oral lichen planus

口腔扁平苔藓
  • 文章类型: Comparative Study
    目的:本研究评估了一种新型粘膜粘附贴剂与0.1%曲安奈德相比,含有10%紫花苜蓿提取物在缓解糜烂性萎缩性口腔扁平苔藓患者症状和降低病变严重程度方面的疗效。
    方法:一项包含两组的初步研究,每人有10个病人,进行了。干预组接受含有10%紫花苜蓿提取物的粘膜粘附贴剂,而对照组接受0.1%曲安奈德贴剂。疼痛和灼烧强度,通过视觉模拟量表测量,根据Thongprasom量表每周评估一次病变的严重程度,共4周。对副作用和患者满意度保留描述性记录。
    结果:两组在整个疗程中疼痛和灼烧强度均有所下降,紫花苜蓿组比曲安奈德组减少更多。各组内燃烧强度的降低是显著的(p<.001),仅在第二次会议中,组间存在显着差异(p=.045)。组间总体差异不显著(p>.05)。两组的病变严重程度也显著降低(p<.001),在第三次会议中(p=.043)和整个研究中(p=.006)观察到的各组之间存在显着差异。
    结论:在粘膜粘附贴剂中使用紫花苜蓿提取物在减轻疼痛方面与皮质类固醇一样有效,燃烧,口腔扁平苔藓患者的病变严重程度,在一些会议中表现出优异的结果。值得注意的是,使用紫花苜蓿没有观察到明显的并发症,使其成为扁平苔藓的一种有希望的治疗选择。
    OBJECTIVE: This study evaluates the efficacy of a novel mucoadhesive patch containing Nigella sativa 10% extract compared to triamcinolone 0.1% in alleviating symptoms and reducing lesion severity in patients with erosive-atrophic oral lichen planus.
    METHODS: A pilot study comprising two groups, each with 10 patients, was conducted. The intervention group received mucoadhesive patches containing N. sativa 10% extract, while the control group received triamcinolone acetonide 0.1% patches. Pain and burning intensity, measured through visual analog scale, and lesion severity based on the Thongprasom scale were assessed weekly for 4 weeks. Descriptive records were kept for side effects and patient satisfaction.
    RESULTS: Pain and burning intensity decreased in both groups throughout the sessions, with the N. sativa group showing a greater reduction than the triamcinolone group. The reduction in burning intensity within each group was significant (p < .001), and there was a significant difference between groups only in the second session (p = .045). The overall difference between groups was not significant (p > .05). Lesion severity also decreased significantly in both groups (p < .001), with a significant difference between groups observed in the third session (p = .043) and overall throughout the study (p = .006).
    CONCLUSIONS: The use of N. sativa extract in mucoadhesive patches was as effective as corticosteroids in reducing pain, burning, and lesion severity in patients with oral lichen planus, with N. sativa showing superior results in some sessions. Notably, no significant complications were observed with N. sativa use, making it a promising treatment option for lichen planus.
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)是一种常见的口腔黏膜疾病,病因不明,发病机制复杂。患有OLP的患者忍受以交替的非侵蚀性和侵蚀性病变为特征的慢性病程。目前尚无明确的治疗方法。特别具有挑战性的是治疗顽固性侵蚀性OLP,强调迫切需要针对特定致病途径的疗法。在像OLP这样的疾病中,病因错综复杂,难以捉摸,动物模型对于假设检验和阐明疾病机制是必不可少的。迄今为止,文献中只报道了三种用于口腔苔藓样病变的动物模型。这篇透视论文评估了这些现有的模型,以及在第三届国际口腔粘膜免疫和微生物组会议上介绍的新型OLP小鼠模型。这些模型的有效性受到严格评估,讨论了它们在促进我们对OLP的理解方面的潜在未来应用。
    Oral lichen planus (OLP) is a prevalent oral mucosal disease characterized by an unknown etiology and a complex pathogenesis. Patients with OLP endure a chronic course marked by alternating non-erosive and erosive lesions, with no definitive cure currently available. Particularly challenging is the treatment of recalcitrant erosive OLP, highlighting an urgent need for therapies targeting specific pathogenic pathways. In diseases like OLP, where the etiopathogenesis is intricate and elusive, animal models are indispensable for hypothesis testing and elucidating disease mechanisms. To date, only three animal models for oral lichenoid lesions have been reported in the literature. This Perspective paper evaluates these existing models, along with a novel OLP mouse model introduced at the 3rd International Conference on Oral Mucosal Immunity and Microbiome. The validity of these models is critically assessed, and their potential future applications in advancing our understanding of OLP are discussed.
