Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus

J Oral Pathol Med (2011) 40 : 286–293 Objective: The aim of this study was to assess oxidative stress and antioxidant profile in patients with oral lichen planus (OLP) using serum and salivary samples and to compare these biomarkers in a group of healthy subjects. Patients and methods: Twenty‐one recently diagnosed patients with OLP and 20 healthy controls with matched periodontal status were recruited to the study. Total antioxidant activity (TAA) and lipid peroxidation product malondialdehyde (MDA) in both serum and saliva were determined. Univariate comparisons between the two groups were made for quantitative and categorical variables to determine any significant differences. Results: In OLP patients, total antioxidant defense (TAA) was significantly lower than that in healthy subjects in their serum samples (P = 0.01). Salivary MDA levels were significantly higher in the OLP group compared with healthy subjects (P = 0.03). A significant correlation was found between serum and saliva TAA estimates in patients with OLP (r = 0.714 and P = 0.0001) and in the control group (r = 0.69 and P = 0.001). Significant correlation was also found between serum and saliva MDA values in control group (r = 0.464 and P = 0.04). A significant inverse correlation was found between salivary MDA and TAA values in the control group (r = ?0.598 and P = 0.005). Conclusions: The findings of this study suggest an increased oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP. These findings may reflect the disease phenomenon of OLP rather than a causal effect and their role in pathogenesis and transformation of OLP to cancer, if any, needs further elucidation.     

Increased salivary lipid peroxidation in human subjects with oral lichen planus

Abstract: Background: Oral lichen planus (OLP) is a chronic inflammatory mucosal disease of unknown aetiology. Recently, increased oxidative stress has been implicated in the pathogenesis of various diseases. The aim of this study was to evaluate the total antioxidant capacity (TAC) and lipid peroxidation level, in the saliva of patients with OLP. Method: Thirty patients with OLP (15 men, 15 women; mean age 44.0, SD ± 11.4 years) and 30 control subjects (16 men, 14 women; aged 23–67 years), matched for age and gender, were enrolled in this case and control study. This study was conducted at the Clinic of Oral Medicine of Tehran University of Medical Sciences in 2007. The unstimulated whole saliva malondialdehyde (MDA), as an indicator of lipid peroxidation and TAC levels were assayed by thiobarbituric acid and ferric reducing antioxidant potential (FRAP), respectively, in both groups. Results: Mean levels of saliva MDA, but not TAC, in patients with OLP was significantly higher than those of the control group. Conclusion: We conclude that OLP patients have more cellular lipid peroxidation than healthy subjects.     

Oxidative stress status and DNA damage in saliva of human subjects with oral lichen planus and oral squamous cell carcinoma

J Oral Pathol Med (2012) 41 : 736–740 Background: The aim of this study was to evaluate oxidative stress status in the saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). Methods: Thirty‐two patients with OLP, 26 patients with OSCC, and 30 non‐involved subjects were enrolled in this study. The study was conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The unstimulated whole saliva malondialdehyde (MDA), as an indicator of lipid peroxidation, the total antioxidant capacity (TAC), and 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) were assayed by thiobarbituric acid, ferric reducing antioxidant potential (FRAP), and ELISA method, respectively. The TAC/MDA ratio was used as an index of oxidative stress status. Data were analyzed by ANOVA followed by the Tukey’s post hoc test. Results and Conclusion: There were no significant differences in saliva TAC and MDA levels between OLP and control, and also between OLP and OSCC patients. MDA and 8‐OHdG were significantly higher but TAC was lower in OSCC patients than control. TAC/MDA ratio was significantly lower in patients with OSCC than both OLP patients and control. TAC/MDA ratio was significantly lower but 8‐OHdG was higher in patients with OLP compared to control. This suggests that patients with OLP and OSCC are more susceptible to an imbalance of antioxidant‐oxidative stress status.     

