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Zheng T, Liu C, Wang Y, Zhou R, Wu D, Tan J, Zhu K. Efficacy and safety of topical clobetasol propionate in comparison with alternative treatments in oral lichen planus: an updated systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1391754. [PMID: 38854667 PMCID: PMC11162109 DOI: 10.3389/fmed.2024.1391754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Background Oral lichen planus (OLP) is a relatively common chronic T cell-mediated disease characterized by pain and inflammation. Clobetasol propionate (CLO) is the first-line drug in the treatment of OLP. The meta-analysis aimed to evaluate the efficacy and safety of CLO for treating patients with OLP. Methods PubMed, Embase and Web of Science were systematically searched from the database inception date up to August 2023. There were no restrictions on language or date of publication. The outcomes of our interest were as follows: improvement of clinical signs and/or symptoms, total lesion size, relapse and adverse events. Results A total of 17 RCTs evaluating the effects of CLO were included in this study. The results revealed no significant difference in the clinical score (WMD = 0.14, 95% CI: -0.39, 0.66; p = 0.609) and pain score (WMD = 0.17, 95% CI: -0.44, 0.79; p = 0.582) between CLO and other treatments. However, clinical resolution (RR = 1.61, 95% CI: 1.17, 2.22; p = 0.003) and symptoms improvement (RR = 1.80, 95% CI: 1.17, 2.77; p = 0.008) were significantly different between CLO and other treatments. Moreover, there was a significant reduction in the total lesion size with CLO treatment (WMD = -0.58, 95% CI: -1.03, -0.13; p = 0.011). In addition, CLO showed no statistical incidence of adverse events (RR = 1.46, 95% CI: 0.86, 2.50; p = 0.161) and relapse (RR = 1.56, 95% CI: 0.66, 3.71; p = 0.314) than other therapies. Conclusion This systematic review and meta-analysis of 17 randomized clinical trials supported the long-term application of CLO as an effective regimen in OLP patients.
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Affiliation(s)
- Tao Zheng
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - ChengYong Liu
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - YeTong Wang
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Zhou
- Changsha Hospital for Maternal and Child Health Care, Changsha, Hunan, China
| | - Dan Wu
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jin Tan
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - KeKe Zhu
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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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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Galib R, Ahmed A, Gupta N, Khan R, Sharma SC. A Comparative Study of the Treatment of Oral Premalignant Lesions with Surgical Excision and Medical Therapy. Indian J Otolaryngol Head Neck Surg 2024; 76:1965-1971. [PMID: 38566720 PMCID: PMC10982230 DOI: 10.1007/s12070-023-04467-w] [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: 07/06/2023] [Accepted: 12/21/2023] [Indexed: 04/04/2024] Open
Abstract
Introduction Potentially malignant oral epithelial lesions are a group of oral conditions with an altered morphological state of the normal mucosal lining and include different lesions such as leukoplakia, erythroplakia, submucosal fibrosis, and lichen planus. Aim To compare the outcome of premalignant oral lesions after medical therapy consisting of submucosal intralesional injection of triamcinolone with hyaluronidase and surgical excision. Materials and Methods This was a comparative prospective interventional study and the study was conducted among 50 patients presented to the Department of Otorhinolaryngology with premalignant oral lesions from the year 2020 to 2022. Patients were divided into two groups by random allocation, group A was treated with medical therapy, and Group B was treated with surgical excision and followed for a minimum of 6 months and the outcome has been categorized. Results All patients were divided into two groups-group A and group B, group A consisted of 22 (44%) patients who were given medical therapy, and group B consisted of 28 (56%) patients who underwent surgical excision. In group A, the clinical response was seen in 8 (36.36%) and in group B, the clinical response was seen in 18 (64.29%) patients. Conclusion Surgical excision was found to be better with more cases of clinical response (64.29%) when compared to medical treatment (36.36%) with a p value of 0.0497 which is significant whereas malignant transformation was almost equal in medical therapy and surgical treatment which was 13.64% and 14.28%, respectively.
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Affiliation(s)
- Rubina Galib
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Aftab Ahmed
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Nainsi Gupta
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - Roobina Khan
- Department of Pathology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
| | - S. C. Sharma
- Department of Otorhinolaryngology, Faculty of Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (A.M.U.), Aligarh, Uttar Pradesh 202002 India
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Kumar S L, Naik Z, Panwar A, M S, Keluskar V, Kumar RS. Comparative evaluation of the efficacy of Nigella sativa (75% v/v) cream and clobetasol propionate (0.05% w/w) gel in oral lichen planus-a double-blinded randomized control trial. Oral Maxillofac Surg 2024; 28:225-234. [PMID: 36547822 DOI: 10.1007/s10006-022-01130-6] [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: 10/22/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The a im of this study is to evaluate and compare the efficacy of Nigella sativa (75% v/v) cream and clobetasol propionate (0.05% w/w) gel for the management of oral lichen planus (OLP). STUDY DESIGN Sixty clinically diagnosed cases of OLP were stratified into moderate cases or severe cases based on burning sensation before getting allocated to group I receiving Nigella sativa cream and group II receiving clobetasol propionate gel, two times a day for 45 days. Patients were examined every 15 days for a change in burning sensation and size of the lesion using the numeric pain rating scale (NRS) and a standard Vernier caliper, respectively. Statistical tests including Mann-Whitney U, Wilcoxon signed-rank, Friedman's, Dunn's post hoc, unpaired t, paired t, one-way repeated measures ANOVA, and Bonferroni's post hoc were applied. RESULTS There was a statistically significant reduction in the burning sensation as well as the size of the lesion in both groups (P ≤ 0.05). There was an 87.8% (moderate cases) and 85.7% (severe cases) reduction in the mean NRS scores on the 45th day in group I when compared to the 96.5% (moderate cases) and 93.48% (severe cases) in group II. There was a 92.9% (moderate cases) and 90.7% (severe cases) reduction in the size of the lesion in group I when compared to the 92.6% (moderate cases) and 93.1% (severe cases) in group II. CONCLUSION The topical application of Nigella sativa cream was effective and comparable to clobetasol propionate 0.05% gel in the management of OLP, without any side effects. Hence, this study recommends the use of topical Nigella sativa cream therapy in the management of OLP. CLINICAL RELEVANCE The current mainstay of treatment for OLP is the administration of topical or systemic corticosteroids, which are known to cause side effects, demanding a search for an alternative. Nigella sativa oil cream could be a safe, promising, cost-effective, adjunctive, or alternative modality. Clinical trial registration number: CTRI/2020/07/026745 (India).
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Affiliation(s)
- Lokesh Kumar S
- Department of Oral Medicine, Radiology, and Special Care Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), No. 162, Poonamalle High Road, Chennai-, 600077, Tamil Nadu, India.
| | - Zameera Naik
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi-, 590010, Karnataka, India
| | - Arun Panwar
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi-, 590010, Karnataka, India
| | - Sridhar M
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi-, 590010, Karnataka, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi-, 590010, Karnataka, India
| | - Ram Surath Kumar
- Department of Public Health Dentistry, KAHER's KLE Vishwanath Katti Institute of Dental Sciences, KLE Academy of Higher Education and Research, JNMC Campus, Nehru Nagar, Belagavi-, 590010, Karnataka, India
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Srivastava R, Sarkar S, Gupta P, Pradhan D, Bagde H, Dhopte A. Efficacy of Topical Turmeric, Calendula officinalis, and Tulsi (Ayurvedic Gel) in the Management of Erosive Lichen Planus: A Placebo-Controlled Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S868-S870. [PMID: 38595380 PMCID: PMC11001141 DOI: 10.4103/jpbs.jpbs_1065_23] [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: 10/16/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background Chronic mucocutaneous symptoms are a hallmark of lichen planus (LP), an inflammatory disease of the stratified squamous epithelium. The most severe type of mucosal lichen is oral erosive lichen planus (OELP). Materials and Methods Thirty patients were included in this prospective trial, with fifteen patients each assigned to Group A and Group B. Patients were given a choice between a placebo gel and an ayurvedic gel comprising pure turmeric, Calendula officinalis, and tulsi powder in an oral basis. At each appointment, the patients' reactions to therapy were scored on the Tel Aviv-San Francisco Scale, whereas the degree of the fire was rated using a Visual Analog Scale. Data analysis was carried out using IBM's Statistical Package for the Social Sciences (SPSS) Insights version 21. Results After receiving ayurvedic gel, patients in Group A reported much less burning than those in Group B (placebo). Group A responded better to therapy overall than Group B. Conclusion This study's findings support the use of an ayurvedic gel made from pure turmeric, Calendula officinalis, and tulsi powder for the treatment of erosive lichen planus.
