesis of OLP. Cat K possibly takes part in the modulation of matrix molecules and cellular receptors.
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Affiliation(s)
- Maria Siponen
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland. , .,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland. ,
| | | | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Pentti Nieminen
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Tuula Salo
- Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland.,HUSLAB, Department of Pathology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
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116
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Lauritano D, Arrica M, Lucchese A, Valente M, Pannone G, Lajolo C, Ninivaggi R, Petruzzi M. Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis. Head Face Med 2016; 12:18. [PMID: 27113338 PMCID: PMC4845340 DOI: 10.1186/s13005-016-0115-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Background Oral lichen Planus (OLP) is a chronic inflammatory disease involving skin and mucous membranes. Its etiology is still uncertain whilst an autoimmune mechanism is known to be implicated. OLP is commonly considered a geriatric disease and gender differences in prevalence are clear, whereby females are generally more frequently affected than males more often during the 5th and 6th decades of life. Lesions are symmetrical and bilateral and the buccal mucosa is frequently involved. The risk of malignant transformation is extremely low. This study aims to describe both the clinical characteristics and the prevalence of OLP among a group of patients from Southern Italy. The results of the present study were compared to analogous retrospective studies. Methods Eighty-seven (31 man and 56 woman) cases of OLP were retrospectively reviewed and demographic and clinical data were collected. Data about OLP as clinical forms, oral and extraoral sites involved and Visual Analogue Scale were also recorded. Results The average age of OLP onset was 59.2 years. The most common clinical presentation was the hyperkeratosic type. Symptomatic OLP was noted in 26.8 % of the patiens. The most frequently affected oral sites were buccal mucosa, tongue, gums. The most frequently associated systemic diseases were diabetes, hypertension, C hepatitis and thyroiditis. Only one patient developed a malignant transformation (1.2 %). Conclusions Previous retrospective studies report data partially comparable with our results. Different geographic area, number of enrolled patients and OLP classification criteria may justify the observed differences.
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Affiliation(s)
- Dorina Lauritano
- Department of Translational Medicine and Surgery Neuroscience Centre of Milan, University of Milano Bicocca, Monza, Italy
| | | | - Alberta Lucchese
- Dental Clinic of Second Universty of Naples (SUN), Naples, Italy
| | - Marina Valente
- Section of Pathology of University of Foggia, Foggia, Italy
| | | | - Carlo Lajolo
- School of Dentistry, Chatolic University, Rome, Italy
| | - Rossella Ninivaggi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Clinica odontoiatrica del Policlinico di Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Clinica odontoiatrica del Policlinico di Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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Dudhia BB, Dudhia SB, Patel PS, Jani YV. Oral lichen planus to oral lichenoid lesions: Evolution or revolution. J Oral Maxillofac Pathol 2016; 19:364-70. [PMID: 26980966 PMCID: PMC4774291 DOI: 10.4103/0973-029x.174632] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The diagnosis between different diseases may be impaired by clinical and histopathologic similarities, as observed in the oral lichen planus (OLP) and oral lichenoid lesion (OLL). Inspite of similar clinicopathological features; etiology, diagnosis and prognosis differ which mandates separation of OLL from OLP. Hence, it is essential for the oral physician and oral pathologist to be familiarized with the individual variations among clinicopathological features of OLP and OLL as well as to obtain a thorough history and perform a complete mucocutaneous examination in addition to specific diagnostic testing. The difficulties faced to establish the diagnosis between these two pathologies are widely investigated in the literature with a lack of definite conclusion. This review is an attempt to throw some light on these clinicopathologic entities with the aim to resolve the diagnostic dilemma.
