Inflammatory Disease Of Oral Mucosa Research Articles

Interpretation and consideration of core outcome set in clinical intervention study of oral lichen planus

Oral lichen planus (OLP), as a chronic inflammatory disease of oral mucosa, cannot be completely cured at present. OLP can develop into oral squamous cell carcinoma and reduce the life quality of patients. The development of high-quality evidence-based strategies for OLP clinical management can effectively alleviate the clinical symptoms and reduce the risk of cancerization, thus to improve the life quality of patients. However, there is a wide variety of outcomes and a lack of uniform standards in previous OLP clinical intervention studies. Therefore, evidence-based analysis of relevant studies cannot be conducted to provide more convincing guidance for clinical diagnosis and treatment. To reduce the heterogeneity of clinical intervention studies, form a data pool for meta-analysis, and provide higher quality evidence-based OLP clinical management protocols, the World Workshop on Oral Medicine Ⅷ identified a core outcome set (COS) for OLP in three steps from March 2022 to January 2023. This article introduces the process of COS formulation, interprets OLP COS, and puts forward the advantages and drawback of OLP COS in this paper. We encourage researchers to use this COS in their future OLP clinical studies for improving the clinical significance and evidence-based value of studies.

Carboxymethyl Chitosan/Sodium Alginate/Chitosan Quaternary Ammonium Salt Composite Hydrogel Supported 3J for the Treatment of Oral Ulcer.

Oral ulcer is a common inflammatory disease of oral mucosa, causing severe burning pain and great inconvenience to daily life. In this study, compound 3J with anti-inflammatory activity was synthesized beforehand. Following that, an intelligent composite hydrogel supported 3J was designed with sodium alginate, carboxymethyl chitosan, and chitosan quaternary ammonium salt as the skeleton, and its therapeutic effect on the rat oral ulcer model was investigated. The results show that the composite hydrogel has a dense honeycomb structure, which is conducive to drug loading and wound ventilation, and has biodegradability. It has certain antibacterial effects and good anti-inflammatory activity. When loaded with 3J, it reduced levels of TNF-α and IL-6 in inflammatory cells by up to 50.0%. It has excellent swelling and water retention properties, with a swelling rate of up to 765.0% in a pH 8.5 environment. The existence of a large number of quaternary ammonium groups, carboxyl groups, and hydroxyl groups makes it show obvious differences in swelling in different pH environments, which proves that it has double pH sensitivity. It is beneficial to adapt to the highly dynamic changes of the oral environment. Compared with single hydrogel or drug treatment, the drug-loaded hydrogel has a better effect on the treatment of oral ulcers.

Targeting Th17 cells: a promising strategy to treat oral mucosal inflammatory diseases.

With the improved quality of life, oral health is under increased pressure. Numerous common oral mucosal diseases, such as oral lichen planus(OLP) and gingivitis, are related to the destruction of the oral immune barrier. The cytokines secreted by T-helper 17 (Th17) cells are essential for maintaining oral immune homeostasis and play essential roles in immune surveillance. When antigens stimulate the epithelium, Th17 cells expand, differentiate, and generate inflammatory factors to recruit other lymphocytes, such as neutrophils, to clear the infection, which helps to maintain the integrity of the epithelial barrier. In contrast, excessive Th17/IL-17 axis reactions may cause autoimmune damage. Therefore, an in-depth understanding of the role of Th17 cells in oral mucosa may provide prospects for treating oral mucosal diseases. We reviewed the role of Th17 cells in various oral and skin mucosal systemic diseases with oral characteristics, and based on the findings of these reports, we emphasize that Th17 cellular response may be a critical factor in inflammatory diseases of the oral mucosa. In addition, we should pay attention to the role and relationship of "pathogenic Th17" and "non-pathogenic Th17" in oral mucosal diseases. We hope to provide a reference for Th17 cells as a potential therapeutic target for treating oral mucosal inflammatory disorders in the future.

