口腔扁平苔藓患者Th1／Th2失衡表达的研究

目的：观察口腔扁平苔藓（oral liclaen planus,OLP）患者外周血中Th1、Th2型细胞转录因子T-het和GATA-3以及Thl、Th2型细胞因子的表达,进一步探索OLP的发病机制。方法：通过密度梯度离心法分离20例充血糜烂型,16例光滑型OLP病例和19例正常对照组人群的外周血单个核细胞,逆转录-聚合酶链反应（RT—PCR）法检测各组外周血单个核细胞中T—betmRNA和GATA-3 mRNA的表达;ELISA法检测各组血清中干扰素-γ（interferon gamma,IFN-1）和白细胞介素-4（interleukin-4,IL-4）的表达。结果：充血糜烂型和光滑型OLP患者中T—betmRNA、IFN-γ的表达均低于正常对照组,差异有统计学意义（P〈0．01）;而充血糜烂型和光滑型OEP患者中GATA-3 mRNA、IL-4的表达均高于正常对照组,差异有统计学意义（P〈0．01）。T—bet mRNA和GATA-3 mRNA的表达在充血糜烂型及光滑型OLP患者组间的差异有统计学意义（P〈0．01）;而IFN-γ和IL-4的表达在充血糜烂型及光滑型OLP患者组间的差异无统计学意义（P〉0．05）。结论：Th1／Th2失衡表达与OLP发病机制密切相关,为临床治疗OLP提供参考。     

口腔扁平苔藓患者外周血T-bet和GATA-3mRNA表达及意义

目的:探讨转录因子T-bet及GATA-3在口腔扁平苔藓(oral lichen planus,OLP)发病中的作用及意义。方法:采用RT-PCR技术测定30例OLP患者以及30例健康人外周血单个核细胞(PBMC)中T-bet和GATA-3 m RNA的表达水平。结果:OLP组及分型后各组T-bet mRNA的表达水平均高于对照组,差异有统计学意义(P<0.05);OLP组及糜烂型OLP组GATA-3 mRNA表达水平高于对照组,差异有统计学意义(P<0.05),非糜烂型OLP组与对照组差异无统计学意义(P>0.05);T-bet/GATA-3比值各组差异均无统计学意义(P>0.05)。结论:T-bet和GATA-3 mRNA的表达增高可能是OLP发病的重要原因,且GATA-3mRNA的表达变化与OLP临床类型有关。     

Oral lichen planus may enhance the expression of Th17-associated cytokines in local lesions of chronic periodontitis

Objectives

This study aims to compare the expression levels of interleukin (IL)-17 and IL-23 in local periodontal tissues from patients with both chronic periodontitis and oral lichen planus (CP-OLP), patients with chronic periodontitis (CP) only, patients with oral lichen planus (OLP) only, and healthy controls (HC).

Materials and methods

The periodontal tissues were collected from 15 CP-OLP patients, 15 CP patients, 15 OLP patients, and 10 healthy controls. Immunohistochemistry (IHC) and real-time quantitative PCR (qPCR) was performed to investigate the protein and mRNA expression level of IL-17 and IL-23 in periodontal lesions from these four groups.

Results

IHC statistical analysis showed that the expression level of IL-17- and IL-23p19-positive cells significantly increased in CP-OLP group compared with that in CP (P?<?0.01) and OLP groups (P?<?0.05), showing intense staining reaction in local lamina propria lesions. Meanwhile, qPCR result showed higher IL-17 mRNA level in CP-OLP compared with that in CP and OLP groups and demonstrated a significant increase than OLP group (P?<?0.05). Moreover, it was found that IL-17 mRNA expression level in erosive CP-OLP patients was significantly correlated with probing depth and attachment loss (P?<?0.05).

Conclusions

This study indicated that there was an increased expression level of IL-17 and IL-23 in periodontal tissues from periodontitis patients with oral lichen planus, which might aggravate the inflammatory response in local lesions.