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Affiliation(s)
- Bhavin B Dudhia
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Sonal B Dudhia
- Department of Oral Medicine and Radiology, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Purv S Patel
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Yesha V Jani
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
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118
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Altered Autophagy-Associated Genes Expression in T Cells of Oral Lichen Planus Correlated with Clinical Features. Mediators Inflamm 2016; 2016:4867368. [PMID: 26980945 PMCID: PMC4770128 DOI: 10.1155/2016/4867368] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/13/2016] [Accepted: 01/13/2016] [Indexed: 01/01/2023] Open
Abstract
Oral lichen planus (OLP) is a T cell-mediated inflammatory autoimmune disease. Autophagy has emerged as a fundamental trafficking event in mediating T cell response, which plays crucial roles in innate and adaptive immunity. The present study mainly investigated the mRNA expression of autophagy-associated genes in peripheral blood T cells of OLP patients and evaluated correlations between their expression and the clinical features of OLP. Five differentially expressed autophagy-associated genes were identified by autophagy array. Quantitative real-time RT-PCR results confirmed that IGF1 expression in the peripheral blood T cells of OLP patients was significantly higher than that in controls, especially in female and middle-aged (30-50 years old) OLP patients. In addition, ATG9B mRNA levels were significantly lower in nonerosive OLP patients. However, no significant differences were found in the expression of HGS, ESR1, and SNCA between OLP patients and controls. Taken together, dysregulation of T cell autophagy may be involved in immune response of OLP and may be correlated with clinical patterns.
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119
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Possible alternative therapies for oral lichen planus cases refractory to steroid therapies. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:496-509. [PMID: 27068310 DOI: 10.1016/j.oooo.2016.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/15/2016] [Accepted: 02/02/2016] [Indexed: 02/05/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disorder with a multifactorial etiopathogenesis. Immune dysregulation plays a critical role in the development and progression of this disease. Patients' lives may be affected by pain caused by atrophic-erosive lesions. Given the obscure etiology, treatment is usually symptomatic. Topical steroids remain the mainstay of management. However, their therapeutic benefits are not always evident. There are substantial data on the possible therapeutic strategies that are effective in OLP cases refractory to steroids. This review provides an overview of the current approaches for the management of steroid-refractory OLP. The miscellaneous treatment regimens include tacrolimus, pimecrolimus, thalidomide, low-level laser therapy, photodynamic therapy, and surgical excision. Some results obtained from these studies were promising. However, further studies, especially randomized controlled trials with strict inclusion and exclusion criteria and larger sample sizes, are required for the evaluation of the long-term safety and efficacy of these therapies.
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120
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Pippi R, Romeo U, Santoro M, Del Vecchio A, Scully C, Petti S. Psychological disorders and oral lichen planus: matched case-control study and literature review. Oral Dis 2016; 22:226-34. [PMID: 26680999 DOI: 10.1111/odi.12423] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/08/2015] [Accepted: 12/09/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) may be linked to psychological disorders. This study investigated psychological factors associated with OLP. METHODS A case-control study with incident OLP case patients and age-gender-socio-economic status-matched controls, recruited from among relatives, accompanying persons, and departmental staff, investigated psychological traits using the Psychological General Well-Being Index-Short form. Common factor analysis was used to generate a set of psychological dimensions. The association between these dimensions and OLP adjusted for confounders (education, number of lifetime sexual partners, drinking-smoking) and interactions was assessed through conditional logistic regression and odds ratios (OR) were estimated. RESULTS A total of 67 case-control pairs were recruited. Psychological dimensions generated were: dimension-1 (anxiety, low vitality), dimension-2 (negative well-being, low vitality), dimension-3 (depressed mood, low self-control). The ORs for OLP were, dimension-1, 1.0 (95% confidence interval -95CI, 0.3-2.6); dimension-2, 0.5 (95CI, 0.2-1.2); dimension-3, 4.8 (95CI, 1.8-12.9). Dimension-3 was highly associated with mild, but not associated with severe, OLP. Literature searching provided 21 studies, with anxiety and depression principally associated with OLP. CONCLUSIONS Depressed mood and low self-control were highly associated with OLP, particularly the reticular-papular forms. These traits could have a causative role in OLP development-progression, but further investigations are necessary.
