1
|
Rezazadeh F, Mahdavi D, Fassihi N, Sedarat H, Tayebi Khorami E, Tabesh A. Evaluation of the salivary level of glutathione reductase, catalase and free thiol in patients with oral lichen planus. BMC Oral Health 2023; 23:547. [PMID: 37559066 PMCID: PMC10413704 DOI: 10.1186/s12903-023-03242-1] [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: 03/04/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE Oral lichen planus (OLP) is a usual chronic inflammatory disease of the oral mucosa with malignant capacity, whose pathogenesis is not yet well known. Free radicals and reactive oxygen species may have a vital role in the pathogenesis of oral lichen planus. This study aimed to assess Glutathione reductase, catalase, and free thiol levels in the saliva of OLP patients and compare it with healthy people. METHODS In this cross-sectional study, 35 patients with OLP and 20 healthy people were involved. Five mL of whole, unstimulated saliva samples were collected in the morning, and the salivary levels of antioxidants were measured by ELISA technique. In this experiment, sex, age and OLP types were also evaluated. RESULTS There was a significant decrease in the patients' salivary level of Glutathione reductase (0.2043 mU/ml in patients and 0.3901 mU/ml in the control group) and catalase (0.1525 mU/ml in patients and 0.2700 mU/ml in the control group) (p = 0.001). But there were no differences between the two groups regarding free-thiol levels (0.0586 mU/ml in patients and 0.0569 mU/ml in the control group) (p = 0.7). However, there was no correlation between age and gender with the antioxidants' contents. There was a significant decrease in glutathione reductase and catalase in the erosive type than in the non-erosive type. CONCLUSIONS In this study, we found that the salivary levels of Glutathione reductase and Catalase were lower in OLP patients than in the healthy group, which means these antioxidants were affected by OLP and also associated with the type of it. So salivary Glutathione reductase and Catalase levels may be used as biomarkers for OLP monitoring and treatment.
Collapse
Affiliation(s)
- Fahimeh Rezazadeh
- Dept. of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Dorsa Mahdavi
- Student research committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Fassihi
- Student research committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Sedarat
- Undergraduate medical Student, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Elham Tayebi Khorami
- Student research committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Amir Tabesh
- Student research committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
2
|
Leong XY, Gopinath D, Syeed SM, Veettil SK, Shetty NY, Menon RK. Comparative Efficacy and Safety of Interventions for the Treatment of Oral Lichen Planus: A Systematic Review and Network Meta-Analysis. J Clin Med 2023; 12:jcm12082763. [PMID: 37109100 PMCID: PMC10144824 DOI: 10.3390/jcm12082763] [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: 02/07/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND This systematic review and network meta-analysis aimed to assess comparative efficacy and safety of interventions to treat symptomatic, biopsy-proven oral lichen planus (OLP). METHODS Search was conducted for trials published in Medline, Embase and Cochrane Central Register of Controlled Trials. Network meta-analysis was performed on data from randomized controlled trials that assessed efficacy and safety of interventions used in the treatment of OLP. Agents were ranked according to their effectiveness in treatment of OLP based on outcomes using surface under the cumulative ranking [SUCRA]. RESULTS In total, 37 articles were included in the quantitative analysis. Purslane was clinically significant and ranked first in improving clinical symptoms [RR = 4.53; 95% CI: 1.45, 14.11], followed by aloe vera [RR = 1.53; 95% CI: 1.05, 2.24], topical calcineurin [RR = 1.38; 95% CI: 1.06, 1.81] and topical corticosteroid [RR = 1.35 95% CI: 1.05, 1.73]. Topical calcineurin demonstrated the highest incidence of adverse effects [RR, 3.25 [95% CI: 1.19, 8.86. Topical corticosteroids were significant in achieving clinical improvement of OLP with RR1.37 [95% CI: 1.03, 1.81]. PDT [MD = -5.91 [95% CI: -8.15, -3.68] and showed statistically significant improvement in the clinical score for OLP. CONCLUSIONS Purslane, aloe vera and photodynamic therapy appear promising in treatment of OLP. More high-quality trials are recommended for strengthening the evidence. Although topical calcineurin is significantly efficacious in the treatment of OLP, significant adverse effects are a concern for clinical use. Based on the current evidence, topical corticosteroids are recommended for treatment of OLP owing to their predictable safety and efficacy.
Collapse
Affiliation(s)
- Xin Yi Leong
- School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Divya Gopinath
- Department of Basic Medical and Dental Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Sakil M Syeed
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Sajesh K Veettil
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Naresh Yedthare Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Rohit Kunnath Menon
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| |
Collapse
|
3
|
Serafini G, De Biase A, Lamazza L, Mazzucchi G, Lollobrigida M. Efficacy of Topical Treatments for the Management of Symptomatic Oral Lichen Planus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1202. [PMID: 36673955 PMCID: PMC9859481 DOI: 10.3390/ijerph20021202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucosal inflammatory disease associated with T-cell-mediated immunological dysfunction. Symptomatic OLP is a painful condition, and complete healing is often not achieved. The aim of this systematic review was to assess the effectiveness of topical drugs, medications, and other interventions compared to placebo or to other treatments in pain reduction and clinical resolution in adult patients with symptomatic OLP. A detailed electronic literature search was performed through the MEDLINE (PubMed) database between 1 January 2005 and 30 September 2022. Eligible studies were selected based on the inclusion criteria, and a quality assessment was conducted. From 649 titles, 121 articles were selected as abstracts, 75 papers were assessed as full text, along with 15 other papers obtained through a manual search. A total of 15 RCTs were finally included in the review process. Because of the significant heterogeneity in the study design of the included studies, no meta-analysis of the data could be performed. Topical corticosteroids represent the first-line treatment in the management of symptomatic OLP due to their efficacy and minimal adverse effects. Calcineurin inhibitors seem to be equally effective and are indicated in recalcitrant cases, extensive lesions, patients susceptible to oral candidiasis, or cases unresponsive to corticosteroids. Other treatments, such as aloe vera, chamomile, isotretinoin, ozone, and laser therapy, could be beneficial as adjunct therapies in association with first-line treatments.
Collapse
Affiliation(s)
- Giorgio Serafini
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
| | | | - Luca Lamazza
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
| | | | | |
Collapse
|
4
|
Łukaszewska-Kuska M, Ślebioda Z, Dorocka-Bobkowska B. The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus- A systematic review. Oral Dis 2022; 28:2063-2071. [PMID: 34273228 DOI: 10.1111/odi.13966] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/25/2021] [Accepted: 07/14/2021] [Indexed: 01/20/2023]
Abstract
The goal of this systematic review was to assess the efficacy of dexamethasone compared to other treatments in oral lichen planus (OLP). The literature search used the following inclusion criteria: randomized controlled trials (RCT) comparing dexamethasone and other treatment strategies in patients with OLP. The outcome measures included relief of symptoms, decrement of erosive area size, and changes in quality of life. A computer and manual search was performed in Pubmed, Web of Science, and Cochrane Library up to January 31, 2021. The risk of bias was measured with the Revised Cochrane risk-of-bias tool for randomized trials. Eight trials with 131 study participants and 132 controls were identified. The following interventions were compared dexamethasone mouthwash, and 5% methylene blue-mediated photodynamic therapy, low-level laser therapy, amlexanox, clobetasol mouthwash, ketoconazole with amitriptyline, and thalidomide 1% paste. The therapeutic outcomes were more advantageous for dexamethasone in comparison with photodynamic therapy (PDT) (2 RCT) and low-level laser therapy (LLLT). Comparable effects were observed for dexamethasone, amlexanox, thalidomide, and PDT (1 RCT). Clobetasol showed more effective action than dexamethasone. Given the small sample sizes, heterogeneity and the few studies included, there is limited evidence to support the selection of treatment for OLP.