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Affiliation(s)
- Rahul Srivastava
- Department of Oral Medicine and Radiology, Rama Dental College Hospital and Research Centre, Mandhana, Kanpur, Uttar Pradesh, India
| | - Saranik Sarkar
- Consultant Periodontist and Oral Implantologist, Howrah, West Bengal, India
| | - Prashant Gupta
- Department of Oral and Maxillofacial Surgery, Rama Dental College Hospital and Research Centre, Mandhana, Kanpur, Uttar Pradesh, India
| | - Devina Pradhan
- Department of Public Health Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Hiroj Bagde
- Professor, Department of Periodontology, CDCRI, Rajnandgaon, Chhattisgarh, India
| | - Ashwini Dhopte
- Department of Oral Medicine and Radiology, Rama Dental College Hospital and Research Centre, Mandhana, Kanpur, Uttar Pradesh, India
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Burcher JT, DeLiberto LK, Allen AM, Kilpatrick KL, Bishayee A. Bioactive phytocompounds for oral cancer prevention and treatment: A comprehensive and critical evaluation. Med Res Rev 2023; 43:2025-2085. [PMID: 37143373 DOI: 10.1002/med.21969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
The high incidence of oral cancer combined with excessive treatment cost underscores the need for novel oral cancer preventive and therapeutic options. The value of natural agents, including plant secondary metabolites (phytochemicals), in preventing carcinogenesis and representing expansive source of anticancer drugs have been established. While fragmentary research data are available on antioral cancer effects of phytochemicals, a comprehensive and critical evaluation of the potential of these agents for the prevention and intervention of human oral malignancies has not been conducted according to our knowledge. This study presents a complete and critical analysis of current preclinical and clinical results on the prevention and treatment of oral cancer using phytochemicals. Our in-depth analysis highlights anticancer effects of various phytochemicals, such as phenolics, terpenoids, alkaloids, and sulfur-containing compounds, against numerous oral cancer cells and/or in vivo oral cancer models by antiproliferative, proapoptotic, cell cycle-regulatory, antiinvasive, antiangiogenic, and antimetastatic effects. Bioactive phytochemicals exert their antineoplastic effects by modulating various signaling pathways, specifically involving the epidermal growth factor receptor, cytokine receptors, toll-like receptors, and tumor necrosis factor receptor and consequently alter the expression of downstream genes and proteins. Interestingly, phytochemicals demonstrate encouraging effects in clinical trials, such as reduction of oral lesion size, cell growth, pain score, and development of new lesions. While most phytochemicals displayed minimal toxicity, concerns with bioavailability may limit their clinical application. Future directions for research include more in-depth mechanistic in vivo studies, administration of phytochemicals using novel formulations, investigation of phytocompounds as adjuvants to conventional treatment, and randomized clinical trials.
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Affiliation(s)
- Jack T Burcher
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Lindsay K DeLiberto
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Andrea M Allen
- School of Dental Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Kaitlyn L Kilpatrick
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
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Racaniello GF, Pistone M, Meazzini C, Lopedota A, Arduino I, Rizzi R, Lopalco A, Musazzi UM, Cilurzo F, Denora N. 3D printed mucoadhesive orodispersible films manufactured by direct powder extrusion for personalized clobetasol propionate based paediatric therapies. Int J Pharm 2023; 643:123214. [PMID: 37423374 DOI: 10.1016/j.ijpharm.2023.123214] [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: 05/21/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
The aim of this work is the development and production by Direct Powder Extrusion (DPE) 3D printing technique of novel oral mucoadhesive films delivering Clobetasol propionate (CBS), useful in paediatric treatment of Oral Lichen Planus (OLP), a rare chronic disease. The DPE 3D printing of these dosage forms can allow the reduction of frequency regimen, the therapy personalization, and reduction of oral cavity administration discomfort. To obtain suitable mucoadhesive films, different polymeric materials, namely hydroxypropylmethylcellulose or polyethylene oxide blended with chitosan (CS), were tested and hydroxypropyl-β-cyclodextrin was added to increase the CBS solubility. The formulations were tested in terms of mechanical, physico-chemical, and in vitro biopharmaceutical properties. The film showed a tenacious structure, with drug chemical-physical characteristics enhancement due to its partial amorphization during the printing stage and owing to cyclodextrins multicomponent complex formation. The presence of CS enhanced the mucoadhesive properties leading to a significant increase of drug exposure time on the mucosa. Finally, the printed films permeation and retention studies through porcine mucosae showed a marked retention of the drug inside the epithelium, avoiding drug systemic absorption. Therefore, DPE-printed films could represent a suitable technique for the preparation of mucoadhesive film potentially usable for paediatric therapy including OLP.
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Affiliation(s)
| | - Monica Pistone
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari Aldo Moro, Orabona St. 4, Bari 70125, Italy
| | - Chiara Meazzini
- Department of Pharmaceutical Science, University of Milan, Via G. Colombo, 71, Milan 20133, Italy
| | - Angela Lopedota
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari Aldo Moro, Orabona St. 4, Bari 70125, Italy
| | - Ilaria Arduino
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari Aldo Moro, Orabona St. 4, Bari 70125, Italy
| | - Rosanna Rizzi
- Institute of Crystallography-CNR, Amendola St. 122/o, Bari 70126, Italy
| | - Antonio Lopalco
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari Aldo Moro, Orabona St. 4, Bari 70125, Italy
| | - Umberto M Musazzi
- Department of Pharmaceutical Science, University of Milan, Via G. Colombo, 71, Milan 20133, Italy
| | - Francesco Cilurzo
- Department of Pharmaceutical Science, University of Milan, Via G. Colombo, 71, Milan 20133, Italy
| | - Nunzio Denora
- Department of Pharmacy - Pharmaceutical Sciences, University of Bari Aldo Moro, Orabona St. 4, Bari 70125, Italy.
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Afzali S, Mohammadisoleimani E, Mansoori Y, Mohaghegh P, Bahmanyar M, Mansoori B, Pezeshki B, Nikfar G, Tavassoli A, Shahi A, Moravej A. The potential roles of Th17 cells in the pathogenesis of oral lichen planus. Inflamm Res 2023:10.1007/s00011-023-01763-7. [PMID: 37414985 DOI: 10.1007/s00011-023-01763-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a T cell-mediated chronic autoimmune disease, whose pathogenesis and etiology are not entirely understood. OLP is characterized by subepithelial lymphocyte infiltration and elevated intra-epithelial lymphocytes. The majority of lamina propria lymphocytes are CD4+ T cells. CD4+ helper T (Th) cells play a crucial role in activating CD8+ cytotoxic T cells (CTLs) through interactions and cytokine production. Th1 and Th2 cells are well-accepted to be associated with OLP pathogenesis. However, OLP treatment is challenging yet, the more information we have about the pathology of OLP, the easier it will be treated. With the discovery of Th17 cells in recent years and the demonstration of their role in autoimmune disease, many researchers started to investigate the role of Th17 in the pathogenesis of OLP. METHODS To make up this review, studies covering the role of TH17 in different types of lichen planus were selected from major databases. RESULTS As we review in this article, Th17 cells and their signature cytokines play an important role in OLP pathogenesis. As well, utilizing some anti-IL-17 antibodies showed promising results in improving the disease; however, more studies are still needed to better understand and treat OLP.
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Affiliation(s)
- Shima Afzali
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Yaser Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Department of Medical Genetics, Fasa University of Medical Sciences, Fasa, Iran
| | - Poopak Mohaghegh
- Pediatrics Department, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Maryam Bahmanyar
- Pediatrics Department, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Behnam Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Babak Pezeshki
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ghasem Nikfar
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Alireza Tavassoli
- Department of Pathology, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Abbas Shahi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
| | - Ali Moravej
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
- Department of Immunology, Fasa University of Medical Sciences, Fasa, Iran.
