An immunocytochemical study of the inflammatory cell infiltrate and epithelial expression of HLA-DR in odontogenic cysts

The presence and distribution of lymphocytes, Langerhans cells, HLA-DR' infiltrating cells and the expression of HLA-DR by lining epithelium was investigated in the walls of odonlogenic cysts using an indirect immunoperoxidase method on acetone-fixed cryostat sections. The 23 cysts studied consisted of 14 dental (radicular) cysts, 5 keratocysts, 2 dentigerous cysts, 1 surgical ciliated cyst and 1 incisive canal cyst. The cell populations detected in the walls of all cysts were similar and consisted of HLA-DR+ macrophage-type cells and a mixture of T and B lymphocytes. Analysis of the T cell subsets revealed that in all cases the CD4⁺, T_h/i subset predominated over the CD8⁺, T_s/c subset. 18/22 cyst linings contained cells expressing a Langerhans cell phenotype (CD1⁺). Cytoplasmic epithelial expression of HLA-DR was detected in 7/22 specimens. Neither the presence of HLA-DR⁺ epithelial cells nor LC were restricted to a given type of cyst. These findings indicate the occurrence of similar cellular processes irrespective of the proposed developmental or inflammatory aetiology of these lesions.     

Oral candidiasis and immune status of HIV-infected patients

A total of 84 HIV-infeted homosexual men having either normal oral mucosa (NOM). erythematous candidiasis (EC) or pseudomembranous candidiasis (PsC) were included in the study. The patients were evaluated by median number of peripheral CD4⁺ cells, CD8⁺ cells and by lymphocyte function assessed by poke-weed mitogen test. There was a significant difference between CD4⁺ counts among patients with the two subtypes of candidiasis (95% CI of median difference: 10 240/mm³; P =0.03). but not for pokeweed mitogen response. Survival analysis showed that after 2 y there was no significant difference in development of AIDS between patients with EC and PsC ( P = 0.29). If patients with both types of oral candidiasis were pooled and compared with patients with NOM. a significant difference in development of AIDS was found ( P = 0.04). It is concluded that HIV-infected patients with oral candidiasis of any subtype (EC or PsC) arc significantly more immune suppressed and show a faster development of AIDS than HIV-infected patients with NOM. However, in this cohort. EC and PsC are of equal importance as predictors for immune suppression and AIDS development.     

Immunocompetent cells in rat periodontal ligament and their recruitment incident to experimental orthodontic tooth movement

The aims of this study were to evaluate the number and distribution of immunocompetent cells in normal rat periodontal ligament (PDL) and to quantify their recruitment incident to experimental tooth movement. 27 young animals had the 1st right maxillary molar moved mesially by an orthodontic appliance for 1, 3, 7 and 14 days, respectively. 4 animals served as untreated controls. An immunohistochemical procedure was carried out on alternate serial cryostat sections, and monoclonal antibodies against CD1 II (macrophages, dendritic cells), CD43⁺ (lymphocytes, polymorphs), CD4 (helper T-lymphocytes), and class II MHC molecules were used. Mean counts of the immunolabeled cells in the control group showed the highest number of GDI lb⁺ and class II molecule expressing cells, while CD4⁺ and CD43⁺ cells were scarcely found. Significant increase in the number of CD1 lb⁺, CD43⁺ cells and class II molecules was found in the PDL of the experimentally moved 1st molars compared with the contralateral side and the control group, while CD4⁺ cells showed no significant increase. CD11b⁺ and cells expressing class II molecules were found around hyalinized tissue, between dentin and cellular cementum and close to Malassez'epithelial cells. In conclusion, normal rat PDL has high number of macrophage and dendritic-like cells, but few lymphocytes and granulocytes. Furthermore, experimental tooth movement leads to significant recruitment of cells belonging to the mononuclear phagocytic system, but has no significant effect on the number of lymphocytes and granulocytes in the rat PDL.     

