Common Oral Mucosal Disease Research Articles

Relationship between Oxidative Stress and Several Common Oral Mucosal Diseases: A Review

Free radicals include reactive oxygen species and reactive nitrogen, which are vital substances in the biological process of the body, which have a positive effect on the human body at normal concentrations. When the content of free radicals is too high, the body will activate the antioxidant system to defend against this damage in order to protect itself. The disorder of the balance between pro-oxidative and antioxidant reactions will lead to oxidative stress: excessive production of free radicals, and the body's antioxidant system cannot effectively resist this invasion, free radicals destroy the molecular tissues that make up DNA, proteins and lipids, followed by irreversible damage. Many studies at home and abroad have shown that patients with some oral mucosal diseases (recurrent aphthous ulcer, oral lichen planus, oral leukoplakia, oral submucosal fibrosis, burning mouth syndrome) often observe oxidative stress in oral tissue or saliva and blood, and explore many potential biomarkers. Through the study of the relationship between oxidative stress and oral mucosal diseases, it will be of guiding significance for the etiological exploration and treatment of oral mucosal diseases. This article reviews the latest research progress on the relationship between oxidative stress and several common oral mucosal diseases in recent years.

Immunohistochemical expression of T-cell subsets (CD4 and CD8) in oral lichen planus.

oral lichen planus (OLP) is a common oral mucosal disease with various clinical manifestations. The most predominant types are reticular and erosive. Despite extensive research on the causes of OLP, the exact etiology remains unclear. However, it is believed that a T-cell-mediated response, which triggers the apoptosis of oral epithelial cells, may contribute to the development of this disorder. This study aims to investigate the different types of T-cells (specifically CD4 and CD8) present in OLP tissue samples. By using immunohistochemistry, the expressions of cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) will be evaluated in biopsy samples taken from OLP patients who exhibit various clinical presentations. this study was a retrospective analysis study. Oral lichen planus was established histologically in forty paraffin-embedded tissue samples. Blocks of OLP were diagnosed and characterized as reticular or erosive. Immunohistochemical staining was conducted using a monoclonal antibody for (CD4) and a polyclonal antibody for CD8. Semi-quantitative techniques were used to analyze the patterns of positively stained cells. Results: forty biopsies of OLP cases were obtained from 24 females and 16 males. The mean age was (49.15±11.39) years. Using an immunohistochemical method, the proportion of CD4 expression: CD8 expression among the epithelial-connective tissue interface was shown to be 24 (60%) cases with a predominance of CD8, 9 (22.5%) cases with no difference, and only 7 (17.5%) cases with a predominance of CD4. The proportion of CD4: CD8 among perivascular parts was shown to be 8 (20%) cases with a predominance of CD8, 20 (50%) cases with no difference, while only 12 (30%) cases had a predominance of CD4. The CD4 perivascular expression was significantly stronger in (71.4%) of erosive OLP than in reticular cases. T-cell subsets (CD4 and CD8) were found in the OLP infiltrates. The correlation may have contributed to the pathogenesis of OLP.

THE ROLE OF JAVA CABE (Piper retrofractum vahl.) ON TRAUMATIC ULCER TREATMENT

Introduction: Dental and oral diseases in Indonesia still need attention. Theoral cavity is a place for microorganisms that cause infection that can affectthe general state of health in which the oral mucosa serves as a protector ordefense to protect the oral cavity from disease. One of the most common oral mucosal diseases is traumatic ulcer. Review: Traumatic ulcer is an oraldisease that often found in the community and often underestimated.Traumatic ulcer is a pathological condition characterized by loss of epithelial tissue due to sloughing of necrotic and widespread inflammatory tissue in thelamina propria, which caused by trauma, for example is when wearingdenture wings too sharp, causing ulcers. The etiology of traumatic ulcers arethermal, chemical, and mechanical trauma. The common location oftraumatic ulcers occurs in the labial/buccal mucosa, palate, and tongue.Needed for appropriate treatment for treat traumatic ulcers. Discussion: Fortreat traumatic ulcer, parts that can be used from the Javanese chili plant arethe fruit, leaves, and roots for treating bad breath, as antipyretic, antioxidant,antibacterial, and etc. Javanese chili (Piper Retrofractum Vahl.) hascompounds that act as antioxidants and antibacterial, namely flavonoid whichtrigger the growth of epithelial tissue in wound tissue, and piperine whichinhibits cyclooxygenase which has an effect on reducing leukocytes thatoccurs in traumatic ulcers. Conclusion: Javanese chili herbs contain activecompounds such as flavonoid and piperine which can heal traumatic ulcers.