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  • 文章类型: Journal Article
    背景:抗再吸收治疗(AR)会破坏骨稳态,并可引起对胃肠道粘膜的直接刺激;然而,它对口腔上皮可能的侵蚀作用尚未完全描述。在最常见的口腔糜烂病变中,口腔扁平苔藓(OLP)通常表现为疼痛的粘膜溃疡,由基底膜炎症损伤引起。因此,这项回顾性研究的目的是描述AR与OLP发病率之间的关系.
    方法:本病例对照研究包括148例患者的数据(17例接受AR治疗的患者(AR组)/131例未接受AR治疗的患者(对照组))。系统处理每个患者记录,并评估两组中AR药物与OLP临床特征之间的关联。
    结果:AR组OLP的侵蚀性明显高于对照组(p=0.029)。的确,使用阿仑膦酸的AR治疗(41.2%)是最常见的报道.此外,在OLP类型中,OLP的糜烂形式与疼痛和烧灼感的相关性最强(p<0.050)。然而,疾病恶化和AR消耗无显著相关性(p=0.150).
    结论:接受AR治疗的患者表现出更多与糜烂型OLP相关的临床症状。不管AR治疗如何,糜烂型OLP与更严重的症状相关。
    BACKGROUND: Antiresorptive therapy (AR) disrupts osseous homeostasis and can induce direct irritation over the gastrointestinal mucosa; however, its possible erosive effects on the oral epithelium have not been totally described. Among the most frequent oral erosive lesions, oral lichen planus (OLP) frequently presents as painful mucosal ulcerations, arising from basal membrane inflammatory damage. Thus, the aim of this retrospective study was to describe the association between AR and the incidence of OLP.
    METHODS: This case-control study included data from 148 patients (17 patients undergoing AR therapy (AR group) / 131 without AR therapy (Control group)). Each patient record was systematically processed and the association between AR drugs and OLP clinical characteristics within both groups was assessed.
    RESULTS: The erosive form of OLP was significantly more frequent in the AR group than in the Control group (p = 0.029). Indeed, the AR treatment using alendronic acid (41.2%) was the most frequently reported. Additionally, the erosive form of OLP showed the strongest association with pain and burning sensation among the OLP types (p < 0.050). However, disease worsening and AR consumption were not significantly associated (p = 0.150).
    CONCLUSIONS: Patients under AR therapy show more clinical symptoms associated to the erosive type of OLP. Regardless of the AR therapy, the erosive type of OLP is associated with more severe symptoms.
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  • 文章类型: Journal Article
    潜在恶性口腔上皮病变是一组口腔疾病,其正常粘膜衬里的形态状态发生改变,包括不同的病变,例如白斑,红斑,粘膜下纤维化,和扁平苔藓.
    比较口腔前病变的结果,包括粘膜下病灶内注射曲安奈德和透明质酸酶和手术切除。
    这是一项比较性的前瞻性介入研究,该研究是在2020年至2022年期间向耳鼻咽喉科就诊的50例口腔癌前病变患者中进行的。通过随机分配将患者分为两组,A组采用药物治疗,B组接受手术切除治疗,随访至少6个月,结果已分类。
    将所有患者分为A组和B组,A组由22名(44%)接受药物治疗的患者组成,B组包括28例(56%)接受手术切除的患者。在A组中,在8个(36.36%)和B组中观察到临床反应,18例(64.29%)患者出现临床缓解.