Evaluation of Oxidative stress using Superoxide Dismutase and Lipid Peroxidation in Lichen Planus: A Tissue Level Enzymatic Analysis Study

Introduction: Oral Lichen Planus (OLP) is a chronic inflammatory disease of oral mucosa with unknown etiology.Many studies have suggested that increased oxidative stress, an imbalance in the antioxidant defense system maybe involved in pathogenesis of Lichen planus.Aim: The aim of this study was to compare the tissue levels of antioxidant Super oxide dismutase (SOD) and lipidperoxidation marker Malondialdehyde (MDA) in established cases of OLP and healthy individuals.Methodology: Ten patients with OLP and 10 control subjects matched for age and sex were enrolled in this casecontrol study. The tissue levels of SOD and MDA were measured both in case and control groups.Results: The tissue levels of SOD were increased that was statistically significant in OLP patients compared tohealthy controls (p<0.01). The lipid peroxidation product MDA were relatively higher in OLP patients comparedto healthy controls. Conclusion: The current study suggests that oxidative damage is one of the major causes forthe pathogenesis of OLP.

THE IMPACT OF ANATOMICAL CHARACTERISTICS ON THE DEVELOPMENT OF ORAL MUCOSAL DISEASES IN CHILDREN WITH DOWN SYNDROME

BACKGROUND: Dental treatment plays a big role in improving the health and quality of life of children with Down syndrome. These children need rationally organized additional dental treatment by different specialists and systematic medical observation. The high incidence and prevalence of periodontal disease in children with Down syndrome are caused by anatomical features of cranial development. OBJECTIVE: pattern identification between anatomical characteristics and development of oral mucosal diseases in children with Down syndrome. METHODS: The study included 24 patients with Down syndrome. They were registered at the Department of Pediatric Dentistry of the Tver Dental Polyclinic (Russia). The age of the patients was from 2 to 13 years old. RESULTS: 59.5% of patients had a missing nasal bone. 58% of children had an arched palate. 65% of children had oral breathing type due to macroglossia and weak temporomandibular joint muscles. It can be the reason for the development of inflammatory oral mucosal diseases. The children with Down syndrome often have stomatitis and gingivitis, which develops into chronic periodontal diseases. 62% of children had the creased tongue at the age of 4 years. Down syndrome has a high prevalence of maxillofacial anomalies of up to 76%. It contributes to the formation of plaque on the teeth and caries. It often leads to damage to the rudiments of permanent teeth. The prevalence of periodontal disease in children with Down syndrome is associated with severe hypotonia of the masticatory muscles up to 87%. CONCLUSION: Pediatric dentists focus on the features of the dental status of children with Down syndrome, taking into account the relationship of pathological processes in the maxillofacial area and somatic pathology. Specialists in pediatric dentistry must understand the importance of early prevention, which can reduce the risk of developing cavities and periodontal disease in children.

Evaluation of Oral Dryness and the Salivary-flow Rate in Patients with Oral Lichen Planus

Background and Objectives: Oral lichen planus (OLP) is a common T-cell-mediated inflammatory oral mucosal disease. One of the complaints among OLP patients is xerostomia. However, the relationship between oral dryness and a decreased salivary-flow rate in these patients is not yet conclusive. So, we investigated oral dryness and the salivary-flow rate in OLP patients using various measurements. Material and Methods: Thirty OLP patients and 30 controls were included. The oral-dryness symptoms were collected using the Xerostomia Inventory (XI) and Bother Index (BI). The salivary-flow rate was measured using a Modified Schirmer Test (MST) and the spitting method. The clinical signs of dry mouth were determined by the clinical oral-dryness score (CODS). The Thongprasom score was used to evaluate the severity of OLP. The data were analyzed using the Mann-Whitney U test and Spearman’s rank correlation coefficient. Results: The XI score and BI score in the OLP group were significantly higher than in the control group. However, CODS, MST, the unstimulated salivary-flow rate, and the stimulated salivary-flow rate were not significantly different between the two groups. There was no correlation between oral dryness and the salivary-flow rate in OLP patients. The severity of OLP was also not correlated to oral dryness and the salivary-flow rate. Conclusion: OLP patients had more complaints about mouth dryness than the controls. However, the salivary-flow rates between the two groups were not different. Additionally, the severity of OLP was not related to dry mouth or the salivary-flow rate. The possible reasons for oral dryness among people with OLP require further investigation.

Electrospun patch delivery of anti-TNFα F(ab) for the treatment of inflammatory oral mucosal disease.

