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Korkitpoonpol N, Kanjanabuch P. Direct immunofluorescence cannot be used solely to differentiate among oral lichen planus, oral lichenoid lesion, and oral epithelial dysplasia. J Dent Sci 2023; 18:1669-1676. [PMID: 37799909 PMCID: PMC10547942 DOI: 10.1016/j.jds.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/22/2023] [Indexed: 02/10/2023] Open
Abstract
Background/purpose Some red and white lesions may have similar manifestations, making them difficult to be diagnosed. A direct immunofluorescence (DIF) assay can assist in making a final diagnosis of oral lichen planus (OLP). The aim of this study was to evaluate and compare the DIF profile in patients who had the clinical presentations of OLP and were histopathologically diagnosed with OLP, OLL (oral lichenoid lesion), or OED (oral epithelial dysplasia). Materials and methods The data were obtained from the medical records of 136 patients with the clinical presentations of OLP. Demographic information, histopathological diagnosis, malignant transformation, and DIF results were collected and analyzed. Results In this study, 117 patients (86.0%) were DIF-positive, while 19 patients (14.0%) were DIF-negative. The highest DIF-positivity rate was in the OLP group (88.9%) followed by the OLL (83.7%), and the OED groups (81%). There were no significant differences in DIF-positivity rate, type of immunoreactants, location, or interpretation among these groups. Shaggy fibrinogen at the basement membrane zone (BMZ) was the most common DIF pattern in all groups. Conclusion The DIF assay alone cannot be regarded as sufficient evidence for OLP, OLL, and OED differentiation. A histopathological examination is required to determine the presence of epithelial dysplasia or malignancy. To diagnose dysplastic lesions with the clinical manifestations of OLP, careful clinicopathologic correlation is mandatory. Due to the lack of scientific evidence to identify the primary pathology and the ongoing malignancy risk of epithelial dysplasia, meticulous long-term follow-up plays a crucial role in patient management.
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Affiliation(s)
- Nattanich Korkitpoonpol
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Patnarin Kanjanabuch
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Intraepithelial Macrophage Expressing CD163 Is a Histopathological Clue to Evaluate the Malignant Potency of Oral Lichenoid Condition: A Case Report and Immunohistochemical Investigation. Diagnostics (Basel) 2020; 10:diagnostics10090624. [PMID: 32842506 PMCID: PMC7555841 DOI: 10.3390/diagnostics10090624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 11/17/2022] Open
Abstract
Oral lichenoid conditions (OLC), including oral lichen planus (OLP), oral lichenoid lesions and oral lichenoid dysplasia, differ in pathogenesis and biological malignancy. However, distinguishing them based on clinical or histological features is difficult. It is well known that CD163+ macrophages are associated with oral cancer aggressiveness. We recently demonstrated that CD163+ macrophages of noncancerous lesions infiltrate the stroma, not the intraepithelial area. In this report, we describe a case of OLC that was not detected as malignant by the first local biopsy. Furthermore, we evaluated the malignant potency of OLC by retrospectively comparing the histological findings between local biopsy and resected specimens focusing on CD163+ macrophages. A 72-year-old man with a white lesion in the unilateral buccal mucosa was diagnosed with OLP through the biopsy although invasive cancer was detected two years later. Intraepithelial CD163+ macrophages were found not only on the resected specimen but also biopsy. This is the first report to demonstrate that intraepithelial CD163+ macrophages may be noteworthy indicators to identify the malignant potency of OLC.
