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Wongpakorn P, Chantarangsu S, Prapinjumrune C. Factors involved in the remission of oral lichen planus treated with topical corticosteroids. BDJ Open 2024; 10:34. [PMID: 38719818 PMCID: PMC11078943 DOI: 10.1038/s41405-024-00217-4] [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: 03/06/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
AIM To determine the factors that affected the complete clinical remission of oral lichen planus (OLP) treated with topical corticosteroids. MATERIAL AND METHODS We retrospectively evaluated the charts of patients diagnosed as OLP. Age, sex, current medical conditions, medications, type of OLP, Thongprasom score, pain level assessed by a numeric rating scale (NRS), Candida infection, topical steroid treatment preparation, duration of treatment until the first complete clinical remission, and follow-up duration were assessed as variables. RESULTS In total 100 patients, after complete remission, 22 patients reported a relapse within 1.5-45 months, with a mean of 15.6 ± 13.2 months. Age, duration, gingiva and vestibule area, hypertension, dyslipidemia, Thongprasom score, preparation and topical corticosteroid potency were factors affecting the remission. Multivariate logistic regression analysis revealed that the patients' age and duration of treatment were significant factors after adjusted for age, sex, and independent factors with a P-value < 0.1 in the univariate analysis. The likelihood of having incomplete remission of the OLP lesion increased by 7.9% for every year increase in age and increased by 2.3% for every month of treatment. CONCLUSIONS There are many different factors between the complete remission and incomplete remission groups. However, age and duration of treatment were significant factors affecting the remission of OLP.
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Affiliation(s)
- Poosit Wongpakorn
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Soranun Chantarangsu
- Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chanwit Prapinjumrune
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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2
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Jørgensen MR. Pathophysiological microenvironments in oral candidiasis. APMIS 2024. [PMID: 38571459 DOI: 10.1111/apm.13412] [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: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
Oral candidiasis (OC), a prevalent opportunistic infection of the oral mucosa, presents a considerable health challenge, particularly in individuals with compromised immune responses, advanced age, and local predisposing conditions. A considerable part of the population carries Candida in the oral cavity, but only few develop OC. Therefore, the pathogenesis of OC may depend on factors other than the attributes of the fungus, such as host factors and other predisposing factors. Mucosal trauma and inflammation compromise epithelial integrity, fostering a conducive environment for fungal invasion. Molecular insights into the immunocompromised state reveal dysregulation in innate and adaptive immunity, creating a permissive environment for Candida proliferation. Detailed examination of Candida species (spp.) and their virulence factors uncovers a nuanced understanding beyond traditional C. albicans focus, which embrace diverse Candida spp. and their strategies, influencing adhesion, invasion, immune evasion, and biofilm formation. Understanding the pathophysiological microenvironments in OC is crucial for the development of targeted therapeutic interventions. This review aims to unravel the diverse pathophysiological microenvironments influencing OC development focusing on microbial, host, and predisposing factors, and considers Candida resistance to antifungal therapy. The comprehensive approach offers a refined perspective on OC, seeking briefly to identify potential therapeutic targets for future effective management.
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Affiliation(s)
- Mette Rose Jørgensen
- Section of Oral Pathology and Oral Medicine, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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3
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Wu T, Bai Y, Jing Y, Chen F. What can we learn from treatments of oral lichen planus? Front Cell Infect Microbiol 2024; 14:1279220. [PMID: 38426013 PMCID: PMC10902003 DOI: 10.3389/fcimb.2024.1279220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Oral lichen planus (OLP), a T-lymphocyte-mediated disease of the oral mucosa, has a complex pathogenesis that involves a number of factors. The disease is characterized by recurrent episodes and requires continuous follow up, and there is no curative treatment available. Erosive lichen planus, among others, has a risk of malignant transformation and requires standardized treatment to control its progression. Different clinical subtypes of oral lichen planus require appropriate treatment. Pharmacological treatments are the most widely available and have the greatest variety of options and a number of novel pharmacological treatments are presented as highlights, including JAK enzyme inhibitors. The second is photodynamic therapy, which is the leading physiological treatment. In addition, periodontal treatment and psychological treatment should not be neglected. In this review, we briefly discuss the most recent developments in therapies for oral lichen planus after summarizing the most widely used clinical treatments, aiming to provide different proposals for future clinical treatment.
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Affiliation(s)
- Tingting Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yang Bai
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yin Jing
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Fangchun Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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4
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Su Z, Lu J, Ling Z, Li W, Yang X, Cheng B, Tao X. Upregulation of IL-37 in epithelial cells: A potential new mechanism of T cell inhibition induced by tacrolimus. Biochem Pharmacol 2023; 216:115796. [PMID: 37690572 DOI: 10.1016/j.bcp.2023.115796] [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: 08/28/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
Oral lichen planus (OLP) is a chronic T cell-mediated mucocutaneous disease characterized by T cell infiltration at the connective tissue-epithelium interface. Traditionally, topical corticosteroids are used as the first-line drugs to treat OLP. However, long-term use of corticosteroids may lead to drug tolerance, secondary candidiasis, and autoimmune adrenal insufficiency. Although topical tacrolimus has often been recommended for short-term use in corticosteroid-refractory OLP, the precise role of tacrolimus in epithelial cells remains elusive. This study showed that tacrolimus could directly upregulate the expression of IL-37 in human gingival epithelial cells by promoting the TGF-βRI/Smad3 pathway independently of calcineurin inhibition and MAPKs. In contrast, dexamethasone, one of the corticosteroids, did not have the same effect. Moreover, IL-37 could inhibit the proliferation of activated T cells and the secretion of effector cytokines and alleviate epithelial cell apoptosis and death caused by activated T cells ina co-culturesystem. Furthermore, compared with healthy controls, IL-37 and p-Smad3 levels significantly increased in the oral mucosa affected by OLP, especially in the epithelium. IL-37 might have mediated a negative feedback mechanism to curb excessive inflammation in OLP. However, the expression of IL-37 was not associated with the infiltration of CD8+ T cells and Tregs in OLP, implying that IL-37 might mostly affect T cell activation rather than T cell differentiation and migration. Overall, this study discovered a potential novel mechanism by which tacrolimus might indirectly inhibit T cell-mediated immune damage by upregulating IL-37 in human gingival epithelial cells.
