1
|
Wang R, Zhang X, Wang S. Differential genotypes of TNF-α and IL-10 for immunological diagnosis in discoid lupus erythematosus and oral lichen planus: A narrative review. Front Immunol 2022; 13:967281. [PMID: 35990645 PMCID: PMC9389012 DOI: 10.3389/fimmu.2022.967281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Discoid lupus erythematosus and oral lichen planus are chronic systemic immune system-mediated diseases with unclear etiology and pathogenesis. The oral mucosa is the common primary site of pathogenesis in both, whereby innate and adaptive immunity and inflammation play crucial roles. The clinical manifestations of discoid lupus erythematosus on the oral mucosa are very similar to those of oral lichen planus; therefore, its oral lesion is classified under oral lichenoid lesions. In practice, the differential diagnosis of discoid lupus erythematosus and oral lichen planus has always relied on the clinical manifestations, with histopathological examination as an auxiliary diagnostic tool. However, the close resemblance of the clinical manifestations and histopathology proves challenging for accurate differential diagnosis and further treatment. In most cases, dentists and pathologists fail to distinguish between the conditions during the early stages of the lesions. It should be noted that both are considered to be precancerous conditions, highlighting the significance of early diagnosis and treatment. In the context of unknown etiology and pathogenesis, we suggest a serological and genetic diagnostic method based on TNF-α and IL-10. These are the two most common cytokines produced by the innate and adaptive immune systems and they play a fundamental role in maintaining immune homeostasis and modulating inflammation. The prominent variability in their expression levels and gene polymorphism typing in different lesions compensates for the low specificity of current conventional diagnostic protocols. This new diagnostic scheme, starting from the immunity and inflammation of the oral mucosa, enables simultaneous comparison of discoid lupus erythematosus and oral lichen planus. With relevant supportive evidence, this information can enhance physicians’ understanding of the two diseases, contribute to precision medicine, and aid in prevention of precancerous conditions.
Collapse
Affiliation(s)
- Ruochong Wang
- Emergency Department, State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuefeng Zhang
- Emergency Department, State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Siyu Wang
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- *Correspondence: Siyu Wang,
| |
Collapse
|
2
|
Sanches ACB, Pires ALPV, Medrado ARAP, de Almeida Reis SR, Freitas VS, Martins GB. Oral Lichen Planus: Associations Between Histomorphometric Characteristics and White and Red Lesions. Head Neck Pathol 2022; 16:969-979. [PMID: 35579856 PMCID: PMC9729480 DOI: 10.1007/s12105-022-01442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Histomorphometry seems to provide more rigid quantitative elements for histological analysis and to bring less subjectivity to the diagnosis of oral lichen planus lesions (OLP). This study aimed to verify the association between white and red lesions and histomorphometric characteristics of OLP lesions. This retrospective cross-sectional study assessed 48 hematoxylin- and eosin-stained histological sections from incisional biopsies obtained from OLP cases. A single previously calibrated evaluator performed the light microscopy analyses to evaluate morphological and morphometric parameters. Analyses of associations among variables were performed using the Fisher's exact test. Morphometric variables were assessed using the Mann-Whitney non-parametric test. Comparisons among the three groups (age range) were performed using the Kruskal-Wallis test. In this study, 81.2% of the participants were women aged < 50 years. Keratosis, acanthosis, and inflammatory infiltrates were noted in 10.4, 10.4, and 37.5% of moderate/severe cases, respectively. Inflammatory infiltrate (52.1%), papillary projections (54.2%), saw teeth (12.5%), basal layer degeneration (39.6%), and Civatte bodies (68.8%) were also observed. There was no significant association between lesion type and clinicopathological variables (p > 0.05) or between lesion type and histological (p > 0.05) and morphometric variables (p > 0.05). Furthermore, the morphometric variables analyzed did not differ between white and red lesions (p > 0.05) or in their associations with clinicopathological variables (p > 0.05). The results of this investigation showed no associations between white and red OLP lesions and the histomorphometric characteristics evaluated.
