Comparison of serum lipid parameters between patients with classic cutaneous lichen planus and oral lichen planus

Relationship between Oral Lichen Planus and Cardiovascular Disease of Atherosclerotic Origin: Systematic Review and Meta-Analysis

Background/Objectives: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral mucosa that affects between 0.5% and 2% of the general population. In the last decade, several studies have associated cardiovascular diseases (CVDs) with some inflammatory skin diseases such as oral lichen planus, demonstrating the presence of dyslipidemia in these pathologies. The objective of this work is to review whether patients with OLP show higher dyslipidemia and CRP levels compared to a healthy control population without OLP. Methods: Searches were carried out in Medline, Scopus, and Cochrane. The studies had to perform a histopathological diagnosis for OLP and the patients could not take any medication to treat this disorder. Non-lichenoid reactions were included. Results: After an initial search that provided us with 254 papers, this number was reduced to 10 articles after a detailed evaluation. All of them were case-control studies that compared the presence of analytical cardiovascular risk factors in patients affected by OLP and in healthy subjects. Conclusions: There is no scientific evidence of the possible association between OLP and CVDs. The only association we can prove is the one between OPL and CVD risk factors, especially those related to the lipid profile. More studies are needed in order to evaluate this relationship in patients diagnosed with CVDs.

Potential implication of serum lipid levels as predictive indicators for monitoring oral lichen planus

Compelling evidence indicates that dyslipidemia is positively associated with oral lichen planus (OLP). The types and magnitude of lipid metabolism disturbance in peripheral blood of OLP patients have been investigated in different studies. Yet, consensus on how these different lipid components varied in levels for the development of OLP lesions has not been reached so far. Herein, a total of 8 eligible studies were recognized, which enrolled 533 cases of OLP and 499 healthy controls. The analysis showed that the average total triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) levels were considerably higher, and high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in OLP patients compared to healthy controls. Collectively, the lipid profile panel maybe serve as the potential predictive indicator for screening OLP.

Potential relationship of dyslipidemia with dietary patterns in oral lichen planus patients-A case-control study

Background/purpose

Dyslipidemia and a high fat diet may increase the predisposition for accumulating body fat in patients with oral lichen planus (OLP). This study aimed to investigate the risk factors obesity, dietary patterns, and lipid metabolism.

Materials and methods

A population-based case-control study was conducted between September 2020 and October 2021, recruiting 275 pairs of OLP cases and controls. Information on lipid profiles, diet frequency and waist circumference were gathered. Principal component and factor analysis were used to analyze the semi-quantitative dietary frequency survey data of patients to extract specific dietary patterns.

Results

Univariate analysis showed that total cholesterol, triglycerides, and low-density lipoprotein were significantly higher in the OLP group than the control and other oral mucosal disease groups (P < 0.05, P < 0.001, and P < 0.001, respectively). Compared with the baseline group, obese and overweight patients were more common in the OLP group. Dyslipidemia was more common in the OLP group (68%) compared to the healthy mucosa group (32%; P < 0.001, OR = 4.52, 95% CI = 2.49-8.18). Four dietary patterns were described among the subjects. The traditional prone animal food pattern (OR: 24.81, 95% CI: 6.05-101.71, P < 0.001) and animal food pattern (OR: 28.77, 95% CI: 8.10-102.15, P = 0.001) were associated with an increased risk of OLP.

Conclusion

The results indicated that a high-fat diet, dyslipidemia and obesity were strongly linked to disease progression in OLP. A diet high in processed food and fat could increase the risk of OLP.

ASCT2-mediated glutamine uptake promotes Th1 differentiation via ROS-EGR1-PAC1 pathway in oral lichen planus