Clinical relevance

Oral lichen planus and chronic periodontitis may have interaction in disease pathogenesis, while IL-17 detection in local lesions may be helpful in identifying the disease severity in periodontitis patients with oral lichen planus.     

转录因子T-bet和GATA-3在口腔扁平苔藓患者外周血单核细胞中的表达

目的:探讨转录因子T-bet和GATA-3在口腔扁平苔藓(OLP)患者外周血单核细胞(PBMCs)中的表达及意义。方法:通过密度梯度离心法分离充血糜烂型及光滑型OLP患者和对照组受试者PBMCs,采用RT-PCR和Western blot法分别检测PBMCs中T-bet、GATA-3 mRNA和蛋白的表达。结果:充血糜烂型、光滑型OLP和对照组外周血单个核细胞中T-bet mRNA表达的相对光密度值分别为0.12±0.04、0.34±0.06和0.57±0.07,T-bet蛋白表达的光吸收度值分别为0.11±0.02、0.40±0.05和0.78±0.07,组间比较差异均有统计学意义(P<0.01);GATA-3 mRNA表达分别为0.83±0.09、0.54±0.07和0.26±0.07,GATA-3蛋白表达分别为0.83±0.060、.55±0.05和0.16±0.03,组间比较差异均有统计学意义(P<0.01)。结论:转录因子T-bet/GATA-3表达失衡是OLP免疫失衡的重要原因之一。     

Psychological problems and quality of life of patients with oral mucosal diseases: a preliminary study in Chinese population

Background

Psychological problems might play important roles in oral mucosal diseases such as recurrent aphthous ulcers (RAU), oral lichen planus (OLP), burning mouth syndrome (BMS), but the relevance to patients’ quality of life remained controversial. The aim of this study was to investigate the psychological problems and oral health-related quality of life in patients with RAU, OLP, and BMS in China, to assess the relationship between psychological problems and quality of life.

Method

Thirty-nine RAU patients, 45 OLP patients, 15 BMS patients and 45 healthy controls were enrolled in the study. Hospital Anxiety and Depression Scale (HADS) were chosen to analyze the patients’ psychological problems. Oral Health Impact Profile (OHIP-14) was used to measure the OHRQoL. The scores of HADS and OHIP-14 were used to analyze the relationship between psychological problems and the quality of life of oral mucosa patients.

Results

Each of OHIP-14 scores and HADS scores in RAU, OLP, BMS was higher than the control group, and there was significant difference in the patients groups with the control cases(P <?0.05). OHIP-14 score of RAU was the highest in three patient groups. Its OHRQoL was lowest in the three groups, which had statistical significance (P <?0.05). Positive correlations existed between the psychological problems and the quality of life of the three patient groups (r_s >?0, P <?0.05), except for the depression of the BMS group (r_s =?0.168, P =?0.395).

Conclusion

Patients with oral mucosal diseases such as RAU, OLP, and BMS had higher levels of anxiety, depression, and lower quality of life. The patient’s psychological problems were related to their quality of life, suggesting that the psychological state of patients with oral mucosal disease need more attention.

     

The relationship between levels of salivary and serum interleukin-6 and oral lichen planus: A systematic review and meta-analysis

Background

The relationship between levels of salivary and serum interleukin (IL)-6 and oral lichen planus (OLP) is not understood fully. The authors conducted a systematic review and meta-analysis to compare levels of salivary and serum IL-6 among people with OLP and healthy control participants.

Levels of potential oral cancer salivary mRNA biomarkers in oral cancer patients in remission and oral lichen planus patients

Objectives

To gather preliminary data concerning the feasibility of using seven salivary mRNAs—IL-8; IL-1β; dual specificity phosphatase 1 (DUSP1); H3 histone family 3A (H3F3A); ornithin decarboxylase antizyme 1 (OAZ1); S100 calcium-binding protein P (S100P); and spermidine/spermine N1-acetyltransferase 1 (SAT1)—for detecting development of oral squamous cell carcinoma (OSCC) in oral lichen planus (OLP) patients and OSCC patients whose disease was in remission.

