Psychological profile in oral lichen planus

AIM: Oral lichen planus (OLP) is an oral lesion with an enigmatic etiology. To explore the possibility of psycho-somatization, we evaluated the psychological personality profiles of OLP patients. METHODS: Twenty patients with reticular; 20 with erosive form of OLP, and 25 controls were tested with the psychological Minnesota Multiphasic Personality Inventory (MMPI)-202 test. Eight clinical scales (hypochondriasis, depression, hysteria, psychopathic deviate, paranoia, psychasthenia, schizophrenia, and hypomania) as well as cortisol level, CD3, CD4, CD8, and CD16 markers by group were compared. Psychosomatization was evaluated by the use of internalization ratio (IR) Index. RESULTS: A characteristic MMPI profile was noted in the OLP groups with high IR index value. Significant differences among the groups were detected for cortisol, CD4, CD8, and CD16 counts. Mean values for hypochondriasis, depression, and hysteria were all significantly different with significantly higher mean scores for both reticular and erosive OLP subjects compared with controls. CONCLUSIONS: Prolonged emotive stress in many OLP patients may lead to psychosomatization and may contribute to the initiation and clinical expression of this oral disorder. Clinical significance: If additional research involving a larger and more diverse sample of patients confirms these findings, clinical trials will be needed to determine whether adjunctive psychological intervention provides a benefit in treating patients with OLP.     

EP—CAM在OLP和OSCC组织中的表达及意义

目的：观察上皮细胞黏附分子（Ep—CAM）在口腔正常黏膜、扁平苔癣（OLP）和鳞癌（OSCC）组织中表达的变化,分析Ep—CAM在口腔黏膜疾病及其癌变发病机制中的作用。方法：采用免疫组织化学法检测10例正常口腔黏膜、30例OLP（15例非糜烂型、15例糜烂型）及20例OSCC组织中Ep—CAM的表达变化。结果：Ep—CAM在正常黏膜组织阴性表达,而在非糜烂型OLP、糜烂型OLP及OSCC组织中表达逐渐增强。结论：Ep—CAM在口腔黏膜癌变的发展过程中可能具有一定的指示意义。     

辅助性T淋巴细胞极化相关细胞因子在口腔扁平苔藓中的研究进展

口腔扁平苔藓是一种病因不明的皮肤黏膜慢性免疫炎症性疾病,辅助性T淋巴细胞(Thcell)在口腔扁平苔藓的发病机制中起到了重要作用。近年来,口腔扁平苔藓中Th细胞的极化状态引起了较为广泛的关注。研究表明,Th细胞极化相关细胞因子的变化与口腔扁平苔藓的发病密切相关。下文就这些细胞因子在口腔扁平苔藓中的研究进展作一综述。     

CXC亚家族趋化因子配体10-受体3/CC亚家族趋化因子配体17-受体4轴在口腔扁平苔藓发病机制中的交互作用

目的 探讨CXC亚家族趋化因子配体10(CXCL10)-CXC亚家族趋化因子受体3(CXCR3)、CC亚家族趋化因子配体17(CCL17)-CC亚家族趋化因子受体4(CCR4)两轴间在口腔扁平苔藓(OLP)发病机制中的交互关系.方法 收集OLP患者(非糜烂、糜烂型)和健康对照者外周血,分离T细胞并鉴定纯度,分为空白(不...     

Ets-1在口腔扁平苔藓中的表达研究

目的 :分析Ets 1(E2 6transformation specific)在口腔扁平苔藓 (OLP)的表达及意义。 方法 :采用免疫组化ABC法检测Ets 1蛋白在 2 0例口腔扁平苔藓和 8例正常口腔黏膜组织中的表达。结果 :70 % (14 /2 0 )的口腔扁平苔藓病例中Ets 1呈阳性表达 ,明显高于正常黏膜组织 ,两者比较有显著性差异 (P <0 .0 5 )。阳性表达率在溃疡型OLP与斑块型OLP间亦有显著性差异 (P <0 .0 5 ) ,并与病程相关 (P <0 .0 5 )。结论 :Ets 1在口腔扁平苔藓中过表达并与其发病有关。     

