bromochloroacetic-acid and Lichen-Planus--Oral

In earlier work, we demonstrated that 0.1 p. 100 topical tretinoin is clinically effective and well tolerated compared with placebo for the treatment of oral leukoplakia and oral keratosic or erythematous lichen planus. Here we aimed to complete this clinical protocol with histological and biochemical analyses comparing the biopsy specimens collected at inclusion and those collected after 4 months of treatment. Histological results were based on changes in keratinization observed between onset of treatment and 4 months treatment. Biochemical studies included the use of antibodies (anti-cytokeratins 10-11, anti-filaggrine) for the immunohistochemical evaluation of keratinization and 2-dimensional gel electrophoresis for measuring cytokeratins. In patients with lichen planus, histological changes during treatment showed that, in the 10 patients in the tretinoin group, keratinization disappeared in 6 and decreased significantly in 3. Immunohistochemistry revealed that cytokeratins 10-11 and filaggrin disappeared in 57 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the patients given placebo. Bidimensional gel electrophoresis showed that cytokeratins 1, 2, 10 and 11 disappeared only in the tretinoin group (60 p. 100 of the cases). In patients with leukoplakia, histological changes during treatment showed that, in the tretinoin group, keratinization disappeared in 5 cases and decreased in 5 others. Immunohistochemistry revealed that cytokeratins 10-11 disappeared in 30 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the placebo group. Bidimensional electrophoresis demonstrated that cytokeratins 1, 2, 10 and 11 disappeared in 43 p. 100 of the patients treated with tretinoin.

Topics: Administration, Topical; Electrophoresis, Gel, Two-Dimensional; Filaggrin Proteins; Humans; Immunohistochemistry; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Mouth Mucosa; Treatment Outcome; Tretinoin

Oral lichen planus (OLP) is one of the most prevalent oral mucosal diseases, but there is no cure for OLP yet. The aim of this study was to gain insights into the role of barrier dysfunction and infection in OLP pathogenesis through analysis of transcriptome datasets available in public databases. Two transcriptome datasets were downloaded from the Gene Expression Omnibus database and analyzed as whole and as partial sets after removing outliers. Differentially expressed genes (DEGs) upregulated in the dataset of OLP versus healthy epithelium were significantly enriched in epidermal development, keratinocyte differentiation, keratinization, responses to bacterial infection, and innate immune response. In contrast, the upregulated DEGs in the dataset of the mucosa predominantly reflected chemotaxis of immune cells and inflammatory/immune responses. Forty-three DEGs overlapping in the two datasets were identified after removing outliers from each dataset. The overlapping DEGs included genes associated with hyperkeratosis (upregulated LCE3E and TMEM45A), wound healing (upregulated KRT17, IL36G, TNC, and TGFBI), barrier defects (downregulated FRAS1 and BCL11A), and response to infection (upregulated IL36G, ADAP2, DFNA5, RFTN1, LITAF, and TMEM173). Immunohistochemical examination of IL-36γ, a protein encoded by one of the DEGs IL36G, in control (n = 7) and OLP (n = 25) tissues confirmed the increased expression of IL-36γ in OLP. Collectively, we identified gene signatures associated with hyperkeratosis, wound healing, barrier defects, and response to infection in OLP. IL-36γ, a cytokine involved in both wound repair and antimicrobial defense, may be a possible therapeutic target in OLP.

Topics: Adult; Aged; Cell Differentiation; Cytokines; Down-Regulation; Female; Gene Expression Profiling; Gene Expression Regulation; Humans; Immunity, Innate; Immunohistochemistry; Keratins; Lichen Planus, Oral; Male; Middle Aged; Receptors, Interleukin-1; Transcriptome; Up-Regulation; Wound Healing

