Lichen Planus Research Articles

Immunohistochemical examination of immunoreactivity of transient receptor potential melastatin 2, glutathione peroxidase 4 and spexin in lichen planus.

In this study, we aimed to investigate the potential contributions to the disease by examining the immunoreactivities of SPX in LP-affected skin tissue using immunohistochemical methods, in light of its recent prominence as a molecule related to diabetes mellitus, along with apoptosis and ferroptosis mediated by GPX4 and TRPM2 channels facilitating oxidative stress-induced cell death. This research explored the immunohistochemical expressions of TRPM2, GPX4, and SPX in Lichen Planus (LP) patients compared to healthy individuals. Forty skin samples were collected, split equally between LP patients and healthy controls, excluding those with other conditions. Samples underwent immunohistochemical staining for TRPM2, SPX, and GPX4, using secondary antibodies and chromogens AEC or DAB. Histoscores were calculated based on staining diffusiveness and severity. Statistical analyses were performed with SPSS 22.0, using t-tests and ANOVA, with significance set at p < 0.05. There were no demographic differences between groups (p > 0.05). LP patients showed significantly lower TRPM2 and GPX4 histoscores and higher SPX histoscores compared to controls (TRPM2 and GPX4: p < 0.001, SPX: p < 0.001). Gender and age did not affect histoscores significantly. Findings suggest TRPM2, GPX4, and SPX play roles in LP pathogenesis, indicating a need for further molecular studies to clarify their involvement. This contributes to understanding LP beyond the traditional apoptosis perspective.

A Comparison of Traditional Chinese Medicine and Multiple Conventional Therapy in Treating Oral Lichen Planus: A Network Meta-analysis.

To evaluate and compare the efficacy of seven conventional treatments and traditional Chinese medicine (TCM) combined therapies for oral lichen planus. This study employs PubMed, Web of Science, Cochrane Library, and Cnki to collect studies. After evaluating the quality and bias risk, RevMan 5.4.1 and R Gemtc package was utilised with a visual analogue scale and side effects as outcomes, to compare the efficacy of the seven treatments. This study included 20 studies, with a sample size of 1669. Our results suggest that photodynamic therapy and TCM demonstrate the most significant decrease in visual analogue scale and the rank is as follows: photodynamic therapy > TCM > TCM combined with non-hormonal immunosuppressive drugs > TCM combined with glucocorticoids > chloroquine combined with glucocorticoids > non-hormonal immunosuppressive drugs > glucocorticoids. Among them, compared to glucocorticoids, photodynamic therapy (-1.55, 95% CI: (-3.09, -0.02)), TCM (-1.25, 95% CI: (-2.46, -0.06)) significantly outperform in statistics. Moreover, no side effects were reported by the photodynamic therapy treatment. In the comparison with non-hormonal immunosuppressive drugs, the result indicates TCM (-4.17, 95% CI (-8.24, -0.34)), glucocorticoids (-2.78, 95% CI (-5.69, -0.17)) and their combination (-2.83, 95% CI (-5.93, -0.05)) have a significantly lower probability of the appearance of side effects. This study indicates that TCM, from the perspectives of efficacy and the likelihood of side effects, outperforms all other common therapies, besides photodynamic therapy, in treating oral lichen planus.

Demographic and Clinical Characteristics of Pre-Malignant Oral Lesions and their Related Factors in an Iranian Population: A Registry-Based Study

Background: Oral Potentially Malignant Disorders (OPMDs) can lead to Oral Squamous Cell Carcinoma (OSCC). The sixth most common cancer in the world is OSCC. This study aimed to describe the demographical and clinical characteristics of OPMD patients and their risk factors registered at the Oral Medicine Department of Shahid Beheshti Dental School in 2019-2021. Methods: The observational-analytical study was conducted using the dental records of 96 consecutive patients using a web-based registration software (OPMDs registry). Information including demographics and clinical features, the type of OPMD, and risk factors were extracted. Data were analyzed using the Chi-square test, T-test, and Fisher’s exact test with SPSS version 21. Results: In this study, 96 patients (average age: 52.41±14.87) including 52 women and 44 men, participated. The most common OPMDs comprised 69 Oral Lichen Planus (OLP) and 15 leukoplakia. The most common location of lesions was the buccal mucosa (74%) with erosions and plaques being the most common morphology types. Most patients with leukoplakia were male, however, majority of the patients with OLP were female (p=0.001). In patients with leukoplakia, 66.5% were smokers; hence, a significant relationship between smoking and OPMD was observed (p=0.001). Patients with OLP commonly presented with burning symptoms, while patients with leukoplakia were mostly asymptomatic (p=0.004). Conclusion: A significant relationship was observed between gender, clinical symptoms, location of lesions, morphology, and type of OPMDs. Most patients with OPMDs were women with OLP in their buccal mucosa, suffering from burning sensation.