Oral lichen planus (OLP) is a T cell-mediated autoimmune disease of oral mucosa concerning with the redox imbalance. Although glutamine uptake mediated by alanine-serine-cysteine transporter 2 (ASCT2) is critical to T cell differentiation, the exact mechanism remains ambiguous. Here, we elucidate a novel regulatory mechanism of ASCT2-mediated uptake in the differentiation and proliferation of T cells through maintaining redox balance in OLP. The results of immunohistochemistry (IHC) showed that both ASCT2 and glutaminase (GLS) were obviously upregulated compared to controls in OLP. Moreover, correlation analyses indicated that ASCT2 expression was significantly related to GLS level. Interestingly, the upregulation of glutamine metabolism in epithelial layer was consistent with that in lamina propria. Functional assays in vitro revealed the positive association between glutamine metabolism and lymphocytes infiltration. Additionally, multiplex immunohistochemistry (mIHC) uncovered a stronger colocalization among ASCT2 and CD4 and IFN-γ, which was further demonstrated by human Th1 differentiation assay in vitro. Mechanistically, targeting glutamine uptake through interference with ASCT2 using L-γ-Glutamyl-p-nitroanilide (GPNA) decreased the glutamine uptake of T cells and leaded to the accumulation of intracellular reactive oxygen species (ROS), which promoted dual specificity phosphatase 2 (DUSP2/PAC1) expression through activation of early growth response 1 (EGR1) to induce dephosphorylation of signal transducer and activator of transcription 3 (STAT3) and inhibit Th1 differentiation in turn. These results demonstrated that glutamine uptake mediated by ASCT2 induced Th1 differentiation by ROS-EGR1-PAC1 pathway, and restoring the redox dynamic balance through targeting ASCT2 may be a potential treatment for T cell-mediated autoimmune diseases.

Lipid Aberrations in Lichen Planus

Lichen planus (LP) is a dermatosis without a fully understood etiopathogenesis, the frequency of which is estimated to be less than 1% among the population. LP may involve the glabrous skin, mucosal membranes, scalp, nails and genital area. Nowadays, there are reports of its association with lipid homeostasis aberrations. In this review, we present the contemporary view of this matter. Dyslipidemia, especially hypertriglyceridemia, seems to be an actual problem in this group of patients, and along with abnormal arterial vessel parameters, indicates an increased risk of atherosclerosis in these subjects. Dermatologists should be attentive to this relationship and aware that the patients may develop different metabolic complications. More studies are required to establish clear guidelines on the management of lipid aberrations in lichen planus.

Lipid Profiles and Cardiovascular Risk in Patients with Oral Lichen Planus

Background: It has been reported that dyslipidemia prevalence and cardiovascular disease risk were increased in subjects with oral lichen planus diagnose. On the other hand, so far, there is no available data on the topic of cardiovascular risk (CVR) in subjects with oral lichen planus (OLP). The main aim of this study, due to lack of any other study covering this topic, was to investigate lipid profile and assess CVR in patients with OLP. Materials and Methods: To create a routine lipid profile, we collected triglyceride serum levels, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol from 63 OLP patients and 63 healthy people representing control subjects. For every patient their individual cardiovascular risk was measured. Results: In comparison with the tested control subjects, patients with OLP had all parameters of the lipid profile elevated, with no differences of statistical importance. Furthermore, the experimental (OLP) and control groups shared similar mean values of the lipid profile parameters. Conclusions: The association of OLP with cardiovascular risk was not established and further studies with more subjects involved are required to validate this connection.

Increased Level of Serum Wingless-Type Mouse Mammary Tumor Virus Integration Site Family Member 5a in Patients with Cutaneous Lichen Planus

Purpose

Methods

Results

Conclusion

Evaluation of the Altered Tissue Expression of HSP60 and HSP70 Genes in Oral and Cutaneous Lichen Planus Compared to Normal Healthy Tissues

Background:

Recent highlights have investigated the possible roles of molecular chaperons like heat shock proteins (HSPs) into Lichen Planus (LP)-onset and pathogenesis. This study for the first, determine the expression of both HSP60 and HSP70 genes in cutaneous LP (CLP) and oral LP (OLP) lesions compared to normal healthy cases and between different subtypes of OLP lesions by real-time (RT)-PCR.

Materials and Methods:

Paraffin blocks of LP lesions including 56 OLP and 56 CLP samples were selected from theMashhad University of Medical sciences, Mashhad, Iran. Also 56 biopsy samples of healthy normal participants were selected. The demographic and clinical characteristics were extracted from their medical records. The expression of HSP60 and HPS70 genes were evaluated using the real-time RT-PCR method.

