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Silva AB, Martins AS, Tosta TAA, Loyola AM, Cardoso SV, Neves LA, de Faria PR, do Nascimento MZ. OralEpitheliumDB: A Dataset for Oral Epithelial Dysplasia Image Segmentation and Classification. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:1691-1710. [PMID: 38409608 DOI: 10.1007/s10278-024-01041-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/28/2024]
Abstract
Early diagnosis of potentially malignant disorders, such as oral epithelial dysplasia, is the most reliable way to prevent oral cancer. Computational algorithms have been used as an auxiliary tool to aid specialists in this process. Usually, experiments are performed on private data, making it difficult to reproduce the results. There are several public datasets of histological images, but studies focused on oral dysplasia images use inaccessible datasets. This prevents the improvement of algorithms aimed at this lesion. This study introduces an annotated public dataset of oral epithelial dysplasia tissue images. The dataset includes 456 images acquired from 30 mouse tongues. The images were categorized among the lesion grades, with nuclear structures manually marked by a trained specialist and validated by a pathologist. Also, experiments were carried out in order to illustrate the potential of the proposed dataset in classification and segmentation processes commonly explored in the literature. Convolutional neural network (CNN) models for semantic and instance segmentation were employed on the images, which were pre-processed with stain normalization methods. Then, the segmented and non-segmented images were classified with CNN architectures and machine learning algorithms. The data obtained through these processes is available in the dataset. The segmentation stage showed the F1-score value of 0.83, obtained with the U-Net model using the ResNet-50 as a backbone. At the classification stage, the most expressive result was achieved with the Random Forest method, with an accuracy value of 94.22%. The results show that the segmentation contributed to the classification results, but studies are needed for the improvement of these stages of automated diagnosis. The original, gold standard, normalized, and segmented images are publicly available and may be used for the improvement of clinical applications of CAD methods on oral epithelial dysplasia tissue images.
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Affiliation(s)
- Adriano Barbosa Silva
- Faculty of Computer Science (FACOM) - Federal University of Uberlândia (UFU), Av. João Naves de Ávila 2121, BLB, 38400-902, Uberlândia, MG, Brazil.
| | - Alessandro Santana Martins
- Federal Institute of Triângulo Mineiro (IFTM), R. Belarmino Vilela Junqueira, S/N, 38305-200, Ituiutaba, MG, Brazil
| | - Thaína Aparecida Azevedo Tosta
- Science and Technology Institute, Federal University of São Paulo (UNIFESP), Av. Cesare Mansueto Giulio Lattes, 1201, 12247-014, São José dos Campos, SP, Brazil
| | - Adriano Mota Loyola
- School of Dentistry, Federal University of Uberlândia (UFU), Av. Pará - 1720, 38405-320, Uberlândia, MG, Brazil
| | - Sérgio Vitorino Cardoso
- School of Dentistry, Federal University of Uberlândia (UFU), Av. Pará - 1720, 38405-320, Uberlândia, MG, Brazil
| | - Leandro Alves Neves
- Department of Computer Science and Statistics (DCCE), São Paulo State University (UNESP), R. Cristóvão Colombo, 2265, 38305-200, São José do Rio Preto, SP, Brazil
| | - Paulo Rogério de Faria
- Department of Histology and Morphology, Institute of Biomedical Science, Federal University of Uberlândia (UFU), Av. Amazonas, S/N, 38405-320, Uberlândia, MG, Brazil
| | - Marcelo Zanchetta do Nascimento
- Faculty of Computer Science (FACOM) - Federal University of Uberlândia (UFU), Av. João Naves de Ávila 2121, BLB, 38400-902, Uberlândia, MG, Brazil
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Shalaby R, Nawawy ME, Selim K, Bahaa S, Refai SE, Maksoud AE, Sayed ME, Essawy A, Elshaer A, ElShaer M, Kamel MM, Gamil Y. The role of vitamin D in amelioration of oral lichen planus and its effect on salivary and tissue IFN-γ level: a randomized clinical trial. BMC Oral Health 2024; 24:813. [PMID: 39020381 PMCID: PMC11256592 DOI: 10.1186/s12903-024-04239-0] [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: 11/28/2023] [Accepted: 04/09/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Oral lichen planus (OLP) is a common, prevalent, immune-mediated, inflammatory disease affecting both the skin and oral mucosa and is considered one of the potentially malignant diseases. Since OLP is regarded as an immunologically mediated disease, some studies suggest the use of vitamin D (VD) for its management as it exhibits immune-modulatory, anti-inflammatory, and antimicrobial properties, as well as anti-proliferative, pro-differentiative, and anti-angiogenic effects. VD has demonstrated a suppressive effect on TH1 pro-inflammatory cytokines, including IFN-γ while augmenting the secretion of anti-inflammatory cytokines. At the same time, VD deficiency is a prevalent public issue. Therefore, the present study aimed to investigate the role of VD as an adjunct to steroids in the management of VD-deficient OLP patients as well as its inhibitory effect on IFN-γ through measurement of salivary and tissue IFN-γ levels in OLP patients. METHODS A total of 40 patients with ulcerative or erythematous OLP, diagnosed according to the World Health Organization's (WHO) modified criteria for OLP, were randomly allocated into one of the two study groups to receive either systemic steroids in addition to VD supplements (Group A) or systemic steroids only (Group B). Blood samples were collected for the measurement of serum VD level (SVDL) using the enzyme-linked immunosorbent assay (ELISA) to involve only patients with VD deficiency or insufficiency (≤ 30 ng/ml). Clinical evaluation of the lesion involved objective signs and subjective symptoms. Also, changes in salivary and tissue INF-γ levels (in pg/mL and pg/mg, respectively) were determined using the ELISA technique. All parameters were measured at baseline and after 4 weeks of treatment. The clinical pharmacy team devised a checklist to record all team interventions. The interventions were categorized into six domains, including drug interactions and/or adverse reactions, medication dose issues, drug selection issues, support with medication history, patient-related concerns, and suggestions for dental medication. RESULTS After one month of treatment, a significantly greater number of patients in group A showed complete pain relief and resolution of clinical lesions, as well as a greater number of patients showing a reduction in the clinical severity of lesions than in group B (P = 0.005). Also, there was a statistically significant reduction in average VAS pain scores and clinical scores in group A compared to group B after 1 month of treatment (P = 0.001 and 0.002, respectively). Furthermore, there was a statistically significant greater reduction in salivary and tissue IFN-γ levels in group A than in group B (P ≤ 0.001 and 0.029, respectively) after 1 month of treatment. CONCLUSION Current evidence suggests a significant preventive and therapeutic role for VD as an adjunct to standard therapies indicated for OLP lesions. These protective and therapeutic functions are achieved through the suppressive effect of VD on pro-inflammatory cytokines, particularly IFN-γ. Also, salivary IFN-γ appears to be a valuable prognostic marker for monitoring the progression of OLP. In addition, the inter-professional collaboration between dentists and clinical pharmacists helped to deliver complete, patient-centered primary care and ensured the quality of the medications included in patient kits, thus improving patient treatment and management. Nevertheless, further studies with larger sample sizes, longer follow-ups, and standardized designs may still be needed.
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Affiliation(s)
- Rania Shalaby
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Marwa El Nawawy
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Khaled Selim
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Samah Bahaa
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sahar El Refai
- Oral Pathology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Mahitab El Sayed
- Clinical Pharmacy Department, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Aya Essawy
- Clinical Pharmacy Department, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Asmaa Elshaer
- Clinical Pharmacology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed ElShaer
- Clinical Pharmacology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Moataz Maher Kamel
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yasmine Gamil
- Department of Oral Medicine, Diagnosis, and Periodontology, Faculty of Oral and Dental Surgery, Modern University for Technology and Information, MTI University, Cairo, Egypt
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Khamis A, Salzer L, Schiegnitz E, Stauber RH, Gül D. The Magic Triangle in Oral Potentially Malignant Disorders: Vitamin D, Vitamin D Receptor, and Malignancy. Int J Mol Sci 2023; 24:15058. [PMID: 37894739 PMCID: PMC10606220 DOI: 10.3390/ijms242015058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
OPMDs (oral potentially malignant disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of various diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also suggest a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD-VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD and investigate their potential association and ramifications for clinical management of OPMDs.
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Affiliation(s)
- Aya Khamis
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
- Oral Pathology Department, Faculty of Dentistry, Alexandria University, Alexandria 5372066, Egypt
| | - Lara Salzer
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
| | - Roland H. Stauber
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Désirée Gül
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
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Panchal KG, Gupta E, Kumar A, Samir PV, Devika GS, Awasthi V, Singh R. Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients. Cureus 2023; 15:e44100. [PMID: 37750131 PMCID: PMC10518139 DOI: 10.7759/cureus.44100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/23/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects. AIM The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up. MATERIALS AND METHODS In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion. RESULTS The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002). CONCLUSION Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.
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Affiliation(s)
- Kalagi G Panchal
- Department of Dentistry, Government Dental College and Hospital, Ahmedabad, IND
| | - Ekta Gupta
- Department of Orthodontics and Dentofacial Orthopedics, Siddhpur Dental College and Hospital, Patan, IND
| | - Amit Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Patna, IND
| | - P V Samir
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar, IND
| | - G S Devika
- Department of Pharmaceutical Analysis, Cherraans College of Pharmacy, Coimbatore, IND
| | - Vijaya Awasthi
- Department of Oral Medicine and Radiology, Gentle Dental Care, Jabalpur, IND
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, IND
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Ibrahim SS, Ragy NI, Nagy NA, El-kammar H, Elbakry AM, Ezzatt OM. Evaluation of muco-adhesive tacrolimus patch on caspase-3 induced apoptosis in oral lichen planus: a randomized clinical trial. BMC Oral Health 2023; 23:99. [PMID: 36788511 PMCID: PMC9930326 DOI: 10.1186/s12903-023-02803-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The study compared the clinical effectiveness of topical Tacrolimus (TAC) in patches or gel with Triamcinolone acetonide (TRI) gel for erosive/atrophic oral lichen planus (OLP) and investigated the influence of these therapies on Caspase-3 expression as a marker of apoptosis. METHODS Thirty patients were randomly assigned into three equal groups to receive either topical TAC 0.1% patch twice daily, topical TAC 0.1% gel, or topical TRI 0.1% gel four times daily for 8 weeks. Each patient's clinical score (CS), visual analogue scale (VAS), and total atrophic area (TAA) of the marker lesion were measured at baseline, 2, 4, and 8 weeks of treatment, as well as after 4 weeks of treatment free period. Caspase-3 expression and lymphocytic counts (LC) were assessed in pre- and post-treatment biopsied stained sections. RESULTS TAC patch resulted in a higher reduction in CS [- 14.00 (15.54%)] and VAS [- 70.21 (15.82%)] followed by TAC gel then TRI gel within the first two weeks. The reduction in VAS and TAA were significantly higher in TAC groups compared to TRI gel, although the difference between TAC treatment was not significant and this was observed throughout the treatment and follow-up periods. Caspase-3 expression increased in connective tissue in all groups. It decreased significantly within the epithelium in both TAC groups but increased in TRI gel. (LC) were significantly lowered with the TAC patch compared to other groups. The percentage change in Caspase-3 epithelial expression was significantly correlated to the CS, TAA, and LC. CONCLUSION Both TAC patch and gel significantly decreased pain and lesion size than TRI gel, with a significant reduction in Caspase-3 expression within the epithelium in comparison to the increase seen with TRI gel. The study protocol was registered at www. CLINICALTRIALS gov (NCT05139667) on 01/12/2021.
