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Xie P, Peng W. Thyroid Dysfunction and Oral Lichen Planus: Evidence From Two-Sample Mendelian Randomization Analysis. Int Dent J 2025; 75:1621-1631. [PMID: 40138996 PMCID: PMC11985110 DOI: 10.1016/j.identj.2025.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 02/04/2025] [Accepted: 02/24/2025] [Indexed: 03/29/2025] Open
Abstract
INTRODUCTION AND AIMS Epidemiological studies have shown that the association between thyroid dysfunction (TD) and oral lichen planus (OLP) is controversial, and the causal relationship remains ill-defined. This study aims to investigate their probable mutual causality using bidirectional Mendelian randomization (MR) analyses. METHODS We extracted genetic instruments for OLP and 10 phenotypes of TD from the genome-wide association studies database. The inverse variance weighted method was primarily used to evaluate the bidirectional causal relationship between TD and OLP. The results' robustness was verified by sensitivity analysis (Cochran's Q test, MR-Egger intercept, and leave-one-out test). Bonferroni correction threshold (0.05/10) was applied to determine significant differences. RESULTS Forward MR analysis indicated that Hashimoto's thyroiditis (HT) was suggestively linked to a higher likelihood of developing OLP (P = .0077), while hypothyroidism significantly increased the risk of OLP occurrence (P = .0002). The reverse MR study found that OLP was suggestively related to the occurrence of hyperthyroidism (P = .0126) and thyroid cancer (P = .0244). Furthermore, OLP was found to significantly increase the risk of HT (P = 3.47 × 10-⁸), Graves' disease (P = 1.03 × 10-⁵), hypothyroidism (P = 1.08 × 10-⁸), and elevated thyroid-stimulating hormone levels (P = 1.99 × 10-⁶). No major pleiotropy or heterogeneity was detected (P > .05). CONCLUSION These findings suggest that hypothyroidism significantly increases the risk of OLP, while OLP may contribute to the development of autoimmune thyroid disorders, particularly HT, Graves' disease, hypothyroidism, and thyroid-stimulating hormone. These findings highlight the complex interaction between endocrine and immune systems, emphasizing the need for further research into shared molecular pathways and potential clinical implications. CLINICAL RELEVANCE This study provides a genetic foundation for understanding the relationship between TD and OLP, which aids early screening and diagnosis and informs therapy development.
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Affiliation(s)
- Pengxian Xie
- College of Stomatology, North China University of Science and Technology, Tangshan, Hebei, China
| | - Wei Peng
- College of Stomatology, North China University of Science and Technology, Tangshan, Hebei, China.
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Keerthika R, Kamboj M, Girdhar A, Narwal A, Devi A, Anand R, Juneja M. An exotic pathogenetic mechanism of angiogenesis in oral lichen planus-A systematic review. J Oral Pathol Med 2023; 52:803-810. [PMID: 37553286 DOI: 10.1111/jop.13472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 05/09/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Angiogenesis plays a vital role at the molecular level in various inflammatory lesions, that lead to their chronicity. Oral lichen planus is an immune-mediated chronic inflammatory disorder. The angiogenetic role and exact mechanisms in oral lichen planus are still unclear due to a dearth of studies. Its clinical significance with angiogenesis also requires further elucidation necessitating a thorough review of the studies that have been conducted so far. The present review was designed to identify the dependence of oral lichen planus progression on angiogenesis which could aid in devising metronomic treatments required to halt the progression of this disease. MATERIALS AND METHODS A thorough search was made using MEDLINE by PubMed, Scopus, Google scholar, Cochrane library, and EMBASE databases. Original research articles, that immunohistochemically evaluated angiogenesis in oral lichen planus were included for review. Risk of bias was analysed for each study using Modified Newcastle-Ottawa scale and Review Manager 5.4 was used to output its result. RESULTS Twenty-nine published articles were included for data synthesis. The most commonly employed antibody was CD34, however, upregulated VEGF expression was the principal while ICAM-1, VCAM-1, and PECAM-1 were critical angiogenic factors to mediate angiogenesis in oral lichen planus. CONCLUSION The current evidence supports that angiogenesis, a fundamental pathogenetic mechanism of oral lichen planus, leads to its persistence and chronicity. However, studies with a larger sample size, standard evaluation criteria, different subtypes, and adequate follow-up are warranted.
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Affiliation(s)
- R Keerthika
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Akhil Girdhar
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Rahul Anand
- Department of Oral and Maxillofacial Pathology, Dr D Y Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
| | - Manish Juneja
- Oral and Maxillofacial Pathologist, Franklin, Massachusetts, USA
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Li Q, Wang F, Shi Y, Zhong L, Duan S, Kuang W, Liu N, Luo E, Zhou Y, Jiang L, Dan H, Luo X, Zhang D, Chen Q, Zeng X, Li T. Single-cell immune profiling reveals immune responses in oral lichen planus. Front Immunol 2023; 14:1182732. [PMID: 37090715 PMCID: PMC10116058 DOI: 10.3389/fimmu.2023.1182732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionOral lichen planus (OLP) is a common chronic inflammatory disorder of the oral mucosa with an unclear etiology. Several types of immune cells are involved in the pathogenesis of OLP.MethodsWe used single-cell RNA sequencing and immune repertoire sequencing to characterize the mucosal immune microenvironment of OLP. The presence of tissue-resident memory CD8+ T cells are validated by multiplex immunofluorescence.ResultsWe generated a transcriptome atlas from four OLP biopsy samples and their paired peripheral blood mononuclear cells (PBMCs), and compared them with two healthy tissues and three healthy PBMCs samples. Our analysis revealed activated tissue-resident memory CD8+ T cells in OLP tissues. T cell receptor repertoires displayed apperant clonal expansion and preferrential gene pairing in OLP patients. Additionally, obvious BCR clonal expansion was observed in OLP lesions. Plasmacytoid dendritic cells, a subtype that can promote dendritic cell maturation and enhance lymphocyte cytotoxicity, were identified in OLP. Conventional dendritic cells and macrophages are also found to exhibit pro-inflammatory activity in OLP. Cell-cell communication analysis reveals that fibroblasts might promote the recruitment and extravasation of immune cells into connective tissue.DiscussionOur study provides insights into the immune ecosystem of OLP, serving as a valuable resource for precision diagnosis and therapy of OLP.
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Affiliation(s)
- Qionghua Li
- 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, Chengdu, Sichuan, China
| | - Fei Wang
- 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, Chengdu, Sichuan, China
| | - Yujie Shi
- 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, Chengdu, Sichuan, China
| | - Liang Zhong
- 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, Chengdu, Sichuan, China
| | - Shumin Duan
- 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, Chengdu, Sichuan, China
| | - Wenjing Kuang
- 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, Chengdu, Sichuan, China
| | - Na 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, Chengdu, Sichuan, China
| | - En Luo
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhou
- 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, Chengdu, Sichuan, China
| | - Lu Jiang
- 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, Chengdu, Sichuan, 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, Chengdu, Sichuan, China
| | - Xiaobo Luo
- 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, Chengdu, Sichuan, China
| | - Dunfang Zhang
- Department of Biotherapy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 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, Chengdu, Sichuan, 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, Chengdu, Sichuan, China
- *Correspondence: Taiwen Li, ; Xin Zeng,
| | - Taiwen Li
- 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, Chengdu, Sichuan, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, China
- *Correspondence: Taiwen Li, ; Xin Zeng,
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Correlation between Oral Lichen Planus and Viral Infections Other Than HCV: A Systematic Review. J Clin Med 2022; 11:jcm11185487. [PMID: 36143134 PMCID: PMC9501453 DOI: 10.3390/jcm11185487] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This review aimed to evaluate the correlation between viral infections (HPV, EBV, HSV-1, CMV) other than HCV and oral lichen planus to assess if there is sufficient evidence to establish if these viruses can play a role in the etiopathogenesis of the disease. MATERIALS AND METHODS We reviewed the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library), employing MeSH terms such as "oral lichen planus" and "OLP" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria. RESULTS A total of 43 articles of the 1219 results initially screened were included in the study. We allocated the 43 selected items into four groups, according to each related virus: HPV, EBV, HSV-1, and CMV. CONCLUSIONS Heterogeneous results neither confirm nor exclude a direct correlation between the investigated viral infections and oral lichen planus etiopathogenesis and its feasible malignant transformation. Many viral agents can cause oral lesions and act as cancerizing agents. Future studies could be desirable to produce comparable statistical analyses and enhance the quantity and quality of the outcomes to promote the translation of research into clinical practice.