Collapse
Affiliation(s)
| | - Zuzanna Ślebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
5
|
Langerhans Cells, T Cells, and B Cells in Oral Lichen Planus and Oral Leukoplakia. Int J Dent 2022; 2022:5430309. [PMID: 35360707 PMCID: PMC8964229 DOI: 10.1155/2022/5430309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/05/2022] [Indexed: 11/18/2022] Open
Abstract
Although oral lichen planus (OLP) and oral leukoplakia (LPL) have different pathogenetic profiles, both may involve chronic inflammation. The aim of this observational study was to evaluate the inflammatory cell profiles of OLP and LPL. The inflammatory cell infiltrates in patients with OLP and LPL were analyzed for the presence of Langerhans cells (LCs; CD1a), T cells (CD3), and B cells (CD20), as well as for the proliferation marker Ki-67. Biopsied specimens from patients with OLP (N = 14) and LPL without dysplasia (N = 13) were immunohistochemically stained with antibodies directed against CD1a, CD3, CD20, and Ki-67, followed by quantitative analyses. A significant increase in the number of CD3+ cells and CD20+ cells was found in the submucosa of OLP, as compared to LPL (p < 0.01). Likewise, the number of CD3+ cells was significantly higher in the epithelium of OLP than of LPL (p < 0.05). No differences were found in the expression of Ki-67 and the number of CD1a+ cells between the two groups. Although an immune response is elicited in both conditions, there are differences at the cellular level between OLP and LPL. A more robust immune activation involving T cells and B cells is seen in OLP. The role of B cells in OLP needs to be further elucidated. Although the number of B cells in LPL is low, their role in the inflammatory response cannot be ruled out.
Collapse
|
6
|
Saengprasittichok N, Sucharitakul J, Matangkasombut O, Prapinjumrune C. Effect of fluocinolone acetonide (0.1%) treatment in oral lichen planus patients on salivary lactoferrin levels and Candida colonization: a prospective study. BMC Oral Health 2022; 22:58. [PMID: 35246095 PMCID: PMC8895920 DOI: 10.1186/s12903-022-02096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although topical steroids are an effective treatment for oral lichen planus, they can have suppressive effects on oral immunity and predispose the patients to Candida overgrowth. Lactoferrin is a crucial local immunity protein in the oral cavity with important antimicrobial activity. The aim of this study was to prospectively investigate salivary lactoferrin secretion levels and Candida colonization in oral lichen planus patients treated with fluocinolone acetonide 0.1% in orabase. Methods Saliva samples were collected from 15 oral lichen planus subjects who had never received topical steroid treatment prior to this study and 15 healthy volunteers to determine their salivary lactoferrin levels using an enzyme-linked immunosorbent assay and to investigate the presence of oral Candida species at baseline and 3 months after treatment with fluocinolone acetonide 0.1% in orabase. Statistical analysis was performed to compare lactoferrin secretion and Candida colonization levels between the groups using the Mann–Whitney U test for independent data or the Wilcoxon Signed-Rank test for paired data. Results The salivary lactoferrin secretion level was not significantly different between the control group and oral lichen planus patients or between before and after treatment with fluocinolone acetonide 0.1% in orabase (P > 0.05). Candida was detected in 11 (73.33%) healthy volunteers, 8 (53.33%) oral lichen planus patients before treatment, and 9 (60%) oral lichen planus patients after treatment with fluocinolone acetonide 0.1% in orabase. There was no significant difference in Candida counts between the groups (P > 0.05). Conclusion Our study indicates that using fluocinolone acetonide 0.1% in orabase to treat oral lichen planus for 3 months did not affect salivary lactoferrin protein secretion or Candida carriage. Trial registration The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR20200723002).
Collapse
Affiliation(s)
- Nuttapong Saengprasittichok
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.,Phaholpolpayuhasena Hospital, Kanchanaburi, Thailand
| | - Jeerus Sucharitakul
- Department of Biochemistry and Research Unit in Integrative Immuno-Microbial Biochemistry and Bioresponsive Nanomaterials, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chanwit Prapinjumrune
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
| |
Collapse
|
7
|
Rashid H, Meijer JM, Diercks GFH, Sieben NE, Bolling MC, Pas HH, Horvath B. Assessment of Diagnostic Strategy for Mucous Membrane Pemphigoid. JAMA Dermatol 2021; 157:780-787. [PMID: 33909024 DOI: 10.1001/jamadermatol.2021.1036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance An accurate diagnosis of mucous membrane pemphigoid (MMP) is essential to reduce diagnostic and therapeutic delay. Objective To assess the diagnostic accuracy of direct immunofluorescence microscopy on mucosal biopsy specimens and immunoserology in a large cohort of patients with suspected MMP. Design, Setting, and Participants This retrospective cohort study was carried out in a single tertiary care center for blistering diseases between January 2002 and March 2019. Eligible participants were patients with suspected MMP and paired data on at least a mucosal biopsy specimen for direct immunofluorescence microscopy (DIF) and indirect immunofluorescence microscopy (IIF) on a human salt-split skin substrate (SSS). In addition, an optional DIF test on a skin biopsy specimen and one or more performed routine immunoserologic tests were analyzed. Data analysis was conducted from April 2019, to June 2020. Main Outcomes and Measures Diagnostic accuracy of DIF, IIF SSS, and immunoblot for BP180 and BP230. Results Of the 787 participants, 121 (15.4%) received the diagnosis of MMP (50 men [41.3%], 71 women [58.7%]; mean [SD] age at diagnosis, 60.1 [17.7] years). Sixty-seven of the patients with MMP (55.4%) had monosite involvement, of which oral site was the most frequently affected (51 [42.1%]). No significant difference was found between the sensitivity of DIF on a perilesional buccal biopsy and a normal buccal biopsy (89.3% vs 76.7%). Three patients with solitary ocular involvement showed a positive DIF of only the oral mucosa. In 6 patients with a negative mucosal DIF, a skin biopsy confirmed diagnosis of MMP. Overall, IIF SSS was less sensitive (44.6%), but highly specific (98.9%). The sensitivity of immunoblot (66.1%) was higher compared to SSS, but with lower specificity (91.3%). Conclusions and Relevance This comparative diagnostic accuracy study of a cohort of 787 patients found a high sensitivity of a mucosal DIF biopsy for diagnosis of MMP, and lower sensitivity of serologic analysis. A biopsy can be taken from either perilesional or normal buccal mucosa. An additional DIF biopsy of another mucosal site or of affected or unaffected skin may increase the diagnostic yield and is recommended in patients with negative DIF results and high clinical suspicion.
Collapse
Affiliation(s)
- Hanan Rashid
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| | - Joost M Meijer
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| | - Gilles F H Diercks
- University of Groningen, University Medical Center Groningen, Department of Pathology, Groningen, the Netherlands
| | - Nini E Sieben
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| | - Maria C Bolling
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| | - Hendri H Pas
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| | - Barbara Horvath
- University of Groningen, University Medical Center Groningen, Department of Dermatology, Center of Blistering Diseases, European Reference Network-Skin Member, the Netherlands
| |
Collapse
|
8
|
Zakhur II, Koshkin SV, Zaitseva GA, Bobro VA. Peculiarities of distribution of HLA class I antigens in patients with lihen planus. VESTNIK DERMATOLOGII I VENEROLOGII 2021. [DOI: 10.25208/vdv1151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The article presents data on the distribution characteristics of the HLA class I system antigens in patients with lichen planus.
Aim. To study the patterns of distribution of HLA class I antigens in the general group. To establish the presence of an association of the disease with antigens of the HLA class I.
Material and methods. Laboratory analysis of the distribution of HLA class I antigens was carried out in 60 patients with various forms of lichen planus who consider themselves Russian on the basis of linguistic and ethnicity. The duration of the disease is 120 years.
Results. When analyzing the typing results in the general group of patients; a tendency to negative association of HLA-A11 and HLA-B7.
It was found that the frequency of haplotype combinations A1-B8; A2-B27; A2-B40; A3-B35 significantly exceeded that of healthy people. Analysis of the frequency of phenotypic combinations revealed a significant increase in A3-A19 and B12-B35.
Conclusion. Haplotype and phenotypic combinations of HLA A1-B8; A2-B27; A2-B40; A3-B35; A3-A19; B12-B35 are provoking factors in the development of various forms of the disease. The presence of these genetic traits in the individual increases the risk of developing lichen planus by 311 times. In turn; the HLA-A11 and B7 antigens play a protective role.