Micronuclear and sister chromatid exchange analyses in peripheral lymphocytes of patients with oral lichen planus – a pilot study*

Objective: The purpose of this study was to determine the genetic instability of peripheral blood lymphocytes from patients diagnosed with oral lichen planus (OLP) by investigation of frequencies of micronuclei (MN) and sister chromatid exchange (SCE). Materials and Methods: A total of 22 newly diagnosed and untreated patients with OLP of same severity scores and twenty healthy controls participated in this study. They were all non‐smokers with no previous history or family history of cancer. The periodontal status, flow rate and buffering capacity of whole mouth saliva were recorded. SCE and MN analyses were performed on peripheral blood lymphocytes of OLP patients and healthy controls. Results: The frequencies of MN (50.00 ± 22.36) and SCE (6.89 ± 1.48) in OLP patients were found to be significantly elevated compared with that in normal individuals (25.20 ± 9.52 and 5.93 ± 1.31; z = 3.946, P = 0.0001; z = 2.346, P = 0.019). There were no significant differences in the MN frequency and SCE between the two subgroups with reticular or erosive types of OLP. Conclusion: These pilot data indicate an increased genomic instability in peripheral blood lymphocytes of a cohort of Turkish patients diagnosed with oral lichen planus as compared with that of healthy individuals. As patients with OLP may have an increased or potential risk for oral malignancy, these assays could be used in translational research to monitor beneficial effects of interventions and long‐term prognosis.     

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.

Serum interleukin-6 level is a useful marker in evaluating therapeutic effects of levamisole and Chinese medicinal herbs on patients with oral lichen planus

Background: Oral lichen planus (OLP) is a T cell‐mediated inflammatory disease. Interleukin‐6 (IL‐6) is a pro‐inflammatory cytokine that has effects on cellular and humoral immunities. Previous studies have shown that keratinocytes and tissue‐infiltrating mononuclear cells from OLP lesions can secrete IL‐6. In some OLP patients, the high serum IL‐6 levels are reduced after treatment, suggesting that IL‐6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP. Methods: In this study, we used a solid phase, two‐site sequential chemiluminescent immunometric assay to determine the baseline serum levels of IL‐6 in a group of 180 patients with erosive OLP (EOLP), nonerosive OLP (NEOLP), erythema multiforme (EM), traumatic ulcers (TU), oral submucous fibrosis (OSF), pemphigus vulgaris (PV), or Sjögren's syndrome (SS), and in 77 normal control subjects. Some OLP patients were treated with levamisole plus Chinese medicinal herbs or levamisole only for 0.5–5.5 months and their serum IL‐6 levels were measured after treatment. Results: We found that approximately 99% of the normal control subjects and the patients with EM, TU, or OSF had a normal serum IL‐6 level less than 5.0 pg/ml. However, 15% (22/149) OLP patients, 15% (20/136) EOLP patients, 20% (5/25) major type EOLP patients, 14% (15/111) minor type EOLP patients, 15% (2/13) NEOLP patients, 14% (1/7) EM patients, 43% (3/7) PV patients, and 100% (6/6) SS patients had a serum IL‐6 level greater than 5.0 pg/ml. The mean serum IL‐6 level in patients with OLP (3.4 ± 3.1 pg/ml, P < 0.001), EOLP (3.4 ± 3.2 pg/ml, P < 0.001), major type EOLP (4.9 ± 3.5 pg/ml, P < 0.001), minor type EOLP (3.0 ± 3.0 pg/ml, P < 0.01), or NEOLP (4.2 ± 1.5 pg/ml, P < 0.001) was significantly higher than that in normal control subjects (2.0 ± 1.5 pg/ml). A significant difference in the mean serum IL‐6 level was also found between major type and minor type EOLP patients (P < 0.01). The mean reduction of serum IL‐6 level in OLP patients treated with levamisole plus Chinese medicinal herbs was significantly higher (7.4 ± 4.7 pg/ml) than that in OLP patients treated with levamisole only (3.8 ± 2.3 pg/ml, P < 0.05), suggesting that the combination therapy was superior to levamisole only. Conclusion: We conclude that levamisole and levamisole plus Chinese medicinal herbs can modulate the serum IL‐6 level in OLP patients. IL‐6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP.     

