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Beibei L, Mengying W, Xiao H, Yuzi J, Lijin M, Ke Z, Shengjie Y, Li L. Dysbiosis and interactions of the mycobiome and bacteriome in mucosal lesions of erosive and non-erosive oral lichen planus patients. J Oral Microbiol 2024; 16:2374639. [PMID: 38979477 PMCID: PMC11229720 DOI: 10.1080/20002297.2024.2374639] [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: 04/19/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024] Open
Abstract
Background Oral lichen planus (OLP) is a common oral mucosal disease, clinically categorized into erosive OLP (EOLP) and non-erosive OLP (NEOLP) based on symptoms, but its pathogenic mechanism remains unclear. This study aims to explore the relationship between OLP and the oral microbiome. Methods We collected oral mucosal samples from 49 patients and 10 healthy individuals and conducted 16S rRNA and ITS gene sequencing to explore the oral fungal and bacterial communities. Results We observed significantly lower α diversity of fungi in the EOLP group, with Candida being significantly enriched as the main dominant genus. In the NEOLP group, Aspergillaceae were significantly enriched. The EOLP group showed significant enrichment of Aggregatibacter and Lactobacillus, but the relative abundance of Streptococcus was notably lower than in the other two groups. In the NEOLP group, two species including Prevotella intermedia were significantly enriched. The microbial co-occurrence and co-exclusion networks display distinct characteristics across the three groups, with Lactobacillus assuming a significant bridging role in the ELOP group. Conclusions Our study indicates that EOLP and NEOLP experience varying degrees of dysbiosis at both the fungal and bacterial levels. Therefore, the pathogenic mechanisms and interactive relationships of these microbiota associated with OLP merit further in-depth investigation.
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Affiliation(s)
- Liang Beibei
- Hebei Key Laboratory of Stomatology, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Wei Mengying
- Department of Dental Pulp, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Huo Xiao
- Department of Oral Mucosa, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Jing Yuzi
- School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Mi Lijin
- Department of Oral Mucosa, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Zhang Ke
- Department of Oral Mucosa, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Yi Shengjie
- School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
| | - Liu Li
- Department of Oral Mucosa, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, PR China
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2
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Ju HM, Ahn YW, Ok SM, Jeong SH, Na HS, Chung J. Microbial Profiles in Oral Lichen Planus: Comparisons with Healthy Controls and Erosive vs. Non-Erosive Subtypes. Diagnostics (Basel) 2024; 14:828. [PMID: 38667474 PMCID: PMC11049134 DOI: 10.3390/diagnostics14080828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/04/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Recent studies have begun exploring the potential involvement of microbiota in the pathogenesis of oral lichen planus (OLP), yet comprehensive investigations remain limited. Hence, this study aimed to compare the microbial profiles in saliva samples obtained from patients with OLP against those from healthy controls (HC), along with a comparison between erosive (E) and non-erosive (NE) OLP patients. Saliva samples were collected from 60 OLP patients (E: n = 25, NE: n = 35) and 30 HC individuals. Analysis revealed no significant differences in alpha diversity, as assessed by the Chao1 and Shannon index, across the three groups. However, Bray-Curtis distance analysis indicated a significant disparity in microbiome composition distribution between HC and E-OLP, as well as HC and NE-OLP groups. The six most abundant phyla observed across the groups were Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, Fusobacteria, and Saccharibacteria (TM7). Notably, OLP groups exhibited a higher prevalence of Bacteroidetes. Prevotella emerged as the predominant genus in the OLP groups, while Capnocytophaga showed a relatively higher prevalence in E-OLP compared to NE-OLP. This study's findings indicate a notable difference in microbiota composition between HC and patients with OLP. Additionally, differences in the microbiome were identified between the E-OLP and NE-OLP groups. The increase in the proportion of certain bacterial species in the oral microbiome suggests that they may exacerbate the inflammatory response and act as antigens for OLP.
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Affiliation(s)
- Hye-Min Ju
- Department of Oral Medicine, Dental and Life Science Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea; (H.-M.J.); (Y.-W.A.); (S.-M.O.); (S.-H.J.)
- Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea
| | - Yong-Woo Ahn
- Department of Oral Medicine, Dental and Life Science Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea; (H.-M.J.); (Y.-W.A.); (S.-M.O.); (S.-H.J.)
- Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea
| | - Soo-Min Ok
- Department of Oral Medicine, Dental and Life Science Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea; (H.-M.J.); (Y.-W.A.); (S.-M.O.); (S.-H.J.)
- Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea
| | - Sung-Hee Jeong
- Department of Oral Medicine, Dental and Life Science Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea; (H.-M.J.); (Y.-W.A.); (S.-M.O.); (S.-H.J.)
- Department of Oral Medicine, Dental Research Institute, School of Dentistry, Pusan National University, Busandaehak-ro 49, Mulgeum-eup, Yangsan 50612, Republic of Korea
| | - Hee-Sam Na
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
- Oral Genomics Research Center, Pusan National University, Yangsan 50612, Republic of Korea
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Jin Chung
- Department of Oral Microbiology, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
- Oral Genomics Research Center, Pusan National University, Yangsan 50612, Republic of Korea
- Dental Research Institute, BK21 PLUS Project, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
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3
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Lavoro A, Cultrera G, Gattuso G, Lombardo C, Falzone L, Saverio C, Libra M, Salmeri M. Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus. J Pers Med 2024; 14:386. [PMID: 38673013 PMCID: PMC11050998 DOI: 10.3390/jpm14040386] [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: 03/07/2024] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, and labial mucosa causing a significant reduction in the quality of life. Currently, there are no specific treatments for this disease, and the available therapies with topical and systemic corticosteroids only reduce symptoms. Although the etiopathogenesis of this pathological condition has not been completely understood yet, several exogenous and endogenous risk factors have been proposed over the years. The present review article summarized the underlying mechanisms of action involved in the onset of OLP and the most well-known triggering factors. According to the current data, oral microbiota dysbiosis could represent a potential diagnostic biomarker for OLP. However, further studies should be undertaken to validate their use in clinical practice, as well as to provide a better understanding of mechanisms of action and develop novel effective intervention strategies against OLP.