Oral lichen planus (OLP) characterized by interface mucositis frequently shows hyper-keratinization. To clarify mechanisms of excess keratinization, we investigated key molecules for cornified cell envelope (CE).. Involucrin (IVL), loricrin (LOR), transglutaminase 1 (TGase 1) and transglutaminase 3 (TGase 3) were immunohistochemically examined in 20 specimens of OLP; five specimens of buccal mucosa served as controls. Subsequently, the data were statistically analyzed.. IVL in OLP was localized in the cell membrane, in contrast to its localization in the cytoplasm in controls. No positive reaction indicative of LOR was noted in any specimens. Although the TGase 1 localization in controls was restricted to the upper three-quarters of the membrane, the localization in OLP was in both membrane and in the cytoplasm of full thickness mucosal layers. The TGase 3 localization pattern was dramatically altered from cytoplasmic to membranous in OLP.. Our data suggest that aberrant TGase 1 and TGase 3 localization and distribution are closely related to hyper-keratinization in OLP. This is the first report of ectopic transglutaminase localization in OLP.

Topics: Cell Membrane; Epithelium; Humans; Intracellular Space; Keratins; Lichen Planus, Oral; Middle Aged; Protein Precursors; Transglutaminases

The aim of this study was to optimize the culture system of keratinocytes obtained from patients with oral lichen planus (OLP) and verify whether this model could simulate the local inflammatory environment of OLP.. Keratinocytes were isolated from 48 patients with OLP and cultured in vitro. The ultrastructure of OLP keratinocytes was observed via electron microscopy. The expression of pancytokeratin and vimentin was determined by immunohistochemistry, and the proliferation of OLP keratinocytes was measured by CCK-8 assay. Immunofluorescence staining was used to detect TLR4 and NF-κB p65 expression, and the levels of IL-1β, IL-6, and TNF-α in the supernatant were measured by ELISA.. When seeded in plates precoated with recombinant human type-1 collagen, keratinocytes isolated from patients who received systemic antifungal treatment and were younger than 40 years were more successful to be cultured in vitro. Characteristic pancytokeratin was expressed in almost all OLP keratinocytes. Compared with normal oral keratinocytes, OLP keratinocytes demonstrated higher levels of TLR4/NF-κB p65 and inflammatory cytokines, including IL-1β, IL-6, and TNF-α.. We successfully optimized the culture system of OLP keratinocytes,which mimicked the local inflammatory environment of OLP and may be used as a cell model of OLP.

Topics: Adolescent; Adult; Age Factors; Aged; Antifungal Agents; Case-Control Studies; Cell Proliferation; Cytokines; Female; Humans; Inflammation; Keratinocytes; Keratins; Lichen Planus, Oral; Male; Microscopy, Electron; Middle Aged; Primary Cell Culture; Toll-Like Receptor 4; Transcription Factor RelA; Vimentin; Young Adult

The Merkel cell-neurite complex initiates the perception of touch and mediates Aβ slowly adapting type I responses. Lichen planus is a chronic inflammatory autoimmune disease with T-cell-mediated inflammation, whereas hyperkeratosis is characterized with or without epithelial dysplasia in the oral mucosa. To determine the effects of lichen planus and hyperkeratosis on the Merkel cell-neurite complex, healthy oral mucosal epithelium and lesional oral mucosal epithelium of lichen planus and hyperkeratosis patients were stained by immunohistochemistry (the avidin-biotin-peroxidase complex and double immunofluorescence methods) using pan cytokeratin, cytokeratin 20 (K20, a Merkel cell marker), and neurofilament 200 (NF200, a myelinated Aβ- and Aδ-nerve fibre marker) antibodies. NF200-immunoreactive (ir) nerve fibres in healthy tissues and in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis were counted and statistically analysed. In the healthy oral mucosa, K20-positive Merkel cells with and without close association to the intraepithelial NF200-ir nerve fibres were detected. In the lesional oral mucosa of lichen planus and hyperkeratosis patients, extremely rare NF200-ir nerve fibres were detected only in the lamina propria. Compared with healthy tissues, lichen planus and hyperkeratosis tissues had significantly decreased numbers of NF200-ir nerve fibres in the oral mucosal epithelium. Lichen planus and hyperkeratosis were associated with the absence of Aβ-nerve endings in the oral mucosal epithelium. Thus, we conclude that mechanosensation mediated by the Merkel cell-neurite complex in the oral mucosal epithelium is impaired in lichen planus and hyperkeratosis.

