Atrophic-erosive Oral Lichen Planus Research Articles

Comparing the Effectiveness and Salivary Levels of TNF-alpha in Patients with Oral Lichen Planus Treated with Topical Clobetasol Propionate and Fluocinolone Acetonide

Objectives: The purpose of this study was to compare the effectiveness and salivary levels of tumor necrosis factor-alpha (TNF-α) in patients with oral lichen planus (OLP) treated with topical clobetasol propionate (CP) and fluocinolone acetonide (FA). Methods: A total of 26 patients diagnosed with erosive-atrophic OLP were randomlydivided into 2 groups: the first group received CP 0.05%, and the other received FA 0.1%. Pain scores, clinical scores, and saliva samples from the patients were collected for analysis both prior to treatment initiation and after 4 weeks. Salivary TNF-α levels were evaluated using an immunology multiplex assay. The Wilcoxon signed-rank test and the Mann-Whitney U test were used for intra-group and inter-group comparisons, respectively. Results: Both treatments showed significant reductions in pain scores, clinical scores, and salivary TNF-α levels compared with the pre-treatment values (p<0.05). After 4 weeks of treatment, CP 0.05% demonstrated a greater reduction in clinical score compared with FA 0.1% (p<0.05). Conclusions: CP 0.05% and FA 0.1% effectively treat OLP. CP 0.05% demonstrated a quicker clinical score reduction than FA 0.1% over four weeks. Additionally, both steroids reduced salivary TNF-α levels, which could indicate the possibility of using diseaserelated biomarkers for monitoring.

Clinical value and potential circulating of miR-99a as tumor suppressor biomarker in serum of oral squamous cell carcinoma and erosive atrophic lichen planus

ObjectivesOral squamous cell carcinoma (OSCC) is the most common type of oral neoplasms that consist of more over 90% of oral cancers. It was demonstrated that erosive atrophic oral lichen planus (OLP) has potential of malignancy transformation into OSCC. The microRNAs are non-coding regulator sequences involved in cancer process. The miR-99a involve in growth, proliferation, migration, invasion, and metastasis of tumor cells. Therefore, we evaluated miR-99a expression in serum of OSCC and erosive atrophic OLP patients in comparison to healthy control individuals to more investigate about level of miR-99a expression in potential premalignant disorder (erosive atrophic OLP) in comparison to malignant transformation form (OSCC). Gene ontology (GO) and pathway analyses were performed to better understand the importance of miR-99a in OSCC. Materials and methodsIn this cross-sectional study, total 90 serum samples from OSCC patients (n = 30), erosive atrophic OLP (n = 30) and healthy control individuals (n = 30) were collected, and then evaluated for miR-99a expression by qPCR. Pathway analysis and protein-protein interaction were done using STRING (v: 12.0), and (GO) terms and related genes were extracted from the GO online search tool. The statistical analysis was evaluated by Kruskal Wallis, Chi-Square, Kruskal Wallis, Spearman and Mann-Whitney tests. The p-value less than 0.05 was considered statistically significant. ResultsmiR-99a expression down regulated in OSCC in comparison to erosive atrophic OLP and control groups (p < 0.05). The miR-99a up regulated in grade I more than grades II and III (p < 0.05). We showed upregulation of miR-99a in early stage more than advanced stage (p < 0.05). Expression of miR-99a reduced accordance to the increasing of tumor size and lymph involvement levels (p < 0.05). The 165 determined targets were classified into three domains. The most significant enrichment in biological processes, cellular components, and molecular functions was in the cellular nitrogen compound biosynthetic process, cytosolic ribosome, and protein binding, respectively. ConclusionsWe highlighted tumor suppressive role of miR-99a in OSCC patients. It seems that miR-99a can be considered a valuable biomarker for the early diagnosis of erosive atrophic OLP before transformation. Clinical relevanceOur results may help to better understand the prognostic factor for oral squamous cell carcinoma to evaluate survival and subsequent tumor development. And it may also help to understand the pathogenesis of OSCC.

