丙型肝炎病毒感染与口腔粘膜扁平苔藓关系的初探

目的 本研究对４０例口腔扁平苔藓（ＯＬＰ）患者及４０名对照组患者分别用于干湿全自动生化分析仪,酶链免疫吸附试验（ＥＬＺＳＡ）及多聚酶链反应（ＰＣＲ）检测外周血ＡＬＴ,抗－ＣＨＶ物ＨＣＶ－ＲＮＡ,以探讨ＨＣＶ感染与ＯＬＰ之间的关系。结果 ４０名ＯＬＰ患者中,１０例（２５．０％）有ＡＬＴ异常,８例（２０．０％）抗－ＨＣＶ阳性,７例（１７．５％）ＨＣＶ－ＲＮＡ阳性、经统计学处理有显著性差异（Ｐ〈０．０－     

先天性唇腭裂病儿TORCH感染的血清学研究

目的：为了探讨弓形虫（ＴＯ）,风疹病毒（ＲＶ）,巨细胞病毒（ＣＭＶ）和单纯疱疹病毒Ⅱ（ＨＳＶⅡ）感染与先天性唇腭裂发生的关系。方法：对１２０例２月龄至１０岁唇腭裂病儿和６２名正常儿童血清抗ＴＯ－ＩｇＭ,抗ＲＶ－ＩｇＭ,抗ＣＭＶ－ＩｇＭ和抗ＨＳＶⅡ－ＩｇＭ用ＥＬＩＳＡ法作检。结果：病儿阳性率分别为４．２％,３．３％,３３．３％和３．３％,正常儿分别为１．６％,３．２％,２１．０％和３．３％,两者统计学上无显著差异。２～３月龄组病儿抗ＣＭＶ－ＩｇＭ阳性率为４３．８％,显著高于正常儿的９．１％（Ｐ＜０．０５）。结论：唇腭裂的发生与ＴＯ,ＲＶ和ＨＳＶⅡ感染可能无明显关系,与先天性ＣＭＶ感染有一定关系。     

单纯疱疹病毒Ⅰ型在RAU发生中的作用探讨

本研究采用ＰＣＲ技术分别对４２例ＲＡＵ患者、２８例ＯＬＰ患者和３０例正常人口腔脱落细胞中ＨＳＶ－１ ＤＮＡ进行检测,结果显示：ＲＡＵ组ＨＳＶ－１ ＤＮＡ阳性率４２．８６％,与ＯＬＰ病例对照组７．１４％及正常对照组６．６７％比较,均有显著性差异（Ｐ〈０．００５）;不同性别、年龄、型别的ＲＡＵ患者口腔脱落细胞ＨＳＶ－１ ＤＮＡ的阳性率无显著性差异（Ｐ〉０．０５）。提示ＨＳＶ－１在ＲＡＵ发生中具有重要作     

先天性唇腭裂病儿TORCH感染的血清学研究

目的：为了探讨弓形虫（ＴＯ），风疹病毒（ＲＶ），巨细胞病毒（ＣＭＶ）和单纯疱疹病毒Ⅱ（ＨＳＶⅡ）感染与先天性唇腭裂发生的关系。方法：对１２０例２月龄至１０岁唇腭裂病儿和６２名正常儿童血清抗ＴＯ－ＩｇＭ，抗ＲＶ－ＩｇＭ，抗ＣＭＶ－ＩｇＭ和抗ＨＳＶⅡ－ＩｇＭ用ＥＬＩＳＡ法作检。结果：病儿阳性率分别为４．２％，３．３％，３３．３％和３．３％，正常儿分别为１．６％，３．２％，２１．０％和３．３％，两者统计     

