Assessment of sleep disturbance in oral lichen planus and validation of PSQI: A case-control multicenter study from the SIPMO (Italian Society of Oral Pathology and Medicine)

The interleukin-6 family in tissues is closely related to the clinical outcomes of oral lichen planus

OBJECTIVE

We attempted to investigate the role of interleukin-6 (IL-6) family expression in local tissues as it relates to presentations and outcomes in oral lichen planus (OLP), which is a common chronic inflammatory oral disease.

MATERIALS AND METHODS

A clinical follow-up cohort of OLP patients was established, and a biological sample library was constructed with categorization into erosive type (EOLP) and nonerosive type (NEOLP). Transcriptome sequencing of the lesions was then performed. A multiple regression model was used to explore the differences in IL-6 family expression among patients with different clinical types and clinical outcomes.

RESULTS

OLP tissue transcriptome sequencing showed that IL-6 family expression in EOLP increased significantly. It was also found that IL-6 family factors in the OLP recurrent erosion group were significantly increased compared to the persistent nonerosion group. Based on the multiple regression analysis of the OLP clinical cohort, it was found that the increased expression of the IL-6 family was closely related to the clinical types and clinical outcomes of OLP.

CONCLUSION

The high expression of the IL-6 family is closely related to the erosion of local mucosa and poor prognosis of OLP patients. IL-6-related factors may be used as therapeutic targets for OLP patients.

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

BACKGROUND

Oral lichen planus (OLP) is an immune-mediated inflammatory chronic disease of the oral mucosa, with different patterns of clinical manifestations which range from keratotic manifestations (K-OLP) to predominantly non-keratotic lesions (nK-OLP). The aim of the study was to analyze the differences in the clinical, psychological profile and symptoms between Italian patients of the North and Central-South with K-OLP and nK-OLP.

METHODS

270 K-OLP and 270 nK-OLP patients were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered.

RESULTS

The Central-South K-OLP (CS-K-OLP) patients reported a higher frequency of pain/burning compared with the K-OLP patients of the North (N-K-OLP) with higher scores in the NRS and T-PRI (p value < 0.001**). The CS-K-OLP and the CS-nK-OLP patients showed higher scores in the HAM-D, HAM-A, PSQI and ESS compared with the Northern patients (p value < 0.001**). Multivariate logistic regression revealed that the NRS and T-PRI showed the greatest increase in the R2 value for the CS-K-OLP (DR2 = 9.6%; p value < 0.001**; DR2 = 9.7% p value < 0.001**; respectively) and that the oral symptoms (globus, itching and intraoral foreign body sensation) and PSQI showed the greatest increase in the R2 value for the CS-nK-OLP (DR2 = 5.6%; p value < 0.001**; DR2 = 4.5% p value < 0.001** respectively).

CONCLUSIONS

Pain and mood disorders are predominant in patients with OLP in the Central-South of Italy. Clinicians should consider that the geographical living area may explain the differences in oral symptoms and psychological profile in OLP.