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Affiliation(s)
- Alessandro Lavoro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Giovanni Cultrera
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Cinzia Lombardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Candido Saverio
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Mario Salmeri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
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Unnikrishnan SP, Rampersaud E, Mcgee A, Cruickshank ME, Abu-Eid R, Hijazi K. Disease severity scoring systems in mucosal lichen planus: A systematic review. Oral Dis 2023; 29:3136-3151. [PMID: 36404123 DOI: 10.1111/odi.14447] [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: 07/21/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
Abstract
Several scoring systems have been developed to evaluate disease severity in mucosal lichen planus, but only a few have been validated to ensure reproducible and accurate assessment of disease severity. The current systematic review was undertaken to identify clinical severity scoring systems in mucosal lichen planus that have undergone validity or reliability testing and to describe their operating characteristics. We performed a bibliographic search in five databases from their inception to October 2022 for severity scoring systems in mucosal lichen planus that have undergone validity or reliability tests. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal tools. We have included 118 studies and identified 11 clinical severity scoring systems for oral lichen planus that have undergone validity or reliability testing. Of these, the most reported were the Thongprasom score, the Oral Disease Severity Score (ODSS) and the REU (Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative) scoring systems. We did not identify clinical scoring systems for extraoral mucosal lichen planus that have undergone validity or reliability testing. The ODSS and REU scoring systems have undergone the highest number of validation attempts and reliability assessments for oral lichen planus respectively. However, we have identified numerous factors that have hampered the universal adoption of a standardised scoring system. There is a need for the development and validation of scoring systems for extraoral mucosal lichen planus.
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Affiliation(s)
- Sreedevi P Unnikrishnan
- Institute of Dentistry, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Edward Rampersaud
- Institute of Dentistry, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Alice Mcgee
- Aberdeen Centre for Women's Health Research, Aberdeen Maternity Hospital, Aberdeen, UK
| | - Maggie E Cruickshank
- Aberdeen Centre for Women's Health Research, Aberdeen Maternity Hospital, Aberdeen, UK
| | - Rasha Abu-Eid
- Institute of Dentistry, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Karolin Hijazi
- Institute of Dentistry, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
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Arduino PG, Gambino A, Macciotta A, El Haddad G, Conrotto D, Carbone M, Carrozzo M, Broccoletti R. Population-based cohort study to assess the gingival lesions in 1319 patients with lichen planus. Oral Dis 2023; 29:3393-3399. [PMID: 36208128 DOI: 10.1111/odi.14398] [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: 04/25/2022] [Revised: 08/18/2022] [Accepted: 10/02/2022] [Indexed: 11/29/2022]
Abstract
AIMS Oral lichen planus (OLP) is a chronic immune disease. In this paper, we evaluated the overall characters, clinical presentation, and outcome of gingival lesions in OLP Italian patients. METHODS AND RESULTS A retrospective cohort study was accomplished: a total of 1319 charts were investigated, of whom 922 were female (69.9%): 617 patients (46.8%) manifested white lesions and 702 red ones (53.2%). While most patients had several oral sites of involvement, the gingiva was the unique location in 103 cases. Symptoms were reported in 480 patients (36.4%): 286 patients with erosive OLP, 103 with atrophic form, and 91 with a white form. Long-lasting surveillance showed that only 40 patients (3.03%) had a total clinical signs remission. Regarding OLP medical treatment provided, patients attending less frequently a dental office underwent more often a specific therapy. CONCLUSIONS To the best of our knowledge, this is the biggest collections of patients with gingival OLP ever described; exclusive gingival lesions are, however, rare and unlikely to undergo a malignant transformation. Moreover, gum lesions seemed to anticipate the appearance of oral lesions and a higher rate of OLP therapy was observed in patients with less frequent dental check-ups and oral hygiene instructions.
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Giorgia El Haddad
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Davide Conrotto
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Mario Carbone
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Marco Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
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6
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González-Serrano J, Serrano J, Sanz M, Torres J, Hernández G, López-Pintor RM. Efficacy and safety of a bioadhesive gel containing propolis extract, nanovitamin C and nanovitamin E on desquamative gingivitis: a double-blind, randomized, clinical trial. Clin Oral Investig 2023; 27:879-888. [PMID: 35900605 PMCID: PMC9889524 DOI: 10.1007/s00784-022-04653-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to professional plaque removal on desquamative gingivitis (DG). MATERIALS AND METHODS A randomized clinical trial was conducted on patients suffering DG due to mucocutaneous diseases. Patients received professional supragingival prophylaxis with oral hygiene instructions and were randomly assigned to use test or control gels as toothpaste and to apply it on DG lesions 3 times/day for 4 weeks. DG clinical score (DGCS), clinical periodontal variables, and visual analog scale (VAS) for pain and oral health impact profile (OHIP-14) were collected at baseline, 2 and 4 weeks. RESULTS Twenty-two patients were randomly assigned to test (n = 11) or control group (n = 11). Eighteen had diagnosis of oral lichen planus and four of mucous membrane pemphigoid. DGCS statistically decreased in both groups after treatment with no significant differences between groups. Clinical periodontal outcomes decreased in both groups, but no significant differences were observed. Periodontal variables statistically improved only in test group after treatment. VAS and OHIP-14 scores decreased in test and control groups without significant differences. However, only one test group showed a statistically significant decrease in VAS and OHIP-14 scores after treatment. No adverse effects were reported. CONCLUSIONS Test gel may alleviate DG and improve quality of life without side effects. CLINICAL RELEVANCE A gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to mechanical debridement may improve both clinical and patient related outcomes in DG patients without side effects. CLINICAL TRIAL REGISTRATION The study protocol was registered at clinicaltrials.gov with the following number: NCT05124366 on October 16, 2021.
