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Stolte KN, Mesas-Fernández A, Meier K, Klein EK, Dommisch H, Ghoreschi K, Solimani F. TYK2 inhibition with deucravacitinib ameliorates erosive oral lichen planus. Exp Dermatol 2024; 33:e15080. [PMID: 38628035 DOI: 10.1111/exd.15080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/21/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
Erosive oral lichen planus (OLP) is a challenging disease. This T cell driven disorder frequently shows a treatment unresponsive course and strongly limits patients' quality of life. The disease lacks FDA or EMA approved drugs for its treatment and the efficacy of the commonly administered treatments (i.e. topical and systemic steroids, steroid sparing agents) is often only partial. Although the etiopathogenesis of the disease still needs to be fully elucidated, recent advances helped to identify interferon-ɣ (IFN-ɣ) as a pivotal cytokine in OLP pathogenesis, thus making the interference with its signalling a therapeutic target. Janus kinase (JAK) inhibitors therefore gained relevance for their inhibitory effect on IFN-ɣ signalling. While some drugs such as abrocitinib, upadacitinib, tofacitinib directly interfere with IFN-ɣ signalling through blockade of JAK1 and/or JAK2, deucravacitinib, a selective TYK-2 inhibitor indirectly interferes on IFN-ɣ activation through interference with interleukin (IL)-12, a potent promotor for Th1/IFN-ɣ responses. This mechanism of action makes deucravacitinib a candidate drug for the treatment of OLP. Here we provide initial evidence that deucravacitinib 6 mg daily has a beneficial effect in three patients with oral OLP.
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Affiliation(s)
- Kim Natalie Stolte
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Alberto Mesas-Fernández
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Edis Kaan Klein
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Farzan Solimani
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
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Yang X, Bao Z, Sun J, Shen X. Evaluating Foxp3+ T regulatory cells in tissue samples of oral lichen planus correlated with disease activity. Oral Dis 2024; 30:808-810. [PMID: 35923126 DOI: 10.1111/odi.14333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/30/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Xi Yang
- Department of Oral and Maxillofacial Surgery, Zhang Zhiyuan Academician Workstation, Hainan Western Central Hospital, Shanghai Ninth People's Hospital, Danzhou, China
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Zhexuan Bao
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Department of Oral Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junyi Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Department of Special Clinic, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Xuemin Shen
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Afzali S, Mohammadisoleimani E, Mansoori Y, Mohaghegh P, Bahmanyar M, Mansoori B, Pezeshki B, Nikfar G, Tavassoli A, Shahi A, Moravej A. The potential roles of Th17 cells in the pathogenesis of oral lichen planus. Inflamm Res 2023:10.1007/s00011-023-01763-7. [PMID: 37414985 DOI: 10.1007/s00011-023-01763-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a T cell-mediated chronic autoimmune disease, whose pathogenesis and etiology are not entirely understood. OLP is characterized by subepithelial lymphocyte infiltration and elevated intra-epithelial lymphocytes. The majority of lamina propria lymphocytes are CD4+ T cells. CD4+ helper T (Th) cells play a crucial role in activating CD8+ cytotoxic T cells (CTLs) through interactions and cytokine production. Th1 and Th2 cells are well-accepted to be associated with OLP pathogenesis. However, OLP treatment is challenging yet, the more information we have about the pathology of OLP, the easier it will be treated. With the discovery of Th17 cells in recent years and the demonstration of their role in autoimmune disease, many researchers started to investigate the role of Th17 in the pathogenesis of OLP. METHODS To make up this review, studies covering the role of TH17 in different types of lichen planus were selected from major databases. RESULTS As we review in this article, Th17 cells and their signature cytokines play an important role in OLP pathogenesis. As well, utilizing some anti-IL-17 antibodies showed promising results in improving the disease; however, more studies are still needed to better understand and treat OLP.
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Affiliation(s)
- Shima Afzali
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yaser Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Department of Medical Genetics, Fasa University of Medical Sciences, Fasa, Iran
| | - Poopak Mohaghegh
- Pediatrics Department, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Bahmanyar
- Pediatrics Department, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Behnam Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Babak Pezeshki
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ghasem Nikfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Alireza Tavassoli
- Department of Pathology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abbas Shahi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | - Ali Moravej
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
- Department of Immunology, Fasa University of Medical Sciences, Fasa, Iran.
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Vičić M, Hlača N, Kaštelan M, Brajac I, Sotošek V, Prpić Massari L. Comprehensive Insight into Lichen Planus Immunopathogenesis. Int J Mol Sci 2023; 24:ijms24033038. [PMID: 36769361 PMCID: PMC9918135 DOI: 10.3390/ijms24033038] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
Lichen planus is a chronic disease affecting the skin, appendages, and mucous membranes. A cutaneous lichen planus is a rare disease occurring in less than 1% of the general population, while oral illness is up to five times more prevalent; still, both forms equally impair the patient's quality of life. The etiology of lichen planus is not entirely understood. Yet, immune-mediated mechanisms have been recognized since environmental factors such as hepatitis virus infection, mechanical trauma, psychological stress, or microbiome changes can trigger the disease in genetically susceptible individuals. According to current understanding, lichen planus immunopathogenesis is caused by cell-mediated cytotoxicity, particularly cytotoxic T lymphocytes, whose activity is further influenced by Th1 and IL-23/Th-17 axis. However, other immunocytes and inflammatory pathways complement these mechanisms. This paper presents a comprehensive insight into the actual knowledge about lichen planus, with the causal genetic and environmental factors being discussed, the immunopathogenesis described, and the principal effectors of its inflammatory circuits identified.
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Affiliation(s)
- Marijana Vičić
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Nika Hlača
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Marija Kaštelan
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Vlatka Sotošek
- Department of Anesthesiology, Reanimation and Intensive Care, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
| | - Larisa Prpić Massari
- Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Correspondence:
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Li Y, He Y, Xiang J, Feng L, Wang Y, Chen R. The Functional Mechanism of MicroRNA in Oral Lichen Planus. J Inflamm Res 2022; 15:4261-4274. [PMID: 35923905 PMCID: PMC9342247 DOI: 10.2147/jir.s369304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/10/2022] [Indexed: 11/23/2022] Open
Abstract
Non-coding RNAs (ncRNAs) are transcribed from the genomes of mammals and other complex organisms, and many of them are alternately spliced and processed into smaller products. Types of ncRNAs include microRNAs (miRNAs), circular RNAs, and long ncRNAs. miRNAs are about 21 nucleotides long and form a broad class of post-transcriptional regulators of gene expression that affect numerous developmental and physiological processes in eukaryotes. They usually act as negative regulators of mRNA expression through complementary binding sequences in the 3’-UTR of the target mRNA, leading to translation inhibition and target degradation. In recent years, the importance of ncRNA in oral lichen planus (OLP), particularly miRNA, has attracted extensive attention. However, the biological functions of miRNAs and their mechanisms in OLP are still unclear. In this review, we discuss the role and function of miRNAs in OLP, and we also describe their potential functional roles as biomarkers for the diagnosis of OLP. MiRNAs are promising new therapeutic targets, but more work is needed to understand their biological functions.