Selenium: A sole treatment for erosive oral lichen planus (Randomized controlled clinical trial)

Oral lichen planus (OLP) is a chronic disease with immune‐mediated pathogenesis. Selenium (Se), an antioxidant, plays a role in modulating immunity. The aim of this clinical trial was to evaluate two Se forms (novel topical hydrogel and oral capsules), solely, in treating erosive OLP based on clinical evaluation and salivary oxidative stress markers. Patients were allocated into one of three groups: group I, topical corticosteroids; group II, topical Se; and group III, systemic Se. Treatment lasted for 6 weeks; patients were clinically evaluated at baseline, 6, and 12 weeks. Biochemical analysis for salivary malondialdehyde (MDA) and total antioxidant capacity (TAC) levels at baseline and 6 weeks was performed. There was a significant reduction in signs and symptoms in response to all treatment modalities. However, there was no significant difference among the three groups at 6 weeks. At 12 weeks, group II had significantly lower pain scores compared with group I. Salivary MDA levels showed a significant decrease in patients of group I and group III. TAC levels showed no significant difference in response to treatment. Selenium can be proposed as a treatment for OLP. Salivary MDA levels can be a biomarker for OLP disease severity.     

Salivary osmolality and hydration status in children with cerebral palsy

J Oral Pathol Med (2011) 40 : 582–586 Background: Unstimulated whole salivary parameters have been identified as potential markers of hydration status. Reduced salivary flow rate and increased salivary osmolality have been shown to be useful to identify dehydration, even when minimal loss of body water occurs. This study aimed to evaluate whether unstimulated salivary flow rate and salivary osmolality from individuals with cerebral palsy correlate with plasma and urine osmolality. Methods: Thirty‐five male and female children, aged 9–13 years old, diagnosed with cerebral palsy were compared to 27 nondisabled children (10–12 years old). Unstimulated whole saliva was collected under slight suction and salivary flow rate (ml/min) was calculated. Plasma without venostasis and urine were also collected. Salivary, plasma and urine osmolality were measured using a freezing point depression osmometer. Results: Cerebral palsy children presented a reduction in salivary flow rate (50%) compared to the control group (P < 0.01). Moreover, an increase in salivary (50%), plasma (3%), and urine osmolality (20%) was also observed in the cerebral palsy children compared to the control group (P < 0.01). Salivary flow rate was negatively correlated with the salivary, plasma and urine osmolality (P < 0.01). Salivary osmolality correlated positively with plasma and urine osmolality (P < 0.01). Conclusion: Cerebral palsy children seem to present impaired adequate hydration status. Since the possible hypohydration condition may be reflected in saliva fluid, which could compromise the protective function exerted by saliva, the earlier this condition is identified the greater the chances of administering preventive measures. Moreover, salivary osmolality is a reliable parameter that reflects changes in plasma and urine.     

A simple test for salivary gland hypofunction using Oral Schirmer''s test

Objective: The objective of this study was to develop a test for detecting salivary gland hypofunction. Study Design: Oral Schirmer's test was performed by placing a strip of filter paper on the floor of the mouth and measuring the wetted length after 5 min. The control group consisted of 70 healthy patients, while another group consisted of 61 patients with Sjögren's Syndrome (SS) and a third group of 31 patients who suffered from xerostomia caused by other pathologies. Results: The mean saliva flow was 40.92 ± 22.28 mm/5 min in the control group, 27.25 ± 24.11 mm/5 min in patients with SS and 36.847 ± 23.4 mm/5 min in the third group. The differences between the control group and the other two groups were statistically different (P > 0.001). Conclusions: The whole saliva test was used to distinguish between healthy adults and subjects with hyposalivation.     

Assessment of salivary total antioxidant levels and oral health status in children with Down syndrome

Down syndrome (DS) is an autosomal chromosomal disorder caused by trisomy of all or a critical part of chromosome 21. Individuals with DS have high levels of oxidative stress throughout their lifespan. It has been suggested that levels of antioxidants could be altered in response to an infection or disease. Aim: To assess the total antioxidant capacity (TAC), nitric oxide (NO), and sialic acid (SA) of saliva in children with DS and its relation to their oral health status. Materials and methods: Thirty‐four noninstitutionalized children in the age group of 7–12 years having DS formed the study group. The control group consisted of 34 normal, healthy children. The W.H.O. criteria were used for diagnosis and recording of dental caries. Oral hygiene status was assessed using the simplified oral hygiene index. Estimation of TAC, NO, and SA levels in saliva was done. Data obtained were subjected to statistical analysis. Results: In comparison to normal children, DS children showed significantly lower TAC of saliva and significantly higher salivary SA levels. In both groups of children, dental caries was higher in primary dentition when compared to their permanent dentition.     