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Affiliation(s)
- Suzan S. Ibrahim
- grid.7269.a0000 0004 0621 1570Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt ,grid.442628.e0000 0004 0547 6200Department of Oral Medicine, Periodontology Oral Diagnosis and Radiology, Faculty of Dental Medicine, Nahda University, Beni Suef, Egypt
| | - Nivine I. Ragy
- grid.440865.b0000 0004 0377 3762Department of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Oral and Dental Medicine, Future University in Egypt, St. South 90Th, New Cairo 1, Cairo, 11835 Egypt
| | - Noha A. Nagy
- grid.440865.b0000 0004 0377 3762Department of Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Oral and Dental Medicine, Future University in Egypt, St. South 90Th, New Cairo 1, Cairo, 11835 Egypt
| | - Hala El-kammar
- grid.440865.b0000 0004 0377 3762Department of Oral Pathology, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| | - Asmaa M. Elbakry
- grid.411303.40000 0001 2155 6022Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt ,grid.449009.00000 0004 0459 9305Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Ola M. Ezzatt
- grid.7269.a0000 0004 0621 1570Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt ,grid.7269.a0000 0004 0621 1570Department of Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, Ain Shams University, 20 Organization of African Union St., Cairo, 1156 Egypt
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Oral immune-mediated disorders with malignant potential/association: An overview. Dis Mon 2023; 69:101349. [PMID: 35337657 DOI: 10.1016/j.disamonth.2022.101349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A group of oral disorders or conditions, which may result from, or could be triggered by an abnormality in the normal immune response of an individual are known as oral immune-mediated disorders. Some of these disorders have malignant potential, while others are associated with malignancy. In this overview, we will discuss a few of the oral diseases (such as oral lichen planus, primary Sjogren's syndrome, systemic lupus erythematosus, dermatitis herpetiformis, and linear immunoglobulin A bullous dermatosis, to name a few), which are caused due to irregularity in the immune system and are either associated with malignancy or capable of undergoing malignant transforming, thereby increasing the morbidity and mortality rate.
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Utz S, Suter V, Cazzaniga S, Borradori L, Feldmeyer L. Outcome and long-term treatment protocol for topical tacrolimus in oral lichen planus. J Eur Acad Dermatol Venereol 2022; 36:2459-2465. [PMID: 35870137 PMCID: PMC9804806 DOI: 10.1111/jdv.18457] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/12/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Topical tacrolimus has been shown to be beneficial in the treatment of oral lichen planus (OLP). However, long-term effects and its optimal application protocol with gradual reduction have not been studied. Accordingly, we analysed the clinical response of OLP to tacrolimus in our daily clinical practice with a focus on the optimal long-term therapeutic scheme. METHODS Retrospective analysis of all consecutive patients diagnosed with OLP and treated with topical tacrolimus (0.03% oral rinse) in a clinical setting between 2015 and 2020. The objective clinical response was measured by a 4-point scale (complete remission, major remission, partial remission and no response), and subjective impairment by a 3-point scale (severe, moderate and none). RESULTS Fifty-seven patients (74% women; median age: 66 years) were included. Fifty-six (98%) patients had prior treatment with topical steroids. After introduction of tacrolimus, objective remission (major or complete) was reached by 28%, 62%, 87% and 97% of patients after 3, 6, 12 and 24 months respectively. Subjective remission was reported by 16%, 48%, 69% and 83% after 3, 6, 12 and 24 months of treatment respectively. The treatment frequency could be gradually reduced from initially twice daily to once daily or less in 28%, 61%, 78% and 87% after 3, 6, 12 and 24 months respectively; 41% of patients completely suspended the treatment at one point, but 67% of them experienced a relapse after a median time of 3.3 months. Four patients (7%) developed a squamous cell carcinoma (SCC) during the observation period. Otherwise, there were only few and minor side-effects. CONCLUSION Topical tacrolimus can be an effective second-line therapy for OLP refractory to potent topical corticosteroids. The therapy frequency can often be reduced during the maintenance period. Both signs of clinical activity and subjective impairment should guide therapy. Regular follow-up is necessary to recognize possible SCC.
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Affiliation(s)
- S. Utz
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
| | - V.G.A. Suter
- Department of Oral Surgery and Stomatology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - S. Cazzaniga
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland,Centro Studi GISEDBergamoItaly
| | - L. Borradori
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
| | - L. Feldmeyer
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
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K. Vijayan A, Muthukrishnan A. A Clinicohistopathological Characterization of Oral Lichen Planus: A Cross-Sectional Study. Cureus 2022; 14:e30568. [DOI: 10.7759/cureus.30568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
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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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Kakoei S, Karbasi N, Raeiszadeh M, Tajadini H, Nekouei AH. The efficacy of henna (Lawsonia inermis L.) mouthwash versus chlorhexidine gluconate 0.2% mouthwash as adjuvant therapy of oral lichen planus: A randomized double-blind clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2022; 290:115037. [PMID: 35134489 DOI: 10.1016/j.jep.2022.115037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/12/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In modern medicine, some traditional remedies are introduced to be effective in treatment. Accordingly, the henna plant (Lawsonia inermis L.) is studied more than before. Previous studies have shown many medical properties for henna, such as anti-inflammatory and anti-fungal properties. AIM OF THE STUDY Oral lichen planus (OLP) is a common mucocutaneous disease with chronic immunomodulatory disruptions. Topical corticosteroids are the first line of OLP treatment. Previous studies have suggested different adjunctive therapies for preventing the side effects of corticosteroids overuse. This study aimed to compare the effects of henna and chlorhexidine mouthwashes as adjunctive therapy. MATERIALS AND METHODS This parallel-group, double-blind, randomized controlled study was conducted on forty OLP patients. Luteolin content was determined in Henna mouthwash composed of 2% aqueous extract of henna, 2% ethanol, 10% glycerol, and 0.1% methylparaben distilled water. Henna or chlorhexidine mouthwashes were prescribed twice daily as an adjuvant to the topical corticosteroid treatment. Visual analog scale (VAS) index and Thongprasom rating were used to measure pain intensity and clinical signs of patients at days 0,7, and 14. The collected data were analyzed using SPSS software (version 26.0; SPSS). Ordinal logistic regression was used to investigate the effect of independent variables on Thongprasom and VAS scores. RESULTS In this clinical trial, 82.6% of the participants were women. There was no difference between the two study groups in terms of VAS scores (p = 0.404) and clinical features (p = 0.305) in the second follow-up visit. All drug regimens caused clinical signs and symptoms relief. CONCLUSIONS There was no significant difference between the groups receiving topical corticosteroid supplementation, neither henna mouthwash nor chlorhexidine mouthwash. The therapeutic effects of henna mouthwash in the main or adjuvant treatment of OLP need more evaluation in future research. Henna mouthwash can be a good alternative to chlorhexidine mouthwash if no side effects are reported.
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Affiliation(s)
- Shahla Kakoei
- Department of Oral and Maxillofacial Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Nahid Karbasi
- Department of Oral and Maxillofacial Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahboobeh Raeiszadeh
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Haleh Tajadini
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Amir H Nekouei
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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11
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Correlation between Clinical and Histopathological Diagnoses in Oral Cavity Lesions: A 12-Year Retrospective Study. Int J Dent 2022; 2022:1016495. [PMID: 35607329 PMCID: PMC9124151 DOI: 10.1155/2022/1016495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/05/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Proper diagnosis plays a key role in the treatment and prognosis of all diseases. Although histopathological diagnosis is still known as the gold standard, final diagnosis becomes difficult unless precise clinical descriptions are obtained. So, this study aimed to evaluate the concordance of the clinical and histopathological diagnoses of all oral and maxillofacial biopsy specimens in a 12-year duration. Materials and Methods Archive files and clinical findings related to 3001 patients who had been referred to the Department of Oral Pathology during a 12-year period were reviewed. The recorded information in files included age, sex, lesion's location, clinical and histopathological diagnoses, and specialty of dentists. Results Out of 3001 cases included and reviewed in this study, 2167 cases (72.2%) were consistent between clinical and histopathologic diagnoses. Age, sex, and clinician's specialty were indicated to have no significant effect on diagnosis (p values = 0.520, 0.310, 0.281, respectively), but location and type of lesion affected that (p values = 0.040 and 0.022, respectively). In regard to location, the highest concordance of clinical and histopathologic diagnoses was observed in mouth floor lesions, and the lowest one was in gingival mucosa. In terms of lesion category, the highest and the lowest concordance rates belonged to white and red lesions and pigmented lesions, respectively. Conclusion The results of the present study show that the consistency of clinical and histopathological diagnoses was three times more than their inconsistency, and the accuracy of the clinicians was largely acceptable.