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Affiliation(s)
- Zhangci Su
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China
| | - Jingyi Lu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China
| | - Zihang Ling
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China
| | - Wei Li
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China
| | - Xi Yang
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China.
| | - Bin Cheng
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China.
| | - Xiaoan Tao
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, Guangdong, China; Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, Guangdong, China.
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5
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Ibrahim T, Wu P, Wang LJ, Fang-Mei C, Murillo J, Merlo J, Shein SS, Tumanov AV, Lai Z, Weldon K, Chen Y, Ruparel S. Sex-dependent differences in the genomic profile of lingual sensory neurons in naïve and tongue-tumor bearing mice. Sci Rep 2023; 13:13117. [PMID: 37573456 PMCID: PMC10423281 DOI: 10.1038/s41598-023-40380-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
Mechanisms of sex-dependent orofacial pain are widely understudied. A significant gap in knowledge exists about comprehensive regulation of tissue-specific trigeminal sensory neurons in diseased state of both sexes. Using RNA sequencing of FACS sorted retro-labeled sensory neurons innervating tongue tissue, we determined changes in transcriptomic profiles in males and female mice under naïve as well as tongue-tumor bearing conditions Our data revealed the following interesting findings: (1) FACS sorting obtained higher number of neurons from female trigeminal ganglia (TG) compared to males; (2) Naïve female neurons innervating the tongue expressed immune cell markers such as Csf1R, C1qa and others, that weren't expressed in males. This was validated by Immunohistochemistry. (3) Accordingly, immune cell markers such as Csf1 exclusively sensitized TRPV1 responses in female TG neurons. (4) Male neurons were more tightly regulated than female neurons upon tumor growth and very few differentially expressed genes (DEGs) overlapped between the sexes, (5) Male DEGs contained higher number of transcription factors whereas female DEGs contained higher number of enzymes, cytokines and chemokines. Collectively, this is the first study to characterize the effect of sex as well as of tongue-tumor on global gene expression, pathways and molecular function of tongue-innervating sensory neurons.
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Affiliation(s)
- Tarek Ibrahim
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Ping Wu
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Li-Ju Wang
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, San Antonio, USA
| | - Chang Fang-Mei
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Josue Murillo
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Jaclyn Merlo
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Sergey S Shein
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health San Antonio, San Antonio, USA
| | - Alexei V Tumanov
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health San Antonio, San Antonio, USA
| | - Zhao Lai
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Korri Weldon
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Yidong Chen
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, San Antonio, USA
| | - Shivani Ruparel
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
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6
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Tram M, Ibrahim T, Hovhannisyan A, Akopian A, Ruparel S. Lingual innervation in male and female marmosets. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 14:100134. [PMID: 38099285 PMCID: PMC10719518 DOI: 10.1016/j.ynpai.2023.100134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 12/17/2023]
Abstract
Several gaps in knowledge exists in our understanding of orofacial pain. Some of these include type of peripheral sensory innervation in specific tissues, differences in innervation between sexes and validation of rodent studies in higher order species. The current study addresses these gaps by validating mouse studies for sensory innervation of tongue tissue in non-human primates as well as assesses sex-specific differences. Tongue and trigeminal ganglia were collected from naïve male and female marmosets and tested for nerve fibers using specific markers by immunohistochemistry and number of fibers quantified. We also tested whether specific subgroups of nerve fibers belonged to myelinating or non-myelinating axons. We observed that similar to findings in mice, marmoset tongue was innervated with nerve filaments expressing nociceptor markers like CGRP and TRPV1 as well as non-nociceptor markers like TrkB, parvalbumin (PV) and tyrosine hydroxylase (TH). Furthermore, we found that while portion of TrkB and PV may be sensory fibers, TH-positive fibers were primarily sympathetic nerve fibers. Moreover, number of CGRP, TrkB and TH-positive nerve fibers were similar in both sexes. However, we observed a higher proportion of myelinated TRPV1 positive fibers in females than in males as well as increased number of PV + fibers in females. Taken together, the study for the first time characterizes sensory innervation in non-human primates as well as evaluates sex-differences in innervation of tongue tissue, thereby laying the foundation for future orofacial pain research with new world smaller NHPs like the common marmoset.
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Affiliation(s)
- Meilinn Tram
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Tarek Ibrahim
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Anahit Hovhannisyan
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Armen Akopian
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Shivani Ruparel
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
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7
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Abdelsamie M, Zahran F, Hussine AA, Shaker O, Al-Mahallawi AM. Clinical and biochemical assessment of the effect of topical use of coenzyme Q10 versus topical corticosteroid in management of symptomatic oral lichen planus: randomized controlled clinical trial. BMC Oral Health 2023; 23:506. [PMID: 37480004 PMCID: PMC10360223 DOI: 10.1186/s12903-023-03206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/06/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic mucocutaneous immunologically mediated condition that has a great adverse effect on oral functions. Corticosteroids are still the first drugs of choice used in the treatment of OLP; however, they have extensive medical side effects. The present study was carried out to assess the clinical therapeutic effect of the topical use of coenzyme Q10 (coQ10 or ubiquinol) versus topical corticosteroids in the management of symptomatic OLP and to determine whether the effect, if any, was due to the powerful antioxidant activity of coQ10. SUBJECTS AND METHODS We performed a randomized, double blinded controlled trial at the Faculty of Dentistry, Cairo University, Egypt. The study was conducted on 34 patients suffering from symptomatic OLP. Patients were randomly divided into two groups: intervention group (I),who received topical CoQ10 in the form of mucoadhesive tablets (40% CoQ10) 3 times daily for one month and control group (II),who received topical corticosteroid (kenacort in Orabase: triamcinolone acetonide 0.1% 5-g adhesive paste - dermapharm), 4 times daily for one month. Patients were evaluated at one-week intervals using the clinical parameters (score) of pain (VAS) and lesion size. Additionally, salivary levels of malondialdehyde (MDA) were detected in both groups before and after treatment using ELISA. All recorded data were analysed using independent t test, ANOVA followed by Bonferroni post hoc test for lesion size and salivary level of MDA data and Mann-Whitney U test and Friedman test for VAS data. RESULTS Both groups showed a significant reduction in pain and the size of the lesions (p ≤ 0.05) with no statistically significant difference between them (p > 0.05), and this clinical improvement was associated with a reduction in the salivary levels of MDA in both groups. CONCLUSIONS The topical use of CoQ10 mucoadhesive tablets was as effective as the topical use of triamcinolone acetonide, and its clinical effect was associated with a reduction in the salivary level of MDA. TRIAL REGISTRATION The study protocol was registered at www. CLINICALTRIAL gov (NCT04091698) and registration date: 17/9/2019.