    与p值为0.0497的药物治疗(36.36%)相比,手术切除的临床反应更多(64.29%)更好,而恶性转化在药物治疗和手术治疗中几乎相等,分别为13.64%和14.28%。分别。
    UNASSIGNED: Potentially malignant oral epithelial lesions are a group of oral conditions with an altered morphological state of the normal mucosal lining and include different lesions such as leukoplakia, erythroplakia, submucosal fibrosis, and lichen planus.
    UNASSIGNED: To compare the outcome of premalignant oral lesions after medical therapy consisting of submucosal intralesional injection of triamcinolone with hyaluronidase and surgical excision.
    UNASSIGNED: This was a comparative prospective interventional study and the study was conducted among 50 patients presented to the Department of Otorhinolaryngology with premalignant oral lesions from the year 2020 to 2022. Patients were divided into two groups by random allocation, group A was treated with medical therapy, and Group B was treated with surgical excision and followed for a minimum of 6 months and the outcome has been categorized.
    UNASSIGNED: All patients were divided into two groups-group A and group B, group A consisted of 22 (44%) patients who were given medical therapy, and group B consisted of 28 (56%) patients who underwent surgical excision. In group A, the clinical response was seen in 8 (36.36%) and in group B, the clinical response was seen in 18 (64.29%) patients.
    UNASSIGNED: Surgical excision was found to be better with more cases of clinical response (64.29%) when compared to medical treatment (36.36%) with a p value of 0.0497 which is significant whereas malignant transformation was almost equal in medical therapy and surgical treatment which was 13.64% and 14.28%, respectively.
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)是一种T细胞介导的慢性炎症性疾病,被归类为口腔潜在恶性疾病(OPMD),并增加了向口腔癌的转化风险。口腔苔藓样反应(OLR)与OLP的临床表现相同。本研究旨在确定与健康对照相比,OLP和OLR的组织形态变化。这有助于计划建立诊断标准。
    这项横断面前瞻性研究是对总共75个组织包埋的石蜡块样品进行的,包括OLPs(n=25),OLR病例(n=25),和健康对照个体(n=25)。通过卡方比较研究组,费希尔的精确,和单向方差分析测试。小于0.05的p值被认为是统计学上显著的。
    细胞核面积和细胞面积的比较显示,研究组在基底层和副基底层中的差异具有统计学意义(P<0.05)。核质比的比较显示,在基础区域(P<0.05)中,研究组之间的差异具有统计学意义(P=0.681)。
    我们在细胞核和细胞区域显示出显著差异,OLP和OLR之间的核质比,和健康的控制,但是OLP和OLR之间没有统计学上的显着差异。因此,这些参数不能用于区分OLP和OLR之间的诊断。
    UNASSIGNED: Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory disease classified as an oral potentially malignant disorder (OPMD) and increased transformation risk to oral cancer. Oral lichenoid reactions (OLRs) share the clinical manifestations of OLP. This study aimed to determine histomorphometric changes in OLPs and OLRs in comparison to the healthy control, which helps to plan for the establishment of diagnostic criteria.
    UNASSIGNED: This cross-sectional prospective study was conducted on a total of 75 tissue-embedded paraffin-block samples, including OLPs (n = 25), OLR cases (n = 25), and healthy control individuals (n = 25). The study groups were compared by chi-squared, Fisher\'s exact, and one-way ANOVA tests. A p-value less than 0.05 was considered statistically significant.
    UNASSIGNED: Comparison of the nuclear area and cellular area showed a statistically significant difference between study groups in basal and parabasal layer (P < 0.05). Comparison of the nuclear-to-cytoplasm ratio showed a statistically significant difference between study groups in basal (P < 0.05) but not in the parabasal region (P = 0.681).
    UNASSIGNED: We showed a significant difference in the nuclear and cellular area, nuclear-to-cytoplasm ratio between OLPs and OLRs, and healthy controls, but there was no statistically significant difference between OLPs and OLRs. Thus, these parameters cannot be applied to differentiate diagnoses between OLPs and OLRs.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    背景:虽然观察性研究和实验数据表明口腔扁平苔藓(OLP)与口腔癌(OCC)之间存在联系,因果关系和炎性细胞因子的作用尚不清楚.