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12
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Jolehar M, Mohseni R, Farhadi S. Correlation between WHO and Modified WHO Classification Systems in the Histopathologic Diagnosis of Oral Lichen Planus Using Intraobserver and Interobserver Variability. Int J Prev Med 2021; 12:126. [PMID: 34760137 PMCID: PMC8551796 DOI: 10.4103/ijpvm.ijpvm_566_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 01/16/2020] [Indexed: 11/04/2022] Open
Abstract
Background Oral lichen planus (OLP) is a relatively common chronic autoimmune disease. In the present study, we tried to correlate the histopathological criteria of WHO and modified WHO (mod.WHO) classification systems using two methods, namely, intraobserver and interobserver observations in these samples. Methods This cross-sectional study was performed on 64 microscopic slides with the diagnosis of the OLP lesions, based on both clinical and histopathological features. At first, each pathologist individually (as intraobserver) examined microscopic slides based on both histopathologic diagnostic criteria. Later, three pathologists in a group (as interobserver) reevaluated microscopic slides 2 months later in the second phase of the study, based on both systems. Eventually, the findings were statistically analyzed with Cohen's kappa coefficient (κ) and reported. Results According to the results, the lichen planus was detected in 8 cases using the WHO method, and in 41 cases using the Mod.WHO method. Intrarater Kappa coefficients were κ = 0.114, P = 0.299; κ = 0.181, P = 0.012; and κ = 0.062, P = 0.424 for three pathologists, respectively. The findings showed no reproducibility (κ = 0.148, P = 0.024) and there was no correlation between the two systems. Statistical analysis revealed that the histopathological criteria of the WHO classification for detecting the lichen planus microscopy were more sensitive but the Mod.WHO classification criteria were more specific for detecting the lichen planus. Conclusions Due to the higher specificity of the histopathological criteria of Mod.WHO classification rather than WHO classification, it seems that Mod.WHO classification has more important and useful criteria for histopathological diagnosis. Finally, we can conclude that the use histopathologic criteria of the Mod.WHO classification is more useful in the diagnosis of lichen planus, although it should be in combination with clinical information.
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Affiliation(s)
- Maryam Jolehar
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Roghieh Mohseni
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sareh Farhadi
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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13
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Saglam E, Ozsagir ZB, Unver T, Alinca SB, Toprak A, Tunali M. Efficacy of injectable platelet-rich fibrin in the erosive oral lichen planus: a split-mouth, randomized, controlled clinical trial. J Appl Oral Sci 2021; 29:e20210180. [PMID: 34614123 PMCID: PMC8523099 DOI: 10.1590/1678-7757-2021-0180] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022] Open
Abstract
Objective Our study compared the effects of injectable platelet-rich fibrin (i-PRF) with those of corticosteroids in the treatment of erosive oral lichen planus (EOLP). Methodology This split-mouth study included 24 individuals diagnosed histopathologically with bilateral EOLP. One bilateral lesion was injected with i-PRF, whereas the other was injected with methylprednisolone acetate in four sessions at 15-day intervals. Visual analog scale (VAS) for pain and satisfaction, oral health impact profile scale-14, and the lesion size were used. Results The intragroup comparisons showed a significant decrease in VAS-pain and lesion size in both the i-PRF group (from 81.88±17.74 to 13.33±18.34, and from 4.79±0.41 to 1.88±1.08, respectively) and the corticosteroid group (from 80.21±17.35 to 23.33±26.81, and from 4.71±0.46 to 2.21±1.35, respectively) in the 6th month compared to baseline (p<0.001). Moreover, VAS-satisfaction increased significantly in both the i-PRF group (from 26.67±17.8 to 85.63±16.24) and the corticosteroid group (from 28.33±17.05 to 74.38±24.11) in the 6th month compared to baseline (p<0.001). However, no significant difference in any value occurred in the intergroup comparisons. Conclusion In patients with EOLP, both methods decreased pain and lesion size similarly, and both increased satisfaction. Therefore, the use of i-PRF may be considered an option in cases refractory to topical corticosteroid therapy. Biochemical and histopathological studies are required to reveal the mechanism of i-PRF action in EOLP treatment.
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Affiliation(s)
- Ebru Saglam
- Health Sciences University, Faculty of Dentistry, Department of Periodontology Istanbul, Turkey
| | - Zeliha Betul Ozsagir
- Health Sciences University, Faculty of Dentistry, Department of Periodontology Istanbul, Turkey
| | - Tugba Unver
- Bezmialem Vakif University, Faculty of Dentistry, Department of Maxillofacial Radiology, Istanbul, Turkey
| | - Suzan Bayer Alinca
- Kecioren Osmanli Public Oral Health Center, Oral and Maxillofacial Surgery, Ankara, Turkey
| | - Ali Toprak
- Bezmialem Vakif University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
| | - Mustafa Tunali
- Canakkale Onsekiz Mart University, Faculty of Dentistry, Department of Periodontology, Canakkale, Turkey
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14
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Marlina E, Goodman RN, Mercadante V, Shephard M, McMillan R, Hodgson T, Leeson R, Porter S, Barber JA, Fedele S, Smith AM. A proof of concept pilot trial of probiotics in symptomatic oral lichen planus (CABRIO). Oral Dis 2021; 28:2155-2167. [PMID: 34464996 DOI: 10.1111/odi.14014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To preliminary evaluate the clinical effects of probiotics in individuals with symptomatic oral lichen planus and the possible mechanisms of action. SUBJECTS AND METHODS A group of 30 individuals with symptomatic oral lichen planus were recruited in a randomised double-blind parallel group controlled (1:1) proof-of-concept pilot trial of probiotic VSL#3 vs placebo. Efficacy outcomes included changes in pain numeric rating scale, oral disease severity score and the chronic oral mucosal disease questionnaire. Adverse effects, home diary and withdrawals were assessed as feasibility outcomes. Mechanistic outcomes included changes in salivary and serum levels of CXCL10 and IFN-γ and in oral microbial composition. RESULTS The probiotic VSL#3 was safe and well tolerated. We observed no statistically significant change in pain, disease activity, quality of life, serum/salivary CXCL10 or oral microbial composition with respect to placebo. Salivary IFN-γ levels demonstrate a trend for a reduced level in the active group (p = 0.082) after 30 days of probiotic consumption. CONCLUSIONS The present proof-of-concept study provides some weak not convincing indication of biological and clinical effects of probiotic VSL#3 in individuals with painful oral lichen planus. Further research in this field is needed, with the current study providing useful information to the design of future clinical trials.
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Affiliation(s)
- Erni Marlina
- Eastman Dental Institute, University College London, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
| | - Richard N Goodman
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Roddy McMillan
- Eastman Dental Institute, University College London, London, UK.,UCLH, Eastman Dental Hospital, London, UK
| | | | - Rachel Leeson
- Eastman Dental Institute, University College London, London, UK.,UCLH, Eastman Dental Hospital, London, UK
| | - Stephen Porter
- Eastman Dental Institute, University College London, London, UK
| | | | - Stefano Fedele
- Eastman Dental Institute, University College London, London, UK.,NIHR UCLH Biomedical Research Centre, London, UK
| | - Andrew M Smith
- Eastman Dental Institute, University College London, London, UK
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15
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Zborowski J, Kida D, Szarwaryn A, Nartowski K, Rak P, Jurczyszyn K, Konopka T. A Comparison of Clinical Efficiency of Photodynamic Therapy and Topical Corticosteroid in Treatment of Oral Lichen Planus: A Split-Mouth Randomised Controlled Study. J Clin Med 2021; 10:jcm10163673. [PMID: 34441967 PMCID: PMC8397092 DOI: 10.3390/jcm10163673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 01/28/2023] Open
Abstract
Background: The aim of the study was to compare the effectiveness of photodynamic therapy (PDT) to steroid therapy in the treatment of oral lichen planus (OLP). Due to the lack of commercially available drug carriers, innovative proprietary solutions were used for both the photosensitiser and the steroid carrier—in the first case to shorten and in the second to extend the contact of the active substance with the mucosa. Methods: A prospective, randomised, single-blind, 12-week full contralateral split-mouth clinical trial of 30 patients with bilateral oral lichen planus was conducted. The prepared matrices were incorporated with active substances methylene blue 5% and 0,05% triamcinolone. The size of lesions, Thongprasom, ABISIS, and VAS scale were evaluated. Results: Relatively high rates of complete remission of lichen were demonstrated: immediately after treatment, 33.3% with PDT and 22.2% with triamcinolone (TA), and after 3 months, 54.2% with PDT and 62.9% with TA. After 3 months of treatment, a reduction in the area of evaluated lesions of 52.7% for PDT and 41.7% for TA was achieved. Conclusion: In situations of topical or general contraindications to oral corticosteroids, resistance to them, or the need for repeated treatment in a short period of time, PDT appears to be a very promising treatment option.
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Affiliation(s)
- Jacek Zborowski
- Department of Periodontology, Wroclaw Medical University, ul. Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
| | - Dorota Kida
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland; (D.K.); (A.S.); (K.N.); (P.R.)
| | - Aleksandra Szarwaryn
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland; (D.K.); (A.S.); (K.N.); (P.R.)
| | - Karol Nartowski
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland; (D.K.); (A.S.); (K.N.); (P.R.)
| | - Patrycja Rak
- Department of Drug Form Technology, Wroclaw Medical University, Borowska 211 A, 50-556 Wroclaw, Poland; (D.K.); (A.S.); (K.N.); (P.R.)
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Tomasz Konopka
- Department of Periodontology, Wroclaw Medical University, ul. Krakowska 26, 50-425 Wroclaw, Poland;
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16
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Meng Z, Zhang H, Li L, Wang K. Clinical significance of miR-142-3p in oral lichen planus and its regulatory role in keratinocyte proliferation. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:441-447. [PMID: 34366268 DOI: 10.1016/j.oooo.2021.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/06/2021] [Accepted: 06/13/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Accumulating microRNAs (miRNAs) have been identified as aberrantly expressed in patients with oral lichen planus (OLP). This study aimed to investigate the role and underlying mechanism of miR-142-3p in OLP. STUDY DESIGN Fifty-six patients with OLP and 44 control participants without OLP were recruited, and real-time quantitative reverse transcription polymerase chain reaction was used for the measurement of miR-142-3p. A receiver operating characteristic (ROC) was counted to assess the diagnostic value. Cell Counting Kit‑8 was used to assess cell proliferation. The luciferase reporter assay was performed to confirm the target gene. RESULTS Compared with the control group, an elevated expression of miR-142-3p was detected in the serum, saliva, and tissues samples from patients with OLP. ROC curve analysis suggested that miR-142-3p could distinguish patients with OLP from those in the control group, and the expression of miR-142-3p was closely associated with the disease severity. Downregulation of miR-142-3p inhibited keratinocyte proliferation. Glucocorticoid receptor α (GRα) was a target gene of miR-142-3p. CONCLUSIONS MiR-142-3p might be a candidate diagnostic biomarker for OLP. Downregulation of miR-142-3p inhibits keratinocyte proliferation, and GRα might be involved in its regulatory role.