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Affiliation(s)
- Yunshan Li
- College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China
| | - Yaodong He
- College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China
| | - Junwei Xiang
- College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China
| | - Linfei Feng
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
| | - Yuanyin Wang
- College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China
- Correspondence: Yuanyin Wang; Ran Chen, College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China, Email ;
| | - Ran Chen
- College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, 230032, People’s Republic of China
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Abdeldayem E, Rashed L, Ali S. Salivary expression of lncRNA DQ786243 and IL-17 in oral lichen planus: case-control study. BMC Oral Health 2022; 22:240. [PMID: 35717182 PMCID: PMC9206297 DOI: 10.1186/s12903-022-02277-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background A growing number of studies has investigated IL-17 in OLP. However, its exact role and interactions are not fully determined. In addition, the literature investigating its salivary expression is limited. The scarcity in the literature studying lncRNAs was noticed, particularly with regards to correlating them with cytokines in OLP. In the current study, the salivary expression of lncRNA DQ786243 and IL-17 was assessed among different forms of OLP. Methods The study included 52 participants in four equal groups: reticular OLP, erythematous OLP, ulcerative OLP, and control group. All eligible OLP patients underwent conventional oral examination, along with basic charting of their demographic data, pain intensity using a visual analogue scale, and clinical evaluation using the Thongprasom et al. scale. The salivary expression of lncRNA DQ786243 and IL-17 was evaluated for all participants using qRT-PCR. Unstimulated whole saliva samples were used. Data were analyzed for statistical significance. Results No statistically significant difference was observed when comparing the mean age and gender distribution of the studied groups. A statistically significant difference was detected when comparing pain and clinical scores in the three OLP forms. The highest expression of both salivary biomarkers was noticed in ulcerative OLP, followed by erythematous OLP and reticular OLP, then the controls, with a significant difference between the studied groups. Upon comparing the salivary expression of DQ786243 in ulcerative and erythematous OLP, no significant difference was detected. No significant difference was detected when comparing salivary expression of IL-17 in erythematous OLP to the other OLP forms. Conclusions The salivary expression of lncRNA DQ786243 and IL-17 was upregulated in OLP compared to healthy individuals. Besides, their expression increased when the severity of OLP was at its highest level in ulcerative OLP. There was a positive correlation between DQ786243 and IL-17. Trial registration The protocol was registered at ClinicalTrials.gov (NCT04503824). The date of registration is 07/08/2020.
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Affiliation(s)
- Engy Abdeldayem
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, 11553, Egypt.
| | - Laila Rashed
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shereen Ali
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, 11553, Egypt
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Husein‐ElAhmed H, Steinhoff M. Potential role of interleukin‐17 in the pathogenesis of oral lichen planus: A systematic review with meta‐analysis. J Eur Acad Dermatol Venereol 2022; 36:1735-1744. [DOI: 10.1111/jdv.18219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Husein Husein‐ElAhmed
- Department of Dermatology and Venereology. Hospital de Baza. Granada. Spain
- Translational Research Institute Hamad Medical Corporation Doha Qatar
| | - Martin Steinhoff
- Translational Research Institute Hamad Medical Corporation Doha Qatar
- Department of Dermatology and Venereology, Hamad Medical Corporation Doha Qatar
- Weill Cornell Medicine‐Qatar College of Medicine Doha Qatar
- Qatar University Medical School Doha Qatar
- Dept. of Dermatology, Weill Cornell Medicine New York NY USA
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8
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Zanetta P, Ormelli M, Amoruso A, Pane M, Azzimonti B, Squarzanti DF. Probiotics as Potential Biological Immunomodulators in the Management of Oral Lichen Planus: What's New? Int J Mol Sci 2022; 23:ijms23073489. [PMID: 35408849 PMCID: PMC8998608 DOI: 10.3390/ijms23073489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disorder with multifactorial aetiology and malignant transformation potential. Despite the treatments so far identified, new tailored and safe specific measures are needed. Recently, human microbiota imbalance has been linked to several immune-mediated diseases, opening new therapeutic perspectives for probiotics; besides their ability to directly interact with the host microbiota, they also display a strain-specific immune-modulatory effect. Thus, this non-systematic review aims to elucidate the molecular pathways underlying probiotic activity, mainly those of Lactobacilli and Bifidobacteria and their metabolites in OLP pathogenesis and malignant transformation, focusing on the most recent in vitro and in vivo research evidence. Findings related to their activity in other immune-mediated diseases are here included, suggesting a probiotic translational use in OLP. Probiotics show immune-modulatory and microbiota-balancing activities; they protect the host from pathogens, hamper an excessive effector T cell response, reduce nuclear factor-kappa B (NF-kB) signalling and basal keratinocytes abnormal apoptosis, shifting the mucosal response towards the production of anti-inflammatory cytokines, thus preventing uncontrolled damage. Therefore, probiotics could be a highly encouraging prevention and immunotherapeutic approach for a safer and more sustainable OLP management.
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Affiliation(s)
- Paola Zanetta
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
| | - Margherita Ormelli
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
| | - Angela Amoruso
- Probiotical Research Srl, Via Mattei 3, 28100 Novara, Italy; (A.A.); (M.P.)
| | - Marco Pane
- Probiotical Research Srl, Via Mattei 3, 28100 Novara, Italy; (A.A.); (M.P.)
| | - Barbara Azzimonti
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
- Correspondence: (B.A.); (D.F.S.); Tel.: +39-0321-660-870 (B.A.)
| | - Diletta Francesca Squarzanti
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
- Correspondence: (B.A.); (D.F.S.); Tel.: +39-0321-660-870 (B.A.)
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Shahidi Dadras M, Rakhshan A, Dadkhahfar S, Barat T. The role of interleukin-17 (IL-17) in the pathogenesis of discoid lupus erythematosus and lichen planopilaris: is immunohistochemistry for IL-17 a promising way to differentiate these entities? Int J Dermatol 2021; 61:647-652. [PMID: 34530493 DOI: 10.1111/ijd.15885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/27/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Interleukin-17 (IL-17) is a pro-inflammatory mediator which its excess secretion by immune cells is found in many chronic autoimmune diseases. This survey is aimed to compare the amount and pattern of distribution of IL-17 positive cells in lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) which are of the most frequent causes of primary cicatricial alopecia (CA). METHODS Biopsies of lesional scalp skin from adult LPP (n = 30), DLE patients (n = 19), and control scalp skin (n = 18) were analyzed by immunohistochemistry (IHC) method using rabbit polyclonal antibody against IL-17. Cells stained positive for IL-17 and their pattern of distribution were assessed and compared between these groups. RESULTS The mean of IL-17 positive cell counts per high power field (HPF) in both LPP and DLE groups was significantly higher in comparison with the control group (both p < .0001). The LPP group had higher values of IL-17 positive cell counts per HPF (47.56 ± 13.37) compared to the DLE group (22.21 ± 11.06) (p < .0001). More than 30 IL-17 positive cell counts in IHC have a sensitivity of 90% and a specificity of 78% for differentiating LPP from DLE. CONCLUSIONS Our findings suggest that IL-17 is effective in the pathogenesis of DLE and LPP and its role is more prominent in LPP. IL-17 positive cells in IHC can distinguish DLE from LPP with satisfactory sensitivity and specificity.