Dynamics of the effect of local treatment on the frequency of nuclei with perinuclear vacuole in the cytogram of buccal epithelium in patients with the erosive and ulcerative form of the lichen planus in the oral cavity mucosa lining

INTRODUCTION. The use of cytologic studies allows evaluating the dynamics of the local treatment conducted of the EUF (L43.82) LP OCML (Erosive and Ulcerative Form of the Lichen Planus in the Oral Cavity Mucosa Lining) in a comprehensive way.AIM. Evaluation of the effect of local the effect of local treatment on the frequency of nuclei with perinuclear vacuole in the cytogram of buccal epithelium of the reticular mesh surface, hyperemic zone and erosive and ulcerative elements in patients with the erosive and ulcerative form of the flat lichen of the oral mucosa (L43.82).MATERIAL AND METHODS. 86 patients with the EUF (L43.82) LP OCML participated in the study. The number of nuclei with perinuclear vacuole was assessed in cytologic preparations obtained from buccal epithelium, which was a reliable criterion to confirm the nature of chronic inflammation. The dynamics of cells with necrosis in the cytogram of buccal epithelium was evaluated using nonparametric criteria as follows: Mann-Whitney test (comparison between subgroups and with the experimental group), Wilcoxon test (to compare within subgroups before and after treatment). Significant differences did not exceed 0.05.RESULTS. In the course of the treatment conducted in the cytogram of buccal epithelium there was a decrease in the frequency of nuclei with perinuclear vacuole of the reticular mesh surface and erosive and ulcerative elements in patients of the main clinical groups 1 and 2(p&lt; 0.001). When analyzing the frequency of nuclei with perinuclear vacuole in the cytogram of buccal epithelium taken from the surface of erosions and ulcers, there were significant differences before and after treatment according to the Wilcoxon test. In the clinical group using the treatment method according to federal guidelines, the frequency of nuclei with perinuclear vacuole was observed at a significance level of p&lt; 0.05, and when using the local treatment complex proposed respectively at p&lt; 0.001.CONCLUSION. Thus, in the cytogram of buccal epithelium according to the Wilcoxon test before and after the local treatment proposed, there was a more evident decrease in the number of nuclei with perinuclear vacuole than with the use of federal guidelines.

Lichen Planus Pigmentosus Inversus: case report and systematic review

Lichen Planus Pigmentosus Inversus (LPPI) is a rare variant of lichen planus characterized by well-demarcated, often slight pruritic, dark-gray plaques in intertriginous zones, hence the attribute of “inversus”, originally described by Pock et al. in 2001. Less than 100 cases have been reported to date, and here we present a case in a 52-year-old male who presented with two months duration of grey-brownish plaques in bilateral axillary, submammary, antecubital, and inguinal folds. No triggering agent was present, and the biopsy showed an interface/lichenoid dermatitis with plenty of pigment incontinence. Topical tacrolimus 0.1% ointment was administered with moderate improvement at five weeks. A review of the literature showed no significant differences in involved sites and age distribution among genders, with a slightly longer duration of manifestations in females. The most administered therapeutic agents were topical corticosteroids, alone or in combination with other agents, and tacrolimus.

Histological Improvement and Cytokine Levels Reduction in Patients with Oral Lichen Planus after Photobiomodulation Therapy.