c－erbB－2的表达与涎腺恶性多形性腺瘤预后的关系

本研究的目的在于观察癌基因ｃ－ｅｒｂＢ－２表达与涎腺恶性多形性腺瘤患者预后的关系。采用抗ｃ－ｅｒｂＢ－２癌蛋白单克隆抗体ＡＢ－３，应用免疫组织化学方法，对６０例涎腺恶性多形性腺瘤中ｃ－ｅｒｂＢ－２癌基因表达产物进行了检测。结果发现，２５例ＭＰＡ显示ｃ－ｅｒｂＢ－２表达产物阳性，阳性表达率４１．６７％。结合临床随访资料分析，ＭＰＡ复发组ｃ－ｅｒｂＢ－２阳性表达率明显高于未复发组（Ｐ＜０．０５）；ｃ－ｅｒｂＢ－２表达阳性患者术后５年生存率明显低于表达阴性者（Ｐ＜０．０５）。表明ｃ－ｅｒｂＢ－２癌基因表达与ＭＰＡ患者的预后密切相关，检测ｃ－ｅｒｂＢ－２表达产物可能成为估价ＭＰＡ预后的可靠指标之一。     

牙周病患者牙龈组织前列腺素E_2、血栓素B_2、6－酮－前列腺素F_（1α）水平的研究

采用ＲＩＡ对１１例健康牙龈组织（Ｈ）、１１名龈炎（Ｇ）患者的１７个牙、２６名成人牙周炎（ＡＰ）患者３６个牙和１４名青少年牙周炎（ＪＰ）患者的２０个牙的牙龈组织同时测定ＰＧＥ_２、ＴＸＢ_２、６－Ｋ－ＰＧＦ_（１α）的含量。结果以ＰＧＥ_２最多，ＴＸＢ_２次之，６－Ｋ－ＰＧＦ_（１α）最少；３种前列腺素（ＰＧｓ）均随病变严重程度而增加，除Ｇ组ＴＸＢ_２和６－Ｋ－ＰＧＦ_（１α）与Ｈ组相差显著（Ｐ＜０．０５）外，其余各病变组与Ｈ组比，３种ＰＧｓ均相差非常显著（Ｐ＜０．０１），ＡＰ组和ＪＰ组比Ｇ组也有非常显著升高（Ｐ＜０．００１），而ＡＰ和ＪＰ组间相差不显著（Ｐ＞０．０５），表明３种ＰＧｓ在牙周病发病中具有重要作用。     

丙型肝炎病毒感染与扁平苔藓

扁平苔藓（ＬＰ）是以异常细胞免疫反应为主的疾病，病因不清。但越来越多的研究表明ＬＰ与丙型肝炎病毒（ＨＣＶ）感染有关。ＨＣＶ是单股正链ＲＮＡ病毒，目前可检测其特异性抗体和ＨＣＶ ＲＮＡ。ＬＰ患者中ＨＣＶ的高感染率提示应对ＬＰ患者进行ＨＣＶ检测。     

人乳头瘤病毒,疱疹病毒I型及人巨细胞病毒与口腔鳞癌关系的研究

目的：研究口腔鳞癌与人乳头瘤病毒（ＨＰＶ）、孢疹病毒Ｉ型（ＨＳＶ－Ｉ）和人巨细胞病毒（ＨＣＭＶ）的关系。方法：采用斑点杂交和ＰＣＢ技术检验３２例口腔鳞癌、１４例口腔白斑和１０例正常口腔粘膜中ＨＰＶ１６、ＨＳＶ－Ｉ及ＨＣＭＶＤＮＡ。结果：在正常口腔粘膜、白斑及口腔鳞癌中ＨＰＶ１６、ＨＳＶ－１及ＨＣＭＶＤＮＡ感染率分别为０％、３５．７％、５０．０％、４０．０％、５０．０％、４３．３％和０％、１４．３％、２８．１％,口腔鳞癌及白斑组织中ＨＰＶ１６－ＤＮＡ的检出率均高于正常口腔,且差别具有显著性（ｐ〈０．０５）;但ＨＳＶ－Ｉ和ＨＣＭＶＤＮＡ在口腔疾患中的检出率与正常比较无显著差别（ｐ〈０．０５）。结论：ＨＰＶ１６感染与口腔鳞癌的发生相关;ＨＳＶ－Ｉ和ＨＣＭＶ可能参予口腔鳞癌的发生及发展,并且与ＨＰＶ１６有协同致癌的作用     