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Affiliation(s)
- R Pippi
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - U Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - M Santoro
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - A Del Vecchio
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - C Scully
- World Health Organisation Collaborating Centre for Oral Health-General Health, London, UK.,University College London, London, UK
| | - S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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121
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Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study. Dermatology 2016; 232:214-9. [PMID: 26784745 DOI: 10.1159/000442438] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thyroid disease has been mentioned to have a possible relation to the development of oral lichen planus (OLP). OBJECTIVE Because goiter is considered endemic in many countries, we proposed to determine whether thyroid disease constitutes a comorbidity of OLP. METHODS Two hundred and fifteen patients diagnosed as having OLP were evaluated concerning their serum thyroid-stimulating hormone and thyroxine (T4) levels. The results were contrasted with those obtained in control series of the same number of subjects matched for age and sex. RESULTS Diagnosis of thyroid disease was present in 15.3% of OLP patients (33/215) and in 5.2% (12/215) of the control group. In relation to OLP patients, the odds ratio of presence of thyroid disorders was 3.06 and that of using levothyroxine medication 3.21. CONCLUSIONS In the present study, OLP patients were associated with thyroid disease, specifically with hypothyroidism. Because most thyroid patients need T4 treatment, our findings confirmed that OLP and thyroid disease could be comorbidities.
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Alrashdan MS, Angel C, Cirillo N, McCullough M. Smoking habits and clinical patterns can alter the inflammatory infiltrate in oral lichenoid lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:49-57. [DOI: 10.1016/j.oooo.2015.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/13/2015] [Accepted: 08/24/2015] [Indexed: 12/26/2022]
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MENDEZ M, HAAS AN, RADOS PV, SANT’ANA FILHO M, CARRARD VC. Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms. Braz Oral Res 2016; 30:e94. [DOI: 10.1590/1807-3107bor-2016.vol30.0094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/23/2016] [Indexed: 11/21/2022] Open
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Lombardi T, Küffer R. [Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus]. Presse Med 2015; 45:227-39. [PMID: 26597583 DOI: 10.1016/j.lpm.2015.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/04/2015] [Accepted: 10/14/2015] [Indexed: 01/12/2023] Open
Abstract
Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus. Lichen planus is a chronic inflammatory dermatosis of the skin, skin appendages and mucous membranes, which frequently affects the oral mucosa. Its aetiology still remains unknown, and currently accepted pathogenesis is that of an autoimmune cell-mediated disease. To the contrary of skin lichen planus, oral lichen planus is a long-term chronic disease with dynamic evolution, in which progressive and profound changes of the clinical and histopathological aspects occur over time and under the influence of various exogenous factors. By convention, in the history of the oral lichen planus four successive stages can be distinguished without well-defined boundaries between them. These stages can be defined as an initial phase; a long intermediate phase with alternating periods of activity and quiescence, which has a gradually increasing risk of malignant transformation; a late stage which activity is traditionally diminished; and a post-lichen cicatricial stage with an absent or negligible and undetectable activity, often undiagnosed because clinically unrecognized; in this stage, the lesion does not respond to usual treatments, but retains the same risk of malignant transformation.
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Affiliation(s)
- Tommaso Lombardi
- Unité de médecine et pathologie orale et maxillo-faciale, faculté de médecine, service de chirurgie maxillo-faciale, département de chirurgie, hôpitaux universitaires de Genève, Genève, Suisse.
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125
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Werneck JT, Dias EP, Gonçalves LS, Silva Junior A. CLA and CD62E expression in oral lichen planus lesions. J Oral Pathol Med 2015; 45:218-23. [PMID: 26332489 DOI: 10.1111/jop.12355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There are few reports on the migration of CLA+ T cells through E-selectin in cutaneous lichen planus, with only one study on oral lichen planus (OLP). This study aimed to analyze CLA expression and assess whether there is a correlation with E-selectin (CD62E) in OLP lesions. MATERIAL AND METHODS Biopsies were performed on 11 patients including two areas: one without clinical and histopathological features of OLP [perilesional group (PLG)] and the other with clinical and histopathological features of OLP [OLP group (OLPG)]. The specimens obtained were divided into two: One was fixed in formalin for routine analysis (H&E), and the other was frozen for CD3, CD4, CD8, CLA, and CD62E immunofluorescence markers. RESULTS More CD4+ (median 1409, range 860-2519), CD8+ (median 1568, range 654-3258), and CLA+ T cells (median 958, range 453-2198) and higher CD62E expression (median 37, range 27-85) were identified in OLPG (P = 0.003; P = 0.003; P = 0.004; P = 0.003, respectively) than those in PLG. The median prevalence analysis was also significantly higher for CLA+CD8+ T cells in OLPG (OLPG = 39.4%, range 18.4-64.2; PLG = 29.4%, range 12.1-47.1) (P = 0.026). None of the correlations between CD3+ or CLA+ T cells and CD62E in OLPG and in PLG were significant. CONCLUSION The significant presence of CLA+ T cells and E-selectin expressions in the OLPG suggests their involvement in the etiopathogenesis of OLP; however, only a weak correlation between CLA+ T cells and E-selectin was observed.