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Yang Y, Hu P, Chen SR, Wu WW, Chen P, Wang SW, Ma JZ, Hu JY. Predicting the Activity of Oral Lichen Planus with Glycolysis-related Molecules: A Scikit-learn-based Function. Curr Med Sci 2023:10.1007/s11596-023-2716-7. [PMID: 37115394 PMCID: PMC10141813 DOI: 10.1007/s11596-023-2716-7] [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: 11/03/2022] [Accepted: 02/09/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Oral lichen planus (OLP) is one of the most common oral mucosa diseases, and is mainly mediated by T lymphocytes. The metabolic reprogramming of activated T cells has been shown to transform from oxidative phosphorylation to aerobic glycolysis. The present study investigated the serum levels of glycolysis-related molecules (lactate dehydrogenase, LDH; pyruvic acid, PA; lactic acid, LAC) in OLP, and the correlation with OLP activity was assessed using the reticular, atrophic and erosive lesion (RAE) scoring system. METHODS Univariate and multivariate linear regression functions based on scikit-learn were designed to predict the RAE scores in OLP patients, and the performance of these two machine learning functions was compared. RESULTS The results revealed that the serum levels of PA and LAC were upregulated in erosive OLP (EOLP) patients, when compared to healthy volunteers. Furthermore, the LDH and LAC levels were significantly higher in the EOLP group than in the nonerosive OLP (NEOLP) group. All glycolysis-related molecules were positively correlated to the RAE scores. Among these, LAC had a strong correlation. The univariate function that involved the LAC level and the multivariate function that involved all glycolysis-related molecules presented comparable prediction accuracy and stability, but the latter was more time-consuming. CONCLUSION It can be concluded that the serum LAC level can be a user-friendly biomarker to monitor the OLP activity, based on the univariate function developed in the present study. The intervention of the glycolytic pathway may provide a potential therapeutic strategy.
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Affiliation(s)
- Yan Yang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Pei Hu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Su-Rong Chen
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Wei Wu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Pan Chen
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shi-Wen Wang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing-Yu Hu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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10
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Ashshi RA, Stanbouly D, Maisano PG, Alaraik AF, Chuang SK, Takako TI, Stoopler ET, Le AD, Sollecito TP, Shanti RM. Quality of life in patients with oral potentially malignant disorders: oral lichen planus and oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:363-371. [PMID: 36549944 DOI: 10.1016/j.oooo.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate and compare quality of life (QoL) parameters in patients with oral potential malignant disorders (OPMDs), namely, oral lichen planus (OLP) and oral epithelial dysplasia (OED). STUDY DESIGN A cross-sectional study was completed at the oral maxillofacial surgery/oral medicine practices at University of Pennsylvania. Patients with clinical and histopathologic confirmation of OLP or OED from January to June 2021 were included in the study. The primary predictor variable was the OPMD type. The primary outcome variable was the score of 3 separate surveys: the Chronic Oral Mucosal Disease Questionnaire-26 (COMDQ-26), Oral Potential Malignant Disorder QoL Questionnaire (OPMDQoL), and Hospital Anxiety and Depression Scale. Multiple linear regression was used to determine independent predictors of increased/decreased questionnaire scores. RESULTS The final study sample consisted of 100 patients:53 patients had OLP (53.0%), 39 patients had OED (39.0%), and 8 patients had OLP with OED (8.0%). Relative to OED, OLP added 15.7 points to the COMDQ-26 survey score (P < .001). Relative to OED, OLP added 8.9 points to the OPMDQoL survey score (P = .003). CONCLUSIONS Oral lichen planus shows significantly poorer QoL specifically within the COMD-26 and OPMDQoL questionnaires, compared with OED. Additionally, patients with OPMDs aged 40 to 64 years were independently associated with higher COMD-26 scores compared with older patients (>65 years).
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Affiliation(s)
- Rawan A Ashshi
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Dani Stanbouly
- School of Dental Medicine, University of Columbia, New York, NY
| | - Pietro G Maisano
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ayman F Alaraik
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sung-Kiang Chuang
- Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tanaka I Takako
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Eric T Stoopler
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Anh D Le
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
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11
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Magos T, Rudd J, Connor S, Setterfield J, Obholzer R. Otic lichen planus - A review of the literature and United Kingdom case series. Clin Otolaryngol 2023; 48:79-82. [PMID: 36148492 DOI: 10.1111/coa.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/13/2022] [Accepted: 08/28/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Tiarnan Magos
- ENT Department, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - James Rudd
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Steve Connor
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
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12
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Gotmare S, Gupta A, Waghmare M, Kavle P, Rathod A, Sonawne S, Pereira T. A comparison of proliferative capacity of reticular and erosive variants of oral lichen planus by argyrophilic nucleolar organizer regions method. J Microsc Ultrastruct 2022; 11:12-16. [PMID: 37144171 PMCID: PMC10153732 DOI: 10.4103/jmau.jmau_104_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/11/2020] [Indexed: 12/04/2022] Open
Abstract
Background Oral lichen planus (OLP), an immune mediated disorder, has been recognized since 1869 and is presented as any one of the six variants. Reticular and erosive are the most frequently encountered. Its proliferative capacity can give some information regarding its progression. We adopted the argyrophilic nucleolar organizer regions (AgNORs) method because of its simplicity to use and dependable results. We evaluated AgNORs in basal, suprabasal, and squamous cell layers. We also compared these three layers within two variants, reticular, and erosive. Materials and Methods Thirty clinically diagnosed patients of OLP were included in the study. Reticular and erosive variants were included in our study. This was followed by hematoxylin and eosin staining and later by the AgNOR method. The mean number of AgNORs per nucleus was calculated. Results Thirteen males and 17 females were the gender distribution. Twenty-three (76.67%) had reticular pattern and seven (23.33%) had erosive pattern. The basal cell layer had the highest mean AgNOR compared to suprabasal and squamous layers. Even among, erosive and reticular variants, the former had higher mean AgNOR counts. Discussion Our results suggest that the inflammatory infiltrate close to the epithelial cells can alter the proliferation index for the pattern of protein synthesis of these cells. Moreover, the high proliferative index in OLP can be related to a specific immunologic response. Conclusion We conclude that AgNOR can be used as a proliferative marker in earlier lesions to detect the severity.
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13
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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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14
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Yang D, Lei S, Pan K, Chen T, Lin J, Ni G, Liu J, Zeng X, Chen Q, Dan H. Application of photodynamic therapy in immune-related diseases. Photodiagnosis Photodyn Ther 2021; 34:102318. [PMID: 33940209 DOI: 10.1016/j.pdpdt.2021.102318] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Abstract
Photodynamic therapy (PDT) is a therapeutic modality that utilizes photodamage caused by photosensitizers and oxygen after exposure to a specific wavelength of light. Owing to its low toxicity, high selectivity, and minimally invasive properties, PDT has been widely applied to treat various malignant tumors, premalignant lesions, and infectious diseases. Moreover, there is growing evidence of its immunomodulatory effects and potential for the treatment of immune-related diseases. This review mainly focuses on the effect of PDT on immunity and its application in immune-related diseases.
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Affiliation(s)
- Dan Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Shangxue Lei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Keran Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Ting Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Jiao Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Guangcheng Ni
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Jiaxin Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Renminnan Road, Chengdu, Sichuan 610041, China.
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15
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Study on the Role of Salivary Flora and NF-κB Inflammatory Signal Pathway in Oral Lichen Planus. Inflammation 2021; 43:994-1008. [PMID: 32016629 DOI: 10.1007/s10753-020-01185-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Oral lichen planus (OLP) is an inflammatory disease. It is believed that infection and immune dysfunction play a key role in its pathogenesis, but the specific mechanism of action remains unclear. The 16s rRNA high-throughput sequencing technique was used to analyze the microbial flora structure in the saliva of OLP patients and healthy controls. The relative abundance of Derxia, Haemophilus, and Pseudomonas in the saliva of the OLP group was lower than that of the healthy control group, but there was no significant difference in the overall structure of the microbial population. In addition, we measured the protein expression levels of toll-like receptor 4 (TLR4) and nuclear factor-kappab p65 (NF-κB p65) in the tissues of OLP patients, and found that there was a significant increase and positive correlation between them (r = 0.907, P = 0.034). The expression levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the OLP group were consistent with those of NF-κB p65. Therefore, we believe that changes in the composition ratio of microbialflora break the original balance state of flora, promote the occurrence of immune inflammatory reaction, and then lead to the generation or aggravation of OLP disease. This discovery provides new ideas for further research on OLP initiation and immune regulation mechanism.
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16
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Rotaru D, Chisnoiu R, Picos AM, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review). Exp Ther Med 2020; 20:198. [PMID: 33123228 PMCID: PMC7588785 DOI: 10.3892/etm.2020.9328] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease, associated with altered cell-mediated immunological function. It has long-term evolution, repeated exacerbations, sometimes painful and resistant to treatment, even all of these, OLP significantly affects patient's life quality. Not least, OLP is accompanied by an increased risk of malignant transformation. A wide spectrum of therapeutic options is available, but none are curative. In this review, 58 structured studies on the clinical symptomatology and treatment strategy of OLP were analyzed. The literature research was performed according to the criteria of the PRISMA system. This study summarizes current knowledge regarding management of OLP and oral lichenoid lesions, discusses the challenges of choosing an adequate treatment and, in attempt to improve the quality of patient life, trying to describe a therapeutic algorithm that takes into consideration the clinical features of the disease. Current OLP therapy aims at eliminating all mucosal-related lesions, reduce symptomatology and decrease the risk of oral cancer and include corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy.