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Affiliation(s)
| | - Azadeh Rakhshan
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of pathology, Shohada-e-Tajrish Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tara Barat
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K. Lichen planus – ein Klinikleitfaden. J Dtsch Dermatol Ges 2021; 19:864-883. [PMID: 34139075 DOI: 10.1111/ddg.14565_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Farzan Solimani
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | | | | | - Kamran Ghoreschi
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
| | - Katharina Meier
- Klinik für Dermatologie, Venerologie und Allergologie, Charité - Universitätsmedizin Berlin
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Solimani F, Forchhammer S, Schloegl A, Ghoreschi K, Meier K. Lichen planus - a clinical guide. J Dtsch Dermatol Ges 2021; 19:864-882. [PMID: 34096678 DOI: 10.1111/ddg.14565] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/05/2021] [Indexed: 12/15/2022]
Abstract
Lichen planus (LP) is a chronic lichenoid inflammatory disorder of the skin, mucosa and of the appendages. LP is classically characterized by the presence of a rich infiltration of inflammatory T cells, which migrate in the upper part of the dermis, arranged in a band-like pattern. Different sub types of the disease have been so far described. Albeit LP is clinically well defined, the disease still represents a therapeutic enigma. Especially with regard to mucosal or scalp affecting LP types, which often present a recalcitrant and treatment unresponsive course, efficacious therapeutic options are still lacking. Thus, LP represents a disease with a high psychosocial burden. Yet, development in the deciphering of LP pathogenesis reveals possible new druggable targets, thus paving the way for future therapeutic options. In this clinical guide, we summarize the current clinical knowledge and therapeutic standards and discuss the future perspective for the management of LP.
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Affiliation(s)
- Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stephan Forchhammer
- Department of Dermatology, University Medical Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Alexandra Schloegl
- Department of Dermatology, University Medical Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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12
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Żychowska M, Woźniak Z, Baran W. Immunohistochemical analysis of the expression of selected cell lineage markers (CD4, CD8, CD68, c-Kit, Foxp3, CD56, CD20) in cutaneous variant of lichen planus. Int J Dermatol 2021; 60:1097-1101. [PMID: 33611791 DOI: 10.1111/ijd.15437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/09/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lichen planus (LP) is considered to be an immune-mediated disease of a not fully understood etiology. There are scarce data on the immune cells forming the band-like infiltration in cutaneous LP (CLP). The objective of the current study was to investigate the immunohistochemical pattern of cells forming the infiltrate in CLP by assessing the immunoexpression of selected cell lineage markers. METHODS The immunohistochemical analysis of the expression of CD4, CD8, CD20, CD56, CD68, c-Kit, and Foxp3 was performed in formalin-fixed paraffin-embedded (FFPE) biopsy specimens from 14 cases of CLP and 11 healthy volunteers. RESULTS The expression of CD4 (P < 0.001), CD8 (P < 0.001), CD68 (P < 0.001), Foxp3 (P < 0.001), CD56 (v = 0.019), and CD20 (P < 0.001) was significantly higher in lesional skin in CLP compared to healthy controls. The ratio of CD4+ to CD8+ cells in the infiltrate was 1.75:1. The expression of Foxp3, CD56, and CD20 was markedly lower than the expression of CD4 and CD8. There was no statistically significant difference in c-Kit expression between CLP lesions and healthy skin (P = 0.57). CONCLUSIONS We found a wide variety of immune cells in the inflammatory infiltrate in CLP. The expression of CD4, CD8, CD68, Foxp3, CD56, and CD20 was significantly increased in CLP, while the expression of c-Kit was comparable in lesional skin and controls. The presence of various cell populations, including T regulatory cells, NK cells, and B cells, may indicate a complex pathogenesis of CLP.
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Affiliation(s)
- Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland.,Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
| | - Zdzislaw Woźniak
- Department of Pathomorphology, Wrocław Medical University, Wrocław, Poland
| | - Wojciech Baran
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wrocław, Poland
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13
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Vičić M, Sotošek V, Brajac I, Kaštelan M, Prpić-Massari L. The possible involvement of granulysin mediated cytotoxicity in keratinocytes disruption in lichen planus. Med Hypotheses 2021; 149:110546. [PMID: 33647607 DOI: 10.1016/j.mehy.2021.110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/16/2021] [Indexed: 11/15/2022]
Abstract
Lichen planus is a chronic mucocutanous disorder histopathologically characterized with a keratinocytes apoptosis, subsequent basal cell layer liquefaction and accumulation of the inflammatory infiltrate in papillary dermis. A formation of apoptotic bodies in basal cell layer is due to a cytotoxic lymphocyte attack to the basal keratinocytes. It has been demonstrated that the cytotoxic molecules included in this attack are perforin and granzyme B. Both molecules are found upregulated in CD8+ lymphocytes that are in close contact to keratinocytes. However, their amount is lower in lichen planus than in other skin disease characterized by liquefaction and vacuolar degeneration of the basal epidermal layer. This could speculate about other cytotoxic molecule such as granulysin that could mediate keratinocyte apoptosis. Therefore, in this article we hypothesize about the crucial role of granulysin molecule in keratinocytes killing that could contribute to a lichen planus pathogenesis.
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Affiliation(s)
- Marijana Vičić
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Vlatka Sotošek
- Department of Anesthesia, Resuscitation and Intensive Care, Medical Faculty University of Rijeka, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia
| | - Ines Brajac
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Marija Kaštelan
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
| | - Larisa Prpić-Massari
- Department of Dermatovenerology, Clinical Hospital Center Rijeka, Medical Faculty, University of Rijeka, Krešimirova 42, 51000 Rijeka, Croatia.