Collapse
|
9
|
You Y, Huang X, Chen Y, You Y. Efficacy and safety of traditional Chinese medicine for erosive oral lichen planus: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2020; 99:e23375. [PMID: 33235110 PMCID: PMC7710173 DOI: 10.1097/md.0000000000023375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a common disease among oral mucous membrane diseases. Erosive oral lichen planus (EOLP) is a type of OLP, it has a potential tendency of cancerization. There have been some randomized controlled trials (RCTs) using Traditional Chinese Medicine (TCM) to treat EOLP. No systematic review on the RCTs of TCM for EOLP has been reported, so we would propose a study protocol that aims to evaluate the evidence the efficacy and safety of TCM for treating patients with EOLP. METHODS The following databases from the inception to June 30, 2020 electronically, including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, VIP, Wanfang database, China Biomedical Literature Database will be searched. RCTs that meet the pre-specified eligibility criteria will be included. RevMan software (V5.3) will be performed data synthesis following data extraction and publication risk assessment. Subgroup and sensitivity analysis will be performed according to the condition of included RCTs. The primary outcomes include visual analogy scale, laboratory immune indicators, and scores of oral lesions and signs. Additional outcomes are clinical effective rate, adverse event rate, and recurrence rate. The Grading of Recommendations Assessment, Development and Evaluation system will be used to assess the strength of the evidence. RESULTS This study will provide a well-reported synthesis of RCTs on the efficacy and safety of TCM in the treatment of EOLP. CONCLUSION This systematic review protocol will be helpful for providing evidence of whether TCM is an effective and safe therapeutic approach for patients with EOLP. ETHICS AND DISSEMINATION Ethical approval is not necessary as this protocol is only for systematic review and it does not involve privacy data or conduct an animal experiment. This protocol will be disseminated by a peer-review journal or conference presentation. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020172366.
Collapse
Affiliation(s)
- Yanyan You
- West China Hospital of stomatology, Sichuan University, South Renmin Road, Wu Hou District
| | - Xiaojin Huang
- West China Hospital of stomatology, Sichuan University, South Renmin Road, Wu Hou District
| | - Yunhui Chen
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu You
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
10
|
Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study. Sci Rep 2020; 10:1667. [PMID: 32015380 PMCID: PMC6997407 DOI: 10.1038/s41598-020-58548-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.
Collapse
|
11
|
Targeted cancer therapies: Oral health care implications. J Am Dent Assoc 2019; 149:100-111. [PMID: 29389333 DOI: 10.1016/j.adaj.2017.08.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 08/23/2017] [Accepted: 08/28/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Targeted treatments have been incorporated into oncology protocols, often with more traditional therapies, and are not totally free of adverse reactions, some of which affect the orofacial region. METHODS The authors searched PubMed, the Cochrane Library, and the US Food and Drug Administration Approved Drug Products database to identify reported adverse effects of targeted agents in the orofacial region as well as other implications in oral health care. Their principal focus was the relatively newer category of molecularly targeted drugs which are called small molecules (SMs). RESULTS The authors identified several categories of SMs and biological agents (for example, monoclonal antibodies) with adverse effects in the orofacial region. The oral and perioral regions are also fields for which there are therapeutic applications for targeted therapies, particularly to treat malignant neoplasms such as head and neck cancers. CONCLUSIONS SMs are the most rapidly growing group of targeted cancer treatments. Patients receiving SMs and other targeted antineoplastic agents may require oral medicine advice and special-care dentistry. PRACTICAL IMPLICATIONS In this narrative review, the authors focus mainly on the orofacial adverse effects of targeted cancer therapies and outline many of the agents that are in use so the dentally focused reader can familiarize themselves with these adverse effects and agents.
Collapse
|
12
|
Abstract
Mucocutaneous diseases affecting the oral cavity are predominantly immune mediated or inflammatory. Three of the most common and clinically significant conditions are reviewed in this article: lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid. Because oral manifestations may be the first or only manifestation of mucocutaneous diseases, oral health professionals play a critical role in the early diagnosis and multidisciplinary management of these conditions.
Collapse
|
13
|
Wei W, Wang Y, Sun Q, Jiang C, Zhu M, Song C, Li C, Du G, Deng Y, Nie H, Tang G. Enhanced T-cell proliferation and IL-6 secretion mediated by overexpression of TRIM21 in oral lesions of patients with oral lichen planus. J Oral Pathol Med 2019; 49:350-356. [PMID: 31353628 DOI: 10.1111/jop.12938] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/12/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUNDS To explore the expression and functions of the tripartite motif-containing protein 21 (TRIM21) in oral lichen planus(OLP) lesions. METHODS Paraffin sections of buccal mucosa samples from 15 cases of reticular oral lichen planus (OLP) patients and 10 healthy controls were used for immunohistochemistry to determine expression and distribution of TRIM21. Buccal mucosae from 11 OLP patients and seven healthy controls were analyzed by qPCR to quantify its gene expression. Peripheral blood mononuclear cells and CD3+ cells from four pairs of age- and sex-matched OLP patients and healthy controls were isolated for immunocytochemistry and culture. Following lentivirus-mediated overexpression of TRIM21 gene in CD3+ cells, CCK-8 was applied to evaluate cell proliferation. Cytokines including IL-2, IL-4, IL-5, IL-6, IL-10, TNF-α, and IFN-γ in the supernatants were measured by the cytometric bead array and verified by ELISA. RESULTS A larger number of TRIM21-positive cells infiltrating the lamina propria were observed in OLP lesions by immunohistochemistry than those of healthy controls. Significantly higher transcription of TRIM21 was revealed by qPCR. TRIM21 overexpression in CD3+ cells significantly enhanced the proliferation and IL-6 secretion in CD3+ cells from 12 to 72 hours. CONCLUSION Overexpressed TRIM21 in OLP may be a primary proinflammatory molecule rather than a secondary and inducible regulatory factor in immunopathogenesis of OLP.
Collapse
Affiliation(s)
- Wei Wei
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yufeng Wang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Qianqian Sun
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chenyan Jiang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Mengxue Zhu
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chencheng Song
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chenxi Li
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Guanhuan Du
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiwen Deng
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hong Nie
- Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guoyao Tang
- Department of Oral Medicine, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| |
Collapse
|
14
|
Samiei M, Ahmadian E, Eftekhari A, Eghbal MA, Rezaie F, Vinken M. Cell junctions and oral health. EXCLI JOURNAL 2019; 18:317-330. [PMID: 31338005 PMCID: PMC6635732 DOI: 10.17179/excli2019-1370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
The oral cavity and its appendices are exposed to considerable environmental and mechanical stress. Cell junctions play a pivotal role in this context. Among those, gap junctions permit the exchange of compounds between cells, thereby controlling processes such as cell growth and differentiation. Tight junctions restrict paracellular transportation and inhibit movement of integral membrane proteins between the different plasma membrane poles. Adherens junctions attach cells one to another and provide a solid backbone for resisting to mechanistical stress. The integrity of oral mucosa, normal tooth development and saliva secretion depend on the proper function of all these types of cell junctions. Furthermore, deregulation of junctional proteins and/or mutations in their genes can alter tissue functioning and may result in various human disorders, including dental and periodontal problems, salivary gland malfunction, hereditary and infectious diseases as well as tumorigenesis. The present manuscript reviews the role of cell junctions in the (patho)physiology of the oral cavity and its appendices, including salivary glands.
Collapse
Affiliation(s)
- Mohammad Samiei
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Ahmadian
- Dental and Periodontal Research center, Tabriz University of Medical Sciences, Tabriz, Iran.,Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aziz Eftekhari
- Pharmacology and Toxicology department, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Mohammad Ali Eghbal
- Drug Applied Research Center and Pharmacology and Toxicology department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fereshte Rezaie
- General Practitioner, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mathieu Vinken
- Department of In Vitro Toxicology and Dermato-Cosmetology, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
15
|
Yu F, Xu N, Zhao B, Ren X, Zhang F. Successful treatment of isolated oral lichen planus on lower lip with traditional Chinese medicine and topical wet dressing: A case report. Medicine (Baltimore) 2018; 97:e13630. [PMID: 30558050 PMCID: PMC6320154 DOI: 10.1097/md.0000000000013630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
RATIONALE Biopsy is very important for the diagnosis of oral lichen planus (OLP) on the lips. Traditional Chinese medicine (TCM) can be used to coordinate the whole body, soften and eliminate swellings and masses, and regulate the functions of qi and blood. Therefore, TCM could be an effective and safe treatment for OLP. Wet dressing is particularly important for the treatment of lip diseases. We report on a rare case of OLP on the lower lip. PATIENT CONCERNS A 38-year-old female patient presenting with a history of recurrent erosion, bleeding, and pain on her lower lip for 10 years. DIAGNOSES Erosive OLP of the lower lip. INTERVENTIONS The patient was treated for 4 months using TCM comprising "Qingwen Jiedu Kouyankang granules," total Paeonia glucosides, and a combination of hormones and anti-inflammatory agents applied locally using a wet dressing. OUTCOMES Lip erosion was improved remarkably after 1 month, and there was no recurrence or aggravation of the condition. The duration of the follow-up period was 5 months. LESSONS The therapeutics used here were effective and safe for the treatment of OLP and could improve the quality of life in patients with lip erosion. The therapeutics provide new insight into the treatment of OLP on the lip.