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Said Z, Murdoch C, Hansen J, Siim Madsen L, Colley HE. Corticosteroid delivery using oral mucosa equivalents for the treatment of inflammatory mucosal diseases. Eur J Oral Sci 2021; 129:e12761. [PMID: 33645844 PMCID: PMC8048628 DOI: 10.1111/eos.12761] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022]
Abstract
Oral lichen planus (OLP) is an immune‐mediated disease of the oral mucosa with idiopathic aetiology. It is frequently treated with topical corticosteroids (applied as gels, mouthwashes, or sprays); however, the mucosal exposure times of topical corticosteroids are short because of removal by the constant flow of saliva and mechanical forces. In this study we used cell monolayers, as well as oral mucosal equivalents (OMEs) containing activated T‐cells, to examine corticosteroid potency and delivery of clobetasol‐17‐propionate from a novel electrospun mucoadhesive patch. The OMEs displayed tight junctions, desmosomes, hemidesmosomes, and an efficient permeability barrier. Following application of corticosteroids to cells cultured as monolayers, the degree of cytotoxicity measured correlated to the level of potency recognized for each corticosteroid; by contrast, OMEs were largely unaffected by corticosteroid treatment. Permeation of clobetasol‐17‐propionate into and through the OMEs was time‐ and dose‐dependent, regardless of whether this corticosteroid was delivered in liquid form or from a mucoadhesive patch, and both liquid‐ and patch‐delivered clobetasol‐17‐propionate significantly reduced the secretion of interleukin‐2 by activated T‐cells. This study confirms that OMEs are more suitable models than cell monolayers for evaluating toxicity and drug delivery. After topical exposure, clobetasol‐17‐propionate accumulated in OMEs at a higher level than betamethasone‐17‐valerate and hydrocortisone‐17‐valerate, and exerted its immunosuppressive actions following application via the patch delivery system, highlighting the efficacy of this mode of drug delivery to treat OLP.
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Affiliation(s)
- Zulfahmi Said
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.,Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Craig Murdoch
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | | | - Helen E Colley
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Yoshida H, Imamura Y, Yoshimura H, Kobayashi M. Induction of High Endothelial Venule-like Vessels in Oral and Cutaneous Lichen Planus: A Comparative Study. J Histochem Cytochem 2020; 68:343-350. [PMID: 32391737 DOI: 10.1369/0022155420923272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease involving the oral mucosa and skin. Both oral LP (OLP) and cutaneous LP (CLP) are histopathologically characterized by dense subepithelial lymphocyte infiltrates; however, the mechanisms underlying lymphocyte recruitment to sites of LP lesions are not fully understood. Here, we assessed the induction of peripheral lymph node addressin (PNAd)-expressing high endothelial venule (HEV)-like vessels in 19 OLP and 17 CLP cases. To do so, we performed immunohistochemical staining for PNAd and CD34, followed by quantitative analysis. We also conducted triple immunohistochemistry for PNAd and either CD3 and CD20 or CD4 and CD8 to identify the lymphocyte subset preferentially recruited via HEV-like vessels. PNAd-expressing HEV-like vessels were induced in and around lymphocyte aggregates in all cases of OLP and in 10 of 17 CLP cases, and these vessels were more frequently observed in OLP relative to CLP. Although the number of T-cells attached per HEV-like vessel exceeded the number of B-cells in both OLP and CLP, the number of CD4+ T-cells attached was greater than the number of CD8+ T-cells only in OLP. These findings combined suggest that PNAd-expressing HEV-like vessels play a more important role in the pathogenesis of OLP compared with CLP.
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Affiliation(s)
- Hisato Yoshida
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui.,Department of Dentistry and Oral Surgery, Faculty of Medical Sciences, University of Fukui
| | - Yoshiaki Imamura
- Division of Surgical Pathology, University of Fukui Hospital, Eiheiji, Japan
| | - Hitoshi Yoshimura
- Department of Dentistry and Oral Surgery, Faculty of Medical Sciences, University of Fukui
| | - Motohiro Kobayashi
- Department of Tumor Pathology, Faculty of Medical Sciences, University of Fukui
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DeAngelis LM, Cirillo N, McCullough MJ. The immunopathogenesis of oral lichen planus-Is there a role for mucosal associated invariant T cells? J Oral Pathol Med 2019; 48:552-559. [PMID: 31172572 DOI: 10.1111/jop.12898] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022]
Abstract
Oral lichen planus (OLP) is a chronic, T-cell-mediated, immune condition of unknown cause. OLP may present with painful symptoms requiring treatment, as well as lesions outside the oral cavity. It is likely that what initiates the OLP disease process is a complex interaction of host susceptibility and environmental triggers. While it is possible that OLP represents a true autoimmune condition against an epithelial autoantigen, the mechanisms that lead to this immune dysregulation are still poorly understood. In this review article, we discuss current concepts relating to the immunopathogenesis of OLP, as well as the potential contributory roles the oral microbiota and mucosal-associated invariant T (MAIT) cells.
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Affiliation(s)
- Lara M DeAngelis
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Nicola Cirillo
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Michael J McCullough
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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Georgescu SR, Tampa M, Mitran MI, Mitran CI, Sarbu MI, Nicolae I, Matei C, Caruntu C, Neagu M, Popa MI. Potential pathogenic mechanisms involved in the association between lichen planus and hepatitis C virus infection. Exp Ther Med 2018; 17:1045-1051. [PMID: 30679972 DOI: 10.3892/etm.2018.6987] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022] Open
Abstract
Lichen planus (LP) is an immune-mediated inflammatory disease that particularly affects the skin and mucous membranes. Its etiology remains elusive, however some trigger factors, including viral or bacterial antigens, drugs and metals, have been postulated. There is a higher prevalence of hepatitis C virus (HCV) infection among patients with LP, with some geographical variations. HCV is an enveloped RNA virus that belongs to the Flaviviridae family and in most instances causes chronic liver infections. It has been hypothesized that HCV may contribute to LP development, but the link between the two disorders is not fully understood. It is still debatable whether HCV leads to the occurrence of LP lesions directly by replication inside the infected cells or indirectly by activating immunological pathways. Molecular studies have revealed HCV RNA in specimens collected from patients with LP. The autoimmune theory was also suggested given that several studies have revealed viral replication and immune response activation associated with autoantibody synthesis. The aim of this review is to summarize the main potential mechanisms involved in the association between LP and HCV infection. Understanding the link between the two disorders may shed some light on the pathogenesis of LP, which is a challenging issue.