Materials and methods

Saliva samples were collected from five study groups (25 subjects/group): newly diagnosed OSCC, OSCC-in-remission, disease-active OLP, disease-inactive OLP, and normal controls. The salivary mRNA levels were determined by a pre-amplification RT-qPCR approach with nested gene-specific primers. Mean fold changes between each pair of study groups were analyzed by the Mann–Whitney U test.

Results

Salivary levels of OAZ1, S100P, and DUSP1 mRNAs were significantly higher in newly diagnosed OSCC patients, compared to: (1) normal controls (p?=?0.003; p?=?0.003; and p?<?0.001, respectively); (2) OSCC-in-remission (p?<?0.001; p?=?0.001; and p?<?0.001, respectively); (3) disease-active OLP (p?<?0.001; p?=?0.016; and p?<?0.001, respectively); and (4) disease-inactive OLP (p?=?0.043; p?<?0.001; and p?<?0.001, respectively). No significant differences were found in the levels of salivary IL-8, IL-1β, H3F3A, and SAT1 mRNAs between newly diagnosed OSCC patients and the normal controls (p?=?0.093, 0.327, 0.764, and 0.560, respectively).

Conclusion

Salivary OAZ1, S100P, and DUSP1 mRNAs are candidate biomarkers for detecting OSCC development in OSCC patients in remission and in OLP patients.

Clinical relevance

The results of this study serve as the basis for a further large-scale study which may lead to a non-invasive screening method for early detection of OSCC.     

Overexpression and varied clinical significance of Th9 versus Th17 cells in distinct subtypes of oral lichen planus

ObjectiveOral lichen planus (OLP) presents with large numbers of T lymphocytes accumulating beneath the epithelium of the oral mucosa; however, its aetiology remains obscure. A potential role for an emerging novel T cell subset, Th9, in OLP has recently been suggested but remains to be clarified. The current aim was to investigate the expression and potential clinical significance of Th9 cells in distinct subtypes of OLP.Materials and methodsPeripheral blood samples were collected from 41 OLP patients and 18 healthy controls (HCs). Flow cytometric analysis was used to detect the CD4+ T helper subset Th9 (IL-9⁺IL-17⁻CD4⁺ Th cells) and Th17 (IL-9⁻IL-17⁺CD4⁺ Th cells) expression levels.ResultsFlow cytometry results showed significantly elevated levels of Th9 cells in reticular and erosive OLP compared to HCs. Th9 expression in erosive OLP was less than in reticular OLP, indicating that Th9 but not Th17 cells may play a predominant role in reticular disease. However, in erosive OLP patients, we found much higher levels of Th17 cells compared to reticular OLP patients and HCs, indicating that Th17 dominates in erosive OLP. Statistical analysis showed positive correlations of Th9 cells and Th17 cells in patients with reticular or erosive OLP but none in HCs.ConclusionsTh9 and Th17 cells may take the predominant roles in reticular and erosive OLP respectively, and their numbers were positively correlated in reticular and erosive OLP patients. Elevated circulating Th9 cells may help maintain immune balance in OLP immunopathogenesis, which requires further investigation.     

Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus

Objective

The aim of this study was to determine the salivary levels of dehydroepiandrosterone (DHEA) and cortisol and scores of depression, anxiety and stress in patients with oral lichen planus (OLP).

Study design

Thirty-one patients with a diagnosis of OLP were selected; they were matched by sex and age with 31 control patients. Symptoms of depression, anxiety and stress were investigated by the instruments Beck Depression Inventory, Beck Anxiety Inventory and Lipp's Inventory of Stress Symptoms for Adults, respectively. Saliva was collected in the morning and at night for the determination of DHEA and cortisol levels by radioimmunoassay.