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Affiliation(s)
- José González-Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Julia Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Mariano Sanz
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Jesús Torres
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Gonzalo Hernández
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Rosa María López-Pintor
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Departamento de Especialidades Clínicas Odontológicas. Facultad de Odontología, Universidad Complutense de Madrid. Plaza Ramón Y Cajal S/N, 28040 Madrid, Spain
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7
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Bankvall M, Carda-Diéguez M, Mira A, Karlsson A, Hasséus B, Karlsson R, Robledo-Sierra J. Metataxonomic and metaproteomic profiling of the oral microbiome in oral lichen planus - a pilot study. J Oral Microbiol 2022; 15:2161726. [PMID: 36605405 PMCID: PMC9809343 DOI: 10.1080/20002297.2022.2161726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background A growing body of evidence demonstrates a different bacterial composition in the oral cavity of patients with oral lichen planus (OLP). Patients and methods Buccal swab samples were collected from affected and non-affected sites of six patients with reticular OLP and the healthy oral mucosa of six control subjects. 16S rRNA gene MiSeq sequencing and mass spectrometry-based proteomics were utilised to identify the metataxonomic and metaproteomic profiles of the oral microbiome in both groups. Results From the metataxonomic analysis, the most abundant species in the three subgroups were Streptococcus oralis and Pseudomonas aeruginosa, accounting for up to 70% of the total population. Principal Coordinates Analysis showed differential clustering of samples from the healthy and OLP groups. ANCOM-BC compositional analysis revealed multiple species (including P. aeruginosa and several species of Veillonella, Prevotella, Streptococcus and Neisseria) significantly over-represented in the control group and several (including Granulicatella elegans, Gemella haemolysans and G. parahaemolysans) in patients with OLP. The metaproteomic data were generally congruent and revealed that several Gemella haemolysans-belonging peptidases and other proteins with inflammatory and virulence potential were present in OLP lesions. Conclusion Our data suggest that several bacterial species are associated with OLP. Future studies with larger cohorts should be conducted to determine their role in the aetiology of OLP and evaluate their potential as disease biomarkers.
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Affiliation(s)
- Maria Bankvall
- Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Miguel Carda-Diéguez
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain
| | - Alex Mira
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain,School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Bengt Hasséus
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Roger Karlsson
- Clinical microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jairo Robledo-Sierra
- Nanoxis Consulting AB, Gothenburg, Sweden,Faculty of Dentistry, CES University, Medellin, Colombia,CONTACT Jairo Robledo-Sierra Faculty of Dentistry, CES University, Medellin, Colombia
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8
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Zhao W, Lin D, Deng S, Wang S, Guo Y, Yang J, Shi X, Zhou H. Synergistic Efficacy of Plaque Control with Intralesional Triamcinolone Acetonide Injection on Erosive Non-Gingival Oral Lichen Planus: A Randomized Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13787. [PMID: 36360666 PMCID: PMC9655481 DOI: 10.3390/ijerph192113787] [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: 09/20/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
This study is the first time to assess the synergistic efficacy and safety of plaque control on erosive non-gingival oral lichen planus (OLP). A randomized, controlled, clinical trial with blind evaluation was designed, and 48 OLP patients with erosive non-gingival OLP lesions were randomly assigned to the experimental group (n = 25, receiving intralesional triamcinolone acetonide injection, periodontal scaling, and oral hygiene instruction) and the control group (n = 23, only receiving intralesional triamcinolone acetonide injection) once a week for 2 weeks. Erosion size, pain level, plaque index, and community periodontal index were measured at every visit. Patients cured of erosion were followed up for 3 months to evaluate the recurrence rate. Adverse reactions were also recorded. At day 14 ± 2, the experimental group showed a higher completely healed percentage of erosion, a greater reduction of erosion size and pain level. However, no significant difference was observed in the recurrence rate. No participants had any severe adverse reactions. In conclusion, an improvement was observed in patients with plaque control, and future studies with larger sample sizes are needed to reinforce the external validity of this study.
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Affiliation(s)
- Wei Zhao
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Department of Oral Medicine, Qingdao Stomatological Hospital, Qingdao 266001, China
| | - Duanxian Lin
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shuzhi Deng
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Shimeng Wang
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yiqing Guo
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jin Yang
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xueke Shi
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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9
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Campana F, Lan R, Girard C, Rochefort J, Le Pelletier F, Leroux-Villet C, Mares S, Millot S, Zlowodzki AS, Sibaud V, Tessier MH, Vaillant L, Fricain JC, Samimi M. French guidelines for the management of oral lichen planus (excluding pharmacological therapy). Ann Dermatol Venereol 2022; 149:14-27. [PMID: 34238586 DOI: 10.1016/j.annder.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific guidelines in France. Our objective was to develop French multidisciplinary guidelines for the management of oral lichen. MATERIALS AND METHODS Working groups from the Groupe d'Etude de la Muqueuse Buccale (GEMUB) formulated a list of research questions and the corresponding recommendations according to the "formal consensus" method for developing practice guidelines. These recommendations were submitted to a group of experts and the degree of agreement for each recommendation was assessed by a scoring group. RESULTS Twenty-two research questions, divided into 3 themes (nosological classification and initial assessment, induced oral lichenoid lesions, and follow-up) resulted in 22 recommendations. Initial biopsy for histology is recommended in the absence of reticulated lesions. Biopsy for direct immunofluorescence is recommended for ulcerated, erosive, bullous types and for diffuse erythematous gingivitis. Management should include a periodontal and dental check-up, and investigation for extra-oral lesions. Hepatitis C testing is recommended only if risk factors are present. Definitions, triggering factors and the management of "induced oral lichenoid lesions" were clarified. Oral lichen must be monitored by a practitioner familiar with the disease at least once a year, using objective tools. CONCLUSION This formalised consensus of multidisciplinary experts provides clinical practice guidelines on the management and monitoring of oral lichen.