Collapse
Affiliation(s)
| | - Na Xu
- Department of Oral Medicine
| | - Bin Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - XiuYun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | | |
Collapse
|
16
|
Henry A, Biddlestone J, McCaul J. 'Nasal flossing': A case report of nasopharyngeal stenosis due to severe erosive lichen planus and a novel therapeutic intervention. Int J Surg Case Rep 2018; 54:99-102. [PMID: 30611058 PMCID: PMC6317303 DOI: 10.1016/j.ijscr.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/17/2018] [Accepted: 11/05/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We describe a case of severe erosive oral lichen planus that led to nasopharyngeal stenosis. This is a rare clinical presentation that was ultimately, successfully treated by surgery combined with post-operative 'nasal flossing': a novel therapeutic intervention. PRESENTATION OF CASE A 76-year-old male suffering from a rare case of severe oral lichen planus that was resistant to conservative measures is described. Initial surgery was complicated by recurrence of nasopharyngeal stenosis. Definitive surgery required revision of nasopharyngeal stenosis release combined with a course of post- operative 'nasal flossing'. The technique for 'nasal flossing' is described and demonstrated in photographs. The patient remained asymptomatic at 3 years using this combined approach, with restoration of olfaction, taste perception and voice quality, significantly enhancing quality of life. DISCUSSION Erosive oral lichen planus is a rare but important presentation in oral medicine. We found 'nasal flossing' to be a successful treatment to maintain nasopharyngeal patency following surgical repair of this uncommon condition. We are not aware that this combined approach has previously been described in the published literature. CONCLUSIONS Severe erosive oral lichen planus can lead to nasopharyngeal stenosis. Nasopharyngeal stenosis in these patients may be refractive to conventional surgical approaches. 'Nasal flossing' is demonstrated to be both practical and acceptable as a surgical adjunct in these difficult to treat cases of recurrent nasopharyngeal stenosis. This report has relevance for all those practicing oral and maxillofacial surgery, ear nose and throat surgery and oral medicine.
Collapse
Affiliation(s)
| | - John Biddlestone
- University of Glasgow, Speciality Registrar, Scottish Deanery, United Kingdom.
| | - James McCaul
- NHS GGC, Professor of Maxillofacial Surgery, University of Bradford, United Kingdom
| |
Collapse
|
17
|
Marshall A, Celentano A, Cirillo N, Mirams M, McCullough M, Porter S. Immune receptors CD40 and CD86 in oral keratinocytes and implications for oral lichen planus. J Oral Sci 2018; 59:373-382. [PMID: 28904313 DOI: 10.2334/josnusd.16-0334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Lichen planus (LP) is a chronic T-cell-mediated mucocutaneous inflammatory disease that targets stratified epithelia, including those lining the oral cavity. The intraoral variant of LP (OLP) is associated with interferon (IFN)-γ production by infiltrating T lymphocytes; however, the role of epithelial cells in the etiopathogenesis OLP is not completely understood. There is however a growing body of evidence regarding the involvement of epithelial-derived cytokines, immune receptors, and costimulatory molecules in the pathobiological processes that promote and sustain OLP. In the present study, we used a reverse transcriptase-polymerase chain reaction assay to assess whether CD40-a receptor found mainly on antigen presenting cells-and the costimulatory molecule CD86 were expressed in oral keratinocytes (three strains of primary normal oral keratinocytes and the H357 cell line) in the presence or absence of IFN-γ. To further characterize the involvement of CD40 in OLP, expression and distribution of receptor and ligand (CD40/CD154) in tissues from OLP were evaluated by immunohistochemistry. The present results are the first to show that both CD40 and CD86 are constitutively expressed at low levels in oral keratinocytes and that their expression was enhanced by IFN-γ stimulation. The intensity of CD40 staining in OLP tissues was strong. Taken together, the results strongly suggest that CD40 and CD86 play a role in the pathophysiology of oral inflammatory diseases such as OLP.
Collapse
Affiliation(s)
| | - Antonio Celentano
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University Federico II of Naples.,Melbourne Dental School and Oral Health Cooperative Research Centre, The University of Melbourne
| | - Nicola Cirillo
- Melbourne Dental School and Oral Health Cooperative Research Centre, The University of Melbourne
| | - Michiko Mirams
- Melbourne Dental School and Oral Health Cooperative Research Centre, The University of Melbourne
| | - Michael McCullough
- Melbourne Dental School and Oral Health Cooperative Research Centre, The University of Melbourne
| | | |
Collapse
|
18
|
Mixed and inhomogeneous expression profile of Th1/Th2 related cytokines detected by cytometric bead array in the saliva of patients with oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:142-151. [PMID: 29627199 DOI: 10.1016/j.oooo.2018.02.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/11/2018] [Accepted: 02/19/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this study was to measure T helper (Th) 1/Th2-related cytokine expression in saliva from patients with oral lichen planus (OLP), compared with healthy controls (HC group) and controls with recurrent aphthous ulcers (RAU group). STUDY DESIGN Saliva was collected from 41 patients with OLP, 14 HCs, and 14 controls with RAU for Th1/Th2-related cytokines analysis with cytometric bead array. Disease activity in OLP was recorded by reticulation/keratosis, erythema, and ulceration scores. RESULTS Interleukin (IL)-6, IL-10, interferon-γ (IFN-γ), and IFN-γ/IL-4 in saliva were significantly higher in the OLP group than in the HC group. A positive and significant correlation among IL-6, IL-10, and reticulation/keratosis, erythema, and ulceration scores in the OLP group was revealed. Significantly increased IL-4, IL-5, IL-6, IL-10, tumor necrosis factor-α and IFN-γ/IL-4 were found in the RAU group. CONCLUSIONS Salivary cytokine profiles analyzed by cytometric bead array may provide a convenient research approach to OLP. Data indicated complicated Th1/Th2-related cytokine profile changes, rather than simple dominance model, in OLP. IL-10 and especially IL-6 may provide a surrogate endpoint for monitoring OLP.
Collapse
|
19
|
Agel M, Al-Chihabi M, Zaitoun H, Thornhill MH, Hegarty AM. Lichen planus in children. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/denu.2018.45.3.227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mona Agel
- Specialty Dentist in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, UK
| | - Mamdouh Al-Chihabi
- Specialty Trainee in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Halla Zaitoun
- Consultant in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Martin H Thornhill
- Professor of Translational Research in Dentistry, School of Clinical Dentistry, University of Sheffield, UK
| | - Anne M Hegarty
- Consultant in Oral Medicine, Charles Clifford Dental Services, Sheffield, UK
| |
Collapse
|
20
|
Liu T, Zhang H, Yang X, Li X, Shi Y, Niu W, Liu T. Study on expression of p16 and human papillomavirus 16 and 18 (E6) in OLP and its malignant transformation. Pathol Res Pract 2018; 214:296-302. [DOI: 10.1016/j.prp.2017.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/03/2017] [Accepted: 09/15/2017] [Indexed: 01/08/2023]
|
21
|
Abstract
Many red and white lesions of the mouth are clinically indistinguishable from those of oral lichen planus (OLP). These lesions, often referred to as oral lichenoid lesions (OLL), can occur as a result of contact sensitivity (lichenoid contact reactions), drug reactions or as part of chronic graft versus host disease (GVHD). Oral lesions in discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE) can also have a similar clinical appearance to OLP. Distinguishing oral lichen planus from oral lichenoid lesions, lupus lesions, or other red and white lesions of the mouth can be difficult (even impossible) but it is important, for optimal management of each condition. All patients with red and white pathological lesions should be referred to an oral medicine or a local oral or maxillofacial surgery department, where a biopsy and other investigations can help to establish a diagnosis, and appropriate treatment and monitoring can be commenced. Dentists and other members of the dental team, such as hygienists and dental therapists, should also equip themselves with the knowledge to be able to explain different pathologies of the mouth to their patients and discuss risk factors.