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Affiliation(s)
- Doina Rotaru
- Department of Odontology, Endodontics and Oral Pathology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
| | - Radu Chisnoiu
- Department of Odontology, Endodontics and Oral Pathology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
| | - Alina Monica Picos
- Department of Prosthodontics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Andrei Picos
- Department of Prevention in Dental Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400089 Cluj-Napoca, Romania
| | - Andrea Chisnoiu
- Department of Prosthodontics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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17
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The Potential of Phytochemicals in Oral Cancer Prevention and Therapy: A Review of the Evidence. Biomolecules 2020; 10:biom10081150. [PMID: 32781654 PMCID: PMC7465709 DOI: 10.3390/biom10081150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Abstract
The etiological factors of oral cancer are complex including drinking alcohol, smoking tobacco, betel quid chewing, human papillomavirus infection, and nutritional deficiencies. Understanding the molecular mechanism of oral cancer is vital. The traditional treatment for patients with oral squamous cell carcinoma (e.g., surgery, radiotherapy, and chemotherapy) and targeted molecular therapy still have numerous shortcomings. In recent years, the use of phytochemical factors to prevent or treat cancer has received increasing attention. These phytochemicals have little or no toxicity against healthy tissues and are thus ideal chemopreventive agents. However, phytochemicals usually have low water solubility, low bioavailability, and insufficient targeting which limit therapeutic use. Numerous studies have investigated the development of phytochemical delivery systems to address these problems. The present article provides an overview of oral cancer including the etiological factors, diagnosis, and traditional therapy. Furthermore, the classification, dietary sources, anticancer bioactivity, delivery system improvements, and molecular mechanisms against oral cancer of phytochemicals are also discussed in this review.
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18
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Serological and psychological assessment of patients with oral lichen planus using serum cortisol levels and hads questionnaire-a case control study. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY 2020; 27:e19-e27. [PMID: 32320169 DOI: 10.15586/jptcp.v27i2.667] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/05/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Oral lichen planus (OLP) is a T cell-mediated chronic autoimmune disorder directed against antigens secreted by the basal cell layer, with an incidence of 0.02-0.22% in Indian population and showing female predilection. Stress is considered one of the etiological factors in the causation, progression, and recurrence of this disease. OBJECTIVES To evaluate the levels of serum cortisol, anxiety, and depression in patients with symptomatic OLP and to correlate the levels of serum cortisol with anxiety and depression. METHODS Sixty subjects were categorized into two groups. Group A: 30 adults with no history of OLP and no psychological history of anxiety and depression. Group B: 30 patients with clinically and histopathologically diagnosed symptomatic OLP. The subjects in both groups were evaluated for anxiety and depression levels using the Hospital Anxiety and Depression Scale (HADS) questionnaire and serum cortisol levels (8-9 am sample) using the chemiluminiscence method. RESULTS Higher depression and anxiety levels were significantly associated with group B with significant P values (P < 0.0001 and <0.0002 respectively) when compared with group A; higher mean serum cortisol levels were seen in group B compared with group A, with P < 0.0001. In group A, a positive correlation was found between depression, anxiety, and serum cortisol levels with non-significant P-value. In group B, a positive correlation was found between depression, anxiety, and serum cortisol levels with a significant P value (P < 0.0001). CONCLUSION Increased levels of depression and anxiety with increased serum cortisol levels were observed in subjects with OLP.
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19
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Saleh W, Tageldin S, Khashaba E, Darwish M, Elnagdy S, Khashaba O. Could photodynamic therapy be utilized as a treatment modality for oral lichen planus? Photodiagnosis Photodyn Ther 2020; 30:101677. [PMID: 32006650 DOI: 10.1016/j.pdpdt.2020.101677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disease. There is no standard treatment modality for OLP. Recently, photodynamic therapy (PDT) has been advocated as a new treatment modality for OLP. AIM The aim of the present study is to compare the effect of PDT using methylene blue (MB) as a photosensitizer to the effect of topical corticosteroids in the treatment of erosive OLP lesions. MATERIALS AND METHODS Our study included 20 patients with erosive OLP. Patients were divided into two groups. The study group included 10 patents which received MB-PDT. Patients were instructed to use MB as mouth path for 5 min. After 10 min, we applied focal red light on OLP lesions (wavelength 660 nm, Intensity 100-130 m W/cm2) for 2 min. The PDT was applied twice a week for four weeks. In the control group, 10 patients were instructed to apply topical betamethasone valerate ointment 100 mg on OLP lesion three times per day for four weeks. Subjective, objective scores and lesion size were recorded at time zero, after 2 weeks and after 4 weeks from the start of treatments. RESULTS Both groups showed statistically significant differences between time zero and the 4th week of treatment in subjective, objective scores and the area of the lesions. MB-PDT showed a higher degree of improvement than topical corticosteroids between time zero and the 4th week of treatment. CONCLUSION Photodynamic therapy can be used as a treatment for erosive OLP. PDT offers improvement of OLP subjective and objective scores without major side effects.
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Affiliation(s)
- Wafaa Saleh
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt.
| | - Sara Tageldin
- College of Dentistry, Alexandria University, 21544, Egypt
| | - Eman Khashaba
- Public Health and Community Medicine Department, College of Medicine, Mansoura University, 35516, Egypt
| | - Mahmoud Darwish
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt
| | - Sherif Elnagdy
- Oral Pathology Department, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt
| | - Omar Khashaba
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, 35516, Egypt
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20
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Lavaee F, Shadmanpour M. Comparison of the effect of photodynamic therapy and topical corticosteroid on oral lichen planus lesions. Oral Dis 2019; 25:1954-1963. [PMID: 31478283 DOI: 10.1111/odi.13188] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the effect of photodynamic therapy with topical corticosteroid in oral lichen planus patients was compared. MATERIAL AND METHODS In this randomized, double-blind clinical trial, eight patients with bilateral oral OLP lesions were recruited. Toluidine blue was applied on the lesions of both sides; a 660-nm diode laser InGaAlP was irradiated for 10 min (power: 25 mW, fluence: 19.23 J/cm2 , probe cross section: 0.78 cm2 ) for three sessions. In the control side of the oral mucosa, only sham laser was used. Follow-up sessions were held on weeks 3 and 7. In week 3, oral paste triamcinolone acetonide 0.1% was prescribed. Response rates were assessed clinically by VAS, Thongprasom sign scoring, clinical severity index, efficacy indices, and the amount of reduction in the size of the lesions. The Mann-Whitney test was used to evaluate the treatment outcomes. RESULTS In spite of the control side, all scores improved significantly between sessions 0 and 4 for the intervention side. The differences between the changes in almost all scores between sessions 0 and 4 in both the intervention and control sides were significantly considerable (p value < .05). CONCLUSION Photodynamic therapy can be used as an alternative therapy alongside standard methods or as a new modality for refractory OLP.
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Affiliation(s)
- Fatemeh Lavaee
- Oral and Dental Disease Research Center, Oral and Maxillofacial Medicine Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shadmanpour
- Orthodontics Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Wang J, Chen G, Shi T, Wang Y, Guan C. Possible treatment for cutaneous lichen planus: An in vitro anti-inflammatory role of Angelica polysaccharide in human keratinocytes HaCaT. Int J Immunopathol Pharmacol 2019; 33:2058738418821837. [PMID: 30791744 PMCID: PMC6328949 DOI: 10.1177/2058738418821837] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cutaneous lichen planus (CLP) is an autoimmune disease. Angelica polysaccharide (AP) has been found to exert immunomodulation activity. In this study, we explored the roles of AP in lipopolysaccharide (LPS)-induced inflammatory injury of human keratinocytes (HaCaT cells), as well as the underlying mechanisms. LPS-induced cell injury was evaluated by alterations of cell viability, apoptosis, and expressions of proteins associated with apoptosis and inflammatory cytokines. Then, the protective effects of AP on LPS-induced cell injury were assessed. The protein expressions of sirtuin 1 (SIRT1) and key kinases in the Nrf2/HO-1 and nuclear factor κB (NF-κB) pathways were measured using western blotting. SIRT1 knockdown and overexpression were used to analyze whether AP affected HaCaT cells through regulating SIRT1. Finally, the possible inhibitory effects of AP on cell injury after LPS treatment were also evaluated. We found that LPS reduced HaCaT cell viability, enhanced apoptosis, and induced release of inflammatory cytokines. AP alleviated LPS-induced HaCaT cell inflammatory injury. The expression of SIRT1 was enhanced after AP treatment. AP activated Nrf2/HO-1 pathway while inhibited NF-κB pathway in HaCaT cells. The protective effects of AP on LPS-induced HaCaT cell injury were reversed by SIRT1 knockdown. Dysregulation of SIRT1 altered the activation of Nrf2/HO-1 and NF-κB pathways in LPS-treated HaCaT cells. Furthermore, AP also exerted inhibitory effects on HaCaT cell injury after LPS stimulation. In conclusion, AP could alleviate LPS-induced inflammatory injury of HaCaT cells through upregulating SIRT1 expression and then activating Nrf2/HO-1 pathway but inactivating NF-κB pathway. This study provided a possible therapeutic strategy for clinical CLP treatments.