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Affiliation(s)
| | - Eliane Pedra Dias
- Medical School, Fluminense Federal University, Rio de Janeiro, Brazil
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126
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Lukács J, Schliemann S, Elsner P. Lichen planus and lichenoid reactions as a systemic disease. Clin Dermatol 2015; 33:512-9. [DOI: 10.1016/j.clindermatol.2015.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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127
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Lucchese A, Gentile E, Capone G, De Vico G, Serpico R, Landini G. Fractal analysis of mucosal microvascular patterns in oral lichen planus: a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:609-15. [PMID: 26320682 DOI: 10.1016/j.oooo.2015.06.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 06/01/2015] [Accepted: 06/08/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The objective of this study was to assess local vascular architecture in atrophic-erosive oral lichen planus (OLP). MATERIALS AND METHODS We investigated the capillary structure of the oral mucosa in 31 patients with OLP and 32 healthy controls. Capillaries images were captured in vivo through a capillaroscope. We applied fractal analysis to quantify the microvasculature morphometric changes in the oral mucosa of atrophic-erosive OLP patients in terms of their fractal dimension (D). RESULTS The oral vascular networks of atrophic-erosive OLP lesions had a significantly higher D, both in buccal mucosae (D=1.167, P=.019) and in tongue (D=1.196, P=.038), compared with the control population (1.123 for both locations, respectively). CONCLUSIONS The present study confirms previous literature data on a close relationship between abnormal vascular architecture and atrophic-erosive OLP. Fractal analysis provided a quantitative descriptor of the complexity of the vascular patterns, which increases in the OLP samples. These data may provide new information on the OLP pathogenesis, as well as serve as morphologic quantifiers for monitoring treatment strategies.
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Affiliation(s)
- Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy.
| | - Enrica Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Giovanni Capone
- Department of Biosciences, Biotechnologies & Biopharmaceutics, University of Bari, Bari, Italy
| | - Gionata De Vico
- Department of Biological Sciences, Naples University Federico II, Naples, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Gabriel Landini
- Oral Pathology Unit, School of Dentistry, The University of Birmingham, Birmingham, England
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128
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Oral lichen planus pemphigoides: a series of four cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:58-68. [DOI: 10.1016/j.oooo.2015.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 01/09/2023]
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129
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Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14:930-51. [PMID: 26117595 DOI: 10.1016/j.autrev.2015.06.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches.
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Affiliation(s)
- Mayson B Mustafa
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; Oral medicine section, Department of Oral and Maxillofacial Surgery, University of Khartoum, Faculty of Dentistry, Khartoum, Sudan
| | | | - Bruce R Smoller
- Department of Pathology, University of Rochester, School of Medicine and Dentistry, USA
| | - Cassian Sitaru
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Signalhaus Freiburg, Schänzlestr. 18, 79104 Freiburg, Germany.