Topics: Humans; Immunoenzyme Techniques; Keratins; Keratosis; Lichen Planus, Oral; Merkel Cells; Microscopy, Confocal; Mouth Mucosa; Nerve Endings; Neurites

The aim of this study was to establish a stable in vitro culture system for keratinocytes obtained from oral lichen planus (OLP) lesions and evaluate cultured keratinocyte characteristics including cell morphology, ultrastructure, and expression of biomarkers.. OLP mucosa (histopathologically confirmed) was collected and cells isolated using the cold enzyme digestion method. Primary culture and serial passage were performed on serum-free keratinocyte medium. Morphological changes of cells were evaluated via inverted phase contrast microscopy, and cellular ultrastructure was observed by electron microscopy. Indirect immunofluorescence was used to detect expression of keratin and nuclear factor-kappaB (NF-κB).. OLP type I keratinocytes was successfully cultured in vitro in serum-free medium. Cellular morphology was typically polygonal during the growth phase. Cells could be passaged continuously for five to six generations without losing viability. Transmission electron microscopy showed large nuclei and multiple vacuoles in the cultured cells consistent with histopathological features of OLP keratinocytes. Indirect immunofluorescence staining was positive for keratin and NF-κB.. This study established that human OLP kera-tinocytes can be successfully cultured cells with histopathologic features and biomarker expression consistent with OLP type I keratinocytes.. This culture system lays a foundation for the establishment of human OLP cell model in vitro.

Topics: Cell Proliferation; Cells, Cultured; Humans; Keratinocytes; Keratins; Lichen Planus, Oral

Heat-shock protein 27 (hsp27) has been implicated in several biological events. In this experimental study, we aimed at analysing, for the first time, the expression of hsp27 in the diverse stages of oral lichen planus (OLP) lesions.. Thirty-six biopsy specimens of patients with OLP and 10 of healthy patients were selected. OLP specimens were divided into three groups: G1 - moderate or mildly active OLP; G2 - active or moderately active atrophic OLP; G3 - mild or inactive atrophic OLP. Hsp27 expression was analysed by immunohistochemistry (staining intensity and percentage of stained cells), and results of staining were compared between the different groups. Gender, age and anatomical location were also studied.. In the basal layer, an increase of hsp27 expression in both G2 and G3 was observed when compared to G1 and control group. In contrast, a decrease of hsp27 expression in the superficial layer was observed in all groups when compared to control group.. The increased expression of Hsp27 in the basal layer observed during the OLP evolution and the less staining in the superficial layers in all cases of OLP suggest that hsp27 may have a role in the OLP pathogenesis.

Topics: Adult; Atrophy; Biopsy; Cell Nucleus; Coloring Agents; Cytoplasm; Epithelium; Female; HSP27 Heat-Shock Proteins; Humans; Immunohistochemistry; Keratins; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Tongue

Aberrant keratinization is common in oral lichen planus (OLP) on buccal mucosa. Because elastin is crucial for maintaining the nonkeratinized phenotype of oral mucosa, we examined whether inflammatory elastases and the accompanying elastolysis were related to this feature.. Protein and mRNA levels of keratinization-associated keratins (K1/10), nonkeratinization-associated keratins (K4/13), elastin, neutrophil elastase, and macrophage metalloelastase (MMP-12) were compared between normal alveolar mucosa and reticular OLP from buccal mucosa. Normal alveolar mucosae were cultured ex vivo on an organ culture system with and without elastase treatment. After 14 days, the mucosae were examined for 4 keratin expressions.. The expressions of K1/10 and elastases increased, whereas those of K4/13 and elastin decreased in OLP. The nonkeratinized mucosa in the organ culture began to express K1/10 when elastase degraded the inherent elastin.. Our study demonstrated that elastolysis in reticular OLP may be related to its aberrant keratinization.