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Affiliation(s)
- Simona Roxana Georgescu
- Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mircea Tampa
- Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania.,Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Madalina Irina Mitran
- Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania.,Department of Microbiology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cristina Iulia Mitran
- Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania.,Department of Microbiology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Maria Isabela Sarbu
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ilinca Nicolae
- Department of Dermatology, 'Victor Babes' Clinical Hospital for Infectious Diseases, 030303 Bucharest, Romania
| | - Clara Matei
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Constantin Caruntu
- Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.,Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Monica Neagu
- Department of Immunology, 'Victor Babes' National Institute of Pathology, 050096 Bucharest, Romania.,Faculty of Biology University of Bucharest, 050095 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.,'Cantacuzino' National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania
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Aghbari SM, Zayed SO, Shaker OG, Abushouk AI. Evaluating the role of tissue microRNA-27b as a diagnostic marker for oral lichen planus and possible correlation with CD8. J Oral Pathol Med 2018; 48:68-73. [PMID: 30276874 DOI: 10.1111/jop.12785] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/03/2018] [Accepted: 09/26/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND MicroRNA-27b (miR27b) is a small, non-coding RNA that is involved in physiological keratinocyte differentiation and regulating inflammatory processes. We performed this study to investigate the value of miR27b as a diagnostic marker for oral lichen planus (OLP) and the correlation between CD8 (cytotoxic T-cell marker) and miR27b tissue expression in OLP patients. METHODS Forty participants (including 20 OLP patients and 20 controls) underwent oral biopsy. The obtained specimens were examined by immunostaining and quantitative RT-PCR for CD8 and miR27b tissue expression, respectively. We used the Spearman rank correlation test to evaluate the correlation between both variables. RESULTS Our analysis showed that in comparison with healthy tissues, OLP tissue samples exhibited significantly higher CD8 levels (P < 0.01), as well as a significant downregulation of miR27b expression (P < 0.0001). Upon comparing different OLP subgroups, no significant difference was detected in terms of miR27b expression; however, the tissue levels of CD8 varied significantly (highest in the erosive subgroup and lowest in the papular/plaque/reticular subgroup). The Spearman rank analysis showed a negative correlation between tissue expression of miR27b and CD8; however, this was not statistically significant (P > 0.05). Further, the receiver operating characteristic curve of tissue miR27b as an OLP biomarker revealed 100% sensitivity and 65% specificity at cutoff value of 4.4. CONCLUSION This study demonstrated increased CD8 levels and downregulation of miR27b in OLP tissues, compared to healthy tissues. Moreover, it revealed the potential of miR27b as an OLP disease biomarker. The possible negative correlation between CD8 and miR27b tissue expression requires further investigation in larger studies.
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Affiliation(s)
| | | | - Olfat Gamil Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine Cairo University, Cairo, Egypt
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Oral lichenoid reactions may possibly be associated with abatacept: A case report and literature update. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:e245-e251. [PMID: 30093316 DOI: 10.1016/j.oooo.2018.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/30/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
Oral lichenoid reactions (OLRs) comprise a group of conditions with a common clinical appearance and histopathologic pattern that may be induced by several conditions or medications. This report describes an OLR possibly induced by a biologic agent. A 69-year-old woman with rheumatoid arthritis presented with a chief complaint of oral pain. The patient retroactively reported of skin lesions as well. Clinically, she had mixed red-white mucosal lesions and ulcers suggestive of an OLR. This diagnosis was supported by histopathologic findings. Withholding the putative etiologic agent, abatacept, resulted in immediate alleviation of both oral and skin lesions. Abatacept and other biologics are thought to help treat inflammation and are becoming more commonly prescribed to treat rheumatoid arthritis. However, the clinicians should explore these medications as a causative factor for OLR.
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Nosratzehi T, Arbabi-Kalati F, Hamishehkar H, Bagheri S. Comparison of the Effects of Curcumin Mucoadhesive Paste and Local Corticosteroid on the Treatment of Erosive Oral Lichen Planus Lesions. J Natl Med Assoc 2017; 110:92-97. [PMID: 29510851 DOI: 10.1016/j.jnma.2017.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Lichen planus is a prevalent chronic mucocutaneous condition, whose exact pathogenesis has not been elucidated yet and its standard treatment at present involves the use of local corticosteroids. Curcumin is a colored material extracted from Curcuma longa plant species and is used as an appetizer and for medical purposes. It has anti-inflammatory, antioxidative and anti-cancerous properties. In the present study, the effect of mucoadhesive pastes containing curcumin and local corticosteroids was evaluated for the treatment of erosive lichen planus lesions. MATERIALS AND METHODS In this case‒control study, 40 patients with oral lichen planus were evaluated. Twenty patients, as the cases, were given mucoadhesive pates containing curcumin and 20 patients, as the controls, were given local corticosteroids. The lesion sizes were recorded in the first session and during the follow-up sessions. Pain severities were measured and recorded using the visual analogue scale (VAS) on the first session and during the follow-up sessions. Data were analyzed with SPSS 19, using Student's t-test and Mann-Whitney test. Data are significant P < 0.05. RESULTS The lesion sizes, pain severities and changes in classification of the lesions exhibited significant differences at different follow-up sessions (weeks 1, 2, 4, 8 and 12) in the two groups (P < 0.05). However, there were no significant differences between the group treated with curcumin and the group treated with local corticosteroids (P > 0.05). CONCLUSION Curcumin was effective in the treatment of oral lichen planus lesions and resulted in decreases in lesion sizes, pain and burning sensation severities and changes in classification of the lesions without any complications.
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Affiliation(s)
- Tahereh Nosratzehi
- Oral and Dental Disease Research Center, Department of Oral Medicine, Dental Research Center, Zahedan University Of Medical Science, Faculty of Dentistry, Zahedan, Iran.
| | - Fateme Arbabi-Kalati
- Oral and Dental Disease Research Center, Department of Oral Medicine, Dental Research Center, Zahedan University Of Medical Science, Faculty of Dentistry, Zahedan, Iran
| | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sudabeh Bagheri
- Department of Oral Medicine, Gorgan University Of Medical Science, Faculty of Dentistry, Gorgan, Iran
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Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res 2016; 308:539-51. [PMID: 27349424 DOI: 10.1007/s00403-016-1667-2] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/16/2016] [Accepted: 06/17/2016] [Indexed: 12/22/2022]
Abstract
Lichen planus (LP) is a common chronic inflammatory condition that can affect skin and mucous membranes, including the oral mucosa. Because of the anatomic, physiologic and functional peculiarities of the oral cavity, the oral variant of LP (OLP) requires specific evaluations in terms of diagnosis and management. In this comprehensive review, we discuss the current developments in the understanding of the etiopathogenesis, clinical-pathologic presentation, and treatment of OLP, and provide follow-up recommendations informed by recent data on the malignant potential of the disease as well as health economics evaluations.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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Kulkarni G, Sakki EP, Kumar YV, Kolimi S, Perika R, Karthik KV, Kumar KM, Kalyan VS. Expression of CD1a by Langerhan's Cells in Oral Lichen Planus - A Retrospective Analysis. J Clin Diagn Res 2016; 10:ZC28-31. [PMID: 27504405 DOI: 10.7860/jcdr/2016/19189.7966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/05/2016] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Langerhan's Cells (LCs) are dendritic cells of the oral epithelium which play a role in a series of oral lesions from gingivitis to oral cancer. Oral Lichen Planus (OLP) is an oral mucosal T-lymphocyte mediated immunologic reaction to an unidentified putative antigen or allergen. AIM The aim of this study was to quantify the presence of immature LCs in OLP comparing them with normal epithelium. MATERIALS AND METHODS A retrospective study using 30 of OLP cases were conducted. Immunohistochemistry was performed using polyclonal anti-CD1a antibodies to identify LCs in 10 cases of normal tissue and 30 samples of OLP. The distribution of LCs among lesional tissue and normal mucosa was analysed using Mann-Whitney U test. RESULTS LC population in OLP was significantly higher when compared to the normal epithelium (p<0.001). CONCLUSION The increase in LCs indicates the active role played during the antigen detection in OLP and subsequent presentation to T-lymphocytes.