Collapse
|
22
|
Marshall A, Celentano A, Cirillo N, McCullough M, Porter S. Tissue-specific regulation of CXCL9/10/11 chemokines in keratinocytes: Implications for oral inflammatory disease. PLoS One 2017; 12:e0172821. [PMID: 28253295 PMCID: PMC5333845 DOI: 10.1371/journal.pone.0172821] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 02/11/2017] [Indexed: 02/01/2023] Open
Abstract
The IFN-γ-inducible chemokines CXCL9, CXCL10, and CXCL11 play a key role in many inflammatory conditions, particularly those mediated by T cells. Therefore, the production of these chemokines in peripheral tissues could be instrumental in the pathophysiology of tissue-specific immunological diseases such as oral lichen planus (OLP). In the present study, we assessed the production of keratinocyte-derived CXCL9/10/11 under basal and inflammatory conditions and investigated whether these chemokines were involved in the pathogenesis of OLP. We used semi-quantitative PCR, ELISA, chemotaxis assays, and fluorescence-activated cell sorting (FACS) to assess the expression and functional role of CXCL9/10/11 in oral keratinocytes (three strains of normal human oral keratinocytes (NHOK), and the H357 oral cancer cell line) in the presence or absence of IFN-γ. CXCL9/10/11 were also assessed in tissues from normal patients and those with oral lichen planus (OLP). The time course study in oral keratinocytes treated with IFN-γ showed that expression of CXCL9/10/11 chemokines was significantly enhanced by IFN-γ in a time-dependent manner. In particular, CXCL10, a prominent chemokine that was overexpressed by IFN-γ-stimulated NHOK, was able to effectively recruit CD4 lymphocytes, mainly CD4+CD45RA- cells. Significantly higher levels of CXCL9/10/11 were found in tissues from patients with OLP compared to normal oral mucosa. Taken together, the results demonstrate that normal oral keratinocytes produce chemotactic molecules that mediate T cell recruitment. This study furthers understanding of chemokine production in oral keratinocytes and their role in the pathophysiology of oral mucosa, with particular relevance to OLP.
Collapse
MESH Headings
- Cell Line, Tumor
- Cell Movement/drug effects
- Chemokine CXCL10/genetics
- Chemokine CXCL10/metabolism
- Chemokine CXCL11/genetics
- Chemokine CXCL11/metabolism
- Chemokine CXCL9/genetics
- Chemokine CXCL9/metabolism
- Chemokines, CXC/genetics
- Chemokines, CXC/metabolism
- Gene Expression Regulation/drug effects
- Humans
- Interferon-gamma/pharmacology
- Keratinocytes/drug effects
- Keratinocytes/immunology
- Keratinocytes/metabolism
- Lichen Planus, Oral/genetics
- Lichen Planus, Oral/immunology
- Lichen Planus, Oral/metabolism
- Lichen Planus, Oral/pathology
- Mouth Mucosa/pathology
- Organ Specificity
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Receptors, CXCR3/metabolism
- T-Lymphocytes/cytology
- T-Lymphocytes/drug effects
Collapse
Affiliation(s)
- Alison Marshall
- University College London, UCL Eastman Dental Institute, London, United Kingdom
| | - Antonio Celentano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
- Melbourne Dental School and Oral Health CRC, The University of Melbourne, Victoria, Australia
| | - Nicola Cirillo
- Melbourne Dental School and Oral Health CRC, The University of Melbourne, Victoria, Australia
| | - Michael McCullough
- Melbourne Dental School and Oral Health CRC, The University of Melbourne, Victoria, Australia
| | - Stephen Porter
- University College London, UCL Eastman Dental Institute, London, United Kingdom
| |
Collapse
|
23
|
Evaluation of salivary level of IL-10 in patients with oral lichen planus, a preliminary investigation. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s00580-017-2415-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
24
|
Bakhtiari S, Toosi P, Samadi S, Bakhshi M. Assessment of Uric Acid Level in the Saliva of Patients with Oral Lichen Planus. Med Princ Pract 2017; 26:57-60. [PMID: 27694755 PMCID: PMC5588325 DOI: 10.1159/000452133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 09/29/2016] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the level of uric acid (UA) in saliva, which is considered to be an antioxidant defense biomarker against oxidative stress in patients with oral lichen planus (OLP). SUBJECTS AND METHODS In this case-control study, 25 OLP patients were included. The reticular form of OLP was verified by a clinical examination with Wickham striae, and other types (erosive, atrophic, ulcerative) were confirmed by histopathological assessment. Thirty healthy individuals matched for age and gender were selected as the control group. In both groups, the Navazesh technique was used to collect the unstimulated saliva. Then, the amount of UA was measured using a Cobas Mira autoanalyzer with a wavelength of 546 nm. The Student t test was used to analyze the data assuming a significance level at <0.05. RESULTS Of the 25 patients, the most common type of OLP was erosive (n = 11, 44%), and the most common site of OLP was seen as bilateral in the buccal mucosa (n = 12, 48%). The mean level of salivary UA was significantly lower in the patients with OLP (2.10 ± 0.19 mg/dL) in comparison with the control group (4.80 ± 0.29 mg/dL; p < 0.001). CONCLUSION In this study, OLP was associated with a decrease in UA levels in the saliva. Salivary UA as a biomarker could be used for monitoring and treating OLP.
Collapse
Affiliation(s)
| | - Parviz Toosi
- Department of Dermatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Samadi
- Department of Oral Medicine, Dental Faculty, Tehran, Iran
| | - Mahin Bakhshi
- Department of Oral Medicine, Dental Faculty, Tehran, Iran
- *Mahin Bakhshi, Department of Oral Medicine, Dental Faculty, Shahid Beheshti University of Medical Sciences, Evin-Daneshjoo Blvd., 1983963113 Tehran (Iran), E-Mail
| |
Collapse
|
25
|
Schreurs O, Karatsaidis A, Schenck K. Phenotypically non-suppressive cells predominate among FoxP3-positive cells in oral lichen planus. J Oral Pathol Med 2016; 45:766-773. [PMID: 27084447 DOI: 10.1111/jop.12447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Oral lichen planus (OLP) is a common T-cell-dominated oral chronic inflammatory disease occurring in periods of remission, quiescence, activity with pronounced inflammation, and acute ulceration. Cell infiltrates in OLP contain varying numbers of CD4+ T cells expressing the transcription factor FoxP3. FoxP3+ CD4+ T cells are, however, a heterogeneous cell population containing suppressive and non-suppressive cells, and their distribution in infiltrates from OLP is unknown. METHODS Biopsies were taken from normal oral mucosa (n = 8) and OLP lesions (n = 19), and a set of in situ methods for the determination of the functional phenotype of FoxP3+ CD4+ T cells was applied. RESULTS Numbers of FoxP3+ CD4+ T cells were highest in the atrophic form of the disease, yet low in the ulcerative form. The main FoxP3+ CD4+ T-cell population observed was FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s- , a phenotype delineating a non-suppressive subset. Numbers of cells with an actively suppressing phenotype (FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s+ ) were, however, about twice as high in reticular lesions as compared with the atrophic form. Many FoxP3+ CD4+ T cells expressed T-bet, the hallmark transcription factor for IFN-γ-producing T cells, indicating that they may enhance immune and inflammatory responses rather than suppress them. CONCLUSIONS The absence of actively suppressing FoxP3+ CD4+ T cells may in part explain why OLP is a remarkably persisting condition, in spite of the presence of substantially high numbers of FoxP3+ CD4+ T cells. The findings emphasize that it is crucial to examine not only numbers but also functional phenotype of FoxP3+ CD4+ T cells in human tissues.