Evaluation of Vitamin D Levels in Pediatric Patients With Recurrent Aphthous Stomatitis.

Recurrent aphthous stomatitis is one of the most common oral mucosal diseases. It is characterized by recurrent painful attacks. Its etiology is unknown. Vitamin D (vit D) is a steroid vitamin with immunomodulatory and anti-inflammatory effects. It is thought that oral cavity diseases may occur in vitamin D deficiency. This study aimed to investigate vit D levels in pediatric patients with recurrent aphthous stomatitis. In this retrospective study, 86 children with recurrent aphthous stomatitis and 71 age-matched healthy children were included in the study. The 25-hydroxyvitamin D levels examined with the enzyme immune assay were recorded for both groups. Serum vit D level was 12±4.5 ng/ml in the group with aphthous stomatitis and 31±7 ng/ml in the healthy group. A statistically significant difference was found in vit D levels between the two groups (p<0.001). Vit D levels were significantly low in children with recurrent aphthous stomatitis. Our findings suggestthat low vit D levels may be associated with recurrent aphthous stomatitis.

A Systematic Review and Meta-Analysis of Acupuncture Treatment for Oral Ulcer.

Oral ulcer (OU) is a common oral mucosal disease manifested with obvious pain. In some studies, the efficacy of acupuncture in OU has been confirmed, but systematic reviews and meta-analyses for them are lacking. Our aim is to evaluate the efficacy of acupuncture in the treatment of OU. We searched the literature from eight databases from their inception to December 2021. We included randomized controlled trials of acupuncture for the treatment of oral ulcer. The meta-analysis was carried out using Review Manager 5.3 and Stata 16.0. The main outcomes were the effective rate and the recurrence rate, the secondary outcomes were the visual analogue score (VAS) and the ulcer healing time. Totally, 18 studies were finally included in the meta-analysis, including 1,422 patients. In meta-analyses, we found that in comparison with Western medicine, acupuncture can improve effective rate (OR = 5.40, 95% CI: 3.40 to 8.58), reduce the ulcer recurrence rate (OR = 0.21, 95% CI: 0.13 to 0.33), and relieve the ulcer pain (MD = -2.26, 95% CI: -4.27to-0.24). In addition, compared with Western medicine, acupuncture plus Western medicine also can improve effective rate (OR = 2.95, 95% CI: 1.48 to 5.85). Compared with the Chinese medicine, the acupuncture plus Chinese medicine can improve the effective rate (OR = 8.26, 95% CI: 3.61 to 18.88) and relieve the ulcer pain (MD = -1.85, 95% CI: -2.51 to -1.19). Acupuncture may be more effective than Western medicine in terms of efficacy rate, and acupuncture combined with Western or Chinese medicine may have the potential to reduce the recurrence of ulcer and relieve the ulcer pain. However, due to limited evidence, higher quality and more rigorously designed clinical trials with larger sample sizes will be needed to further confirm our findings.

Comparison of Effects of Honey and 0.1% Triamcinolone Acetonide in the Management of Recurrent Aphthous Stomatitis - A Randomised, Single-Blind Study

Introduction: Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease known to humans and are characterized by the development of painful, recurring solitary or multiple ulcers confined to the oral mucosa. RAS is often painful and worsens during drinking and talking. Aim: To evaluate and compare the effects of honey and 0.1% triamcinolone acetonide in patients with ulcers of recurrent aphthous stomatitis minor. Materials and Methods: Sixty patients having RAS minor were divided into two groups of 30 participants each by simple random sampling. Group A was treated with application of 0.5 ml of honey thrice a day for a week or until complete healing of the ulcer. Group B was treated with application of 5 g of 0.1% triamcinolone acetonide oral paste thrice a day for a week or until complete healing of the ulcer. For all the individuals, baseline parameters like the size of the ulcer, pain, and burning sensation were recorded on day 0, reassessment was done on day 4 and day 7, followed by statistical analysis. Results: The study showed that the reduction in the size of ulcers, VAS score for pain, and VAS score for burning sensation were similar in patients receiving honey as compared to patients receiving 0.1% triamcinolone acetonide. No adverse effects were reported in patients receiving honey, and there were mildly adverse reactions in some patients receiving 0.1% triamcinolone acetonide oral paste. Conclusion: Honey, a natural anti-inflammatory agent, seems to hold immense potential as an alternative medication for managing RAS minor ulcers. It has better patient compliance as compared to 0.1% triamcinolone acetonide.