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Affiliation(s)
| | - Fat'heya Zahran
- Oral Medicine, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amal A Hussine
- Oral Medicine, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Olfat Shaker
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abdulaziz Mohsen Al-Mahallawi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- School of Life and Medical Sciences, University of Hertfordshire Hosted By Global Academic Foundation, New Administrative Capital, Cairo, Egypt
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8
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Ibrahim T, Wu P, Wang LJ, Fang-Mei C, Murillo J, Merlo J, Tumanov A, Lai Z, Weldon K, Chen Y, Ruparel S. Sex-dependent Differences in the Genomic Profile of Lingual Sensory Neurons in Naïve and Tongue-Tumor Bearing Mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.14.524011. [PMID: 36711730 PMCID: PMC9882171 DOI: 10.1101/2023.01.14.524011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Mechanisms of sex-dependent orofacial pain are widely understudied. A significant gap in knowledge exists about comprehensive regulation of tissue-specific trigeminal sensory neurons in diseased state of both sexes. Using RNA sequencing of FACS sorted retro-labeled sensory neurons innervating tongue tissue, we determined changes in transcriptomic profiles in males and female mice under naïve as well as tongue-tumor bearing conditions Our data revealed the following interesting findings: 1) Tongue tissue of female mice was innervated with higher number of trigeminal neurons compared to males; 2) Naïve female neurons innervating the tongue exclusively expressed immune cell markers such as Csf1R, C1qa and others, that weren't expressed in males. This was validated by Immunohistochemistry. 4) Accordingly, immune cell markers such as Csf1 exclusively sensitized TRPV1 responses in female TG neurons. 3) Male neurons were more tightly regulated than female neurons upon tumor growth and very few differentially expressed genes (DEGs) overlapped between the sexes, 5) Male DEGs contained higher number of transcription factors whereas female DEGs contained higher number of enzymes, cytokines and chemokines. Collectively, this is the first study to characterize the effect of sex as well as of tongue-tumor on global gene expression, pathways and molecular function of tongue-innervating sensory neurons.
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Affiliation(s)
- Tarek Ibrahim
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Ping Wu
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Li-Ju Wang
- Greehey Children’s Cancer Institute, University of Texas Health San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, USA
| | - Chang Fang-Mei
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Josue Murillo
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Jaclyn Merlo
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
| | - Alexei Tumanov
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health San Antonio, USA
| | - Zhao Lai
- Greehey Children’s Cancer Institute, University of Texas Health San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Korri Weldon
- Greehey Children’s Cancer Institute, University of Texas Health San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Yidong Chen
- Greehey Children’s Cancer Institute, University of Texas Health San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, USA
| | - Shivani Ruparel
- Department of Endodontics, School of Dentistry, University of Texas Health San Antonio, USA
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Lee H, Davoudi J, Vistoso A, Khalifeh M, Sedghizadeh P. Reactivated herpetic gingivostomatitis with secondary herpes‐associated erythema multiforme and oral candidiasis post‐COVID infection: A case report. Clin Case Rep 2023; 11:e7175. [PMID: 37006852 PMCID: PMC10064031 DOI: 10.1002/ccr3.7175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
The presence and reactivation of oral lesions such as herpetic gingivostomatitis, erythema multiforme, and candidiasis in a COVID‐19 recovered patient could be related to COVID‐19s profound role in immune dysregulation or related therapies.
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Affiliation(s)
- Haeseong Lee
- Herman Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCalifornia90089USA
| | - Jouliana Davoudi
- Department of Periodontology and Diagnostic Sciences, Herman Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCalifornia90089USA
| | - Anette Vistoso
- Department of Periodontology and Diagnostic Sciences, Herman Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCalifornia90089USA
| | - Mohammad Khalifeh
- Department of Periodontology and Diagnostic Sciences, Herman Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCalifornia90089USA
| | - Parish Sedghizadeh
- Department of Periodontology and Diagnostic Sciences, Herman Ostrow School of DentistryUniversity of Southern CaliforniaLos AngelesCalifornia90089USA
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10
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Alqahtani SS, Alabeedi FM. Association of oral candidiasis with oral lichen planus in patients using corticosteroid therapy - Meta-analysis. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY = JOURNAL DE LA THERAPEUTIQUE DES POPULATIONS ET DE LA PHARMACOLOGIE CLINIQUE 2023; 30:e1-e13. [PMID: 36631413 DOI: 10.47750/jptcp.2023.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 01/13/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease that commonly affects the skin and mucous membranes. There is a difference of opinion among clinicians about whether OLP has been associated with oral candidiasis. Nonetheless, in OLP patients, the oral candidiasis prevalence rate ranges from 7.7 to 16.6%, as established through biopsy findings, whereas 37-50% of the prevalence rate has been noticed in culture findings. Oral candidiasis has been linked to several local and systemic factors, including salivary gland dysfunction, dental prostheses, topical or inhaled corticosteroids, smoking, and the use of systemic medications. The aim was to highlight the association of Candida in patients diagnosed with OLP, correlate the use of steroid therapy, and enumerate the factors of using steroid therapy as implicated causes for oral candidiasis. A search was made using search engines such as PubMed, Scopus, Cochrane Database of Systematic Reviews, Science Citation Index, NIH Public Access, and Clarivate Analytics (Figure 1). The keywords using the research option for this field were "Oral Candidiasis" AND "Oral Lichen planus" or "Candidiasis" AND "Corticosteroids" or "Topical Corticosteroids" AND Oral Lichen planus or "Inhalation Corticosteroids" AND "Candidiasis" or "Oral Lichen planus" AND "Corticosteroids." The database search was made for the duration of 1991 to -2021 (Table 1). Additional articles were obtained regarding the literature on OLP and oral candidiasis and were considered background material. The incidence of oral candidiasis and associated lichen planus following steroid therapy enlisted by various authors has been addressed. According to the results of this study, there is a positive correlation between the presence of oral candidiasis in the OLP's patients treated with corticosteroids. Finally, this meta-analysis concluded that there is a positive correlation between the presence of Candida species in OLP and steroid medication.