Collapse
Affiliation(s)
- Olav Schreurs
- The CrossTalk Group, Department of Oral Biology, University of Oslo, Oslo, Norway.
| | - Andreas Karatsaidis
- The CrossTalk Group, Department of Oral Biology, University of Oslo, Oslo, Norway
| | - Karl Schenck
- The CrossTalk Group, Department of Oral Biology, University of Oslo, Oslo, Norway
| |
Collapse
|
26
|
Does Lichen Planus Cause Increased Carotid Intima-Media Thickness and Impaired Endothelial Function? Can J Cardiol 2016; 32:1246.e1-1246.e6. [PMID: 26948036 DOI: 10.1016/j.cjca.2015.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 11/12/2015] [Accepted: 11/12/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lichen planus (LP) has been associated with cardiovascular disease (CVD) risk factors, but there are no studies on the association between LP and subclinical atherosclerosis. We investigated the presence of subclinical atherosclerosis in patients with LP not known to have CVD using carotid intima-media thickness (CIMT) and flow-mediated dilatation (FMD). METHODS The study included 30 patients with LP and 30 controls. High-resolution ultrasonography was used to assess CIMT and FMD. Participants' biochemical parameters, body mass index (BMI), and waist circumference were recorded in both groups. RESULTS FMD was significantly lower (7.45% ± 3.63% vs 11.01% ± 5.34%; P = 0.004) and CIMT was higher (0.8 mm [range, 0.7-0.9 mm] vs 0.6 mm [0.4-0.6 mm]; P < 0.001) in the LP group compared with the control group. After adjustment for age, sex, BMI, high-density lipoprotein cholesterol levels, and C-reactive protein levels, the presence of LP was associated with impairment of FMD (β = -0.441; 95% CI, -9.336 to -0.321; P = 0.037) and an increase in CIMT (β = 0.459; 95% CI, 0.057 to -0.351; P = 0.008). CONCLUSIONS Reduced FMD and increased CIMT levels are sensitive indicators of target-organ damage and display increased risk for cardiovascular morbidity and mortality. Our study found that patients with LP showed a tendency toward impaired levels of FMD and increased CIMT. LP may be a novel predictor of early vascular dysfunction and structural changes.
Collapse
|
27
|
Abstract
Chronic infection with the hepatitis C virus (HCV) is a major cause of liver disease worldwide and is also responsible for extrahepatic manifestations (EHMs) involving the skin, kidneys, salivary glands, eyes, thyroid, and immune system. Mixed cryoglobulinemia is the prototype EHM related to HCV infection. Although these HCV-related EHMs may contribute to significant rates of morbidity affecting patient's quality of life and survival, most of these complications can reverse after HCV eradication by interferon therapy. This notwithstanding, individual patients may have an irreversible injury in various organs that is not reversed by a cure of the HCV infection.
Collapse
Affiliation(s)
- Mauro Viganò
- Hepatology Division, Ospedale San Giuseppe, Università degli Studi di Milano, Via San Vittore 12, Milan 20122, Italy
| | - Massimo Colombo
- Division of Gastroenterology and Hepatology, "A. M. and A. Migliavacca" Center for Liver Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via F. Sforza 35, Milan 20122, Italy.
| |
Collapse
|
28
|
Lukács J, Schliemann S, Elsner P. Lichen planus and lichenoid reactions as a systemic disease. Clin Dermatol 2015; 33:512-9. [DOI: 10.1016/j.clindermatol.2015.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
29
|
Chamani G, Rad M, Zarei MR, Lotfi S, Sadeghi M, Ahmadi Z. Efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus: a systematic review and meta-analysis. Int J Dermatol 2015. [DOI: 10.1111/ijd.12925] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Goli Chamani
- Orofacial Pain Clinic; Department of Oral Medicine; Dental School; Kerman Iran
| | - Maryam Rad
- Oral and Dental Diseases Research Center; Kerman University of Medical Sciences; Kerman Iran
| | - Mohammad Reza Zarei
- Orofacial Pain Clinic; Department of Oral Medicine; Dental School; Kerman Iran
| | - Sodabeh Lotfi
- Orofacial Pain Clinic; Department of Oral Medicine; Dental School; Kerman Iran
| | - Masoumeh Sadeghi
- Research Center for Modeling in Health; Kerman University of Medical Sciences; Kerman Iran
| | - Zahra Ahmadi
- Oral and Dental Diseases Research Center; Kerman University of Medical Sciences; Kerman Iran
| |
Collapse
|
30
|
Vohra S, Singal A, Sharma SB. Clinical and serological efficacy of topical calcineurin inhibitors in oral lichen planus: a prospective randomized controlled trial. Int J Dermatol 2015; 55:101-5. [DOI: 10.1111/ijd.12887] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/16/2014] [Accepted: 10/25/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Suruchi Vohra
- Department of Dermatology & STD; University College of Medical Sciences & GTB Hospital (University of Delhi); Dilshad Garden India
| | - Archana Singal
- Department of Dermatology & STD; University College of Medical Sciences & GTB Hospital (University of Delhi); Dilshad Garden India
| | - Suman Bala Sharma
- Department of Biochemistry; University College of Medical Sciences & GTB Hospital (University of Delhi); Dilshad Garden India
| |
Collapse
|
31
|
|
32
|
Suter VGA, Warnakulasuriya S. The role of patch testing in the management of oral lichenoid reactions. J Oral Pathol Med 2015; 45:48-57. [PMID: 25990286 DOI: 10.1111/jop.12328] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The distinction of oral lichenoid reactions from oral lichen planus may be difficult in a clinical setting. Our aims were to ascertain the utility of patch testing to confirm the association of oral lichenoid reactions with dental restorations and to identify the benefits of replacement of restorations, primarily made of amalgam. METHODS Patients seen in an oral medicine unit over a 10-year period diagnosed with oral lichenoid reactions, with oral lichen planus resistant to treatment or with atypical lichenoid features were included in this study. All had been subjected to skin patch testing. Histopathology reports blinded to patch test results were scrutinized. Patch-test-positive subjects were advised to have their restorations replaced. All were followed up to determine disease resolution for at least 3 months thereafter. RESULTS Among 115 patients, 67.8% patients reacted positive to a dental material and nearly a quarter to mercury or amalgam. No correlation was found between pathology and skin patch testing results (P = 0.44). A total of 87 patients were followed up in clinic, and among 26 patch-test-positive patients who had their amalgam fillings replaced, moderate to complete resolution was noted in 81%. CONCLUSIONS Skin patch testing is a valuable tool to confirm clinically suspected oral lichenoid reactions. Pathology diagnoses of oral lichenoid reactions did not correlate with patch test results. Prospective studies are needed to ascertain that a clinically suspected oral lichenoid reaction with a positive patch test result may resolve after the replacement of amalgam fillings.
Collapse
Affiliation(s)
- Valerie G A Suter
- Department of Oral Medicine, King's College London Dental Institute, WHO Collaborating Centre for Oral Cancer, London, UK.,Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Saman Warnakulasuriya
- Department of Oral Medicine, King's College London Dental Institute, WHO Collaborating Centre for Oral Cancer, London, UK
| |
Collapse
|
33
|
Mostafa D, Tarakji B. Photodynamic therapy in treatment of oral lichen planus. J Clin Med Res 2015; 7:393-9. [PMID: 25883701 PMCID: PMC4394911 DOI: 10.14740/jocmr2147w] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 12/18/2022] Open
Abstract
Oral lichen planus (OLP) is a relatively common chronic immunologic mucocutaneous disorder. Although there are many presenting treatments, some of them proved its failure. Recently, the use of photodynamic therapy (PDT) has been expanding due to its numerous advantages, as it is safe, convenient, and non-invasive and has toxic effect towards selective tissues. This article provides comprehensive review on OLP, its etiology, clinical features and recent non-pharmacological treatments. We also describe the topical PDT and its mechanisms. Our purpose was to evaluate the efficacy of PDT in treatment of OLP through collecting the data of the related clinical studies. We searched in PubMed website for the clinical studies that were reported from 2000 to 2014 using specific keywords: "photodynamic therapy" and "treatment of oral lichen planus". Inclusion criteria were English publications only were concerned. In the selected studies of photodynamic treatment, adult patients (more than 20 years) were conducted and the OLP lesions were clinically and histologically confirmed. Exclusion criteria were classical and pharmacological treatments of OLP were excluded and also the using of PDT on skin lesions of lichen planus. We established five clinical studies in this review where all of them reported improvement and effectiveness of PDT in treatment of OLP lesions. The main outcome of comparing the related clinical studies is that the photodynamic is considered as a safe, effective and promising treatment modality for OLP.
Collapse
Affiliation(s)
- Diana Mostafa
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
34
|
Abstract
There are several extrahepatic cutaneous manifestations associated with hepatitis B and hepatitis C virus infection. Serum sickness and polyarteritis nodosa are predominantly associated with hepatitis B infection, whereas mixed cryoglobulinemia associated vasculitis and porphyria cutanea tarda are more frequently seen in hepatitis C infection. The clinico-pathogenic associations of these skin conditions are not completely defined but appear to involve activation of the host immune system including the complement system. Management of the aforementioned cutaneous manifestations of viral hepatitis is often similar to that done in cases without viral hepatitis, with control of immune activation being a key strategy. In cases associated with hepatitis B and C, control of viral replication with specific antiviral therapy is also important and associated with improvement in most of the associated clinical manifestations.