Topics: Elastin; Gene Expression; Humans; Keratins; Leukocyte Elastase; Lichen Planus, Oral; Matrix Metalloproteinase 12; Mouth Mucosa; Paraffin Embedding

Adequate brushing of oral mucosa is important for accurate human papillomavirus (HPV) detection in potentially malignant (oral leukoplakia [OL], oral lichen planus [OLP]) and malignant (oral squamous cell carcinoma [OSCC]) lesions. Since various factors may limit the adequacy of oral brushing and, consequently, the accuracy of HPV detection, modified sampling procedures should be evaluated for their effect on HPV frequency and/or types detected.. To compare the HPV frequency in samples obtained by brushing the lesion site with the frequency in samples obtained by brushing an apparently normal adjacent site. The correlation between HPV frequency and keratinization of the site affected by the lesion, as well as sociodemographic variables (age, sex, smoking and drinking habits), was also examined.. HPV DNA was detected in brushing samples from 50 patients with OL, 49 with OLP, and 17 with OSCC. Polymerase chain reaction (PCR) amplification was performed by MY09/MY11 and GP05+/GP06+ primers; the HPV type was identified by DNA sequencing and a reverse hybridization (line probe) assay. Data were analyzed by the Z test, the Fisher's exact test, the chi-square test, odds ratio (OR), and a logistic regression model.. HPV DNA was detected in 22% of samples from lesion sites and in 16% of samples from adjacent sites (p = 0.22) in patients with OL, in 24.5% and 22.4% of samples from lesion and adjacent sites, respectively, in patients with OLP (p = 0.40), and in 35.3% and 41.2% of samples from lesion and adjacent sites, respectively, in patients with OSCC (p = 0.36). Lesions adjacent to HPV-positive normal sites had an increased rate of HPV detection (OR = 30; 95% CI 9.57, 94.1). HPV-18 was the most frequent genotype, followed by HPV-6, -16, -33, and -53. HPV prevalence was reduced in lesions at keratinized sites (14.5%) compared with non-keratinized sites (34.4%; p = 0.007; OR = 0.32; 95% CI 0.13, 0.81).. In patients with OL, OLP, or OSCC, a high prevalence of HPV infection was shown in apparently normal sites adjacent to lesion sites infected by HPV. The lower HPV frequency in lesions at keratinized sites suggests that HPV detection by lesion brushing is affected by keratinization. The keratinized epithelium may be less susceptible to HPV infection or, alternatively, the highly proliferative activity in non-keratinized sites may predispose to HPV infection.. Results from this study indicate that taking samples from normal sites adjacent to oral lesions may be of value in HPV detection, particularly when the lesions are located at keratinized sites. This sampling procedure may allow more accurate diagnosis of HPV infection compared with sampling only the lesion site, and may also represent a reliable method to investigate the biological characteristics of HPV infection and related oral carcinogenesis.

Topics: Alphapapillomavirus; Carcinoma, Squamous Cell; DNA, Viral; Female; Humans; Keratins; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Papillomavirus Infections

The aim of this study was immunolabeling oncoproteins Ck14, p53, p21 and Bcl-2 in order to evaluate their expression in premalignant and malignant stomatological lesions in oral epithelial, and to compare this expression with exfoliative cytology alterations in the same patients. It was studied biopsies and cytologies of 13 subjects with oral lichen planus, with or without Human Papilloma Virus (HPV), leukoplakia and squamous cell carcinoma clinically diagnosed and confirmed by anatomopathological studies. The oral lichen planus lesion presented binuclei orange cells; and in leukoplakia lesions only orange stained was observed; meanwhile koilocytes, inflammatory cells, enlarge nuclear volume and pathogenic microorganisms were observed in the HPV infections and squamous cells carcinoma (SCC). The Ck14, p53, p21 and Bcl-2 proteins were found modified in the leukoplakia, oral lichen planus and cancer. Cytological alterations and positive immunolabeling or over-expression of Ck14 cytokeratine in the upper epithelial stratus should be indicator of malignant transformations as doing subsequence exams.