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Affiliation(s)
- Zhichao Meng
- Department of Dermatology, Guangrao People's Hospital, Shandong, China
| | - Hong Zhang
- Department of Dermatology, Linyi City Lanshan District People's Hospital, Linyi, Shandong, China
| | - Leilei Li
- Department of Stomatology, Dongying People's Hospital, Shandong, China
| | - Kuimei Wang
- Department of Dermatology, Mengyin People's Hospital, Shandong, China.
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17
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Su Z, Hu J, Cheng B, Tao X. Efficacy and safety of topical administration of tacrolimus in oral lichen planus: An updated systematic review and meta-analysis of randomized controlled trials. J Oral Pathol Med 2021; 51:63-73. [PMID: 34133803 DOI: 10.1111/jop.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/08/2021] [Accepted: 06/04/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Symptomatic oral lichen planus is a common chronic T-cell-mediated disorder characterized by pain and inflammation. The meta-analysis aimed to compare and evaluate the effects and safety of tacrolimus for treating patients with symptomatic oral lichen planus. METHODS A comprehensive literature review was performed, including PubMed, the Cochrane Library, Embase, and Web of Science published up to and including December 2020. ClinicalTrials.gov was searched for ongoing trials. There were no restrictions on language or date of publication. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials and estimated the proportion of between-trial heterogeneity. RESULTS A total of 9 RCTs evaluating the effects of tacrolimus were included in this study. The results revealed no significant difference in clinical resolution and relapse between tacrolimus and corticosteroids. However, tacrolimus may be more likely to cause mild adverse effects. In particular, clinical resolution was not significantly different between tacrolimus and clobetasol propionate, and between tacrolimus and triamcinolone acetonide, while tacrolimus was more likely to cause adverse effects than triamcinolone acetonide and clobetasol propionate. Moreover, there was no significant difference in pain resolution between tacrolimus and clobetasol. Furthermore, adverse effects were not significantly different between tacrolimus and pimecrolimus. CONCLUSIONS This systematic review and meta-analysis of 9 clinical trials supported the short-term application of tacrolimus as an effective regimen in OLP patients resistant to other topical and systemic therapies. Furthermore, the adverse effects of tacrolimus were minor and transient and did not affect tacrolimus' continued application.
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Affiliation(s)
- Zhangci Su
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Jiaqi Hu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Bin Cheng
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoan Tao
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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18
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Jana A, Thomas J, Ghosh P. Erosive oral lichen planus inflicts higher cellular stress than reticular type. J Oral Maxillofac Pathol 2021; 25:279-285. [PMID: 34703122 PMCID: PMC8491350 DOI: 10.4103/0973-029x.325127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/03/2021] [Accepted: 05/18/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Lichen planus is a chronic inflammatory mucocutaneous disease which frequently involves the oral mucosa. The most common types of oral lichen planus (OLP) are reticular (asymptomatic) and erosive (ulcerative) with malignant potentiality. The aims of the present study are to assess the cellular stress level in both types of OLP lesions with respect to oxidative stress, DNA damage and inflammation. MATERIALS AND METHODS Freshly diagnosed untreated 25 OLP reticular type and 25 OLP erosive (OLP-E) type patients aged 35-55 years were enrolled in the study along with age and sex-matched 25 healthy subjects as control. Tissue antioxidant enzymes were measured biochemically, single-cell DNA damage was measured by comet assay and the molecular markers for inflammation were assessed by using semi-quantitative reverse transcriptase-polymerase chain reaction. Statistical analyses were performed using one-way ANOVA and Tukey's post hoc test. RESULTS Oxidative stress was significantly greater in OLP-E type compared to the reticular. mRNA expression of cyclooxygenase-2 was significantly elevated (P < 0.0001) in erosive form, but such expression of nuclear factor kappa beta, tumor necrosis factor-alpha, Interleukin-6 and inducible nitric oxide synthase did not significantly differ between the two disease groups. Comet assay revealed a higher degree of DNA strand breakage in erosive lesions. CONCLUSIONS The unhandled free radicals may imbalance the homeostatic network toward pro-inflammatory, DNA damaging responses, creating a vicious cell-damaging spree resulting in stress. Molecular analyses showed that erosive lichen planus is more under stress than the reticular form.
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Affiliation(s)
- Abhishek Jana
- Department Physiology, West Bengal State University, Kolkata, West Bengal, Kerala, India
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
| | - Jincy Thomas
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Thiruvananthapuram, Kerala, India
| | - Pratiti Ghosh
- Department Physiology, West Bengal State University, Kolkata, West Bengal, Kerala, India
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19
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Idrees M, Farah CS, Khurram SA, Firth N, Soluk-Tekkesin M, Kujan O. Observer agreement in the diagnosis of oral lichen planus using the proposed criteria of the American Academy of Oral and Maxillofacial Pathology. J Oral Pathol Med 2021; 50:520-527. [PMID: 33730381 DOI: 10.1111/jop.13170] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a common chronic inflammatory condition with an undefined malignant transformation potential. There have been many attempts at providing a specific definition of OLP without conclusive outcomes. A new set of diagnostic criteria was proposed in 2016 by the American Academy of Oral and Maxillofacial Pathology (AAOMP) in an endeavour to resolve this issue, and this has not yet been evaluated. This study aimed to assess the utility of AAOMP proposed criteria for the diagnosis of OLP. METHODS Five pathologists blindly assessed a cohort of 215 digital whole slide images (WSI) obtained from haematoxylin and eosin-stained microscopic slides. Forty-six WSI were included twice to assess the intra-observer agreement. Included cases were diagnosed clinically as either OLP or oral lichenoid reaction. Each pathologist was asked to utilize the AAOMP histopathological criteria while assessing slides. The variations in diagnoses were assessed by unweighted kappa statistics. RESULTS The level of intra-observer agreement was very good (0.801 to 0.899). The level of inter-observer agreement among the observers varied from good (0.658) to very good (0.842) when the responses were categorized as evident/compatible OLP versus no OLP and was good (0.62 to 0.725) when the responses were categorized as evident OLP, versus compatible OLP, versus no OLP. The clinico-pathological correlation was 87.6%. CONCLUSION A reliable level of agreement can be achieved by pathologists for the diagnosis of OLP using the AAOMP criteria for differentiation between lichenoid and other conditions. There are still limitations in discriminating OLP from oral lichenoid lesions microscopically.
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Affiliation(s)
- Majdy Idrees
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research and Education, Nedlands, WA, Australia.,Oral, Maxillofacial and Dental Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia.,Australian Clinical Labs, Subiaco, WA, Australia
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Norman Firth
- Clinipath Pathology, Osborne Park, WA, Australia
| | - Merva Soluk-Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
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20
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Detection of Human Papillomavirus 33 in Erosive Oral Lichen Planus. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.101488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: A correlation is suggested between oral lichen planus (OLP) and the human papillomavirus (HPV) with possible malignant transformation potential in OLP. Objectives: The present study aimed at evaluating the prevalence of HPV-16 and HPV-18 as the most recognized oncogenic subtypes and relatively recently introduced subtype HPV33 in OLP samples. Methods: This retrospective study was carried out on 32 OLP samples (consisting of 12 reticular and 20 erosive forms) and 20 healthy oral mucosa samples. Polymerase chain reaction (PCR) was undertaken to identify HPV Deoxyribonucleic Acid (DNA). Subsequently, the samples positive for HPV DNA underwent PCR analysis again with the specific primers. The data were analyzed statistically by Fisher’s exact test regarding the significance level of lower than 0.05. Results: Eight out of 32 OLP samples (25%) and none of the 20 normal mucosa samples (0%) exhibited HPV DNA. The presence of HPV in the OLP group was significantly higher than that in the normal mucosa (P = 0.014). Also, all the samples that exhibited HPV DNA were registered as the erosive form. Besides, one sample (3.12%) exhibited the 873-bp band, which was attributed to HPV-18, and 7 samples (21.87%) exhibited the 300-bp band, which was attributed to HPV-33. Conclusions: Based on the recent findings in the current study of the Iranian population, the presence of high-risk HPV subtypes, whether primarily or as a secondary infection, can suggest the malignant transformation potential for the studied OLP samples. The exclusive presence of these subtypes in the erosive type of this lesion and the noticeable presence of HPV-33 might reflect this issue’s importance. However, further studies are necessary to evaluate the possibility of a higher proliferation rate of HPV in erosive lichen planus and identify its possible malignant transformation mechanism.
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21
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Rotaru DI, Sofineti D, Bolboacă SD, Bulboacă AE. Diagnostic Criteria of Oral Lichen Planus: A Narrative Review. Acta Clin Croat 2020; 59:513-522. [PMID: 34177062 PMCID: PMC8212651 DOI: 10.20471/acc.2020.59.03.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/27/2018] [Indexed: 01/29/2023] Open
Abstract
Oral lichen planus (OLP) is a disease with unclear etiology or pathogenesis, categorized by the World Health Organization as oral lichenoid lesions (OLL; interface mucositis or lichenoid mucositis) into a group of potentially malignant disorders. The diagnosis of OLP is challenging because the clinical and histopathologic features are frequently seen in OLP, OLL and/or other mucosal diseases with lichenoid characteristics. Furthermore, OLP has a dynamic nature. Finally, an early and precise diagnosis can play a decisive role, allowing timely treatment and thus improving the patient quality of life. This article summarizes the state-of-the-art regarding OLP and OLL and discusses the challenges faced on making an accurate diagnosis, aiming to provide a practical guideline for the postgraduates and oral physicians in reaching the diagnosis of these lesions.
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22
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Oral Lichen Planus and Polycythemia: Possible Association. Case Rep Dent 2020; 2020:8820114. [PMID: 32832164 PMCID: PMC7428844 DOI: 10.1155/2020/8820114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/02/2020] [Accepted: 07/21/2020] [Indexed: 01/10/2023] Open
Abstract
Oral lichen planus is a chronic inflammatory disease of established immune-mediated pathogenesis that affects the oral mucosa. Polycythemia is a nonaggressive myeloproliferative disorder, characterized by an increase in red blood cell mass, often with uncontrolled production of granulocytes and platelets. Their association was rarely mentioned in the scientific literature. The aim of this paper was to report their occurrence in a 52-year-old male patient. Although a casual connection cannot be excluded, both diseases share many similarities in the immune dysfunctions involved in their pathogenesis and their clinical features. Such a hypothesis remains to be demonstrated by further studies. The presence of oral lesions should alert the clinicians in the process of identifying and early diagnosing these diseases. Thus, complications can be prevented and treatment can be started at an early stage, avoiding further damage.