Comparative Evaluation of Pimecrolimus Cream 1% and Triamcinolone Aceonide Paste in Treatment of Atrophic-Erosive Oral Lichen Planus.

This study was done to assess the effects of pimecrolimus cream 1% and triamcinolone aceonide paste in the treatment of atrophic-erosive oral lichen planus. A total of 100 patients diagnosed both clinically and histopathologically as lichen planus were considered in the present study. Subjects were classified into two groups. Group I: Patients in this group were treated with 1% pimecrolimus cream and Group II: Patients falling under this group were treated with triamcinolone acetonide in 0.1% concentration. None of the patients reported worsening clinical signs and symptoms. No significant difference in efficacy and reduction in burning sensation of either pimecrolimus or trimcinolone acetonide was present. Present study found no significant difference in the efficacy of both the agents studied.

Role of human papillomavirus in the pathogenesis of oral lichen planus

Oral Lichen Planus (OLP) is a chronic inflammatory disease with a cell-mediated immunopathologic response. Although OLP has been studied extensively for decades, its exactaetiologyremains unclear. Autoimmunity, viruses like Hepatitis C Virus (HCV), Human Papillomavirus (HPV), and stress have all beenhypothesized in recent articles. HPVs are epitheliotropic viruses with an affinity for keratinocytes and are principally found in the anogenital tract, urethra, skin, larynx, tracheobronchial and oral mucosa. This article aimed to review the frequency of HPV prevalence in OLP. A computer database search was performed through the use of PubMed from 1987 to 2021. The summary showed that the association of HPV and OLP varied significantly by geographic population. The correlation of HPV and erosive-atrophic oral lichen planus was comparable and well above that of HPV and non-EA-OLP. Among HPV genotypes, HPV 16 showed an extremely strong association with OLP, and HPV 18 showed a relatively strong one.

Preliminary evaluation of the utility of optical coherence tomography in detecting structural changes during photobiomodulation treatment in patients with atrophic-erosive oral lichen planus.

Oral lichen planus (OLP) is a common oral inflammatory condition. Against symptomatic atrophic-erosive OLP, topical steroids, or photobiomodulation (PBM) are deployed. Optical coherence tomography (OCT) provides a real-time, non-invasive, tissue investigation. Aim of this study was to evaluate modifications of OCT pattern in patients with painful atrophic-erosive OLP, before and after treatment with PBM, comparing those results with patients treated with topical steroid. Two groups of 20 OLP patients were evaluated. Group A underwent two daily application of 0.05 % clobetasol propionate for 8 weeks; group B was treated with eight weekly PBM sessions using a 980/645 nm diode laser. OCT scans were performed before and after treatment, and six months after end of the proposed protocol. Changes of width of stratified epithelium (EP) and lamina propria (LP) were quantified. After 8-weeks, both groups experienced a significant increase of EP width (p < 0.05), and a significant decrease of LP width (p < 0.05), with Δ-EP in Group A significantly higher than Group B (p = 0.0015); conversely, Δ-LP was not significantly different (p > 0.05). After six months, significant increase of EP width remained only in group B (p = 0.01), with no significant decrease of LP mean width in both groups (p > 0.05). Increase of EP and decrease of LP might be explained as consequence of clobetasol and PBM ability to promote epithelial healing, and to reduce interface inflammation. When investigated with OCT, clobetasol appears to provide more significant short-term structural changes, whereas PBM might guarantee long-term alterations.