Collapse
Affiliation(s)
- Ana Carla Barletta Sanches
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Laboratório de Bioquímica Oral, Instituto de Ciências da Saúde (UFBA), Av. Reitor Miguel Calmon, s/n. Sala 410. Vale do Canela, Salvador, Brazil
| | | | | | - Silvia Regina de Almeida Reis
- Bahiana School of Medicine and Public Health, Salvador, Bahia Brazil ,Pathology, Berlin’s Free University, Berlin, Germany
| | - Valéria Souza Freitas
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Brazil ,Dentistry Course, State University of Feira de Santana, Feira de Santana, Brazil ,Postgraduate Program in Public Health, State University of Feira de Santana, Bahia, Brazil
| | - Gabriela Botelho Martins
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Clinical Stomatology, PUCRS, Porto Alegre, Brazil ,Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
| |
Collapse
|
3
|
Zanetta P, Ormelli M, Amoruso A, Pane M, Azzimonti B, Squarzanti DF. Probiotics as Potential Biological Immunomodulators in the Management of Oral Lichen Planus: What's New? Int J Mol Sci 2022; 23:ijms23073489. [PMID: 35408849 PMCID: PMC8998608 DOI: 10.3390/ijms23073489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disorder with multifactorial aetiology and malignant transformation potential. Despite the treatments so far identified, new tailored and safe specific measures are needed. Recently, human microbiota imbalance has been linked to several immune-mediated diseases, opening new therapeutic perspectives for probiotics; besides their ability to directly interact with the host microbiota, they also display a strain-specific immune-modulatory effect. Thus, this non-systematic review aims to elucidate the molecular pathways underlying probiotic activity, mainly those of Lactobacilli and Bifidobacteria and their metabolites in OLP pathogenesis and malignant transformation, focusing on the most recent in vitro and in vivo research evidence. Findings related to their activity in other immune-mediated diseases are here included, suggesting a probiotic translational use in OLP. Probiotics show immune-modulatory and microbiota-balancing activities; they protect the host from pathogens, hamper an excessive effector T cell response, reduce nuclear factor-kappa B (NF-kB) signalling and basal keratinocytes abnormal apoptosis, shifting the mucosal response towards the production of anti-inflammatory cytokines, thus preventing uncontrolled damage. Therefore, probiotics could be a highly encouraging prevention and immunotherapeutic approach for a safer and more sustainable OLP management.
Collapse
Affiliation(s)
- Paola Zanetta
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
| | - Margherita Ormelli
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
| | - Angela Amoruso
- Probiotical Research Srl, Via Mattei 3, 28100 Novara, Italy; (A.A.); (M.P.)
| | - Marco Pane
- Probiotical Research Srl, Via Mattei 3, 28100 Novara, Italy; (A.A.); (M.P.)
| | - Barbara Azzimonti
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
- Correspondence: (B.A.); (D.F.S.); Tel.: +39-0321-660-870 (B.A.)
| | - Diletta Francesca Squarzanti
- Laboratory of Applied Microbiology, Department of Health Sciences (DiSS), Center for Translational Research on Allergic and Autoimmune Diseases (CAAD), School of Medicine, Università del Piemonte Orientale (UPO), Corso Trieste 15/A, 28100 Novara, Italy; (P.Z.); (M.O.)
- Correspondence: (B.A.); (D.F.S.); Tel.: +39-0321-660-870 (B.A.)
| |
Collapse
|
4
|
Solhaug MB, Schreurs O, Schenck K, Blix IJ, Baekkevold ES. Origin of langerin (CD207)‐expressing antigen presenting cells in the normal oral mucosa and in oral lichen planus lesions. Eur J Oral Sci 2021; 130:e12835. [DOI: 10.1111/eos.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/01/2022]
Affiliation(s)
| | - Olav Schreurs
- Institute of Oral Biology University of Oslo Oslo Norway
| | - Karl Schenck
- Institute of Oral Biology University of Oslo Oslo Norway
| | - Inger Johanne Blix
- Institute of Oral Biology University of Oslo Oslo Norway
- Department of Periodontology Dental Faculty University of Oslo Oslo Norway
| | - Espen S. Baekkevold
- Institute of Oral Biology University of Oslo Oslo Norway
- Department of Pathology Oslo University Hospital and University of Oslo Oslo Norway
| |
Collapse
|
5
|
Topical Cyclosporine in Oral Lichen Planus-A Series of 21 Open-Label, Biphasic, Single-Patient Observations. J Clin Med 2021; 10:jcm10225454. [PMID: 34830736 PMCID: PMC8622196 DOI: 10.3390/jcm10225454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Topical cyclosporine (CSA) has been reported as an alternative treatment in steroid-refractory oral lichen planus (OLP), but evidence is limited and conflicting. An N-of-1 trial setting could be appropriate to evaluate interindividual differences in treatment response. We studied a series of 21 open-label, biphasic single-patient observations. Patients (15 women, 6 men) with OLP recalcitrant to topical steroids received four weeks of CSA mouth rinse (200 mg/twice daily) followed by four weeks of drug withdrawal. Pain (visual analogue scale (VAS) score), disease extent (physicians’ global assessment (PGA) score) and quality of life (Dermatology Life Quality Index (DLQI) score,) were assessed at baseline (T0), after four weeks of treatment (T1) and after another four weeks without treatment (T2). Median age was 58 years (interquartile range/IQR = 52–67) and median disease duration was 18 months (IQR = 12–44). Median baseline VAS score decreased significantly at T1 (p = 0.0003) and increased at T2 (p = 0.032) (T0 = 5 (IQR = 3–6.5); T1 = 2 (IQR = 0.5–3.4); T2 = 3 (IQR = 2–4.8)). Similarly, median baseline PGA score decreased significantly at T1 (p = 0.001) and increased at T2 (p = 0.007) (T0 = 2 (IQR = 1.3–2.5); T1 = 1 (IQR = 1–2); T2 = 2 (IQR = 1–2)). Median baseline DLQI score also decreased significantly at T1 (p =.027) but did not change at T2 (p = 0.5) (T0 = 2.5 (IQR = 1–5.8); T1 = 1 (IQR = 0–3); T2 = 1 (IQR = 1–4)). CSA responders (n = 16) had significantly higher median baseline VAS scores (5.2 (IQR = 5–6.5)) than nonresponders (n =5) (2 (IQR = 2–3.5) (p = 0.02). In our study, pain, disease extent and quality of life of patients with OLP improved significantly during therapy with low-dose CSA mouth rinse and exacerbated after drug withdrawal. Remarkably, patients with high initial VAS scores seemed to profit most.