Salivary tissue factor concentration and activity in patients with oral lichen planus

Purpose

This study aimed to evaluate the tissue factor (TF) concentration and activity in patients with oral lichen planus (OLP) under oxidative stress.

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.     

The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trial

Background: Nowadays, it has been widely accepted that the local cell‐mediated immunologic disorders may play an important role in the pathogenesis of oral lichen planus (OLP). Therefore, we sieved out polysaccharide nucleic acid fraction of bacillus Calmette‐Guerin (BCG‐PSN) from various immunomodulators to evaluate the short‐term therapeutic efficacy and clinical safety of intralesional BCG‐PSN injection for erosive OLP. Methods: A total of 56 OLP patients were randomly assigned to receive either intralesional injection of 0.5 ml BCG‐PSN every other day (31 of 56) or 10 mg triamcinolone acetonide (TA, a positive‐controlled group, 25 of 56) every week for 2 weeks. After the cessation of treatment, those cured from erosion were followed up for 3 months. Another two researchers measured erosive areas and recorded visual analog scale (VAS) scores both at the start and the end of the treatment. We also registered adverse reactions and the recurrence intervals. Results: After 2‐week treatment, 27 of 31 BCG‐PSN‐treated patients (87.1%) and 22 of 25 TA‐treated patients (88.0%) healed. There were no statistical differences between the two groups in erosive areas (27.86 ± 27.97 vs. 25.68 ± 34.65, P = 0.801) and VAS scores (2.45 ± 1.64 vs. 2.40 ± 1.38, P = 0.946). Three of 31 BCG‐PSN‐treated patients (9.7%) vs. 2 of 25 TA‐treated patients (8.0%) experienced the swelling or burning sensation (P = 0.827). A total of 49 of 56 patients were followed up. There were no statistical differences in the recurrence rates (33.3% vs. 45.5%, P = 0.386) and intervals (80.89 ± 26.83 vs. 73.48 ± 28.11, P = 0.419). Conclusions: Topical intralesional BCG‐PSN injection is as effective as TA for erosive OLP, which suggests that topical intralesional BCG‐PSN injection can be a promising therapeutic alternative for erosive OLP, especially for those insensitive, or even resistant, to glucocorticoids.     

Evaluation of oxidative status in patients with chronic periodontitis and polycystic ovary syndrome: A cross‐sectional study

1 Background

In patients with polycystic ovary syndrome (PCOS), chronic periodontitis (CP) contributed to increased oxidative stress (OS), owing to an increase in serum and salivary 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) and malondialdehyde (MDA) levels and a decrease in serum total antioxidant status (TAS) levels. The aim of the present study is to investigate salivary and serum 8‐OHdG and MDA levels as well as total antioxidant status (TAS) in females with CP and PCOS compared with healthy females.

2 Methods

Four groups, each consisting of 22 individuals, were: 1) women with both PCOS and CP (PCOSCP); 2) systemically healthy women with CP; 3) periodontally healthy women with PCOS (PCOSPH); and 4) periodontally and systemically healthy women (PH). Demographic and clinical periodontal parameters were measured. Oxidative parameters were evaluated in serum and salivary samples.

3 Results

Salivary 8‐OHdG levels in the PCOSCP and CP groups were statistically higher than those in both the PCOSPH and the PH groups (P < 0.05). There was no statistical difference between the PCOSCP, CP, and PCOSPH groups with regard to salivary MDA and TAS levels (P > 0.05). Highest serum 8‐OHdG and MDA levels and lowest serum TAS levels were seen in the PCOSCP group (P < 0.05). Serum 8‐OHdG and MDA levels in the PCOSPH group were higher than those in both systemically healthy groups (PH and CP) (P < 0.05). Salivary TAS levels were highest (P < 0.05) in the PH group. There was no statistical difference between the CP and PCOSPH groups, but serum TAS levels were lower than those in the PH group (P < 0.05).

4 Conclusions

CP, which led to an increase in serum and salivary 8‐OHdG and MDA levels and a decrease in serum TAS levels in patients with PCOS, contributed to increased OS. This effect was more prominent in serum levels than in salivary levels.     