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Liu Y, Zhu J, Guo H, Li W, Wang X, Chen Z, Liu F, Bilig A. Evaluation of treatment response in oral chronic graft-versus-host patients by power doppler ultrasound: a prospective study. Dentomaxillofac Radiol 2020; 49:20190295. [PMID: 31617748 PMCID: PMC7026929 DOI: 10.1259/dmfr.20190295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/03/2019] [Accepted: 10/10/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To date, imaging and non-invasive examination methods for evaluating the oral tissue of patients who with oral chronic graft-versus-host disease (GVHD) are still lacking. Herein, we assessed the ultrasonography imaging characteristics of chronic GVHD patients' buccal soft tissue and evaluated the response to treatment using gray-scale and power Doppler (PD) ultrasound. The overall objective of the study was to determine the potential of ultrasonography to provide an early and objective indication of a therapeutic response to treatment intervention in oral chronic GVHD. METHODS Buccal mucosa in 21 patients with clinically diagnosis of oral chronic GVHD were assessed before and after 14 day treatment between 2016 and 2018. Ultrasonography assessment included thickness and echogenicity evaluation, and PD. Echogenicity and PD were measured and scored according to a semi-quantitative method. Ultrasonography parameters were compared with clinical activity assessments of disease activity and patient-reported measures. RESULTS Following 14 day therapy, a significant decrease in PD scores and patient-reported measures was observed (p < 0.01), and clinical assessment scores also decreased (p < 0.05). Changes from baseline PD scores correlated significantly with patient-reported measures (r = 0.85, p < 0.01). Changes in PD scores correlated moderately with the changes in the clinical assessments from baseline (r = 0.46, p < 0.05). A significant decrease in PD scores was observed in the buccal soft tissue of patients that responded clinically to the treatment. A significant decrease in PD scores was also observed in patients that were failed to show clinical improvement (p < 0.05). CONCLUSION Ultrasonography is a novel and feasible imaging technique for measurement of the response of oral chronic GVHD to therapy. Ultrasonography yields additional information about buccal mucosa and is a complementaty to clinical examination.
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Affiliation(s)
- Yiqun Liu
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Jiaan Zhu
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Huijie Guo
- Department of Stomatology, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Wenxue Li
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Xiuming Wang
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Zheng Chen
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Fang Liu
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
| | - Ariun Bilig
- Department of Ultrasound, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, People’s Republic of China
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Mane DR, Rahman SU, Desai KM, Kale AD, Bhat KG, Arany PR. Roles of the matricellular protein Tenascin-C in T-lymphocyte trafficking and etiopathogenesis of Oral Lichen Planus. Arch Oral Biol 2019; 110:104622. [PMID: 31783297 DOI: 10.1016/j.archoralbio.2019.104622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE This study was aimed at examining the role of Tenascin-C in T cell trafficking in Oral Lichen Planus (OLP). DESIGN For the in vivo immunohistochemical analyses, 115 OLP samples were collected from patients and immunostaining was performed. The intensity and distribution of TN-C expression were quantified and correlated with histological analyses of basement membrane integrity and presence of inflammatory infiltrate. For the in vitro study, TN-C and collagen were coated on culture plates and migration of T lymphocytes was assessed. RESULTS TN-C immunoexpression was increased in terms of both distribution and intensity along the basement membrane zone. These changes were significantly associated with basement membrane duplication (distribution p < 0.002 and intensity p < 0.001) and bands of inflammation (distribution p < 0.002 and intensity p < 0.001) assessed by Chi-square test. T lymphocytes demonstrated significant migration towards TN-C as compared to collagen (n = 3, p < 0.05). CONCLUSIONS These findings indicate TN-C may have a key role in promoting T cell migration at the epithelial-mesenchymal junction in OLP. These observations suggest TN-C could be a good target for therapeutic intervention, either in itself or synergistically with anti-inflammatory directed strategies in this chronic disease management.
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Affiliation(s)
- Deepa R Mane
- Oral Pathology and Microbiology, KLE's VK Institute of Dental Sciences and Hospital, Belgaum, Karnataka 590010, India
| | - Saeed Ur Rahman
- Oral Biology, School of Dental Medicine, University of Buffalo, New York, 14214, USA
| | - Karishma M Desai
- Oral Pathology and Microbiology, KLE's VK Institute of Dental Sciences and Hospital, Belgaum, Karnataka 590010, India; Oral Biology, School of Dental Medicine, University of Buffalo, New York, 14214, USA
| | - Alka D Kale
- Oral Pathology and Microbiology, KLE's VK Institute of Dental Sciences and Hospital, Belgaum, Karnataka 590010, India
| | - Kishore G Bhat
- Prabhakar Kore Basic Science Research Laboratory, KLE'sUniversity, Belgaum, Karnataka 590010, India
| | - Praveen R Arany
- Oral Pathology and Microbiology, KLE's VK Institute of Dental Sciences and Hospital, Belgaum, Karnataka 590010, India; Oral Biology, School of Dental Medicine, University of Buffalo, New York, 14214, USA.