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Affiliation(s)
- Ganesh Kulkarni
- Senior Lecturer, Department of Oral Pathology, Malla Reddy Institute of Dental Sciences , Hyderabad, Telangana, India
| | - Esther Priyadarshini Sakki
- Senior Lecturer, Department of Oral Pathology, Meghana Institute of Dental sciences , Nizamabad, Telangana, India
| | - Yennavaram Vijay Kumar
- Associate Professor, Department of Public Health Dentistry, MNR Dental College and Hospital , Sangareddy, Telangana, India
| | - Sadananda Kolimi
- Assistant Professor, Department of Periodontics, Government Dental College and Research Institute , VIMS, Bellary, Karnataka, India
| | - Ravi Perika
- Senior Lecturer, Department of Oral Pathology, Malla Reddy Institute of Dental Sciences , Hyderabad, Telangana, India
| | - Kalepu Venkata Karthik
- Senior Lecturer, Department of Oral Pathology, SVS Institute of Dental Sciences , Mahbubnagar, Telangana, India
| | - Kandukuri Mahesh Kumar
- Assistant Professor, Department of Pathology, Malla Reddy Institute of Medical Sciences , Hyderabad, Telangana, India
| | - Venumbaka Siva Kalyan
- Reader, Department of Public Health Dentistry, Mamatha Dental College , Khammam, Telangana, India
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Souto GR, Nunes LFM, Tanure BB, Gomez RS, Mesquita RA. CD1a+ dendritic cells in oral lichen planus and amalgam lichenoid reaction. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:651-6. [PMID: 27086000 DOI: 10.1016/j.oooo.2016.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/07/2016] [Accepted: 02/16/2016] [Indexed: 11/16/2022]
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Alrashdan MS, Angel C, Cirillo N, McCullough M. Smoking habits and clinical patterns can alter the inflammatory infiltrate in oral lichenoid lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:49-57. [DOI: 10.1016/j.oooo.2015.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/13/2015] [Accepted: 08/24/2015] [Indexed: 12/26/2022]
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16
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Totan A, Miricescu D, Parlatescu I, Mohora M, Greabu M. Possible salivary and serum biomarkers for oral lichen planus. Biotech Histochem 2015; 90:552-8. [PMID: 25839238 DOI: 10.3109/10520295.2015.1016115] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
There are few reports concerning the potential for clinical application of oxidative stress (OS) and collagen degradation markers in oral lichen planus (OLP) patients. We investigated the possibility of using some disease-related biomarkers in saliva and serum of OLP patients. Our study included 30 patients with OLP and 30 controls. We evaluated serum and salivary OS biomarkers including 8-OHdG, MDA, uric acid, TAC and GPx. We also investigated collagen degradation markers such as CTX I and MMP-8. We found significantly increased salivary levels of MMP-8 and CTX I in the OLP group compared to controls and significant differences between the OLP and control groups in serum and saliva for 8-OHdG, MDA (significantly increased), uric acid, TAC and GPx (significantly reduced). Currently there are no criteria for evaluating which OLP patients have a greater risk of malignant transformation. In addition to clinical surveillance, the serum and salivary biomarkers that we evaluated may be useful biomarkers for monitoring OLP patients in the future.
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Affiliation(s)
- A Totan
- a Biochemistry Department, Faculty of Dental Medicine , University of Medicine Carol Davila , Bucharest , Romania
| | - D Miricescu
- a Biochemistry Department, Faculty of Dental Medicine , University of Medicine Carol Davila , Bucharest , Romania
| | - I Parlatescu
- b Oral Pathology Department, Faculty of Dental Medicine , University of Medicine Carol Davila , Bucharest , Romania
| | - M Mohora
- a Biochemistry Department, Faculty of Dental Medicine , University of Medicine Carol Davila , Bucharest , Romania
| | - M Greabu
- a Biochemistry Department, Faculty of Dental Medicine , University of Medicine Carol Davila , Bucharest , Romania
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Abstract
Oral lichen planus (OLP) is commonly found in middle-aged women. Although the cause is unknown, research points to several complex immunologic events and cells that are responsible for the inflammatory destruction and chronicity of these lesions. Biopsy for histologic diagnosis is recommended. The mainstay of treatment remains topical corticosteroids; however, newer therapies such as immunomodulating agents are available for recalcitrant lesions. In cases of lichenoid mucositis or reactions, treatment should be directed at identifying and removing the presumed cause. Given the apparent risk of squamous cell carcinoma in these patients, frequent follow-up and repeat biopsy are vital.
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Affiliation(s)
- Scott S De Rossi
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Otolaryngology/Head & Neck Surgery, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA; Department of Dermatology, Medical College of Georgia, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA.
| | - Katharine Ciarrocca
- Department of Oral Rehabilitation, College of Dental Medicine, Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
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Abstract
Oral mucosal diseases encompass several common conditions that affect the general population. Some of these disorders present with signs and symptoms that are pathognomonic for the condition, whereas others present with similar features that can make clinical diagnosis difficult to achieve. It is important for physicians to have a clear understanding of these disorders to provide appropriate care to patients. This article reviews clinical aspects of common oral mucosal disorders, including candidiasis, herpes simplex viral infections, aphthous stomatitis, lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid.
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Affiliation(s)
- Eric T Stoopler
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Thomas P Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Ryan K, Hegarty AM, Hodgson T. Aetiology, diagnosis and treatment of oral lichen planus. Br J Hosp Med (Lond) 2014; 75:492-6. [DOI: 10.12968/hmed.2014.75.9.492] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Anne M Hegarty
- Consultant in Oral Medicine in the Department of Oral Medicine, Charles Clifford Dental Hospital, Sheffield S10 2SZ
| | - Tim Hodgson
- Consultant in Oral Medicine, Eastman Dental Hospital UCLH Foundation Trust and Eastman Dental Institute UCL, London
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20
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Di Fede O, Majorana A, Manfredi M, Pentenero M, Giuliani M. Odontoiatria di genere: la condizione femminile nella pratica odontoiatrica. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Liu C, Xie B, Yang Y, Lin D, Wang C, Lin M, Ge L, Zhou H. Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:584-90. [DOI: 10.1016/j.oooo.2013.07.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/21/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
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22
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In vitro culture system for keratinocytes obtained from oral lichen planus lesions. Clin Oral Investig 2013; 18:1195-1203. [DOI: 10.1007/s00784-013-1083-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 07/31/2013] [Indexed: 01/04/2023]
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23
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Payeras MR, Cherubini K, Figueiredo MA, Salum FG. Oral lichen planus: focus on etiopathogenesis. Arch Oral Biol 2013; 58:1057-69. [PMID: 23660124 DOI: 10.1016/j.archoralbio.2013.04.004] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 03/09/2013] [Accepted: 04/11/2013] [Indexed: 02/07/2023]
Abstract
Lichen planus is a chronic mucocutaneous inflammatory disease, which frequently affects the oral mucosa of white females over 40 years old. Its aetiology remains uncertain and the pathogenesis is still the object of much speculation. The present paper presents the most well known antigens, and describes the action of different cells and proteins associated with the development of that disease, as well as the possible agents involved with its malignant transformation. Different external agents, especially virus, and internal agents, like stress, and the heat shock protein antigen expression, associated or not, can alter the basal keratinocytes of the oral mucosa making them susceptible to apoptosis by CD8(+) cytotoxic T cell as well as activate matrix metalloproteinase and mast cell degranulation, which produce a great range of inflammatory mediators and cytokines determining the clinical onset of the disease. Regarding carcinogenesis, since it is a complex process and presents multifactorial origin, it is believed that there may be a synergism between intrinsic, such as inflammation mediators, and extrinsic agents (tobacco, alcohol, viral infections) for the OLP malignant transformation to occur. However, further studies are needed to better understand the origin, pathogenesis and process of malignant transformation of OLP.
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Affiliation(s)
- Márcia Rodrigues Payeras
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sol, Av. Ipiranga 6690, Porto Alegre, RS, Brazil.
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24
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Ynson ML, Forouhar F, Vaziri H. Case report and review of esophageal lichen planus treated with fluticasone. World J Gastroenterol 2013; 19:1652-1656. [PMID: 23539434 PMCID: PMC3602484 DOI: 10.3748/wjg.v19.i10.1652] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/08/2012] [Accepted: 01/24/2013] [Indexed: 02/06/2023] Open
Abstract
Lichen planus is a fairly common chronic idiopathic disorder of the skin, nails and mucosal surfaces. Esophageal involvement of this disease on the other hand is rare and only about 50 cases have been reported in literature. Given its rarity, it can be difficult to diagnose and may be easily misdiagnosed as reflux esophagitis. Currently, there are no clear recommendations on the optimal management of this disease and little is known about the best treatment approach. Systemic steroids are usually the first line treatment and offer a favorable response. In this report, we would like to present a novel approach in the management of esophageal lichen planus in a middle-aged woman treated successfully with swallowed fluticasone propionate 220 mcg twice a day for 6 wk, as evidenced by objective clinical findings. Based on our review of related literature and experience in this patient, we feel that a trial of swallowed fluticasone may be a prudent approach in the management of these patients since it has a more favorable side effect profile than systemic treatment.