Evaluation of cinnamaldehyde mucoadhesive patches on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial

Background & objectiveThe use of herbal medicines to treat common oral diseases increases rapidly. Recurrent aphthous stomatitis is one of the most common oral mucosal diseases, which has an unclear etiology and could lead to severe pain and dysfunction. Cinnamaldehyde is a major component of cinnamon bark oil. Biological properties of cinnamaldehyde, such as antioxidant, antitumor, antifungal, cytotoxic, and anti-mutational characteristics, have been identified. Considering the prevalence of recurrent aphthous stomatitis and the importance of using herbal resources for treatment, the present study aimed to evaluate the effect of mucosal adhesive patches containing Cinnamaldehyde on minor recurrent aphthous stomatitis lesions.Material & methodsIn this randomized, double-blind clinical trial, patients were divided into two groups. The intervention group received three daily mucosal adhesive patches to be used in the morning, afternoon, and night. The control group also did the same with a placebo. To evaluate the healing and determine the diameter of the lesions, patients were clinically examined on days zero, 3, 5, and 7. The VAS scale evaluated pain at baseline and after each meal for seven days. The Fisher's exact test, t-test, Shapiro Wilk test, Friedman test, and the Mann–Whitney test were used to analyze the data using the SPSS 20 software.ResultsThere was no statistically significant difference in the mean diameter of the inflammatory lesion and pain intensity in the two groups in the baseline (p > 0.05). However, the ulcer size was significantly reduced in the cinnamaldehyde group on the third, fifth, and seventh days of the study. Except for baseline, the mean pain intensity significantly decreased in the cinnamaldehyde group compared to the placebo group (p < 0.05).ConclusionCinnamaldehyde mucoadhesive patches effectively reduced and improved aphthous lesions and pain intensity in patients and can be considered a treatment for RAS. Registration number: IRCT20180312039060N2—First registration date: 20/07/2018. The present study was registered as a retrospective study.

Diagnostic and managing algorithms for common oral mucosal bullous diseases

大疱性疾病是指一组以疱、大疱为基本损害的皮肤黏膜疾病，口腔临床以寻常型天疱疮、黏膜类天疱疮及副肿瘤性天疱疮最常见。本文将从常见口腔黏膜大疱性疾病的临床表现、检查方法、诊断思路、诊断标准和治疗特点等方面进行阐述，强调大疱性疾病的规范化诊治理念，即“3个尽量”：尽量获取足够多的诊断依据、尽量做好治疗前全身与局部状况评估、尽量按照各指南和专家共识推荐的方法进行治疗，为临床口腔医师对口腔黏膜常见大疱性疾病的诊治提供参考。.

Differentiation and Treatment of Recurrent Oral Ulcer from False and Real Specimens

Recurrent oral ulcer is the most common oral mucosal disease in clinical practice. It often occurs repeatedly and has obvious local pain. Clinical treatment is difficult and difficult to find a good method Mark this virtual to real, this paper expounds the disease of this virtual pathogenesis characteristics, emphasis on traditional Chinese medicine in the treatment of recurrent aphthous should be severely, puts forward the qing xie fu fire, tonifying spleen zi kidney treatment, the accurate syndrome differentiation, flexible, providing and 1 proven cases were presented as evidence, designed to radically reduce the onset of symptoms and reduce the recurrence rate, in order to transfer the rich clinical experience in traditional Chinese medicine.

New Progress of T Cells in Oral Lichen Planus

Oral lichen planus (OLP) is a relatively common chronic oral mucosal disease mediated by T cells, and its pathogenesis may include antigen-specific and non-specific. The etiology is unknown and the course of the disease is chronic and prolonged. The treatment has become a rather difficult clinical problem. There is no cure for OLP at present. Histologically, it is characterized by band-like infiltration of subepithelial T lymphocytes, rupture of the basement membrane, and liquefaction and degeneration of basal cells. Its etiology is not yet fully understood, its course is chronic, and its treatment has become a difficult clinical problem. Because of the malignant phenomenon of long-term erosion lesions, WHO lists it as a precancerous state. The main pathological changes of OLP are liquefaction and degeneration of basal cells and infiltration of subepithelial lymphocytes. The pathogenesis of OLP is not yet fully understood. OLP is an inflammatory disease mediated by T cells, which is related to autoimmune function. Various pathogenic factors lead to changes in the antigenicity of epithelial keratinocytes. The altered antigens are taken up by Langerhans cells and presented to T cells, these cells release and activate various cytokines to destroy the epithelium, and these cytokines activate T cells to initiate a series of immune responses, leading to the formation of OLP lesions. Studies have found that the pathogenesis of OLP is a process of immune damage mediated by T cells, which is related to the body's autoimmune function.