Background: Oral lichen planus (OLP) is a mucocutaneous disease associated with the formation of symptomatic lesions in the mouth that are often refractory to treatment. An as-yet-unknown antigen triggers an inflammatory reaction in which various immune and non-immune cells release multiple cytokines that contribute to disease progression. The ability of photobiomodulation (PBM) to reduce the symptoms and signs of the disease has been shown, but little is known about its molecular and cellular effects. The aim of this study was to evaluate changes in pro-inflammatory cytokine levels and in histological findings in OLP patients treated with photobiomodulation therapy. Methods: Twenty OLP patients underwent PBM with diode laser (810 nm), (0.50 W, 30 s, 1.2 J/cm2), 3 times weekly for a month. Pain level and clinical scores of lesions were recorded before and after therapy. Salivary levels of IL-1β, IL-6, and TNF-α in OLP patients were measured before and after PBM and compared with those of 10 healthy controls. Biopsies were taken at the beginning and end of treatment to assess pathomorphological changes. Results: PBM significantly reduced the level of pain and clinical scores of the lesions. Salivary levels of IL-1β, IL-6, and TNF-α in OLP patients were significantly higher compared to those in healthy controls and decreased after therapy. 60% of the post-treatment OLP biopsies demonstrated histological improvement, characterized by inflammatory infiltrate reduction (50%), epithelial hyperplasia reduction (30%), epithelial thickening (15%), or epidermal-dermal attachment repair (5%). Conclusion: The effectiveness of PBM therapy in OLP patients was confirmed at the clinical, molecular, and histomorphological levels.

Association of serum and salivary dipeptidyl peptidase-4 (DPP-4) with oral cancerous and precancerous lesions; an observational diagnostic accuracy study

BackgroundEnhancing the prognosis and treatment outcomes of oral cancer relies heavily on its early detection. This study aims to establish a connection between serum and salivary dipeptidyl peptidase-4 (DPP-4) levels and oral squamous cell carcinoma (OSCC), comparing them with oral potentially malignant lesions (OPMLs) and control subjects and validating salivary DPP-4 as a diagnostic marker for the early detection of oral cancer.MethodologyForty-five systemically healthy individuals were categorized into three groups: Group I consisted of 15 patients diagnosed with OSCC, Group II comprised 15 patients with OPMLs (including leukoplakia and oral lichen planus), and Group III included 15 participants without any oral mucosal lesions. Serum and whole unstimulated salivary samples were collected from all participants to assess DPP-4 levels using an enzyme-linked immunosorbent assay (ELISA) kit. Receiver operating characteristic (ROC) analysis was conducted to determine the area under the curve (AUC), sensitivity, specificity, and diagnostic accuracy of DPP-4.ResultsBoth serum and salivary DPP-4 levels were highest in the healthy group, followed by OPMLs, and lowest in the OSCC group, with statistically significant differences observed. ROC analysis demonstrated excellent diagnostic accuracy of salivary DPP-4 in distinguishing OSCC from healthy individuals, OPMLs from healthy individuals, and OSCC from OPMLs, with accuracies of 100%, 100%, and 96.67%, respectively. Salivary DPP-4 levels also exhibited a statistically significant correlation with OSCC grades.ConclusionsDPP-4 appears to play a protective, anti-oncogenic role in maintaining oral tissue health. The remarkable diagnostic accuracy of both serum and salivary DPP-4 in discriminating between OSCC, OPMLs, and healthy controls suggests its potential utility as a well-established marker for early oral cancer diagnosis. Salivary DPP-4, being non-invasive, could serve as a convenient chair-side diagnostic tool for the early detection of OSCC.Clinical trial registrationThe study was retrospectively registered on clinicaltrial.gov with NCT06087042, date of registration (first posted date): 17/10/2023

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.

Application of Targeted Optical Coherence Tomography in Oral Cancer: A Cross-Sectional Preliminary Study.