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Affiliation(s)
- Sulaiman S Alqahtani
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Araxbia.;
| | - Faris M Alabeedi
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Araxbia
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11
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Zhang Z, Jia Y, Tao L, Liu X, Han Y, Wang X. Clinical Evaluation of Dexamethasone Plus Gentamycin Mouthwash Use in Combination with Total Glucosides of Paeony for Treatment of Oral Lichen Planus without Fungal Infection: A Comparative Study with Long-Term Follow-Up. J Clin Med 2022; 11:jcm11237004. [PMID: 36498580 PMCID: PMC9739003 DOI: 10.3390/jcm11237004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/15/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a common chronic inflammatory disease of the oral mucosa and considered a potential malignant disease, for which a method for complete cure is lacking. The dexamethasone and gentamicin mouthwash, combined with total glucosides of paeony (TGP), was tested in the treatment of OLP patients without fungal infection, with a view to provide evidence that may assist in resolving the dilemma. Methods: A randomized and single-blind clinical trial of 48 non-erosive and erosive OLP patients was conducted, with the patients divided into two groups. Group A was treated with dexamethasone plus gentamycin mouthwash and Group B received an additional TGP capsule together with the aforementioned mouthwash. All the patients were followed up with four times, at 2 weeks, 1 month, 3 months, and 6 months. The clinical manifestations, sign score, and VAS scale were recorded. The total effective rate (%) was defined as (cases of complete resolution + cases of partial resolution)/total cases observed × 100%. Results: A total of 43 patients completed all follow-up appointments. Among the 21 patients in Group A, the total effective rate was 61.9%. Of the 22 patients in Group B, the total effective rate was 89.66%. The clinical manifestation, sign score, and VAS of the two groups all indicated improvements, and there were significant differences between the two groups (p < 0.05). Conclusions: Dexamethasone plus gentamycin mouthwash combined with TGP treatment for OLP patients is a safe and effective treatment of OLP.
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Affiliation(s)
- Zhihui Zhang
- Department of Stomatology, Peking University Third Hospital, Beijing 100191, China
| | - Yan Jia
- Department of Stomatology, Peking University Third Hospital, Beijing 100191, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Xiaodan Liu
- Department of Stomatology, Peking University Third Hospital, Beijing 100191, China
| | - Ying Han
- Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing 100081, China
- Correspondence: (Y.H.); (X.W.)
| | - Xiao Wang
- Department of Stomatology, Peking University Third Hospital, Beijing 100191, China
- Correspondence: (Y.H.); (X.W.)
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Kakoei S, Karbasi N, Raeiszadeh M, Tajadini H, Nekouei AH. The efficacy of henna (Lawsonia inermis L.) mouthwash versus chlorhexidine gluconate 0.2% mouthwash as adjuvant therapy of oral lichen planus: A randomized double-blind clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2022; 290:115037. [PMID: 35134489 DOI: 10.1016/j.jep.2022.115037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/12/2021] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In modern medicine, some traditional remedies are introduced to be effective in treatment. Accordingly, the henna plant (Lawsonia inermis L.) is studied more than before. Previous studies have shown many medical properties for henna, such as anti-inflammatory and anti-fungal properties. AIM OF THE STUDY Oral lichen planus (OLP) is a common mucocutaneous disease with chronic immunomodulatory disruptions. Topical corticosteroids are the first line of OLP treatment. Previous studies have suggested different adjunctive therapies for preventing the side effects of corticosteroids overuse. This study aimed to compare the effects of henna and chlorhexidine mouthwashes as adjunctive therapy. MATERIALS AND METHODS This parallel-group, double-blind, randomized controlled study was conducted on forty OLP patients. Luteolin content was determined in Henna mouthwash composed of 2% aqueous extract of henna, 2% ethanol, 10% glycerol, and 0.1% methylparaben distilled water. Henna or chlorhexidine mouthwashes were prescribed twice daily as an adjuvant to the topical corticosteroid treatment. Visual analog scale (VAS) index and Thongprasom rating were used to measure pain intensity and clinical signs of patients at days 0,7, and 14. The collected data were analyzed using SPSS software (version 26.0; SPSS). Ordinal logistic regression was used to investigate the effect of independent variables on Thongprasom and VAS scores. RESULTS In this clinical trial, 82.6% of the participants were women. There was no difference between the two study groups in terms of VAS scores (p = 0.404) and clinical features (p = 0.305) in the second follow-up visit. All drug regimens caused clinical signs and symptoms relief. CONCLUSIONS There was no significant difference between the groups receiving topical corticosteroid supplementation, neither henna mouthwash nor chlorhexidine mouthwash. The therapeutic effects of henna mouthwash in the main or adjuvant treatment of OLP need more evaluation in future research. Henna mouthwash can be a good alternative to chlorhexidine mouthwash if no side effects are reported.