Collapse
|
6
|
Ge X, Xie H, Wang L, Li R, Zhang F, Xu J, Zhao B, Du J. MicroRNA-122 promotes apoptosis of keratinocytes in oral lichen planus through suppressing VDR expression. J Cell Mol Med 2021; 25:3400-3407. [PMID: 33656264 PMCID: PMC8034474 DOI: 10.1111/jcmm.16418] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
MicroRNA‐122 (miR‐122) is known to be up‐regulated by inflammation to exert a variety of biological functions in hepatocellular carcinoma (HCC)‐derived human cell lines. Vitamin D receptor (VDR) is reported to regulate excessive oral keratinocytes apoptosis which compromises oral epithelial barrier in oral lichen planus (OLP). Although many studies have suggested that miR‐122 is capable of regulating cell apoptosis, its effects on the development of OLP and VDR expression are still unclear. Herein, we demonstrate that miR‐122 expression is increased in the epithelial layer of OLP. Mechanically, transcription factor nuclear factor‐κB (NF‐κB) selectively binds with κB element in the promoter of miR‐122 to accelerate gene transcription. The up‐regulation of miR‐122 induces cell apoptosis in human oral keratinocytes (HOKs) by targeting VDR mRNA. In VDR knockout oral keratinocytes, miR‐122 fails to improve caspase 3 activity and cleaved caspase 3 and poly(ADP‐ribose) polymerase (PARP) levels. Moreover, VDR overexpression is able to reverse lipopolysaccharide (LPS)‐ or activated CD4+ T cell–induced miR‐122 up‐regulation and ameliorate miR‐122‐stimulated caspase 3 activity. Collectively, our results suggest that miR‐122 promotes oral keratinocytes apoptosis in OLP through decreasing VDR expression.
Collapse
Affiliation(s)
- Xuejun Ge
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.,Department of Endodontics, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Hanting Xie
- Department of Pathology, Shanxi Medical University, Taiyuan, China
| | - Lu Wang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Ran Li
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Fang Zhang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.,Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Jing Xu
- Department of Pathology, Shanxi Medical University, Taiyuan, China
| | - Bin Zhao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Jie Du
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.,Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.,Institute of Biomedical Research, Shanxi Medical University, Taiyuan, China
| |
Collapse
|
7
|
He Y, Deng J, Zhao Y, Tao H, Dan H, Xu H, Chen Q. Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis. BMC Oral Health 2020; 20:302. [PMID: 33148217 PMCID: PMC7640434 DOI: 10.1186/s12903-020-01260-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management; however, there are different opinions on the efficacy of PDT for OLP. The aim of this study was to comprehensively assess the efficacy of PDT in the treatment of OLP and compare PDT with steroid therapy. Methods A systematic review and meta-analysis were conducted to assess the curative effect of PDT. Five electronic databases were searched, PubMed, Web of Science, the Cochrane Library, Embase, and EBSCO up to 1 December, 2019. Random and fixed effects models for pooled estimates calculation were used and the Meta package of R was applied. Results Pooled estimates revealed that, after PDT, the lesion size decreased by 1.53 cm2 (95% confidence interval (CI): 0.71–2.35) after PDT and the partial response (PR) was 0.77 (95% CI: 0.65–0.85). The visual analogue scale (VAS) score decreased by 3.82 (95% CI: 2.80–4.85) and the Thongprasom sign score decreased by 1.33 (95% CI: 0.56–2.10) after PDT. Subgroup analyses revealed that the 5-aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with a PR of 0.87 (95% CI: 0.80–0.91). The topical use of 5-ALA yielded a better response than gargling methylene blue. In terms of VAS, the diode laser showed a better clinical PR in the treatment of OLP. In terms of changes in lesion size, the efficacy of the semiconductor laser was higher than that of the diode laser. PDT had a similar efficacy to topical corticosteroids, as shown by pooled estimates of five randomised controlled trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality for the management of OLP. PDT is as effective as topical corticosteroid in the treatment of OLP and could be used for cases resistant to steroids or when steroids are contraindicated.
Collapse
Affiliation(s)
- Yuqing He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Jiaxin Deng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Yi Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Huiqian Tao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Hao Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China.
