Abstract
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.
Highlights
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort
photodynamic therapy (PDT) treatment is accompanied by clinical amelioration of OLP
OLP were treated with PDT within 14 days (4 sessions; day 1, 3, 7, and 14; Fig. 1) and clinical parameters were assessed at day 1 and day 28, 42, and 56
Summary
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The erosive and atrophic forms may present with remarkable burning and pain sensations that restrict food intake and performance of oral hygiene measures leading to weight loss, nutritional deficiencies[7,8], loss of teeth and function with a major impact on the quality of life (QOL) These OLP forms are often resistant to treatment[9,10] and have a higher tendency to malignant transformation[11,12]. PDT induces a decrease of CD4+CD137+ and CD8+CD137+ and IL-17+ T cells and CXCL10 plasma levels
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