Collapse
|
35
|
Lucchese A. A potential peptide pathway from viruses to oral lichen planus. J Med Virol 2015; 87:1060-5. [PMID: 25776836 DOI: 10.1002/jmv.24131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/11/2022]
Abstract
Oral lichen planus is an idiopathic inflammatory disease of oral mucous membranes, characterized by an autoimmune epidermis attack by T cells. It remains unknown, however, how such aggressive T cells are activated in vivo to cause epidermal damage. This study analyzes the relationship at the peptide level between viruses and oral lichen planus disease. Four potentially immunogenic peptides (SSSSSSS, QEQLEKA, LLLLLLA, and MLSGNAG) are found to be shared between HCV, EBV, HHV-7, HSV-1, and CMV and three human proteins (namely pinin, desmoglein-3, and plectin). The described peptide sharing might be of help in deciphering the still unexplained immunopathogenic pathway that leads to oral lichen planus.
Collapse
Affiliation(s)
- Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, Second University of Naples (SUN), Napoli, Italy
| |
Collapse
|
36
|
|
37
|
|
38
|
Abstract
Oral lichen planus (OLP) is commonly found in middle-aged women. Although the cause is unknown, research points to several complex immunologic events and cells that are responsible for the inflammatory destruction and chronicity of these lesions. Biopsy for histologic diagnosis is recommended. The mainstay of treatment remains topical corticosteroids; however, newer therapies such as immunomodulating agents are available for recalcitrant lesions. In cases of lichenoid mucositis or reactions, treatment should be directed at identifying and removing the presumed cause. Given the apparent risk of squamous cell carcinoma in these patients, frequent follow-up and repeat biopsy are vital.
Collapse
Affiliation(s)
- Scott S De Rossi
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Otolaryngology/Head & Neck Surgery, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Dermatology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA.
| | - Katharine Ciarrocca
- Department of Oral Rehabilitation, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
| |
Collapse
|
39
|
Davidopoulou S, Theodoridis H, Nazer K, Kessopoulou E, Menexes G, Kalfas S. Salivary concentration of the antimicrobial peptide LL-37 in patients with oral lichen planus. J Oral Microbiol 2014; 6:26156. [PMID: 25491431 PMCID: PMC4258636 DOI: 10.3402/jom.v6.26156] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/10/2014] [Accepted: 11/11/2014] [Indexed: 12/12/2022] Open
Abstract
Background The antimicrobial peptide LL-37 is a significant molecule of innate immunity and recent studies indicate that it plays an important role in maintaining oral health. Yet limited knowledge exists on its role in oral diseases and oral lichen planus (OLP) in particular. Objective The study aimed to examine: 1) the salivary concentration of LL-37 in patients with OLP and healthy subjects, 2) the relation between the type (reticular or erosive) and size of OLP lesions and LL-37 concentration, and 3) the effect of the therapeutic modalities on LL-37 levels. Design The salivary peptide concentration in samples from 20 patients and 30 healthy subjects at the same age range was determined by ELISA. Results Despite the wide variation in peptide concentration found in both groups, the healthy subjects exhibited significantly lower levels than patients. Patients with the erosive form had significantly higher peptide concentrations than patients with the reticular form. Systemic treatment with corticosteroids resulted in a significant decrease of the salivary peptide concentration, while other treatment modalities, such as administration of vitamins A and E or local application of corticosteroids had no effect. Improved clinical appearance of the lesions was followed by a decrease in the salivary LL-37 level. Conclusions Salivary concentration of LL-37 correlates to the manifestation of mucosa lesions in OLP patients, the highest levels being observed in the most severe cases. This increase in peptide levels may protect against lesion infection and promote a quick wound healing.
Collapse
Affiliation(s)
- Sotiria Davidopoulou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece;
| | - Haris Theodoridis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Nazer
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eftichia Kessopoulou
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Menexes
- Department of Labor of Agronomy, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Kalfas
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
40
|
Gaber MA, Maraee AH, Alsheraky DR, Azeem MHA. Immunohistochemical expression of perforin in lichen planus lesions. Ultrastruct Pathol 2014; 38:413-9. [PMID: 25269012 DOI: 10.3109/01913123.2014.960541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory papulosquamous skin disease characterized by epidermal basal cell damage and a particular band-like infiltrate predominantly of T cells in the upper dermis. It is characterized by the formation of colloid bodies representing apoptotic keratinocytes. The apoptotic process mediated by CD8+ cytotoxic T lymphocytes and natural killer cells mainly involves two distinct pathways: the perforin/granzyme pathway and the Fas/FasL pathway. So far, little is known regarding the role of perforin-mediated apoptosis in LP. AIM Is to study the expression and distribution of perforin in the epidermis and dermis of lesional LP skin. MATERIALS AND METHODS Skin biopsy specimens from lesional skin of 31 patients with LP and 10 healthy persons were analyzed by immunohistochemistry. RESULTS Significant accumulation of perforin + cells was found in both epidermis and dermis of LP lesions compared with healthy skin. Perforin expression was significantly upregulated in the epidermis of LP lesions. CONCLUSION Accumulation of perforin + cells in the epidermis of LP lesions suggest a potential role of perforin in the apoptosis of basal keratinocytes.
Collapse
Affiliation(s)
- Mohamed Abdelwahed Gaber
- Department of Dermatology and Andrology, Faculty of Medicine, Menoufia University , Shebeen-Elkoum , Egypt
| | | | | | | |
Collapse
|
41
|
Zhang Z, Han Y, Song J, Luo R, Jin X, Mu D, Su S, Ji X, Ren YF, Liu H. Interferon-γ regulates the function of mesenchymal stem cells from oral lichen planus via indoleamine 2,3-dioxygenase activity. J Oral Pathol Med 2014; 44:15-27. [PMID: 25212102 DOI: 10.1111/jop.12224] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Little is known about mesenchymal stem cells (MSCs) in normal or inflammatory oral mucosal tissues, such as in oral lichen planus (OLP). Our objectives were to identify, isolate, and characterize MSCs from normal human oral mucosa and OLP lesions, and to evaluate indoleamine 2,3 dioxygenase (IDO) activity in mediating immunomodulation of MSCs from these tissues. METHODS Expressions of MSCs-related markers were examined in isolated cells by flow cytometry. Self-renewal and multilineage differentiations were studied to characterize these MSCs. Interferon-γ (IFN-γ), IDO, and STRO-1 were assessed by immunofluorescence. MSCs from oral mucosa and OLP or IFN-γ-pretreated MSCs were co-cultured with allogeneic mixed lymphocyte reaction assays (MLR). Proliferation and apoptosis of MLR or MSCs were detected by CCK8 and the annexin V-FITC apoptosis detection kit, respectively. IDO expression and activity were measured by real-time PCR, Western blotting, and high-performance liquid chromatography. RESULTS Isolated cells from oral mucosa and OLP expressed MSC-related markers STRO-1, CD105, and CD90 but were absent for hematopoietic stem cell markers CD34. Besides, they all showed self-renewal and multilineage differentiation capacities. MSCs in OLP presented STRO-1/IDO+ phenotype by immunofluorescence. MSCs and IFN-γ-pretreated MSCs could inhibit lymphocyte proliferation via IDO activity, but not via cell apoptosis. Long-term IFN-γ could also inhibit MSC proliferation via IDO activity. CONCLUSIONS Mesenchymal stem cells can be isolated from human oral mucosa and OLP tissues. Besides self-renewal and multilineage differentiation properties, these cells may participate in immunomodulation mediated by IFN-γ via IDO activity in human OLP.