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Xia DN, Tan YQ, Yang JY, Zhou G. Omega-3 polyunsaturated fatty acids: a promising approach for the management of oral lichen planus. Inflamm Res 2020; 69:989-999. [PMID: 32770320 DOI: 10.1007/s00011-020-01388-0] [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: 04/08/2020] [Revised: 07/26/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a T-cell-mediated inflammatory disease with a risk of malignant transformation. Although the etiology of OLP is still uncertain, growing evidence suggests that oral microbiota, antigen-specific, and non-specific mechanisms are involved in the pathogenesis of OLP. Antigen-specific mechanisms include antigen presentation, T-cell activation, nuclear factor-kappa B signaling pathway, and cytokine secretion, while non-specific mechanisms consist of matrix metalloproteinases (MMP)-9 upregulation, psychological pressure, oxidative damage, aberrant expression of microRNAs (miRNAs), and autophagy. Till now, there is no cure for OLP, and the main purpose of OLP therapy is symptomatic control. FINDING Seafood and its derivative omega-3 polyunsaturated fatty acids (n-3 PUFAs) can suppress antigen presentation, T-cell activation, and nuclear factor-kappa B signaling pathway, modulate the overexpressed inflammatory cytokines, inhibit the expression of MMP-9, as well as regulate the expression of miRNAs and autophagy. And they are possible agents for ameliorating psychological disorder and oxidative damage. Moreover, n-3 PUFAs supplementation has a beneficial effect on preventing tumorigenesis. CONCLUSION n-3 PUFAs consumption may provide a non-toxic, inexpensive administration for OLP.
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Affiliation(s)
- Duo-Na Xia
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, 430070, Wuhan, China
| | - Ya-Qin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, 430070, Wuhan, China
| | - Jing-Ya Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, 430070, Wuhan, China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, 430070, Wuhan, China. .,Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Amin NR, Yussif N, Ahmed E. The effect of smoking on clinical presentation and expression of TLR-2 and CD34 in Oral lichen Planus patients: clinical and immunohistochemical study. BMC Oral Health 2020; 20:129. [PMID: 32349717 PMCID: PMC7191681 DOI: 10.1186/s12903-020-01118-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral lichen planus is a chronic inflammatory disease which is considered as a potential precancerous condition. Numerous studies have confirmed that inflammation is a strong risk factor for cancer development. Smoking is associated with potentially malignant disorders of the oral and oropharyngeal mucosa. The adverse consequences of smoking in various pathologies are mediated by its effects on the immune-inflammatory system. Little is known about the influence of cigarette smoke content on the course of OLP and inflammatory response. METHODS Twenty oral lichen planus smoker patients, 20 oral lichen planus non-smoker patients and 20 control patients were included in this work. Pain and clinical scores were calculated for each patient. Image analysis to calculate area percent for TLR-2 and CD34 immuno-expression was performed. Data was tabulated and statistically analyzed. RESULTS The present study showed no statistically significant difference in clinical and pain scores between the smoker and non-smoker groups. However, there was a significant difference in area percent values for TLR-2 and CD34 immuno-expression between the smoker and the non-smoker groups. CONCLUSION Smoking enhanced TLR-2 and CD34 expression in OLP which are considered as inflammatory mediators and are contributing factors in the pathogenesis of oral lichen planus.
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Affiliation(s)
- Nermine Raouf Amin
- Oral and Maxillofacial Pathology department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nermin Yussif
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Enji Ahmed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.,Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
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Saleh W, Tageldin S, Khashaba E, Darwish M, Elnagdy S, Khashaba O. Could photodynamic therapy be utilized as a treatment modality for oral lichen planus? Photodiagnosis Photodyn Ther 2020; 30:101677. [PMID: 32006650 DOI: 10.1016/j.pdpdt.2020.101677] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disease. There is no standard treatment modality for OLP. Recently, photodynamic therapy (PDT) has been advocated as a new treatment modality for OLP. AIM The aim of the present study is to compare the effect of PDT using methylene blue (MB) as a photosensitizer to the effect of topical corticosteroids in the treatment of erosive OLP lesions. MATERIALS AND METHODS Our study included 20 patients with erosive OLP. Patients were divided into two groups. The study group included 10 patents which received MB-PDT. Patients were instructed to use MB as mouth path for 5 min. After 10 min, we applied focal red light on OLP lesions (wavelength 660 nm, Intensity 100-130 m W/cm2) for 2 min. The PDT was applied twice a week for four weeks. In the control group, 10 patients were instructed to apply topical betamethasone valerate ointment 100 mg on OLP lesion three times per day for four weeks. Subjective, objective scores and lesion size were recorded at time zero, after 2 weeks and after 4 weeks from the start of treatments. RESULTS Both groups showed statistically significant differences between time zero and the 4th week of treatment in subjective, objective scores and the area of the lesions. MB-PDT showed a higher degree of improvement than topical corticosteroids between time zero and the 4th week of treatment. CONCLUSION Photodynamic therapy can be used as a treatment for erosive OLP. PDT offers improvement of OLP subjective and objective scores without major side effects.
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Affiliation(s)
- Wafaa Saleh
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt.
| | - Sara Tageldin
- College of Dentistry, Alexandria University, 21544, Egypt
| | - Eman Khashaba
- Public Health and Community Medicine Department, College of Medicine, Mansoura University, 35516, Egypt
| | - Mahmoud Darwish
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt
| | - Sherif Elnagdy
- Oral Pathology Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Omar Khashaba
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt
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26
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The Relationship between the Concentration of Salivary Tyrosine and Antioxidants in Patients with Oral Lichen Planus. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:5801570. [PMID: 31871551 PMCID: PMC6906868 DOI: 10.1155/2019/5801570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/30/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022]
Abstract
The diagnosis of oral lichen planus (OLP) is based on clinical examination and histopathological criteria. Noninvasive diagnostics of saliva may be considered as a confirmation of OLP diagnosis and a potential alternative to an invasive method. The objective of the present study was to evaluate the relationship between the level of tyrosine (Tyr) as well as antioxidants like uric acid (UA) and glutathione peroxidase (GPx) activity in the saliva of patients with OLP in comparison with the control group (healthy subjects without any oral changes). A total of 40 patients with OLP and 40 healthy volunteers were selected for the study based on the modified WHO diagnostic (clinical and histopathological) criteria. High-performance liquid chromatography (HPLC) was performed for Tyr concentration, while GPx activity and uric acid levels were determined by a colorimetric method. The concentrations of Tyr, UA, and GPx activity were statistically lowered in OLP patients compared to the control group. All examined parameters correlated strongly and positively with each other. Mean values of salivary UA concentrations differed between the groups of OLP patients (reticular and erosive forms) and controls (206.66 vs. 196.54 vs. 218.49 μmol/L, respectively, p = 0.001). A similar trend was demonstrated in salivary Tyr concentration which differed statistically between the study and control groups (0.08 vs. 0.07 vs. 0.13 μmol/L, respectively, p = 0.001). Determining of a relationship between the concentrations of Tyr, UA, and GPx activity may be useful in the prognosis of OLP. The HPLC method may be employed, as an additional noninvasive diagnostic procedure to screen OLP patients, during the routine diagnostics of salivary biochemical parameters such as aromatic amino acids.
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Zucoloto ML, Shibakura MEW, Pavanin JV, Garcia FT, da Silva Santos PS, Maciel AP, de Barros Gallo C, Souza NV, Innocentini LMAR, Humberto JSM, Motta ACF. Severity of oral lichen planus and oral lichenoid lesions is associated with anxiety. Clin Oral Investig 2019; 23:4441-4448. [PMID: 30989337 DOI: 10.1007/s00784-019-02892-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are chronic inflammatory diseases whose symptoms can impair patient's quality of life (QoL). Psychological factors seem to play an important role in these diseases. This study aimed to determine the impact of oral health and anxiety levels on the QoL of patients with OLP and OLL. PATIENTS AND METHODS This was a cross-sectional study composed of OLP and OLL patients and a control group matched by age and sex with no autoimmune/inflammatory or malignant oral lesions. Anxiety levels and oral health impact on QoL were assessed using the Hamilton Anxiety Scale (HAM-A) and the Oral Health Impact Profile-14 (OHIP-14), respectively. The instruments were filled through personal interview before starting the treatment for oral lesions. RESULTS A total of 87 patients diagnosed with OLP (n = 45) and OLL (n = 42), and 87 controls were included in the study. Statistical differences were observed for the psychic and somatic anxiety dimensions between severities of diseases. Patients with OLP or OLL had higher scores for the OHIP-14 dimensions physiological discomfort and social limitation compared with controls. In addition, higher scores for physical pain, physical disability, social disability, and handicap were detected among patients with greater severity. CONCLUSION Greater severity of OLP and OLL seems to be associated with increased levels of anxiety, higher scores of oral health impact profile, and decreased QoL. CLINICAL RELEVANCE Patients with severe OLP/OLL may benefit from additional therapeutic treatments, such as psychological and/or psychiatric management, concomitant to treatment specific to oral lesions.
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Affiliation(s)
- Miriane Lucindo Zucoloto
- Department of Social Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Matheus Eiji Warikoda Shibakura
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Jefferson Veronezi Pavanin
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Fernanda Teixeira Garcia
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Aloizio Premoli Maciel
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Nathalia Vilela Souza
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Lara Maria Alencar Ramos Innocentini
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.,Division of Dentistry and Stomatology, Ribeirão Preto Clinical Hospital, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janaina Silva Martins Humberto
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.