牙周炎患者红细胞免疫状态的初步分析

目的：通过对牙周炎患者外周血红细胞Ｃ３ｂ受体花环率（ＲＢＣ－Ｃ３ｂＲＲ）和红细胞免疫复合物花环率（ＲＢＣ－ＩＣＲ）的检测,观察青少年牙周炎（ＪＰ）、快速进展型牙周炎（ＲＰＰ）、成人牙周炎（ＡＰ）的红细胞免疫功能状况。方法：采用红细胞酵母菌花环试验方法。结果：ＪＰ、ＲＰＰ患者红细胞免疫粘附力明显低于正常人。ＪＰ、ＲＰＰ患者ＲＢＣ－Ｃ３ｂＲＲ分别为（１０．０３±０．９２）％、（１２．２０±０．９４）％,与对照组（１５．９０±１．７７）％有显著差异（Ｐ＜０．００１,Ｐ＜０．０１）;ＲＢＣ－ＩＣＲ分别为（２７．８９±１．７７）％、（２７．０１±１．７９）％,与对照组（３０．６４±３７）％有显著性差异（Ｐ＜０．０１）;ＡＰ患者ＲＢＣ－Ｃ３ｂＲＲ为（１６．０２±１．２５）％、ＲＢＣ－ＩＣＲ为（３０．０４±１．７３）％,与对照组无显著性差异（Ｐ＞０．０５）。结论：提示ＪＰ、ＲＰＰ的发病机理可能与宿主的红细胞免疫功能低下有关。     

口腔粘膜下纤维性变组织中内皮素1的免疫组织化学和定量研究

目的：探讨ＥＴ－１在口腔粘膜下纤维性变（ＯＳＦ）发病机制中的作用。方法：采用免疫组化染色ＳＡＢＣ法和图像分析技术,对ＯＳＦ早、中、晚期各１０例、口腔扁平苔藓（ＯＬＰ）１０例以及正常人１０例的颊粘膜组织中ＥＴ－１表达进行定量分析。结果：①ＯＳＦ组织中ＥＴ－１免疫阳性物质超量表达,正常及ＯＬＰ组织中ＥＴ－１表达微弱;②ＯＳＦ早、中、晚期组织中ＥＴ－１含量显著高于正常（Ｐ〈０．０１）,且早、中期显著高于晚期（Ｐ〈０．０１）;③ＯＳＦ早、中期组织ＥＴ－１含量显著高于ＯＬＰ（Ｐ〈０．０１）,晚期间质ＥＴ－１含量显著高于ＯＬＰ（Ｐ〈０．０５）,上皮ＥＴ－１含量两者差异不显著（Ｐ〉０．０５）;④口腔粘膜中上皮和间质的ＥＴ－１含量呈显著正相关（Ｐ〈０．０５）。结论：ＥＴ－１在ＯＳＦ的表达具有特异性,且可能影响ＯＳＦ病变的发生发     

Hepatitis C virus infection in Italian patients with oral lichen planus: a prospective case-control study