Immunoelectron microscopic study of distribution of T cell subsets in oral lichen planus

Abstract – Monoclonal anti-CD4, anti-CD8, and anti-GD18 antibodies were applied in avidinbiotin-peroxidase complex staining using a pre-embedding immunoelectron microscopy technique. Although most of the local T cells in situ were of CD4⁺ subtype, local CD8⁺ cells generally had a lower nucleus/cytoplasm ratio and contained more cell organelles than CD4⁺ cells. This suggests a local activation of CD8⁺ subpopulation, rather than activation of the numerically predominant CD4⁺ cells. Topographical analysis disclosed that all lymphocytes, regardless of location, were CD18⁺ and that most of the CD8 ⁺ cells were located subbasally and intraepithelially, whereas CD4⁺ cells often occurred in small clusters deeper down in the subepithelial lymphocyte-rich band. Furthermore, CD8⁺ cells were often in close contact with macrophages, whereas CD4⁺ cells were in some instances in direct contact with plasma cells. This indicates that CD4⁺ cells may be involved in T cell-dependent B cell-mediated immunoglobulin synthesis, whereas CD8⁺ cytotoxic lymphocytes and tissue macrophages may be involved in the local pathogenetic process leading to basement membrane alterations.     

Extent and diversity of inflammatory cell infiltrates in squamous cell carcinomas and basal cell epitheliomas of the head and neck

Using monoclonal antibodies reactive with Langerhans' cells (LCs), macrophages, and T cell subpopulations, the density and proportions of cells of the immune system of the normal oral mucosa were determined immunohistochemically, and compared with findings in oral squamous cell carcinomas (SCC) and basal cell epitheliomas (BCE). In normal oral epithelia, the dominant cell type was the LC, positive for CD 1, and expressing HLA-DR antigens (DR⁺). Many intraepithelial cells were lymphocytes of the suppressor/cytotoxic phenotype (CD 8⁺), which was also the most prominent cell type in the normal mueosal slroma. Significant differences were observed for the content of CD 8-, OKM 1-, and CD 4-positive cells in the epithelium of normal oral mucosa, SCC, and BCE, and for the amount of CD 1-positive Langerhans cells in the connective tissue of the different groups of tissues. When CD 4/CD 8 ratios were calculated, differences between SCC and BCE became most evident. A CD 4/CD 8 ratio greater 0.5 was seen to be characteristic for BCE. Thus, in contrast to the striking preponderance of suppressor/cytotoxic lymphocytes (CD 8⁺) in SCC, BCE showed typically almost balanced numbers of suppressor/cytotoxic (CD 8⁺) and helper/induced (CD 4⁺) lymphocytes. This finding further underlines the biological differences recognized between these most common neoplasias of the head and neck.     

High numbers of T cells in gingiva from patients with human immunodeficiency virus (HIV) infection

A quantitative, immunohistologic evaluation of CD3⁺, CD4⁺and CD8⁺ cells was carried out on gingival biopsies from 25 HIV-infected persons with gingivitis or periodontitis and 13 HIV-seronegative persons with periodontitis. CD3⁺ T cells were found in all biopsies. CD8⁺ cells were significantly more numerous and the CD4⁺/CD8⁺ ratio was significantly decreased in the gingival connective tissue of the HIV⁺ patients (P < 0.05). The number of CD4⁺ lymphocytes subjacent to the pocket epithelium was moderately lower in the HIVH patients as compared to the HIV⁺ patients (P < 0.05). HIV⁺ patients with a history of necrotizing periodontal disease had fewer CD4⁺ cells subjacent to the oral gingival epithelium than patients without such disease (P < 0.05). The general HIV-related changes in T lymphocyte numbers were therefore reflected in inflamed gingival tissues. HIV⁺ patients had, however, significantly higher CD4⁺/CD8⁺ ratios in gingiva than in peripheral blood (P < 0.05), indicating that CD4⁺ T cells are actively recruited to gingiva, even in cases of extreme CD4⁺ T lymphocytopenia.     