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130
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Hashemy SI, Gharaei S, Vasigh S, Kargozar S, Alirezaei B, Jahed Keyhani F, Amirchaghmaghi M. Oxidative stress factors and C-reactive protein in patients with oral lichen planus before and 2 weeks after treatment. J Oral Pathol Med 2015; 45:35-40. [DOI: 10.1111/jop.12326] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Seyed Isaac Hashemy
- Surgical Oncology Research Center; Imam Reza hospital, Faculty of Medicine; Mashhad University of Medical Sciences; Mashhad Iran
| | - Shideh Gharaei
- School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
| | - Samaneh Vasigh
- School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
| | - Sanaz Kargozar
- School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
| | | | | | - Maryam Amirchaghmaghi
- Oral and Maxillofacial Diseases Research Center; Department of Oral Medicine, School of Dentistry; Mashhad University of Medical Sciences; Mashhad Iran
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131
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Kolude BM, Bouquot JE. Clinical pathologic conference case 3: A thick, granular white gingival plaque in an adult male. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:e279-84. [DOI: 10.1016/j.oooo.2014.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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132
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Yin J, Yang X, Zeng Q, Yang L, Cheng B, Tao X. The positive correlation of the CCL2-CCR2 axis with the disease activity may indicate the fundamental role in the pathogenesis of oral lichen planus. J Oral Pathol Med 2015; 45:41-7. [DOI: 10.1111/jop.12325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Jingfang Yin
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xi Yang
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Guangzhou China
| | - Qi Zeng
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Linglan Yang
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Bin Cheng
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xiaoan Tao
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
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133
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Lucchese A. A potential peptide pathway from viruses to oral lichen planus. J Med Virol 2015; 87:1060-5. [PMID: 25776836 DOI: 10.1002/jmv.24131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/11/2022]
Abstract
Oral lichen planus is an idiopathic inflammatory disease of oral mucous membranes, characterized by an autoimmune epidermis attack by T cells. It remains unknown, however, how such aggressive T cells are activated in vivo to cause epidermal damage. This study analyzes the relationship at the peptide level between viruses and oral lichen planus disease. Four potentially immunogenic peptides (SSSSSSS, QEQLEKA, LLLLLLA, and MLSGNAG) are found to be shared between HCV, EBV, HHV-7, HSV-1, and CMV and three human proteins (namely pinin, desmoglein-3, and plectin). The described peptide sharing might be of help in deciphering the still unexplained immunopathogenic pathway that leads to oral lichen planus.
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Affiliation(s)
- Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples (SUN), Napoli, Italy
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134
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Firth FA, Friedlander LT, Parachuru VPB, Kardos TB, Seymour GJ, Rich AM. Regulation of immune cells in oral lichen planus. Arch Dermatol Res 2015; 307:333-9. [DOI: 10.1007/s00403-015-1540-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/11/2015] [Accepted: 01/18/2015] [Indexed: 12/13/2022]
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Abstract
Oral lichen planus (OLP) is commonly found in middle-aged women. Although the cause is unknown, research points to several complex immunologic events and cells that are responsible for the inflammatory destruction and chronicity of these lesions. Biopsy for histologic diagnosis is recommended. The mainstay of treatment remains topical corticosteroids; however, newer therapies such as immunomodulating agents are available for recalcitrant lesions. In cases of lichenoid mucositis or reactions, treatment should be directed at identifying and removing the presumed cause. Given the apparent risk of squamous cell carcinoma in these patients, frequent follow-up and repeat biopsy are vital.
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Affiliation(s)
- Scott S De Rossi
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Otolaryngology/Head & Neck Surgery, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Dermatology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA.
| | - Katharine Ciarrocca
- Department of Oral Rehabilitation, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