To assess the aetiology of liver disease associated with lichen planus, we prospectively studied 70 consecutive newly diagnosed patients with oral lichen planus (OLP) living in northwest Italy (Piemonte) and 70 controls matched for age and sex with other oral keratoses coming from the same district. Twenty-two patients with OLP (3.4%) and 9 controls (12.9%) were found to be affected by chronic liver disease (CLD) ( P =0.014). In sixteen of the 22 OLP patients with CLD the liver disease was hepatitis C virus (HCV)-related. whereas 2 of the 9 controls had a HCV-related CLD ( P =0.016). In another OLP case, liver damage was related to a combination of HCV and alcohol abuse. The prevalence of HCV antibodies in the whole OLP group (27.1%) was significantly higher than in controls (4.3%) ( P =0.014). whereas no difference was found between the OLP and control groups regarding hepatitis B virus markers and other common causes of CLD. HCV infection was more frequently found in patients with erosive OLP (58.8%) than in patients with non-erosive OLP (13.2%) ( P =0.004). Serum HCV-RNA was detected by polymerase chain reaction (RT-PCR) in the majority (93.7%) of OLP patients who had HCV antibodies. Excluding OLP and control patients with HCV markers, there was no difference between the two groups regarding frequency of CLD. Our data show that HCV is probably the main pathogenic factor in liver disease of Italian patients with OLP. and suggests that HCV could be involved in the pathogenesis of OLP.     

Antibodies to epithelial components in oral lichen planus (OLP) associated with hepatitis C virus (HCV) infection

Oral lichen planus (OLP) is a common chronic inflammatory disorder sometimes associated with hepatitis C virus (HCV) infection. An increased prevalence of autoimmune markers has been reported in patients with HCV infection. The aim of the present study was to determine, by conventional indirect immunofluorescence, the nature and frequency of circulating antibodies to epithelial antigens in the sera of HCV-positive patients who also have OLP. The study comprised four groups: 14 patients with OLP and HCV infection. 14 HCV-seronegative patients with OLP, 21 HCV-seropositive patients without OLP and 18 healthy controls. We found a significant association between the concomitance of OLP and HCV infection and the presence of such antibodies. It is concluded that some patients with HCV-associated OLP may have circulating antibodies to epithelial antigens, although their precise aetiological role in the development of this disease in HCV infection remains unknown.     

丙型肝炎病毒在口腔扁平苔藓发病中的意义

目的：探索丙型肝炎病毒在口腔扁平苔藓发病中的意义。方法：应用ＰＣＲ技术对６０例口腔扁平苔藓患者进行了丙型肝炎病毒ＲＮＡ的检测。结果：在６０例口腔扁平苔藓患者中，其中７例丙型肝炎病毒ＲＮＡ阳性，与对照组相比具有显著性差异（Ｐ＜０．０５）；且丙型肝炎病毒ＲＮＡ阳性患者的损害均表现为白纹伴糜烂。结论：在口腔扁平苔藓中，尤其是在糜烂伴白纹的口腔扁平苔鲜患者中，应用敏感的ＰＣＲ技术检测血液中的丙型肝炎病毒ＲＮＡ，不仅对于防治慢性肝炎，而且对于探索口腔扁平苔藓的病因与治疗均具有重要意义。     

Hepatitis C virus‐associated oral lichen planus: is the geographical heterogeneity related to HLA‐DR6?

BACKGROUND: The association between hepatitis C virus (HCV) and oral lichen planus (OLP) is more common in the Mediterranean area and Japan, possibly because of immunogenetic factors. METHODS: Intermediate-resolution HLA-DRB typing by hybridization with oligonucleotide probes was performed in 31 Italian OLP patients with HCV infection, in 45 Italian OLP and in 48 British OLP patients without HCV infection. As healthy controls we included data from 145 unrelated Italian and 101 unrelated British bone marrow donors. RESULTS: Italian HCV+ve OLP patients possessed the HLA-DR6 allele more frequently than Italian and British OLP patients without HCV infection (51.6% vs. 17.7% vs. 16.7%; P corrected = 0.028 and 0.017, respectively). There was no difference in the frequency of the HLA-DR6 allele between Italian and British control subjects. CONCLUSIONS: The present data suggest that HLA-DR6 may be responsible for the peculiar geographic heterogeneity of the association between HCV and OLP.     