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14
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Pietschke K, Holstein J, Meier K, Schäfer I, Müller-Hermelink E, Gonzalez-Menendez I, Quintanilla-Martinez L, Ghoreschi FC, Solimani F, Ghoreschi K. The inflammation in cutaneous lichen planus is dominated by IFN-ϒ and IL-21-A basis for therapeutic JAK1 inhibition. Exp Dermatol 2020; 30:262-270. [PMID: 33113249 DOI: 10.1111/exd.14226] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Cutaneous lichen planus (CLP) and psoriasis (PSO) are both common chronic inflammatory skin diseases for which development of new treatments requires the identification of key targets. While PSO is a typical Th17/IL-17-disorder, there is some evidence that Th1/IFN-ɣ dominate the inflammatory process in CLP. Nonetheless, the immunopathogenesis of CLP is not fully explained and key immunological factors still have to be recognized. In this study, we compared the immune signature of CLP lesions with the well-characterized inflammation present in PSO skin. First, we analysed the histological and immunohistological characteristics of CLP and PSO. Second, we assessed the cytokine expression (IL1A, IL1B, IL4, IL6, IL8, IL10, IL17A, IL19, IL21, IL22, IL23A, IL13, IFNG, TNF, IL12A, IL12B and IL36G) of lesional skin of CLP with PSO by qPCR. Histology revealed a similar epidermal thickness in CLP and PSO. Immunohistochemically, both diseases presented with an inflammatory infiltrate mainly composed by CD3+ CD4+ T cells rather than CD3+ CD8+ . Importantly, mRNA analysis showed a distinct cytokine signature: while levels of IL12B, IL1A, IL6 and IL23 were similar between the two groups, the characteristic PSO-associated cytokines IL8, IL17A, IL22, IL19 and IL36G were expressed at very low levels in CLP. In contrast, CLP lesional skin was dominated by the expression of IFNG, IL21, IL4, IL12A and TNF. Immunohistochemistry confirmed the dominance of IL-21, IFN-ɣ and also pSTAT1 in the dermal infiltrate of CLP, while IL-17A was more present in PSO. Collectively, this study improves our understanding of the immunological factors dominating CLP. The dominating cytokines and signalling proteins identified suggest that anti-cytokine therapeutics like JAK inhibitors may be beneficial in CLP.
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Affiliation(s)
- Katharina Pietschke
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Julia Holstein
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Katharina Meier
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Iris Schäfer
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany
| | - Eva Müller-Hermelink
- Department of Dermatology, University Medical Center Tübingen, Eberhard Karls University, Tubingen, Germany.,Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Irene Gonzalez-Menendez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tubingen and Comprehensive Cancer Center, Tubingen University Hospital, Tubingen, Germany
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tubingen and Comprehensive Cancer Center, Tubingen University Hospital, Tubingen, Germany
| | - Franziska C Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kamran Ghoreschi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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15
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Mahmoud SB, Anwar MK, Shaker OG, El Sharkawy DA. Possible Relation between Vitamin D and Interleukin-17 in the Pathogenesis of Lichen Planus. Dermatology 2020; 237:896-901. [PMID: 33091918 DOI: 10.1159/000510539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/24/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lichen planus (LP) is a chronic autoimmune inflammatory mucocutaneous disease. Interleukin (IL)-17 is the signature cytokine of T-helper 17 cells, involved in the aetiology of many autoimmune and inflammatory disorders. Vitamin D has an immune-regulatory role and suppresses IL-17 production via direct transcriptional inhibition of IL-17 gene expression. OBJECTIVE To explore the relationship of IL-17 and vitamin D levels with LP, and the possible inter-relationship between IL-17 and vitamin D. METHODS The study enrolled 30 patients with LP and 30 healthy controls. Blood samples and skin biopsies were taken from all participants for evaluation of serum vitamin D, and serum and tissue IL-17 levels using enzyme-linked immunosorbent assay (ELISA). RESULTS Patients had significantly higher serum and tissue IL-17 (p < 0.001 for both), as well as significantly lower serum vitamin D levels and more deficient patterns of vitamin D status than controls (p < 0.001 for both). In the patient group, there was a statistically significant positive correlation between extent of the disease and serum IL-17. There was no direct statistical correlation between IL-17 levels and serum vitamin D in either patients or controls. CONCLUSION This study confirms a previously suggested role of IL-17 in the pathogenesis of LP and suggests its relation to the extent and severity of the disease. We also found an association between vitamin D deficiency and LP. However, a direct relationship between IL-17 and vitamin D deficiency could not be clarified.
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Affiliation(s)
- Sara Bahaa Mahmoud
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt,
| | | | - Olfat Gamil Shaker
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Increased Serum Level and High Tissue Immunoexpression of Interleukin 17 in Cutaneous Lichen Planus: A Novel Therapeutic Target for Recalcitrant Cases? DISEASE MARKERS 2020; 2020:6521274. [PMID: 32774513 PMCID: PMC7396028 DOI: 10.1155/2020/6521274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
Background Interleukin-17 is supposed to play an important role in the pathogenesis of oral lichen planus (OLP). However, there is scarce data in the literature on its significance in the cutaneous variant of the disease. Objectives To determine the serum level and tissue immunoexpression of IL-17 in cutaneous lichen planus (CLP). Methods Fifty-two adult patients with CLP, without any significant autoimmune or inflammatory conditions, were included in the first part of the study. The control group consisted of 27 age- and sex-matched healthy volunteers. Serum concentration of IL-17 was quantified using enzyme-linked immunosorbent assay (ELISA) kit. In the second part of the study, the tissue expression of IL-17 was assessed in archival paraffin-embedded biopsy specimens from CLP (n = 14) against normal control tissues (n = 11) using immunohistochemical assays. The expression was evaluated using Zeiss Axio Imager A2 light microscope. Positively stained cells were counted in 10 fields of view for biopsy specimen at 200x magnification, and the mean value was calculated. Results The serum level of IL-17 was significantly elevated in patients with CLP, compared with healthy volunteers (0.218 ± 0.221 ng/ml versus 0.126 ± 0.058 ng/ml, respectively; p = 0.025). No correlation was found between the serum concentration of IL-17 and patient age, gender, disease duration, extent of skin involvement, the presence or intensity of pruritus, and coexistence of mucosal lesions. In tissue samples from CLP lesions, significantly higher numbers of cells expressing IL-17 were found when compared to a healthy skin (p < 0.001). Conclusion Elevated serum concentration of IL-17 and high expression in a lesional skin support the hypothesis that IL-17 is implicated in the immunopathogenesis of CLP. These findings may constitute a premise for the future use of anti-IL-17 monoclonal antibodies in the treatment of severe and recalcitrant forms of CLP.
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17
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Trindade de Carvalho L, Meah N, Wall D, Sinclair R. Recalcitrant lichen planopilaris and frontal fibrosing alopecia responding to tildrakizumab. Dermatol Ther 2020; 33:e13694. [PMID: 32458516 DOI: 10.1111/dth.13694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/07/2020] [Accepted: 05/25/2020] [Indexed: 12/19/2022]
Abstract
Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocytic, cicatricial alopecias. Clinically, LPP presents with multifocal patchy alopecia, while FFA, considered a variant of LPP, results in hairline recession. Frontal recession in FFA may progress as far as the mid-scalp and infrequently beyond. Treatment to arrest the inflammatory process can be challenging and response variable. We report a case of recalcitrant lichen planopilaris and frontal fibrosing alopecia demonstrating significant clinical improvement after four doses of the interleukin-23 monoclonal antibody tildrakizumab.