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, No. 14, Sec.3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| |
Collapse
|
8
|
Cruz AF, Vitório JG, Duarte‐Andrade FF, Diniz MG, Canuto GAB, Toledo JS, Fonseca FP, Fernandes AP, André LC, Gomes CC, Gomez RS. Reticular and erosive oral lichen planus have a distinct metabolomic profile: A preliminary study using gas chromatography‐mass spectrometry. J Oral Pathol Med 2019; 48:400-405. [DOI: 10.1111/jop.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 02/09/2019] [Accepted: 02/19/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Aline Fernanda Cruz
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Jéssica Gardone Vitório
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Filipe Fideles Duarte‐Andrade
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Marina Gonçalves Diniz
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | | | - Juliano Simões Toledo
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Ana Paula Fernandes
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Leiliane Coelho André
- Department of Clinical and Toxicological AnalysisFaculty of PharmacyUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Carolina Cavaliéri Gomes
- Department of PathologyBiological Sciences InstituteUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and PathologySchool of DentistryUniversidade Federal de Minas Gerais (UFMG) Belo Horizonte Brazil
| |
Collapse
|
9
|
Yang XY, Li XZ, Zhang SN. Metabolomics analysis of oral mucosa reveals profile perturbation in reticular oral lichen planus. Clin Chim Acta 2018; 487:28-32. [PMID: 30218656 DOI: 10.1016/j.cca.2018.09.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/06/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory mucosal disorder and potentially oral premalignant lesion affecting the stratified squamous epithelia. In OLP, reticular type is the most common clinical form of the disease. However, little is known about it. Metabolomics analysis may help to investigate the disease pathogenesis and to improve clinical treatment. METHODS Liquid chromatography (LC)-mass spectrometry (MS) system, XCMS software, SIMCA software, and OSI / SMMS software were integrated to identify differentially expressed metabolites for the pathways and pathology analysis. RESULTS Totally, 21 modulated metabolites were identified, whose dysregulations affected 30 metabolic pathways. Through an impact-value screen (impact-value>0.1), 8 pathways were selected as the significantly dysregulated pathways. Pathological network showed that these metabolites participated in 5 pathological processes, that is, inflammatory lesion, DNA damage and repair disorder, apoptosis process, oxidative stress injury, and abnormal energy expenditure. CONCLUSION The study revealed the metabolic perturbation of oral mucosa in reticular OLP, which may provide an important reference for the understanding of the pathogenesis of the disease and the discovery of therapeutic targets.
Collapse
Affiliation(s)
- Xu-Yan Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, PR China
| | - Xu-Zhao Li
- Pharmacy School, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
| | - Shuai-Nan Zhang
- Pharmacy School, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
| |
Collapse
|
10
|
Zhao B, Xu N, Li R, Yu F, Zhang F, Yang F, Ge X, Li YC, Du J. Vitamin D/VDR signaling suppresses microRNA-802-induced apoptosis of keratinocytes in oral lichen planus. FASEB J 2018; 33:1042-1050. [PMID: 30074824 DOI: 10.1096/fj.201801020rrr] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Vitamin D is known to play a protective role in inflammatory diseases. Although the suppressive effect of vitamin D/vitamin D receptor (VDR) signaling has been shown in the context of oral lichen planus (OLP), the molecular basis of its regulatory function remains poorly understood. Herein, we reported that miR-802 overexpression in OLP could aggravate apoptosis of oral keratinocytes by targeting B-cell lymphoma 2 mRNA. In addition, vitamin D/VDR signaling was able to suppress miR-802 expression in LPS-treated or activated CD4+ T cell-stimulated human oral keratinocytes by blocking NF-κB pathways, thereby inhibiting OLP apoptosis. Consistent with the results in vitro, we showed that miR-802 expression was enhanced in oral keratinocytes from VDR-/- mice, and an inverse correlation between VDR and miR-802 was found in human biopsy specimens of OLP. Collectively, our data suggest that vitamin D/VDR signaling suppresses oral keratinocyte apoptosis by targeting miR-802.-Zhao, B., Xu, N., Li, R., Yu, F., Zhang, F., Yang, F., Ge, X., Li, Y. C., Du, J. Vitamin D/VDR signaling suppresses microRNA-802-induced apoptosis of keratinocytes in oral lichen planus.
Collapse
Affiliation(s)
- Bin Zhao
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Na Xu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Ran Li
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Feiyan Yu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Fang Zhang
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Fang Yang
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Xuejun Ge
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and
| | - Yan Chun Li
- Division of Biological Sciences, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Jie Du
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China; and.,Division of Biological Sciences, Department of Medicine, The University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
11
|
LPS-induced Vitamin D Receptor Decrease in Oral Keratinocytes Is Associated With Oral Lichen Planus. Sci Rep 2018; 8:763. [PMID: 29335479 PMCID: PMC5768778 DOI: 10.1038/s41598-018-19234-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/28/2017] [Indexed: 01/06/2023] Open
Abstract
The suppressive function of vitamin D on oral lichen planus (OLP) have been documented previously. Vitamin D receptor (VDR) expression is down-regulated in OLP, but the molecular mechanism of its decrease and the related anti-inflammatory contributor of epithelial VDR signaling is unclear. Herein, we demonstrated that lipopolysaccharide (LPS) remarkedly down-regulated VDR expression of keratinocytes, and the reduced regulation was dependent on tumor necrosis factor alpha (TNFα)-miR-346 pathway. In human specimen studies, VDR levels of oral mucosal epithelia from OLP patients decreased substantially accompanied with robust TNFα and miR-346 induction, compared to the normal tissues. In addition, vitamin D/VDR signaling inhibited LPS-induced p53-upregulated modulator of apoptosis (PUMA) induction in keratinocytes via impeding nuclear factor-κB (NF-κB) activation, resulting in keratinocytes apoptosis reduction. Importantly, PUMA activity was up-regulated strongly in diseased epithelium, reversely correlated with VDR expression. Totally, our data indicate that LPS is responsible for VDR downregulation in oral keratinocytes, which is associated with OLP development.
