Immunological evaluation in oral lichen planus with chronic hepatitis C

Oral lichen planus (OLP) is frequently associated with hepatitis C virus (HCV) infection. We have previously reported that the pathogenesis of OLP arises from host rather than viral factors. In this study, we investigated the role of these factors in 41 patients with chronic hepatitis C: 22 with OLP (group 1) and 19 without OLP (group 2). All patients had antibodies to HCV (anti-HCV) and were serum HCV RNA-positive; none were HBsAg-positive. Immune abnormalities in serum were evaluated by testing for antinuclear antibody (ANA), rheumatoid factor (RF) activity, immunoglobulins (IgG, IgM, and IgA), and cryoglobulin. The rate for ANA positivity and IgM levels were significantly higher in group 1 than in group 2 (P<0.05). Mean age in group 1 was significantly higher in group 2 (P=0.0001). Of the factors tested, ANA, IgM, and age, logistic regression showed that age correlated independently with OLP (P=0.003). In 5 patients in group 1, the infiltrating lymphocytic subsets of the OLP lesion were examined histopathologically. Predominant T cell infiltration was shown in all 5 patients. In addition to host factors, we also examined viral factors in both groups of patients, measuring serum HCV RNA level and determining HCV genotype. There were no significant differences between the groups in these viral factors. This study suggested that host factors induced by the HCV infection are more important than viral factors in the pathogenesis of OLP associated with hepatitis C.     

IP-10和IL-6在口腔扁平苔藓中表达的研究

目的:检测正常口腔黏膜与口腔扁平苔藓(OLP)黏膜的上皮和固有层结缔组织中干扰素诱导蛋白10(IP-10)、细胞因子白细胞介素-6(IL-6)mRNA的表达,探讨其在OLP中的作用。方法:应用荧光实时定量RT-PCR技术检测10例OLP黏膜和6例正常口腔黏膜的上皮和固有层结缔组织中IP-10、IL-6mRNA的表达量。结果:OLP黏膜上皮和固有层结缔组织中IP-10、IL-6mRNA的表达均较正常口腔黏膜明显升高(P<0.05),但IP-10、IL-6mRNA的表达量没有明显差异(P>0.05)。结论:OLP组织中趋化因子IP-10、细胞因子IL-6表达量改变可能与其发生发展有一定关系。     

Epithelial p53 gene expression and mutational analysis, combined with growth fraction assessment, in oral lichen planus

The immunohistochemical detection of epithelial p53 protein expression in oral lichen planus (OLP) biopsies was supplemented with molecular analysis for mutations of the p53 gene using the polymerase chain reaction - single stranded conformational polymorphism (PCR-SSCP) technique. p53 protein expression, in the basal epithelial cell layer, as detected by the DO7 and 1801 antibodies, was significantly more frequent in OLP compared with other oral keratoses and normal mucosa, as was the growth fraction. The 10 OLP biopsies that had the most frequent p53 staining (plus a case of OLP found in continuity with a SCC) were screened by the PCR-SSCP technique, but no mutations were detected in the p53 gene (exons 5–9). The p53 overexpression in the OLP samples may be a physiological response to the hyper-proliferative state, as revealed by the growth fraction determination. This may usefully serve to protect against mutagenesis, and so be a factor in the low incidence of carcinoma associated with OLP.     

FOXP3和GITR在口腔扁平苔藓及口腔鳞状细胞癌中的表达及意义

目的研究FOXP3、GITR在口腔扁平苔藓（OLP）和口腔鳞状细胞癌（OSCC）组织中的表达及其意义。方法采用免疫组化方法检测30例OLP组织、30例OSCC组织和15例口腔正常黏膜（NOM）组织中FOXP3、GITR的表达。结果NOM组FOXP3和GITR阴性表达;OLP组和OSCC组FOXP3和GITR表达分别较NOM组显著增加（P〈0.01）;OLP组和OSCC组之间FOXP3和GITR表达无显著性差异（P〉0.05）;FOXP3和GITR在OLP组和OSCC组中的表达存在正相关关系。结论在OLP的发生及发展成OSCC过程中,FOXP3和GITR均可能起着一定的作用。     