Chronic ulcerative oral mucosal inflammatory diseases, including oral lichen planus and recurrent aphthous stomatitis, are painful and highly prevalent, yet lack effective clinical management. In recent years, systemic biologic therapies, including monoclonal antibodies that block the activity of cytokines, have been increasingly used to treat a range of immune-mediated inflammatory conditions such as rheumatoid arthritis and psoriasis. The ability to deliver similar therapeutic agents locally to the oral epithelium could radically alter treatment options for oral mucosal inflammatory diseases, where pro-inflammatory cytokines, in particular tumour-necrosis factor-α (TNFα), are major drivers of pathogenesis. To address this, an electrospun dual-layer mucoadhesive patch comprising medical-grade polymers was investigated for the delivery of F(ab) biologics to the oral mucosa. A fluorescent-labelled F(ab) was incorporated into mucoadhesive membranes using electrospinning with 97% v/v ethanol as a solvent. The F(ab) was detected within the fibres in aggregates when visualised by confocal microscopy. Biotinylated F(ab) was rapidly eluted from the patch (97±5% released within 3h) without loss of antigen-binding activity. Patches applied to oral epithelium models successfully delivered the F(ab), with fluorescent F(ab) observed within the tissue and 5.1±1.5% cumulative transepithelial permeation reached after 9h. Neutralising anti-TNFα F(ab) fragments were generated from whole IgG by papain cleavage, as confirmed by SDS-PAGE, then incorporated into patches. F(ab)-containing patches had TNFα neutralising activity, as shown by the suppression of TNFα-mediated CXCL8 release from oral keratinocytes cultured as monolayers. Patches were applied to lipopolysaccharide-stimulated immune-competent oral mucosal ulcer equivalents that contained primary macrophages. Anti-TNFα patch treatment led to reduced levels of active TNFα along with a reduction in the levels of disease-implicated T-cell chemokines (CCL3, CCL5, and CXCL10) to baseline concentrations. This is the first report of an effective device for the delivery of antibody-based biologics to the oral mucosa, enabling the future development of new therapeutic strategies to treat painful conditions.

MiR-155-5p modulates inflammatory phenotype of activated oral lichen-planus-associated-fibroblasts by targeting SOCS1.

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease. Cytokines are closely associated with OLP development. In addition to immune cells, fibroblasts have been reported to induce regional inflammation. MicroRNA(miR)-155-5p is reportedly increased significantly in OLP and is known to regulate inflammation. This study aimed to investigate the role of miR-155-5p in fibroblasts of OLP lesions. Normal mucosal fibroblasts (NFs) and OLP associated-fibroblasts (OLP AFs) were isolated from the oral mucosa of 15 healthy controls and 30 OLP patients. We detected the expression of miR-155-5p and fibroblast activation protein alpha (FAP-α) using quantitative RT-PCR and analyzed their correlation. Interleukin (IL)-6 and IL-8 levels were determined using ELISA. Expression of suppressor of cytokine signaling (SOCS) 1 was analyzed by western blotting. A dual-luciferase reporter assay was performed to investigate the interaction between miR-155-5p and SOCS1. MiR-155-5p and FAP-α were significantly increased and positively correlated in OLP AFs. Overexpression of miR-155-5p in OLP AFs augmented IL-6 and IL-8 release and decreased SOCS1 expression, whereas knockdown of miR-155-5p in OLP AFs decreased IL-6 and IL-8 release. The expression of SOCS1 was downregulated in OLP AFs, and SOCS1 silencing augmented IL-6 and IL-8 production in OLP AFs. Furthermore, miR-155-5p inhibited SOCS1 expression by directly targeting its 3'-UTR in OLP AFs. MiR-155-5p regulates the secretion of IL-6 and IL-8 by downregulating the expression of SOCS1 in activated OLP AFs. Our results provide novel insights into the pathogenesis of OLP and identify a potential new target for OLP therapy.

Guideline for the diagnosis and treatment of oral lichen planus (revision)

Oral lichen planus (OLP) is a chronic and inflammatory oral mucosal disease that commonly affects middle-aged females. Most OLP cases might exhibit such symptom as pain, roughness and other discomfort, and more severe forms may show a high risk of developing oral cancer. Active preventive measure, precise diagnosis and standard therapeutic approach play a vital role in the management and prevention of OLP. This guideline is a revision on the base of trial in 2012, which mainly covers the following 8 aspects: etiology and medical records, clinical manifestations, pathological manifestations, diagnosis, differential diagnosis, laboratory examination, disease treatment and prevention, aiming at providing scientific evidence and guidance for the dental clinicians in diagnose and treatment of OLP.