Expression of lymphocyte function-associated antigen 3 in oral lichen planus

OBJECTIVE: The expression pattern of lymphocyte function-associated antigen 3 (LFA-3) in the buccal mucosa of oral lichen planus (OLP) patients was compared to that of healthy controls to investigate the possible role of LFA-3 in cell interactions within OLP lesions.
MATERIALS AND METHODS: Samples of buccal mucosa from 17 clinically healthy individuals and 17 OLP lesions were analysed. Expression of LFA-3, CD2, CD3 and CD 14 was visualized by an immunoperoxidase technique and assessed microscopically.
RESULTS: In healthy buccal mucosa LFA-3 was expressed on keratinocytes, Langerhans cells within the epithelium and on endothelial cells in the lamina propria. In OLP patients a similar pattern of LFA-3 staining was observed. In addition, cytoplasmic LFA-3, without accompanying surface staining, was seen on a subpopul-ation of macrophage-like cells. Substantial amounts of LFA-3 also appeared to be associated with non-cellular components of the extracellular matrix within the inflammatory infiltrate.
CONCLUSIONS: We have obtained evidence for a previously undescribed localization of LFA-3 within macro-phages, and have observed that expression of LFA-3 is apparently elevated within OLP lesions. LFA-3 may play an important role in the pathogenesis of OLP.     

KLF-6在口腔扁平苔藓恶变中的表达研究

目的 探讨KLF 6在口腔扁平苔藓发病机制及癌变中的作用。方法 分别采用免疫组化和Western blot方法对10例正常口腔黏膜、30例扁平苔藓患者和22例口腔鳞癌患者的上皮组织中KLF 6蛋白进行t检测,比较其在三者之间的差异。SPSS 14.0对数据进行检验。结果 扁平苔藓患者组织中KLF 6蛋白的表达明显低于正常口腔黏膜,两组之间具有显著性差异;口腔鳞癌患者组织中KLF 6蛋白的表达明显低于扁平苔藓组织,两组之间具有显著性差异。结论 KLF 6的表达异常可能在口腔扁平苔藓的发生发展及癌变的过程中起作用。     

Immunohistologic analysis of epithelial cell populations in oral lichen planus

Previous studies have demonstrated heterogeneity within lesional lymphocytes in drug-related oral lichen planus (D-LP) and idiopathic lichen planus (I-LP). This study examined the phenotype of Langerhans cells (LC) and keratinocytes in non-erosive D-LP and I-LP. In I-LP, keratinocytes expressed HLA-DR antigens whilst LC co-expressed CDIa, MHC Class II and CD4 antigens. The high levels of expression of MHC Class II antigens by LC were maintained during short term organ culture. In I-LP, the epithelium contained occasional CD25+ dendritic cells (putative activated LC). These cell phenotypes are suggestive of cell activation and likely result from local production of gamma interferon. In D-LP, expression of MHC Class II antigens on LC was reduced and no CD25+ cells were detected. The epithelium contained an increased number of CD45RA+ dendritic cells. While no differences between the production of interleukin-1 and interleukin-1 inhibitors by tissue samples could be detected, it is likely that the variations in epithelial cell phenotypes in I-LP and D-LP reflect altered cytokine production.     

DNA ploidy in oral lichen planus,determined by image cytometry

J Oral Pathol Med (2010) 39 : 206–211 Background: The objective of this study was to use image cytometry to determine the degree and frequency of DNA ploidy in biopsies of reticular and atrophic‐erosive oral lichen planus and to analyze 14 karyometric measurements of the nuclei of epithelial cells from each specimen. Methods: A total of 40 slides were analyzed, each of them representing one biopsy of one oral lichen planus (OLP) lesion from each one of the 40 patients (cases) studied. Specimens were embedded in paraffin and comprised 20 slides of reticular oral lichen planus (group R) and 20 slides of atrophic‐erosive oral lichen planus (group AE). Results: Group R, the reticular lichen samples, had 18 diploid cases and two aneuploid cases. Group AE, the atrophic‐erosive lichen samples, had 10 diploid cases, one tetraploid case, and nine aneuploid cases. Of the 14 karyometric measurements of the nuclei of OLP epithelial cells analyzed, the group R mean values for mean density and minimum density were significantly greater than the group AE mean values, and mean roundness in group AE was significantly greater than in group R (t‐test: P < 0.05). Conclusions: The most common degree of DNA ploidy in OLP lesions was diploidy. Comparing the two groups (chi‐square test of association P = 0.021) demonstrated that diploidy was associated with the reticular clinical form of OLP, while aneuploidy was associated with the atrophic‐erosive clinical form of oral lichen planus.     