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Chen J, Wang Y, Du G, Zhang W, Cao T, Shi L, Wang Y, Mi J, Tang G. Down-regulation of miRNA-27b-3p suppresses keratinocytes apoptosis in oral lichen planus. J Cell Mol Med 2019; 23:4326-4337. [PMID: 30973209 PMCID: PMC6533518 DOI: 10.1111/jcmm.14324] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 03/04/2019] [Accepted: 03/22/2019] [Indexed: 12/17/2022] Open
Abstract
Oral lichen planus (OLP) is considered a precancerous lesion with no known cure. Recent studies reported that abnormal regulation of apoptosis was involved in the pathogenesis of OLP. Next generation sequencing was used to screen the candidate microRNAs and genes in biopsies from patients with OLP and healthy mucosa. Human oral keratinocytes were transfected into the related oligonucleotides of miR‐27b‐3p/cyclophilin D and their control groups. Apoptosis was detected by TdT‐mediated dUTP nick end labelling and flow cytometry. The levels of mRNA and protein were detected by quantitative PCR, Western blots, and enzyme‐linked immunosorbent assays, respectively. Luciferase assays were performed to detect the luciferase activities of miR‐27b‐3p and cyclophilin D. Here, we showed that basal epithelium apoptosis was reduced and the miR‐27b‐3p levels were decreased in clinical OLP samples. We also found that down‐regulation of miR‐27b‐3p inhibited epithelial keratinocyte apoptosis by up‐regulating cyclophilin D expression. Moreover, cyclophilin D increased the protein stability of Bcl2 through direct binding, and Bcl2 suppressed caspase9/3 activation and cytochrome C release. Taken together, these data showed that miR‐27b‐3p regulated keratinocyte apoptosis through cyclophilin D/Bcl2 signalling, suggesting the miR‐27b‐3p regulated the pathogenesis of OLP.
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Affiliation(s)
- Junjun Chen
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Biochemistry & Molecular Cell Biology, Shanghai Key Laboratory of Tumor Microenvironment and Inflammation, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufeng Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanhuan Du
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenyi Zhang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyi Cao
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linjun Shi
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanni Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Mi
- Department of Biochemistry & Molecular Cell Biology, Shanghai Key Laboratory of Tumor Microenvironment and Inflammation, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Contaldo M, Di Stasio D, Petruzzi M, Serpico R, Lucchese A. In vivo reflectance confocal microscopy of oral lichen planus. Int J Dermatol 2019; 58:940-945. [PMID: 30773623 DOI: 10.1111/ijd.14410] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/10/2018] [Accepted: 01/29/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In vivo reflectance confocal microscopy (RCM) is an imaging technique that can virtually biopsy vital tissues, noninvasively and in real time. It results in horizontal virtual slices at a microscopic resolution that correlates well with conventional histopathology. Despite the widespread use of RCM in dermatology, it is still rarely applied to the study of oral pathologies. The aim of the present work is to describe RCM cellular and architectural findings in oral mucosae affected by oral lichen planus (OLP). MATERIALS AND METHODS A series of conventionally diagnosed OLP lesions underwent RCM imaging with a portable reflectance confocal microscope that could scan from the surface to the submucosa. The confocal findings were collected, described, and compared with the literature. RESULTS A total of 31 oral sites affected by OLP in 12 patients were considered. According to their clinical appearance, 22 lesions showed a reticular-plaque pattern, six lesions were mainly atrophic-erosive, and the remaining three presented a mixed pattern. RCM examination showed hypergranulosis, epithelial disarray, spongiosis, necrotic keratinocytes, epithelial and subepithelial inflammatory cell infiltration, and dilated vessels; all findings were in lichen planus, with differences noted between the "white" and "red" manifestations of this pathology. CONCLUSIONS The use of RCM in routine clinical oral pathology tests is recommended to avoid recurrence of OLP and changes in its responsiveness to therapy, thus limiting the need for biopsy of lesions suspected of tumoral changes.
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Affiliation(s)
- Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Massimo Petruzzi
- Interdisciplinar Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
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30
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Chen J, Du G, Chang Y, Wang Y, Shi L, Mi J, Tang G. Downregulated miR‐27b promotes keratinocyte proliferation by targeting
PLK
2 in oral lichen planus. J Oral Pathol Med 2019; 48:326-334. [DOI: 10.1111/jop.12826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/07/2018] [Accepted: 01/07/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Junjun Chen
- Department of Oral MedicineShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine Shanghai China
- Department of Biochemistry & Molecular Cell BiologyShanghai Key Laboratory of Tumor Microenvironment and InflammationShanghai Jiao Tong University School of Medicine Shanghai China
| | - Guanhuan Du
- Department of Oral MedicineShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine Shanghai China
| | - Yuzhou Chang
- Shanghai Institute of Immunology & Department of Immunology and MicrobiologyKey Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of EducationFaculty of Basic MedicineShanghai Jiao Tong University School of Medicine Shanghai China
| | - Yufeng Wang
- Department of Oral MedicineShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine Shanghai China
| | - Linjun Shi
- Department of Oral MedicineShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine Shanghai China
| | - Jun Mi
- Department of Biochemistry & Molecular Cell BiologyShanghai Key Laboratory of Tumor Microenvironment and InflammationShanghai Jiao Tong University School of Medicine Shanghai China
| | - Guoyao Tang
- Department of Oral MedicineShanghai Ninth People's HospitalCollege of StomatologyShanghai Jiao Tong University School of Medicine Shanghai China
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Aghbari SM, Zayed SO, Shaker OG, Abushouk AI. Evaluating the role of tissue microRNA-27b as a diagnostic marker for oral lichen planus and possible correlation with CD8. J Oral Pathol Med 2018; 48:68-73. [PMID: 30276874 DOI: 10.1111/jop.12785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/03/2018] [Accepted: 09/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND MicroRNA-27b (miR27b) is a small, non-coding RNA that is involved in physiological keratinocyte differentiation and regulating inflammatory processes. We performed this study to investigate the value of miR27b as a diagnostic marker for oral lichen planus (OLP) and the correlation between CD8 (cytotoxic T-cell marker) and miR27b tissue expression in OLP patients. METHODS Forty participants (including 20 OLP patients and 20 controls) underwent oral biopsy. The obtained specimens were examined by immunostaining and quantitative RT-PCR for CD8 and miR27b tissue expression, respectively. We used the Spearman rank correlation test to evaluate the correlation between both variables. RESULTS Our analysis showed that in comparison with healthy tissues, OLP tissue samples exhibited significantly higher CD8 levels (P < 0.01), as well as a significant downregulation of miR27b expression (P < 0.0001). Upon comparing different OLP subgroups, no significant difference was detected in terms of miR27b expression; however, the tissue levels of CD8 varied significantly (highest in the erosive subgroup and lowest in the papular/plaque/reticular subgroup). The Spearman rank analysis showed a negative correlation between tissue expression of miR27b and CD8; however, this was not statistically significant (P > 0.05). Further, the receiver operating characteristic curve of tissue miR27b as an OLP biomarker revealed 100% sensitivity and 65% specificity at cutoff value of 4.4. CONCLUSION This study demonstrated increased CD8 levels and downregulation of miR27b in OLP tissues, compared to healthy tissues. Moreover, it revealed the potential of miR27b as an OLP disease biomarker. The possible negative correlation between CD8 and miR27b tissue expression requires further investigation in larger studies.
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Affiliation(s)
| | | | - Olfat Gamil Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine Cairo University, Cairo, Egypt
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Otero Rey EM, Yáñez-Busto A, Rosa Henriques IF, López-López J, Blanco-Carrión A. Lichen planus and diabetes mellitus: Systematic review and meta-analysis. Oral Dis 2018; 25:1253-1264. [PMID: 30203902 DOI: 10.1111/odi.12977] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/25/2018] [Accepted: 09/05/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to perform a systematic review and meta-analysis answering the following questions: (a) "What is the prevalence and risk of oral lichen planus among patients with diabetes mellitus?" and (b) "What is the prevalence and risk of diabetes mellitus among patients with oral lichen planus?". MATERIAL AND METHODS A bibliographic search was conducted in PubMed/Medline and Scopus database from 1966 to March 2018, using the following terms: "Lichen planus" AND "Diabetes mellitus" AND "Prevalence" AND "Oral mucosal lesions". RESULTS Twenty-two studies were included in this review. Twelve studies assessed the prevalence of diabetes mellitus among patients with lichen planus. The prevalence reported ranges from 1.6% to 37.7% with a relative risk of 2.432. Ten studies assessed the prevalence of lichen planus among patients with diabetes mellitus which showed a prevalence of lichen planus ranging from 0.5% to 6.1% with a relative risk of 1.4. CONCLUSIONS Contradictory results were found when analyzing the relationship between lichen planus and diabetes mellitus. Diverse factors should be considered when studying this association for a correct interpretation of results. Diabetes mellitus has high prevalence and morbidity, which is why new case-control studies are needed to further investigate this association.
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Affiliation(s)
- Eva María Otero Rey
- Stomatology Department, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Anabel Yáñez-Busto
- Stomatology Department, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Inés Filipa Rosa Henriques
- Stomatology Department, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain.,Dentistry Hospital University of Barcelona (HOUB), University of Barcelona, l'Hospitalet de Llobregat, Barcelona, Spain.,Oral Health and Masticatory System Group (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - Andrés Blanco-Carrión
- Stomatology Department, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Shimada K, Ochiai T, Hasegawa H. Ectopic transglutaminase 1 and 3 expression accelerating keratinization in oral lichen planus. J Int Med Res 2018; 46:4722-4730. [PMID: 30213231 PMCID: PMC6259409 DOI: 10.1177/0300060518798261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Oral lichen planus (OLP) characterized by interface mucositis frequently shows hyper-keratinization. To clarify mechanisms of excess keratinization, we investigated key molecules for cornified cell envelope (CE). Methods Involucrin (IVL), loricrin (LOR), transglutaminase 1 (TGase 1) and transglutaminase 3 (TGase 3) were immunohistochemically examined in 20 specimens of OLP; five specimens of buccal mucosa served as controls. Subsequently, the data were statistically analyzed. Results IVL in OLP was localized in the cell membrane, in contrast to its localization in the cytoplasm in controls. No positive reaction indicative of LOR was noted in any specimens. Although the TGase 1 localization in controls was restricted to the upper three-quarters of the membrane, the localization in OLP was in both membrane and in the cytoplasm of full thickness mucosal layers. The TGase 3 localization pattern was dramatically altered from cytoplasmic to membranous in OLP. Conclusion Our data suggest that aberrant TGase 1 and TGase 3 localization and distribution are closely related to hyper-keratinization in OLP. This is the first report of ectopic transglutaminase localization in OLP.