The diagnosis of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) represent a significant challenge in oral medicine. Optical coherence tomography (OCT) shows promise for evaluating oral tissue microstructure but lacks standardized diagnostic protocols tailored to the structural variability and lesions of oral mucosa. This cross-sectional observational study aims to evaluate the diagnostic accuracy of targeted biopsy-based and site-coded OCT protocols for common OPMDs and OSCC. Adult patients clinically diagnosed with OPMDs, including oral leukoplakia (OL), oral lichen planus (OLP), and OSCC were enrolled. Clinical and OCT evaluation before and after punch scalpel-site registration preceding diagnostic biopsy on the target site was performed. Blinded observers analyzed the OCT scans for OCT-based diagnoses. Sensitivity, specificity, and diagnostic accuracy for OCT evaluations before and after punch scalpel-site registration were statistically compared with histological findings. A dataset of 2520 OCT scans and 210 selected images from 21 patients was obtained. Sensitivity and specificity post-target site registration were high for OSCC (98.57%, 100.00%), OL (98.57%, 98.57%), and OLP (97.14%, 98.57%). The positive predictive values ranged from 97.14% to 100.00%, while negative predictive values ranged from 98.57% to 99.29%. Inter-observer agreements were strong for OSCC (0.84) and moderate for OL (0.54) and OLP (0.47-0.49). Targeted OCT scans significantly improved diagnostic accuracy for all conditions (p < 0.001). This preliminary study supports using site-targeted OCT scans followed by a site-targeted punch biopsy, enhancing precision in oral diagnostics. This approach is foundational for developing pioneering automated algorithms guiding oral cancer and pre-cancer diagnosis via OCT imaging.

Association between Periodontal Disease and Oral Benign, Potentially Malignant, Malignant, and Chronic Immune-Mediated Disorders: A Clinical Study.

Background: Periodontal disease is an inflammatory, chronic, and multifactorial disease. The objective of this study is to analyze the association between periodontal disease and some disorders such as papillomas (benign lesions), lichen planus (a chronic immune-mediated disorder), leukoplakia (potentially malignant lesions), and oral cancer (malignant lesions). Methods: For this study, 42 patients were recruited whose supragingival and subgingival plaque was qualitatively analyzed using a phase-contrast microscope, which allowed for the detection of compatible bacterial flora (immobile and composed mainly of cocci) indicative of periodontal health and incompatible bacterial flora (mobile and composed mainly of spirochetes) indicative of periodontal pathology. Patients with incompatible bacterial flora were then subjected to a laser-assisted periodontal treatment with irrigation with hydrogen peroxide within the periodontal pockets (a non-surgical laser-assisted periodontal protocol which is referred to as dye-free photodynamic therapy). Results: Based on the 42 patients recruited, there was no association between oral cavity lesions and periodontal pathogenic bacteria. Four of them were found to have incompatible bacterial flora. Indeed, it was found that almost all the patients had been previously instructed in the proper techniques of home oral hygiene, and more than half of them reported that they carried out periodic check-ups by a dental hygienist. Of the four patients with signs and symptoms of periodontitis, two stated a willingness to undergo the non-surgical laser-assisted periodontal protocol and showed improvements in periodontal indices such as CAL, PPD, and BoP. Conclusions: hygienists and dentists are determining factors in the prevention of periodontal disease and for the maintenance of good oral health.

On intimate care in men: A review

Even though intimate hygiene plays an essential role in the prevention of various genital diseases, there are currently few studies on this topic. There is a wide range of diseases that affect the male genital organs. There is a wide range of diseases that affect the male genital organs. Inflammation of the glans penis (balanitis) occurs in 3–11% of males during their lifetime; one of its leading causes is poor hygiene. However, many non-venereal dermatoses occur in this anatomical region. Most often, patients complain of itching, as well as pain, burning, and various rashes. The most common reason for seeking medical attention is irritant contact dermatitis. Various allergens cause more acute reactions in the anogenital region due to the structural features of the skin of the genitals. Components of detergents and hygiene products, accessories for sexual practices, medications, and contraceptives can become provoking factors of genital allergic dermatitis. Among the dermatoses affecting the male genitalia, lichen planus should be noted, which occurs in males twice as often as in females, and the oral mucosa is often involved in the inflammatory process. Lichen sclerosus can also occur on the skin of the penis, leading to phimosis, a decrease in quality of sexual life, and often requiring circumcision. Psoriasis also can affect the anogenital area. Rashes may be isolated, but other anatomical areas are also involved in most cases. Psoriatic lesions of the genitals are visually different from typical elements in other areas of the skin. Minimizing discomfort due to these diseases is possible by using specialized care products. The skin of the genitals in men has specific features that are important to consider when developing the composition of the products.