In-vivo usefulness of optical coherence tomography in atrophic-erosive oral lichen planus: Comparison between histopathological and ultrastructural findings

Oral lichen planus (OLP) is a common premalignant chronic inflammatory disorder. Optical Coherence Tomography (OCT) provides a real-time, non-invasive, and in-situ optical signature using light of varying wavelengths to examine tissue. Aim of the present study was to assess the possible role of OCT as diagnostic tool for atrophic-erosive OLP by examining OCT scans of healthy buccal mucosa, and comparing their ultrastructural features with those of a buccal mucosa affected by atrophic-erosive OLP, using their histopathological counterparts as the gold standard. Through grayscale (enface scan) and an application in which the vascularization of the tissue is visible (dynamic scan), it was possible to distinguish the healthy from the lichenoid pattern from 20 controls (12 M; 8 F; mean age: 41.32 years) and 20 patients with histologically confirmed atrophic-erosive OLP (7 M; 13 F; mean age: 64.27 years). In detail, mean width of stratified squamous epithelium (EP) and lamina propria (LP) were evaluated. Among controls, EP and LP showed a mean width of 300 (±50) and of 600 (±50) μm respectively; among cases, disruption of membrane basement prevented from any measurement. Furthermore, a differential pattern of EP and LP emerged between the two groups: a light-grayish, hypo-reflective, homogeneous area of EP recurring in controls turned into a hyper-reflective, non-homogeneous area among cases. Dynamic scan showed a differential profile of LP vascularization, varying from a hypo-reflective red area with small blood vessels in the control group, to a hypo/hyper-reflective area, completely overrun by a denser, wider blood flow amid OLP cases. Although histopathological examination remains the gold standard for OLP diagnosis, OCT could be a potentially helpful tool for the clinician and the pathologist, since it allows analysis of the vascularization of the sample without adversely affecting histological processing.

Efficacy of 1064 Q switched Nd:YAG laser in the treatment of oral lichen planus

Background: The erosive-atrophic form of oral lichen planus (OLP) is usually presented with severe pain and burning sensation that is usually refractory to traditional treatment. Topical corticosteroid is considered the first line despite their adverse effects. Therefore, new therapeutic approaches are required.Aim: This study aimed to examine the effectiveness of Nd:YAG laser in the treatment of long-standing erosive-atrophic OLP.Patients and methods: Twenty-four patients diagnosed with OLP were included in this study. A total of 59 lesions was assessed as regards to the degree of pain by visual analog scale and clinical scores by Thongprasom sign scoring system before and after treatment. All patients were treated by Nd:YAG laser therapy with (1064 nm 0.5 W, 30 s, 1.2 J/cm2) three times weekly and for 1 month. Treatment efficacy index was determined after the end of therapy.Results: A significant pain reduction was detected after Nd:YAG laser treatment (p < .0001). In addition to that, complete resolution was achieved in about 37.3% of the lesions and improvement in clinical signs was found in 59.3% of the lesions. By the end of therapy, about 30.5% showed score 1 while 11.9% of them were scored 3. Also, 8.5% of the lesion was scored 2, 6.8% were scored 4 and 5.1% were scored 5. Actually, all of the participating patients showed some degree of improvement and most of them achieved moderate recovery.Conclusion: The results of this study can indicate that Nd:YAG laser is an effective modality that can be used safely in the management of erosive-atrophic OLP.

Effects of Low Level Laser Therapy on Erosive-atrophic Oral Lichen Planus.

The erosive-atrophic form of oral lichen planus (OLP) is associated with severe pain and burning sensation and is often unresponsive to treatment. Topical corticosteroids are considered as a medication of first choice but they can produce adverse effects. Therefore, new therapeutic approaches are required. The aim of this study was to investigate the effectiveness of biomodulation with diode laser in patients presenting with long-standing erosive-atrophic OLP. Twelve patients, clinically and histologically diagnosed with OLP, participated in this study. The level of pain and the clinical scores of total 59 lesions were recorded before treatment using visual analog scale and Thongprasom sign scoring system respectively. All patients received low level laser therapy (LLLT) with diode laser (810 nm) with parameters (0.5 W, 30 s, 1.2 J/cm2) three times weekly for a month. The response rate was assessed according to the decrease in pain and sign scores. Treatment efficacy index was calculated. There was a significant reduction in pain after LLLT (p<0.0001). Improvement in clinical signs was achieved in 59.3% of the lesions. At the end of the treatment 5.1% of the lesions exhibited score 5; 6.8% - score 4, 11.9% of the lesions were scored 3 and 8.5% and 30.5% showed score 2 and score 1, respectively. Complete resolution was revealed in 37.3% of the lesions. All patients experienced some degree of improvement. Most of the cases showed moderate recovery. The present results indicate that LLLT is an effective and harmless modality for management of erosive-atrophic OLP.