Collapse
|
12
|
Abstract
A recently described lineage of lymphocytes, Th17 cells, has been associated with inflammatory and autoimmune diseases. The aim of this article was to assess the immunoexpression of cytokines related to this lineage, interleukin-17 (IL-17) and IL-23 and in reticular and erosive oral lichen planus (OLP). The sample included 41 cases of OLP (23 reticular and 18 erosive) and 10 cases of inflammatory fibrous hyperplasia (IFH). Lymphocytes exhibiting cytoplasmic immunostaining were counted. Epithelial immunostaining was also evaluated. There was no statistical differences in the number of IL-17 and IL-23 lymphocytes between the OLP (55.40 and 48.40, respectively) and IFH (39.30 and 44.40, respectively). A significantly higher number of IL-23 lymphocytes was found in erosive OLP group (63.80) when compared with reticular (41.40) and IFH lesions (44.40) (P=0.019). Furthermore, epithelial immunopositivity for IL-17 and IL-23 was higher in OLP lesions than in IFH (P=0.012 and P=0.011, respectively). A significantly higher number of IL-23 lymphocytes in erosive OLP and the strong epithelial immunopositivity for IL-23 and IL-17 in OLP group could suggest an important participation of TCD4 Th17 response in this disorder.
Collapse
|
13
|
Barbosa NG, Silveira ÉJD, Lima ENDA, Oliveira PT, Soares MSM, de Medeiros AMC. Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus. Int J Dermatol 2014; 54:e1-6. [DOI: 10.1111/ijd.12485] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Natália G. Barbosa
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Éricka J. D. Silveira
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Emeline N. de A. Lima
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Patrícia T. Oliveira
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | | | | |
Collapse
|
14
|
Lei L, Zhan L, Tan W, Chen S, Li Y, Reynolds M. Foxp3 gene expression in oral lichen planus: a clinicopathological study. Mol Med Rep 2014; 9:928-34. [PMID: 24469541 DOI: 10.3892/mmr.2014.1919] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 11/19/2013] [Indexed: 11/06/2022] Open
Abstract
CD4+CD25+ Forkhead‑box protein 3 (Foxp3+) regulatory T cells are important in oral lichen planus (OLP). The present study aimed to investigate Foxp3 expression in CD4+CD25+ T cells of peripheral blood mononuclear cells and oral lesions in patients diagnosed with OLP, who were grouped as OLP subtype, duration and relapse. Using quantitative polymerase chain reaction (qPCR), western blotting and immunohistochemistry, Foxp3 expression levels in explants of oral lesions and CD4+CD25+ T cells from 32 patients with OLP were measured and compared, with 10 healthy subjects as the control group. Foxp3 mRNA expression levels in the explants of oral lesions and circulating CD4+CD25+ T cells in patients with OLP were significantly higher than those in the control group (P<0.05). In patients with clinically erosive lesions, Foxp3 mRNA expression was significantly lower in circulating CD4+CD25+ T cells and tissue explants compared to patients with reticular lesions (P<0.01 and P<0.05, respectively), and lowest in patients with a history of OLP of >1 year or with a history of relapse (P<0.05 and P<0.01, respectively). Foxp3 protein levels in reticular OLP were significantly higher than those in erosive OLP and the control group. The incidence of Foxp3 protein expression in OLP tissues was 36.24±18.92 and 10.44±6.51% in normal oral mucosa (P=0.019). Atrophic/erosive OLP lesions showed a higher proportion of Foxp3‑expressing cells than that of reticular OLP lesions (P<0.05). This study indicated that Foxp3 expression in patients with OLP is associated with the severity and duration of the disorder, suggesting altered immune suppression in the development, clinical course and responsiveness to treatment.