Is oral lichen planus a potential malignant disorder?: A critical appraisal.

Dear Editor, “The difficulty lies not in new ideas, but in escaping old ones” - John Keynes Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease of unknown etiology.[1] One of the most controversial aspects of OLP is its potentially malignant nature.[2] Numerous studies on OLP have reported varying malignant transformation rates of OLP from very high to almost negligible giving rise to conflicting findings.[23] Recent studies have reported malignant transformation of OLP ranging between 0.44 and 2.28%.[456] In this letter, we would like to put forth our views regarding the malignant transformation of OLP and its inclusion in oral potential malignant disorders (OPMDs). GLOBOCAN in 2018 reported the estimated average age-standardized rate of oral cancers worldwide as 4 per 100 000 (range between 0.4 and 20.4 per 100 000). So, based on the estimated worldwide prevalence of OLP, 5–20 OLP patients per 100 000 of the general population will develop oral cancer within 5 years. On comparing the global cancer prevalence rate with OLP, it shows that most oral squamous cell carcinoma (OSCC) cases have apparently developed from OLP, which seems questionable.[7] In most of the systematic reviews and meta-analyses, after application of strict criteria to the clinical appearance of the affected site and transformed location, histopathological presentation, habits, comorbid conditions, age, and gender, it is evidenced that the malignant transformation rate of OLP is exaggerated due to insufficient diagnostic criteria, inaccurate follow-up and/or average quality of investigation.[8] The diagnosis of OLP requires the presence of both clinical and histopathological features.[9] Unfortunately, many times diagnosis is solely based on clinical judgement without biopsy. It is quite possible that OSCC may clinically present as OLP and the clinician may institute topical/systemic steroid therapy without histopathological examination. Subsequent biopsy of those unresponsive lesions turns out to be OSCC, resulting in an inadvertent increase in the malignant transformation rate of OLP in studies. Topical/systemic steroid treatment results in decreased local immunity, providing a potential cause for conversion to cancer that cannot be ignored.[31011] Systemic condition like diabetes causes disturbances in cellular and humoral immune functions, reducing the immunity in OLP-affected patient which may lead to malignant transformation.[12] Association of tobacco and/or alcohol may also play a role in mucosal alteration at the microscopic level, increasing the likelihood of malignant transformation.[3] Though the investigators have supported the potentially malignant nature of OLP, a small but significant number of OSCC occur in non-smokers and non-drinkers with a range of 3–24%. Even with this finding the overall malignant transformation rate of OLP remains lower compared to the occurrence of OSCC in non-smokers and non-drinkers (OLP—2.28% vs OSCC in non-smokers and non-drinkers 3–24%).[6131415] Based on the above observations, it is high time for us to rethink whether OLP should still be considered as an OPMD? Once diagnosed with OLP, informing the patient about possible malignant transformation induces cancerophobia, causing stress and disturbing their emotional status further aggravating the signs and symptoms of OLP.[16] Until then, based on the literature reporting the potentially malignant nature of OLP, we suggest the need for psychological counseling for all OLP patients. This will definitely serve to alleviate their anxiety, thus making them more receptive to treatment. We hope our letter will generate a healthy discussion among the readers to arrive at a common consensus by putting forth their views on this topic. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Посилення антиоксидантного захисту та інгібування перекисного окислення ліпідів на тлі комплексного лікування дітей iз запальними захворюваннями слизової оболонки порожнини рота

Автори наводять клініко-біохімічні результати визначення параметрів системи «перекисне окислення ліпідів — антиоксидантний захист» на тлі комплексного лікування дітей iз запальними захворюваннями слизової оболонки порожнини рота. Проведене лікування призводить до зниження токсичної дії перекисних радикалів і також може служити додатковим критерієм ефективності терапії.