Results

There was no significant difference between the groups with respect to depression (P = 0.832), anxiety (P = 0.061) or stress (P = 0.611), or with respect to morning and night salivary levels of DHEA (P = 0.888, P = 0.297) and cortisol (P = 0.443, P = 0.983).

Conclusions

The results suggest an association of OLP with anxiety. However, DHEA and cortisol levels did not differ between groups, which does not support any neuroendocrine aetiology for OLP.     

Immunohistochemical expression of matrix metalloproteinases in squamous cell carcinoma of the tongue and lower lip

Objective

To evaluate the immunohistochemical expression of MMP-1, -2, -7, -9 and -26 in oral squamous cell carcinomas (SCCs) according to tumour site and histological grade of malignancy.

Study design

Fifteen cases of SCC of the lower lip and 15 cases of tongue SCC were selected and divided into low grade malignancy (n = 17) and high grade malignancy (n = 13).

Results

Higher immunohistochemical expression of MMPs by neoplastic cells was observed in tongue SCCs, with a statistically significant difference for MMP-9 (P < 0.05). High-grade SCCs showed a higher expression of MMPs, except for MMP-2, with a statistically significant difference for MMP-7 (P < 0.05) and MMP-26 (P < 0.05). In addition, a direct association was observed between morphological scores of malignancy and MMP immunoreactivity, with the association being significant for MMP-7 and MMP-26.

Conclusion

The present results demonstrate the important role of MMPs in the development of SCCs of the lower lip and tongue.     

Influence of the ability to roll the tongue and tongue-training parameters on oral motor performance and learning

Objective

Training of tongue function is an important part of rehabilitation of patients with brain damage. A standardized tongue-training task has been shown to induce cortical plasticity. This study tested the possible influence of the natural ability to roll the tongue and modulations of tongue-training parameters on tongue-training performance.

Design

A total of 44 healthy adult subjects participated. 29 subjects (15 with and 14 without ability to roll their tongue) performed 1 h standard tongue-training task. Another 15 subjects participated in 2 sessions: Standard and Modulation in randomized order. Standard session: 1 h tongue-training with fixed training parameters; Modulation session: 1 h tongue-training with modulation of training parameters every 20 min (3 different settings – A, B, C, with different timing of task). Perceived task difficulty was evaluated on a 0–10 numerical rating scale (NRS).

Results

All participants improved performance during training (P < 0.001). The ability to roll the tongue did not influence tongue-training performance (P = 0.617). Modulation of training parameters influenced baseline training performance (P < 0.018) and improvement (P = 0.039). The mean perceived difficulty on NRS was: Standard: 6 ± 2; Modulation: A: 6 ± 2; B: 7 ± 1; C: 4 ± 1. Perceived task difficulty (ρ = −0.740, P < 0.001) and performance improvement (ρ = −0.610, P < 0.001) were inversely correlated with baseline training performance.

Conclusion

The natural ability to roll the tongue did not influence tongue-training performance. Modulation of tongue-training parameters by alteration of timing of the training task influenced tongue-training performance and perceived task difficulty.     

Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals

Objective

We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT).

Methods

Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints.

Results

The eminence inclination (P?<?0.05), eminence height (P?<?0.0001), mediolateral width of condyle (P?<?0.0001), and anterior joint space (P?<?0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P?<?0.0001), ratio of anterior joint space to posterior joint space (P?<?0.001), posterior joint space (P?<?0.05), eminence inclination (P?<?0.05), eminence height (P?<?0.05), condyle shape (P?<?0.0001), and fossa shape (P?<?0.05).

Conclusions

The present analyses suggest that a steeper articular eminence inclination may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.

     

A novel application of the buccal micronucleus cytome assay in oral lichen planus: a pilot study

Background

The most important complication of oral lichen planus is malignancy transformation.

Objective

The aim of this study was to assess cellular and nuclear morphology in a group of patients with oral lichen planus measured by means of buccal micronucleus cytome assay.