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Affiliation(s)
- Shahla Kakoei
- Department of Oral and Maxillofacial Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Nahid Karbasi
- Department of Oral and Maxillofacial Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahboobeh Raeiszadeh
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Haleh Tajadini
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Persian Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran.
| | - Amir H Nekouei
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Saengprasittichok N, Sucharitakul J, Matangkasombut O, Prapinjumrune C. Effect of fluocinolone acetonide (0.1%) treatment in oral lichen planus patients on salivary lactoferrin levels and Candida colonization: a prospective study. BMC Oral Health 2022; 22:58. [PMID: 35246095 PMCID: PMC8895920 DOI: 10.1186/s12903-022-02096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although topical steroids are an effective treatment for oral lichen planus, they can have suppressive effects on oral immunity and predispose the patients to Candida overgrowth. Lactoferrin is a crucial local immunity protein in the oral cavity with important antimicrobial activity. The aim of this study was to prospectively investigate salivary lactoferrin secretion levels and Candida colonization in oral lichen planus patients treated with fluocinolone acetonide 0.1% in orabase. Methods Saliva samples were collected from 15 oral lichen planus subjects who had never received topical steroid treatment prior to this study and 15 healthy volunteers to determine their salivary lactoferrin levels using an enzyme-linked immunosorbent assay and to investigate the presence of oral Candida species at baseline and 3 months after treatment with fluocinolone acetonide 0.1% in orabase. Statistical analysis was performed to compare lactoferrin secretion and Candida colonization levels between the groups using the Mann–Whitney U test for independent data or the Wilcoxon Signed-Rank test for paired data. Results The salivary lactoferrin secretion level was not significantly different between the control group and oral lichen planus patients or between before and after treatment with fluocinolone acetonide 0.1% in orabase (P > 0.05). Candida was detected in 11 (73.33%) healthy volunteers, 8 (53.33%) oral lichen planus patients before treatment, and 9 (60%) oral lichen planus patients after treatment with fluocinolone acetonide 0.1% in orabase. There was no significant difference in Candida counts between the groups (P > 0.05). Conclusion Our study indicates that using fluocinolone acetonide 0.1% in orabase to treat oral lichen planus for 3 months did not affect salivary lactoferrin protein secretion or Candida carriage. Trial registration The trial was registered at the Thai Clinical Trials Registry (TCTR identifier: TCTR20200723002).
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Affiliation(s)
- Nuttapong Saengprasittichok
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.,Phaholpolpayuhasena Hospital, Kanchanaburi, Thailand
| | - Jeerus Sucharitakul
- Department of Biochemistry and Research Unit in Integrative Immuno-Microbial Biochemistry and Bioresponsive Nanomaterials, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chanwit Prapinjumrune
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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14
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Risk Factors of Oropharyngeal Candidiasis in COVID-19 Patients: A Case-control Study. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.114631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: With the emergence and spread of coronavirus disease 2019 (COVID-19) globally, health care systems have faced the biggest challenge in recent decades. Objectives: The present study aimed to identify risk factors associated with oropharyngeal candidiasis (OPC) in COVID-19 patients. Methods: The total number of confirmed COVID-19 patients was 218 (105 cases with OPC and 113 controls without OPC). The questionnaire used in this study consisted of demographic data, treatment strategy, clinical and laboratory data, and underlying diseases collected from the onset of clinical OPC until the end of hospitalization. Results: Pseudomembranous candidiasis (77/105, 73.3%) was the most prevalent form of OPC in case patients. The majority of the cases (58.1%) and controls (58.4%) were males. Increasing age (P = 0.03) and hospitalization length (P = 0.016) were significantly associated with OPC in COVID-19 patients. Diabetes (P = 0.003), solid tumor (P = 0.019), and hypertension (P = 0.000) were the most common underlying conditions. The use of dentures (P = 0.003) and poor oral hygiene (P = 0.000) were related to OPC in the case group. Therapy with chloroquine (P = 0.012), IVIG (P = 0.001), diuretics (P = 0.000), and corticosteroid pulse therapy (P = 0.000) were significantly associated with developing OPC in case patients. Conclusions: Old age, hospitalization length, poor oral hygiene, corticosteroids use, diabetes, solid tumor, and hypertension may predispose COVID-19 patients to develop OPC.
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15
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Brennan MT, Madsen LS, Saunders DP, Napenas JJ, McCreary C, Ni Riordain R, Pedersen AML, Fedele S, Cook RJ, Abdelsayed R, Llopiz MT, Sankar V, Ryan K, Culton DA, Akhlef Y, Castillo F, Fernandez I, Jurge S, Kerr AR, McDuffie C, McGaw T, Mighell A, Sollecito TP, Schlieve T, Carrozzo M, Papas A, Bengtsson T, Al-Hashimi I, Burke L, Burkhart NW, Culshaw S, Desai B, Hansen J, Jensen P, Menné T, Patel PB, Thornhill M, Treister N, Ruzicka T. Efficacy and Safety of a Novel Mucoadhesive Clobetasol Patch for Treatment of Erosive Oral Lichen Planus. J Oral Pathol Med 2021; 51:86-97. [PMID: 34907617 DOI: 10.1111/jop.13270] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa. Currently there is no approved treatment for oral lichen planus (OLP). We report on the efficacy and safety of a novel mucoadhesive clobetasol patch (Rivelin® -CLO) for the treatment of OLP. METHODS Patients with confirmed OLP and measurable symptomatic ulcer(s) participated in a randomized, double-blind, placebo-controlled, multicenter clinical trial testing a novel mucoadhesive clobetasol patch (Rivelin® -CLO) in OLP across Europe, Canada and USA. Patients were randomized to placebo (non-medicated), 1, 5, 20 µg Clobetasol/patch, twice daily, for 4 weeks. The primary endpoint was change in total ulcer area compared to baseline. Secondary endpoints included improvement from baseline in pain, disease activity, and quality of life. RESULTS Data were analyzed and expressed as mean [SD]. One hundred thirty-eight (138) patients were included in the study; 99 females and 39 males, mean age was 61.1 [11.6] years. Statistical analyses revealed that treatment with 20-μg Rivelin® -CLO patches demonstrated significant improvement with ulcer area (P=0.047), symptom severity (P=0.001), disease activity (P=0.022), pain (P=0.012), and quality of life (P=0.003) as compared with placebo. Improvement in OLP symptoms from beginning to the end of the study was reported as very much better (best rating) in the 20-µg group (25/32) patients compared to the placebo group (11/30), (P=0.012). Adverse events were mild/moderate. Candidiasis incidence was low (2%). CONCLUSIONS Rivelin® -CLO patches were superior to placebo demonstrating statistically significant, clinically relevant efficacy in objective and subjective improvement and, with a favorable safety profile.