Use of unbiased metagenomic and transcriptomic analyses to investigate the association between feline calicivirus and feline chronic gingivostomatitis in domestic cats

To identify associations between microbes and host genes in cats with feline chronic gingivostomatitis (FCGS), a debilitating inflammatory oral mucosal disease with no known cause, compared with healthy cats and cats with periodontitis (control cats). 19 control cats and 23 cats with FCGS. At least 1 caudal oral mucosal swab specimen was obtained from each cat. Each specimen underwent unbiased metatranscriptomic next-generation RNA sequencing (mNGS). Filtered mNGS reads were aligned to all known genetic sequences from all organisms and to the cat transcriptome. The relative abundances of microbial and host gene read alignments were compared between FCGS-affected cats and control cats and between FCGS-affected cats that did and did not clinically respond to primary treatment. Assembled feline calicivirus (FCV) genomes were compared with reverse transcription PCR (RT-PCR) primers commonly used to identify FCV. The only microbe strongly associated with FCGS was FCV, which was detected in 21 of 23 FCGS-affected cats but no control cats. Problematic base pair mismatches were identified between the assembled FCV genomes and RT-PCR primers. Puma feline foamy virus was detected in 9 of 13 FCGS-affected cats that were refractory to treatment and 5 healthy cats but was not detected in FCGS-affected cats that responded to tooth extractions. The most differentially expressed genes in FCGS-affected cats were those associated with antiviral activity. Results suggested that FCGS pathogenesis has a viral component. Many FCV strains may yield false-negative results on RT-PCR-based assays. Coinfection of FCGS-affected cats with FCV and puma feline foamy virus may adversely affect response to treatment.

Immune mechanisms involved in the coexistence of oral lichen planus and autoimmune thyroid diseases.

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease with unclear etiology. Autoimmune thyroid diseases (AITD) is a type of autoimmune disease characterized by increased thyroid-specific antibodies. In recent years, more and more studies have found that the incidence of AITD is increased in OLP patients. The occurrence and development of OLP and AITD may be related to the expression of thyroid autoantigen in oral keratinocytes, the imbalance of thyroid hormone （Th）1/Th2 and Th17/Treg cell subsets, the abnormal quantity and function of follicular helper T cells and chemokines and the specific killing ability of CD8 T cells to target cells. In this article, the possible immune mechanisms involved in the coexistence of OLP and AITD are reviewed to provide insights for the diagnosis, treatment and prevention of these two diseases from the perspective of immunology.

Cortisol And Psychological Factors in Etiology of Lichen Planus

Background and Objectives: Lichen planus is a common chronic inflammatory disease of oral mucosa and skin, whose exact pathogenic mechanisms have not been understood. Cortisol, has been used as an indicator in various psychological evaluation studies. Salivary cortisol measurement is an indicator of free cortisol in human serum and provides noninvasive and easy technique. Aims, evaluation of cortisol levels and psycho-immunity profile in lichen planus patients was done. Using case-control method. Materials and Method: 145 participants were admitted which had been done at dermatological outpatient clinic at Al-Yarmook Teaching Hospital. 32 patients were clinically proven cases of LP, 113 subjects along with age and sex-matched healthy controls. DASS Score questionnaire was administered to evaluate the psychiatric status (depression, anxiety and stress), Saliva samples were collected, and analyzed for cortisol level by using ELISA in study group and 46 of control group. The serum test were examined in 32 for each group using enhanced lanthanide fluoroimmunoassay technique for cortisol. Results: The mean serum and Salivary cortisol level of the LP group showed a very highly significant difference (p=0.001) from the controls in multivariate statistic. The mean of DASS scores and the depression derangement specifically showed a very highly significant difference (p=0.001) from the controls. The stress and anxiety derangement showed high difference but it failed to reach to significant difference from the controls. There is an important association between serum and salivary cortisol concentration. Conclusion: the cortisol and psychiatric factors play a vital role in the pathogenesis of LP and saliva cortisol could be a possible indicator instead of serum cortisol

Regulatory effect of 17β-estradiol on the expression of β-defensin-2 and proinflammatory cytokines in human oral epithelial cells.