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Affiliation(s)
| | - Nekma Meah
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Dmitri Wall
- Sinclair Dermatology, East Melbourne, Victoria, Australia
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Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study. Sci Rep 2020; 10:1667. [PMID: 32015380 PMCID: PMC6997407 DOI: 10.1038/s41598-020-58548-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.
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19
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Carvalho MFMSD, Cavalieri D, Do Nascimento S, Lourenço TGB, Ramos DVR, Pasqualin DDC, Martins LAL, Rocha FA, Heller D, Marti L. Cytokines Levels and Salivary Microbiome Play A Potential Role in Oral Lichen Planus Diagnosis. Sci Rep 2019; 9:18137. [PMID: 31792433 PMCID: PMC6889227 DOI: 10.1038/s41598-019-54615-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 11/12/2019] [Indexed: 12/22/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic Th1-mediated inflammatory mucocutaneous disease of the skin and oral mucosa that can have various clinical presentations. Lesions are usually bilateral and often painful. While cutaneous Lichen Planus (LP) lesions are self-limiting, the oral lesions are chronic and rarely remissive. The diagnosis of oral lichen planus (OLP) is often challenging, and confirmation by histopathological criterion is generally advised. The aim of our study was to identify the cytokines present in OLP-suggestive lesions and in non-specific inflammatory lesions (NSIL) used as controls. Moreover, assess cytokines protein levels and oral microbiota composition in whole saliva samples. Histopathological analysis, immunohistochemistry and gene expression were used as techniques to analyze the oral mucosal tissue samples. ELISA was conducted to analyze salivary cytokine levels and 16S rRNA sequencing was used to determine the salivary microbiome. As a result we observed larger number of infiltrated lymphocytes (p = 0.025), as well, more T CD4 lymphocytes in the epithelial tissue (p = 0.006) in OLP samples compared to NSIL. In addition, the OLP samples displayed more apoptotic cells compared to NSIL (p = 0.047). Regarding the cytokine analysis, IFN-γ and IL-33 were more expressed in OLP lesions than in NSIL samples (p < 0.001; p = 0.026). Furthermore, our results demonstrated higher levels of IFN-γ protein expression in the saliva of OLP group compared to controls (p = 0.0156). We also observed noted differences in the oral microbiota composition between OLP and NSIL saliva samples. In conclusion, OLP lesions presented larger numbers of apoptotic and inflammatory cells, higher levels of IFN-γ and IL-33 compared to NSIL, and these lesions also differ regarding oral microbiota composition. These results are consistent with the Th-1-mediated chronic inflammation nature of oral lichen planus investigated lesions and displayed unique features that could be used as a diagnostic tool.
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Affiliation(s)
| | - Denise Cavalieri
- Secretaria Municipal de Saúde de São Paulo, Centro de Especialidades Odontológicas III Alto da Boa Vista, São Paulo, Brazil
| | | | | | | | | | | | | | - Débora Heller
- Hospital Israelita Albert Einstein, Experimental Research, São Paulo, Brazil.,Universidade Cruzeiro do Sul - College of Dentistry, São Paulo, Brazil
| | - Luciana Marti
- Hospital Israelita Albert Einstein, Experimental Research, São Paulo, Brazil.
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20
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Kumaran MS, Bishnoi A, Srivastava N, Tekumalla S, Vinay K, Bhatia A, Parsad D. Significant reduction in the expression of interleukins-17A, 22 and 23A, forkhead box p3 and interferon gamma delineates lichen planus pigmentosus from lichen planus. Arch Dermatol Res 2019; 311:519-527. [PMID: 31089878 DOI: 10.1007/s00403-019-01926-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/14/2019] [Accepted: 05/02/2019] [Indexed: 12/13/2022]
Abstract
Recent studies have noticed significant role of interleukin (IL)-17, 22, 23, Foxp3, interferon-gamma (IFN-γ) and Wnt5a in oral and cutaneous lichen planus (LP). This study was undertaken to assess whether similar expression exists in lichen planus pigmentosus (LPP). We recruited 30 patients of treatment-naïve 'LPP' (in absence of cutaneous/mucosal LP elsewhere, group 1), 10 patients having active treatment-naïve cutaneous 'LP' (group 2), 10 patients having 'post-LP' hyperpigmentation (in absence of active LP and off treatment for at least past 3 months, group 3), and 10 controls. Quantitative real-time polymerase chain reaction (qRT-PCR, peripheral blood mononuclear cells [PBMCs] and skin) and immunohistochemistry (IHC, skin) was performed. mRNA expression (in PBMCs) of IL-17A, IL-22, IL-23A, IFN-γ and Foxp3 was significantly decreased in group 1 and 3 as compared to group 2 (p < 0.05). Wnt5a expression was maximal in controls; and while there was no difference between group 1 and 2; whereas expression in group 3 was significantly lesser than group 1 and 2 (p < 0.05). qRT-PCR (skin) and IHC (skin) revealed similar results; and mRNA expression and mean fluorescence intensity of IL-17A, IL-22, IL-23A/R was significantly increased in group 2 and 3 compared to group 1 (p < 0.05). Mean fluorescence intensity and mRNA expression of IFN-γ, Foxp3 and Wnt5a were significantly increased in group 2 compared to group 1 (p < 0.05); whereas the difference between group 1 and 3 was not significant. Mean fluorescence intensity and mRNA expression of IL-17A, 1L-22 and IFN-γ showed no difference between group 2 and 3; whereas that of IL-23A/R, foxp3 and wnt5a were significantly higher in group 2 than group 3 (p < 0.05). Overall, maximal expression of IL-17A, IL-22, IL-23A, IFN-γ and Foxp3 (mRNA PBMCs) was observed in LP. Minimal expression of IL-17A, IL-22, IL-23A/R, IFN-γ and Foxp3 (mRNA skin and IHC skin) was seen in LPP patients. In contrast to LP, LPP lacks the expression of IFN-γ, Foxp3 and the cytokines representing Th17 pathway, and thus seems to have a distinct pathogenesis.