Hepatitis C virus infection and oral lichen planus: a report from the Netherlands

The reported frequency of anti-hepatitis C virus (HCV) antibodies in groups of cutaneous lichen planus (CLP) and/or oral lichen planus (OLP) patients varies from about 4% to 65%. Most of these studies have been performed in countries with a high overall prevalence of HCV infection in the general population, such as the southern European countries and Japan. Limited data are available from areas with a low prevalence of HCV infection. Therefore, we investigated the prevalence of HCV infection in a series of 55 patients with OLP in the Netherlands, which apparently has a low prevalence of HCV infection. None of the 55 patients revealed serological evidence of antibodies to HCV. The present data suggest that HCV infection in OLP patients in the Netherlands is probably not very common. A larger study group with a sex- and age-matched control group is required to advise against routine serological examination for HCV infection in Dutch OLP patients.     

The magnitude of the association between hepatitis C virus infection and oral lichen planus: meta-analysis and case control study

Although hepatitis C virus (HCV) infection is associated with oral lichen planus (OLP), a case–control study and a meta-analysis were designed to investigate the magnitude of such an association. A total of 413 presumptive OLP patients (18–75 years) who referred to a dental clinic in Rasht (Iran) were consecutively selected. OLP was diagnosed clinically (typical forms) and histologically (atypical forms) by a calibrated examiner. A total of 487 adults (20–77 years) attending the same dental clinic were the controls. The two groups were homogeneous in terms of age, gender and occupation. Subjects were tested for anti-HCV antibodies. The odds ratio (OR) for OLP attributable to HCV infection was non-significant [OR 1.2, 95% confidence interval (95CI) 0.3–4.8], suggesting that the association between HCV and OLP was weak in the Iranian context. Meta-analysis of observational studies characteristics of primary studies were that cases were diagnosed clinically (only typical forms) and histologically and exposure was assessed through anti-HCV antibodies. Exposed/unexposed cases/controls were extracted and zero values were appropriately transformed. As much as 44 studies, including the present, were located. Publication bias could not be totally excluded. The pooled OR, estimated using the random-effect model, was 2.8 (95CI 2.4–3.2). Sensitivity analysis confirmed the robustness of results. Subgroup analysis showed non-significant differences between American/European and Asian/African studies. The fraction of global OLP cases associated with HCV (population attributable fraction) was 2.1% (95CI 1.9–2.2%). Although HCV and OLP were significantly associated, the majority of OLP patients were not affected by HCV.     

The clinical impact of direct-acting antiviral treatment on patients affected by hepatitis C virus-related oral lichen planus: a cohort study

Objectives

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease. Literature supports an association between OLP and Hepatitis C virus (HCV) infection. The current treatment for HCV infection with direct-acting antivirals (DAAs) is highly effective and safe. The aim of this study is to evaluate the clinical impact of viral eradication with DAAs in patients with HCV and OLP.

Materials and methods

For this cohort observational study, 18 patients with HCV and OLP were recruited; all patients received DAAs. Nineteen patients with OLP without HCV were recruited as controls. Both groups received an oral clinical examination, taking photographs of the oral mucosa, at three time points. Size and type of lesions, clinical and efficacy scores, were evaluated at each time point with ImageJ software. Changes were assessed by a general linear model repeated measures analysis. Kruskal–Wallis H and Mann–Whitney U tests were used to evaluate the differences between subgroups.

Results

All patients of the study group reached a sustained virological response. The study group showed a correlation between viral load and clinical status (p?<?0.05), higher clinical scores at baseline (p?=?0.001) and higher efficacy index than controls (p?<?0.001), improving over time (p?<?0.001); controls did not show significant changes (p?=?0.196). One patient of the experimental group developed oral squamous cell carcinoma (OSCC) of the tongue during the DAAs treatment.

Conclusions

In this study, patients with HCV and OLP showed a worst clinical oral status than controls at baseline. However, treatment for virus eradication can improve the oral lichen planus clinical course.

Clinical relevance

HCV eradication can improve the clinical course of patients with HCV-related OLP.