Immunophenotyping in Saliva as an Alternative Approach for Evaluation of Immunopathogenesis in Chronic Periodontitis

Background: To date, flow cytometric immunophenotyping has not been used to investigate immune patterns in saliva samples from individuals with inflammatory processes in the oral cavity, such as chronic periodontitis (CP). Saliva analysis could be a non‐invasive method for evaluating oral health. The objective of this study is to determine the phenotype of leukocytes and total immunoglobulin A (IgA), IgG, and IgM titers in the saliva of individuals with CP. Methods: Saliva samples were obtained from patients with CP (n = 12) and from a control group (n = 27) without oral diseases. Flow cytometry was performed to determine the frequency of T cells (CD4⁺ and CD8⁺), B cells, and natural killer (NK) cells as well as the total leukocyte population. Immunoglobulin titers were determined by dot enzyme‐linked immunosorbent assay. Results: Cell immunophenotyping revealed that patients with CP had a higher frequency of total leukocytes (47.94% ± 5.1%; P < 0.001), B cells (43.93% ± 6.2%; P = 0.006), NK cells (0.16% ± 0.04%; P = 0.03), and CD4⁺ T cells (38.99% ± 4.4%; P = 0.002) than individuals without oral pathologies (24.75% ± 2.2%, 20.60% ± 2.7%, 0.09% ± 0.03%, and 16.82% ± 3.5%, respectively). No significant differences in salivary total IgA, IgG, and IgM titers were found between the two cohorts studied. Nevertheless, higher total IgG levels were observed in patients with CP, which could indicate a possible correlation between clinical attachment level and salivary IgG (P = 0.07; r² = 0.08). Conclusion: These results show that cell phenotyping by flow cytometry could be an effective tool for determining leukocyte profiles in saliva samples from patients with CP and healthy individuals.     

扁平苔藓患者血清及唾液中IL-1O的表达及相关性研究

目的：探讨口腔扁平苔藓（OLP）患者唾液及血清中白细胞介素-10 （IL-10）的表达情况及其相关性,以进一步了解OLP患者唾液代替血液作为生物学样本来研究OLP中IL-10的可行性.方法：实验分3组：OLP糜烂组15例,OLP非糜烂组15例,正常对照组15例.采用ELISA法分别检测3组对象血清和唾液中IL-10的含量,对结果进行统计分析.结果：OLP糜烂组血清中IL-10水平为（30.11±3.02） pg/mL,明显高于非糜烂组（19.03±3.33） pg/mL和正常对照组（16.43±2.19） pg/mL,差异有统计学意义（P ＜0.05）;OLP糜烂组唾液中IL-10平均水平为（10.05 ±3.12） pg/mL明显高于非糜烂组（5.50±1.1） pg/mL和正常对照组（4.47±1.7） pg/mL,差异有统计学意义（P＜0.05）;两实验组血清和唾液中IL-10水平成正相关,（r=0.731,P＜0.01）.结论：实验组血清和唾液中IL-10水平高度相关,可以通过检查唾液替代检查血液来研究OLP中IL-10的水平.     

Evaluation of salivary total oxidant-antioxidant status and DNA damage of children undergoing fixed orthodontic therapy

Objective:To determine the total oxidant status (TOS), total antioxidant status (TAS), and the 8-hydroxy-2′-deoxyguanosine (8-OHdG) levels and their interrelationship in the saliva of children undergoing fixed orthodontic therapy.Materials and Methods:Thirty children were randomly divided into three groups. The attachments were bonded to all of the teeth using three different orthodontic composites: Transbond XT, Kurasper F, and GrenGloo. The salivary levels of TOS, TAS, and 8-OHdG were determined three times, as follows: before treatment (T₁) and at 1 month (T₂) and 3 months (T₃) following appliance placement. All data were statistically analyzed.Results:There were no significant differences in TOS, TAS, and 8-OHdG within the same time periods among the three different orthodontic composites (P > .05). TAS in all composite groups decreased over time. These decreases were found to be significant for Kurasper F and GrenGloo at the T₁–T₃ and T₂–T₃ time periods (P < .05). In all composite groups 8-OHdG decreased between T₁ and T₂ (P < .05). However, 8-OHdG in all composite groups increased from T₂ to T₃. These differences in 8-OHdG were significant in Kurasper F and GrenGloo (P < .05).Conclusions:Fixed orthodontic appliances bonded with the tested composites did not increase the cytotoxicity markers in saliva.     

