Erosive Form Of Oral Lichen Planus Research Articles

Peculiarities of the format of genetic blood systems in patients with oral lichen planus

The number of patients with oral lichen planus (OLP) has increased due to the raise of aggressive forms of the disease (erosive, ulcerative and hyperkeratotic forms) with a possible risk of malignancy. There are isolated researches which indicate a genetic determinism to OLP, but more often these conclusions are based on insufficiently adequate and out of date methods, which make it impossible to correctly interpret the obtained data. The aim was to identify a genetical predisposition with a programmed risk to the oral lichen planus. The main group – 278 patients with the OLP (aged 26-65 years). The control group – 298 people (blood donors) who didn’t have dental diseases, as well as diseases of internal organs and systems. The groups were homogeneous by gender and age. In our research we used such methods: clinical, radiological, immunogenetic, statistical methods were used. The erosive form of OLP was associated with 0(I) group in 54.2±0.4% of cases, while the hyperkeratotic form was associated with group 0(I) only in 28.7±1.8% of cases. B(ІІІ) and AB(ІB) groups were less often associated with the erosive form of OLP and were observed in 17.3±0.1% and 2.0±0.1% of cases, respectively. The integration of A(ІІ) group in the erosive form of OLP was 30.5±0.1%, but the indicator was higher than in individuals with B(III) and AB(IV) groups. Hyperkeratotic form of OLP was more often observed in A(II) carriers than in 0(I) and was 44.1±0.1% versus 28.7±1.8%, respectively. With blood group B (ІІІ), the relationship with OLP is not traced. Correlative relationship with erythrocyte blood antigens of the ABO system in patients with oral lichen planus was established. Risk groups for the development of erosive and hyperkeratotic forms of lichen planus in patients with gastrointestinal tract pathology O(I)>A(II)>B(III) – with erosive form and A(II)>O(I)>B(III)) – with hyperkeratosis.

Конфігурація інтеграційних особливостей генетичної детермінованості систем еритроцитарних антигенів у хворих з червоним плескатим лишаєм слизової оболонки порожнини рота

Relevance. Over the past few years, the number of patients with oral lichen planus (OLP) has almost doubled due to the increase in aggressive forms of OLP with a possible risk of malignancy. Only a few isolated studies indicate a genetic determinism for OLP, but more often these data were obtained based on insufficiently adequate and modern research methods, which complicate the correct interpretation of the obtained results. Purpose: to study the presence of genetic determinism of erythrocyte blood antigens to oral lichen planus. Materials and methods. The patients were divided into 2 groups - the main group - 278 patients at OLP (aged 26-65 years) and the control group - 298 people (blood donors), where dental diseases, as well as diseases of internal organs and systems were excluded. The groups were homogeneous in terms of age and gender. Clinical-radiological, immunogenetic and statistical methods were applied. Research results. The erosive form of OLP was associated with group 0(I) in 54.2±0.4% of cases, and the hyperkeratotic form was combined with group 0(I) only in 28.7±1.8% of cases. B (²²²) and AB (IV) groups were less often associated with the erosive form of OLP and were observed in 17.3±0.1 and 2.0±0.1% of cases, respectively. The integration of the A(II) group with the erosive form of OLP was significantly lower than with 0(I) carriers and amounted to 30.5±0.1%, but the indicator was higher than in individuals with B (III) and AB (IV) groups The hyperkeratotic form of OLP was more often observed in A(II) carrier than in 0(I) and was 44.1±0.1% versus 28.7±1.8%, respectively. With blood group B(²²²), the relationship with OLP is not traced. Conclusion. A correlative relationship was established with erythrocyte blood antigens of the ABO system in patients with OLP. Detailed risk groups for the development of erosive and hyperkeratotic forms of ChPL in patients with pathology of the gastrointestinal tract O(I)> A(II)> B(III) - with erosive form and A(II)> O(I)> B(III) ) - with hyperkeratosis. Key words: oral mucosa, oral lichen planus, erythrocyte blood systems, genetic determinism.

Cancer Stem Cells' Biomarker ALDH1&2 Increased Expression in Erosive Oral Lichen Planus Compared to Oral Leukoplakia.