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Affiliation(s)
- Michael T Brennan
- Atrium Health Carolinas Medical Center, Department of Oral Medicine, Charlotte, NC, USA
| | | | - Deborah P Saunders
- Health Sciences North, Northeast Cancer Centre, Sudbury, Ontario, Canada; Northern Ontario School of Medicine, Sudbury, Ontario, Canada
| | - Joel J Napenas
- Atrium Health Carolinas Medical Center, Department of Oral Medicine, Charlotte, NC, USA
| | - Christine McCreary
- Cork University Dental School and Hospital, College of Medicine and Health, University College Cork, Ireland
| | - Richeal Ni Riordain
- Cork University Dental School and Hospital, College of Medicine and Health, University College Cork, Ireland
| | | | - Stefano Fedele
- University College London, UCL Eastman Dental Institute and UCLH NIHR Biomedical Research Centre, London, UK
| | - Richard J Cook
- King´s College London, Faculty of Dentistry Oral & Craniofacial Sciences, Oral Medicine & Oral Clinical Research Unit, Guy's Hospital Campus, London, UK
| | - Rafik Abdelsayed
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Vidya Sankar
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Tufts University School of Dental Medicine, Boston, MA, USA
| | - Kevin Ryan
- University of Glasgow Hospital & Dental School, Glasgow, UK
| | - Donna A Culton
- University of North Carolina at Chapel Hill, Department of Dermatology, Chapel Hill, NC, USA
| | - Yousra Akhlef
- Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | | | | | - Sabine Jurge
- University of Sheffield School of Clinical Dentistry, Sheffield, UK
| | | | | | - Tim McGaw
- Kaye Edmonton Clinic, Edmonton, Alberta, Canada
| | - Alan Mighell
- School of Dentistry, The University of Leeds, Leeds, UK
| | - Thomas P Sollecito
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Marco Carrozzo
- School of Dental Sciences, Newcastle University, Newcastle, UK
| | - Athena Papas
- Tufts University School of Dental Medicine, Boston, MA, USA
| | | | - Ibtisam Al-Hashimi
- UT Southwestern Medical Center, Dallas, TX, USA.,Currently Scientific Consultant
| | | | - Nancy W Burkhart
- The International Oral Lichen Planus Support Group, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Shauna Culshaw
- University of Glasgow Hospital & Dental School, Glasgow, UK
| | - Bhavik Desai
- TMJ & Orofacial Treatment Centers of Wisconsin, WI, USA
| | | | - Pia Jensen
- Afyx Therapeutics A/S, Copenhagen, Denmark
| | | | - Paras B Patel
- Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Martin Thornhill
- Atrium Health Carolinas Medical Center, Department of Oral Medicine, Charlotte, NC, USA.,University of Sheffield School of Clinical Dentistry, Sheffield, UK
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
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16
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Molkenthin F, Hertel M, Neumann K, Schmidt-Westhausen AM. Factors influencing the presence of Candida dubliniensis and other non-albicans species in patients with oral lichen planus: a retrospective observational study. Clin Oral Investig 2021; 26:333-342. [PMID: 34142239 PMCID: PMC8791885 DOI: 10.1007/s00784-021-04004-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/20/2021] [Indexed: 11/24/2022]
Abstract
Objectives The epidemiologic distribution of non-albicans species in the oral cavity of oral lichen planus (OLP) patients remains uncertain. Therefore, the aim of this study was to identify factors associated with the presence of C. dubliniensis and other non-albicans species. Furthermore, independent risk factors for Candida superinfection in OLP should be identified. Material and methods Epidemiologic data and microbiological findings from 268 symptomatic OLP patients who underwent continuous oral swab culture over a 5-year period (2015–2019) were retrospectively reviewed. Candida species identification and semi-quantification were obtained by culture on CHROMagar Candida, followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results C. albicans was the most frequently isolated species (72.3%), followed by C. glabrata (7.3%), C. dubliniensis (5.8%), C. krusei and C. parapsilosis (both 2.6%). The presence of C. dubliniensis was significantly associated with tobacco smoking. Other non-albicans spp. were significantly more often detected in patients using removable dentures. Increasing age and the intake of psychotropic drugs were identified as independent risk factors of Candida superinfection in OLP. Conclusion In OLP patients, certain local and systemic factors increase the risk of carrying potentially drug-resistant Candida species and the development of Candida superinfection of OLP lesions. Clinical relevance Due to the frequent detection of non-albicans species in OLP, resistance or at least reduced sensitivity to azole antifungals should be expected, especially in smokers and patients using removable dentures. In the case of oral complaints, a superinfection with Candida should be considered, whereby older patients and patients taking psychotropic drugs have an increased risk for oral infection with Candida.
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Affiliation(s)
- Florian Molkenthin
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany.
| | - Moritz Hertel
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany
| | - Konrad Neumann
- Institute of Medical Biometrics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Andrea Maria Schmidt-Westhausen
- CharitéCentre 3, Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4, 14197, Berlin, Germany
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17
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Osipoff A, Carpenter MD, Noll JL, Valdez JA, Gormsen M, Brennan MT. Predictors of symptomatic oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:468-477. [DOI: 10.1016/j.oooo.2019.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 01/07/2023]
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18
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Shavit E, Hagen K, Shear N. Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know. F1000Res 2020; 9. [PMID: 32226613 PMCID: PMC7096219 DOI: 10.12688/f1000research.18713.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 01/04/2023] Open
Abstract
Lichen planus (LP) is a chronic autoimmune disease. Oral lesions may occur in isolation or in combination with other affected muco-cutaneous sites. Oral LP (OLP) may present as one of the various manifestations of LP or may present as a disease sui generis with a broad range of severity. Despite this disease targeting the oral mucosa, its great impact on quality of life is underrated. In this article, we provide an updated review of the pathophysiology and epidemiology of OLP and offer guidance for its diagnosis and management. We also propose an algorithmic approach to the clinical forms of OLP and a novel staging system to facilitate management decisions.
