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.