Lectin binding to chronic inflammatory gingival tissue: possible adhesion mechanisms based on lectin-carbohydrate interactions

In this study, we analyzed the expression of different leukocyte surface antigens, of the adhesion molecules ELAM-1 and GMP-140 and binding of various lectins and neoglycoproteins in inflamed gingival tissue. Cell suspensions from collagenase-digested gingiva were analyzed by flow cytometry in a FACScan. The expression of ELAM-1, GMP-140, carbohydrate structures and lectins in gingival specimens was also studied by immunohistochemistry. Gingival tissue of patients with active periodontal disease contained between 5% and 50% CD45⁺ mononuclear cells, consisting mainly of CD19⁺ cells (B lymphocytes). CD62, resembling GMP-140, and ELAM-1 were strongly expressed on endothelial cells of these patients. Control subjects usually contained almost no CD45⁺ cells in their gingiva and no CD62⁺ or ELAM-1-positive endothelial cells could be found in 5 of 6 control persons. Analysis of the glycosylation pattern revealed staining of infiltrating cells by peanut agglutinin (PNA; specificity for galactose), whereas soy bean agglutinin (SBA; specificity for N-acetyl-galactosamine) bound to epithelial cells. An endogenous lactosyl-specific lectin could be detected on endothelial cells by binding of lactosyl-BSA. Ulex europeus I agglutinin (UEA-1, specific for fucose) showed selective staining of endothelial and epithelial cells. Expression of a fucose-binding lectin, demonstrated by binding of fucosylated BSA, could be found on infiltrating cells. The adhesion molecules ELAM-1 and GMP-140 seem to be involved in cell adhesion during chronic inflammation of the gingiva. Interaction of other carbohydrate residues with endogenous lectins might resemble additional adhesion mechanisms inflamed gingiva.     

Increased number of CD25+ FoxP3+ regulatory T cells in oral squamous cell carcinomas detected by chromogenic immunohistochemical double staining

Background:  The role of tumor-infiltrating regulatory T cells (Treg) compromising antitumor effects of immune cells in oral squamous cell carcinoma (OSCC) is largely unknown.
Purpose:  The presence of CD25⁺ FoxP3⁺ Treg as well as of CD3⁺ FoxP3⁺ and of CD8⁺ FoxP3⁺ tumor-infiltrating lymphocytes (TIL) was verified in OSCC and compared with non-cancerous lymphoepithelial tissue.
Method:  Three double stainings (CD3/FoxP3, CD8/FoxP3 and CD25/FoxP3) were performed on tissue sections of 15 OSCC and compared with 15 human tonsils.
Results:  OSCC biopsy samples provide evidence for a strong infiltration of TIL, in particular, naturally occurring CD25⁺ FoxP3⁺ Treg. Whereas a comparison of OSCC and control tissue did not show significant changes in the number of CD3⁺ FoxP3⁺ TIL and of CD8⁺ FoxP3⁺ TIL, a significantly higher frequency of CD25⁺ FoxP3⁺ TIL (Treg) could be observed in OSCC ( P  < 0.001, two-sided t -test). Given the small number of specimens, a significant correlation with tumor stage could not be verified.
Conclusion:  Chromogenic double staining of CD4/FoxP3 is a promising tool for the detection of Treg in paraffin-embedded tissue of OSCC.     

Oral mucosal lesions in experimental graft-versus-host disease: morphological and immunohistochemical characterization of infiltrating cells

To facilitate recognition of the oral mucosal lesion that develops in rats with graft-versus-host disease (GVHD) induced by injecting spleen cells of parental strain rats (Brown Norway) into non-irradiated (Brown Nonvay×Lewis) F1 hybrid rats, we followed the development of the tongue lesion histologically and immunohistochemically. This assessment revealed an increase in the number of MHC class II⁺ cells with dendritic shape in the lamina propria to be the earliest stage of the tongue lesions in GVHD rats. The subsequent mononuclear cell infiltration with epithelial cell destruction, characteristic of GVHD. consisted of CD8⁺ cells and macrophages. Our findings seem to indicate that MHC class II⁺ cells with dendritic shape may provide antigen presentation in the induction of local immunological responses, including tissue destruction, by CD8⁺ cells and macrophages in the tongue of GVHD rats.     