Although estrogen deficiency has been proposed as a risk factor for oral mucosal inflammatory diseases in post-menopausal women, the mechanisms involved remain unclear. This study aimed to investigate the effect of 17β-estradiol (E2) on the inflammatory response stimulated by interleukin-1 beta (IL-1β) in human oral mucosal epithelial cells (hOMECs) and its possible mechanism. Primary hOMECs were obtained from female infants and cultured in keratinocyte growth medium. The hOMECs at second passage were collected and stimulated by 10-7 mol/L ICI182,780 or 10-7 mol/L G1 for 1hour, E2 (10-7 mol/L, 10-8 mol/L, 10-9 mol/L) for 36hour, 100ng/mL IL-1β for 12hours, respectively. Human beta-2 defensin (hBD-2), tumor necrosis factor-alpha (TNF)-α, IL-6, IL-8, estrogen receptor-alpha (ERα), estrogen receptor-beta (ERβ), and G protein-coupled receptor 30 (GPR30) mRNA levels and protein levels were measured by real-time quantitative polymerase chain reaction (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and Western Blot (WB), respectively. Expression of hBD-2 and inflammatory cytokines increased after IL-1β stimulation, which was down-regulated by E2 pre-treatment. With ICI182,780, the suppression of E2 on hBD-2 mRNA was attenuated. With G1, the mRNA expression and protein expression of hBD-2 were reduced. Pre-treatment of hOMECs with E2 at physiological concentrations inhibited the IL-1β-induced expression of hBD-2 and inflammatory cytokines. The protective effects of E2 suggest its potential use treating oral inflammatory diseases in clinical practice.

Development and chinization of diagnostic criteria for oral lichen planus

Oral lichen planus (OLP) is a common chronic inflammatory disease of oral mucosa. The diagnostic criteria of OLP is the cornerstone of clinical diagnosis and treatment and scientific research. However, there are various understandings of the diagnostic criteria in China. Thus several questions need to be answered, for example, how to combine the international diagnostic criteria with China's specific conditions, how to apply the criteria into clinical practice, and how to use the criteria guiding clinical work and scientific research in China. The authors of this article systematically introduced and discussed the development, content and difference of the international diagnostic criteria of OLP. We proposed "23 Princeples" for the selection of biopsy indications in OLP diagnosis based on authors' personal experiences in clinical and basic research and the actual conditions of Chinese clinicians. We also express our own views and suggestions about some other hot issues associated with OLP diagnosis.

Serum and Salivary Level of Nitric Oxide (NOx) and CRP in Oral Lichen Planus (OLP) Patients.

Statement of the Problem: Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease with unclear etiology while a few cases of disease become malignant.Purpose: This study aimed to evaluate the level of nitric oxide (NOx) and C-reactive protein (CRP) as oxidative stress and inflammation status in sample of OLP patients.Materials and Method: In this case-control study, serum and salivary NOx and CRP levels were evaluated in twenty two OLP patients as the case group confirmed by clinical and histopathological diagnosis, and twenty two healthy control groups collected from Tooba Oral Pathology Laboratory in Sari in 2016. The data were analyzed by using independent-samples t-test, Mann-Whitney U-test and Chi-square by using SPSS version 21. The statistical significant level was considered at p< 0.05.Results: Salivary and serum NOx levels in case group showed statistically significantly higher than healthy control group (p= 0.035 and p= 0.001, respectively). CRP values were significantly higher both in serum (p= 0.001) and in saliva (p= 0.035). A significant correlation was found between CRP and NOx values in serum (r= 0.521, p= 0.0001) and saliva (r= 0.427, p= 0.045).Conclusion: Oxidative stress causes damage to organs in the human body. Correct understanding of oxidative stress and its association with free radicals and inflammatory markers related to oral disease are important for effective treatments. The results of the study advocate the effects of NOx and CRP levels in pathogenesis of OLP. Therefore, antioxidant drugs might probably be considered in the treatment of OLP.

Gene variability in matrix metalloproteinases in patients with recurrent aphthous stomatitis.

The development of recurrent aphthous stomatitis (RAS), inflammatory disease of oral mucosa, is influenced by both environmental and genetic factors. The aim of this study was to investigate polymorphisms located in seven genes coding different types of matrix metalloproteinases (MMPs)-collagenases (MMP1, MMP8, and MMP13), gelatinases (MMP2 and MMP9), stromelysin (MMP3), and membrane-type metalloproteinase (MMP16) in patients with RAS and healthy controls. Totally, 223 subjects were included in this case-control study and their detailed anamnestic, clinical, and laboratory parameters were recorded. Seventy-seven patients with RAS and 146 controls were genotyped for seventeen polymorphisms in the MMPs genes using the real-time polymerase chain reaction (PCR) or PCR with restriction analysis. Allele, genotype, and haplotype frequencies of the studied polymorphisms between RAS patients and controls were similar, except for allele distributions of MMP1 rs1144393, MMP9 rs3918242, and MMP16 rs10429371, which were different between patients with RAS and healthy controls (P=.023, P=.049 and P=.025, all Pcorr >0.05, respectively). Moreover, the comparison of genotype frequencies (TT vs CC+CT) of the MMP16 rs10429371 variant showed a marginally significant difference between RAS patients and controls (P=.05, Pcorr >0.05, OR=1.68, 95% CI=0.95-2.98). No significant relationship between investigated polymorphisms in seven MMPs genes and RAS development in the Czech population was observed in this study.