依济复治疗复发性口腔溃疡和糜烂型口腔扁平苔藓的临床疗效观察

目的 观察依济复（rhEGF)治疗复发性口腔溃疡和糜烂型口腔扁平苔藓的短期疗效。方法 复发性口腔溃疡70例及糜烂型扁平苔藓30例随机分为两,依济复组采用依济复局喷,对照组采用溃疡糊剂局涂,观察疼痛,充血程度及病损最大直径的改变。结果 同对照组相比较,依济复组疼痛程度显著减轻,病损最大直径显著减小。结果具有统计学意义。依济复组总有效率达100%,对照组为42%,除依济复组1例,对照组3例诉用药后局部刺痛感外,其余无不良反应。结论 依济复治疗复发性口腔溃疡和糜烂型扁平苔藓具较好的短期临床疗效。     

口腔扁平苔藓氯喹治疗前后红细胞免疫粘附功能和循环免疫复合物的观察

本实验对30例口腔扁平苔藓（OLP）患者使用氯喹（CQ）前后及30名健康人进行了红细胞免疫粘附功能（RCIA）和循环免疫复合物（CIC）检测，结果显示：未经治疗的OLP组红细胞C3b受体花环率和红细胞免疫复合物花环率降低，循环免疫复合物水平上升，与健康对照组比较有显著性差异；经CQ治疗后的OLP组红细胞C3b受体花环率和红细胞免疫复合物花环率较治疗前上升，经统计学处理有显著性差异，与健康对照组比较无显著性差异，循环免疫复合物水平较治疗前下降，与健康对照组比较无显著性差异。结果提示：改善红细胞免疫粘附功能可能为CQ治疗OLP的机理之一。     

曲安奈德和帕夫林联合治疗老年糜烂型OLP疗效观察

目的：探讨局部注射曲安奈德配合口服帕夫林治疗老年人糜烂型OLP的疗效。方法：对34例老年糜烂型OLP患者用药治疗前后检测T淋巴细胞亚群的变化及观察临床疗效指标。结果：患者经治疗后临床有效率91.18%,T淋巴细胞亚群检测CD3＋、CD4＋T细胞升高（P〈0.01）,CD8＋T细胞下降（P〈0.01）,CD4＋/CD8＋治疗后上升（P〈0.01）。结论：口腔糜烂型OLP经治疗后,临床疗效肯定,血中T淋巴细胞亚群状态有明显改善。     

78例口腔扁平苔藓临床疗效观察

目的观察丹参和金因肽联合治疗口腔糜烂型扁平苔藓(OLP)的短期疗效。方法将78例患者随机分为两组，治疗组40例采用丹参和金因肽联合治疗，对照组38例口服氯喹治疗，2个月为1疗程，两组均治疗2个疗程，观察口腔斑纹、溃疡、充血等临床指标的变化。结果上述3项指标明显好转，治疗组有效率达77．50％，对照组有效率为76．37％，两组差异无显著性。结论丹参和金因肽联合治疗OLP疗效肯定，副作用小，可推广使用。     

口炎清胶囊治疗口腔扁平苔藓疗效分析

目的观察中成药口炎清胶囊治疗口腔扁平苔藓（Oral Lichen Planus,OLP）的疗效。方法对我院196例OLP患者随机分为治疗组及对照组。对照组采用昆明山海棠加复合维生素B,辅助口腔溃疡油进行治疗;治疗组采用我院自发研制的中成药口炎清胶囊加复合维生素B,辅助口腔溃疡油进行治疗。比较两组的近期（4周）和远期（6个月）疗效。结果治疗组的近期和远期有效率均显著高于对照组,差异有统计学意义（P〈0.05）。结论采用中成药口炎清胶囊治疗OLP能发挥各君臣药的互补作用,而复合维生素B含有多种辅酶,能参与体内多种营养物质代谢反应。该治疗方法通过调节机体的免疫机制,有利于口腔黏膜细胞的修复,巩固疗效,减少复发,疗效满意。