Circulating mucosal-associated invariant T cell alterations in adults with recent-onset and long-term oral lichen planus

BackgroundMucosal-associated invariant T (MAIT) cells play key roles in many inflammatory diseases. However, their effects on the long-term course of oral lichen planus (OLP) and recent-onset OLP remain unclear. In this study, we aimed to investigate the function of MAIT cells in the different processes of OLP and to explore the immunological background of this disease.MethodsThe frequency, phenotype, cytokine secretion, and clinical relevance of MAIT cells were investigated. MAIT cells were collected from the peripheral blood of 14 adults with recent-onset OLP (7–120 days after disease onset) and 16 adults with long-term course OLP (>2 years after diagnosis) using flow cytometry and compared with 15 healthy blood donors. Statistical analyses were performed using the GraphPad Prism software.ResultsMAIT cells from adults with recent-onset OLP exhibited an activated phenotype, as indicated by an increased frequency of CD69+ (p < 0.05) and CD38+MAIT cells (p < 0.01) and elevated production of the proinflammatory cytokine IL-17 A (p < 0.01), compared with healthy adult donors. In adults with long-term OLP, MAIT cells exhibited an activated and exhausted phenotype, characterized by high expression of CD69 (p < 0.01) and PD-1 (p < 0.001) and increased production of granzyme B released (p < 0.01). Compared with recent-onset OLP patients, long-term OLP patients showed a decreased production of CD8+, and CD4−CD8− cells, but an increase in PD-1+ production (p < 0.05).ConclusionsCirculating MAIT cells exhibited activation in OLP patients across varying disease durations. Given that PD-1 expression is elevated in adults with long-term OLP, it is reasonable to infer that circulating MAIT cells in long-term OLP may exhibit a more exhausted state than those in recent-onset OLP.

Zoon's plasma cell balanitis associated with genital lichen planus.

Zoon's plasma cell balanitis associated with genital lichen planus.

MICROBIOLOGICAL CHARACTERISTICS OF THE ORAL MUCOSAIN PATIENTS WITH LICHEN PLANUS ERYTHEMATOSUS

Lichen planus is a multifactorial disease that involves immune, neuroendocrine, microbiological, and other metabolic processes associated with skin and mucosal damage. The microflora of the oral cavity in CPL SOPR was studied by E. S. Leontieva etal., 2014, the microbiocenosis of various biotopes of the oral cavity in patients with CPL SOPR was studied. The study involved 95 patients with CPL SOPR, who underwent hygienic, periodontal and microbiological research methods. The results of the degree of bacterial contamination indicate a more pronounced colonization of foci of CPL lesion by representatives of the coccoid flora: Streptococcus salivares and Streptococcus mutans, but there is no correlation between them. Isolated Streptococcus Sanguis colonies were observed in 55% of patients. In addition, fungi of the genus Candida albicans were detected in 50%, the average level of adhesion of Candida albicans strains in patients with CPL was 16.78±1.64%. The frequency of detection of fungi of the genus Candida albicans in foci of CPL lesion correlates (r=0.79) with the activity of the disease course. The significance of Candida albicans contamination is determined not so much by the degree of contamination of the lesion foci, but by such pathogenic properties of Candida albicansas the level of adhesion and the activity of germination tubes formation [1,2,3,6,11,2,3,6,11]. Authors Chuikin S. V., Akmalova G. M., Chernysheva N. D., 2014, analyzed the qualitative and quantitative microbiocenosis of the oral cavity in patients with CPL. The study included 145 patients with CPL aged 21 to 76 years, of whom 5% were men and 95% were women. The predominant form of CPL was erosive-ulcerative form (33.1%), the lowest frequency was observed in 2% of patients with bullous form. The results of the study showed that dysbiotic changes were observed with a predominance of candida infection and were found in 57.2% of the examined patients, which are observed more often in erosive-ulcerative and bullous forms of CPL. The results of the study showed that all the examined patients had microbiocenosis disorders of varying severity from dysbiotic shift to IYgrade IY dysbiosis and high sensitivity to bacteriophages was revealed. It should be noted that high sensitivity of pathogenic and opportunistic microorganisms sown in дисбактериозахoral dysbiosis was detected to цефалоспориногоcephalosporin antibiotics (100%), oxacillin (79%), gentamicin (76%), lincomycin (73%). [5,7,9,12]. A number of foreign authors Villa (TG, Sá ncheznchez-Pérez rez Á, Sieiro C., 2021) believe that microbial infection triggers an autoimmune response. Withdysbiosisof the intestinal microbiota , there is a violationof the integrity of the intestinal barrier, followed by an increase in intestinal permeability, and the penetration микроорганизмof microorganisms and their toxinов into the circulatory system. Current knowledge about this disease requires the inclusion of this disease in the list of autoimmune diseases, since the progression of CPL involves colonization of locally affected areas by bacteria, fungi or viruses that occur after damage to the oral mucosa and skin. The process of healing the disease should include eliminating microbial dysbiosis and restoring the normal microbiota of the oral mucosa, skin, and intestines. [4,6,8,10,13,14].