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Affiliation(s)
- F Campana
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - R Lan
- Aix Marseille Univ, APHM, CNRS, EFS, ADES, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - C Girard
- Dermatologie, CHU de Montpellier, 34295 Montpellier cedex, France
| | - J Rochefort
- Odontologie, Hôpital La Pitié Salpetrière - Université Paris Diderot, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - F Le Pelletier
- Anatomie Pathologique, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - C Leroux-Villet
- Dermatologie, Hôpital Avicenne, 125 Rue de Stalingrad, 93000 Bobigny, France
| | - S Mares
- Chirurgie Maxillo-faciale, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Millot
- Chirurgie Orale, CHU de Montpellier, 34295 Montpellier cedex, France
| | | | - V Sibaud
- Dermatologie, IUCT Oncopôle, 31000 Toulouse, France
| | - M-H Tessier
- Dermatologie, CHU de Nantes, 44000 Nantes, France
| | - L Vaillant
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France
| | - J-C Fricain
- Université de Bordeaux, INSERM U1026, service de chirurgie orale, CHU Bordeaux, 33000 Bordeaux, France
| | - M Samimi
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France.
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Eita AAB, Zaki AM, Mahmoud SA. Serum 8-isoprostane levels in patients with resistant oral lichen planus before and after treatment with lycopene: a randomized clinical trial. BMC Oral Health 2021; 21:343. [PMID: 34266435 PMCID: PMC8281687 DOI: 10.1186/s12903-021-01711-z] [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: 02/15/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Oral lichen planus is an autoimmune disease in which topical steroids are the first line of treatment. The adverse effects of systemic corticosteroids prescribed for resistant oral lichen planus cases advocate alternative modalities. Lycopene is an antioxidant with a wide range of beneficial properties. This trial aimed to evaluate the effect of pure lycopene as compared to systemic corticosteroids (Prednisolone) on the symptoms, signs and oxidative stress in patients with erosive oral lichen planus recalcitrant to topical steroids. Methods Twenty patients were randomly divided into the test (lycopene) and control (corticosteroids) groups. Numeric rating scale and Escudier et al. (Br J Dermatol 4:765–770, 2007. 10.1111/j.1365-2133.2007.08106.x) lesion scores were assessed at baseline and weeks 4 and 8 from baseline. Serum levels of 8-isoprostane were measured in all patients at baseline and at the end of treatment (week 8). Results There was a significant reduction in signs and symptoms after the end of treatment in each group. However, no significant difference was found between the lycopene and the corticosteroids group. Moreover, a significant reduction in 8-isoprostane levels was observed in the lycopene group from baseline and as compared to the control group. Conclusions Based on the study results, lycopene is a safe and effective therapeutic modality for resistant oral lichen planus. 8-isoprostane is a biomarker of lipid peroxidation that can be reduced by lycopene. Trial registration ID: PACTR202003484099670. 'Retrospectively registered on 11/3/2020'. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01711-z.
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Affiliation(s)
- Aliaa Abdelmoniem Bedeir Eita
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Azza Mohamed Zaki
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Sabah Abdelhady Mahmoud
- Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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11
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Comparative Analyses of the Subgingival Microbiome in Chronic Periodontitis Patients with and without Gingival Erosive Oral Lichen Planus Based on 16S rRNA Gene Sequencing. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9995225. [PMID: 34258290 PMCID: PMC8257348 DOI: 10.1155/2021/9995225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/28/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
The aim of the study was to compare the microbiota composition and bacterial diversity of subgingival plaque in chronic periodontitis patients with and without gingival erosive oral lichen planus. The subgingival plaque samples of 20 chronic periodontitis patients with gingival erosive oral lichen planus (CP-OLP group) and 19 chronic periodontitis patients without gingival erosive oral lichen planus (CP group) were analyzed by 16S rRNA gene high-throughput sequencing. Compared with the CP group, the richness and diversity of subgingival plaque microflora in the CP-OLP group decreased significantly. There were some differences between the two groups in the composition of microflora on the levels of phylum and genus. Distributions of Prevotella and Leptotrichia in the CP-OLP group were significantly lower than those in the CP group. The dominant genera in CP-OLP group were Pseudomonas and Granulicatella. These results indicated that gingival erosive oral lichen planus may influence the structure and proportion of subgingival plaque microflora.
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12
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Association between Clinical Signs of Oral Lichen Planus and Oral Health-Related Quality of Life: A Preliminary Study. Dent J (Basel) 2020; 8:dj8040113. [PMID: 33020378 PMCID: PMC7711772 DOI: 10.3390/dj8040113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/06/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023] Open
Abstract
Subjective patient’s symptoms and Oral Health-Related Quality of Life (OHRQoL) are recommended to be involved in oral lichen planus (OLP) studies. This study aims to assess the OHRQoL of OLP patients, and their associations with pain and OLP in Thai patients. Sixty-nine patients were interviewed using the Numeric Rating Scale (NRS) for pain perception and Oral Impacts on Daily Performance (OIDP) index. OLP signs examined included localization, types, number of affected sides and clinical severity using the Thongprasom sign scoring system. There were significant associations (rs = 0.490, p < 0.001) between clinical severity and the intensity of oral impacts as well as pain (rs = 0.298, p = 0.013). The intensity of oral impacts and pain increased according to the increasing OLP clinical severity, except for the white striae lesions (Thongprasom sign score 1). The erosive/ulcerative OLP lesions (Thongprasom sign scores 4 and 5) were the most painful symptom and had the highest degree of oral impacts (p < 0.001). No significant associations were found between the number of affected lesion sides and OHRQoL (p = 0.316) and pain (p = 0.284). OHRQoL was associated with OLP type and clinical severity but not with the number of affected sides.