Topics: Adult; Aged; Carcinoma, Squamous Cell; Case-Control Studies; Cytodiagnosis; Female; Humans; Immunohistochemistry; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Neoplasm Proteins; Papillomaviridae; Prognosis; Proto-Oncogene Proteins c-bcl-2; Proto-Oncogene Proteins p21(ras); Tumor Suppressor Protein p53

The aim of this exploratory study was to assess the efficacy of a natural metabolite of vitamin A, retinaldehyde 0.1%, vehicled in a gel in 17 patients with oral lichen planus and in 13 patients with oral leukoplakia, twice daily for 2 months. Our investigation was clinical, histological, immunohistochemical through the expression of markers of cell terminal differentiation and biochemical by using two-dimensional gel electrophoresis of cytokeratins (CK). In addition, the activity of retinaldehyde was studied ex vivo on surviving buccal mucosa. Retinaldehyde gel 0.1% showed good clinical efficacy, resulting in 6% disappearance and 82% improvement of the lesions in lichen planus and 17% disappearance and 75% improvement in leukoplakia. This was confirmed with immunohistochemistry, which revealed down-regulation of filaggrin and CK-10 as markers of terminal differentiation in both diseases. The effects of retinaldehyde in these two diseases were further demonstrated in the ex vivo surviving mucosal model, resulting in histological disappearance of keratinization in 80% of the lichen planus fragments and 40% of the leukoplakia fragments, associated with down-regulation of filaggrin and CK-10.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Biopsy; Female; Filaggrin Proteins; Humans; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Male; Middle Aged; Retinaldehyde

The expression of proliferating cell nuclear antigen (PCNA), cytokeratin 16 (ck16) and Ag nucleolar organizer regions (AgNORs) were assessed in 20 cases of lichen planus, 20 cases of keratosis and 20 cases of normal oral mucosa in order to evaluate the rate of keratinocyte proliferation in these tissues. Three hundred cells were counted in each sample: 100 basal cells, 100 suprabasal cells and 100 squamous cells. The mean number of AgNORs and the percentage of PCNA positive cells were calculated. Except from similar staining of suprabasal cells of lichen planus and keratosis, PCNA and AgNORs values were higher in all layers of lichen planus than in both keratosis and normal oral mucosa. The three groups showed similar ck16 immunostaining: all of the cells were positive, except those of the basal layer. The results suggest that the keratinocyte proliferation index is higher in lichen planus than in keratosis and normal mucosa. Besides, ck16 should not be used to differentiate the entities studied.

Topics: Adult; Aged; Cell Division; Female; Humans; Immunoenzyme Techniques; Keratinocytes; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Nucleolus Organizer Region; Observer Variation; Proliferating Cell Nuclear Antigen; Reproducibility of Results; Silver Staining; Statistics as Topic

Gene expression for the differentiation-specific keratins (K4, K13, K1 and K10) was analyzed in oral non-dysplastic keratoses, oral lichen planus (OLP) and lichenoid reactions (LR) by comparative in situ hybridization (ISH) and immunohistochemistry (IHC) to investigate molecular changes in the altered differentiation pattern from non- to para- or orthokeratinization. At the protein level, K4 and K13 were detected homogeneously in the suprabasal compartment of parakeratotic epithelium but showed reduced expression in orthokeratoses, particularly in the presence of lymphocytes. Corresponding transcripts were restricted to basal and lower prickle cells. Synthesis of K1 and K10 was upregulated and more pronounced in orthokeratotic epithelia. The study showed an alteration in the pattern of differentiation-specific keratins, although involvement of the lymphocytic infiltrate in OLP and LR resulted in further gene modulation. In both diseases, K1 and K10 showed transcriptional control, proteins having the same distribution as their transcripts. This represented a change from post-transcriptional regulation in normal buccal epithelium, in which mRNAs for K1 and K10 are more widely expressed than their proteins. Thus, the pattern of keratin gene expression may be altered in response to frictional/smoking stimuli or immune-mediated mechanisms.

