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Bao J, Chen C, Yan J, Wen Y, Bian J, Xu M, Liang Q, He Q. Antioxidant therapy for patients with oral lichen planus: A systematic review and meta-analysis. Front Pharmacol 2022; 13:1030893. [PMID: 36438849 PMCID: PMC9684670 DOI: 10.3389/fphar.2022.1030893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/28/2022] [Indexed: 09/21/2023] Open
Abstract
Aims: This study aimed to systematically review the efficacy and safety of antioxidants for patients with Oral lichen planus (OLP). Methods: Databases, including PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar, were searched up to 30 April 2022, for randomized controlled trials on the antioxidant therapy of OLP. The following endpoints were analyzed: pain score, clinical score, pain resolution rate, clinical resolution rate, and adverse effects. Results: A total of 19 studies met the inclusion criteria, and 17 studies with 704 patients were included in the meta-analysis. The findings showed that antioxidant therapy could significantly reduce the pain score [standardized mean difference -0.72 (-1.36, -0.07), P = 0.03, I2 = 87%, PI2 < 0.00001] and clinical score [SMD -2.06 (-3.06, -1.06), P < 0.0001, I2 = 94%, PI2 < 0.00001] of patients with OLP and improve the pain resolution rate [risk ratio (RR) 1.15 (1.01, 1.31), P = 0.04, I2 = 45%, PI2 = 0.09] and clinical resolution rate [RR 1.40 (1.10, 1.78), P = 0.006, I2 = 72%, PI2 = 0.002]. Conclusion: The study demonstrated that antioxidant therapy was beneficial for patients with OLP, and antioxidants might be used to treat OLP. Systematic Review Registration: https://clinicaltrials.gov/, identifier CRD4202233715.
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Affiliation(s)
- Jie Bao
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chu Chen
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiayu Yan
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Stomatology, Sichuan Integrated Traditional and Western Medicine Hospital, Chengdu, China
- School of Stomatology, North Sichuan Medical College, Nanchong, China
| | - Yueqiang Wen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiamin Bian
- School of Stomatology, North Sichuan Medical College, Nanchong, China
| | - Mengting Xu
- Department of Stomatology, Sichuan Integrated Traditional and Western Medicine Hospital, Chengdu, China
| | - Qin Liang
- Department of Stomatology, Pengzhou Hospital of Traditional Chinese Medicine, Pengzhou, China
| | - Qingmei He
- Department of Neurological, Chongqing Shi Yong Chuan Hospital of Traditional Chinese Medicine, Chongqing, China
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González-Moles MÁ, Keim-del Pino C, Ramos-García P. Hallmarks of Cancer Expression in Oral Lichen Planus: A Scoping Review of Systematic Reviews and Meta-Analyses. Int J Mol Sci 2022; 23:13099. [PMID: 36361889 PMCID: PMC9658487 DOI: 10.3390/ijms232113099] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 09/05/2023] Open
Abstract
Oral lichen planus (OLP) is a common chronic inflammatory disease of unknown etiology and likely autoimmune nature that is currently considered an oral potentially malignant disorder, implying that patients suffering from this process are at risk of developing oral cancer in their lifetime. The molecular alterations that develop in OLP and that make the affected oral epithelium predisposed to malignancy are unknown, although, as in other autoimmune diseases (ulcerative colitis, primary biliary cirrhosis, etc.), they may be linked to oncogenesis-promoting effects mediated by the inflammatory infiltrate. So far there is no in-depth knowledge on how these hallmarks of cancer are established in the cells of the oral epithelium affected by OLP. In this scoping review of systematic reviews and meta-analyses the state of evidence based knowledge in this field is presented, to point out gaps of evidence and to indicate future lines of research. MEDLINE, Embase, Cochrane Library and Dare were searched for secondary-level studies published before October 2022. The results identified 20 systematic reviews and meta-analyses critically appraising the hallmarks tumor-promoting inflammation (n = 17, 85%), sustaining proliferative signaling (n = 2, 10%), and evading growth suppressors (n = 1, 5%). No evidence was found for the other hallmarks of cancer in OLP. In conclusion, OLP malignization hypothetically derives from the aggressions of the inflammatory infiltrate and a particular type of epithelial response based on increased epithelial proliferation, evasion of growth-suppressive signals and lack of apoptosis. Future evidence-based research is required to support this hypothesis.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Carmen Keim-del Pino
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Al-Hallak N, Hamadah O, Mouhamad M, Kujan O. The efficacy of injectable platelet-rich fibrin in the treatment of symptomatic oral lichen planus. Oral Dis 2022. [PMID: 35593522 DOI: 10.1111/odi.14261] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/09/2022] [Accepted: 05/16/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The use of autologous platelet concentrates has shown growing evidence as a promising therapy. We conducted a split-mouth study to evaluate the effectiveness of injectable platelet-rich fibrin (PRF) compared to triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). MATERIALS AND METHODS This split-mouth randomized trial included twelve patients with symptomatic, bilateral OLP lesions. The participants were randomly allocated to receive a 1-mL intralesional PRF injection on one side of the buccal mucosa and a 0.5-mL TA injection on the counterpart side. The application was performed once a week for 4 weeks. The outcomes were measured using a visual analog scale score, REU score, and lesion areas. RESULTS Both injectable TA and PRF were effective in the management of oral lichen planus. After four weeks of treatment, there was an average reduction in the VAS score (68.5% i-PRF, 91% TA) and an average reduction in the REU score (74% i-PRF, 91% TA). There were no statistically significant differences between the two treatment methods (P > 0.05). CONCLUSIONS Intralesional injection with TA showed more effectiveness than i-PRF in the management of OPL lesions. Although, i-PRF cannot be considered a first-line treatment option, it showed promising alternative therapy choice with no side effects.