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13
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Razmara F, Khayamzadeh M, Shabankare G. Applying dental implant therapy in patients with oral lichen planus: a review of literature. Int J Implant Dent 2020; 6:21. [PMID: 32458407 PMCID: PMC7250998 DOI: 10.1186/s40729-020-00216-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Lichen planus (LP) is a violent, paranormal inflammatory disease that can affect the skin or any lining of the mucous membrane. LPs are a branch of immune-mediated inflammatory disease (IMID) that collaborates with the function and structure of the immune system that are precipitated through various etiological infectious agents. Oral lichen planus (OLP) is one of the most common kinds of IMID. These traumas might limit the normal life of patients and, in some cases, can be treated spontaneously. In patients who are affected by OLP, the dental clinicians must be capable of the proper diagnosis of the disorder. Dental implants are progressively applied for the treatment of partial or complete edentulism. Implant rehabilitation in OLP patients is one of the main challenges for patients and dental clinicians. There is not enough knowledge about this condition, and also medical documents are limited. In this study, by conducting a comprehensive review of literature, we tried to collect related data around the safety and success rate of implant rehabilitation in patients who suffer from OLP disorder. There proved to be no relation between implant survival rate and OLP diseases, but it is proven that some factors such as bone quality and fracture resistance, parafunctional habits, and resection of the marginal mandible could powerfully affect it. For evaluation of the advantages and disadvantages of applying implants in patients with OLP disorders, implementation of controlled studies is required.
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Affiliation(s)
- Farnoosh Razmara
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Oral and Maxillofacial Surgery Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khayamzadeh
- Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
| | - Ghazal Shabankare
- School of Dentistry, Tehran University of Medical Sciences, International Campus, Tehran, Iran
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14
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Pihlstrom BL. Selections from the current literature. J Am Dent Assoc 2019. [DOI: 10.1016/j.adaj.2019.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Mergoni G, Magnani V, Goldoni M, Vescovi P, Manfredi M. Effects of oral healthcare motivation in patients with gingival oral lichen planus: A randomized controlled trial. Oral Dis 2019; 25:1335-1343. [PMID: 30947385 DOI: 10.1111/odi.13104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/18/2019] [Accepted: 04/01/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The role of dental plaque in gingival lesions caused by oral lichen planus has not been fully defined. The aim of this clinical trial was to evaluate the effects of oral healthcare motivation on clinical variables in patients with gingival oral lichen planus. MATERIAL AND METHODS Oral lichen planus patients with symptomatic gingival lesions were randomized in control and intervention groups. The intervention group was instructed to effectively remove bacterial biofilm from dental surfaces, while controls did not receive any advice. The outcome variables were as follows: quality of life (OHIP-14), pain, plaque index and clinical severity of the disease (Escudier index). Outcome variables were assessed at 0, 4 and 20 weeks and analysed using an ANOVA model for factorial design. RESULTS Data from 60 patients were collected. Regression analysis showed a significant positive trend of OHIP-14, plaque index and Escudier index in the intervention group compared to controls (p < 0.05). Pain did not prove significantly different (p = 0.408). CONCLUSIONS Plaque control improved both OHIP-14 and gingival lesion clinical severity. Oral hygienists should be involved in the multidisciplinary management of patients affected by oral lichen planus with gingival lesions.
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Affiliation(s)
- Giovanni Mergoni
- Dipartimento di Medicina e Chirurgia, Centro Universitario di Odontoiatria, Università di Parma, Parma, Italy
| | - Veronica Magnani
- Dipartimento di Medicina e Chirurgia, Centro Universitario di Odontoiatria, Università di Parma, Parma, Italy
| | - Matteo Goldoni
- Dipartimento di Medicina e Chirurgia, Statistica Medica, Università di Parma, Parma, Italy
| | - Paolo Vescovi
- Dipartimento di Medicina e Chirurgia, Centro Universitario di Odontoiatria, Università di Parma, Parma, Italy
| | - Maddalena Manfredi
- Dipartimento di Medicina e Chirurgia, Centro Universitario di Odontoiatria, Università di Parma, Parma, Italy
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Mozaffari HR, Molavi M, Lopez-Jornet P, Sadeghi M, Safaei M, Imani MM, Sharifi R, Moradpoor H, Golshah A, Jamshidy L. Salivary and Serum Interferon-Gamma/Interleukin-4 Ratio in Oral Lichen Planus Patients: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2019; 55:medicina55060257. [PMID: 31181785 PMCID: PMC6630336 DOI: 10.3390/medicina55060257] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 02/07/2023]
Abstract
Background and Objectives: Interferon-gamma (IFN-γ)/interleukin-4 (IL-4) ratio may indicate a change in the immune response with a potential pathological effect presented in oral lichen planus (OLP) patients. Herein, this meta-analysis evaluated the role of serum and salivary interferon-gamma/interleukin-4 ratio in the severity and development of OLP. Materials and Methods: The Scopus, Cochrane Library, PubMed, and Web of Science databases were systematically searched to retrieve the relevant studies published up from the database inception to March 2019. The crude mean difference (MD) and 95% confidence interval (CI) were calculated by RevMan 5.3 software using a random-effects model. A sensitivity analysis was performed on the results using the CMA 2.0 software. A total of 98 studies were retrieved from the databases, of which at last seven studies were included in this meta-analysis. Results: The findings showed that the pooled MDs of serum and salivary IFN-γ/IL-4 ratio were −0.22 (95% CI: −1.16, 0.72; p = 0.64) and 0.17 (95% CI: −1.50, 1.84; p = 0.84) in OLP patients compared to controls, respectively. In addition, the pooled MDs of serum and salivary IFN-γ/IL-4 ratio were −0.15 (95% CI: −0.53, 0.23; p = 0.43) and −0.39 (95% CI: −0.63, −0.15; p = 0.001) in patients with erythematous/ulcerative subtype compared to patients with reticular subtype, respectively. Conclusions: In conclusion, the results of meta-analysis demonstrated that serum and salivary IFN-γ/IL-4 ratio cannot play a major role in OLP development and severity.