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25
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Lee YC, Shin SY, Kim SW, Eun YG. Intralesional injection versus mouth rinse of triamcinolone acetonide in oral lichen planus: a randomized controlled study. Otolaryngol Head Neck Surg 2013; 148:443-9. [PMID: 23325710 DOI: 10.1177/0194599812473237] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the efficacy, relapse, and adverse effects between intralesional injection and mouth rinse of triamcinolone acetonide (TA) in patients with oral lichen planus (OLP). STUDY DESIGN A randomized controlled study. SETTING College medical center. SUBJECTS AND METHODS Forty consecutive patients, who had been diagnosed with OLP, were recruited. Participants were randomly divided into 2 groups using intralesional injection or mouth rinse of TA. The severity of pain and burning sensation on a 10-cm visual analog scale (VAS) and the Oral Health Impact Profile-14 (OHIP-14) were assessed at weeks 0, 1, 2, 3, 4, and 6. The signs of OLP were quantified using a special scoring system for OLP. The rate of relapse and the adverse effects were compared between both groups. RESULTS The VAS scores for pain and burning mouth sensation and objective scoring for OLP were significantly improved at 1, 2, 3, 4, and 6 weeks in both groups. The changes in the VAS for burning mouth sensation, OHIP-14, and objective scoring for OLP were similar between both groups. The change in the VAS for pain from baseline to week 1 in the intralesional injection group was significantly higher than in the mouth rinse group. The rate of adverse effects was significantly higher in the mouth rinse group than in the intralesional injection group (44.4% vs 5.0%). CONCLUSION The efficacies of both treatments were similar. The rate of adverse effects was significantly lower for intralesional injection of TA than mouth rinse of TA.
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Affiliation(s)
- Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
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26
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Pathomorphological and Immunohistochemical Analysis of Proliferative Activity of the Buccal Mucosal Epithelium in Lichen Planus. Bull Exp Biol Med 2012; 154:283-6. [DOI: 10.1007/s10517-012-1931-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ahmed Haji Omar A, Hietanen J, Kero M, Lukinmaa PL, Hagström J. Oral lichen planus and chronic junctional stomatitis: differences in lymphocyte subpopulations. Acta Odontol Scand 2012; 67:366-9. [PMID: 19626466 DOI: 10.1080/00016350903136605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is an oral counterpart or oral manifestation of the common skin disease lichen planus. Chronic junctional stomatitis (CJS) is a relatively unknown condition characterized by a stromal lymphocyte infiltrate, which is also a diagnostic feature of OLP. The differential diagnosis of OLP and CJS is unclear and they have been suggested to represent variants of the same disease. MATERIAL AND METHODS To investigate possible differences in lymphocyte (sub)populations between these two conditions, we immunostained 10 OLP and 10 CJS specimens for CD1-a, and the lymphocyte markers, CD3, CD4, CD5, CD8, and CD20. We scored the staining results by a four-step grading system and used the Fisher exact test to analyze them statistically. RESULTS The proportional amount of (CD20 positive) B lymphocytes was higher in CJS than in OLP and the predominance of CD4 positive T lymphocytes over CD8 positive T lymphocytes was stronger in OLP than in CJS. The differences were statistically significant. CONCLUSION The results reflect differences in the lymphatic infiltrate between OLP and CJS. Their significance needs further investigation.
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Oral lichen planus as a preneoplastic inflammatory model. J Biomed Biotechnol 2012; 2012:759626. [PMID: 22675259 PMCID: PMC3362930 DOI: 10.1155/2012/759626] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 03/16/2012] [Indexed: 01/24/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic oral inflammatory disease of unknown etiology. According to reports, 1-2% of OLP patients develop oral squamous cell carcinoma (OSCC) in the long run. While World Health Organization (WHO) classifies OLP as “a potentially malignant disorder,” it is still a matter of debate which mechanisms drive OLP to such a condition. The current hypothesis connecting OLP and OSCC is that chronic inflammation results in crucial DNA damage which over time results in cancer development. Initial studies investigating the OLP and OSCC link were mainly retrospective clinical studies. Over the past years, several amount of information has accumulated, mainly from molecular studies on the OLP malignant potential. This article is a critical review of whether OLP has a malignant potential and, therefore, represents a model of preneoplastic inflammation.
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Durrani O, Banahan K, Sheedy FJ, McBride L, Ben-Chetrit E, Greiner K, Vaughan RW, Kondeatis E, Hamburger J, Fortune F, Stanford MR, Murray PI, O'Neill LA, Wallace GR. TIRAP Ser180Leu polymorphism is associated with Behcet's disease. Rheumatology (Oxford) 2011; 50:1760-5. [PMID: 21705416 DOI: 10.1093/rheumatology/ker200] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES The initiating cause of Behçet's disease (BD) is unknown, but an aberrant response to infection has been suggested. In this study, single nucleotide polymorphisms in Toll-like receptors (TLRs) and associated molecules that have a sentinel function at mucosal surfaces were analysed in patients with BD. METHODS TLR expression was determined by immunohistochemistry in buccal mucosal tissue from patients with BD, in tissue from patients with lichen planus (LP) or pyogenic granuloma (PG) as disease controls, or from healthy individuals. Using SSP-PCR we analysed SNP in CD14, TLR2, TLR4 and TIRAP (TIR domain-containing adaptor protein) in patients with BD from different geographical regions. RESULTS TLR expression was increased in buccal lesions from patients with BD compared with healthy controls; however, a similar increase was seen in lesion tissue from patients with LP or PG, suggesting that this was a generalized inflammatory response as opposed to a BD-specific response. SNP analysis showed no association between CD14, TLR2 or TLR4 polymorphisms. However, TIRAP 180Leu was significantly associated with BD in UK, but not Middle Eastern, patients. CONCLUSION TLR expression showed no difference in tissue from patients with BD compared with either disease or healthy controls. Likewise, SNPs in TLR genes were no different from healthy controls. The association with the increased function variant of TIRAP suggests that encounter with a pathogen at mucosal sites will lead to increased cytokine production and tissue damage with persistence of mucosal lesions.
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Affiliation(s)
- Omar Durrani
- Academic Unit of Ophthalmology, School of Immunity and Infection, University of Birmingham, Vincent Drive, Birmingham B15 2TT, UK
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Girardi C, Luz C, Cherubini K, de Figueiredo MAZ, Nunes MLT, Salum FG. Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus. Arch Oral Biol 2011; 56:864-8. [PMID: 21377142 DOI: 10.1016/j.archoralbio.2011.02.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 12/23/2010] [Accepted: 02/07/2011] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to determine the salivary levels of dehydroepiandrosterone (DHEA) and cortisol and scores of depression, anxiety and stress in patients with oral lichen planus (OLP). STUDY DESIGN Thirty-one patients with a diagnosis of OLP were selected; they were matched by sex and age with 31 control patients. Symptoms of depression, anxiety and stress were investigated by the instruments Beck Depression Inventory, Beck Anxiety Inventory and Lipp's Inventory of Stress Symptoms for Adults, respectively. Saliva was collected in the morning and at night for the determination of DHEA and cortisol levels by radioimmunoassay. RESULTS There was no significant difference between the groups with respect to depression (P=0.832), anxiety (P=0.061) or stress (P=0.611), or with respect to morning and night salivary levels of DHEA (P=0.888, P=0.297) and cortisol (P=0.443, P=0.983). CONCLUSIONS The results suggest an association of OLP with anxiety. However, DHEA and cortisol levels did not differ between groups, which does not support any neuroendocrine aetiology for OLP.