Topics: Cell Differentiation; Epithelium; Gene Expression Regulation; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; In Situ Hybridization; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Lichenoid Eruptions; Lymphocytes; Mouth Diseases; Mouth Mucosa; Parakeratosis; RNA Processing, Post-Transcriptional; RNA, Messenger; Transcription, Genetic; Up-Regulation

The expression of heat shock proteins HSP60 and HSP70 and cytokeratins CK1/10 and CK7/18 were compared in epithelium of oral lichen planus (OLP) lesions and oral fibromas using an avidin-biotin-peroxidase complex (ABC) immunohistochemical method. An immunostaining intensity distribution (IID) index was developed to assess staining intensity and the proportion of positively stained cells in different layers of the epithelium. The expression of HSP60 in the basal layer was significantly higher in OLP than in fibromas. No difference in HSP70 expression was evident between OLP and fibromas. The expression of CK1/10 in the epithelial basal and suprabasal layers was significantly higher in OLP than in fibromas. There was no demonstrable staining for CK7/18 in either OLP or fibromas. A significant correlation was evident between the expression of HSP60 and CK1/10 in the basal epithelial cells in OLP. The findings support a role for HSP60 in the pathogenesis of OLP. A unifying hypothesis of the pathogenesis of OLP, involving two sequential immune reactions, is proposed.

Topics: Adult; Basement Membrane; Chaperonin 60; Epithelial Cells; Fibroma; Genetic Predisposition to Disease; HSP70 Heat-Shock Proteins; Humans; Immunoenzyme Techniques; Keratins; Lichen Planus, Oral; Middle Aged; Mouth Neoplasms; Odds Ratio; Statistics, Nonparametric

Immunohistochemistry with monospecific antibodies was used to study the expression patterns of cytokeratins (Cks) and vimentin in non-dysplastic lesions of the oral cavity, including lichen planus and fibromas. In hyperplastic lesions, Ck expression did not deviate significantly from the normal non-keratinizing squamous epithelium of the oral cavity. Hyperkeratotic lesions showed pronounced aberrations in their Ck profile. These lesions were characterized by extended expression of the keratinization marker Ck 10, the basal cell Ck 14 and the hyperproliferation-associated Ck 16 in the suprabasal compartment. The stratification markers Cks 4 and 13 showed a decreased expression. Coexpression of Cks and vimentin was found in lesions having accumulations of inflammatory cells in the subepithelial cell layer. These changes are felt to characterize benign mucosal lesions without dysplasia and might be helpful for distinguishing these lesions from potentially malignant ones.

Topics: Antibodies, Monoclonal; Cell Division; Epithelial Cells; Epithelium; Fibroma; Gene Expression Regulation; Humans; Hyperplasia; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Vimentin

Smears of buccal mucosa, dorsal surface of the tongue and floor of mouth were taken from 10 patients with histologically confirmed oral lichen planus and 12 healthy age- and sex-matched controls. In buccal smears, no significant differences in cytoplasmic and nuclear areas were observed between lesional, adjacent non-lesional and control tissues. However, the cytoplasmic area in smears from lichen planus lesions on the dorsum of the tongue and adjacent clinically normal mucosa was reduced compared with healthy controls. The cytoplasmic: nuclear ratio in smears from clinically normal floor of mouth in oral lichen planus was similarly reduced. Papanicolaou-stained smears from buccal lichen planus showed increased keratinization compared with normal buccal mucosa. These findings demonstrate that quantitative cytology can detect both cytoplasmic and nuclear changes in oral lichen planus.