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Affiliation(s)
- Muthu Sendhil Kumaran
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Anuradha Bishnoi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Niharika Srivastava
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Sindhuja Tekumalla
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Alka Bhatia
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Davinder Parsad
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
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Artemisinin and its derivatives: a potential therapeutic approach for oral lichen planus. Inflamm Res 2019; 68:297-310. [DOI: 10.1007/s00011-019-01216-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 12/20/2022] Open
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Wang J, Yang L, Wang L, Yang Y, Wang Y. Forkhead box p3 controls progression of oral lichen planus by regulating microRNA‐146a. J Cell Biochem 2018; 119:8862-8871. [PMID: 30125971 DOI: 10.1002/jcb.27139] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/18/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Jing Wang
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
| | - Lijie Yang
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
| | - Luyao Wang
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
| | - Yanjie Yang
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
| | - Yannan Wang
- Department of Stomatology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China
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Schmidt T, Solimani F, Pollmann R, Stein R, Schmidt A, Stulberg I, Kühn K, Eming R, Eubel V, Kind P, Arweiler N, Sitaru C, Hertl M. T H1/T H17 cell recognition of desmoglein 3 and bullous pemphigoid antigen 180 in patients with lichen planus. J Allergy Clin Immunol 2018; 142:669-672.e7. [PMID: 29626572 DOI: 10.1016/j.jaci.2018.02.044] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/02/2018] [Accepted: 02/21/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Thomas Schmidt
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Farzan Solimani
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Robert Pollmann
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Ronja Stein
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Ansgar Schmidt
- Department of Pathology, Philipps-University, Marburg, Germany
| | - Inna Stulberg
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Katja Kühn
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Rüdiger Eming
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Verena Eubel
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany
| | - Peter Kind
- Hautzentrum Offenbach, Offenbach, Germany
| | - Nicole Arweiler
- Department of Periodontology, Philipps-University, Marburg, Germany
| | - Cassian Sitaru
- Department of Dermatology, Albert-Ludwigs-University, Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Freiburg, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-University, Marburg, Germany.
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24
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Gueiros LA, Arão T, Souza T, Vieira CL, Gomez RS, Almeida OP, Lodi G, Leão JC. IL17A polymorphism and elevated IL17A serum levels are associated with oral lichen planus. Oral Dis 2017; 24:377-383. [DOI: 10.1111/odi.12718] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 12/13/2022]
Affiliation(s)
- LA Gueiros
- Centro de Ensino e Pesquisa de Laser em Odontologia - CEPLO; Programa de Pós-graduação em Odontologia; Universidade Federal de Pernambuco; Recife Brazil
| | - T Arão
- Departamento de Cirurgia Oral e Patologia; Faculdade de Odontologia; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - T Souza
- Centro de Ensino e Pesquisa de Laser em Odontologia - CEPLO; Programa de Pós-graduação em Odontologia; Universidade Federal de Pernambuco; Recife Brazil
| | - CL Vieira
- Centro de Ensino e Pesquisa de Laser em Odontologia - CEPLO; Programa de Pós-graduação em Odontologia; Universidade Federal de Pernambuco; Recife Brazil
| | - RS Gomez
- Departamento de Cirurgia Oral e Patologia; Faculdade de Odontologia; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - OP Almeida
- Área de Patologia; Faculdade de Odontologia de Piracicaba; Universidade Estadual de Campinas; Piracicaba Brazil
| | - G Lodi
- Oral Medicine Unit; Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche; Università degli Studi di Milano; Milan Italy
| | - JC Leão
- Centro de Ensino e Pesquisa de Laser em Odontologia - CEPLO; Programa de Pós-graduação em Odontologia; Universidade Federal de Pernambuco; Recife Brazil
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25
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de Barros Gallo C, Marichalar-Mendia X, Setien-Olarra A, Acha-Sagredo A, Bediaga NG, Gainza-Cirauqui ML, Sugaya NN, Aguirre-Urizar JM. Toll-like receptor 2 rs4696480 polymorphism and risk of oral cancer and oral potentially malignant disorder. Arch Oral Biol 2017. [DOI: 10.1016/j.archoralbio.2017.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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26
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Zhou L, Cao T, Wang Y, Yao H, Du G, Chen G, Niu X, Tang G. Frequently Increased but Functionally Impaired CD4+CD25+ Regulatory T Cells in Patients with Oral Lichen Planus. Inflammation 2017; 39:1205-15. [PMID: 27106476 DOI: 10.1007/s10753-016-0356-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory mucosal disease, and CD4(+)CD25(+) regulatory T cells (Tregs) are considered involved in the pathogenesis of OLP. In this study, to investigate whether there are intrinsic factors that might cause functional changes in Tregs in this disease, we evaluated the frequency of Tregs in peripheral blood and oral lesions and the expression levels of function-related transcription factors, forkhead/winged-helix transcription factor box P3 (FOXP3), transforming growth factor β (TGF-β), interleukin 10 (IL-10), and TGF-β receptors (TβRI and TβRII) mRNAs in Tregs of patients with oral lichen planus (OLP). We also investigated the frequency of pro-inflammatory cytokines (IFN-γ and IL-17A) producing Foxp3(+) regulatory cells. Increased proportions of Tregs were found in OLP patients. The expression of FOXP3 on mRNA and protein level was elevated in the Tregs of OLP. The expression of TGF-β was lower both on the mRNA and serum level, whereas the expression of IL-10 showed no significant difference between the OLP patients and normal controls. The percentages of CD4(+)FOXP3(+)IL-17(+) T cells were significantly higher than that of normal controls, whereas the percentages of CD4(+)FOXP3(+)IFN-γ(+) T cells did not differ significantly. Furthermore, impaired suppressive function of CD4(+)CD25(+) T cells was demonstrated in OLP patients by in vitro proliferation assay. These data indicate that Tregs in OLP are frequently expanded but functionally deficient. This could explain, at least in part, why the increased Tregs in OLP fail to control the pathogenesis and development of this autoimmune disease.
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Affiliation(s)
- Leilei Zhou
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Tianyi Cao
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Yufeng Wang
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Hui Yao
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Guanhuan Du
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Guangjie Chen
- Department of Immunology, Institutes of Medical Sciences, Shanghai Institute of Immunology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaoyin Niu
- Department of Immunology, Institutes of Medical Sciences, Shanghai Institute of Immunology, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Guoyao Tang
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People' s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Peng Q, Zhang J, Ye X, Zhou G. Tumor-like microenvironment in oral lichen planus: evidence of malignant transformation? Expert Rev Clin Immunol 2017; 13:635-643. [PMID: 28494213 DOI: 10.1080/1744666x.2017.1295852] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Qiao Peng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Jing Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
- Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Xiaojing Ye
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
- Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
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Anderson JG, Peralta S, Kol A, Kass PH, Murphy B. Clinical and Histopathologic Characterization of Canine Chronic Ulcerative Stomatitis. Vet Pathol 2017; 54:511-519. [PMID: 28113036 DOI: 10.1177/0300985816688754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Canine chronic ulcerative stomatitis, also known as chronic ulcerative paradental stomatitis, is a painful condition of the oral cavity. The purpose of this study was to determine if there are commonalities in clinical and radiographic features among patients, whether the histopathologic evaluation might inform the pathogenesis, and whether the condition appears similar to human oral mucosal diseases. To do this, we prospectively collected clinical, radiographic, and histopathologic data from 20 dogs diagnosed with the disease. Clinical data were based on a clinical disease activity index, oral and periodontal examination parameters, and full-mouth dental radiographs. The histopathological and immunohistochemical data were based on oral mucosal samples obtained from erosive or ulcerated areas. Our findings revealed that canine chronic stomatitis is clinically characterized by painful oral mucosal ulcers of varying size, pattern, appearance, and distribution, most often associated with teeth with early periodontitis. Histologic examination revealed a subepithelial lichenoid band (interface mucositis) where B cells, T cells, and Forkhead-box protein 3 (FoxP3)- and interleukin-17-expressing cells were present. These cells might play a role in the underlying immune response and an immune-mediated pathogenesis is suspected. The clinical and histopathologic features of this chronic inflammatory mucosal disease in dogs resemble those of oral lichen planus in humans.