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Affiliation(s)
- Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran.
| | - Maryam Molavi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran.
| | - Pia Lopez-Jornet
- Facultad de Medicina y Odontologia Universidad de Murcia, Hospital Morales Meseguer, Clinica Odontologic Adv Marques Velez s/n, 30008 Murcia, Spain.
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran.
| | - Mohsen Safaei
- Oral and Dental Sciences Research Laboratory, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
| | - Mohammad Moslem Imani
- Department of Orthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
| | - Roohollah Sharifi
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
| | - Hedaiat Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
| | - Amin Golshah
- Department of Orthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
| | - Ladan Jamshidy
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran.
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Panta P, Andhavarapu A, Sarode SC, Sarode G, Patil S. Reverse Koebnerization in a linear oral lichenoid lesion: A case report. Clin Pract 2019; 9:1144. [PMID: 31312420 PMCID: PMC6600350 DOI: 10.4081/cp.2019.1144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/19/2019] [Indexed: 11/23/2022] Open
Abstract
The spectacle of Koebner’s phenomenon (KP) is interesting in that trauma precipitates a subset of pathologically distinct conditions, indicating the subtle interplay between sensitization and dermato-mucosal integrity. KP is interesting because, if factors initiating it are controlled, then it may be possible to prevent these debilitating conditions through induction of reverse Koebnerization. Herein, we present a report of a patient with an erosive lesion, localized to the occlusal plane on buccal and lingual mucosa, that interestingly subsided following 1 week after a dental scaling procedure. This report analytically describes the role of dental calculus and cuspal trauma as important triggers surrounding the genesis of oral lichenoid lesion and oral lichen planus. An engaging discussion on these closely related enigmatic entities forms the central theme of this report.
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Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Archana Andhavarapu
- Department of Pulmonary Medicine, Malla Reddy Medical College for Women, Suraram, Quthubullapur, Hyderabad, Telangana, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaramnagar, Pimpri, Pune, Maharashtra, India
| | - Gargi Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaramnagar, Pimpri, Pune, Maharashtra, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Garcia-Pola MJ, Rodriguez-López S, Fernánz-Vigil A, Bagán L, Garcia-Martín JM. Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e136-e144. [PMID: 30818305 PMCID: PMC6441599 DOI: 10.4317/medoral.22782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/22/2018] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. Material and Methods The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. Results After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. Conclusions In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis. Key words:Desquamative gingivitis, oral hygiene, oral lichen planus, mucous membrane pemphigoid; pemphigus, plasma cell gingivitis.
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Affiliation(s)
- M-J Garcia-Pola
- Department of Oral Medicine, Faculty of Medicine and Sciences of the Health, Julian Clavería, 33006 Oviedo, Spain,
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Bianco L, Romano F, Maggiora M, Bongiovanni L, Guzzi N, Curmei E, Arduino PG, Aimetti M. Effect of sonic versus manual supervised toothbrushing on both clinical and biochemical profiles of patients with desquamative gingivitis associated with oral lichen planus: A randomized controlled trial. Int J Dent Hyg 2018; 17:161-169. [PMID: 30507032 DOI: 10.1111/idh.12377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/07/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this randomized, parallel-design, clinical trial was to investigate the effectiveness of an intensive plaque control programme with sonic versus manual toothbrushing on clinical outcomes and gingival crevicular fluid (GCF) levels of matrix metalloproteinases (MMP) in desquamative gingivitis (DG) patients. METHODS A total of 32 patients affected by DG secondary to oral lichen planus (OLP) were consecutively recruited and randomly assigned to a test (n = 16) and control (n = 16) group. Both groups were enrolled in an intensive control programme comprising supragingival scaling and polishing, and brush-specific instructions for a period of 8 weeks. The treatment of interest (test) was the use of a sonic-powered toothbrush, and the standard treatment (control) was the utilization of a soft-bristle manual toothbrush for twice-daily home oral hygiene procedures. Periodontal parameters, patient-centred outcomes, MMP-1 and MMP-9 GCF levels were evaluated at baseline and 8 weeks after starting the programme. RESULTS The plaque control programme resulted in statistically significant reduction in periodontal parameters with consequent improvement in the clinical features, painful symptoms and severity of DG lesions in both groups (all P < 0.001). When a sonic toothbrush was used, there was a more significant decrease in clinical indices, mucosal disease scores and GCF levels of MMP-1 and MMP-9. CONCLUSIONS This clinical trial reported the effectiveness of a combined protocol based on professional oral hygiene and supervised toothbrushing in OLP patients with DG. The daily use of a sonic toothbrush would seem to perform better in the short term.