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Affiliation(s)
- Carla Girardi
- Oral Medicine Division, São Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Ding G, Wang W, Liu Y, Zhang C, Wang S. Mesenchymal stem cell transplantation: A potential therapy for oral lichen planus. Med Hypotheses 2011; 76:322-4. [DOI: 10.1016/j.mehy.2010.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Accepted: 09/19/2010] [Indexed: 01/01/2023]
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32
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CD27 and CD38 lymphocytes are detected in oral lichen planus lesions. ACTA ACUST UNITED AC 2011; 111:211-7. [DOI: 10.1016/j.tripleo.2010.09.075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Revised: 05/19/2010] [Accepted: 09/23/2010] [Indexed: 11/19/2022]
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Xiong C, Li Q, Lin M, Li X, Meng W, Wu Y, Zeng X, Zhou H, Zhou G. The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trial. J Oral Pathol Med 2009; 38:551-8. [PMID: 19486267 DOI: 10.1111/j.1600-0714.2009.00796.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nowadays, it has been widely accepted that the local cell-mediated immunologic disorders may play an important role in the pathogenesis of oral lichen planus (OLP). Therefore, we sieved out polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) from various immunomodulators to evaluate the short-term therapeutic efficacy and clinical safety of intralesional BCG-PSN injection for erosive OLP. METHODS A total of 56 OLP patients were randomly assigned to receive either intralesional injection of 0.5 ml BCG-PSN every other day (31 of 56) or 10 mg triamcinolone acetonide (TA, a positive-controlled group, 25 of 56) every week for 2 weeks. After the cessation of treatment, those cured from erosion were followed up for 3 months. Another two researchers measured erosive areas and recorded visual analog scale (VAS) scores both at the start and the end of the treatment. We also registered adverse reactions and the recurrence intervals. RESULTS After 2-week treatment, 27 of 31 BCG-PSN-treated patients (87.1%) and 22 of 25 TA-treated patients (88.0%) healed. There were no statistical differences between the two groups in erosive areas (27.86 +/- 27.97 vs. 25.68 +/- 34.65, P = 0.801) and VAS scores (2.45 +/- 1.64 vs. 2.40 +/- 1.38, P = 0.946). Three of 31 BCG-PSN-treated patients (9.7%) vs. 2 of 25 TA-treated patients (8.0%) experienced the swelling or burning sensation (P = 0.827). A total of 49 of 56 patients were followed up. There were no statistical differences in the recurrence rates (33.3% vs. 45.5%, P = 0.386) and intervals (80.89 +/- 26.83 vs. 73.48 +/- 28.11, P = 0.419). CONCLUSIONS Topical intralesional BCG-PSN injection is as effective as TA for erosive OLP, which suggests that topical intralesional BCG-PSN injection can be a promising therapeutic alternative for erosive OLP, especially for those insensitive, or even resistant, to glucocorticoids.
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Affiliation(s)
- C Xiong
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041, China
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Abdel-Latif AM, Abuel-Ela HA, El-Shourbagy SH. Increased caspase-3 and altered expression of apoptosis-associated proteins, Bcl-2 and Bax in lichen planus. Clin Exp Dermatol 2009; 34:390-5. [PMID: 19309373 DOI: 10.1111/j.1365-2230.2008.03029.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disease of probable immune-based aetiology. The pathogenesis of LP is unclear, but apoptotic changes in epidermal (epithelial) cells have been reported. OBJECTIVE To evaluate apoptosis in LP through studying caspase-3 expression and to determine whether the apoptosis-associated proteins Bcl-2 and Bax are significantly involved in the pathogenesis of LP. METHODS In total, 25 lesional biopsy specimens [15 cutaneous LP (CLP) and 10 oral LP (OLP)] and 10 control specimens [5 normal skin and 5 normal oral mucosa] were studied using immunochemical methods for the expression of caspase-3, Bcl-2 and Bax proteins. RESULTS Compared with controls, a significant increase in caspase-3 and Bax protein expressions were found in LP lesions. Basal cell expression of caspase-3 was positive in 14 cases (56%), and 12 cases (48%) showed mild expression. Caspase-3 expression in inflammatory infiltrate was positive in 13 cases (52%). Of these, 12 cases (48%) showed mild positivity. Bax was localized mostly to the upper prickle layer. Basal cell expression of Bcl-2 was negative in 18 (72%) cases, with no significant difference between patients with LP and controls. Bcl-2 was expressed in the inflammatory infiltrate in 15 cases of LP (60%), showing mild expression in 12 cases (48%). Compared with CLP, there was a significant increase in caspase-3 expression in OLP, despite the nonsignificant difference in Bcl-2 and Bax protein expressions by the epithelial cells. CONCLUSION Increased caspase-3 and altered expression of Bcl-2 and Bax were found in LP, indicating the possible involvement of these proteins in the pathogenesis of the disease. The observed increase in apoptosis in OLP compared with CLP might explain the difference in clinical behaviour that distinguishes these LP variants.
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Affiliation(s)
- A M Abdel-Latif
- Department of Dermatology and Venereology and Faculty of Medicine, Tanta University, Tanta, Egypt.
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35
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Chandan VS, Murray JA, Abraham SC. Esophageal lichen planus. Arch Pathol Lab Med 2008; 132:1026-9. [PMID: 18517264 DOI: 10.5858/2008-132-1026-elp] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2007] [Indexed: 12/14/2022]
Abstract
Esophageal lichen planus is an underrecognized condition, with fewer than 50 cases reported to date. Unlike cutaneous lichen planus, esophageal lichen planus occurs almost exclusively in middle-aged or older women who also have oral involvement. It commonly involves the proximal esophagus and manifests as progressive dysphagia and odynophagia. Endoscopic findings can include lacy white papules, pinpoint erosions, desquamation, pseudomembranes, and stenosis. Histologic features of esophageal lichen planus have only rarely been illustrated. They differ from those of cutaneous disease in several respects, including the presence of parakeratosis, epithelial atrophy, and lack of hypergranulosis. Correct diagnosis of esophageal lichen planus is difficult but bears important therapeutic implications. It is typically a chronic and relapsing condition that can require systemic or local immunosuppressive therapy and repeated endoscopic dilatations for esophageal strictures. Esophageal lichen planus may have malignant potential, as evidenced by 3 patients who developed squamous carcinoma of the esophagus after longstanding disease.
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Affiliation(s)
- Vishal S Chandan
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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36
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Mitamura J, Onodera K, Ooya K. Histopathological and immunohistochemical study of oral lichen planus in the buccal mucosa: relationship between clinicopathological features and histometrical analysis. ACTA ACUST UNITED AC 2008. [DOI: 10.3353/omp.13.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The expression of TNF-α and ICAM-1 in lesions of lichen planus and its implication. ACTA ACUST UNITED AC 2007; 27:739-41. [DOI: 10.1007/s11596-007-0632-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Indexed: 12/12/2022]
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Kose O, Stewart J, Waseem A, Lalli A, Fortune F. Expression of cytokeratins, adhesion and activation molecules in oral ulcers of Behçet's disease. Clin Exp Dermatol 2007; 33:62-9. [PMID: 17983454 DOI: 10.1111/j.1365-2230.2007.02558.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Behçet's disease (BD) is a multisystemic inflammatory disorder of which oral aphthous ulceration is a major feature. AIMS/HYPOTHESIS. This study sought to determine the role of cytokeratins, differentiation and proliferation markers, gammadelta T-cell adhesion and activation molecules, and apoptotic markers in oral ulcers of this disease. METHODS Expression patterns for cytokeratins (K1, K6, K14, K15, K16), integrins (beta1 and alpha6), CD3 T-cell and gammadelta T-cell adhesion and activation markers [CD40, CD44, CD54, ICAM-1, CD58, leucocyte function-associated antigen (LFA)-3, vascular cell adhesion molecule-1 (VCAM-1), CD86], and cellular proliferation and differentiation markers (Ki67 and involucrin), and apoptotic markers (CD95 and Bcl-2) in oral ulcers of nine patients with BD and four healthy controls were analysed by immunohistochemistry. RESULTS K14, K15 and involucrin expression were unchanged, whereas Ki67, the proliferation marker, was reduced by around 50%. K1, K6, K16, beta1 integrin and the apoptotic marker CD95 were upregulated, whereas alpha6 integrin and Bcl-2 were downregulated in BD samples. CD3 and gammadelta T-cell expression and other adhesion molecules including CD44, CD86, CD58 (LFA-3), VCAM-1 and intercellular adhesion molecule-1 (CD54) were upregulated, whereas CD40 showed little change. CONCLUSIONS Our data demonstrates changes in cell-cell and cell-extracellular matrix interactions that affect cell homeostasis and may participate in the formation of oral ulcers in BD.