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Affiliation(s)
- Eran Shavit
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Dermatology Unit, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Klieb Hagen
- Department of Dentistry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Neil Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Medicine (Dermatology, Clinical Pharmacology, and Toxicology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Ma J, Shi H, Sun H, Li J, Bai Y. Antifungal effect of photodynamic therapy mediated by curcumin on Candida albicans biofilms in vitro. Photodiagnosis Photodyn Ther 2019; 27:280-287. [PMID: 31233886 DOI: 10.1016/j.pdpdt.2019.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/11/2019] [Accepted: 06/20/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Canida albicans can cause opportunistic infections ranging from superficial mucous membrane lesions to life-threatening disease. The aim of this study is to investigate the antifungal effect of photodynamic therapy (PDT) mediated by curcumin (CUR) on C. albicans biofilms in vitro. METHODS One standard strain ATCC 90028 and two clinical isolates from HIV (CCA1) and oral lichen planus (CCA2) patients' oral cavities were used in this study. Biofilms were photosensitized with 60 μM CUR and irradiated by light emitting diode (LED) under the wavelength of 455 nm and energy densities of 2.64, 5.28, 7.92, 10.56, 13.2 J/cm2. Then the antifungal effects of CUR-PDT were evaluated by XTT reduction assay and confocal light scanning microscopy (CLSM) observations. The effects of CUR-PDT on the expression levels of hypha-specific and biofilm-related genes including EFG1, UME6, HGC1 and ECE1 were assessed by quantitative Real-time PCR (qRT-PCR) method. RESULTS The inhibition rates after CUR-PDT in three biofilms(ATCC 90028, CCA1, CCA2)were 90.87%, 66.44% and 86.74% respectively (p < 0.05). Relative gene expression levels of EFG1, UME6, HGC1 and ECE1 were all downregulated after CUR-PDT, with fold-decrease of 6.865, 3.382, 2.167 and 6.887 in ATCC 90028, 2.466, 2.146, 1.627 and 3.102 in CCA1, and 5.406, 2.347, 2.073and 3.711 in CCA2 (p < 0.05). CONCLUSIONS Curcumin-mediated PDT could effectively inactivateCandida albicans biofilms in vitro. Expression of genes involved in biofilms formation were downregulated after CUR-PDT.
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Affiliation(s)
- Jing Ma
- Institution: Department of Stomatology, Huashan Hospital, Fudan University, No.12, Rd. Wulumuqi, Shanghai, China.
| | - Hang Shi
- Institution: Department of Stomatology, Huashan Hospital, Fudan University, No.12, Rd. Wulumuqi, Shanghai, China.
| | - Hongying Sun
- Institution: Department of Stomatology, Huashan Hospital, Fudan University, No.12, Rd. Wulumuqi, Shanghai, China.
| | - Jiyang Li
- Institution: School of Pharmacy, Fudan University, No.826, Rd. Zhangheng, Shanghai, China.
| | - Yu Bai
- Institution: Department of Stomatology, Huashan Hospital, Fudan University, No.12, Rd. Wulumuqi, Shanghai, China.
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20
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Characterization of sensory neuronal subtypes innervating mouse tongue. PLoS One 2018; 13:e0207069. [PMID: 30408082 PMCID: PMC6224080 DOI: 10.1371/journal.pone.0207069] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
The tongue is uniquely exposed to water-soluble environmental chemicals that may lead to injury or tumorigenesis. However, comparatively little research has focused on the molecular and functional organization of trigeminal ganglia (TG) afferent neurons innervating the tongue. The current study identified and characterized lingual sensory neurons based on a neuronal subtype classification previously characterized in the dorsal root ganglion (DRG) neurons. We employed immunohistochemistry on transgenic reporter mouse lines as well as single-cell PCR of known markers of neuronal subtypes to characterize neuronal subtypes innervating the tongue. Markers expressed in retrogradely labeled TG neurons were evaluated for the proportion of neurons expressing each marker, intensity of expression, and overlapping genes. We found that tongue-innervating sensory neurons primarily expressed CGRP, TRPV1, TrkC, 5HT3A and Parvalbumin. These markers correspond to peptidergic and a subgroup of non-peptidergic C-nociceptors, peptidergic A nociceptors, proprioceptors and myelinated low-threshold mechanoreceptors (LTMRs). Interestingly, as reported previously, we also found several differences between TG and DRG neurons indicating the need for single-cell sequencing of neuronal types based on tissue type within all TG as well as DRG neurons.
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21
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Edens MH, Carpenter MD, Napeñas JJ, Brennan MT. Impact of salivary hypofunction on incidence of orofungal infections with use of topical steroids for management of oral lichen planus and xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:501-505. [PMID: 30309830 DOI: 10.1016/j.oooo.2018.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The aim of this study was to determine if salivary hypofunction increases the incidence of oral fungal infections (OFIs) after topical steroid use for the management of oral lichen planus (OLP). STUDY DESIGN Patients with a diagnosis of OLP, treated for at least 2 weeks with topical steroids, had baseline salivary flow evaluations completed, and had a follow-up visit within 5 weeks of steroids being prescribed were assessed. Patients were evaluated for clinical signs of fungal infection at follow-up visits. RESULTS Forty-Seven patients (91% female) met the inclusion criteria, with 21.3% developing an OFI after topical steroid use. Demographic characteristics, type of OLP, steroid used, and antifungal used did not impact the development of an OFI. The mean stimulated salivary flow was significantly lower in the group that developed an OFI compared with the group that did not develop an OFI (8.31 mL/15 min vs 15.4 mL/15 min, respectively; P = 0.0006). A higher incidence of OFIs occurred in the low stimulated flow group versus the normal flow group (39% vs 4%, respectively). Most patients in the OFI group received a preventative antifungal (90%). CONCLUSIONS OFIs increased after steroid treatment in patients with OLP who had low stimulated salivary flows. Antifungals (90%) were not effective in preventing OFIs in patients with OLP who had salivary hypofunction and were treated with topical steroids.
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Affiliation(s)
- Mary Hil Edens
- Oral Medicine Resident, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Michael D Carpenter
- Research Assistant, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Joel J Napeñas
- Associate Professor, Oral Medicine Residency Director, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Michael T Brennan
- Professor and Department Chair, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.