A Randomized controlled clinical trial on dose optimization of thalidomide in maintenance treatment for recurrent aphthous stomatitis.

Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease, and ulcer-free periods are a major concern for patients. Thalidomide has been shown to be an effective systemic drug in the treatment of RAS, but the value of undertaking a trial to evaluate various maintenance doses was warranted. We performed this randomized controlled clinical trial with a two-stage design. Firstly, all the 125 cases of RAS received prednisone at a starting dose of 15mg/d for one week as an initial therapeutic drug. Secondly, the 100 cases of RAS in the experimental group received thalidomide (50mg/d vs. 25mg/d) as a maintenance drug to observe its efficacy and safety. During maintenance medication at the fourth and eighth weekend, the two doses (50 and 25mg/d) of thalidomide were equivalent in reducing the incidence of ulcers, ulcer number, and ulcer pain, respectively (all p>0.05). Notably, the ulcer-free period in the group using 25mg/d thalidomide for eight weeks was longer (mean, >3months) than those in the other groups (all p<0.05). Importantly, the total adverse events in the group using 25mg/d thalidomide were significantly less than those in the group using 50mg/d (p<0.001). Moreover, the effect of 50mg/d thalidomide on the levels of various salivary cytokines was not superior to 25mg/d medication (p>0.05). This dose optimization study concluded that 25mg/d thalidomide had a long-term effect on extending the recurrence interval of RAS with better safety.

Efficacy of hyaluronic acid for recurrent aphthous stomatitis: a systematic review of clinical trials.

Recurrent aphthous stomatitis (RAS) is a very common oral mucosal disease, and its management is quite challenging with no definitive cure being available so far. Many studies have tried hyaluronic acid (HA) for alleviating signs and symptoms of RAS. The present systematic review sought to assess the available evidence regarding the efficacy of HA in management of RAS. Two reviewers independently conducted extensive search in four online databases (PubMed, Scopus, Web of Science, and Google Scholar) and the gray literature, with no restriction to date or language of the publication. All clinical trials that assessed the efficacy of HA in reducing signs and symptoms of RAS were included. Risk of bias was assessed by two reviewers independently, using the Cochrane assessment tool. Due to substantial heterogeneity, no meta-analysis was feasible. Out of the 75 identified articles, nine clinical trials involving 538 RAS patients (259 in HA group) were included. The risk of bias was high in five studies, low in one study, and unclear in three studies. The comparative groups varied greatly across the included studies: triamcinolone (in three studies), chlorhexidine mouthwash, lidocaine, placebo, iodine glycerin, diclofenac, and laser therapy. Overall, the results revealed a good efficacy of HA in alleviating pain and shortening the healing time of RAS, without any reported side effects. Compared to triamcinolone, HA showed superior results in one study, and comparable results in two studies. The available evidence suggests that HA is a promising treatment option for RAS. However, given the huge heterogeneity of the included studies and high risk of bias in some of these studies, the evidence is inconclusive. Further well-designed clinical trials with standardized methodologies and adequate sample sizes are warranted to discern the efficacy of HA for RAS. Hyaluronic acid might be a viable alternative therapeutic option for patients with RAS.

Resident Perspectives 56-5

Resident Perspectives 56-5

Association of bedtime with recurrent aphthous stomatitis: A cross-sectional study among health-care professional students.