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Affiliation(s)
- O Kose
- Gulhane School of Medicine (GATA), Department of Dermatology, Ankara, Turkey
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Bascones-Ilundain C, Gonzalez-Moles MA, Esparza G, Gil-Montoya JA, Bascones-Martinez A. Significance of liquefaction degeneration in oral lichen planus: a study of its relationship with apoptosis and cell cycle arrest markers. Clin Exp Dermatol 2007; 32:556-63. [PMID: 17608758 DOI: 10.1111/j.1365-2230.2007.02457.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the utility of liquefaction degeneration as a marker of apoptosis in oral lichen planus (OLP). METHODS TdT-mediated dUTP-biotin nick-end labelling (TUNEL) assay and immunohistochemical methods were used to detect p21 proteins and the active form of caspase 3 in 32 tissue samples of oral mucosa with OLP and 20 samples of normal oral mucosa. RESULTS Liquefaction degeneration was moderate or intense in 27.5% (n=8) and slight in 72.4% (n=21) of OLP samples. There was low expression of apoptosis markers (TUNEL, active caspase 3 form), which was not significantly associated with liquefaction degeneration of the basal cell layer. Basal and suprabasal expression of p21 was significantly more frequent in samples with more intense liquefaction degeneration of basal cells (P<0.01). CONCLUSIONS Our results demonstrate that liquefaction degeneration, as a morphological expression of T lymphocyte attack, does not unequivocally indicate apoptosis. Attacked basal cells more frequently respond with cell-cycle arrest or senescence than with apoptosis.
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Affiliation(s)
- C Bascones-Ilundain
- Department of Periodontics and Dentistry, Complutense University, Madrid, Spain
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40
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Villarroel Dorrego M, Speight PM, Barrett AW. CD40 in human oral epithelia. Oral Oncol 2007; 43:626-33. [PMID: 17307023 DOI: 10.1016/j.oraloncology.2006.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 11/30/2006] [Accepted: 12/01/2006] [Indexed: 02/04/2023]
Abstract
CD40 is a transmembrane glycoprotein belonging to the tumour necrosis factor receptor superfamily, which has a role in a number of biological functions, including the regulation of cell growth and division, and cell mediated immunity. Although originally described on leucocytes, principally B lymphocytes, there is now abundant evidence for the cellular diversity of CD40. The aim of this article is to review the available data on CD40 in oral epithelium, principally that lining the oral mucosa, but also that of the salivary glands.
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Affiliation(s)
- Mariana Villarroel Dorrego
- Department of Oral Pathology, Oral Medicine and Oral Surgery, Universidad Santa Maria and Institute of Dental Research, Universidad Central de Venezuela, Caracas, Venezuela
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Gustafson J, Eklund C, Wallström M, Zellin G, Magnusson B, Hasséus B. Langerin-expressing and CD83-expressing cells in oral lichen planus lesions. Acta Odontol Scand 2007; 65:156-61. [PMID: 17514517 DOI: 10.1080/00016350601137251] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Dendritic Langerhans cells (LCs) have been attributed a role in the pathogenesis of lichen planus as autoantigen-presenting cells initiating expansion of autoreactive T cells. Langerin and CD83, which are cell molecules expressed on LCs, are associated with antigen presentation. The present study examined expression of Langerin and CD83 molecules on LCs in patients with oral lichen planus (OLP). MATERIAL AND METHODS Biopsies were obtained from seven patients with OLP. Oral mucosa from seven healthy subjects served as controls. Monoclonal antibodies (mAbs) were used in standard immunohistochemical procedures to visualize CD1a-, Langerin-, and CD83-molecule-expressing cells. RESULTS CD1a+ and Langerin+ cells were found in significantly higher frequencies in OLP epithelium compared with healthy oral epithelium (p<0.01 and p<0.05, respectively); however, the frequency of CD83+ cells did not differ (p>0.05). The connective tissue in OLP lesions showed significantly higher frequencies of CD1a+, Langerin+, and CD83+ cells compared with healthy connective tissue (p<0.01, p<0.01, and p<0.05). CD1a+ and Langerin+ cells in OLP and healthy epithelium had a dendritic morphology. CONCLUSIONS The study shows increased numbers of CD1a- and Langerin-expressing LCs in OLP compared with healthy controls. In the connective tissue, CD83+ cells with dendritic morphology were localized to regions of lymphocyte clusters. The presence of CD83+ dendritic cells in areas of lymphocyte clusters in the connective tissue of OLP lesions indicates the possibility of ongoing autoantigen presentation.
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Affiliation(s)
- Jenny Gustafson
- Section of Oral Immunology/Clinic for Oral Medicine, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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Piattelli A, Carinci F, Iezzi G, Perrotti V, Goteri G, Fioroni M, Rubini C. Oral lichen planus treated with 13-cis-retinoic acid (isotretinoin): effects on the apoptotic process. Clin Oral Investig 2007; 11:283-8. [PMID: 17483968 DOI: 10.1007/s00784-007-0117-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 04/18/2007] [Indexed: 11/30/2022]
Abstract
The aim of the present study is to verify the efficacy of isotretinoin in oral lichen planus (OLP). In a double-blind study, ten patients with biopsy-proven OLP were treated for 4 months with 0.1% isotretinoin gel and another ten patients with placebo. At the end of the first period of observation, the patients who had been given the placebo were given isotretinoin for a further 4 months. A complete response was defined as the disappearance of the lesions as assessed by inspection, whereas a partial response was defined as a 50% or more reduction in the size of the lesions. All patients treated with isotretinoin showed a significant improvement of the oral lesions, whereas in the patients who were given the placebo, the size of the lesions remained the same. The patients who were given isotretinoin after the placebo showed a reduction in lesions. In total, there were ten complete and ten partial responses. Lesions were analysed histologically and immunohistochemically with antibodies against bcl-2 and Ki-67. Ki-67 and bcl-2 have statistical significant increased values from before to after treatment, whereas apoptotic bodies decreased one. All these facts could have contributed to the partial or complete regression of OLP lesions. The increase in Ki-67 positive cells show that the epithelium requires for enhanced proliferation and healing. The present results revealed a disturbed cell death programme in OLP that could underline an abnormal epithelial differentiation. The results of this pilot study show that the topical use of isotretinoin is effective in treating OLP.
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Bagis B, Atilla P, Cakar N, Hasanreisoglu U. Immunohistochemical evaluation of endothelial cell adhesion molecules in human dental pulp: effects of tooth preparation and adhesive application. Arch Oral Biol 2007; 52:705-11. [PMID: 17324377 DOI: 10.1016/j.archoralbio.2007.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Revised: 12/27/2006] [Accepted: 01/06/2007] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Studies have demonstrated that restorative procedures can initiate pulpal inflammation. Adhesion molecules on endothelial cells mediate the leukocyte-endothelium interaction, which is the fundamental event of inflammation. The aim of this study was to evaluate possible changes in the endothelial cell adhesion molecules (CAMs) of human dental pulp with tooth preparation, and after the application of one-step self-etch adhesive. MATERIALS AND METHODS Twenty healthy human premolars and third molars scheduled to be extracted for orthodontic reasons were randomly assigned to four experimental groups. Group 1 involved sound intact teeth representing the controls. In group 2, teeth were prepared for full crown and extracted within 2h. Groups 3 and 4 comprised the teeth coated with one-step self-etch adhesive, iBond Gluma inside following the preparation and extracted after 24 and 48h, respectively. Tissue distribution and staining intensity of CAMs including E-selectin, P-selectin, ICAM-1, VCAM-1 and PECAM-1 was investigated in the pulp samples using monoclonal antibodies and the streptavidin-biotin-horse-radish immunoperoxidase procedure. The assessment of immunohistochemical reactions was performed by two independent observers using a semi-quantitative scale. RESULTS All the CAMs evaluated were expressed by the healthy pulp tissues. Significant alterations in the distribution and staining intensity of CAMs were detected following tooth preparation. One-step self-etch adhesive tested in the present study induced inflammatory reactions in the pulp (P<0.05, Mann-Whitney U-test). CONCLUSION It seems evident that tooth preparation for full crown and application of one-step self-etch adhesive on prepared teeth had a potential to interfere with the inflammatory response.