Collapse
Affiliation(s)
- Lei Lei
- Department of Stomatology, Medical College of Jinan University, Guangzhou, Guangdong 510632, P.R. China
| | - Lihua Zhan
- Department of Stomatology, First Affiliated Hospital, Shenzhen, Guangdong 518008, P.R. China
| | - Weixia Tan
- DiWang Clinic of Shenzhen Arrail Dental, Shenzhen, Guangdong 518008, P.R. China
| | - Shaohua Chen
- Institute of Hematology, Medical College, Jinan University, Guangzhou, Guangdong 510632, P.R. China
| | - Yangqiu Li
- Institute of Hematology, Medical College, Jinan University, Guangzhou, Guangdong 510632, P.R. China
| | - Mark Reynolds
- Department of Periodontics, University of Maryland, School of Dentistry, Baltimore, MA 21201, USA
| |
Collapse
|
15
|
Brant JMC, Aguiar MCF, Grandinetti HAM, Rodrigues LV, Vasconcelos AC. A comparative study of apoptosis in reticular and erosive oral lichen planus. Braz Dent J 2013; 23:564-9. [PMID: 23306235 DOI: 10.1590/s0103-64402012000500016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The oral lichen planus (OLP) is a chronic inflammatory disease, probably autoimmune, with different clinical forms. The most common types are the reticular and the erosive ones. Apoptosis participates in the destruction of basal keratinocytes, but its role in the perpetuation of the subepithelial lymphocytic infiltrates was not yet investigated. To evaluate the involvement of apoptosis in the epithelium and in subepithelial lymphocytic infiltrates, 15 samples of reticular and erosive OLP and 10 samples of healthy oral mucosa were collected and processed histologically. Apoptosis was quantified in the epithelium and in inflammatory cell infiltrates. TUNEL reaction was used to measure apoptosis in the infiltrates. Erosive OLP showed more intense epithelial apoptosis than reticular OLP and controls. In contrast, apoptosis in the inflammatory cell infiltrates was more frequent in reticular than in erosive OLP. Lymphocytes were the predominant cells within the inflammatory cell infiltrates and were more frequent in erosive OLP than in reticular type. These results suggest that different apoptotic levels are involved in the erosive/reticular switch in OLP, determining different clinical presentations. In conclusion, decreased apoptosis in inflammatory infiltrates may contribute to the persistence of T lymphocytes, worsening the attack to the epithelium in erosive OLP.
Collapse
Affiliation(s)
- Juliana M C Brant
- Department of Oral Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | | | | | | |
Collapse
|
16
|
In vitro culture system for keratinocytes obtained from oral lichen planus lesions. Clin Oral Investig 2013; 18:1195-1203. [DOI: 10.1007/s00784-013-1083-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 07/31/2013] [Indexed: 01/04/2023]
|
17
|
Pouralibaba F, Babaloo Z, Pakdel F, Aghazadeh M. Serum Level of Interleukin 17 in Patients with Erosive and Non erosive Oral Lichen Planus. J Dent Res Dent Clin Dent Prospects 2013; 7:91-4. [PMID: 23875087 PMCID: PMC3713867 DOI: 10.5681/joddd.2013.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 02/21/2013] [Indexed: 12/30/2022] Open
Abstract
Background and aims Oral lichen planus is a relatively common chronic oral mucosal disease of unknown etiology. Regarding numerous studies on the immunologic factors involved in the etiology of lichen planus, the present study evaluated the serum interleukin-17 (IL-17) level in patients with erosive and non-erosive oral lichen planus.
Materials and methods This descriptive analytical study included 24 patients with erosive oral lichen planus (EOLP), 24 patients with non-erosive oral lichen planus (NEOLP) and 24 healthy volunteered as control. Blood samples of the subjects underwent ELISA, using special kits, to determine serum interleukin-17 levels. Data was analyzed using with descriptive statistic, chi-square test, and one-way ANOVA and Tukey post-hoc test with SPSS 16 software.
Results EOLP patients showed a high level of serum IL-17 compared with NEOLP patents and control groups (EOLP=184.16 ± 12.41 pg/mL, NEOLP=106.09±10.78 pg/mL, control=15.50 ± 4.34 pg/mL, P - 0.001).
Conclusion High level of serum IL-17 in erosive oral lichen planus patients compared to the non-erosive type and healthy individuals may be the reason for higher inflammation and atrophy in the erosive type.
Collapse
Affiliation(s)
- Firoz Pouralibaba
- Dntal and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University, Tabriz, Iran
| | | | | | | |
Collapse
|
18
|
Proliferation and apoptosis of peripheral blood mononuclear cells in patients with oral lichen planus. Inflammation 2012; 36:419-25. [PMID: 23135214 DOI: 10.1007/s10753-012-9561-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Oral lichen planus (OLP) is generally accepted to be a T cell-mediated chronic inflammatory disease with an unclear pathogenesis. There have been numerous studies on the proliferation and apoptosis of T cells in situ. In contrast, research on the proliferation and apoptosis of peripheral blood mononuclear cells (PBMCs) in patients with OLP is rare. The aim of the present study was to investigate the proliferation and apoptosis of PBMCs in patients with OLP. PBMCs were isolated from 20 patients with reticular OLP, 20 patients with atrophic-erosive OLP, and 20 healthy volunteers. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-2,5-tetrazolium bromide assays were performed to investigate the proliferation of PBMCs, and caspase-3 colorimetric assays were performed to investigate the apoptosis of PBMCs. The proliferation rate of PBMCs in atrophic-erosive OLP subjects was significantly higher than that in both healthy (P < 0.05) and reticular OLP (P < 0.05) subjects. In contrast, the proliferation rate of PBMCs in reticular OLP subjects was significantly lower than that in healthy subjects (P < 0.05). The apoptosis rates of PBMCs in OLP subjects (P < 0.05) and atrophic-erosive OLP subjects (P < 0.05) were significantly lower than the apoptosis rate in the healthy group. Our findings reinforce the view that T cell-mediated immune responses play a critical role in the pathogenesis of OLP. It can reasonably be concluded that these abnormalities are linked to the presence of inflammatory infiltrates.
