Abstract
The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.
Highlights
Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with an estimated prevalence of around 0.1 to 2% worldwide that mainly affects middle-aged and elderly women.[1,2,3,4,5,6,7] Currently, the disease has been clinically classified as reticular/plaque, erythematous/erosive, or ulcerative forms, and more than one clinical type may occur in the same patient.[8]
The present systematic review focused on the current knowledge about the neuro-immuneendocrine profile of OLP based on the perspective that cellular immunity-mediated mechanisms and/or neuroendocrine dysregulation could act as factors precipitating OLP
Psychological stresses could exacerbate or precipitate cutaneous LP through neuroendocrine and neuroimmunologic mechanisms. It is worth relating the cutaneous LP with OLP, considering that we reviewed the association between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients
Summary
Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with an estimated prevalence of around 0.1 to 2% worldwide that mainly affects middle-aged and elderly women.[1,2,3,4,5,6,7] Currently, the disease has been clinically classified as reticular/plaque, erythematous/erosive, or ulcerative forms, and more than one clinical type may occur in the same patient.[8] The classic manifestation of the disease is a reticular white line pattern (Wickham striae), with a bilateral and symmetrical presentation, and an asymptomatic course.[3,9,10,11] The etiopathogenesis is still unknown, but it is accepted that development of the lesions is related to a T cell response against epithelial cells as a result of different types of stimuli, including medications as well as genetic and psychological factors.[8,12,13]
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