    方法:本研究采用单变量和多变量孟德尔随机化(MR)分析来研究OLP与OCC风险之间的因果关系。此外,探讨了炎性细胞因子在调节这种关联中的潜在作用.仪器变量来自FinngenR9数据集中与OLP相关的遗传变异(n=377,277),有41种炎性细胞因子作为潜在的介质,OCC(n=4,151)作为结果变量。分析方法包括方差加权反(IVW),加权中位数,MR-Egger,和MR-PRESSO用于评估OLP之间的因果关系,炎性细胞因子,和OCC风险。然后应用多变量MR(MVMR)来量化这些细胞因子在OLP和增加的OCC风险之间的关系中的介导作用。
    结果:MR分析提供了OLP(OR=1.417,95%CI=1.167-1.721,p<0.001)与OCC风险之间存在因果关系的有力证据。此外,两种炎症细胞因子受OLP显著影响,IL-13(OR=1.088,95%CI:1.007-1.175,P=0.032)和IL-9(OR=1.085,95%CI:1.005-1.171,P=0.037),已确定。随后的分析显示,仅在IL-13(OR=1.408,95%CI:1.147-1.727,P=0.001)和更高的OCC风险之间存在显着因果关系。将其确立为潜在的调解人。Further,MVMR分析显示IL-13(OR=1.437,95%CI=1.139~1.815,P=0.002)介导OLP与OCC的关系,占调解的8.13%。
    结论:这项研究不仅阐明了OLP与OCC风险之间的潜在因果关系,而且还强调了IL-13在这种关联中的关键中介作用。
    BACKGROUND: While observational studies and experimental data suggest a link between oral lichen planus (OLP) and oral cavity cancer (OCC), the causal relationship and the role of inflammatory cytokines remain unclear.
    METHODS: This study employed a univariable and multivariable Mendelian Randomization (MR) analysis to investigate the causal relationship between OLP and the risk of OCC. Additionally, the potential role of inflammatory cytokines in modulating this association was explored. Instrumental variables were derived from genetic variants associated with OLP (n = 377,277) identified in Finngen R9 datasets, with 41 inflammatory cytokines as potential mediators, and OCC (n = 4,151) as the outcome variable. Analytical methods including Inverse Variance Weighted (IVW), Weighted Median, MR-Egger, and MR-PRESSO were utilized to assess the causal links among OLP, inflammatory cytokines, and OCC risk. Multivariable MR (MVMR) was then applied to quantify the mediating effects of these cytokines in the relationship between OLP and increased OCC risk.
    RESULTS: MR analysis provided strong evidence of a causal relationship between OLP (OR = 1.417, 95% CI = 1.167-1.721, p < 0.001) and the risk of OCC. Furthermore, two inflammatory cytokines significantly influenced by OLP, IL-13 (OR = 1.088, 95% CI: 1.007-1.175, P = 0.032) and IL-9 (OR = 1.085, 95% CI: 1.005-1.171, P = 0.037), were identified. Subsequent analysis revealed a significant causal association only between IL-13 (OR = 1.408, 95% CI: 1.147-1.727, P = 0.001) and higher OCC risk, establishing it as a potential mediator. Further, MVMR analysis indicated that IL-13 (OR = 1.437, 95% CI = 1.139-1.815, P = 0.002) mediated the relationship between OLP and OCC, accounting for 8.13% of the mediation.
    CONCLUSIONS: This study not only elucidates the potential causal relationship between OLP and the risk of OCC but also highlights the pivotal mediating role of IL-13 in this association.