Collapse
|
19
|
Al-Azri AR, Gibson RJ, Keefe DMK, Logan RM. Matrix metalloproteinases: do they play a role in mucosal pathology of the oral cavity? Oral Dis 2012; 19:347-59. [DOI: 10.1111/odi.12023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 08/16/2012] [Accepted: 09/04/2012] [Indexed: 12/19/2022]
Affiliation(s)
| | - RJ Gibson
- School of Medical Sciences; University of Adelaide; Adelaide; SA; Australia
| | - DMK Keefe
- Department of Medical Oncology, Royal Adelaide Hospital Cancer Centre; Adelaide; SA; Australia
| | - RM Logan
- School of Dentistry; University of Adelaide; Adelaide; SA; Australia
| |
Collapse
|
20
|
Mittal N, Shankari GM, Palaskar S. Role of angiogenesis in the pathogenesis of oral lichen planus. J Oral Maxillofac Pathol 2012; 16:45-8. [PMID: 22438642 PMCID: PMC3303522 DOI: 10.4103/0973-029x.92972] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: The etiology of oral lichen planus (OLP) is not fully understood. It is generally considered to be a T-cell mediated chronic inflammatory oral mucosal disease. There is increasing evidence that chronic inflammation is linked to the diseases associated with endothelial dysfunction and is involved in the induction of aberrant angiogenesis. Aim: Our aim was to evaluate the role of angiogenesis in the pathogenesis of OLP by immunohistochemistry, using the CD34 antibody. Materials and Methods: Forty tissue sections (7 of erosive lichen planus, 18 of reticular oral lichen planus, and 15 of normal oral mucosa), were assessed for microvessel density (MVD) in five selected areas of high inflammatory infiltrate by immunohistochemistry for the expression of CD34 antibody. Results and Conclusion: The mean MVD was 44.47 in the control group (normal oral mucosa) and 97.24 in the OLP group, showing that there is increased angiogenesis in the latter. Reticular OLP had mean MVD of 84.61 and erosive OLP had mean MVD of 129.71, showing relatively greater angiogenesis in erosive OLP as compared to reticular OLP. Thus, angiogenesis can be considered to play a role in both the etiopathogenesis and the progression of OLP.
Collapse
Affiliation(s)
- Nitasha Mittal
- Department of Oral and Maxillofacial Pathology, Desh Bhagat Dental College, Sri Muktsar Sahib, Punjab, India
| | | | | |
Collapse
|
21
|
Pereira JS, Monteiro BV, Nonaka CF, Silveira ÉJ, Miguel MC. FoxP3(+) T regulatory cells in oral lichen planus and its correlation with the distinct clinical appearance of the lesions. Int J Exp Pathol 2012; 93:287-94. [PMID: 22804765 DOI: 10.1111/j.1365-2613.2012.00827.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to evaluate the presence of FoxP3(+) cells in oral lichen planus (OLP) and to correlate the findings with clinical and histopathological features of these lesions. The sample consisted of 32 cases of OLP (17 reticular and 15 erosive cases) and 10 cases of inflammatory fibrous hyperplasia (IFH). Clinical examination, histopathological and histomorphometric analysis, and immunohistochemistry (anti-FoxP3 antibody) were performed. Cells were counted in juxtaepithelial and intraepithelial regions of the lesions, and the results are expressed as the mean and range. Most erosive lesions were keratinized and exhibited epithelial atrophy, whereas most reticular lesions were hyperkeratinized. Mean epithelial thickness and mean density of the inflammatory infiltrate were higher in reticular lesions than in erosive OLP. Juxtaepithelial FoxP3(+) cells were slightly more frequent in erosive lesions (mean: 1.7 and range: 0-9.4) than in reticular lesions (mean: 1.5 and range: 0-8.3). There was a significant difference in the frequency of these cells between OLP (mean: 1.6 and range: 0-9.4) and IFH (mean: 0.5 and range: 0-1.4) (P < 0.05). The number of intraepithelial FoxP3(+) cells was higher in reticular OLP and IFH when compared with erosive lesions. The larger number of juxtaepithelial FoxP3(+) cells in OLP compared to IFH might be related to the distinct etiopathogenesis of these lesions. High disease activity or action of the oral microbiota may explain the slightly higher frequency of FoxP3(+) cells in erosive lesions.