ALDH1&2 has been considered an oral cancer stem cell (CSC) marker. Oral carcinogenesis is a process that usually passes through oral potentially malignant disorders (OPMD). Oral lichen planus (OLP) consists of immune-related chronic disorders that have been included in the OPMDs due to their possible transformation into oral cancer. The aim of this study was to investigate the early presence of ALDH1&2 in OLP compared to early oral leukoplakias (OL), especially mildly and non-dysplastic OL. The study type is experimental, and the study design is characterized as semiquantitative research which belongs to the branch of experimental research. The study sample consisted of paraffin-embedded OLP biopsy samples from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, during the period 2009-2019. The study sample contained 24 cases of OLP (14 erosive and 10 reticular) and 30 cases of OL (16 cases of moderately and severely dysplastic OL and 14 cases of mildly and non-dysplastic OL). The CSC-related biomarker ALDH1&2 was examined using semiquantitative immunohistochemistry (monoclonal antibody sc-166362, Santa Cruz Biotechnology, Dallas, Texas, USA, 1:100). ALDH1&2 expression was evaluated through a scale of 1 to 3 depending on the percentage of positive epithelial cells and was compared to normal epithelium as well as cases of OL (the most prominent OPMD). The statistical analysis was performed with the Pearson chi-square test and the significance level was set at p≤0.05. The cytoplasmic staining of ALDH1&2 was observed mostly in the epithelial cells of the basal layer of the epithelium of OLP. Overall, this expression was significantly increased compared to normal epithelium. In addition, statistically significantly higher expression of ALDH1&2 was observed in the erosive form of OLP. Interestingly, this OLP positivity was higher compared to mild and non-dysplastic leukoplakias (p<0.001). ALDH1&2 is a confirmed CSC marker that was found to be clearly increased in OLP and characteristically in erosive OLP epithelium for the first time. Noteworthy, it was more prominent in erosive OLP rather than in mildly and non-dysplastic OL. Whether this pattern of expression raises the red flag of an early epithelial "CSC" phenotype in OLP or that ALDH1&2 expression indicates a response to the OLP inflammatory process requires further investigation.

Altered Expression of Vascular Cell Adhesion Molecule-1 in Oral Lichen Planus.

Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory mucocutaneous disease affected by the interaction between keratinocytes and T cells. Recent evidence indicates that vascular cell adhesion molecule-1 (VCAM1) plays a vital role in mediating immune and inflammatory responses. In this study, the expression of VCAM1 in OLP was detected by immunohistochemical staining and its correlations with clinical features were analyzed. The disease severity of OLP was assessed by the reticular, atrophic, and erosive scoring system. We found that VCAM1 was generally localized in the cytoplasm of epithelial cells, and in nucleus, cytoplasm, and extracellular matrix of subepithelial infiltrated cells in superficial layer of lamina propria. Moreover, VCAM1 levels in epithelium and lamina propria of OLP were significantly higher than that in controls, respectively. In addition, VCAM1 level in epithelium was increased compared with that of lamina propria. There were no significant differences for VCAM1 expression between nonerosive and erosive forms of OLP. The expression of VCAM1 in OLP was not associated with the severity of disease, gender, and age. Thus, we speculated that spatial expression differences of VCAM1 in local lesions of OLP may involve the pathogenesis of OLP.

Dental Implant Treatment in Patients Suffering from Oral Lichen Planus: A Narrative Review.

Background: The aim of this study was to describe the complications and survival rates of dental implants placed in patients suffering from oral lichen planus (OLP) and to present recommendations for implant treatment in this group of patients through a narrative review of the published studies. Methods: A search of the literature was conducted using four databases: PubMed/Medline, Web of Science, Cochrane, and Scopus with a stop date of May 2022. Results: Eighteen studies were evaluated. The results showed that dental implant survival rates in patients with OLP were similar to those reported in the general population. Moreover, the existing literature seemed to imply that OLP is not a suspected risk factor for peri-implant diseases. However, patients suffering from erosive forms of OLP or desquamative gingivitis and poor oral hygiene were more susceptible to developing peri-implant diseases; in addition, oral squamous cell carcinoma was observed in a few cases of OLP. Conclusion: With the limitations of this narrative review, dental implants may be regarded as a safe and feasible therapeutic approach to the treatment of patients with well-controlled OLP. These patients should be monitored carefully during follow-up care. Well-designed prospective trials are required to validate the present findings.