Study design

This study included thirty patients with a clinicopathological diagnosis of oral lichen planus (all with atrophic–erosive clinical forms of OLP) and thirty healthy control subjects. Both samples were similar in age and gender. The buccal micronucleus cytome assay protocol consisted of: cell collection from both cheeks with a cytobrush; cell centrifuge; slide preparation, fixation and staining followed by fluorescent microscope analysis. 2 × 10⁶ exfoliated cells were screened for nuclear abnormalities: micronuclei, nuclear buds, binucleation, basal and differentiated cells, condensed chromatin, karyorrhectic cells, pyknosis and karyolytic cells.

Results

Patients with oral lichen planus showed significantly higher frequencies of micronuclei (p < 0.001), nuclear buds (p < 0.001), binucleated cells (p < 0.021) than the control group.

Conclusions

This method is an easy way for clinicians to assess DNA damage, proliferative potential of basal cells and cell death in buccal cells in cases of oral lichen planus.     

糖皮质激素对口腔扁平苔藓辅助性T细胞平衡的影响

目的　明确口腔扁平苔藓 (OLP)患者的Th1 /Th2免疫应答模式,探讨糖皮质激素对OLP患者辅助性T细胞平衡的影响。方法　密度梯度离心法分离OLP患者和对照组外周血单个核细胞,分别用植物血凝素(PHA)和地塞米松刺激OLP患者外周血单个核细胞,采用酶联免疫吸附法,检测培养上清液中干扰素γ(IFN γ)和白细胞介素 4(IL 4)的含量;应用半定量逆转录聚合酶链反应技术,检测培养细胞中IFN γ和IL 4mRNA的表达水平。结果　外周血单个核细胞经PHA诱导培养,OLP患者组IFN γ的水平低于健康对照组 (P<0 05),IL 4的水平高于对照组,但差异无统计学意义(P>0 05),IFN γ/IL 4的比值低于对照组 (P<0 05 )。地塞米松可抑制IFN γ和IL 4的水平(P<0 01),且对IFN γ的抑制作用较IL 4更为显著。结论　OLP患者存在Th1 /Th2的平衡失调,为Th2占优势的免疫应答,糖皮质激素对OLP的Th1 /Th2细胞因子均有抑制作用。     

The effects of amalgam restorations on plasma mercury levels and total antioxidant activity

Objective

This study evaluated the effects of amalgam restorations on plasma mercury levels and total antioxidant activities (TAA).

Design

The study was comprised of 48 subjects ranging in age from 20 to 32 years. Of these, 33 had dental amalgam restorations and 15 had no dental amalgam restorations. In those patients with amalgams, the total number of amalgam restorations and surfaces were counted, and the total and occlusal areas (mm²) of restorations were measured using a Counting Measurement Machine. Blood samples were collected from all participants. Plasma mercury levels were measured using an Atomic Absorption Spectrometer and Hydride System, and plasma TAA levels were measured using an Antioxidant Assay Kit. Statistical analysis was performed using the SPSS 10.01 software program. Data was evaluated by t test and correlation analysis.

Results

Plasma mercury (P-Hg) levels were found to be significantly higher in subjects with amalgam restorations when compared to subjects without amalgams (p < 0.01); the differences in P-TAA levels between subjects with and without amalgams were not found to be statistically significant (p > 0.05). No significant correlations were found between P-Hg concentrations and P-TAA levels (p > 0.05). Significant positive correlations were found between P-Hg concentrations and the number of amalgam restorations (p < 0.01), number of amalgam surfaces (p < 0.05), total amalgam surface area (p < 0.05) and amalgam occlusal surface area (p < 0.01). However, no significant correlations were found between these parameters and P-TAA (p > 0.05).

Conclusions

The results of our study showed that dental amalgams are a major source of plasma mercury; however, amalgam restorations were not found to have a significant effect on plasma-total antioxidant activities.     