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Affiliation(s)
- Jun Wang
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guanzhi Chen
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tongxin Shi
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yingying Wang
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chengfei Guan
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Burke LB, Brennan MT, Ni Riordain R, Madsen LS. Novel Oral Lichen Planus Symptom Severity Measure for assessing patients' daily symptom experience. Oral Dis 2019; 25:1564-1572. [PMID: 31006147 DOI: 10.1111/odi.13109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/27/2019] [Accepted: 04/15/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE A novel Oral Lichen Planus Symptom Severity Measure was developed as a clinical outcome assessment of the daily symptom experience of patients with oral lichen planus. METHODS A literature review and expert input were followed by open-ended concept elicitation interviews with 17 adults with oral lichen planus in the United States and Ireland. Item content was generated, and the interviews continued until input saturation was reached. The final electronic version of the measure was cognitively debriefed in 6 US patients and subsequently translated and linguistically validated in Germany and Denmark. RESULTS Concept elicitation interviews demonstrated content validity and saturation in identifying symptoms and daily activities that generate symptoms in patients with oral lichen planus. The content and electronic daily diary format demonstrated content validity during cognitive debriefing interviews. Linguistic validation of the 7-item Oral Lichen Planus Symptom Severity Measure in Germany and Denmark confirmed the content validity of the German and Danish versions. CONCLUSIONS Qualitative research methods generated evidence that the 7-item Oral Lichen Planus Symptom Severity Measure version 1.0 is a well-defined assessment tool to characterize the severity, specificity and variations of symptoms in patients with oral lichen planus.
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Affiliation(s)
| | - Michael T Brennan
- Department of Oral Medicine, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina
| | - Richeal Ni Riordain
- Department of Oral Medicine, Cork University Dental School and Hospital, Cork, Ireland
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Abstract
Lichen planus (LP) is a potentially malignant disorder with an immune-mediated etiopathogenesis. The condition frequently affects the skin, oral mucosa, skin appendages, and other mucous membranes. Oral lesions usually precede the onset of skin lesions and in majority of cases may only be presenting symptom. Isolated LP of the lip is rarely encountered in the clinical practice and is usually seen along with skin/other mucous membrane involvement. The clinical appearance poses diagnostic dilemmas and is often misinterpreted. This case report aims to highlight an interesting case of LP of the lower lip in a 50-year-old male patient. The patient presented with a diffuse erosive lesion on the lower lip bordered by white radiating striae on its inner aspect. Histopathological and immunofluorescent studies confirmed LP of the lip. Topical corticosteroids and Vaseline lip therapy were prescribed to the patient. There was considerable healing in the lip lesion during the follow-up period. However, recurrence was noted in the left buccal mucosa.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia University, New Delhi, India
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24
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Abstract
Lichen planus (LP) is a relatively common autoimmune T-cell-mediated disease of unknown aetiology affecting the mucous membranes, skin and nails. Its prevalence varies between 0.5 and 2.2% of the population in epidemiological studies with a peak incidence in the 30-60 years range and with a female predominance of 2:1. Mucosal lichen planus tends to follow a chronic course with acute exacerbations. Spontaneous remission of oral lichen planus (OLP) is uncommon, and indeed mucosal LP may become worse with time. In contrast, cutaneous lichen planus may follow a milder clinical course though some variants may be severe such as those affecting the palms and soles and the scalp and the genital tract in females (vulvovaginal gingival LP) where scarring leads to significant complications. It is important to identify those cases that may be drug induced or be associated with a contact allergic or irritant reaction (lichenoid reaction) or the rarer oral presentation of discoid lupus erythematosus. There is a very small risk of malignancy (approximately 1:200 patients/year) associated with oral lichen planus; thus patients should be informed that long term monitoring via their general dental practitioner is appropriate. This review will focus on the clinical presentation and management of oral lichen planus.
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Affiliation(s)
- Daniela I Ion
- Guy's and St Thomas NHS Foundation Trust, Dental Institute, King's College London, UK
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25
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Tadakamadla J, Kumar S, Lalloo R, Gandhi Babu DB, Johnson NW. Impact of oral potentially malignant disorders on quality of life. J Oral Pathol Med 2017; 47:60-65. [PMID: 28766765 DOI: 10.1111/jop.12620] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients. METHODS Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF-12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF-12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS). RESULTS A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, "physical impairment and functional limitations" than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased. CONCLUSIONS OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.
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Affiliation(s)
- Jyothi Tadakamadla
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Santhosh Kumar
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, St Lucia, Qld, Australia
| | - Dara Balaji Gandhi Babu
- Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, Telangana, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
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Satelur KP, Bopaiah S, Bavle RM, Ramachandra P. Role of Cathepsin B as a Marker of Malignant Transformation in Oral Lichen Planus: An Immunohistochemical Study. J Clin Diagn Res 2017; 11:ZC29-ZC32. [PMID: 28969269 DOI: 10.7860/jcdr/2017/30740.10274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/20/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Malignant transformation of Oral Lichen Planus (OLP) remains a much discussed but very less understood realm. Various hypotheses and theories have been put forward to explain the same. Malignant transformation is a complex interplay of epithelial mesenchymal factors acting in tandem. This study tries to identify and asses the stromal changes that pave the way for epithelial migration using Cathepsin B (CB) a cysteine protease belonging to the Cathepsin family. Various studies have been done to study its role in human cancers which have proven that CB helps mark and identify tissue digestion. AIM The purpose of this study was to evaluate the expression of CB, in OLP and examine its possible role in malignant transformation. MATERIALS AND METHODS Immunohistochemical analysis of CB expression was done in 50 OLP tissues along with 10 normal mucosa tissue and 10 Oral Squamous Cell Carcinoma (OSCC) cases (control groups). Evaluation was done on the basis of intensity of staining. The intensity was graded in all the cases by assigning values of 0 to 4 in ascending order. Two other observers evaluated the staining and intensity independently and the average of the observations was taken. RESULTS A variable staining pattern in both the stroma and the cytoplasm of the epithelial cells was noticed. The staining intensity was clearly increased in OLP tissues when compared to normal control tissue and OSCC which served as our positive control. The staining patterns in tissues of OLP and OSCC to Cathepsin B were similar. The staining intensity of Cathepsin B was observed to be increased in both these groups of tissues. CONCLUSION This study demonstrated a significantly increased expression of CB in OLP. This may be correlated to a possible indicator for its eventual malignant transformation. This overexpression of CB amounts to an array of stromal changes that take place and different mechanisms that get activated underneath the epithelium leading to the formation of what is known as a tumour microenvironment, a well proven entity. We hypothesize that it is this which felicitates the invasion of the overlying epithelial cells.
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Affiliation(s)
- Krishnanand Prakash Satelur
- Professor, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Shiny Bopaiah
- Postgraduate Student, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Radhika Manoj Bavle
- Professor and Head, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Prashant Ramachandra
- Reader, Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
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Mansourian A, Shanbehzadeh N, Kia SJ, Moosavi MS. Increased salivary aldehyde dehydrogenase 1 in non-reticular oral lichen planus. An Bras Dermatol 2017; 92:168-171. [PMID: 28538873 PMCID: PMC5429099 DOI: 10.1590/abd1806-4841.20174964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 03/27/2016] [Indexed: 11/27/2022] Open
Abstract
Background Oral lichen planus is a potentially malignant disorder. One of the malignant
transformation markers is cancer stem cells. One of the proposed marker for
the detection of cancer stem cells's in head and neck cancer is aldehyde
dehydrogenase. Recently it is shown that aldehyde dehydrogenase 1 expression
in tissue samples is associated with oral lichen planus malignant
transformation. Objective This study evaluates salivary aldehyde dehydrogenase 1 in oral lichen
planus. Method Thirty patients and 30 age and sex-matched healthy volunteers were recruited.