Salivary and plasma levels of Toll-like receptor 2 and Toll-like receptor 4 in chronic periodontitis

Background: This cross‐sectional study was planned to investigate whether patients with chronic periodontitis exhibit different salivary or plasma concentrations of Toll‐like receptor (TLR) 2 and TLR4 compared to subjects who are clinically healthy. Methods: Whole saliva and plasma samples were obtained and full‐mouth clinical periodontal measurements were recorded from 22 otherwise healthy patients with chronic periodontitis and 21 systemically and periodontally healthy control subjects. Salivary and plasma TLR2 and TLR4 levels were determined by enzyme‐linked immunoassays. Data were tested statistically using Mann‐Whitney U test. Results: The healthy group exhibited significantly lower values in all clinical measurements (P <0.001). The salivary TLR2 levels were similar in the two study groups (P >0.05). The patients with chronic periodontitis exhibited significantly higher salivary TLR4 (P <0.01) and plasma TLR2 and TLR4 levels (P <0.05). Conclusion: The present findings support a hypothesis that inflammation increases expression of TLRs which leads to an increased detection of TLRs in saliva and plasma, which could be useful as a diagnostic test for periodontal diseases.     

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 : 689–696 Background: The aim of this study was to investigate the roles of Matrix Metalloproteinases (MMP)‐2, Metalloproteinases‐7, Metalloproteinases‐10 and Tissue Inhibitors of Metalloproteinase‐1 (TIMP‐1) in the pathogenesis of oral lichen planus (OLP) disease in same tissue samples. Methods: Thirty‐nine individuals [29 patients with OLP (74%) and 10 healthy control subjects (25%)] were included in our study. The mean age was 48 ± 14.39 with a range of 20–75. Results: MMP‐2 and MMP‐7 expression was significantly different in the patient and control groups in the epithelium and the connective tissue (P < 0. 05). The ratio of MMP‐2/TIMP‐1 and MMP‐7/TIMP‐1 were higher in patient with OLP group than control group. Conclusions: Along with the exposure of the role of MMPs activity on diseases characterized by the tissue destruction, several studies were conducted on the pharmacological control of MMPs activity. However, understanding of the biological functions of MMPs is very important for the development and implementation of MMP inhibitors in the treatment of diseases. According to the results of this study, we suggest that MMP‐2, MMP‐7, and TIMP‐1 may be involved in the formation of OLP lesions. Further studies on MMPs may be useful for understanding and treating the diseases such as OLP.     

Anti‐angiogenic therapy (bevacizumab) in the management of oral lichen planus

Oral lichen planus (OLP), a mucocutaneous chronic inflammatory disease, is conventionally managed using topical corticosteroid therapy. Given the fact that OLP is strongly linked to angiogenesis, anti‐angiogenic drugs, such as bevacizumab, might be introduced as an alternative treatment for contraindicated, non‐responsive patients. The aim of the present study was to report the short‐term effectiveness and safety of intralesional bevacizumab injection in the management of atrophic/erosive OLP. A case series study was conducted in patients with atrophic/erosive OLP in the buccal mucosa, assigned to receive either 2.5 mg of bevacizumab, by intralesional injection (n = 20, test), or topical 0.1% triamcinolone acetonide ointment (n = 20, control). The size, score, and pain intensity of the lesions were assessed pre‐ and post‐treatment. Tissue biopsies were collected for histopathologic, immunohistochemical, and ultrastructural examination. After 1 wk, the test group had significant reductions both in lesion seize and in pain scores compared with controls. A marked decrease in vascular endothelial growth factor (VEGF) and interleukin‐8 immunoexpression was noted in tissue biopsies from bevacizumab‐treated lesions compared with control lesions. Furthermore, ultrastructural examination of OLP tissue specimens revealed significant healing signs associated with bevacizumab treatment. Short‐term data suggest that intralesional bevacizumab injection effectively and safely achieved resolution of atrophic/erosive OLP lesions without disease exacerbations during a 3‐month follow‐up period.