Pathogenic relevance of antibodies against desmoglein3 inpatients with oral lichen planus.

Oral lichen planus (OLP) is a Tcell driven disorder that significantly impairs patients' quality of life. Previous reports suggest that both cellular and humoral activities against desmoglein (dsg) 1 and 3 may be involved in OLP pathogenesis. Here, we aim to analyze the frequency of occurrence and pathological significance of anti-dsg antibodies in a large cohort of OLP patients. OLP patients were screened for anti-dsg antibodies by enzyme-linked immunosorbent assay in three tertiary referral centers. OLP sera with anti-dsg antibodies were further analyzed by Western blot and dispase-based keratinocyte dissociation assay (DDA) to identify the targeted dsg ectodomains and to assess their pathogenicity. Of 151-screened individuals with OLP, only four patients (2.6%) with erosive OLP showed serum IgG against dsg1/3. Western blot analysis with recombinant dsg3 ectodomains revealed preferential recognition of the extracellular domain 5. By DDA with spontaneously immortalized human keratinocytes, none of the sera from these four patients induced acantholysis. Activation of humoral immunity occurs prevalently in patients with erosive OLP, probably due to epitope spreading. OLP serum antibodies are unable to induce loss of intercellular adhesion in vitro, strongly suggesting that they are not disease causing but rather an epiphenomenon.

Comprehensive analysis of clinical research profiles and study characteristics of oral potentially malignant disorders: an observational study

ObjectiveThe study aims to present an observational study of clinical trials on Oral Potentially Malignant Disorders (OPMDs) and corresponding publications. Study design and settingWe searched the OPMDs-related clinical studies registered in the ClinicalTrials.gov database before March 1, 2024. Subsequently, we investigated the publication status of primary completed studies using PubMed and Google Scholar. ResultsA total of 185 studies were identified for analysis, including 141 interventional studies and 44 observational studies. The most commonly studied disease type was oral lichen planus (OLP), accounting for 113 studies (61.1 %). Interventional studies on OPMDs were predominantly early-phased, blind, randomized, parallel and single-center. The primary purpose of these studies was treatment (106, 75.2 %). Among the treatments, herbal medicine (21, 19.8 %), photodynamic therapy (17, 16.0 %), and glucocorticoids (14, 13.2 %) were of greatest interest. In addition, 58 (63.0 %) of the primarily completed interventional studies were published, with a median time to publication of 33.6 months. Published interventional studies including OLP patients and factorial designs had shorter time to publication. However, these studies were less frequently published in high-impact journals and most primary results were positive. ConclusionsClinical trials on OPMDs predominantly focused on OLP and herbal medicine. The quality of studies is unsatisfactory and publication rate is suboptimal. Improvements are needed in ClinicalTrials.gov registration standards, high-quality study design and more stringent publishing requirements.