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Affiliation(s)
- J G Anderson
- 1 Sacramento Veterinary Dental Services, Rancho Cordova, CA, USA
| | - S Peralta
- 2 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - A Kol
- 3 Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA, USA
| | - P H Kass
- 4 Department of Analytic Epidemiology, School of Veterinary Medicine and School of Medicine, University of California, Davis, CA, USA
| | - B Murphy
- 3 Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA, USA
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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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Weber B, Schlapbach C, Stuck M, Simon HU, Borradori L, Beltraminelli H, Simon D. Distinct interferon-gamma and interleukin-9 expression in cutaneous and oral lichen planus. J Eur Acad Dermatol Venereol 2016; 31:880-886. [PMID: 27696572 DOI: 10.1111/jdv.13989] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/22/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cutaneous (CLP) and oral lichen planus (OLP) as the main subtypes of lichen planus (LP) present with different clinical manifestation and disease course, although their histopathologic features such as the band-like lymphocyte infiltrate and keratinocyte apoptosis are similar. So far, the underlying cellular and molecular mechanisms remain poorly understood. OBJECTIVE The aim of this study was to characterize and compare the in situ cellular infiltrates, cytokine expression profiles and apoptosis markers in CLP and OLP. METHODS Using immunofluorescence staining and laser scanning microscopy, we evaluated the cellular infiltrate (CD1a, CD3, CD4, CD8, CD21, CD57, CD123), cytokine expression (interleukin (IL)-1, IL-6, IL-9, IL-10, IL-17, IL-22, IL-23, tumour necrosis factor-α, transforming growth factor-β, interferon (IFN)-γ), and apoptosis markers (Fas, Fas ligand, cleaved caspase-3, TUNEL) of 21 anonymized biopsy specimens of LP (11 CLP, 10 OLP). RESULTS Among infiltrating cells mainly T cells and natural killer (NK) cells as well as plasmacytoid dendritic cells (DC) were observed. A predominance of CD8+ T cells was noted in OLP. In both CLP and OLP, T helper (Th)1, Th9, Th17, and Th22-type cytokines were expressed. The expression of IL-9, IFN-γ and IL-22 was higher in CLP compared to that of OLP (P = 0.0165; P = 0.0016; P = 0.052 respectively). Expression of Fas and Fas ligand as well as cleaved caspase-3-positive cells was observed in the epithelium of all LP samples. CONCLUSIONS The cell and cytokine patterns of CLP and OLP were partially distinct and generally resembled those reported for autoimmune diseases. The presence of CD8+ and NK cells as well as Fas/Fas ligand expression suggested that various pathways involved in keratinocyte apoptosis are relevant for LP. These results might help to establish targeted therapies for LP.
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Affiliation(s)
- B Weber
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Schlapbach
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M Stuck
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - H-U Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - L Borradori
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - H Beltraminelli
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Regulatory T-cells and IL17A+ cells infiltrate oral lichen planus lesions. Pathology 2016; 48:564-73. [DOI: 10.1016/j.pathol.2016.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 05/11/2016] [Accepted: 06/09/2016] [Indexed: 12/29/2022]
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Speeckaert R, Lambert J, Grine L, Van Gele M, De Schepper S, van Geel N. The many faces of interleukin-17 in inflammatory skin diseases. Br J Dermatol 2016; 175:892-901. [PMID: 27117954 DOI: 10.1111/bjd.14703] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 01/04/2023]
Abstract
Interleukin (IL)-17 is an emerging target for inflammatory skin disorders. Given the remarkable success of its therapeutic inhibition in psoriasis, the pathogenic role of this cytokine is being explored in other immune-mediated diseases. Interestingly, IL-17 is linked to particular skin conditions where its activation coincides with disease flares. The leading hypothesis for its contribution to proinflammatory signalling cascades is driving inflammasome activation. However, IL-17 stimulation also releases a range of noninflammasome-related cytokines from human skin. Furthermore, a role in cytotoxic responses and an important interplay with the microbiome is hypothesized. While treatment failure would be surprising in neutrophilic dermatoses, the picture might be more complex in lymphocyte-mediated conditions. Nonetheless, increasing insights into the pathogenesis suggest that beneficial responses are also probable in the latter conditions. Study of this pathway in the skin reveals some intriguing aspects of the IL-17-related immunological network.
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Affiliation(s)
- R Speeckaert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
| | - J Lambert
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - L Grine
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - M Van Gele
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - S De Schepper
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
| | - N van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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Shakweer MM, Behairy M, Elhefnawy NG, Elsaid TW. Value of Foxp3 expressing T-regulatory cells in renal tissue in lupus nephritis; an immunohistochemical study. J Nephropathol 2016; 5:105-10. [PMID: 27540538 PMCID: PMC4961819 DOI: 10.15171/jnp.2016.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 06/28/2016] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Forkhead box P3 (Foxp3) functions as a master regulator in the development and function of T-regulatory (Treg) cells. Recent studies have shown that autoimmune diseases including systemic lupus erythematosus (SLE) are associated with an imbalance with the Treg cells and T helper (Th) subtypes. OBJECTIVES To evaluate immunohistochemical expression of Foxp3 positive Treg cells in lupus nephritis (LN) and analyze its association with clinicopathologic parameters. MATERIALS AND METHODS Renal biopsy specimens of 50 patients with LN were studied. Specimens were divided into; group A; 25 LN cases without proliferative activity (Class II and V) and group B: 25 cases with proliferative activity (Class III and IV). Immunohistochemical staining for anti-human Foxp3 antibody and grading from grade 0 to grade 3 was done. RESULTS Foxp3 expression in group A was (grade 0 in 14 [56.0%], grade +1 in 11 [44.0 %]) in comparison to group B (grade +1 in 6 [24.0%], grade +2 in 11 [44.0%] and grade +3 in 8 [32.0%]) (P < 0.001). Foxp3 expression was significantly correlated to National Institutes of Health (NIH) activity and chronicity indices (P < 0.05), as well as serum creatinine (P < 0.01) in both groups A and B and there was a highly significant correlation with proteinuria (P < 0.01) in group B with proliferative LN. CONCLUSIONS Immunohistochemical Foxp3 expression in renal tissue was higher in proliferative versus non-proliferative LN and is associated with activity and severity of LN. Further studies are needed to determine its prognostic value in LN.