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Affiliation(s)
- Katsumitsu Shimada
- 1 Department of Oral Pathology, Matsumoto Dental University, Nagano, Japan
| | - Takanaga Ochiai
- 1 Department of Oral Pathology, Matsumoto Dental University, Nagano, Japan
| | - Hiromasa Hasegawa
- 2 Hard Tissue Pathology Unit, Graduate School of Oral Medicine, Matsumoto Dental University, Nagano, Japan
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Shimada K, Ochiai T, Shen FC, Hasegawa H. Phenotypic alteration of basal cells in oral lichen planus; switching keratin 19 and desmoglein 1 expression. J Oral Sci 2018; 60:507-513. [PMID: 30146538 DOI: 10.2334/josnusd.17-0396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
In oral lichen planus, extracellular matrix and basal cells are damaged by T-lymphocytes. As a consequence, changes in expression of collagen fibers within the connective tissue and cytoskeletons of the epithelial tissue can be observed. With the goal of examining the characteristic changes undergone by basal cells as a consequence of T-lymphocytes damage in oral lichen planus, we investigated protein expression in the epithelial-connective junction. We selected 20 cases of oral lichen planus and 5 control samples of buccal mucosa. Subsequently, we divided the oral lichen planus cases into thin and thick parts based on the mean values of epithelial thickness from the control samples, and counted the positive rate of collagen IV, keratin 19, desmoglein 1, and Ki-67. Collagen IV immune-reactivity partially disappeared or thickened in oral lichen planus. The keratin 19 positive rate in oral lichen planus cases was significantly lower than in the controls. Desmoglein 1 positive rate of the thick part was significantly higher compared to the thin part of oral lichen planus. Thus, modifications in basal cells with both reduced keratin 19 expression and alterations of desmoglein 1 expression suggest that in oral lichen planus, as a consequence of cell injury or regeneration in the interface area, there is a disappearance of the "true basal cell nature".
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Affiliation(s)
| | | | - Fa-Chih Shen
- Department of Oral Pathology, Matsumoto Dental University.,Department of Dentistry, Sijhih Cathay General Hospital
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Direct Immunofluorescence as a Helpful Tool for the Differential Diagnosis of Oral Lichen Planus and Oral Lichenoid Lesions. Am J Dermatopathol 2018; 40:491-497. [DOI: 10.1097/dad.0000000000001071] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Topical pimecrolimus versus betamethasone for oral lichen planus: a randomized clinical trial. Clin Oral Investig 2018; 23:947-956. [PMID: 29909565 DOI: 10.1007/s00784-018-2519-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/05/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Oral lichen plans (OLP) is a potentially malignant inflammatory mucocutaneous disease. CD133 is an investigated surface marker for cancer stem-like cells (CSCs) that may be involved in tumor initiation in head and neck carcinomas. We compared short-term clinical effectiveness of topical pimecrolimus as selective inflammatory cytokine release inhibitor with betamethasone cream for erosive/atrophic OLP and investigated the influence of this therapy on CD133 expression. MATERIAL AND METHODS Thirty patients were randomly assigned into two equal groups to receive topical pimecrolimus (group I) or betamethasone (group II) four times daily for 4 weeks. A marker lesion in each patient were assessed at baseline using clinical score (CS) and visual analog scale (VAS) then at 1, 2, and 4 weeks and after 4 weeks of treatment-free period. CD133 expression was detected in pre- and post-treatment immunostained sections. RESULTS Both drugs showed a reduction in CS, VAS, and CD133 expressions after treatment termination (p < 0.001). Pimecrolimus-treated lesions showed significant higher 1st week reduction in severity (33.1% (22.2)), pain score (57.53% (14.27)), less recurrence in follow-up period and less CD133 expression by the end of the 1st 4 weeks compared with betamethasone. CONCLUSION Pimecrolimus showed earlier clinical response and less recurrence rate compared with standard topical corticosteroid in symptomatic OLP lesions, and both treatment reduced CD133-positive CSC population. CLINICAL RELEVANCE The study proved the benefits of topical pimecrolimus in early management of painful lesions of OLP and its ability to inhibit CSCs, suggesting a possible role in reducing risk of malignant transformation.
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Mendes GG, Servato JPS, Borges FC, Rosa RR, Siqueira CS, de Faria PR, Loyola AM, Cardoso SV. Differential metallothionein expression in oral lichen planus and amalgam-associated oral lichenoid lesions. Med Oral Patol Oral Cir Bucal 2018; 23:e262-e268. [PMID: 29680841 PMCID: PMC5945242 DOI: 10.4317/medoral.22144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 04/25/2018] [Indexed: 01/20/2023] Open
Abstract
Background Oral lichen planus (OLP) is a chronic inflammatory disease mediated by T cells, which manifests as reticular (white) or erosive (red) lesions, that are eventually painful. Oral lichenoid lesion (OLL) are distinguished from OLP by the presence of precipitating factors. The aim of this study was to evaluate whether the presence of metallothionein, which is involved in anti-apoptotic pathways and the anti-oxidative response, could serve as a differential diagnostic for OLP and OLL. Material and Methods We evaluated the expression of metallothionein in 40 cases of OLP and 20 cases of OLL using immunohistochemistry. Results and Conclusions White OLP has higher concentrations of metallothionein than red OLP in basal and parabasal layers. Moreover, metallothionein was more frequently observed in the cytoplasm and nuclei of basal cells in OLP patients compared to the same regions of OLL cases. Metallothionein levels are related to OLP severity and may contribute to a differential diagnosis between OLP and OLL. Key words:Oral lichen planus, oral lichenoid lesions, autoimmune disorders, metallothionein, immunohistochemistry.
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Affiliation(s)
- G-G Mendes
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Área de Patologia. Av. Pará, 1720, Campus Umuarama. CEP: 38405-320, Uberlândia - MG Brazil,
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Salem A, Almahmoudi R, Vehviläinen M, Salo T. Role of the high mobility group box 1 signalling axes via the receptor for advanced glycation end-products and toll-like receptor-4 in the immunopathology of oral lichen planus: a potential drug target? Eur J Oral Sci 2018; 126:244-248. [DOI: 10.1111/eos.12416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Abdelhakim Salem
- Department of Clinical Medicine, Clinicum; University of Helsinki; Helsinki Finland
- Department of Oral and Maxillofacial Diseases, Clinicum; University of Helsinki; Helsinki Finland
| | - Rabeia Almahmoudi
- Department of Oral and Maxillofacial Diseases, Clinicum; University of Helsinki; Helsinki Finland
| | - Mari Vehviläinen
- Department of Social Services and Health Care; Unit for Specialized Oral Care in the Metropolitan Area and Kirkkonummi; Helsinki Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum; University of Helsinki; Helsinki Finland
- Cancer and Translational Medicine Research Unit; University of Oulu; Oulu Finland
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Evaluating the accuracy of microRNA27b and microRNA137 as biomarkers of activity and potential malignant transformation in oral lichen planus patients. Arch Dermatol Res 2018; 310:209-220. [DOI: 10.1007/s00403-018-1805-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 05/22/2017] [Accepted: 01/04/2018] [Indexed: 01/01/2023]
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Radwan-Oczko M, Zwyrtek E, Owczarek JE, Szcześniak D. Psychopathological profile and quality of life of patients with oral lichen planus. J Appl Oral Sci 2018; 26:e20170146. [PMID: 29364344 PMCID: PMC5777404 DOI: 10.1590/1678-7757-2017-0146] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/19/2017] [Accepted: 08/03/2017] [Indexed: 12/20/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic, multifocal, sometimes painful, inflammatory disease of the oral mucosa. OLP can predispose development of psycho-emotional disorders. Until now, the relationship between the severity of lichen planus and the psychological profile of patients (psychological well-being, perceived stress and pain coping strategies) has never been studied. Study was conducted on 42 OLP patients. Number of sites involved, severity and activity score of OLP were evaluated. Psychological tests were used to evaluate patients' psycho-emotional condition. The mean duration time of symptomatic OLP was 43 months. We detected that the longer the duration of subjective symptoms, the poorer the quality of life and the higher the level of perceived stress (PSS). Also, the higher the PSS results, the greater the anxiety and depression on Hospital Anxiety and Depression Scale (HADS). Likewise, higher level of depression in HADS was strongly correlated with worse quality of life. (p≤0.05). In this study, we detected a relationship between duration of the disease, level of perceived stress and quality of life. The longer the disease lasts, the higher it tends to catastrophize. This may influence development or increase of the anxiety and depression and may decrease patients' quality of life.
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Affiliation(s)
| | - Edyta Zwyrtek
- Lower Silesian Mental Health Center, Wroclaw, Poland
| | | | - Dorota Szcześniak
- Wroclaw Medical University, Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw, Poland
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Akram Z, Javed F, Hosein M, Al-Qahtani MA, Alshehri F, Alzahrani AI, Vohra F. Photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:167-174. [DOI: 10.1111/phpp.12371] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Mervyn Hosein
- Faculty of Dentistry; Ziauddin Medical University; Karachi Pakistan
| | - Mohammed A. Al-Qahtani
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | | | | | - Fahim Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
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Masquijo-Bisio PA, Gandolfo MS, Keszler A, Itoiz ME, Paparella ML. Usefulness of a direct immunofluorescence in the diagnosis of plaque type oral lichen planus. Ann Diagn Pathol 2017; 31:20-22. [PMID: 29146053 DOI: 10.1016/j.anndiagpath.2017.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Patricia Alejandra Masquijo-Bisio
- Cátedra de Clínica Estomatológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina; Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina.
| | - Mariana Silvia Gandolfo
- Cátedra de Clínica Estomatológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
| | - Alicia Keszler
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
| | - Maria Elina Itoiz
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina.
| | - María Luisa Paparella
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
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Gambino A, Carbone M, Broccoletti R, Carcieri P, Conrotto D, Carrozzo M, Arduino PG. A report on the clinical-pathological correlations of 788 gingival lesion. Med Oral Patol Oral Cir Bucal 2017; 22:e686-e693. [PMID: 29053652 PMCID: PMC5813986 DOI: 10.4317/medoral.21845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The diagnosis and treatment of a variety of non-plaque related gingival diseases have become an integrated aspect of everyday dentistry. The aim of this study was to analyse the relationship between clinical appearance and histopathological features of gingival lesions in a large Northern Italian population. MATERIAL AND METHODS A retrospective study of 788 cases of gingival and alveolar mucosal biopsies was set up. Statistical analysis was performed by calculating the odds ratio and 95% confidence interval (C.I.), in order to assess the degree of association between the clinical parameters considered (primary lesions) and the single pathologies, statistically evaluated by Mantel-Haenszel tests. The correlation between clinical and histological diagnosis was classified as follow: 1) expected data (ED): provisional clinical diagnosis; 2) real data (RD): final histopathology diagnosis; 3) concordant data (CD): correspondence between the expected data and real data. The correlation was calculated as follow: CC (complete concordance) = CD x 100 / ED, this expressing the percentage in which the clinical and the histological diagnosis overlapped. RESULTS The most frequently observed and biopsied primary lesions resulted to be exophytic, followed by mucosal colour changes and finally by losses of substance. The statistically significant association between primary lesion and their manifestation in gingival pathologies was reported. Volume increases, for instance, were positively correlated to plasma cell epulis, pyogenic granuloma, fibrous reactive hyperplasia and hemangioma. Verrucous-papillary lesions were most often seen in verrucous carcinoma, verrucous leukoplakia and mild dysplasia. White lesion resulted to be related to leukoplakia or oral lichen planus. Red lesions resulted to be related only oral lichen planus. Erosive vesicle-bullous lesions were linked to disimmune pathologies. Ulcerative lesions were positively associated to oral squamous cell cancer. Finally, potentially malignant disorders have the most percentage high concordance. Among the malignant lesions, the correlation increased up to the squamous cell carcinoma and leukaemia. CONCLUSIONS This article presented the frequency and the clinico-pathological concordance of all primary lesions and the histopathological diagnosis of gingival lesions. For every primary lesion, it is possible to correlate a specific histopathological diagnosis in a statistical manner. This can be a valuable aid for not specialist clinicians who daily observe mucosae and have the opportunity to intercept major diseases.