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Affiliation(s)
- Laura Bianco
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Marina Maggiora
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Loretta Bongiovanni
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Nicoletta Guzzi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Elena Curmei
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Paolo Giacomo Arduino
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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20
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Effect of a structured plaque control on MMP-1 and MMP-9 crevicular levels in patients with desquamative gingivitis associated with oral lichen planus. Clin Oral Investig 2018; 23:2651-2658. [PMID: 30327948 DOI: 10.1007/s00784-018-2704-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES No data are available in the literature on the extent to which the immune host-response and bacterial-elicited inflammation separately contributes to the increase in gingival crevicular fluid (GCF) levels of inflammatory biomarkers in patients affected by desquamative gingivitis (DG) secondary to oral lichen planus (OLP). The aim of this study was to investigate the effect of a structured plaque control intervention on GCF levels of MMP-1 and MMP-9 in OLP patients with DG and to compare them with those of non-OLP patients. MATERIALS AND METHODS The study population consisted of 18 unrelated Caucasian patients with DG, while 18 periodontally healthy subjects were recruited for the control group. Periodontal parameters and GCF biomarker amounts were evaluated at baseline and 2 months after a structured plaque control intervention, comprising professional oral hygiene sessions, manual toothbrushing, and interdental cleaning advice, only for DG patients. Determination of MMP-1 and MMP-9 levels was carried out by means of an enzyme-linked immunosorbent assay. RESULTS Plaque control program led to improvement in all examined clinical parameters and resulted in significant decrease in GCF total amount and concentration of MMP-1 and MMP-9 in comparison to baseline (p < 0.001). However, MMP-1 and MMP-9 levels in DG patients were still significantly higher than those in the healthy control group (p < 0.01). CONCLUSIONS These findings would seem to support an intrinsic upregulated expression of MMPs in DG patients that is exacerbated by bacterial plaque. CLINICAL RELEVANCE The present outcomes provide further scientific grounds for the importance of strict professional oral hygiene sessions in DG patients.
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Mester A, Lucaciu O, Ciobanu L, Apostu D, Ilea A, Campian RS. Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP. Bosn J Basic Med Sci 2018; 18:217-223. [PMID: 29984679 DOI: 10.17305/bjbms.2018.3133] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 12/20/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals. We selected the articles focusing on the clinical features and treatment management of OLP in patients with/without HCV infection. Topical corticosteroids are considered the first-line treatment in OLP. Calcineurin inhibitors or retinoids can be beneficial for recalcitrant OLP lesions. Systemic therapy should be used in the case of extensive and refractory lesions that involve extraoral sites. Surgical intervention is recommended for isolated lesions. In patients with HCV, monotherapy with interferon (IFN)-α may either improve, aggravate or trigger OLP lesions, while combined IFN-α and ribavirin therapy does not significantly influence the progression of lesions. Direct-acting antiviral (DAA) therapy appears to be a promising approach in patients with HCV-related OLP, as it can improve symptoms of both liver disease and OLP, with fewer side effects. Nevertheless, for clinical utility of DAAs in OLP patients, further studies with larger sample sizes, adequate treatment duration, and long term follow-up are required.
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Affiliation(s)
- Alexandru Mester
- Department of Oral Rehabilitation, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
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Maderal AD, Lee Salisbury P, Jorizzo JL. Desquamative gingivitis. J Am Acad Dermatol 2018; 78:851-861. [DOI: 10.1016/j.jaad.2017.04.1140] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/30/2017] [Indexed: 10/17/2022]
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Robledo-Sierra J, van der Waal I. How general dentists could manage a patient with oral lichen planus. Med Oral Patol Oral Cir Bucal 2018; 23:e198-e202. [PMID: 29476684 PMCID: PMC5911349 DOI: 10.4317/medoral.22368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/22/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. MATERIAL AND METHODS Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. RESULTS In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. CONCLUSIONS General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment.
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Affiliation(s)
- J Robledo-Sierra
- VU University Medical Center (VUmc)/ ACTA, Department of Oral and Maxillofacial Surgery and Pathology, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands,
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Derikvand N, Ghasemi SS, Moharami M, Shafiei E, Chiniforush N. Management of Oral Lichen Planus by 980 nm Diode Laser. J Lasers Med Sci 2017; 8:150-154. [PMID: 29123636 DOI: 10.15171/jlms.2017.27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Oral lichen planus (OLP) is a mucocutaneous disease with uncertain etiology. As the etiology is unknown standard treatment modalities are not available. The traditional and common treatment relies on corticosteroids whether topical or systemic. In recent years, development of lasers made a proper path to use this instrument for treatment of the diseases which are refractory to conventional treatments. Previous studies in this field used CO2, ND:YAG, Excimer and some wavelength of diode lasers for the treatment of different types of lichen planus. Case Report: In this study, we present an OLP case which is treated using 980 nm diode laser. The result was measured by visual analogue scale (VAS) and clinical assessment; as a result, symptoms including pain and soreness started to decrease within a week, and by the end of a month completely subsided; the lesion disappeared totally as well. No recurrence was observed after a month and no side-effect was reported. Conclusion: 980 nm diode laser can be successfully used for treatment of patients with OLP.
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Affiliation(s)
- Nahid Derikvand
- Department of Periodontics, School of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Mohammad Moharami
- Laser Research Center of Dentistry, Dental Research Institute, Tehran University of Medial Sciences, Tehran, Iran
| | - Ehsan Shafiei
- Maxillofacial Surgeons, Private Practice, Khorramabad, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dental Research Institute, Tehran University of Medial Sciences, Tehran, Iran
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Monea M, Hănțoiu T, Stoica A, Vlad R, Sitaru A. Original Research. The Influence of Desquamative Gingivitis on Periodontal Health. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background: Desquamative gingivitis (DG) is a non-plaque-induced, blistering and painful condition occurring most frequently on the labial aspect of the attached gingiva of anterior teeth. The incidence of DG is highest around 50 years of age, and usually indicates the presence of oral or systemic diseases. The purpose of our study was to determine the impact of DG on periodontal health by recording the plaque index, gingival index and gingival bleeding index in a group of patients with DG, compared to healthy controls. Materials and methods: Recordings of specific indices were performed in a group of 26 patients with DG and compared with 24 healthy individuals. These were followed by radiographic examinations in order to assess the loss of marginal alveolar bone. Results: The results showed that patients with DG had a statistically significant increase in periodontal indices, with more gingival inflammation and plaque retention compared to the control group (p <0.05). The highest scores for gingival inflammation were recorded in patients with DG, but on radiographic evaluation the difference was related only to gender, men being more affected by alveolar bone loss in both groups (p <0.05). Conclusions: The incidence and severity of gingival inflammation proved to be higher in patients with DG, which calls for better preventive and maintenance treatment protocols in this group of patients. Early diagnosis and initial-phase periodontal treatment are very important in preventing further tissue breakdown.
