Oral lichen planus in thai patients has a low prevalence of human papillomavirus

Expression of human papillomavirus 16 and 18 DNA in oral lichen planus using polymerase chain reaction

Introduction

Oral lichen planus (OLP) is a chronic inflammatory disease with cell-mediated immune dysregulation. The aetiology of OLP has been studied extensively for decades. Viruses like Hepatitis C Virus (HCV), human papillomavirus (HPV), herpes simplex virus (HSV), and stress have been hypothesized to play a role in the pathogenesis and malignant transformation of OLP. HPV has been proved to be an etiological agent in oropharyngeal cancers and non-tobacco-associated leukoplakia. The role of human papillomavirus in the pathogenesis of OLP has to be studied extensively.

Aim

This study aims to detect the presence of HPV 16 and HPV 18 DNA in the biopsy samples of OLP and also to determine the role played by the virus in the pathogenesis and malignant transformation of OLP.

Materials and Methods

Biopsy samples comprising 30 OLP tissues were collected. The DNA was extracted by the cetyltrimethylammonium bromide method. Polymerase chain reaction was performed by using general primers to amplify the HPV E6 gene.

Results

Twelve out of 30 (40%) OLP cases were positive for HPV DNA. A significant relation was found between HPV, site (buccal mucosa) and the type (reticular) of the lesion (P = 0.007). However, the difference between the percentage of HPV positive males and females was statistically insignificant (P = 0.852).

Conclusion

This study confirmed the presence of high-risk HPV 16 and HPV 18 DNA in OLP. The study showed a significantly higher expression of HPV in erosive OLP when compared to reticular OLP, suggesting a possible role of HPV in the malignant transformation of OLP.

Correlation between Oral Lichen Planus and Viral Infections Other Than HCV: A Systematic Review

OBJECTIVES

This review aimed to evaluate the correlation between viral infections (HPV, EBV, HSV-1, CMV) other than HCV and oral lichen planus to assess if there is sufficient evidence to establish if these viruses can play a role in the etiopathogenesis of the disease.

MATERIALS AND METHODS

We reviewed the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library), employing MeSH terms such as "oral lichen planus" and "OLP" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria.

RESULTS

A total of 43 articles of the 1219 results initially screened were included in the study. We allocated the 43 selected items into four groups, according to each related virus: HPV, EBV, HSV-1, and CMV.

CONCLUSIONS

Heterogeneous results neither confirm nor exclude a direct correlation between the investigated viral infections and oral lichen planus etiopathogenesis and its feasible malignant transformation. Many viral agents can cause oral lesions and act as cancerizing agents. Future studies could be desirable to produce comparable statistical analyses and enhance the quantity and quality of the outcomes to promote the translation of research into clinical practice.

Detection of Human Papillomavirus 33 in Erosive Oral Lichen Planus

Background: A correlation is suggested between oral lichen planus (OLP) and the human papillomavirus (HPV) with possible malignant transformation potential in OLP. Objectives: The present study aimed at evaluating the prevalence of HPV-16 and HPV-18 as the most recognized oncogenic subtypes and relatively recently introduced subtype HPV33 in OLP samples. Methods: This retrospective study was carried out on 32 OLP samples (consisting of 12 reticular and 20 erosive forms) and 20 healthy oral mucosa samples. Polymerase chain reaction (PCR) was undertaken to identify HPV Deoxyribonucleic Acid (DNA). Subsequently, the samples positive for HPV DNA underwent PCR analysis again with the specific primers. The data were analyzed statistically by Fisher’s exact test regarding the significance level of lower than 0.05. Results: Eight out of 32 OLP samples (25%) and none of the 20 normal mucosa samples (0%) exhibited HPV DNA. The presence of HPV in the OLP group was significantly higher than that in the normal mucosa (P = 0.014). Also, all the samples that exhibited HPV DNA were registered as the erosive form. Besides, one sample (3.12%) exhibited the 873-bp band, which was attributed to HPV-18, and 7 samples (21.87%) exhibited the 300-bp band, which was attributed to HPV-33. Conclusions: Based on the recent findings in the current study of the Iranian population, the presence of high-risk HPV subtypes, whether primarily or as a secondary infection, can suggest the malignant transformation potential for the studied OLP samples. The exclusive presence of these subtypes in the erosive type of this lesion and the noticeable presence of HPV-33 might reflect this issue’s importance. However, further studies are necessary to evaluate the possibility of a higher proliferation rate of HPV in erosive lichen planus and identify its possible malignant transformation mechanism.

Human papillomavirus in premalignant oral lesions: No evidence of association in a Spanish cohort

Background

Human papillomavirus (HPV) is the cause of a fraction of head and neck squamous cell carcinoma. Although this relation is well-known, it is still not clear the role of HPV in premalignant oral lesions such as oral lichen planus (OLP) and dysplasia. We aimed to evaluate the HPV-DNA prevalence and type distribution in a set of oral biopsies obtained from patients diagnosed with OLP and dysplasia, as well as the role of HPV in these lesions.