Evaluation of Combined Topical Ozone and Steroid Therapy in Management of Oral Lichen Planus.

AIM:The present study aims to assess the therapeutic effect of the combination of topical ozone and steroid therapy in comparison to topical ozone alone versus topical steroid as a control in the management of atrophic - erosive oral lichen planus (OLP).METHODS:Sixty-six patients are having atrophic-erosive OLP were included in the study. They were randomly divided into three equal groups to be treated with topical corticosteroids alone (steroid group) as control, topical ozone alone (ozone group) or combination of topical steroids and ozone (combined group). Assessment of pain and sign scores was done before and after each treatment modality.RESULTS:The results revealed that the greatest significant percentage of change and subsequent improvement in pain and sign scores were recorded in the combined group.CONCLUSION:Reported data in this study using the combination of ozone and steroid therapy could provide a new promising safe and effective adjunct therapy for management of OLP.

Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus.

The efficacy of photodynamic therapy (PDT) or low level laser therapy (LLLT) in the treatment of oral lichen planus (OLP) is debatable. The aim of this study was to compare the effects of PDT, LLLT or topical corticosteroid application in the treatment of erosive-atrophic OLP. Forty-five adult patients with erosive-atrophic biopsy-proven OLP on the tongue or buccal mucosa (size ≤3 cm) were randomly divided into three groups. Group-1: patients receiving PDT topical application of 50 μl toluidine blue (1 mg/ml) with micropipette and after 10 min treated by laser irradiation using GaAlAs laser (630 nm, 10 mW/cm2, continuous wave, spot size: 1 cm2); Group-2: patients receiving LLLT using diode laser (630 nm, 10 mW, continuous wave, spot size: 1 cm2); and Group-3: patients receiving topical corticosteroid applications consisting of dexamethasone (0.5 mg in 5 ml water) mouthwash for 5 min. Demographic data, type, and severity of the lesions and pain were recorded before and after treatment and then at the 1 year follow-up. There was a significant difference in sign score changes before and after the treatment in the PDT group (p = 0.03), LLLT group (p = 0.04) and in the control group (p = 0.02). There was a statistically significant difference between group-1 (p = 0.001) and group-2 (p = 0.001) against group-3 before and after treatment. Mean amount of improvement in pain was significantly greater in the control group in comparison with the PDT and LLLT groups (p < 0.001). The efficacy index of the PDT group improved significantly more than the LLLT (p = 0.001) and corticosteroid groups (p = 0.001). Within the limits of the present RCT, it is indicated that PDT and LLLT are effective in the treatment of erosive-atrophic forms of OLP in adult patients. However, further comparative clinical trials are needed to obtain strong conclusions in this regard.