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Affiliation(s)
- A Gambino
- Department of Surgical Sciences, University of Turin, CIR - Dental School, Oral Medicine Section, Via Nizza 230, 10126 Turin, Italy,
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Aghbari SMH, Abushouk AI, Shakir OG, Zayed SO, Attia A. Correlation between tissue expression of microRNA-137 and CD8 in oral lichen planus. Clin Oral Investig 2017; 22:1463-1467. [PMID: 29034442 DOI: 10.1007/s00784-017-2252-6] [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] [Received: 06/20/2017] [Accepted: 10/10/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Oral lichen planus (OLP) is a chronic, inflammatory condition, classified by the World Health Organization as a premalignant lesion. We performed this study to evaluate the correlation between microRNA-137 (miR-137) and CD8 oral tissue expression in OLP patients. MATERIALS AND METHODS Twenty OLP patients [classified into three groups: (a) papular, reticular, or plaque; (b) atrophic; and (c) erosive] and 20 healthy controls were subjected to biopsy of the oral mucosa. To evaluate CD8 tissue expression, we performed immunohistochemical examination, followed by immunostaining and computerized quantification. The expression of miR-137 was evaluated using real-time quantitative PCR. We used SPSS software (version 15 for windows) to perform the statistical analysis. RESULTS Our analysis showed an increased tissue expression of CD8 (p < 0.01) and reduced expression of miR-137 (p < 0.001) in OLP patients, compared to the control group. Moreover, there was a statistically significant difference (p = 0.001) between OLP subgroups in terms of CD8 tissue expression [highest in erosive OLP and lowest in papular/reticular/plaque OLP]. However, these subgroups showed no significant difference (p = 0.168) in terms of miR-137 expression. A negative correlation (p < 0.05) between tissue expression of miR-137 and CD8 was noted with a varying correlation coefficient in different OLP subgroups (-0.250 in erosive OLP, -0.491 in atrophic OLP and -0.616 in papular/reticular/plaque OLP). CONCLUSIONS Our findings indicate reduced expression of miR-137 and a reverse correlation between tissue expression of miR-137 and CD8 in the oral mucosa of OLP patients. CLINICAL RELEVANCE Future studies should investigate the therapeutic potential of miR-137 overexpression in OLP patients.
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Affiliation(s)
| | | | | | | | - Attia Attia
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Chen J, Du G, Wang Y, Shi L, Mi J, Tang G. Integrative analysis of mRNA and miRNA expression profiles in oral lichen planus: preliminary results. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:390-402.e17. [DOI: 10.1016/j.oooo.2017.05.513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 12/12/2022]
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A clinical evaluation of the efficacy of photodynamic therapy in the treatment of erosive oral lichen planus: A case series. Photodiagnosis Photodyn Ther 2017; 18:12-19. [DOI: 10.1016/j.pdpdt.2017.01.178] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/28/2016] [Accepted: 01/18/2017] [Indexed: 01/15/2023]
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Alberdi-Navarro J, Marichalar-Mendia X, Lartitegui-Sebastián MJ, Gainza-Cirauqui ML, Echebarria-Goikouria MA, Aguirre-Urizar JM. Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data. Med Oral Patol Oral Cir Bucal 2017; 22:e307-e313. [PMID: 28390133 PMCID: PMC5432079 DOI: 10.4317/medoral.21730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/15/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. MATERIAL AND METHODS Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. RESULTS The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from "plaque-like" lesions presented hyperkeratosis (p>0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. CONCLUSIONS The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied.
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Affiliation(s)
- J Alberdi-Navarro
- Unidad de Patología Oral y Maxilofacial, Servicio Clínica Odontológica, Facultad de Medicina y Enfermería, Universidad del País Vasco, EHU Leioa 48940, Vizcaya, Spain,
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Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS, Elsaadany BA, Ahmed EM. Malignant transformation of oral lichen planus and oral lichenoid lesions: A meta-analysis of 20095 patient data. Oral Oncol 2017; 68:92-102. [PMID: 28438300 DOI: 10.1016/j.oraloncology.2017.03.012] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 03/25/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES For over a century, a heated debate existed over the possibility of malignant transformation of oral lichen planus (OLP). We performed this meta-analysis to evaluate the malignant potential of OLP and oral lichenoid lesions (OLL) and investigate the possible risk factors for OLP malignant transformation into oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS We searched Medline, Scopus, and Web of Knowledge for relevant observational studies. Data on OLP malignant transformation were calculated as a pooled proportion (PP), using the Der-Simonian Liard method. We performed subgroup analyses by OLP diagnostic criteria, site, and clinical type, using Open Meta[Analyst] software. Data on possible risk factors for malignant transformation were pooled as odds ratios (ORs), using Comprehensive Meta-Analysis software. RESULTS Pooling data for OLP malignant transformation from 57 studies (19,676 patients) resulted in an overall PP of 1.1% [95% CI: 0.9%, 1.4%], while pooling data from 14 recent studies that used the World Health Organization-2003 diagnostic criteria resulted in an overall-PP of 0.9% [95% CI: 0.5%, 1.3%]. The risk of malignant transformation was higher (PP=2.5%, 95% CI [1%, 4%]) in OLL patients (419 patients). A significant increase of malignant transformation risk was noted among smokers (OR=2, 95% CI [1.25, 3.22]), alcoholics (OR=3.52, 95% CI [1.54, 8.03]), and HCV-infected patients (OR=5, 95% CI [1.56, 16.07]), compared to patients without these risk factors. CONCLUSION A small subset of OLP patients (1.1%) develop OSCC; therefore, regular follow-up for these patients is recommended. A higher incidence of malignant transformation was found among smokers, alcoholics, and HCV-infected patients; however, these associations should be further investigated.
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Affiliation(s)
| | | | - Attia Attia
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Amr Menshawy
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | | | - Eman Magdy Ahmed
- Faculty of Oral and Dental Medicine, Beni Suef University, Beni Suef, Egypt
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Ghallab NA, Kasem RF, El-Ghani SFA, Shaker OG. Gene expression of miRNA-138 and cyclin D1 in oral lichen planus. Clin Oral Investig 2017; 21:2481-2491. [PMID: 28275859 DOI: 10.1007/s00784-017-2091-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 01/03/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study aimed to evaluate microRNA-138 (miR-138) gene expression and its target cyclin D1 (CCND1) gene and protein expression in oral lichen planus (OLP) mucosa in an attempt to investigate their possible roles in OLP immunopathogenesis. METHODS Sixty oral biopsy specimens were harvested from 30 healthy subjects and 30 OLP patients, subdivided into reticular, atrophic, and erosive groups (n = 10 each). Samples were subjected to quantitative real-time polymerase chain reaction analysis for quantification of miR-138 and CCND1 relative gene expression and immunohistochemical analysis to determine CCND1 protein expression. RESULTS Samples from OLP patients had a significant underexpression of miR-138 gene and overexpression of CCND1 at both gene and protein levels compared to normal mucosa samples. The lowest levels of miR-138 expression were observed in atrophic and erosive OLP compared to reticular OLP, and the highest levels of CCND1 gene and protein expression were in atrophic OLP. An inverse correlation was demonstrated between the miR-138 expression and both CCND1 gene and protein expression in OLP patients. A significant positive correlation between CCND1 gene and protein expression was also observed. CONCLUSION Downregulation of miR-138 increases the gene and protein expression of its potential target CCND1 in OLP mucosa which might have a pivotal role in the disease pathogenesis. CLINICAL RELEVANCE This research implied that miR-138 may have a role in identification of symptomatic OLP lesions. MiR-138 might be considered as a potential tool in future OLP molecular therapy.
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Affiliation(s)
- Noha A Ghallab
- Department of Oral Medicine, Periodontology and Diagnosis, Faculty of Oral and Dental Medicine, Cairo University, 43 Zahraa Street, Dokki, Giza, Egypt.
| | - Rehab Fawzy Kasem
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Safa Fathy Abd El-Ghani
- Department of Oral Pathology, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt
| | - Olfat G Shaker
- Department of Medical Biochemistry& Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
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Magliocca KR, Fitzpatrick SG. Autoimmune Disease Manifestations in the Oral Cavity. Surg Pathol Clin 2016; 10:57-88. [PMID: 28153136 DOI: 10.1016/j.path.2016.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Immune-related disorders of the oral cavity may occur as primary disease process, secondary to systemic disease or neoplasm, or as a reaction to medications and other agents. The entities represented within this group may vary significantly by severity, clinical presentation, microscopic presentation, and special testing results. The selected immune-related conditions of the oral cavity in this article are categorized and presented by their prototypical tissue reaction patterns: vesiculobullous, including acantholytic and subepithelial separation; psoriasiform; spongiotic; and lichenoid reaction patterns.
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Affiliation(s)
- Kelly R Magliocca
- Department of Pathology and Laboratory Medicine, Emory University, 500 Peachtree Street Northeast, Atlanta, GA 30308, USA.
| | - Sarah G Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, 1395 Center Drive, Gainesville, FL 32610, USA
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