Expression of nucleotide-binding oligomerization domain 1 and 2 in oral lichen planus

Background/purposeOral lichen planus (OLP) is a chronic inflammatory disease of oral mucosa. The present study investigated the expression of nucleotide-binding oligomerization domain (NOD), a pivotal sensor protein of the innate immune system, in OLP. Materials and methodsOral mucosal biopsies were collected from 20 patients with OLP and 6 individuals with normal oral mucosa (NOM). The expression of NOD1 and NOD2 was determined using RT-PCR and immunohistochemistry in OLP and NOM samples. ResultsThe mRNA expression of NOD1 and NOD2 was significantly higher in the OLP group than in the NOM group. The protein expression of NOD1 was marginally upregulated in all mucosal layers in the OLP group compared with that of the NOM group; however, the differences were not significant. The expression of NOD2 was elevated in infiltrating lymphocytes of the submucosal layer in the OLP group compared with the NOM group, but was undetected in other inflammatory disease, inflammatory fibrous hyperplasia (IFH). This study revealed the upregulation of NOD2 mRNA and protein in the OLP group, but not in the NOM group. ConclusionThese findings suggest that NOD2 may play an important role in the pathogenesis of OLP and represents a new diagnostic and treatment target.

Salivary vitamin E and uric acid in patients with OLP and healthy individuals

Background: Oral Lichen planus (OLP) is a T-cell mediated chronic inflammatory oral mucosal disease of unknown etiology. Recent studies have reported an increased oxidative stress and lipid peroxidation in such patients. This suggests that reactive oxygen species may have a role in the pathogenesis of lichen planus. Oxidative stress in OLP release molecules consisting of granzymes resulting in local tissue damage in the effectors. Antioxidants that can defend against oxidative stress in the body cells include enzymes, as well as non- enzymatic antioxidants, such as melatonin, uric acid, vitamin A and E. Purpose: To study the level of salivary vitamin E and uric acid as antioxidant agents in patients with OLP and compared with healthy control. Methods: Twenty five patients with OLP were enrolled in this study. Age, gender, occupation, smoking status (smokers or non-smokers), lesion types, duration, location and size were recorded for each patient. After an oral examination, salivary samples were collected and flow rates (ml/min) were recorded. The collected samples were centrifuged at 3000 rpm for 10 minutes; the clear supernatants were separated and stored frozen at (-20 c) until analysis. Then salivary vitamin E was investigated using ELISA kit based on bioten double antibody sandwich technology. Uric acid was analyzed using a proprietary enzymatic reaction mixture that enables the detection of uric acid by the production of a red chromogen, which is quantitatively measured at a wavelength of 515 or 520 nm. Results: The mean age of OLP patients was 48.3 years with a range of 30-60 years. Control group consisted of 35 healthy subjects who were age matched with OLP patients. Fourteen (56%) patients were with reticular and 11 (44%) were with erosive form, with the buccal mucosa was the most commonly affected site (88%), followed by tongue (8%) then gingiva (4%). A significantly lower salivary flow-rate, lower salivary vitamin E and uric acid level in OLP patients compared to control; while, no significant difference was seen between reticular and erosive type of OLP for both vitamin E and uric acid level. Regarding gender, no differences were found between males and females in salivary vitamin E. No significant correlation was found between vitamin E /uric acid and age. Similarly, no difference was found between males and females in uric acid. Conclusion: Salivary anti-oxidant markers represented by vitamin E and uric acid decreased in OLP patients due to increase oxidative stress which may have an important role in the pathogenesis. Thus, it is recommended to give OLP patients anti-oxidant agents that may either help in healing process or decreased the severity.