Oral lichen planus was diagnosed based on the modified World Health
Organization criteria. Subjects in the case group were divided into
reticular and non-reticular forms. Unstimulated salivary samples were
collected at 10-12 AM. Saliva concentrations of aldehyde dehydrogenase 1
were measured by ELISA. Results The differences between aldehyde dehydrogenase levels in the oral lichen
planus group compared with the control group were not significant but
aldehyde dehydrogenase in non-reticular oral lichen planus was significantly
higher than that of the reticular form. Limitations of the study This is a cross-sectional study, thus longitudinal studies in oral lichen
planus may present similar or different results. Conclusions The mechanism of malignant transformation in oral lichen planus is not
defined. Previous analyses revealed that the aldehyde dehydrogenase 1
expression is significantly correlated with increased risk of
transformation. This finding is consistent with our results because in the
erosive and ulcerative forms of oral lichen planus, which have an increased
risk of transformation, salivary aldehyde dehydrogenase 1 was overexpressed.
A higher salivary aldehyde dehydrogenase level in non-reticular oral lichen
planus can be a defensive mechanism against higher oxidative stress in these
groups. Aldehyde dehydrogenase may be one of the malignant transformation
markers in oral lichen planus. Further studies are needed for introducing
aldehyde dehydrogenase as a prognostic indicator in certain lesions.
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Affiliation(s)
- Arash Mansourian
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences - Tehran, Iran
| | - Najmeh Shanbehzadeh
- Department of Oral Medicine, School of Dentistry, Hormozgan University of Medical Sciences - Bandar Abbas, Iran
| | - Seyed Javad Kia
- Department of Oral Medicine, Guilan University of Medical Sciences, Dental School - Rasht, Iran
| | - Mahdieh-Sadat Moosavi
- Dental Research Center, Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences - Tehran, Iran
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Mostafa D, Moussa E, Alnouaem M. Evaluation of photodynamic therapy in treatment of oral erosive lichen planus in comparison with topically applied corticosteroids. Photodiagnosis Photodyn Ther 2017; 19:56-66. [PMID: 28450262 DOI: 10.1016/j.pdpdt.2017.04.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/24/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND The treatment of erosive oral lichen planus represents a therapeutic challenge. Despite numerous existing remedies, some of these treatments display disappointing results. Since it is a chronic disease with no current cure, the best treatment should target mainly the reduction of the duration and severity of symptomatic outbreaks with minimal side effects. To date, corticosteroids remain the first choice of treatment for oral lichen planus (OLP) patients. Although, topical corticosteroids have been found to be the safest and the most successful agents in the treatment of OLP, their prolonged use may cause mucosal problems and may lead to systemic complications. Recently, the use of photodynamic therapy has been well introduced in the treatment of oral diseases. Our clinical study was done to evaluate clinically the effect of photodynamic therapy mediated by methylene blue (MB-PDT) on signs and symptoms of erosive oral lichen planus (EOLP) lesions in comparison with the conventional topical corticosteroids (TC) treatment. The present work tried this recent modality of treatment to overcome the disadvantages of TC. MATERIAL AND METHODS Twenty patients with clinical and histological diagnosis of EOLP were selected from Oral Medicine and periodontology department in Faculty of Dentistry, Alexandria University in a randomized parallel study design. They were divided into two groups; group A (control group) involved ten patients who were instructed to use the conventional TC (kenakort A-orabase). While, group B (study group) contained ten patients who received PDT using diode laser 660nm mediated by methylene blue (MB). RESULTS Both groups presented statistically significant difference from baseline to follow up periods. But, the MB-PDT in treatment of EOLP showed more remarkable reduction in pain and lesion scores in comparison with corticosteroids treatment. CONCLUSION The results of this study allow the conclusion that the MB-PDT is considered to be a better treatment for OELP in comparison with TC because it is much more effective in pain reduction and lesion regression.
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Affiliation(s)
- Diana Mostafa
- Department of Preventive Dental Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia.
| | - Eglal Moussa
- Professor of Oral Medicine Department, Faculty of Dentistry, Alexandria University, Egypt
| | - Manal Alnouaem
- Professor of Oral Pathology Department, Faculty of Dentistry, Alexandria University, Egypt
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Karthikeyan P, Aswath N. Stress as an etiologic co-factor in recurrent aphthous ulcers and oral lichen planus. J Oral Sci 2017; 58:237-40. [PMID: 27349545 DOI: 10.2334/josnusd.15-0610] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study aimed to examine the role of stress in the occurrence of recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP), as well as to analyze the efficacy of saliva, urine, and serum cortisol levels as markers of stress. This study included 30 subjects with RAS (Group A), 30 with OLP (Group B), and 30 controls (Group C). The serum, salivary, and urinary cortisol levels were measured using electro-chemiluminescence immunoassay. The results were analyzed using the independent t-test, and a statistically significant difference (P = 0.000) was observed between the study and control groups. Further analysis was done using ANOVA and post-hoc tests. The results of this study suggest that RAS and OLP patients had higher cortisol levels than controls, indicating that stress acts as a co-factor in the pathogenesis of RAS and OLP. Although urinary cortisol level was found to be the best indicator of stress, saliva can also be used as a reliable marker. (J Oral Sci 58, 237-240, 2016).
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30
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Maia HCDM, Pinto NAS, Pereira JDS, de Medeiros AMC, da Silveira ÉJD, Miguel MCDC. Potentially malignant oral lesions: clinicopathological correlations. EINSTEIN-SAO PAULO 2016; 14:35-40. [PMID: 27074232 PMCID: PMC4872915 DOI: 10.1590/s1679-45082016ao3578] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/15/2016] [Indexed: 12/02/2022] Open
Abstract
Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.
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31
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Rabinovich OF, Ivina AA, Guseva AV, Babichenko II. [Immunomorphology of oral lichen planus]. STOMATOLOGII︠A︡ 2016; 95:4-7. [PMID: 27239989 DOI: 10.17116/stomat20169524-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The article is devoted to immunohistochemical study of reticular and erosive forms of oral lichen planus. Morphological examination of the reticular form revealed the increased number of Langerhans cells (CD1a), mast cells (CD25) and T lymphocytes (CD4, CD8, CD16) in the oral epithelium. Activation of these cells leads to the secretion of TNF-α and destruction of basal keratinocytes, which manifests as a focal reduction of intercellular protein expression of E-cadherin. Destruction of basal keratinocytes in a reticular form of oral lichen planus is accompanied by a significant decrease in proliferative activity of the basal cell layer (21.7±10.2%) compared with normal mucosa (33.6±7.0%), p=0.0045. In erosive form along with the above changes IgG and C3d complement's elements are revealed, which confirms the activation of immune complex mechanisms in the erosion area.
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Affiliation(s)
- O F Rabinovich
- Central Research Institute of Dentistry and Maxillofacial Surgery, Ministry of Health of Russian Federation, Moscow, Russia
| | - A A Ivina
- Peoples' Friendship University of Russia, Moscow, Russia
| | - A V Guseva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Ministry of Health of Russian Federation, Moscow, Russia
| | - I I Babichenko
- Peoples' Friendship University of Russia, Moscow, Russia
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Aboushelib MN, Elsafi MH. Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. J Prosthodont 2016; 26:29-33. [DOI: 10.1111/jopr.12379] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Mohammed Hamdy Elsafi
- Fine Measurements Lab, Dental Biomaterials Department, Faculty of Dentistry; Alexandria University; Alexandria Egypt
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Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BVR, Dineshshankar J, Yoithapprabhunath TR. A clinical study on oral lichen planus with special emphasis on hyperpigmentation. J Pharm Bioallied Sci 2015; 7:S495-8. [PMID: 26538905 PMCID: PMC4606647 DOI: 10.4103/0975-7406.163513] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a unique disorder affecting generally the older age group. Numerous studies have been done on various aspects of OLP such as pathogenesis, rate of malignant transformation, etc. However, very few studies are available with respect to clinical features especially association of hyperpigmentation and OLP. This study aims at studying the clinical aspects of OLP and study the association between hyperpigmentation and OLP in a south Indian population. MATERIALS AND METHODS A total of 58 patients with OLP who attended the outpatient department of our institution were included in the study and a complete history, followed by thorough intraoral examination was done. All the data were recorded and assessed for statistical analysis using SPSS software. RESULTS We found that the male to female ratio affected with OLP was 1:1 and the most common form of OLP that was seen was the reticular subtype. Also, buccal mucosa was the most common affected site and more than 60% patients had hyperpigmentation associated with the site affected by OLP. We found a statistically significant relation between the reticular type of OLP and the older age group (51-70 years) with hyperpigmentation. CONCLUSION Although further studies are required to say anything conclusively, post-inflammatory changes occurring the mucosa due to OLP could be a cause for hyperpigmentation in the sites affected.