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

BackgroundThe role of human papilloma virus (HPV) in oral lichen planus (OLP) is controversial.ObjectivesThe primary aim of the current study is to calculate the pooled risk estimates of HPV infection in OLP when compared with healthy controls.MethodsBibliographic searches were conducted in three electronic databases. Articles on the association between HPV and OLP were selected from case-control studies or cross-sectional studies, following predefined criteria. Pooled data were analyzed by calculating odds ratios (OR) and 95% confidence interval (CI).ResultsOf the 233 publications identified, 22 case-control studies met the inclusion criteria. Collectively, 835 cases and 734 controls were available for analysis. The summary estimate showed that OLP patients have significantly higher HPV prevalence (OR: 6.83; 95% CI: 4.15–11.27) than healthy controls. In subgroup analyses, the association of HPV and OLP varied significantly by geographic populations. The ORs ranged from 2.43 to 132.04. The correlation of HPV and erosive-atrophic oral lichen planus (EA-OLP) (OR: 9.34) was comparable and well above that of HPV and non-EA-OLP (OR: 4.32). Among HPV genotypes, HPV 16 showed an extremely strong association with OLP (OR: 11.27), and HPV 18 showed a relatively strong one (OR: 6.54).ConclusionIn conclusion, a significant association was found between HPV and OLP. The strength of the association varied across geographic populations, clinical types of OLP, and HPV genotypes. The results suggest that HPV might play an important causal role in OLP and in its malignant to progression.

Fractal analysis of mucosal microvascular patterns in oral lichen planus: a preliminary study

The objective of this study was to assess local vascular architecture in atrophic-erosive oral lichen planus (OLP). We investigated the capillary structure of the oral mucosa in 31 patients with OLP and 32 healthy controls. Capillaries images were captured in vivo through a capillaroscope. We applied fractal analysis to quantify the microvasculature morphometric changes in the oral mucosa of atrophic-erosive OLP patients in terms of their fractal dimension (D). The oral vascular networks of atrophic-erosive OLP lesions had a significantly higher D, both in buccal mucosae (D=1.167, P=.019) and in tongue (D=1.196, P=.038), compared with the control population (1.123 for both locations, respectively). The present study confirms previous literature data on a close relationship between abnormal vascular architecture and atrophic-erosive OLP. Fractal analysis provided a quantitative descriptor of the complexity of the vascular patterns, which increases in the OLP samples. These data may provide new information on the OLP pathogenesis, as well as serve as morphologic quantifiers for monitoring treatment strategies.

The effect of pimecrolimus cream 1% compared with triamcinolone acetonide paste in treatment of atrophic-erosive oral lichen planus.

Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with atrophic and erosive types of OLP often have symptoms of soreness, and require proper treatment. The main treatment for OLP has been the administration of topical or systemic corticosteroids. The objective of this study was to compare the efficacy of adcortyl cream (triamcinolone acetonide in orabase) with topical pimecrolimus cream for the treatment of erosive OLP. Twenty-eight patients with OLP were enrolled in a single blind clinical trial and assigned to either a pimecrolimus 1% cream group or an adcortyl 0.1% cream group. The medication was applied every day for 2 months and patients were assessed every 2 weeks. The mean lesion size and mean pain and burning sensation scores did not differ between the pimecrolimus and adcortyl cream groups. The pimecrolimus cream was well tolerated. No clinical drug-related adverse events were observed. Topical pimecrolimus cream may be recommended as a safe and effective alternative therapy in the treatment of OLP. Pimecrolimus cream is as effective as adcortyl cream in managing the signs and symptoms of OLP.

Comparison of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus.

BackgroundThe treatment options for oral lichen planus (OLP) are numerous and include topical and systemic agents. Intralesional and systemic corticosteroids are used; however, the therapeutic results are often disappointing.ObjectiveTo compare the influence of ozone, laser, and topical corticosteroid therapies in the treatment of OLP.MethodsOne hundred twenty adult patients with ≤3 cm atrophic-erosive biopsy-proven OLPs in the tongue or buccal mucosa were recruited into the study. They were randomly assigned, by preoperative envelope drawing, to be treated with low-level laser therapy (LLLT group), ozone therapy (ozonated group), and topical corticosteroid therapy (positive control group). A placebo treatment containing base ointment without the active corticosteroid component was administered to patients in the negative control group. Response rate scores were determined on the basis of changes in the appearance score and pain score of the lesions between baseline and after each treatment.ResultsThe study subjects consisted of 56 male and 64 female OLP patients with a combined mean age of 42.6±8.3 years (range, 28~55 years). No statistically significant difference was detected in clinical severity among the groups. The sign scores decreased in almost all scoring groups; however, statistically significant improvement was found in the ozonated and corticosteroid-treated groups. Symptom improvement was achieved after treatment with LLLT, ozone, and corticosteroid (p<0.05). The efficacy indices were significantly higher in the ozonated and corticosteroid-treated groups.ConclusionOzone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.