High-level laser therapy versus scalpel surgery in the treatment of oral lichen planus: a randomized control trial

ObjectiveTo compare the clinical effectiveness of various types of high-level laser therapy (HLLT) toward scalpel excision for the surgical treatment of erosive oral lichen planus (OLP).Materials and methodsThe total number of 128 individuals were enrolled in the study. The 35 did not meet the inclusion criteria due to malignancy signs and presence of diabetes mellitus. In total, 8 were lost to follow-up, and 10 were excluded from the analysis, due to analgesics intake. This way 75 patients with the erosive form of OLP were analyzed in three intervention groups (Er:YAG, n = 19; Nd:YAG, n = 15; Er:YAG + Nd:YAG combination, n = 20) and one control group with scalpel excision (n = 21). The therapy effectiveness has been assessed based on the comparison of salivary interleukin (IL)-1β, IL-6 and interferon (IFN)-γ preoperative levels to 14, 30 days, and 2 years postoperation, as well as pain level and time of epithelization.ResultsAll HLLT groups demonstrated a significantly (p > 0.05) higher IL-1β, IL-6, IFNγ and pain level reduction and quicker epithelization toward the control group on the 30th day, except Nd:YAG in case of IFNγ level. The highest IL-1β, IFNγ and pain level reduction and quicker epithelization on the 30th day was observed in Er:YAG group, followed by Er:YAG + Nd:YAG combination, Nd:YAG respectively. However no significant difference was observed between the HLLT groups with regard to IL-6 level reduction. After a 2-year follow-up, no significant difference was observed between all study groups with regard to all variables.ConclusionHLLT yields a superior clinical outcome compared to the scalpel excision for the surgical treatment of oral lichen planus, whereby the Er:YAG has been proposed as the most effective laser type at the end of the first postoperative month.Clinical relevanceFor the surgical treatment of erosive OLP the Er:YAG laser may be a preferable treatment option compared to Nd:YAG and scalpel surgery.Trial registrationThe present trial was registered retrospectively in the German Clinical Trials Register, as a member of WHO international clinical trials registry platform, on the 18.03.2020 with the following number: DRKS00020986

Erosive lichen Planus of Gingiva – A case Report

Oral Lichen Planus (OLP) is a common chronic immunological inflammatory mucocutaneous disorder that varies in appearance from keratotic (reticular or plaque like) to erythmatous and ulcerative. The erosive form of OLP manifests as a mixture of erythematous and ulcerated areas bounded by finely radiating keratotic striaeTreatment should be directed at achieving specific goals after considering the degree of clinical involvement, Reticular lesions that are asymptomatic generally require no therapy. All treatment should be aimed at eliminating atrophic and ulcerative lesions, alleviating symptoms, and potentially decreasing the risk of malignant transformation. Relief of painful symptoms can be obtained with mid potency topical corticosteroids. Systemic corticosteroids are, usually reserved for cases where topical approaches have failed, where there is recalcitrant, erosive, or erythematous OLP, or for widespread OLP when skin, genitals, esophagus, or scalp are also involved.

Diagnosis of oral lichen planus from analysis of saliva samples using terahertz time-domain spectroscopy and chemometrics.

The ability to diagnose oral lichen planus (OLP) based on saliva analysis using THz time-domain spectroscopy and chemometrics is discussed. The study involved 30 patients (2 male and 28 female) with OLP. This group consisted of two subgroups with the erosive form of OLP (n = 15) and with the reticular and papular forms of OLP (n = 15). The control group consisted of six healthy volunteers (one male and five females) without inflammation in the mucous membrane in the oral cavity and without periodontitis. Principal component analysis was used to reveal informative features in the experimental data. The one-versus-one multiclass classifier using support vector machine binary classifiers was used. The two-stage classification approach using several absorption spectra scans for an individual saliva sample provided 100% accuracy of differential classification between OLP subgroups and control group.