Oral ulcers in HIV-positive Peruvian patients: an immunohistochemical and in situ hybridization study

Background:  This study describes the histopathological, immunohistochemical (IHC) and in situ hybridization (ISH) data of 25 cases of oral ulcers in HIV-positive patients, with clinical and microscopical features similar to ulcers not otherwise specified (NOS)/necrotizing ulcerative stomatitis (NUS).
Methods:  Sex, age and clinical history were obtained from the clinical records. Histological analysis for H&E, Gomori–Grocott and Ziehl–Neelsen stains, IHC analysis to detect infectious agents and to characterize inflammatory cellular infiltrate, and ISH for cytomegalovirus (CMV) and EBER1/2 were performed.
Results:  Twenty-one patients were men and four were women (mean age of 34.6 years). The tongue was preferentially affected. Microscopically, the lesions showed extensive necrosis, leukocytoclasia, vasculitis with luminal fibrin clots and an intense inflammatory cellular infiltrate predominated by CD68⁺ atypical large cells, normal-sized and crescent-shaped nuclei macrophages, interspersed by CD8⁺ T lymphocytes. Mast cells were also observed in all samples studied. CD4⁺ T lymphocytes, CD20⁺ B lymphocytes and VS38c⁺ plasma cells were practically absent. CMV and EBER1/2 were identified in scarce cells of 3 and 16 of 25 cases respectively.
Conclusion:  These results show that CD68⁺ macrophages, followed by CD8⁺ T lymphocytes, were the predominant inflammatory cells, indicating they are relevant to the pathogenesis of the ulcers, possibly reflecting an abnormal immune response in the oral mucosa. The clinicopathological and immunoprofile features of the present cases are similar to NOS ulcers/NUS in HIV-positive patients.     

Distribution of macrophage lineage cells in rat gingival tissue after topical application of lipopolysaccharide: an immunohistochemical study using monoclonal antibodies: OX6, ED1 and ED2

To discuss the role of macrophage lineage cells on the periodontal tissue destruction, we immunohistochemically examined the phenotype and the dynamics of macrophage lineage cells 1 or 3 h or 1, 2, 3 or 7 d after topical application of LPS (5 mg/ml in physiological saline) from the rat gingival sulcus using 3 monoclonal antibodies: OX6 (antigen-presenting cells), ED1 (monocytes, macrophages and dendritic cells) and ED2 (resident macrophages). We could detect at least 3 different types of macrophage lineage cells, namely OX6⁺/ED1⁺/ED2⁻ dendritic cells and exudate macrophages and ED2⁺ resident macrophages. After LPS application the majority of macrophage lineage cells accumulated in the subjunctional epithelial area were newly extravasated OX6⁺/ED1⁺/ED2⁻ dendritic cells or macrophages. The number Department of Oral Pathology, Hiroshima of these cells increased progressively with time and reached a maximum level at University School of Dentistry, d 2. On the other hand, number and tissue distribution of ED2⁺ resident macrophages did not change. These results indicate that several types of macrophage lineage cells exist in rat gingival tissue and suggest that dendritic cells and exudate macrophages transiently accumulated after LPS application are responsible for various host immune response and tissue destruction caused by LPS.     

Increased levels of circulating endothelial progenitor cells in subjects with moderate to severe chronic periodontitis