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Giuliani M, Troiano G, Cordaro M, Corsalini M, Gioco G, Lo Muzio L, Pignatelli P, Lajolo C. Rate of malignant transformation of oral lichen planus: A systematic review. Oral Dis 2018; 25:693-709. [PMID: 29738106 DOI: 10.1111/odi.12885] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/09/2018] [Accepted: 04/26/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature to determine: (a) the malignant transformation rate (TR) of oral lichen planus (OLP) and its risk factors; (b) whether or not oral lichenoid lesions (OLL) have a different malignant TR. MATERIALS AND METHODS PubMed, Scopus, and Web of Science were used as search engines: only observational, full-length, English language studies were investigated. PRISMA protocol was used to evaluate and present results. PROSPERO registration code is CRD42016048529. RESULTS Among 7,429 records screened, only 21 were included in this review. Ninety-two of 6,559 patients developed oral squamous cell carcinoma, with an overall TR of 1.40% (1.37% for OLP and 2.43% for OLL), an annual TR of 0.20%. Female gender, red clinical forms, and tongue site seem to slightly increase the transformation risk. CONCLUSIONS This systematic review confirms that both OLP and OLL, the latter with a slightly higher TR, may be considered potentially malignant disorders and suggest that erosive type, female gender and tongue site should be considered as risk factors for OLP transformation. Major efforts should be done to establish strict clinical and histological criteria to diagnose OLP and to perform sounder methodological observational studies.
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Affiliation(s)
- Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Cordaro
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine (DIM), University of Bari, Bari, Italy
| | - Gioele Gioco
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Carlo Lajolo
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
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Keller MK, Kragelund C. Randomized pilot study on probiotic effects on recurrent candidiasis in oral lichen planus patients. Oral Dis 2018; 24:1107-1114. [PMID: 29570907 DOI: 10.1111/odi.12858] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 12/31/2022]
Abstract
Some patients with oral lichen planus (OLP) experience recurrent oral candidiasis(OC). Probiotic bacteria have shown to reduce the oral Candida count in vivo. OBJECTIVE To study whether probiotic intervention reduces recurrent OC in patients with OLP. MATERIAL AND METHODS Twenty-two patients with symptomatic OLP were enrolled in the double-blinded, randomized, placebo-controlled intervention study. Lozenges containing Lactobacilli reuteri (DSM 17938 and ATCC PTA 5289) or placebo were dissolved intra-orally three times daily for 16 weeks, after which patients were followed up for 36 weeks. Mucosal symptoms, VAS pain, OLP severity score, plaque index (PI) and gingival index (GI), Candida count/carriage, and OC and/or need for symptomatic treatment were registered. Statistical significance was set at p < .05. RESULTS No difference was observed between the groups during the intervention or follow-up in terms of recurrent OC (p = .966) or need for symptomatic treatment (p = 1.000). There was no difference in terms of Candida count (p = .96) or carriage over time (p = .511). GI decreased in the probiotic group and increased in the placebo group (p = .046). OLP severity score decreased in both groups during the study period (p = .039). Across the entire study period, the placebo group had higher VAS pain score (p = .037). CONCLUSIONS Probiotic intervention did not reduce recurrent OC or Candida count/carriage, but the study experienced recruitment problems, which may have influenced results.
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Affiliation(s)
- M K Keller
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C Kragelund
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Akram Z, Javed F, Hosein M, Al-Qahtani MA, Alshehri F, Alzahrani AI, Vohra F. Photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2017; 34:167-174. [DOI: 10.1111/phpp.12371] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Mervyn Hosein
- Faculty of Dentistry; Ziauddin Medical University; Karachi Pakistan
| | - Mohammed A. Al-Qahtani
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | | | | | - Fahim Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
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25
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Bombeccari GP, Giannì AB, Spadari F. Oral Candida colonization and oral lichen planus. Oral Dis 2017; 23:1009-1010. [DOI: 10.1111/odi.12681] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gian Paolo Bombeccari
- Maxillo-Facial and Dental Unit; Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Aldo Bruno Giannì
- Maxillo-Facial and Dental Unit; Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
| | - Francesco Spadari
- Maxillo-Facial and Dental Unit; Fondazione Ca’ Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Milan Italy
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26
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Peng Q, Zhang J, Ye X, Zhou G. Tumor-like microenvironment in oral lichen planus: evidence of malignant transformation? Expert Rev Clin Immunol 2017; 13:635-643. [PMID: 28494213 DOI: 10.1080/1744666x.2017.1295852] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Qiao Peng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Jing Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
- Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Xiaojing Ye
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
- Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, P.R. China
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Zadik Y, Elad S, Shapira A, Shapira MY. Treatment of oral mucosal manifestations of chronic graft-versus-host disease: dexamethasone vs. budesonide. Expert Opin Pharmacother 2017; 18:235-242. [PMID: 28081677 DOI: 10.1080/14656566.2017.1282464] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The oral mucosa is commonly involved in chronic graft-versus-host disease (cGVHD). Oral mucosal cGVHD markedly affect individual's daily function and wellbeing. In some cases, it might become a life threating complication. Areas covered: This article describes the rationale for treatment, method of topical application in the oral cavity, evidence supporting the topical administration of dexamethasone and budesonide for oral cGVHD, and their adverse effects. Expert opinion: Evidence supports the use of topical dexamethasone and budesonide for treatment of oral cGVHD. Topical corticosteroid choice for oral cGVHD, takes into consideration the potency, bioavailability, preferred concentration, and possible adverse effects. Budesonide's pharmacological characteristics mark it as a preferable topical agent for oral cGVHD.
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Affiliation(s)
- Yehuda Zadik
- a Department of Oral Medicine, Sedation and Maxillofacial Imaging , Hadassah-Hebrew University School of Dental Medicine , Jerusalem , Israel.,b Department of Oral Medicine , The Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces , Tel Hashomer , Israel
| | - Sharon Elad
- c Division of Oral Medicine, Hospital General Dentistry, Eastman Institute for Oral Health , University of Rochester Medical Center , Rochester , NY , USA.,d Wilmot Cancer Center , University of Rochester Medical Center , Rochester , NY , USA
| | - Anat Shapira
- e Pharmacy Division , Hadassah-Hebrew University Medical Center , Jerusalem , Israel
| | - Michael Y Shapira
- f Bone Marrow Transplantation and Cancer Immunotherapy Department , Hadassah-Hebrew University Medical Center , Jerusalem , Israel
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Tejani S, Sultan A, Stojanov I, Woo SB. Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:448-54. [DOI: 10.1016/j.oooo.2016.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/05/2016] [Accepted: 06/11/2016] [Indexed: 12/14/2022]
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