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Affiliation(s)
- Ravi Teja Chitturi
- Department of Oral Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Pandian Sindhuja
- Consultant Oral Pathologist, G.D Karthik Hospital, Karaikudi, Tamil Nadu, India
| | - R Arjun Parameswar
- Department of Oral Pathology, Pushpagiri Dental College, Thiruvalla, Kerala, India
| | - Ramdas Madhavan Nirmal
- Department of Oral Pathology, Rajah Muthiah Dental College and Hospital, Annamalai Nagar, Tamil Nadu, India
| | - B Venkat Ramana Reddy
- Department of Oral Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Janardhanam Dineshshankar
- Department of Oral Pathology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
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Gupta S, Jawanda MK. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management. Indian J Dermatol 2015; 60:222-9. [PMID: 26120146 PMCID: PMC4458931 DOI: 10.4103/0019-5154.156315] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP.
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Affiliation(s)
- Sonia Gupta
- Department of Oral Pathology, Swami Devi Dyal Hospital and Dental College, Golpura, Barwala, Punjab, India
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35
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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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36
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Werneck JT, Costa TDO, Stibich CA, Leite CA, Dias EP, Silva Junior A. Oral lichen planus: study of 21 cases. An Bras Dermatol 2015; 90:321-6. [PMID: 26131860 PMCID: PMC4516094 DOI: 10.1590/abd1806-4841.20153704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/26/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: Lichen planus is considered to be the most common dermatological disease involving
the oral mucosa. OBJECTIVE: To investigate the profile, clinical features, and the presence of dysplasia and
candidiasis in patients with oral lichen planus. METHODS: A total of 21 patients were selected from 258 patients at risk for oral cancer
development. RESULTS: Most of the patients were white (76,2%), female (66,6%), with mean age of 58.8
years. Eight were smokers and seven were alcohol consumers. The buccal mucosa was
the most affected site, followed by the tongue and the gingiva. The reticular
pattern was the most common appearance. Histopathology depicted dysplasia in nine
cases and cytopathology was positive for Candida in eight cases in the first
appointment. CONCLUSION: Our data are similar to the literature. Cytopathology was important for the
diagnosis of candidiasis. Although the presence of dysplasia was verified, further
studies are necessary to clarify the importance of this finding.
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37
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Oliveira JPD, Uribe NC, Abulafia LA, Quintella LP. Esophageal lichen planus. An Bras Dermatol 2015; 90:394-6. [PMID: 26131872 PMCID: PMC4516088 DOI: 10.1590/abd1806-4841.20153255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 11/28/2014] [Indexed: 11/23/2022] Open
Abstract
Lichen planus is a chronic inflammatory disease that affects the skin, mucous
membranes, nails and scalp. Esophageal lichen planus is a rarely reported
manifestation of lichen planus, presenting itself commonly in middle-aged women, with
symptoms such as dysphagia. We report a case of esophageal lichen planus in a
54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although
lichen planus is a disorder well known by dermatologists, reports of esophageal
lichen planus are rare in dermatologic literature. The esophageal lichen planus is
little known and underdiagnosed, with a significant delay between the onset of
symptoms and diagnosis.
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Affiliation(s)
- Janine Pichler de Oliveira
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Natalia Caballero Uribe
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luna Azulay Abulafia
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Leonardo Pereira Quintella
- Instituto de Dermatologia Prof. Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Mostafa D, Tarakji B. Photodynamic therapy in treatment of oral lichen planus. J Clin Med Res 2015; 7:393-9. [PMID: 25883701 PMCID: PMC4394911 DOI: 10.14740/jocmr2147w] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 12/18/2022] Open
Abstract
Oral lichen planus (OLP) is a relatively common chronic immunologic mucocutaneous disorder. Although there are many presenting treatments, some of them proved its failure. Recently, the use of photodynamic therapy (PDT) has been expanding due to its numerous advantages, as it is safe, convenient, and non-invasive and has toxic effect towards selective tissues. This article provides comprehensive review on OLP, its etiology, clinical features and recent non-pharmacological treatments. We also describe the topical PDT and its mechanisms. Our purpose was to evaluate the efficacy of PDT in treatment of OLP through collecting the data of the related clinical studies. We searched in PubMed website for the clinical studies that were reported from 2000 to 2014 using specific keywords: "photodynamic therapy" and "treatment of oral lichen planus". Inclusion criteria were English publications only were concerned. In the selected studies of photodynamic treatment, adult patients (more than 20 years) were conducted and the OLP lesions were clinically and histologically confirmed. Exclusion criteria were classical and pharmacological treatments of OLP were excluded and also the using of PDT on skin lesions of lichen planus. We established five clinical studies in this review where all of them reported improvement and effectiveness of PDT in treatment of OLP lesions. The main outcome of comparing the related clinical studies is that the photodynamic is considered as a safe, effective and promising treatment modality for OLP.
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Affiliation(s)
- Diana Mostafa
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
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Wu D, Chen X, Dong C, Liu Q, Yang Y, He C, Wang J, Sun M, Wu Y. Association of single nucleotide polymorphisms in MPO and COX genes with oral lichen planus. Int J Immunogenet 2015; 42:161-7. [PMID: 25823564 DOI: 10.1111/iji.12193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 02/08/2015] [Accepted: 03/04/2015] [Indexed: 11/28/2022]
Abstract
Oral lichen planus (OLP) is an intractable, chronic inflammatory disorder, and its pathogenesis is still largely unknown. Some literatures supported that genes involved in both oxidative stress and prostaglandin metabolism play an important role in the process of inflammation. To explore their association with OLP, we investigated four single nucleotide polymorphisms (SNPs) from myeloperoxidase (MPO) and cyclooxygenase (COX) genes in 475 Chinese individuals (242 case and 233 controls) by MassArray. Although the genotype distributions had no significant differences between the patients and controls, we found that in different gender, rs2243828 from MPO displayed the statistically significant variance genotype frequencies between patients and controls (P = 0.018 in females, P = 0.035 in males). Moreover, for the major allele recessive model, this SNP also showed a significant difference between case and control groups in males (P = 0.015). In this study, we first observed significant association with MPO polymorphism and OLP risk in different gender groups in Chinese, suggesting MPO polymorphism is a gender-specific risk factor of OLP probably by influencing sex hormone-sensitive elements to regulate inflammatory gene expression networks, and we further revealed that oxidative stress was actually involved in the pathogenesis of this disease. Moreover, these findings inspire us some constructive solutions to the treatment of this disease.
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Affiliation(s)
- D Wu
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - X Chen
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - C Dong
- Hematology Department, Xianyang Rainbow Hospital, Xi'an, Shaanxi, China
| | - Q Liu
- Periodontal Mucosal Department, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Y Yang
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - C He
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - J Wang
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - M Sun
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Y Wu
- Center for DNA Typing, Department of Biochemistry and Molecular Biology, The Fourth Military Medical University, Xi'an, Shaanxi, China
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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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41
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Mostafa B, Ahmed E. Prevalence of oral lichen planus among a sample of the Egyptian population. J Clin Exp Dent 2015; 7:e7-e12. [PMID: 25810846 PMCID: PMC4368022 DOI: 10.4317/jced.51875] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/04/2014] [Indexed: 01/26/2023] Open
Abstract
Objectives: To report on the prevalence of oral lichen planus among a sample of the Egyptian population.
Study Design: 4470 Egyptian patients, aged 15-75 years, were seen at the outpatient clinic at the Faculty of Oral and Dental Medicine, Cairo University, Egypt. 31.25 % of these patients were males and 68.75% were females. Oral mucosal lesions consistent with oral lichen planus (OLP) were identified both clinically and confirmed histologically (in atypical cases) so that the prevalence of oral lichen planus in this study is 1.43%.