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Affiliation(s)
- Bora Bagis
- Department of Prosthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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44
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Xia J, Li C, Hong Y, Yang L, Huang Y, Cheng B. Short-term clinical evaluation of intralesional triamcinolone acetonide injection for ulcerative oral lichen planus. J Oral Pathol Med 2006; 35:327-31. [PMID: 16762012 DOI: 10.1111/j.1600-0714.2006.00441.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Efforts are made in a continued searching for novel therapies for symptomatic oral lichen planus (OLP). This study aimed to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TA) injection for ulcerative OLP. METHODS Forty-five patients with clinical and histologically confirmed ulcerative OLP on bilateral buccal mucosa, one for treatment and the other for control, were studied. All participants received 0.5 ml TA (40 mg/ml) on experimental sites. Visual analogue scale score and lesion areas were recorded at the time of injection and 1-week interval. After 2 weeks, if the treated ulceration reduced < 81% in size, a second injection was given. RESULTS The treated group gave rapid relief of signs and symptoms, while the control group showed minimal decrease. 38 (84.4%) patients demonstrated complete response in ulceration size. No complications were noted with TA injections. CONCLUSIONS Intralesional TA injection in ulcerative OLP is effective and safe in achieving lesion and pain regression.
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Affiliation(s)
- Juan Xia
- Department of Oral Medicine, Guanghua School of Stomatology, Sun Yat-sen University, No. 56 Lingyuanxi Road, Guangzhou, Guangdong 510 055, China
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Abstract
The mucosal lining of the respiratory and digestive systems contains the largest and most complex immune system in the body, but surprisingly little is known of the immune system that serves the oral mucosa. This review focuses on dendritic cells, particularly powerful arbiters of immunity, in response to antigens of microbial or tumor origin, but also of tolerance to self-antigens and commensal microbes. Although first discovered in 1868, the epidermal dendritic Langerhans cells remained enigmatic for over a century, until they were identified as the most peripheral outpost of the immune system. Investigators' ability to isolate, enrich, and culture dendritic cells has led to an explosion in the field. Presented herein is a review of dendritic cell history, ontogeny, function, and phenotype, and the role of different dendritic cell subsets in the oral mucosa and its diseases. Particular emphasis is placed on the mechanisms of recognition and capture of microbes by dendritic cells. Also emphasized is how dendritic cells may regulate immunity/tolerance in response to oral microbes.
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Affiliation(s)
- C W Cutler
- Department of Periodontics, 110 Rockland Hall, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794-8703, USA.
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46
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Abstract
Ulcers commonly occur in the oral cavity, their main symptom being pain. There are different ways to classify oral ulcers. The most widely accepted form divides them into acute ulcers--sudden onset and short lasting--and chronic ulcers--insidious onset and long lasting. Commonest acute oral ulcers include traumatic ulcer, recurrent aphthous stomatitis, viral and bacterial infections and necrotizing sialometaplasia. On the other hand, oral lichen planus, oral cancer, benign mucous membrane pemphigoid, pemphigus and drug-induced ulcers belong to the group of chronic oral ulcers. It is very important to make a proper differential diagnosis in order to establish the appropriate treatment for each pathology.
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Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina Bucal y Periodoncia, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, Spain
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Abstract
Recent studies have shown that the recognition of lipid antigens by the immune system is important for defence against infection and other diseases, and that lipid-specific responses occur at higher frequencies than previously suspected. Thanks to several recent advances in this field, we now have a better appreciation of the molecular and cellular requirements of T-cell stimulation by lipids. These findings have raised new questions about the mechanisms of lipid presentation, the priming and clonal expansion of lipid-specific T cells, and their differentiation into memory cells. A greater understanding of lipid-specific T cells and the molecular mechanisms of lipid immunogenicity should facilitate the development of lipid-based vaccines.
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Affiliation(s)
- Gennaro De Libero
- Experimental Immunology, Department of Research, University Hospital, Basel 4031, Switzerland.
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48
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Cooper SM, Prenter A, Allen J, Dean D, Wojnarowska F. The basement membrane zone and dermal extracellular matrix in erosive lichen planus of the vulva: an immunohistochemical study demonstrating altered expression of hemidesmosome components and anchoring fibrils. Clin Exp Dermatol 2005; 30:277-81. [PMID: 15807689 DOI: 10.1111/j.1365-2230.2005.01751.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Histopathology demonstrates disruption of the basal layer of the epidermis in lichen planus (LP) and altered expression of basement membrane zone (BMZ) components occurs in cutaneous and oral LP. This is the first study in erosive LP of the vulva to investigate the expression of components of the BMZ and extracellular matrix by indirect immunofluorescence. Six biopsies from lesional vulval erosive LP were compared with two biopsies from normal vulva and five biopsies from normal skin. In erosive vulval LP there was widespread disruption of several BMZ components compared to normal skin. The hemidesmosome antigens were disrupted and attenuated, or absent. Expression of lamina lucida proteins and anchoring filaments also showed some alteration. Lamina densa components were altered and in particular there was very marked thickening, streaking and fragmentation of the anchoring fibrils. Some dermal extracellular matrix proteins were increased. This study has demonstrated widespread damage to the BMZ in erosive LP of the vulva, in particular the hemidesmosomes (alpha6beta4 integrin, BP230, BP180) and anchoring fibrils (collagen VII). This suggests an alteration in antigenic expression in the BMZ that may lead to exposure of epitopes and thus make these proteins vulnerable to attack by autoantibodies.
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Affiliation(s)
- S M Cooper
- Department of Dermatology, Oxford Radcliffe Hospitals, Oxford, OX7 2LJ, UK.
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DeRossi SS, Ciarrocca KN. Lichen planus, lichenoid drug reactions, and lichenoid mucositis. Dent Clin North Am 2005; 49:77-89, viii. [PMID: 15567362 DOI: 10.1016/j.cden.2004.08.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Lichen planus is a common mucocutaneous disease affecting a significant portion of the general population. This article reviews the most current concepts on the epidemiology, etiology, pathogenesis, clinical presentations, and treatment of oral lichen planus, lichenoid drug reactions, and lichenoid mucositis.
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Affiliation(s)
- Scott S DeRossi
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
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Kastelan M, Prpić Massari L, Gruber F, Zamolo G, Zauhar G, Coklo M, Rukavina D. The role of perforin-mediated apoptosis in lichen planus lesions. Arch Dermatol Res 2004; 296:226-30. [PMID: 15452725 DOI: 10.1007/s00403-004-0512-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2004] [Revised: 08/16/2004] [Accepted: 08/26/2004] [Indexed: 12/31/2022]
Abstract
Lichen planus is recognized as a T-cell-mediated disease. Histologically, it is characterized by the formation of colloid bodies representing apoptotic keratinocytes. The apoptotic process mediated by CD8(+) cytotoxic T lymphocytes (CTLs) and NK cells mainly involves two distinct pathways: the perforin/granzyme pathway and the Fas/FasL pathway. So far, little is known regarding the role of perforin-mediated apoptosis in lichen planus. In the present study, the expression and distribution of perforin, T and NK cell subsets in the epidermis and dermis of lesional and nonlesional lichen planus skin were studied. Skin biopsy specimens from lesional and nonlesional skin of ten patients with lichen planus and eight healthy persons were analysed by immunohistochemistry. Significant accumulation of T cells, particularly of CD4(+) and CD8(+) subsets, was found in both epidermis and dermis of lichen planus lesions compared with nonlesional and healthy skin. There were no significant differences in the incidence of NK cells (CD16(+) and CD56(+)) between lesional, nonlesional and healthy skin. Perforin expression was significantly upregulated in the epidermis of lichen planus lesions. In conclusion, accumulation of perforin(+) cells in the epidermis of lichen planus lesions suggest a potential role of perforin in the apoptosis of basal keratinocytes.
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Affiliation(s)
- Marija Kastelan
- Department of Dermatology, Clinical Hospital Centre Rijeka, Kresimirova 42, HR-51000 Rijeka, Croatia.
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