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Affiliation(s)
- Marwa M Shakweer
- Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Maha Behairy
- Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nadia G Elhefnawy
- Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer W Elsaid
- Internal Medicine and Nephrology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Domingues R, de Carvalho GC, Aoki V, da Silva Duarte AJ, Sato MN. Activation of myeloid dendritic cells, effector cells and regulatory T cells in lichen planus. J Transl Med 2016; 14:171. [PMID: 27286889 PMCID: PMC4901415 DOI: 10.1186/s12967-016-0938-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/02/2016] [Indexed: 02/08/2023] Open
Abstract
Background Lichen planus (LP) is a chronic mucocutaneous inflammatory disease. Evaluating the balance between regulatory T cells and effector T cells could be useful for monitoring the proinflammatory profile of LP. Therefore, this study aimed to assess populations of dendritic cells (DCs) and regulatory and effector T cells in peripheral blood samples collected from patients with LP to evaluate the polyfunctionality of T cells upon toll-like receptor (TLR) activation. Methods Peripheral blood mononuclear cells collected from 18 patients with LP and 22 healthy control subjects were stimulated with agonists of TLR4, TLR7, TLR7/TLR8 or TLR9. Frequencies of circulating IFN-α+ plasmacytoid DCs (pDCs); TNF-α+ myeloid DCs (mDCs); regulatory T cells (Tregs); and IL-17-, IL-10-, IL-22-, TNF-, and IFN-γ-secreting T cells were assessed via flow cytometry. Results The frequencies of regulatory CD4+ and CD8+CD25+Foxp3+CD127low/− T cells and TNF-α+ mDCs were induced following activation with TLR4, TLR7 and TLR8 agonists in the LP group. Moreover, increased baseline frequencies of CD4+IL-10+ T cells and CD8+IL-22+ or IFN-γ+T cells were found. In the LP group, TLR4 activation induced an increased frequency of CD4+IFN-γ+ T cells, while TLR7/8 and staphylococcal enterotoxin B (SEB) activation induced an increased frequency of CD8+ IL-22+ T cells. An increased frequency of polyfunctional CD4+ T cells that simultaneously secreted 3 of the evaluated cytokines (not including IL-10) was verified upon TLR7/8/9 activation, while polyfunctional CD8+ T cells were already detectable at baseline. Conclusions TLR-mediated activation of the innate immune response induced the production of proinflammatory mDCs, Tregs and polyfunctional T cells in patients with LP. Therefore, TLR activation has an adjuvant role in inducing both innate and adaptive immune responses. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0938-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosana Domingues
- Laboratory of Dermatology and Immunodeficiencies, LIM-56, Department of Dermatology, Medical School, University of São Paulo, Institut of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 500, 3rd floor 24, São Paulo, 05403-000, Brazil
| | - Gabriel Costa de Carvalho
- Laboratory of Dermatology and Immunodeficiencies, LIM-56, Department of Dermatology, Medical School, University of São Paulo, Institut of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 500, 3rd floor 24, São Paulo, 05403-000, Brazil
| | - Valéria Aoki
- Dermatological Outpatient Clinic, Hospital das Clínicas, Medical School of the University of São Paulo, São Paulo, Brazil
| | - Alberto José da Silva Duarte
- Laboratory of Dermatology and Immunodeficiencies, LIM-56, Department of Dermatology, Medical School, University of São Paulo, Institut of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 500, 3rd floor 24, São Paulo, 05403-000, Brazil
| | - Maria Notomi Sato
- Laboratory of Dermatology and Immunodeficiencies, LIM-56, Department of Dermatology, Medical School, University of São Paulo, Institut of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 500, 3rd floor 24, São Paulo, 05403-000, Brazil.
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Kurago ZB. Etiology and pathogenesis of oral lichen planus: an overview. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:72-80. [PMID: 27260276 DOI: 10.1016/j.oooo.2016.03.011] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 02/07/2023]
Abstract
Oral lichen planus is a noninfectious, chronic inflammatory condition that involves the oral mucosal stratified squamous epithelium and the underlying lamina propria and may be accompanied by skin lesions. This overview describes the current understanding of the immunopathologic mechanisms implicated in oral lichen planus.
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Affiliation(s)
- Zoya B Kurago
- Associate Professor, Departments of Oral Health and Diagnostic Sciences and Oral Biology, Augusta University Dental College of Georgia; Department of Pathology, Augusta University Medical College of Georgia; Augusta University Cancer Center, Augusta, GA, USA.
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Nuzzolo P, Celentano A, Bucci P, Adamo D, Ruoppo E, Leuci S, Mignogna MD. Lichen planus of the lips: an intermediate disease between the skin and mucosa? Retrospective clinical study and review of the literature. Int J Dermatol 2016; 55:e473-81. [DOI: 10.1111/ijd.13265] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 11/05/2015] [Accepted: 11/18/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Paolo Nuzzolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
| | - Antonio Celentano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - Paolo Bucci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
| | - Daniela Adamo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
| | - Elvira Ruoppo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; University Federico II of Naples; Naples Italy
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Abstract
Oral lichen planus (OLP) is a common T cell-mediated mucocutaneous disease of unknown etiology. A great number of factors have been suggested as relevant to the etiology of this disease. In this article, the authors assemble recent knowledge about the pathogenesis of OLP, discuss some proposed hypotheses, and compare OLP with oral lichenoid lesions.
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Affiliation(s)
- Patrícia A Nogueira
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sueli Carneiro
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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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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Zhang Y, Zhang D, Tu C, Zhou P, Zheng Y, Peng Z, Feng Y, Xiao S, Li Z. Wnt5a is involved in the pathogenesis of cutaneous lichen planus. Clin Exp Dermatol 2015; 40:659-64. [PMID: 25581355 DOI: 10.1111/ced.12561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cutaneous lichen planus (CLP) is a chronic inflammatory and immune-mediated disease. Wnt5a is one of the most extensively studied Wnt proteins, and has important functions in stimulating inflammation, cell proliferation, cell fate determination and cell differentiation. Wnt5a expression in CLP has not been comprehensively studied to date. AIM To determine the expression and distribution of Wnt5a in CLP. METHODS Skin samples were obtained from patients with CLP and healthy controls (HCs). The WNT5A gene was detected by real-time quantitative PCR, and Wnt5a protein by immunohistochemical analysis and western blotting. RESULTS WNT5A mRNA was upregulated in CLP samples compared with the HC skin samples (P < 0.001). Wnt5a protein was overexpressed in all layers of the epidermis and dermis in CLP lesions compared with HC skin (all P < 0.001). These results were confirmed by western blotting. CONCLUSIONS The data presented in this study suggest that Wnt5a pathway may play an important role in the pathogenesis of CLP.
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Affiliation(s)
- Y Zhang
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - D Zhang
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - C Tu
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - P Zhou
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Y Zheng
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Z Peng
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Y Feng
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - S Xiao
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
| | - Z Li
- Department of Dermatology, Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, PR China
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