Aim: Emerging evidence shows that periodontal disease is associated with endothelial dysfunction. The purpose of this study was to determine the association between chronic periodontitis (CP) and circulating endothelial progenitor cells (EPC).
Materials and Methods: Eighty-six non-smoking subjects (36 males and 50 females, aged 35–80 years) were recruited, including 23 subjects with no or mild CP and 63 subjects with moderate to severe CP. The levels of circulating EPC were quantitatively determined by fluorescence-activated cell analysis, including CD34⁺/kinase insert domain-containing receptor (KDR)⁺ (more mature EPC) and CD133⁺/KDR⁺ (less mature EPC). Periodontal conditions, the intima–media thickness of carotid arteries and circulating biomarkers were examined.
Results: Subjects with moderate to severe CP exhibited an increased risk of high EPC count, compared with those with no or mild CP: CD34⁺/KDR⁺ EPC [odds ratio (OR)=9.5, 95% confidence interval (95% CI) 1.5–61.0, p= 0.018; CD133⁺/KDR⁺ EPC, OR=4.6, 95% CI 1.1–19.5, p =0.039]. C-reactive protein was significantly associated with high CD34⁺/KDR⁺ EPC count and age was inversely related with high EPC count. Age, gender and CD34⁺/KDR⁺ EPC were independent variables of increased carotid intima–media thickness ( p <0.05).
Conclusion: This study shows for the first time that moderate to severe CP is associated with an increased level of circulating EPC.     

Systemic treatment of anti-CD4+CD25+ T cell monoclonal antibody exacerbates sialoadenitis in submandibular glands during the early life in lupus-prone female NZB × NZWF1 mice

Background:  The maintenance mechanisms of peripheral tolerance by CD4⁺CD25⁺ T cells before the development of sialoadenitis in secondary Sjögren's syndrome (sSS) are not well understood. The aim of the present study is to examine the effect of reduction of CD4⁺CD25⁺ T cells on the development of sialoadenitis during the early life in female NZB × NZWF₁ (B/WF₁) mice, a model for human sSS.
Methods:  Female B/WF₁ mice at 3 days after birth were treated with either anti-mouse CD4⁺CD25⁺ T cells rat IgG₁ monoclonal antibody (mAb) or Rat IgG₁(control). At 25 weeks of age, autoantibodies against nucleus and cytoplasm of ductal epithelial and myoepithelial cells, and histpathology of submandibular glands were examined in the mAb-treated and control groups. Also the development of anti-Ro/SS-A antibodies was examined until 25 weeks of age in both groups.
Results:  The mAb-treated group showed severe lesions with the development of autoantibodies compared to the control group.
Conclusions:  The present results suggest that peripheral CD4⁺CD25⁺ T cells may, at least in part, contribute to down-regulate the development of sialoadenitis in submandibular glands of lupus-prone female B/WF₁ mice during their early life.     

Epithelial dendritic cells in pathological human oral tissues

Epithelial dendritic cells (EDC) were examined in human oral tissues with non-specific keratosis, lichen planus and squamous cell carcinoma. Acetone-fixed frozen sections were stained using an indirect immunoperoxidase technique and monoclonal antibodies to the human CD1 thymocyte (OKT6) and HLA-DR antigens. Significantly more T6⁺ and DR⁺ EDC were present in lichen planus tissues than normal controls, tissues with non–specific keratosis and the epithelia overlying/adjacent to squamous cell carcinomas, the latter tissues having comparable numbers of both T6⁺ and DR⁺ EDC. By contrast, significantly fewer T6⁺ EDC and significantly more DR⁺ cells were present in the invasive epithelium of squamous cell carcinomas than the overlying/adjacent epithelium of carcinomas, the non-specific keratosis group and the normal tissues. 23–60% of pathological tissues had either focal or general DR⁺ reactivity in keratinocytes, but there was no correlation between the density of T6⁺ or DR⁺ EDC and the keratinocyte DR status of the tissues. The results suggest that immunological enhancement occurs in lichen planus and possibly immunological impairment may characterize invasive squamous cell carcinoma.     

The changes in the T-lymphocyte subsets in a population of Turkish children with puberty gingivitis