A Tissue-Engineered Model of T-Cell–Mediated Oral Mucosal Inflammatory Disease

T-cell-mediated oral mucocutaneous inflammatory conditions including oral lichen planus (OLP) are common but development of new treatments aimed at relieving symptoms and controlling OLP progression are hampered by the lack of experimental models. Here, we developed a tissue-engineered oral mucosal equivalent (OME) containing polarised T-cells to replicate OLP pathogenesis. Peripheral blood CD4+ and CD8+ T-cells were isolated, activated and polarised into Th1 and cytotoxic T-cells (Tc). OME were constructed by culturing oral keratinocytes on an oral fibroblast-populated hydrogel to produce a stratified squamous epithelium. OME stimulated with IFN-γ and TNF-α or medium from Th1 cells caused increased secretion of inflammatory cytokines/chemokines. A model of T-cell-mediated inflammatory disease was developed by combining OME on top of a Th1/Tc-containing hydrogel, followed by epithelial stimulation with IFN-γ/TNF-α. T-cell recruitment towards the epithelium was associated with increased secretion of T-cell chemoattractants CCL5, CXCL9 and CXCL10. Histological assessment showed tissue damage associated with cleaved-caspase-3 and altered laminin-5 expression. Treatment with inhibitors directed against JAK, KCa3.1 channels or clobetasol in solution and/or via a mucoadhesive patch prevented cytokine/chemokine release and tissue damage. This disease model has potential to probe for mechanisms of pathogenesis or as a test platform for novel therapeutics or treatment modalities.

Treatment strategies for erosive genital lichen planus: A systematic review of therapeutic modalities and emerging breakthroughs.

Erosive genital lichen planus (EGLP) is a severe form of lichen planus characterized by painful erosions in the genital area, leading to significant distress and complications. This review aims to provide a thorough examination of EGLP, focusing on its clinical manifestations, diagnostic challenges, and various treatment strategies, with an emphasis on patient-centered care. Adhering to PRISMA guidelines, we conducted a systematic review of 26 studies that explored dermatological treatments for EGLP. Our literature search was comprehensive, covering PubMed, Scopus, and Web of Science. Data were extracted systematically using established tools to ensure a robust analysis of the treatment modalities. EGLP presents with a range of symptoms, including severe pain, itching, and sexual dysfunction. Treatment options include topical corticosteroids, systemic medications, and surgical interventions. Despite the availability of various therapies, many cases are refractory to treatment, resulting in chronic symptoms and reduced quality of life. Emerging therapies show promise but are not yet established as standard practice. Management of EGLP requires a tailored, multidimensional approach. While topical corticosteroids remain essential, the development of new therapies offers hope for improved outcomes. A patient-centered approach is vital to address both the physical and psychosocial impacts of EGLP. Continued research is necessary to refine treatment protocols and enhance patient care.

Photobiomodulation Therapy in the Management of Oral Lichen Planus: A Systematic Review and Meta-Analysis.

Photobiomodulation therapy (PBMT) is a non-invasive and the latest form of therapy used in the treatment of non oncological diseases as well as cancers of various types and locations. The aim of this study was to systematically review and assess the efficacy of PBMT in managing oral lichen planus (OLP) compared to the interventions. A systematic review and meta-analysis were implemented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search using PubMed, Scopus, and Cochrane was conducted to retrieve relevant studies published until June 2023. The outcomes evaluated included the reduction in pain score and clinical severity scores (Prospero No CRD42023428626). A total of eight studies were identified for qualitative synthesis. The pooled analysis incorporating six studies revealed that there are no significant differences for both mean pain score (mean difference [MD] = 0.21, 95% confidence interval [CI] = -0.51, 0.93) as well as clinical score (MD = -0.08, 95% CI = -0.4, 0.25) between PBMT and comparison groups. Subgroup analysis based on corticosteroids as controls showed that there was no significant difference in mean reduction in pain score between PBMT and topical steroids (MD = 0.38, 95% CI = -0.54, 1.31). PBMT is as effective as other interventions in the treatment of OLP, though not superior, and can be a promising alternative treatment for cases resistant to steroids or when steroids are contraindicated. Further studies are recommended to standardize the optimal settings for the treatment of OLP.

SFRP2+ fibroblasts amplify inflammatory responses in oral lichen planus

SFRP2+ fibroblasts amplify inflammatory responses in oral lichen planus