Masseter muscle thickness three years after surgical correction of class III dentofacial deformity

Objective

To analyse the effect of integrated orthodontic treatment, orthognathic surgery and orofacial myofunctional therapy on masseter muscle thickness in patients with class III dentofacial deformity three years after orthognathic surgery.

Design

A longitudinal study was conducted on 13 patients with class III dentofacial deformities, denoted here as group P1 (before surgery) and group P3 (same patients 3 years to 3 years and 8 months after surgery). Fifteen individuals with no changes in facial morphology or dental occlusion were assigned to the control group (CG). Masseter muscle ultrasonography was performed in the resting and biting situations in the three groups. Data were analysed statistically by a mixed-effects linear model considering a level of significance of P < 0.05.

Results

Significantly higher values (P < 0.01) of masseter muscle thickness (cm) were detected in group P3 (right rest: 0.82 ± 0.16, left rest: 0.87 ± 0.21, right bite: 1 ± 0.22, left bite: 1.04 ± 0.28) compared to group P1 (right rest: 0.63 ± 0.19, left rest: 0.64 ± 0.15, right bite: 0.87 ± 0.16, left bite: 0.88 ± 0.14). Between P3 and CG (right rest: 1.02 ± 0.19, left rest: 1 ± 0.19, right bite: 1.18 ± 0.22, left bite: 1.16 ± 0.22) there was a significant difference on the right side of the muscle (P < 0.05) in both situations and on the left side at rest.

Conclusion

The proposed treatment resulted in improved masseter muscle thickness in patients with class III dentofacial deformity.     

Lichen planus orale e lesioni lichenoidi. Una guida per l’odontoiatra

Objectives

To provide dentists with up-to-date information on the management of patients with oral lichen planus (OLP).

Materials and methods

We reviewed clinically relevant papers retrieved via a search of PubMed, Embase, and Scopus databases.

Results

OLP is a chronic inflammatory disease of unknown etiology, which is characterized by bilateral, symmetrically distributed, reticular lesions involving the oral mucosa (although other clinical variants are frequently observed). Patients may be asymptomatic or complain of a burning sensation of variable intensity. The diagnosis is based on clinical and histological data. Because of the chronic nature of the disease, topical immunosuppressive drug therapy is indicated when there are symptomatic or ulcerated lesions. Periodic reassessment is useful because of OLP is potentially malignant.     

Interferon-γ +874A/T polymorphism in relation to generalized chronic periodontitis and the presence of periodontopathic bacteria

Background

Interferon gamma (IFN-γ) is one of the key regulatory cytokines that has a significant effect on immune responses. It may be important in the chronic inflammatory diseases such as periodontitis in which increased IFN-γ levels were found. The aim of this study was to analyze +874A/T polymorphism in the IFN-γ gene and its associations with the presence of periodontopathic bacteria and susceptibility to generalized chronic periodontitis (CP).

Methods

A total of 498 unrelated Czech white subjects were included in the present study. Genomic DNA was obtained from the peripheral blood of 244 patients with CP and 254 healthy subjects. The IFN-γ +874A/T polymorphism was determined by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Subgingival bacterial colonization (A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia, T. denticola, P. micros, F. nucleatum in subgingival pockets) was investigated by the DNA-microarray based periodontal pathogen detection kit in a subgroup of subjects (N = 110).

Results

Our results showed no differences in the allele and genotype frequencies of the IFN-γ +874A/T polymorphism between patients with CP and controls (P > 0.05). Although we found significant differences in the occurrence of periodontal bacteria between patients with CP and healthy controls (from P < 0.00001 to P < 0.05), no significant association between IFN-γ +874A/T polymorphism and periodontal pathogens was observed in any group.

Conclusions

In conclusion, these findings indicate that putative functional variant in the IFN-γ is not associated with susceptibility to chronic periodontitis or microbial composition in the Czech population.