Objective.   The aim of the study was to investigate the number of CD4 and CD8 T lymphocytes, analyse subjects with gingivitis and those without, and determine the role of T lymphocytes in the pathobiology of puberty gingivitis.
Material and methods.   Fifty individuals with and without puberty gingivitis were recruited for this study. The CD4⁺ and CD8⁺ T-lymphocyte counts were determined using flow cytometry on the biopsy samples, and the CD4⁺/CD8⁺ ratio was calculated. At the same time, periodontal index scores were recorded to assess the periodontal status. Acquired data were analysed statistically using a paired t -test to compare laboratory values obtained before and after the treatment in individuals with puberty gingivitis and disease-free individuals. In addition, Pearson's correlation analysis was performed to investigate the relation between laboratory values and clinical measurements.
Results.   The CD4⁺/CD8 ratio in gingival tissues obtained from test group was significantly higher ( P <  0.05) than that found in the gingival tissue obtained from control group. We found that the CD4⁺ and CD8⁺ lymphocyte counts continued to increase significantly ( P <  0.001) and the CD4⁺/CD8⁺ ratio continued to drop significantly ( P <  0.05) after treatment in test group.
Conclusions.   T lymphocytes could play a significant role in the pathobiology of puberty gingivitis     

Mucosal cell-mediated immunological changes associated with experimental graft-versus-host disease

This study examined the histological changes and local cellular immune response induced within the lingual mucosa in an allogeneic F, hybrid rat model of graft-versus-host disease (GvHD) with a view to studying oral lymphocyte-epithelial cell reactions. Highest levels of disease, as reflected by both a GvHD index and the extent of the oral mucosal changes, were obtained using primed donor (Lewis rats) splenocytes and irradiated hosts (Lew/Da rats). The lingual mucosae of test animals were characterised by irregular epithelial keratosis, an absence of basal cell liquefaction and a diffuse inflammatory cell infiltrate, histological features consistent with an oral lichenoid tissue reaction. Immunohistochemical studies showed that mucosal involvement was characterised by infiltration of the lamina propria by NK cells (CD8⁺, CD5⁻), "activated" cells (CD25⁺) and T cells (CD5⁺) with selective migration of the latter, including a CD5⁺. CD8⁻ subset (helper/inducer T cell), into the epithelium. Epithelial expression of la was invariably associated with these inflammatory cell infiltrates and correlated with the GvHD index. These findings suggest the presence of local mucosal T cell activation in the absence of detectable epithelial cell damage, which may be equivalent to the early initiating events in the pathogenesis of oral lichen planus. However, whilst experimental graft-versus-host disease appears to be a useful model for studying lymphocyte-epithelial interactions, the induced oral mucosal changes are more consistent with a lichenoid reaction rather than lichen planus.     

Two cases of tongue cancer treated with intra- and peri-tumoral injection of recombinant interleukin-2 alone: immunohistochemical considerations to clinical tumor response

SUBJECTS AND METHODS: Two cases with stage II tongue cancer who exhibited different responses to intra-and peri-tumoral administration of rlL-2 alone are presented. Special consideration is given to the relationship between tumor responses to rlL-2 and clinicopatholog-ical and immunohistopathological findings.
RESULTS: The patient who responded completely to treatment showed an exophytic tumor growth pattern, low-grade cancer invasion, and predominant infiltration of CD8⁺ lymphocytes over CD4⁺ lymphocytes in cancer cell nests. The non-responder showed endophytic tumor growth, high-grade cancer invasion, and uniform distribution of both CD4⁺ and CD8⁺ lymphocytes in cancer cell nests.
CONCLUSIONS: Distribution of adequate amounts of T lymphocytes subsets may be necessary in order for good tumor response to biotherapy with rlL-2; other clinical and histopathological variables predicting the effect for cancer chemotherapy remain to be identified.     

Expression of CDIa on monocytes cultured with supernatants from periodontally diseased gingival epithelial cells