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Chung PI, Hwang CY, Chen YJ, Lin MW, Chen TJ, Hua TC, Wu LC, Chu SY, Chen CC, Lee DD, Chang YT, Liu HN. Autoimmune comorbid diseases associated with lichen planus: a nationwide case-control study. J Eur Acad Dermatol Venereol 2014; 29:1570-5. [DOI: 10.1111/jdv.12939] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 11/25/2014] [Indexed: 12/17/2022]
Affiliation(s)
- P.-I. Chung
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - C.-Y. Hwang
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
- Department of Dermatology; Wan Fang Hospital; Taipei Medical University; Taipei Taiwan
| | - Y.-J. Chen
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
- Department of Dermatology; Taichung Veterans General Hospital; Taichung Taiwan
| | - M.-W. Lin
- Institute of Public Health; National Yang-Ming University; Taipei Taiwan
| | - T.-J. Chen
- Department of Family Medicine; Taipei Veterans General Hospital; Taipei Taiwan
| | - T.-C. Hua
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - L.-C. Wu
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - S.-Y. Chu
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - C.-C. Chen
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - D.-D. Lee
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - Y.-T. Chang
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
| | - H.-N. Liu
- Department of Dermatology; Taipei Veterans General Hospital; Taipei Taiwan
- Department of Dermatology; National Yang-Ming University; Taipei Taiwan
- Department of Dermatology; National Defense Medical Center; Taipei Taiwan
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Yardimci G, Kutlubay Z, Engin B, Tuzun Y. Precancerous lesions of oral mucosa. World J Clin Cases 2014; 2:866-872. [PMID: 25516862 PMCID: PMC4266835 DOI: 10.12998/wjcc.v2.i12.866] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 08/28/2014] [Accepted: 09/24/2014] [Indexed: 02/05/2023] Open
Abstract
Precancerous lesions of oral mucosa, known as potentially malignant disorders in recent years, are consists of a group of diseases, which should be diagnosed in the early stage. Oral leukoplakia, oral submucous fibrosis, and oral erythroplakia are the most common oral mucosal diseases that have a very high malignant transformation rate. Oral lichen planus is one of the potentially malignant disorders that may be seen in six different subtypes including papular, reticular, plaque-like, atrophic, erosive, and bullous type, clinically. Atrophic and erosive subtypes have the greater increased malignant transformation risk compared to another subtypes. Although there are various etiological studies, the etiology of almost all these diseases is not fully understood. Geographically, etiologic factors may vary. The most frequently reported possible factors are tobacco use, alcohol drinking, chewing of betel quid containing areca nut, and solar rays. Early diagnosis is very important and can be lifesaving, because in late stages, they may be progressed to severe dysplasia and even carcinoma in situ and/or squamous cell carcinoma. For most diseases, treatment results are not satisfactory in spite of miscellaneous therapies. While at the forefront of surgical intervention, topical and systemic treatment alternatives such as corticosteroids, calcineurin inhibitors, and retinoids are widely used.
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138
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Siponen M, Kullaa A, Nieminen P, Salo T, Pasonen-Seppänen S. Altered expression of hyaluronan, HAS1-2, and HYAL1-2 in oral lichen planus. J Oral Pathol Med 2014; 44:401-9. [PMID: 25421996 DOI: 10.1111/jop.12294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is an immune-mediated mucosal disease of unclear etiology and of unresolved pathogenesis. Hyaluronan (HA) is an extracellular matrix glycosaminoglycan involved in inflammation and tumor progression. However, its presence in OLP has not been reported. We therefore aimed to study the immunohistochemical expression of HA, its receptor CD44, hyaluronan synthases (HAS1-3), and hyaluronidases (HYAL1-2) in OLP. METHODS The presence of HA, CD44, HAS1-3, and HYAL1-2 was studied by immunohistochemical methods in 55 OLP and 23 control oral mucosal specimens (CTR). The localization, intensity, and differences of the epithelial expression between OLP and CTRs were analyzed. RESULTS HA and CD44 were found on cell membranes in the epithelial basal and intermediate layers in CTR and OLP specimens. The HA staining intensity was stronger in the basal layer of the epithelium in OLP than in CTRs (P < 0.001). HAS1 (P = 0.001) and HAS2 (P < 0.001) showed stronger staining in the basal and weaker staining in the superficial (P < 0.001) epithelial layers in OLP than in CTRs. The immunostaining of HAS3 was low in both OLP and CTRs. Positive HYAL1 and HYAL2 staining were mainly found in the basal and intermediate epithelial layers, and their intensities were significantly increased in OLP, except HYAL 2 in the intermediate epithelial layer. CONCLUSIONS HA, HAS1-2, and HYAL1-2 have altered expression in OLP compared to CTRs and may therefore have a role in OLP pathogenesis.