Methods

A retrospective cohort of all premalignant oral lesions consecutively diagnosed from March 30^th 1995 to May 21^st 2014 at Hospital of Bellvitge and Odontological University Hospital of Bellvitge was identified and classified in four groups: OLP (groups 1 and 2) and dysplasias (groups 3 and 4) that progressed or not to invasive cancer during follow-up. A random selection targeting 25 cases was aimed to be performed for each group. All selected cases were subjected to pathological evaluation, DNA quality control and HPV-DNA detection. HPV-DNA positive samples were further subject to p16^INK4a analysis.

Results

A total of 83 cases yielded a valid HPV-DNA result. From those, 7 and 34 cases were OLP that progressed or not to invasive cancer during follow-up, whereas 24 and 18 cases were displasias that progressed or not to invasive cancer during follow-up, respectively. HPV-DNA was detected in 4 samples (3 dysplastic lesions and 1 OLP). Two samples were HPV16 positive (2%), 1 sample HPV18 positive (1%) and 1 sample (1%) was HPV indeterminate. Two out of four HPV-DNA positive cases had high p16^INK4a expression and none of the HPV positive cases progressed to invasive cancer during long-term follow-up.

Conclusions

We found a low HPV-DNA attributable fraction in premalignant lesions of the oral cavity, suggesting that HPV is unlikely to play a significant role in oral carcinogenesis in our setting.

Human papillomavirus infection in oral potentially malignant disorders and cancer

Human papillomavirus (HPV) infects keratinocytes in the mucosa or skin, and persistent infection with HPV may lead to premalignant lesions and invasive cancer, especially cervical cancer. It has also been hypothesized that HPV infection is an etiological factor of oral squamous cell carcinoma and oral precancerous disorders such as lichen planus, leukoplakia, and erythroplakia. A high percentage of HPV in oral lesions supports the possible viral contribution, but an association of HPV infection with these lesions remains to be established. The current paper will update the latest progress of HPV infection in several oral potentially malignant disorders and oral squamous cell carcinoma and discuss the impact of HPV infection on the progression of oral potentially malignant disorders.

The Magnitude of the Association between Human Papillomavirus and Oral Lichen Planus: A Meta-Analysis

Background

The role of human papilloma virus (HPV) in oral lichen planus (OLP) is controversial.

Objectives

The primary aim of the current study is to calculate the pooled risk estimates of HPV infection in OLP when compared with healthy controls.

Methods

Bibliographic searches were conducted in three electronic databases. Articles on the association between HPV and OLP were selected from case-control studies or cross-sectional studies, following predefined criteria. Pooled data were analyzed by calculating odds ratios (OR) and 95% confidence interval (CI).

Results

Of the 233 publications identified, 22 case-control studies met the inclusion criteria. Collectively, 835 cases and 734 controls were available for analysis. The summary estimate showed that OLP patients have significantly higher HPV prevalence (OR: 6.83; 95% CI: 4.15–11.27) than healthy controls. In subgroup analyses, the association of HPV and OLP varied significantly by geographic populations. The ORs ranged from 2.43 to 132.04. The correlation of HPV and erosive-atrophic oral lichen planus (EA-OLP) (OR: 9.34) was comparable and well above that of HPV and non-EA-OLP (OR: 4.32). Among HPV genotypes, HPV 16 showed an extremely strong association with OLP (OR: 11.27), and HPV 18 showed a relatively strong one (OR: 6.54).

Conclusion

In conclusion, a significant association was found between HPV and OLP. The strength of the association varied across geographic populations, clinical types of OLP, and HPV genotypes. The results suggest that HPV might play an important causal role in OLP and in its malignant to progression.

Role of human papillomavirus in oral squamous cell carcinoma and oral potentially malignant disorders: A review of the literature

Human papillomaviruses (HPVs) are epitheliotropic viruses with an affinity for keratinocytes and are principally found in the anogenital tract, urethra, skin, larynx, tracheobronchial and oral mucosa. On the basis of high, but variable frequency of HPV in oral squamous cell carcinoma (OSCC), malignant potential of HPV infection has been hypothesized but not definitely confirmed. The aim of this review was to highlight the genomic structure and possible mechanism of infection and carcinogenesis by HPV in the oral mucosa and to review the frequency of HPV prevalence in OSCC and oral potentially malignant disorders. A computer database search was performed through the use of PubMed from 1994 to 2014. Search keywords used were: HPV and oral cancer, HPV and oral leukoplakia, HPV and oral lichen planus, HPV and OSCC, HPV and verrucous carcinoma, HPV and proliferative verrucous leukoplakia, HPV and oral papilloma.