OBJECTIVE: Langerhans cells are believed to originate from the monocyte lineage and have been reported to increase in number with plaque accumulation and gingival inflammation. The aim of this study was to investigate the effects of local gingival epithelial factors on the induction of CDla, a Langerhans cell phenotype, on monocyte rich populations.
MATERIALS AND METHODS: Peripheral blood monocyte rich populations from healthy subjects were cultured for 24 h with either healthy gingival or periodontally diseased gingival epithelial supernatants. Additionally, the monocyte rich populations were cultured with cytokines IL-Iα, IL-Iβ, IL-6 and TNF-α which are known to be produced by epithelial cells or co-cultured with autologous epithelial cells. The percent CDIa positive cells was determined using FACS analysis.
RESULTS: Healthy gingival supernatants did not induce CDIa expression in monocyte rich populations, however, a significant increase in per cent CDla⁺ cells for monocyte rich populations cultured with five (P < 0.01) of six periodontal gingival epithelial supernatants was found. IL-lα or TNF-α (10ng/well) resulted in a significant increase in the per cent CDla⁺ cells (P < 0.01). Depletion of CDla⁺ Langerhans cells from healthy gingival epithelium did not enhance induction of CDIa expression in monocyte rich populations. Monocyte rich populations cultured together with non-depleted epithelial cultures resulted in a decreased percent of CDla⁺ cells.
CONCLUSION: These findings indicated that epithelial factor/s associated with periodontally involved epithelia, may be involved in inducing a Langerhans cell phenotype in monocyte rich populations. The data also provide indirect evidence for a role of Langerhans cells in inhibiting induction of CDIa in healthy epithelium.     

Intra-epithelial subpopulations of T lymphocytes and Langerhans cells in oral lichen planus

This study has addressed the question of whether there is selective recruitment and distribution of intra-epithelial leucocytes in lesions of oral lichen planus (OLP). T-lymphocyte subsets were examined in the epithelium and peripheral blood of patients and controls using flow cytometry and double immunofluorescence, and the relationship between keratinocyte intercellular adhesion molecule-1 (ICAM-1) expression with T-lymphocyte and Langerhans cell (LC) distribution was examined. The circulating 'memory'subset (CD45RO⁺) of T-helper cells (CD4⁺) was increased from 49.1% in controls to 65.7% in patients ( P = 0.005), while the 'naive'subset (CD45RA⁺), which was absent from control epithelium, comprised 24% of helper cells in OLP ( P =0.037) and all T-cell and LC counts were significantly raised in ICAM-1-expressing areas of epithelium. These data demonstrate changes in intra-epithelial T-lymphocyte and LC populations compared with normal oral mucosa and suggest there is selective recruitment in OLP. In addition, Keratinocyte ICAM-1 expression does appear to be associated with accumulation of infiltrating T lymphocytes and LC.     

Cellular immune correlates of clinical severity in oral lichen planus: preliminary association with mood states

OBJECTIVES: We investigated cellular immune and psycho-immune dysfunctions in patients with erosive and non-erosive oral lichen planus (OLP) lesions.
METHODS: Patients with erosive or non-erosive OLP were screened at the UCLA Dental Clinic. The profile of mood states (POMS) was administered. T lymphocyte subpopulations were monitored by dual fluorescence. T lymphocytes were stimulated with phytohemagglutinin (PHA) for assessment of markers of activation by flow cytometry and of interleukin (IL)-2 production by ELISA.Plasma cortisol and neopterin levels were assessed by radioimmunoassay.
RESULTS: Circulating T cells that express the cluster of differentiation no.4 (CD4⁺) but devoid of the CD45RA marker, and POMS score were significantly associated ( r = 0.83, P < 0.05) in the patients we studied. We found a significantly higher ( P < 0.05) per cent and absolute lymphocyte numbers of circulating CD4+CD45RA cells in the OLP patients with erosive lesions, compared to OLP patients with non-erosive lesions. The ratio of CD4⁺ CD45RA⁺ over CD4+CD45RA cells was significantly ( P < 0.05) biased toward the CD4+CD45RA subpopulation in OLP patients with erosive lesions (ratio = 0.19 ± 0.09) compared to patients with non-erosive OLP lesions (ratio = 0.47 ± 0.15). The expression of CD54, but not that of CD69, was significantly blunted ( P < 0.05) in OLP patients following CD3⁺ cell stimulation. IL-2 production and plasma neopterin were normal in these patients. There was no correlation between plasma cortisol and T cell populationS. CONCLUSIONS: We find fine differences in psycho-immune interactions between patients afflicted with non-erosive OLP lesions compared to those with erosive OLP lesions.