Collapse
Affiliation(s)
- Joabe S Pereira
- Department of Oral Pathology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | | | | | | |
Collapse
|
22
|
Rubaci AH, Kazancioglu HO, Olgac V, Ak G. The roles of matrix metalloproteinases-2, -7, -10 and tissue inhibitor of metalloproteinase-1 in the pathogenesis of oral lichen planus. J Oral Pathol Med 2012; 41:689-96. [DOI: 10.1111/j.1600-0714.2012.01160.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Lara LADS, De Andrade JM, Mauad LMQ, Ferrarese SR, Marana HRC, Tiezzi DG, De Sá Rosa e Silva ACJ. Genital manifestation of graft-vs.-host disease: a series of case reports. J Sex Med 2011; 7:3216-25. [PMID: 20626607 DOI: 10.1111/j.1743-6109.2010.01885.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION After hematopoietic stem cell transplantation (HSCT), many patients present genital graft-vs.-host disease (GVHD) that can culminate with sexual problems, which are poorly dimensioned. AIM We hope to draw attention to the need to perform genital biopsy to diagnose genital GVHD, and thus to call attention to the need to incorporate careful attention to sexual health in the treatment of these patients. METHODS Five allogeneic stem cell transplant recipients complaining of coital pain after HSCT were clinically diagnosed for genital GVHD. Genital biopsies were given for histological analysis, and microphotographs of the corresponding marked field in the slide were taken. Specimens were evaluated by the site pathologist and then sent to a reference pathologist, each blinded to the histological findings. A literature search was performed in PubMed/MEDLINE (1966-2009) for cross-sectional and cohort studies or trials related to genital GVHD. Expert opinions peer reviews and case reports were also considered. MAIN OUTCOME MEASURES HSCT, genital GVHD, genital biopsy. RESULTS The biopsy showed evidence of dilated apoptotic cells in the basal layer and detachment of the epithelial lining of the mucosa, hyalinization and thickening of collagen fibers, capillary ectasia, and mononuclear inflammatory infiltrate of the submucosa. Three patients presented vulval lesion such as leucoplasia and ulcer on the large lip. Histological analyses showed evidence of epithelial hyperplasia and influx of inflammatory cells to the epithelial surface, intercellular edema and spongiosis, apoptotic bodies on the basal layer of the epithelium, spongiosis, and nuclear vacuolization. A common treatment based on corticotherapy resulted in complete remission of coetaneous or mucous genital lesions in all five patients. CONCLUSION Genital biopsy is important to differentially diagnose GVHD and secondary symptoms due to hypoestrogenism. Prevention is the most important step in controlling the evolution GVHD in the vagina to prevent vaginal obstruction and sexual dysfunction.
Collapse
Affiliation(s)
- Lúcia Alves da Silva Lara
- Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil.
| | | | | | | | | | | | | |
Collapse
|
24
|
Kimkong I, Hirankarn N, Nakkuntod J, Kitkumthorn N. Tumour necrosis factor-alpha gene polymorphisms and susceptibility to oral lichen planus. Oral Dis 2010; 17:206-9. [DOI: 10.1111/j.1601-0825.2010.01722.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Zyada MM, Fikry HE. Immunohistochemical study of syndecan-1 down-regulation and the expression of P35 protein in oral lichen planus: a clinicopathologic correlation with hepatitis C infection in the Egyptian population. Ann Diagn Pathol 2010; 14:153-61. [DOI: 10.1016/j.anndiagpath.2009.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 12/19/2009] [Indexed: 11/30/2022]
|
26
|
Griffin JS, Scott DW, Erb HN. Prevalence of apoptotic epidermal keratinocytes in eosinophilic dermatoses of the cat: a retrospective light-microscopic study of 145 skin-biopsy specimens. J Feline Med Surg 2009; 12:86-90. [PMID: 19576830 DOI: 10.1016/j.jfms.2009.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2009] [Indexed: 10/20/2022]
Abstract
A retrospective light-microscopic study was performed on skin-biopsy specimens from 145 cats with eosinophilic inflammatory dermatoses in order to determine the prevalence of apoptotic epidermal keratinocytes (AKs), the prevalence of eosinophils in close proximity to AKs, and whether there was a difference in the prevalence of AKs or the prevalence of eosinophils in close proximity to AKs based on histopathological reaction pattern. Overall, 62/145 (43%) specimens had AKs. Of the cases in which AKs were seen, 18% had eosinophils in close proximity to the AKs. The specimens were divided into three groups based on histopathological reaction pattern: perivascular-to-interstitial, diffuse, and nodular. No difference in the prevalence of AKs was found among the three histological groups. Because the sample size containing eosinophils in close proximity to AKs was too small to compare the three histological patterns individually, nodular and non-nodular patterns were compared. No difference in the presence of eosinophils in close proximity to AKs was found in these two subsets. More AKs were present if eosinophils were in close proximity to the AKs (range 1-9 with eosinophils near compared to 0-7 without).
Collapse
Affiliation(s)
- Joya S Griffin
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | | | | |
Collapse
|
27
|
Transient liver hypoxia after liver hilus dearterialization. ScientificWorldJournal 1979; 2014:742826. [PMID: 24672362 PMCID: PMC3929580 DOI: 10.1155/2014/742826] [Citation(s) in RCA: 203] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 10/20/2013] [Indexed: 02/06/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.
Collapse
|