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Tao Y, Ai R, Hao Y, Jiang L, Dan H, Ji N, Zeng X, Zhou Y, Chen Q. Role of miR-155 in immune regulation and its relevance in oral lichen planus. Exp Ther Med 2018; 17:575-586. [PMID: 30651838 PMCID: PMC6307429 DOI: 10.3892/etm.2018.7019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/04/2018] [Indexed: 02/05/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic mucosal inflammatory disease. The World Health Organization has described it as a potentially malignant condition. The pathogenesis of OLP remains to be fully elucidated, but extensive evidence suggests that immunologic and inflammatory factors have important roles. MicroRNAs (miRs), which are small non-coding RNAs, have been reported to be involved in OLP. In particular, miR-155 is significantly upregulated in patients with OLP. miR-155 has numerous functions and is closely linked to inflammation and immune system regulation. However, in-depth studies of the mechanisms via which miR-155 is involved in OLP are currently insufficient. Considering the close association between miR-155 and immune regulation as well as the importance of immune factors in OLP, the role of miR-155 in the immune system was herein summarized with a focus on OLP. The present review provides a basis for further study of the molecular mechanisms underlying the development and progression of OLP.
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Affiliation(s)
- Yan Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ruixue Ai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yilong Hao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Ning Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Yu Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine of West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:612-627. [PMID: 29396319 DOI: 10.1016/j.oooo.2017.12.011] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 01/08/2023]
Abstract
Oral potentially malignant disorders (OPMDs) have a statistically increased risk of progressing to cancer, but the risk varies according to a range of patient- or lesion-related factors. It is difficult to predict the risk of progression in any individual patient, and the clinician must make a judgment based on assessment of each case. The most commonly encountered OPMD is leukoplakia, but others, including lichen planus, oral submucous fibrosis, and erythroplakia, may also be seen. Factors associated with an increased risk of malignant transformation include sex; site and type of lesion; habits, such as smoking and alcohol consumption; and the presence of epithelial dysplasia on histologic examination. In this review, we attempt to identify important risk factors and present a simple algorithm that can be used as a guide for risk assessment at each stage of the clinical evaluation of a patient.
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Affiliation(s)
- Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, Australia
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Abstract
Survivin is a protein functionally important for cell division, apoptosis, and possibly, for micro-RNA biogenesis. It is an established marker of malignant cell transformation. In non-malignant conditions, the unique properties of survivin make it indispensable for homeostasis of the immune system. Indeed, it is required for the innate and adaptive immune responses, controlling differentiation and maintenance of CD4+ and CD8+ memory T-cells, and in B cell maturation. Recently, survivin has emerged as an important player in the pathogenesis of autoimmune diseases. Under the conditions of unreserved inflammation, survivin enhances antigen presentation, maintains persistence of autoreactive cells, and supports production of autoantibodies. In this context, survivin takes its place as a diagnostic and prognostic marker in rheumatoid arthritis, psoriasis, systemic sclerosis and pulmonary arterial hypertension, neuropathology and multiple sclerosis, inflammatory bowel diseases and oral lichen planus. In this review, we summarise the knowledge about non-malignant properties of survivin and focus on its engagement in cellular and molecular pathology of autoimmune diseases. The review highlights utility of survivin measures for clinical applications. It provides rational for the survivin inhibiting strategies and presents results of recent reports on survivin inhibition in modern therapies of cancers and autoimmune diseases.
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