Background:Although recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease, the etiology remains poorly understood till date. In addition, RAS lacks definitive therapeutic options, and hence, it becomes even more important to know the etiological factor so as to relieve the symptoms and render treatment effectively. Recently, late bedtime has been shown to be associated with RAS. Due to prolonged duty hours along with lengthy learning and training periods, late bedtime is a frequent observation among health-care professional students. However, this is a less explored field in the previous studies on RAS.Aims:This study aimed to evaluate the role of bedtime in the causation of RAS among health-care professional students.Methods:This present cross-sectional survey was carried out among medical, dental and nursing students studying in our medical campus, using an anonymous, self-administered questionnaire consisting of 18 items. The collected data was statistically analyzed and interpreted. Descriptive analysis and Chi-square tests were employed to assess the association of RAS with various variables.Results:Among a total of 1111 students who participated in the study, 39.8% (n = 442) experienced RAS. Factors such as history of digestive tract disease, family history and stress showed a positive correlation with RAS. Interestingly, both during examination and nonexamination period, RAS was more prevalent among students with bedtime >11pm than in students with bedtime <11 pm.Conclusion:The study indicates that late bedtime is an independent risk factor for RAS and thus clinicians should focus on recommending a healthy lifestyle with adequate sleep to patients with RAS. This would benefit patients with RAS, especially health-care professional students, and could probably contribute to long-term remission in RAS.

Human Saliva Metabolome for Oral Lichen Planus Biomarker Identification.

Oral Lichen Planus (OLP) is one of the most common oral mucosal diseases. However, the current diagnostic method for OLP has limitations, and sometimes it is easy to be misdiagnosed. Salivary metabolomics may provide new ideas for the diagnosis of OLP. To identify the biomarkers for the early detection of OLP. A non-targeted metabolomic analysis method was established based on UHPLC-Q-Orbitrap HRMS (Ultra-performance liquid chromatography-quadrupole/orbitrap high resolution mass spectrometry) to analyze the differential metabolites in saliva samples of patients with OLP and healthy subjects. Saliva samples were collected from 120 OLP patients and 125 healthy subjects. A total of 19 differential metabolites were identified, including 6 amino acid metabolites, 2 carnitines, 2 lipid metabolites and 9 other metabolites. The integrated biomarkers were constructed by 3 metabolites according to Receiver Operating Characteristic (ROC). Meanwhile, multiple metabolic pathways were found to be involved in the occurrence and development of OLP. Metabolomics can be used to characterize the characteristics of metabolic disorders in patients with OLP, which is also helpful to the early diagnosis of OLP and reveal the pathological process of OLP.

Evaluation of the Efficacy and Performance of a New Nano-Drug Carrier in the Treatment of Recurrent Oral Ulcerper.

Recurrent oral ulcer is a common oral mucosal disease. Due to its periodic and recurrent characteristics, the onset of burning pain is unbearable, which brings great inconvenience to the patient's life and seriously affects the patient's quality of life. There are certain limitations to conventional drug therapy. With the rapid development of nanotechnology, the obvious advantages of nanotechnology such as targeting, controlled release, biocompatibility is obviously shown. The combination of nanotechnology and medical research has led to the emergence of polymer nanoparticles and ligands. Nano-drugs for gene therapy, and many other new nano-drug carriers, polymer micelle is a new type of nano drug carrier that has appeared in recent years. It has both a hydrophilic shell and a hydrophobic core, and has a variety of excellent properties, such as higher stability in vivo and in vitro, and poorly soluble drugs. In this paper, a new method for treating recurrent oral ulcers based on a new nano-drug carrier was studied. Because of the hydrophilicity and biocompatibility of oral cell surface proteins, the research progress of nanopharmaceutical carrier in the treatment of recurrent oral ulcers is reviewed. The experimental results show that the method has good reproducibility and high efficiency in the treatment of recurrent oral ulcers. It is used to explore the application and progress of nanotechnology in the diagnosis and treatment of recurrent oral ulcers, and to provide new ideas for the clinical diagnosis and treatment of recurrent oral ulcers. This new technical method has wide practical application value.

Evaluation the relationship between psychological profile and salivary cortisol in patients with recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases which are diagnosed with recurrent and painful ulcers. The possible association between psychological factors and salivary stress related factors in patients with aphthous ulcers has been discussed in various studies. The aim of this study was to evaluate salivary cortisol level, anxiety, and depression in patients with RAS. In this case control study, 30 patients with RAS and 30 healthy individuals were enrolled by matching their age and sex. Anxiety and depression were assessed by beck anxiety inventory and beck depression inventory. Unstimulated saliva of both groups were collected and then tested by DiaMetra kit and the ELISA method. Data were analyzed by SPSS using an Independent t-test and Mann-Whitney test. A statistical significance level of <0.05 was considered. The mean salivary cortisol in the case group was 5.35 ng/ml and in the control group was 4.73 ng/ml which was not statistically significant (P > 0.05). There was no significant difference in anxiety and depression level between the two groups (P > 0.05). According to Spearman correlation coefficient, there was an average, negative, and significant correlation between salivary cortisol and anxiety and depression scores in the case group (P < 0.05). This study shows that, although the mean salivary cortisol was slightly higher in patients with aphthous lesions, anxiety, and depression were not possible factors for RAS. There was a moderate, negative correlation between salivary cortisol level and stress and anxiety in patients with RAS.