Results:

The comparison of the expression of HSP60 and HSP70 genes among the patients with CLP and OLP showed a significant overexpression of HSP60 and HSP70 genes in both groups compared to the normal participants (P = 0.001). The expression of HSP60 and HSP70 genes was high in both the groups of CLP and OLP patients, but the amount was not significantly different between the two groups. Comparing the two mucosal subgroups of OLP lesions (non-erosive and erosive) showed that the expression of the HSP60 and HSP70 in erosive subtypes of OLP was significantly higher than the non-erosive subtypes of OLP (P = 0.001).

Conclusion:

Regarding the overexpression of HSP60 and HSP70 in the LP lesions compared to healthy biopsies, we conclude that HSP60 and HSP70 could have key roles in the etiopathogenesis of the OLP and CLP lesions. The overexpression of both HSP60 and HSP70 in the erosive OLP group compared to the non-erosive OLP group emphasized the possible roles of HSPs in the pathogenesis and premalignant changes of OLP lesions.

Evaluation of correlation between transcription factors and IL-17 in oral and cutaneous lichen planus lesions and Leukocytes

BACKGROUND

Lichen planus (LP) is a chronic autoimmune disease with different clinical subtypes including cutaneous LP (CLP) and oral LP (OLP). We aimed to compare mRNA expression of RORγt and IL-17 in paraffin-embedded blocks of OLP and CLP lesions with normal oral mucosa (NOM), and also its correlation with hematologic parameters.

MATERIALS & METHODS

This study included 89 paraffin-embedded blocks contain OLP (44 cases), CLP (45 cases) and NOM from the archive of Mashhad University of Medical Sciences, Mashhad, Iran. The expression of RORγt and IL-17 was evaluated by Real-time RT-PCR method. The result was compared to Leukocyte counts and the other hematological parameters of studied patients.

RESULTS

The results of our study showed IL-17 and RORγt expression in OLP lesions were significantly higher than CLP and NOM groups (P = 0.001). Although we found high expression of RORγt and IL-17 in erosive OLP in compared to classic OLP lesion, but this increment was not significant for IL-17 (P = 0.26) and RORγt (P = 0.14). Further, Leukocyte and monocyte counts were substantially high in OLP group in compared to the CLP and NOM groups (P < 0.05).

CONCLUSIONS

We concluded that increased expression of RORγt and IL-17 in LP lesions could play role in the pathogenesis of LP. As well, higher expression of RORγt and IL-17 in oral LP more than cutaneous LP might be associated with difference in clinical behavior of the two types of disease and role of these factors in premalignant behavior of OLP lesions.

High serum level of interleukin-6 is linked with dyslipidemia in oral lichen planus

Oral lichen planus (OLP) is a complex chronic inflammatory disorder in which autocytotoxic CD8⁺ T cells, locally present in the affected tissue, induce basal keratinocyte apoptosis, through the release of several cytokines, such as interleukin-6 (IL-6). IL-6 is a proinflammatory cytokine that is related to alterations in lipid metabolism in psoriasis patients. Impaired lipid metabolism together with high serum levels of triglycerides have been found in association with OLP. However, the correlation between serum levels of IL-6 and dyslipidemia has not yet been studied in this disorder. The present study aimed to demonstrate the association between OLP, systemic inflammation through increased release of inflammation mediators such as IL-6 and alteration of lipid metabolism, in order to support the concept of OLP as a marker of systemic inflammation and a potential risk factor of cardiovascular morbidities. For this purpose, we designed a case-control study using a cohort of 18 patients with different clinical forms of OLP compared with 18 control group patients with other oral conditions, to identify a potential correlation between serum levels of IL-6 and serum lipid levels. High plasma serum levels of IL-6 were found to be correlated with cholesterol, high density lipoprotein cholesterol and triglyceride serum levels in the patients with OLP. There was a significant association between erosive and atrophic clinical forms of OLP and the pathological serum values of IL-6 and triglycerides, respectively, making these two parameters good predictive factors of the clinical form of OLP. Further studies of other biomarkers of systemic inflammation using larger cohorts of OLP patients are necessary in order to consider LP as a marker of systemic inflammation and to support the screening of these patients for lipid metabolism changes and treatment with specific antagonists in order to prevent cardiovascular events.