Results: 64 patients were diagnosed with OLP (20 males and 44 females). The average age of the affected group was 48.07 years. Associated skin lesions were detected in 15/64 patients (23.44%) and tobacco habits was observed in 20/64 patients (31.25%). The average period of follow-up of the affected cases was 1-2 years, during which two cases developed squamous cell carcinoma of the oral lesion.
Conclusions: Within the limitations of this study it revealed the prevalence of OLP among middle-aged women. Atrophic lesions were most frequent, followed by the erosive forms. Anti-HCV circulating antibodies were more common in patients with OLP and, notably, OLP was associated with Diabetes mellitus in 15.63% of patients.
Key words:Prevalence, oral lichen planus, Egypt.
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Affiliation(s)
- Basma Mostafa
- Assistant Professor. Oral and Dental Research Division, National Research Centre, Cairo, Egypt
| | - Enji Ahmed
- Lecturer. Oral Medicine and Periodontology Dep., Faculty of Oral and Dental Medicine, Cairo University, Egypt
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Teja CSR, Devy AS, Nirmal RM, Sunil PM, Deepasree M. Cytomorphometric analysis of exfoliated cells in oral lichen planus. Cytojournal 2014; 11:3. [PMID: 24738004 PMCID: PMC3986549 DOI: 10.4103/1742-6413.127214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/23/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Tumors are distinguished from normal tissues partly by their pronounced variability of cellular and nuclear dimensions. Therefore, such factors may be an indicator to assess whether the cells are malignant or not. Exfoliative cytology is a reliable tool in assessing such changes in the uterine cervix and has been used in the oral cavity also with success. The aims and objectives of the following study were to evaluate the malignant changes by assessing the quantitative parameters such as cytoplasmic diameter, cytoplasmic perimeter and cytoplasmic area (CD, CP, CA) and nuclear diameter, nuclear perimeter and nuclear area (ND, NP, NA) and cytoplasmic to nuclear ratio in the exfoliated cells of various subtypes of oral lichen planus (OLP) using cytomorphometry. MATERIALS AND METHODS Oral exfoliated cells from nineteen cases of histologically proven OLP (1 atrophic, 13 reticular, 4 erosive and 1 plaque) and ten controls with healthy mucosa were taken and stained by Feulgen-Rossenback reaction and cytomorphometric analysis was performed using an image analysis software. The parameters taken into account were CD, CP, CA and ND, NP, NA. Furthermore CA/NA was calculated. The parameters were statistically analyzed using the t-test. RESULTS Cytomorphometric analysis of all the parameters showed no significant difference between the control group and the reticular/plaque subtypes, whereas statistically significant (P < 0.05) differences was obtained between the control group and the atrophic/erosive subtypes group when compared using t-test. CONCLUSIONS The cytomorphometric analysis of OLP shows that erosive/atrophic subtypes of OLP are at more risk and exfoliative cytology and cytomorphometry can be used as a tool to assess the malignant changes.
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Affiliation(s)
| | - A Santha Devy
- Department of Oral Pathology, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - R Madhavan Nirmal
- Department of Oral Pathology, Rajah Muthiah Dental College and Hospital, Annamalai Nagar, Tamil Nadu, India
| | - P M Sunil
- Department of Oral Pathology, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala, India
| | - M Deepasree
- Department of Oral Pathology, Rajah Muthiah Dental College and Hospital, Annamalai Nagar, Tamil Nadu, India
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Lorenzini G, Viviano M, Chisci E, Chisci G, Picciotti M. A comparative immunohistochemical and immunophenotypical study on lymphocytes expression in patients affected by oral lichen planus. J Oral Pathol Med 2013; 42:642-7. [DOI: 10.1111/jop.12058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Guido Lorenzini
- Tuscan School of Dental Medicine; University of Siena; Siena Italy
| | - Massimo Viviano
- Tuscan School of Dental Medicine; University of Siena; Siena Italy
| | - Elettra Chisci
- Department of Orthodontics; University of Ferrara; Ferrara Italy
| | - Glauco Chisci
- Tuscan School of Dental Medicine; University of Siena; Siena Italy
- Department of Maxillofacial Surgery; University of Siena; Siena Italy
| | - Maria Picciotti
- Tuscan School of Dental Medicine; University of Siena; Siena Italy
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Immunological diseases of buccal localisation]. Med Clin (Barc) 2012; 140:88-92. [PMID: 22989674 DOI: 10.1016/j.medcli.2012.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/04/2012] [Accepted: 06/14/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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45
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Comparison of periodontal status in gingival oral lichen planus patients and healthy subjects. Dermatol Res Pract 2012; 2012:561232. [PMID: 22570646 PMCID: PMC3337596 DOI: 10.1155/2012/561232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/05/2012] [Indexed: 12/02/2022] Open
Abstract
Background and Objective. Oral lichen planus (OLP) is a common chronic mucocutaneous disease. OLP can occur in different oral sites such as gingiva. The purpose of study was to evaluate the periodontal status of OLP patients with desquamative gingivitis (DG) and compare it with that of healthy control. Methods. This study was case-control. 32 patients with gingival OLP as a case group and 32 healthy subjects as a control group were selected. The periodontal status of all subjects including plaque index (PI), bleeding on probing (BOP), and clinical attachment level (CAL) was evaluated in both groups. Finally data were analyzed by t-test. Results. The mean values of periodontal parameters were observed to be higher in case group compared with control group, and this was significant (P < 0.05). Conclusion. Our results showed that periodontal status is worse in gingival OLP if compared with healthy controls.
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Sadaksharam J, Nayaki KPT, Panneer Selvam N. Treatment of oral lichen planus with methylene blue mediated photodynamic therapy - a clinical study. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 28:97-101. [DOI: 10.1111/j.1600-0781.2012.00647.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jayachandran Sadaksharam
- Department of Oral Medicine and Radiology; Tamilnadu Government Dental College and Hospital; Chennai; India
| | - K. P. Thanigai Nayaki
- Department of Dental Surgery; Coimbatore Medical College and Hospital; Coimbatore; India
| | - Niranzena Panneer Selvam
- Department of Oral Medicine and Radiology; Tamilnadu Government Dental College and Hospital; Chennai; India
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47
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Abdel Hay RM, Fawzy MM, Metwally D, Kadry D, Ezzat M, Rashwan W, Rashed LA. DNA polymorphisms and tissue cyclooxygenase-2 expression in oral lichen planus: a case-control study. J Eur Acad Dermatol Venereol 2011; 26:1122-6. [PMID: 21923838 DOI: 10.1111/j.1468-3083.2011.04229.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disorder defined as a precancerous condition. Special attention has been paid to the expression of cyclooxygenase-2 (COX-2) and its potential role in development of oral squamous cell carcinoma. The identification of single nucleotide polymorphisms that affect gene function or expression and contribute to disease predisposition has become a major area of investigation toward understanding the mechanisms for cancer. OBJECTIVE The objective of this study is to investigate the association between the COX-2 765G>C gene polymorphism, tissue COX-2 expression and the development of OLP as a chronic inflammatory condition. METHODS This study was done on 50 patients with OLP and 50 healthy controls. COX-2 activity was assessed by measuring tissue prostaglandin E (PGE)2 levels by enzyme immunometric assay kit. COX-2 765G>C gene polymorphism was assessed by reverse transcriptase-polymerase chain reaction (RT-PCR) followed by restricted fragment length polymorphism (RFLP). RESULTS OLP patients showed statistically significant higher mean PGE2 than the control group. We did not observe any statistically significant differences in genotype distribution or allele frequency between the patients and the control group (P > 0.05). Odds ratio showed no statistically significant association between COX-2 765G>C polymorphism and lichen planus. CONCLUSION The present evidence thus indicates that variation in the COX-2 gene is unlikely to be of relevance to the aetiology of OLP. As this is the first report concerning the COX-2 -765G>C gene polymorphism and the risk of OLP, additional studies with larger sample size will be required to confirm these findings.
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Affiliation(s)
- R M Abdel Hay
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Artico G, Bruno IS, Seo J, Hirota SK, Acay R, Migliari DA. Reação liquenoide à carbamazepina em mucosa bucal: relato de caso. An Bras Dermatol 2011; 86:S152-5. [DOI: 10.1590/s0365-05962011000700040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 10/14/2010] [Indexed: 11/22/2022] Open
Abstract
As reações liquenoides por drogas são mais comuns na pele, mas também podem ocorrer na mucosa bucal. Estas lesões são de difícil diagnóstico por causa de sua semelhança clínica com às do líquen plano oral idiopático. O presente artigo relata um caso de reação liquenoide em mucosa bucal, associado ao uso de carbamazepina, no qual o processo de diagnóstico é enfatizado
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