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Affiliation(s)
- Noor Al-Hallak
- Department of Oral Medicine, The Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Omar Hamadah
- Department of Oral Medicine, The Faculty of Dental Medicine, Damascus University, Damascus, Syria.,Department of Oral Medicine and Pathology, The Faculty of Dental Medicine, AL-Sham Privat University, Damascus, Syria
| | - Manal Mouhamad
- Department of Dermatology, The Faculty of Medicine, Damascus University, Syria
| | - Omar Kujan
- Oral Diagnostic and Surgical Sciences, UWA Dental School, The University of Western Australia, Perth, WA, Australia
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Systematic Review and Meta-Analysis of Oxidative Stress and Antioxidant Markers in Oral Lichen Planus. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:9914652. [PMID: 34616506 PMCID: PMC8490066 DOI: 10.1155/2021/9914652] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/14/2021] [Accepted: 08/28/2021] [Indexed: 12/20/2022]
Abstract
Background Oral lichen planus (OLP) is a relatively common chronic inflammatory disease of unknown etiology, which might be caused by oxidative stress and impaired antioxidant defense. Objective To systematically investigate the markers of oxidative stress and antioxidant systems in the saliva and blood from OLP patients and healthy controls. Methods The PubMed, Cochrane Library, and Embase were systematically queried to collect data from studies in which oxidative stress/antioxidant markers from OLP and healthy subjects had been evaluated until March 10, 2021. Results A total of 28 studies fulfilled inclusion criteria, and 25 of them, having 849 OLP patients and 1,052 control subjects and analyzing 12 oxidative stress and antioxidant state marker levels, were subjected to meta-analysis. We found a significant decrease in total antioxidant capacity (TAC) and uric acid (UA) and a significant increase in malondialdehyde (MDA) and nitric oxide (NO) levels in the saliva and serum/plasma of OLP patients. Moreover, a significant elevation of 8-hydroxy-deoxyguanosine (8-OHdG) and advanced oxidation protein product (AOOP) level and a decrease in vitamin C were also observed in the saliva of the OLP group. In contrast, salivary vitamin A, zinc, glutathione peroxidase (GPx), vitamin E, and nitrite were not significantly different between the two groups. In single studies, markers of oxidative stresses such as superoxide dismutase (SOD) and 8-isoprostanelevels were elevated in OLP, and antioxidant parameters such as glutathione (GSH) and total protein (TP) levels were dysregulated. Conclusion This meta-analysis helps to clarify the profile of oxidative stress and antioxidant state markers in OLP patients although existing evidence is rather heterogeneous and many studies are affected by several limitations. Larger and more standardized studies are warranted to ascertain whether these markers are potential causes or effects of OLP and whether antioxidant therapy improving oxidative stress will be useful.
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Georgescu SR, Mitran CI, Mitran MI, Nicolae I, Matei C, Ene CD, Popa GL, Tampa M. Oxidative Stress in Cutaneous Lichen Planus-A Narrative Review. J Clin Med 2021; 10:2692. [PMID: 34207416 PMCID: PMC8234860 DOI: 10.3390/jcm10122692] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/13/2021] [Accepted: 06/17/2021] [Indexed: 12/14/2022] Open
Abstract
Lichen planus (LP) is a chronic, immune-mediated inflammatory skin condition that mainly affects the skin (cutaneous LP, CLP) and oral mucosa (oral LP, OLP). However, the mechanisms involved in the pathogenesis of the disease are not fully elucidated. Over time, several theories that could explain the appearance of LP lesions have been postulated. The key players in LP pathogenesis are the inflammatory infiltrate consisting of T cells and the proinflammatory cytokines. The cytokines stimulate the production of reactive oxygen species that induce cell apoptosis, a defining element encountered in LP. The lead inquiry triggered by this revolves around the role of oxidative stress in LP development. There are currently numerous studies showing the involvement of oxidative stress in OLP, but in terms of CLP, data are scarce. In this review, we analyze for the first time the currently existing studies on oxidative stress in CLP and summarize the results in order to assess the role of oxidative stress in skin lesions offering a fresher updated perspective.
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Affiliation(s)
- Simona Roxana Georgescu
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (S.R.G.); (C.M.); (M.T.)
- Department of Dermatology, Victor Babes Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
| | - Cristina Iulia Mitran
- Department of Microbiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Cantacuzino National Medico-Military Institute for Research and Development, 011233 Bucharest, Romania
| | - Madalina Irina Mitran
- Department of Microbiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Cantacuzino National Medico-Military Institute for Research and Development, 011233 Bucharest, Romania
| | - Ilinca Nicolae
- Department of Dermatology, Victor Babes Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
| | - Clara Matei
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (S.R.G.); (C.M.); (M.T.)
| | - Corina Daniela Ene
- Department of Nephrology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Nephrology, Carol Davila Clinical Hospital of Nephrology, 010731 Bucharest, Romania
| | - Gabriela Loredana Popa
- Department of Microbiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mircea Tampa
- Department of Dermatology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (S.R.G.); (C.M.); (M.T.)
- Department of Dermatology, Victor Babes Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania;
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