Associations between mast cells and laminin in oral lichen planus

Mast cell numbers are increased significantly in oral lichen planus (OLP). In other inflammatory conditions, mast cells frequently adhere to extracellular matrix proteins such as laminin. The aim of this study, therefore, was to determine whether the distribution of mast cells in OLP is related topographically to laminin in vascular and epithelial basement membranes. Monoclonal antibodies for tryptase, laminin and the α6β1 CD49f laminin-binding integrin were used to identify mast cells, basement membranes (blood vessels and basal epithelium) and the "classical" laminin adhesion receptor, respectively. A double-labelling immunoperoxidase technique was employed to examine and compare mast cell-laminin relationships in OLP (n=19) and normal buccal mucosa (NBM, n=13). In both OLP and NBM, the majority of mast cells were located close to vascular basement membranes. Quantitative studies revealed that the number of mast cells associated with the laminin of vascular basement membranes (distance <1 μm) was two-fold and three-fold higher, respectively, in the superficial and deep layers in OLP compared with NBM (P<0.001). The frequency distribution of mast cells associated with basal epithelium was not statistically different in both groups (P>0.05). The association of mast cells with laminin may be an important determinant of mast cell density in OLP. During OLP lesion formation and progression, the preferential distribution of mast cells in the immediate perivascular region provides an ideal situation for mast cell-derived mediators to influence the vascular endothelium.     

Immune mechanisms in oral lichen planus

Oral lichen planus (OLP) is a T cell-mediated inflammatory disease of the oral mucosa that has been extensively researched over many years but as yet the mechanisms of pathogenesis are still not fully understood. Whilst the specific aetiological factors driving OLP remain ambiguous, evidence points to the development of a chronic, dysregulated immune response to OLP-mediating antigens presented by innate immune cells and oral keratinocytes leading to increased cytokine, chemokine and adhesion molecule expression. These molecules recruit T cells and mast cells to the diseased site and orchestrate a complex interplay between cells that culminates in keratinocyte cell death, mucosal basement membrane destruction and long-term chronicity of the disease. The main lymphocytes involved are thought to be CD8+ cytotoxic and CD4+ Th1 polarised T cells although recent evidence indicates the involvement of other Th subsets such as Th9, Th17 and Tregs, suggesting that a more complex immune cell relationship exists during the disease process. This review provides an overview of the immune mechanisms at play in OLP pathogenesis with particular emphasis on the role of the different Th subsets and how these recent discoveries may guide research towards identifying potential therapeutic targets.     

Detection of fascin and CCR-7 positive mature dendritic cells in oral lichen planus

Background: Dendritic cells (DC) play a crucial role in the pathogenesis of oral lichen planus (OLP) with respect to antigens presented to T cells. We performed immunohistochemical analysis to elucidate the process of activation of DC in OLP. Methods: Thirty biopsy specimens were obtained from the patients with OLP. The expressions of CD1a, Langerin, S‐100, fascin, chemokine receptor‐7 (CCR‐7), D2‐40, cyclooxygenase‐2 (COX‐2), and microsomal prostaglandin E synthase‐1 (mPGES‐1) in DC from OLP and disease free control were investigated using specific antibodies. The distribution and number (1 mm²) of DC were assessed in the intra‐epithelium and the submucosa specimens. Correlation between the number of DC and epithelium thickness was also determined. Result: Immature DC (Langerin⁺, CD1a⁺, and S‐100⁺) were identified in the epithelia from OLP patients and control, though the numbers of Langerin⁺ and CD1a⁺ positive cells were decreased in the OLP samples as compared to the control. Mature DC (fascin⁺) were identified in the submucosa specimens, not found in the epithelium from OLP or control. Double immunostaining revealed DC positive for fascin and CCR‐7 in the submucosa, which had migrated into D2‐40⁺ lymph vessels. Furthermore, keratinocytes expressed both Prostaglandin E₂ (PGE₂) converting enzymes, COX‐2, and mPGES‐1, indicating PGE₂ synthesis in the epithelial layer of the OLP specimens. Conclusion: Our results indicate that DC change from immature to mature in the epithelium and are then drawn out to the submucosa. We demonstrate that mature DC localized in the submucosa, it consequently migrates into lymph vessels. This maturation process of DC is an important immunopathological feature of OLP.     