Collapse
Affiliation(s)
- Zhihui Zhang
- School and Hospital of Stomatology, Peking University, Beijing, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Prucktrakul C, Youngnak-Piboonratanakit P, Kanjanabuch P, Prueksrisakul T, Thongprasom K. Oral lichenoid lesions and serum antinuclear antibodies in Thai patients. J Oral Pathol Med 2014; 44:468-74. [DOI: 10.1111/jop.12257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Chalakorn Prucktrakul
- Oral Medicine Department, Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | | | - Patnarin Kanjanabuch
- Oral Medicine Department, Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Titipong Prueksrisakul
- Oral Medicine Department, Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Kobkan Thongprasom
- Oral Medicine Department, Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| |
Collapse
|
43
|
Ho JK, Hantash BM. Systematic review of current systemic treatment options for erosive lichen planus. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.12.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
44
|
Nalamliang N, Tangnantachai N, Thongprasom K. Medications in Thai Patients with Oral Lichen Planus, Oral Lichenoid Drug Reaction and Glossitis. ACTA ACUST UNITED AC 2014. [DOI: 10.5005/jp-journals-10029-1075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
ABSTRACT
Introduction
Medications have been widely used in the dental patients for the treatment of their systemic diseases. In fact, those drugs have some side-effects to many organs and also the oral cavity. The aim of our study was to investigate the relationship between medications and oral lichen planus (OLP), oral lichenoid drug reaction (OLDR) and glossitis (GT) in Thai patients.
Materials and methods
One hundred and thirty-eight cases of Thai patients were included in this study. Medical records of all cases with oral lesions and symptoms referred to the oral medicine clinic during 2007 to 2010 were extracted. Oral lichen planus group consisted of 88 cases, GT 26 cases and OLDR 24 cases. All data were analyzed using SPSS for Windows version 11.5.
Results
In our study, 75.5% of patients used more than one medication while single drug used was 24.5%. Antihypertensive drugs were the most commonly used in all groups. Antihypertensive and hypolipidemic drugs were equally taken 22.4% in OLP patients. Patients with OLDR taking antihypertensive in 54.2% followed by hypolipidemic (37.5%), NSAIDs (25%), hypoglycemic/antiplatelet (16.7%) each and others 25%. Patients in GT group were also used antihypertensive drugs 35%, NSAIDs 25%, hypolipidemic 20% respectively.
Conclusion
Most of patients with oral lesions took more than one medication. Antihypertensive drugs were the most commonly used in Thai patients with oral lesions.
How to cite this article
Nalamliang N, Tangnantachai N, Thongprasom K. Medications in Thai Patients with Oral Lichen Planus, Oral Lichenoid Drug Reaction and Glossitis. Int J Experiment Dent Sci 2014;3(2):73-76.
Collapse
|
45
|
Lo Russo L, Gallo C, Pellegrino G, Lo Muzio L, Pizzo G, Campisi G, Di Fede O. Periodontal clinical and microbiological data in desquamative gingivitis patients. Clin Oral Investig 2013; 18:917-25. [PMID: 23900791 DOI: 10.1007/s00784-013-1038-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 07/02/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy,
| | | | | | | | | | | | | |
Collapse
|
46
|
Oral lichen planus in thai patients has a low prevalence of human papillomavirus. ISRN DENTISTRY 2013; 2013:362750. [PMID: 23762572 PMCID: PMC3677628 DOI: 10.1155/2013/362750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/08/2013] [Indexed: 01/01/2023]
Abstract
Background. Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease, with an etiopathogenesis associated with cell-mediated immunological dysfunction. Viral infection has been hypothesized as a predisposing factor in the pathogenesis of this disease. Viruses may alter host cell function by inducing the abnormal expression of cellular proteins leading to disease development. However, reports on the relationship between human papillomavirus (HPV) and OLP are inconclusive. Objective. To explore the association between HPV and OLP in Thai patients. Materials and Methods. DNA was extracted from thirty-seven fresh-frozen tissue biopsy specimens from OLP lesions, and polymerase chain reaction assay for the L1 and E1 genes covering 32 types of high- and low-risk HPV was performed. Results. HPV DNA was detected in one tissue biopsy from an atrophic-type OLP lesion. All control samples were negative. Genomic sequencing of the E1 gene PCR product demonstrated that the HPV-type 16 found in the lesion is closely related to the East Asian type. Conclusion. Our data indicate a low prevalence of HPV infection in OLP lesions in Thai patients.
Collapse
|
47
|
Chauhan I, Beena VT, Srinivas L, Sathyan S, Banerjee M. Association of cytokine gene polymorphisms with oral lichen planus in Malayalam-speaking ethnicity from South India (Kerala). J Interferon Cytokine Res 2013; 33:420-7. [PMID: 23651237 DOI: 10.1089/jir.2012.0115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic mucocutaneous condition that affects the oral mucous membrane as well as skin. It is a chronic cell-mediated autoimmune condition where the T-cell-mediated immune response plays an important part in the pathogenesis by causing damage to basal keratinocytes in oral mucosa. Cytokine gene polymorphisms have an unquestionable role in the orchestration of the immune response, leading to different functional scenarios, which in turn influence the outcome of the disease establishment and evolution. The purpose of this study was to understand the role of these cytokine gene polymorphisms in the tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), and IL-6 genes with OLP in 101 individuals of Malayalam-speaking ethnicity from South India (Kerala). We further investigated the role of these polymorphisms in patients suffering from OLP with other comorbid factors. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism. The results demonstrate that the A allele in the TNF-α -308 polymorphism could play an important role in the susceptibility to OLP. IL-1β +3954 in OLP was associated with other comorbid factors in both allelic and genotypic combinations. However, when patients suffering from OLP were stratified to understand the involvement of other comorbid factors, we observed that the T and C alleles were independent risk factors for chronic periodontitits and diabetes mellitus. On the other hand, IL-6 -597 did not show any disease association with OLP in the study population. This study indicates that proinflammatory cytokines are an important factor in understanding the disease burden of OLP and their comorbid factors.
Collapse
Affiliation(s)
- Isha Chauhan
- Department of Oral Pathology and Microbiology, Himachal Institute of Dental Sciences, Paonta Sahib, India.
| | | | | | | | | |
Collapse
|
48
|
Ahmed Haji Omar A, Hietanen J, Kero M, Lukinmaa PL, Hagström J. Oral lichen planus and chronic junctional stomatitis: differences in lymphocyte subpopulations. Acta Odontol Scand 2012; 67:366-9. [PMID: 19626466 DOI: 10.1080/00016350903136605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is an oral counterpart or oral manifestation of the common skin disease lichen planus. Chronic junctional stomatitis (CJS) is a relatively unknown condition characterized by a stromal lymphocyte infiltrate, which is also a diagnostic feature of OLP. The differential diagnosis of OLP and CJS is unclear and they have been suggested to represent variants of the same disease. MATERIAL AND METHODS To investigate possible differences in lymphocyte (sub)populations between these two conditions, we immunostained 10 OLP and 10 CJS specimens for CD1-a, and the lymphocyte markers, CD3, CD4, CD5, CD8, and CD20. We scored the staining results by a four-step grading system and used the Fisher exact test to analyze them statistically. RESULTS The proportional amount of (CD20 positive) B lymphocytes was higher in CJS than in OLP and the predominance of CD4 positive T lymphocytes over CD8 positive T lymphocytes was stronger in OLP than in CJS. The differences were statistically significant. CONCLUSION The results reflect differences in the lymphatic infiltrate between OLP and CJS. Their significance needs further investigation.
Collapse
|
49
|
Oral lichenoid contact lesions to mercury and dental amalgam--a review. J Biomed Biotechnol 2012; 2012:589569. [PMID: 22888200 PMCID: PMC3409574 DOI: 10.1155/2012/589569] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 03/19/2012] [Indexed: 12/14/2022] Open
Abstract
Human oral mucosa is subjected to many noxious stimuli. One of these substances, in those who have restorations, is dental amalgam which contains mercury. This paper focuses on the local toxic effects of amalgam and mercury from dental restorations. Components of amalgam may, in rare instances, cause local side effects or allergic reactions referred to as oral lichenoid lesions (OLLs). OLLs to amalgams are recognised as hypersensitivity reactions to low-level mercury exposure. The use of patch testing to identify those susceptible from OLL is explored, and recommendations for removing amalgam fillings, when indicated are outlined. We conclude that evidence does not show that exposure to mercury from amalgam restorations poses a serious health risk in humans, except for an exceedingly small number of hypersensitivity reactions that are discussed.
Collapse
|
50
|
Lodi G, Carrozzo M, Furness S, Thongprasom K. Interventions for treating oral lichen planus: a systematic review. Br J Dermatol 2012; 166:938-47. [DOI: 10.1111/j.1365-2133.2012.10821.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- G. Lodi
- Unit of Oral Pathology and Oral Medicine, Università degli Studi di Milano, Via Beldiletto 1, Milan 20142, Italy
| | - M. Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, U.K
| | - S. Furness
- Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Manchester, U.K
| | - K. Thongprasom
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|