Oral Mini Pulse Therapy a Novel Therapy in a Management of Multivariant Oral Lichen Planus: An Unusual Case Report

Oral lichen planus (OLP) is a chronic mucocutaneous disease with an unknown aetiology, affecting 0.5%-2% of the population and with a predilection for females in fourth to fifth decade of life. Most oral lichen planus lesions are asymptomatic but the atrophic and erosive forms of OLP can cause symptoms ranging from spontaneous soreness to severe pain interfering with eating, speech and swallowing. Various drugs have been used for the treatment of OLP including corticosteroids and other immunomodulators. However, no therapy is considered as the single most effective and without side effects in the management of this enigmatic disease. This is a case report of successful management of extensive, symptomatic multivariant OLP with a novel treatment with oral mini pulse (OMP) therapy.

Serum levels of heat shock protein-70 in patients with Oral Lichen Planus

Usually increased presence of Heat Shock Proteins (HSPs) is considered to mediate inflammation process in Oral Lichen Planus (OLP) lesions, but in contrast HSP-70 expression found to be stable or even decreased in those lesions. The purpose of this study was to detect the serum titres of the HSP-70 in patients with OLP compared to healthy individuals, which may indicate an alternative, systemic role. Serum levels of HSP- 70 were detected by sandwich-ELISA in 45 patients with reticular (n=28) and erosive (n=17) OLP, respectively. A group of 35 healthy individuals was used as control. HSP-70 was detected in significantly increased levels in OLP (p&lt;0.05) compared to controls. The increase was prominent in reticular-OLP (p&lt;0.05), whereas no difference was observed between serum HSP-70 in erosive OLP compared to controls. These results indicate a systemic initiation of the immune response in the pathogenesis and process of OLP. The higher titres of HSP-70 in reticular but not erosive form of OLP indicate rather an immunoregulatory role in chronicity than in the acute inflammatory process of OLP. Consequently, the evaluation of serum imbalances of HSP-70 in OLP using ELISA may be a useful marker for disease's monitoring and/or efficacy of systemic treatment.

Role of apoptosis in erosive and reticular oral lichen planus exhibiting variable epithelial thickness

Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical types. Reticular and erosive forms are the most common. Although the cause of OLP remains speculative, many findings suggest auto-immune involvement, mediated by T lymphocytes against the basal keratinocytes. Inflammation, mechanical trauma or toxic agents can affect the epithelial homeostasia. Increased apoptosis may cause a decrease in epithelial thickness reflecting in the activity of the lesion. The objective of this study was to evaluate the occurrence of apoptosis and epithelial thickness in reticular and erosive forms of OLP. 15 samples of OLP each type (reticular and erosive) plus 10 of healthy mucosa were collected and processed. After morphometry, the apoptotic index and epithelial thickness were obtained. TUNEL and M30 CytoDEATH immunohistochemical assay were used to validate the morphologic criteria used. Apoptosis in the erosive OLP was significantly more intense than in the reticular type and both forms of OLP presented more apoptosis than the healthy oral mucosa. Healthy oral mucosa was thicker than both OLP forms and thicker in OLP reticular form than in the erosive one. The clinical differences between reticular and erosive forms of OLP are related to variations in epithelial thickness and in intensity of apoptosis.

Psychological profile in oral lichen planus

Oral lichen planus (OLP) is an oral lesion with an enigmatic etiology. To explore the possibility of psycho-somatization, we evaluated the psychological personality profiles of OLP patients. Twenty patients with reticular; 20 with erosive form of OLP, and 25 controls were tested with the psychological Minnesota Multiphasic Personality Inventory (MMPI)-202 test. Eight clinical scales (hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania) as well as cortisol level, CD3, CD4, CD8, and CD16 markers by group were compared. Psychosomatization was evaluated by the use of internalization ratio (IR) Index. A characteristic MMPI profile was noted in the OLP groups with high IR index value. Significant differences among the groups were detected for cortisol, CD4, CD8, and CD16 counts. Mean values for hypochondriasis, depression, and hysteria were all significantly different with significantly higher mean scores for both reticular and erosive OLP subjects compared with controls. Prolonged emotive stress in many OLP patients may lead to psychosomatization and may contribute to the initiation and clinical expression of this oral disorder. If additional research involving a larger and more diverse sample of patients confirms these findings, clinical trials will be needed to determine whether adjunctive psychological intervention provides a benefit in treating patients with OLP.