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Affiliation(s)
- Monica Monea
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Tudor Hănțoiu
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Alexandra Stoica
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Ramona Vlad
- Master student, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Alexandru Sitaru
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
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The presence of bacteria within tissue provides insights into the pathogenesis of oral lichen planus. Sci Rep 2016; 6:29186. [PMID: 27383402 PMCID: PMC4935860 DOI: 10.1038/srep29186] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 06/16/2016] [Indexed: 12/14/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic T cell-mediated mucocutaneous disease of unknown etiopathogenesis. Although various antigens have been considered, what actually triggers the inflammatory response of T cells is unknown. In the present study, we propose that intracellular bacteria present within tissues trigger T cell infiltration and provide target antigens. Sections of OLP (n = 36) and normal (n = 10) oral mucosal tissues were subjected to in situ hybridization using a universal probe targeting the bacterial 16S rRNA gene and immunohistochemistry with anti-CD3, anti-CD4, anti-CD8, and anti-macrophage-specific antibodies. Bacteria were abundant throughout the epithelium and the lamina propria of OLP tissues, which exhibited positive correlations with the levels of infiltrated CD3(+), CD4(+), and CD8(+) cells. Furthermore, bacteria were detected within the infiltrated T cells. Pyrosequencing analysis of the mucosal microbiota from OLP patients (n = 13) and control subjects (n = 11) revealed a decrease in Streptococcus and increases in gingivitis/periodontitis-associated bacteria in OLP lesions. Using the selected bacterial species, we demonstrated that certain oral bacteria damage the epithelial physical barrier, are internalized into epithelial cells or T cells, and induce production of T cell chemokines CXCL10 and CCL5. Our findings provide insights into the pathogenesis of OLP.
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Ní Ríordáin R, Shirlaw P, Alajbeg I, Al Zamel GY, Fung PL, Yuan AD, McCreary C, Stoopler ET, De Rossi SS, Lodi G, Greenberg MS, Brennan MT. World Workshop on Oral Medicine VI: Patient-reported outcome measures and oral mucosal disease: current status and future direction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:152-60.e11. [DOI: 10.1016/j.oooo.2015.01.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/26/2014] [Accepted: 01/14/2015] [Indexed: 02/08/2023]
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Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14:930-51. [PMID: 26117595 DOI: 10.1016/j.autrev.2015.06.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches.
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Affiliation(s)
- Mayson B Mustafa
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; Oral medicine section, Department of Oral and Maxillofacial Surgery, University of Khartoum, Faculty of Dentistry, Khartoum, Sudan
| | | | - Bruce R Smoller
- Department of Pathology, University of Rochester, School of Medicine and Dentistry, USA
| | - Cassian Sitaru
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Signalhaus Freiburg, Schänzlestr. 18, 79104 Freiburg, Germany.
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Stone SJ, Heasman PA, Staines KS, McCracken GI. The impact of structured plaque control for patients with gingival manifestations of oral lichen planus: a randomized controlled study. J Clin Periodontol 2015; 42:356-62. [DOI: 10.1111/jcpe.12385] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Simon J. Stone
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | - Peter A. Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | - Konrad S. Staines
- School of Oral and Dental Sciences; University of Bristol; Bristol UK
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Gangeshetty N, Kumar BP. Oral lichenplanus: Etiology, pathogenesis, diagnosis, and management. World J Stomatol 2015; 4:12-21. [DOI: 10.5321/wjs.v4.i1.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 12/01/2014] [Accepted: 01/12/2015] [Indexed: 02/06/2023] Open
Abstract
Oral Lichen planus (OLP) is a common chronic mucocutaneous disorder with an immune mediated pathogenesis. Its appearance may vary from presence of keratotic to erythematous areas. Etiology of OLP is unknown, but it is thought to be the result of an autoimmune process with an unknown predisposing factor. Oral lichen planus is a complex and poorly understood clinical condition with periods of remissions and exacerbations. Management of the OLP is diversified with few lesions requiring treatment for years and few others are mild, requiring no treatment.
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Plaque control improves the painful symptoms of oral lichen planus gingival lesions. A short-term study. Br Dent J 2014. [DOI: 10.1038/sj.bdj.2014.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gene expression based evidence of innate immune response activation in the epithelium with oral lichen planus. Arch Oral Biol 2014; 59:354-61. [PMID: 24581860 DOI: 10.1016/j.archoralbio.2013.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 11/26/2013] [Accepted: 12/26/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a disease of the oral mucosa of unknown cause producing lesions with an intense band-like inflammatory infiltrate of T cells to the subepithelium and keratinocyte cell death. We performed gene expression analysis of the oral epithelium of lesions in subjects with OLP and its sister disease, oral lichenoid reaction (OLR), in order to better understand the role of the keratinocytes in these diseases. DESIGN Fourteen patients with OLP or OLR were included in the study, along with a control group of 23 subjects with a variety of oral diseases and a normal group of 17 subjects with no clinically visible mucosal abnormalities. Various proteins have been associated with OLP, based on detection of secreted proteins or changes in RNA levels in tissue samples consisting of epithelium, stroma, and immune cells. The mRNA level of twelve of these genes expressed in the epithelium was tested in the three groups. RESULTS Four genes showed increased expression in the epithelium of OLP patients: CD14, CXCL1, IL8, and TLR1, and at least two of these proteins, TLR1 and CXCL1, were expressed at substantial levels in oral keratinocytes. CONCLUSIONS Because of the large accumulation of T cells in lesions of OLP it has long been thought to be an adaptive immunity malfunction. We provide evidence that there is increased expression of innate immune genes in the epithelium with this illness, suggesting a role for this process in the disease and a possible target for treatment.
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