A Randomized Placebo-controlled Double Blind Clinical Trial of Quercetin for Treatment of Oral Lichen Planus.

Background and aims. Standard treatment of oral lichen planus (OLP) includes topical or systemic corticosteroids that have many adverse effects. A trend toward alternative natural or herbal drugs has attended recently. This study was conducted to evaluate the effect of quercetin in treatment of erosive-atrophic OLP.Materials and methods. Thirty patients participated in this randomized clinical trial from April 2010 to June 2010 (Trial Registration Number: NCT01375101). Patients were randomly allocated in two groups. Both groups received the standard treatment (dexamethasone mouthwash and nystatin suspension). Experimental group received oral 250 mg quercetin hydrate capsules (bid) and the control group received placebo capsules. The pain and severity of the lesions were recorded at the initial visit and the follow-ups. All recorded data were analyzed with chi-square, Mann-Whitney, t-test, Wilcoxon and Friedman tests using SPSS 11.5.Results. There were no significant differences between the two groups in severity of the lesions and pain in the follow-ups.According to the Friedman test, there was a significant reduction in pain (P = 0.01) and severity indices (P = 0.00) in the case group. These differences were not observed in the control group(P = 0.26,SI; and P = 0.86, PI). No adverse effect of quercetin was reported.Conclusion. According to the results, no significant therapeutic effect can be considered for quercetin in treatment of OLP.

MANAGEMENT OF ATROPHIC-EROSIVE GINGIVAL LICHEN PLANUS WITH TOPICAL AND SYSTEMIC CORTICOSTEROID THERAPY, A CASE REPORT

The gingiva is a target of autoimmune diseases and about 10% of patients with oral lichen planus have the disease confined to the gingiva, clinically named desquamative gingivitis. The purpose of this paper is to describe 59 year-old female with atrophic-erosive gingival lichen planus that was presented to the Department of Oral Diagnosis, School of Dentistry at Sulaimani University service for evaluation of persistent pain, associated soreness and burning of her gingiva for 3-4 years, which were localized for anterior maxillary region. The histopathological examination confirmed the diagnosis of atrophic-erosive oral lichen planus. The treatment prescribed for the patient was topical and systemic corticosteroid (prednisolone). Substantial improvement was observed in the gingival lesion with reduction in erythema in some regions and complete resolution of pain. The results presented allow the authors to consider the association between local and systemic corticosteroid as a potential therapy for atrophic-erosive gingival lichen planus.

Pimecrolimus vs. tacrolimus for the topical treatment of unresponsive oral erosive lichen planus: a 8 week randomized double‐blind controlled study

Oral lichen planus (OLP) is a chronic inflammatory disease, affecting nearly 1-2% of the population; Proposed therapies are usually symptomatic and numerous drugs have been used, but recently, it has been published that there is insufficient evidence to support the effectiveness of any specific treatment as being superior. To the best of our knowledge, direct evaluation of the efficacy of topically applied pimecrolimus and tacrolimus in the treatment of atrophic-erosive OLP, refractory to topical steroids, is still lacking. To assess the efficacy and safety of topical calcineurin inhibitors for unresponsive OLP. An 8 week randomized, double-blind controlled trial, followed by a 6 month follow-up period. Patients were treated with either pimecrolimus 1% cream or tacrolimus 0.1% ointment, both mixed with an equivalent amount of 4% hydroxyethyl cellulose gel. The medications were to be applied twice daily for 2 months. Each patient was examined at the beginning of therapy, and then every 2 weeks during the treatment and every 3 months of follow-up. Main outcome measures were: (i) to compare the effectiveness of topically applied pimecrolimus and tacrolimus; (ii) to evaluate which is more cost-effective; (iii) to determine which drug is faster in reducing signs and symptoms and (iv) which gives the longest remission. Thirty patients were involved in the study. Both drugs were effective at inducing clinical improvement, with no statistical difference. Pimecrolimus creams revealed a significantly better stability of the therapeutic effectiveness (P = 0.031). Both medications would currently appear to be a treatment of choice for patients with unresponsive atrophic-erosive OLP. Pimecrolimus seemed to be more effective in providing long-term resolution of signs and symptoms. Future efforts are however needed to obtain more objective evidence of the benefit of these medications in the treatment of immunologically mediated oral mucosal lesion.