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Affiliation(s)
- Maria Siponen
- Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Arja Kullaa
- Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland.,Educational Dental Clinic, Health Center of Oulu, Oulu, Finland
| | - Pentti Nieminen
- Medical Informatics and Statistics Research Group, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tuula Salo
- Department of Diagnostics and Oral Medicine, Institute of Dentistry, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland.,Institute of Dentistry, University of Helsinki, Helsinki, Finland.,Graduate Program in Estomatopatologia, Piracicaba Dental School, University of Campinas, Piracicaba-São Paulo, Brazil
| | - Sanna Pasonen-Seppänen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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139
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Otero-Rey EM, Suarez-Alen F, Peñamaria-Mallon M, Lopez-Lopez J, Blanco-Carrion A. Malignant transformation of oral lichen planus by a chronic inflammatory process. Use of topical corticosteroids to prevent this progression? Acta Odontol Scand 2014; 72:570-7. [PMID: 24850508 DOI: 10.3109/00016357.2014.914570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral lichen planus is a potentially malignant disorder with a capacity, although low, for malignant transformation. Of all the factors related to the process of malignant transformation, it is believed that the chronic inflammatory process plays a key role in the development of oral cancer. This inflammatory process is capable of providing a microenvironment based on different inflammatory cells and molecules that affect cellular growth, proliferation and differentiation. OBJECTIVES The objectives of our study are: to review the available evidence about the possible relationship between the chronic inflammatory process present in oral lichen planus and its malignant transformation, to discuss the potential therapeutic implications derived from this relationship and to study the role that topical corticosteroids play in the control of oral lichen planus inflammation and its possible progression to malignant transformation. CONCLUSION The maintenance of a minimum dose of topical corticosteroids could prevent the inflammatory progression of oral lichen planus to oral cancer.
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Affiliation(s)
- Eva Maria Otero-Rey
- Department of Stomatology, School of Dental Medicine, University of Santiago de Compostela , Spain
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140
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Abstract
Oral mucosal diseases encompass several common conditions that affect the general population. Some of these disorders present with signs and symptoms that are pathognomonic for the condition, whereas others present with similar features that can make clinical diagnosis difficult to achieve. It is important for physicians to have a clear understanding of these disorders to provide appropriate care to patients. This article reviews clinical aspects of common oral mucosal disorders, including candidiasis, herpes simplex viral infections, aphthous stomatitis, lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid.
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Affiliation(s)
- Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Thomas P Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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141
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Ryan K, Hegarty AM, Hodgson T. Aetiology, diagnosis and treatment of oral lichen planus. Br J Hosp Med (Lond) 2014; 75:492-6. [DOI: 10.12968/hmed.2014.75.9.492] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Anne M Hegarty
- Consultant in Oral Medicine in the Department of Oral Medicine, Charles Clifford Dental Hospital, Sheffield S10 2SZ
| | - Tim Hodgson
- Consultant in Oral Medicine, Eastman Dental Hospital UCLH Foundation Trust and Eastman Dental Institute UCL, London
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142
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Dillenburg CS, Martins MAT, Munerato MC, Marques MM, Carrard VC, Sant'Ana Filho M, Castilho RM, Martins MD. Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: a randomized controlled trial. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:068002. [PMID: 24887747 DOI: 10.1117/1.jbo.19.6.068002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 04/30/2014] [Indexed: 06/03/2023]
Abstract
Oral lichen planus (OLP) is a relatively common chronic mucocutaneous inflammatory disease and a search for novel therapeutic options has been performed. We sought to compare the efficacy of laser phototherapy (LPT) to topical clobetasol propionate 0.05% for the treatment of atrophic and erosive OLP. Forty-two patients with atrophic/erosive OLP were randomly allocated to two groups: clobetasol group (n=21): application of topical clobetasol propionate gel (0.05%) three times a day; LPT group (n=21): application of laser irradiation using InGaAlP diode laser three times a week. Evaluations were performed once a week during treatment (Days 7, 14, 21, and 30) and in four weeks (Day 60) and eight weeks (Day 90) after treatment. At the end of treatment (Day 30), significant reductions in all variables were found in both groups. The LPT group had a higher percentage of complete lesion resolution. At follow-up periods (Days 60 and 90), the LPT group maintained the clinical pattern seen at Day 30, with no recurrence of the lesions, whereas the clobetasol group exhibited worsening for all variables analyzed. These findings suggest that the LPT proved more effective than topical clobetasol 0.05% for the treatment of OLP.