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  • 文章类型: Meta-Analysis
    炎症细胞因子长期以来被认为与口腔扁平苔藓(OLP)的发展密切相关,我们通过孟德尔随机化(MR)方法进一步探讨了两者之间的因果关系。
    我们通过大型全基因组关联研究(GWAS)进行了双向MR分析。数据包括一个大规模的OLP数据集,以及41种炎性细胞因子的数据集。所有数据均来自布里斯托尔大学数据库,其中包括41种炎症细胞因子,和GWAS目录数据库,其中包括91种炎性细胞因子。OLP数据来自Finngen数据库,其中包括6411例和405770例健康对照。我们使用了逆方差加权(IVW)方法,MR-Egger方法,加权中位数法,简单模态法和加权模态法分析炎性细胞因子与OLP之间的因果关系,并结合灵敏度分析进一步验证了结果的稳健性。我们对相同基因的阳性或潜在阳性结果进行了荟萃分析,以确认最终结果的可靠性。
    我们主要使用IVW分析方法,使用本杰明·霍奇伯格(BH)方法校正。当p<0.00038(0.05/132)时,结果是显著的因果关系;当0.00038OLP和一些炎性细胞因子之间存在因果关系,这可能在OLP的发病机制中起重要作用,需要进一步关注。
    Inflammatory cytokines have long been considered closely related to the development of oral lichen planus (OLP), and we further explored the causal relationship between the two by Mendelian randomization (MR) method.
    We performed bidirectional MR analyses by large genome-wide association studies (GWAS). The data included a large-scale OLP dataset, as well as datasets of 41 inflammatory cytokines. All data were obtained from the University of Bristol database, which includes 41 inflammatory cytokines, and the GWAS Catalog database, which includes 91 inflammatory cytokines. OLP data were obtained from the Finngen database, which includes 6411 cases and 405770 healthy controls. We used the inverse variance weighted (IVW) method, MR-Egger method, weighted median method, simple mode method and weighted mode method to analyze the causal relationship between inflammatory cytokines and OLP, and we also combined with sensitivity analysis to further verify the robustness of the results. We performed a meta-analysis of positive or potentially positive results for the same genes to confirm the reliability of the final results.
    We primarily used the IVW analysis method, corrected using the Benjamin Hochberg (BH) method. When p<0.00038 (0.05/132), the results are significantly causal; when 0.00038There is a causal association between OLP and some inflammatory cytokines, which may play an important role in the pathogenesis of OLP and require further attention.
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  • 文章类型: Randomized Controlled Trial
    背景:口腔扁平苔藓(OLP)是一种免疫起源的慢性疾病,通常以皮质类固醇作为金标准治疗。光生物调节(PBM)可能代表一种替代疗法,有可能通过减轻疼痛来治疗各种病理状况,减少炎症,促进组织愈合,而没有类固醇疗法的缺点。因此,本研究的目的是比较光生物调节和0.1%曲安奈德对糜烂性口腔扁平苔藓的影响。
    方法:这项随机对照临床试验包括44例口腔扁平苔藓患者。患者被分配到两组中的一组:对照组(n=22)接受0.1%的局部曲安奈德,每天3次,与咪康唑口服凝胶,每天一次,持续4周,和光生物调节组(n=22)接受980nm二极管激光的激光治疗,输出功率为300mW,每周两次,共5周(共10次)。在基线时对患者进行评估,6周,术后12周疼痛,临床评分,和唾液丙二醛水平的生化评价。使用Mann-Whitney检验分析所有记录的数据,以比较两个研究组的疼痛情况。病变大小,和唾液中丙二醛的含量.弗里德曼测试,接下来是事后测试,用于比较同一组内3个时期的基线数据,6周,和12周。
    结果:两组在疼痛和临床评分方面均有明显改善,它们之间没有统计学差异。此外,两组的唾液丙二醛水平均有显着改善,它们之间没有显著差异。
    结论:光生物调节可能是治疗糜烂性口腔扁平苔藓的一种有希望的治疗方式,而没有类固醇治疗的副作用。唾液丙二醛水平可用作评估疾病严重程度及其对治疗的反应的生物标志物。
    背景:该研究已在ClinicalTrials.gov(NCT05951361)(19/07/2023)注册。
    BACKGROUND: Oral lichen planus (OLP) is a chronic illness of immune origin that is typically treated with corticosteroids as a gold standard therapy. Photobiomodulation (PBM) may represent an alternative remedy that has the potential to treat a variety of pathological conditions by alleviating pain, reducing inflammation, and promoting tissue healing without the drawbacks of steroid therapies. Thus, the aim of the current study was to compare the effect of photobiomodulation to topical 0.1% triamcinolone acetonide on erosive oral lichen planus.