玉屏风口服液对口腔扁平苔藓差异表达基因干预的初步探讨

目的 应用基因芯片技术及最新公共数据库,观察玉屏风口服液作用后口腔扁平苔藓(oral lichen planus,OLP)组织中基因表达谱改变。方法 分离纯化正常口腔黏膜组织、口腔扁平苔藓病变组织和服用玉屏风口服液后扁平苔藓病变组织mRNA,制备表达谱探针,混合后用BiostarH-40s型基因芯片杂交,用ScanArray 4000荧光扫描仪扫描芯片荧光信号图像,利用GenePix Pro 3.0软件分析检测玉屏风口服液作用口腔扁平苔藓组织中的差异表达基因,并进行筛选。结果 服用玉屏风口服液后,病变组织有5条基因表达上调,3条基因表达下调,功能以转录基因为主。结论 玉屏风口服液对口腔扁平苔藓的差异表达基因具有干预作用,干预基因以转录基因为主。?     

表皮生长因子受体在口腔扁平苔藓组织中的表达

目的探讨口腔扁平苔藓(OLP)癌变及发病机制。方法采用免疫组化法检测10例正常口腔黏膜,16例扁平苔藓,10例扁平苔藓伴不典型增生,14例口腔鳞癌上皮组织中表皮生长因子受体(EGFR)的表达水平。结果OLP伴不典型增生组织中EGFR的表达高于正常黏膜(P<0.05)。口腔鳞癌中EGFR的表达高于正常黏膜及OLP(P<0.01)。结论EGFR的过表达在OLP的发生、发展过程中可能起着重要的作用。     

Cytologic and DNA-cytometric examination of oral lesions in lichen planus

BACKGROUND: The aim of the present study was to evaluate the diagnostic value of exfoliative cytology (EC) and DNA image cytometry applied to oral lesions of lichen planus (LP; n = 56), in order to detect or exclude malignant transformation. METHODS: Brush and excisional biopsies were obtained from 56 patients. In cases of oral LP in which brush biopsies were suspicious for tumor cells, nuclear DNA contents were measured, using a TV Image Analysis System. RESULTS: In 50 patients EC yielded tumor cell-negative, doubtful in four cases and suspicious results obtained in two cases. DNA image cytometry revealed DNA-aneuploidy only in the two suspicious cases. The comparison between cytologic/DNA-cytometric diagnosis and biopsy histology resulted in a total agreement (LP without dysplasia: 54 and squamous cell carcinoma in LP: two cases). CONCLUSIONS: In conclusion, cytology with DNA-cytometry is a highly sensitive, specific, and non-invasive method, which can be used for periodical follow up of oral LP lesions in order to early detect or exclude malignancy.     

端粒酶逆转录酶mRNA在口腔扁平苔藓中的表达

目的 探讨端粒酶逆转录酶(TERT)mRNA在口腔扁平苔藓(OLP)中的表达及临床意义。方法 采用原位杂交(ISH)的方法,检测了20例糜烂型扁平苔藓(erosive oral lichen planus,eOLP)、20例非糜烂型扁平苔藓(non-erosive oral lichen planus,neOLP)和12例正常口腔黏膜TERT mRNA的表达。结果 糜烂型OLP的TERT mRNA阳性率明显高于非糜烂型OLP的TERT mRNA阳性率(P<0.05)。糜烂型OLP与非糜烂型OLP染色强度相比有统计学意义(P<0.05)。结论 糜烂型OLP的上皮细胞可能比非糜烂型OLP的上皮细胞处于更高的增殖状态。     

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口腔扁平苔藓(orallichenplanus,OLP)是一种累及口腔黏膜且可反复发作的慢性炎症疾病,患病率为0.51%,在口腔黏膜疾病中居第2位,属常见病。皮肤和黏膜可单独或同时发病,病理表现相似:主要以口腔黏膜不同程度的角化异常、基底层细胞液化变性、上皮下结缔组织中淋巴细胞呈带状浸润为典型表现。