Effect and mechanism of Kangfuxin liquid on oral ulcer in patients with chemotherapy treated hematologic malignancies: Network pharmacology study and clinical observations

Abstract Background Oral ulcer (OU) is a common oral mucosal disease, which has a high prevalence in patients with malignant tumors, leading to systemic infection which can be life-threatening. Kangfuxin liquid (KFX), as a traditional Chinese medicine, has been widely used in the treatment of ulcers and dermatologic lesions in recent years, and has shown effective results. However, there are few descriptions of its efficacy in the treatment of oral ulcer caused by chemotherapy in patients with hematological malignancies, and its mechanism of action is not clear. Method Retrospective clinical study and network pharmacology-based method were utilized in this study. First of all, we collect clinical research data by using the hospital's historical electronic medical records, and later it was analyzed to describe its clinical efficacy. Secondly, the effective components and the inferred targets of KFX were obtained by the collected literatures and SwissTargetPrediction database. Then, an interaction network between shared targets of KFX and OU was constructed using STRING online tool. Topological analyses were performed to extract hub gene targets. The gene target pathway of KFX was analyzed by David database. Finally, molecular docking was used to predict the binding mode and affinity. Results Clinical observation showed, KFX can effectively shorten the healing duration of ulcer and time for pain relief, limit the occurrence and development of oral diseases, and improve the quality of life of patients. In addition, in the past six years, no adverse drug reactions were recorded. Network pharmacological analysis data show that PI3K-Akt signaling pathway, RAP1 signaling pathway and TNF signaling pathway together plays an important role in the treatment of oral ulcer with KFX. Through molecular docking technology, we also believe that AKT1 and MMP9 are the core potential targets of KFX in the treatment of OU. Conclusions Application of network pharmacology and molecular docking provides new insights on the efficacy, active ingredients and molecular mechanism of KFX in the treatment of oral ulcer, and preliminarily reveals the pharmacological mechanism of KFX in the treatment of OU through the characteristics of “multi-components, multi-targets, and multi-approaches” synergistic effect.

Oral mucosal disease in eldery people

Oral mucosal lesions are more common among the elderly people. Oral health, including oral mucosal disease, is a important factor of quality of life in elderly people. Oral mucosal disease can lead to poor nutritional intake of the elderly due to pain and discomfort. Identification and institution of proper treatment of these lesions are an important part of total oral health care. In this article will review common oral mucosal disease in eldery.

PTHLH Predicts the Prognosis of Patients with Oral Leukoplakia.

BackgroundOral leukoplakia is the most common oral mucosal disease. A proportion of such cases can progress to oral squamous cell carcinoma (OSCC). The mechanism of oral leukoplakia malignant transformation is still unclear. In this study, we analyzed the expression of parathyroid hormone-like hormone (PTHLH) in oral leukoplakia and the effect on prognosis, so as to find reliable molecular markers that can predict oral leukoplakia malignant transformation.MethodsWe measured PTHrP which is coded by PTHLH in oral leukoplakia tissues of 79 cases (30 cases progressed to OSCC and 49 did not) and analyzed the clinical outcomes. Then, PTHLH expression was reduced using lentivirus-mediated small hairpin RNA (shRNA) interference to determine the biological role of PTHLH in DOK cells.ResultsPTHrP was found to be highly expressed in 38% of tissues of oral leukoplakia. There was weak or no PTHrP expression in 25 patients, moderate expression in 24 patients, and strong in 30 patients with oral leukoplakia. The expression level was associated with the degree of atypical hyperplasia and poor prognosis. The cell proliferation, invasion, migration, cell cloning, and cell cycle were affected after reducing PTHLH expression.ConclusionOur data suggest that either PTHLH or PTHrP plays a key role in the malignant transformation of oral leukoplakia and might be a reliable biomarker for predicting the carcinogenesis of oral leukoplakia.