    METHODS: This randomized controlled clinical trial involved 44 patients complaining of erosive oral lichen planus. Patients were assigned to one of two groups: control group (n = 22) received 0.1% topical triamcinolone acetonide three times daily with miconazole oral gel once daily for 4 weeks, and photobiomodulation group (n = 22) received laser therapy by 980 nm diode laser utilizing output power 300 mW twice weekly for 5 weeks (a total of 10 sessions). The evaluation of patients was performed at baseline, 6 weeks, and 12 weeks postoperatively in terms of pain, clinical scores, and biochemical evaluation of salivary malondialdehyde levels. All recorded data were analyzed using Mann-Whitney test to compare the two studied groups regarding pain, lesion size, and salivary levels of malondialdehyde. Friedman test, followed by post hoc test, was used for comparison of the data within the same group along the 3 periods at baseline, 6 weeks, and 12 weeks.
    RESULTS: Both groups showed significant improvement in pain and clinical scores, with no statistical difference between them. Moreover, there was a significant improvement in salivary malondialdehyde levels for both groups, with no significant difference between them.
    CONCLUSIONS: Photobiomodulation could be a promising therapeutic modality for management of erosive oral lichen planus without the side effects of steroid therapy. The salivary malondialdehyde level could be used as a biomarker to evaluate the disease severity and its response to the treatment.
    BACKGROUND: The study has been registered at ClinicalTrials.gov (NCT05951361) (19/07/2023).
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)是一种影响皮肤和粘膜的自身免疫起源的慢性炎性疾病。这项研究的目的是评估红外热成像(IRT)作为口腔扁平苔藓(OLP)患者诊断工具的有效性。以及味觉障碍,在有和没有舌头参与的情况下。在87名患者的样本中进行了病例对照研究,分为三组:健康个体(对照组;n=43),无舌头受累的OLP患者(n=24),和OLP患者的舌头受累(n=20)。评估患者症状和病变的临床特征。使用IRT:背侧获得了舌头的四个热图像,左右侧面,和舌尖。一般味觉感知能力和主观甜味,酸,咸,在所有三组中评估苦味感觉。三组间IRT值差异无统计学意义(p≥0.05)。在舌头受累的OLP患者中,在疾病的混合形式中观察到显着更高的值(p=0.032)。有和没有舌头受累的OLP患者的味觉没有明显变化(p=0.69)。IRT可以作为评估OLP活动与舌头有关的补充工具。然而,在这个领域需要更多的研究。
    Oral lichen planus (OLP) is a chronic inflammatory disease of autoimmune origin that affects the skin and mucous membranes. The aim of this study was to assess the effectiveness of infrared thermography (IRT) as a diagnostic tool in patients with oral lichen planus (OLP), as well as disturbances in taste perception, in cases with and without tongue involvement. A case-control study was carried out in a sample of 87 patients divided into three groups: healthy individuals (controls; n = 43), OLP patients without involvement of the tongue (n = 24), and OLP patients with involvement of the tongue (n = 20). The patient symptoms and the clinical characteristics of the lesions were assessed. Four thermal images of the tongue were obtained using IRT: dorsum, right and left lateral surface, and tip of the tongue. General taste perception capacity and subjective sweet, acid, salty, and bitter sensation were evaluated in all three groups. There were no statistically significant differences in the IRT values among the three groups (p ≥ 0.05). In the OLP patients with involvement of the tongue, significantly higher values were observed in the mixed forms of the disease (p = 0.032). The OLP patients with and without involvement of the tongue showed no significant alterations in taste sensation (p = 0.69). IRT may serve as a complementary tool for assessing the activity of OLP with involvement of the tongue. However, more research is needed in this field.
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