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Affiliation(s)
- Caroline Siviero Dillenburg
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Medicine, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Maria Cristina Munerato
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Medicine, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Márcia Martins Marques
- University of São Paulo, School of Dentistry, Department of Dentistry, São Paulo, São Paulo 05508-000, Brazil
| | - Vinícius Coelho Carrard
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Manoel Sant'Ana Filho
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Rogério Moraes Castilho
- University of Michigan, School of Dentistry, Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, Ann Arbor, Michigan 48109-1078
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
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143
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Lin XC, Sun HY, Zhen YX, Zhang H, Shi H, Wang XX. Low expression of glucocorticoid receptor α in oral lichen planus correlates with activation of nuclear factor κB: a preliminary study. J Oral Pathol Med 2014; 43:600-5. [PMID: 25320751 DOI: 10.1111/jop.12168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Xue-cai Lin
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
| | - Hong-ying Sun
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
| | - Yue-xiang Zhen
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
| | - Hui Zhang
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
| | - Hang Shi
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
| | - Xia-xia Wang
- Department of Stomatology; Huashan Hospital; Fudan University; Shanghai China
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144
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Gene expression based evidence of innate immune response activation in the epithelium with oral lichen planus. Arch Oral Biol 2014; 59:354-61. [PMID: 24581860 DOI: 10.1016/j.archoralbio.2013.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/26/2013] [Accepted: 12/26/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a disease of the oral mucosa of unknown cause producing lesions with an intense band-like inflammatory infiltrate of T cells to the subepithelium and keratinocyte cell death. We performed gene expression analysis of the oral epithelium of lesions in subjects with OLP and its sister disease, oral lichenoid reaction (OLR), in order to better understand the role of the keratinocytes in these diseases. DESIGN Fourteen patients with OLP or OLR were included in the study, along with a control group of 23 subjects with a variety of oral diseases and a normal group of 17 subjects with no clinically visible mucosal abnormalities. Various proteins have been associated with OLP, based on detection of secreted proteins or changes in RNA levels in tissue samples consisting of epithelium, stroma, and immune cells. The mRNA level of twelve of these genes expressed in the epithelium was tested in the three groups. RESULTS Four genes showed increased expression in the epithelium of OLP patients: CD14, CXCL1, IL8, and TLR1, and at least two of these proteins, TLR1 and CXCL1, were expressed at substantial levels in oral keratinocytes. CONCLUSIONS Because of the large accumulation of T cells in lesions of OLP it has long been thought to be an adaptive immunity malfunction. We provide evidence that there is increased expression of innate immune genes in the epithelium with this illness, suggesting a role for this process in the disease and a possible target for treatment.
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145
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Lu R, Zhang J, Sun W, Du G, Zhou G. Inflammation-related cytokines in oral lichen planus: an overview. J Oral Pathol Med 2013; 44:1-14. [PMID: 24329772 DOI: 10.1111/jop.12142] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2013] [Indexed: 12/11/2022]
Abstract
Cytokines are powerful mediators which play a central role in both innate and adapted immune responses. Aberrant productions of cytokines may lead to the onset of immune deficiency, allergy or autoimmunity, which are involved in the mechanisms of various immune-mediated inflammatory diseases. Oral lichen planus (OLP) is a chronic inflammation disease affecting the oral mucosa with unknown aetiology. Previous studies have described the abnormal expression patterns of various inflammation-related cytokines, such as IL-1, 2, 4, 5, 6, 8, 10, 12, 17, 18, TGF-β, IFN-γ and TNF-α, in lesions, saliva, serum and peripheral blood mononuclear cells from patients with OLP, which may reflect the immune dysregulation status and emerge as central players in the immunopathogenesis of OLP. Besides, the gene polymorphisms of several cytokines such as IFN-γ, TNF-α, IL-4, IL-10 have been found to be involved in the susceptibility of OLP. In this review, we gave a brief introduction of the characteristics and biological functions of these inflammation-related cytokines and summarized for the first time the current knowledge on the involvement of inflammation-related cytokines in OLP. Further research on the exact roles of these cytokines will aid the understanding of the pathogenesis and the identification of novel therapeutic approaches of OLP.
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Affiliation(s)
- Rui Lu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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146
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Mortazavi N. Role of oxidative stress in malignant transformation of oral lichen planus. Oral Oncol 2013; 49:e41-2. [PMID: 24084408 DOI: 10.1016/j.oraloncology.2013.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/08/2013] [Indexed: 01/16/2023]
Affiliation(s)
- Nazanin Mortazavi
- Department of Oral Medicine, Dental School, Babol University of Medical Sciences, PO Box 47135-853, Babol, Iran.
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