Proliferation and Apoptosis of Peripheral Blood Mononuclear Cells in Patients with Oral Lichen Planus

Oral lichen planus (OLP) is generally accepted to be a T cell-mediated chronic inflammatory disease with an unclear pathogenesis. There have been numerous studies on the proliferation and apoptosis of T cells in situ. In contrast, research on the proliferation and apoptosis of peripheral blood mononuclear cells (PBMCs) in patients with OLP is rare. The aim of the present study was to investigate the proliferation and apoptosis of PBMCs in patients with OLP. PBMCs were isolated from 20 patients with reticular OLP, 20 patients with atrophic-erosive OLP, and 20 healthy volunteers. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-2,5-tetrazolium bromide assays were performed to investigate the proliferation of PBMCs, and caspase-3 colorimetric assays were performed to investigate the apoptosis of PBMCs. The proliferation rate of PBMCs in atrophic-erosive OLP subjects was significantly higher than that in both healthy (P < 0.05) and reticular OLP (P < 0.05) subjects. In contrast, the proliferation rate of PBMCs in reticular OLP subjects was significantly lower than that in healthy subjects (P < 0.05). The apoptosis rates of PBMCs in OLP subjects (P < 0.05) and atrophic-erosive OLP subjects (P < 0.05) were significantly lower than the apoptosis rate in the healthy group. Our findings reinforce the view that T cell-mediated immune responses play a critical role in the pathogenesis of OLP. It can reasonably be concluded that these abnormalities are linked to the presence of inflammatory infiltrates.

Implications of Th1 and Th17 cells in pathogenesis of oral lichen planus

Oral lichen planus (OLP) is considered a T cell-mediated autoimmune disease with unknown aetiology. T helper cells appear to play an important role in the pathogenesis of OLP. We investigated the possible role of T helper cells, Th1 and Th17, in the lesions and circulation of patients with OLP. Forty patients with OLP and 15 healthy volunteers were recruited. Double immunofluorescence staining was used to detect Th1 and Th17 cells in the OLP lesions, and intracellular cytokine staining and flow cytometry to evaluate the proportion of Th1 and Th17 cells in peripheral blood. The levels of serum interferon (IFN)-γ and interleukin (IL)-17 were assessed by using an enzyme-linked immunosorbent assay. It was found that Th17 cells, as well as Th1 cells, were present in OLP lesions. The proportion of peripheral Th1 and Th17 cells was significantly increased in patients with OLP. The proportion of Th17 cells in atrophic-erosive OLP was elevated as compared with that in reticular OLP. Serum IL-17 levels in OLP patients were significantly higher than in controls, and those in the atrophic-erosive OLP group were increased as compared with the reticular OLP group. However, the levels of serum IFN-γ were slightly decreased in OLP patients. Our data suggested that Th1 and Th17 cells in the local lesions and peripheral blood may be associated with the pathogenesis of OLP, and that IL-17 may be an important proinflammatory cytokine in OLP. These findings enhance our understanding of OLP pathogenesis.

The effect of low intensity laser therapy in treatment of erosive-atrophic oral lichen planus

The effect of low intensity laser therapy in treatment of erosive-atrophic oral lichen planus