Topics: Adult; Aged; Case-Control Studies; Cell Nucleus; Coloring Agents; Cytoplasm; Eosine Yellowish-(YS); Female; Fluorescent Dyes; Hematoxylin; Humans; Keratins; Lichen Planus, Oral; Male; Middle Aged; Mouth Floor; Mouth Mucosa; Tongue; Tongue Diseases

Two biopsy specimens showed unusual histology characterized by features consistent with resolving oral lichen planus and voluminous, finely granular cells in the lamina propria, resembling the cells of granular cell tumour. Immunocytochemistry and lipid-pigment histochemistry indicated that the granular cells are macrophages of low proliferative activity laden with early ceroid. It is likely that damaged basal keratinocytes provide debris for the formation of the latter. "Oral ceroid granuloma' would be an appropriate term for collections of such reactive macrophages occurring in the oral tissues.

Topics: Adult; Ceroid; Cytoplasmic Granules; Female; Humans; Keratins; Lichen Planus, Oral; Lipofuscin; Macrophages; Middle Aged; Staining and Labeling

The purpose of this investigation is to examine the possible biochemical and topographic cytokeratin alterations in lichen planus of oral mucosa. Biopsy samples of clinically normal buccal mucosa (n = 5), normal gingiva (n = 5), lichen planus from buccal mucosa (n = 5), and lichen planus from gingiva (n = 5) were obtained from patients of both sexes. Cytokeratin expression was determined by means of immunohistochemical labeling with use of a battery of monoclonal antibodies against cytokeratins and filaggrin and two-dimensional gel electrophoresis. In buccal mucosa, which is not keratinized cytokeratins 4 and 13 are expressed in the majority. In buccal mucosa lichen planus, the appearance of cytokeratins 1, 2, 10, and 11 coincides with a decrease in cytokeratins 4 and 13 and a moderate increase in cytokeratins 6, 16, 17, and 19. In normal gingiva, which is normally keratinized, the main cytokeratins are 1, 2, 10, and 11. In gingival lichen planus, a slight decrease in these cytokeratins and in cytokeratin 13 expression was noted. Finally, alterations in cytokeratins 5 and 14, explained by marked alterations of basal cells, were observed. The battery of antibodies used in this study, in correlation with two-dimensional gel electrophoresis, could represent useful diagnostic tools that enable the distinction between inflammatory keratosis and so-called quiescent lichen planus. Moreover, this work showed that cytokeratins 1, 2, 10, and 11 and filaggrin are sensitive tools that may help detect early relapse before clinical exacerbation. Finally, these biochemical techniques may be useful to follow the evolution of lichen planus under treatment.

Topics: Antibodies, Monoclonal; Diagnosis, Differential; Disease Progression; Electrophoresis, Gel, Two-Dimensional; Female; Filaggrin Proteins; Fluorescent Antibody Technique; Gingiva; Humans; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Male; Mouth Mucosa

50 patients with oral lichen planus (LP) were investigated for current anxiety and depression and for related personality factors. Anxiety levels, as measured on the Hospital Anxiety and Depression (HAD) Scale, were elevated in 50% of cases while depression scores, measured on the same scale, were low in all but a few. The sample profile showed a slight tendency towards anxiety, as measured by the Cattell 16 PF Questionnaire, but did not confirm previous reports of high intelligence and intellectual orientation. There were no statistically significant associations between erosive oral LP and either anxiety or depression, as measured on the HAD Scale, or anxiety as measured by the Cattell 16 PF Questionnaire.

Topics: Adult; Aged; Anxiety; Depression; Epithelium; Erythema; Female; Humans; Intelligence; Keratins; Lichen Planus, Oral; Lymphocytes; Male; Middle Aged; Personality; Personality Inventory; Ulcer

The keratin pattern in oral epithelia is related to the type of terminal differentiation observed morphologically (keratinization/nonkeratinization) and to the presence or absence of epithelial dysplasia. Furthermore, it has been suggested recently that inflammatory phenomena influence the keratin expression in human gingiva. The aim of the present study was to describe the keratin pattern in oral lichen planus (OLP) lesions, which are well known to be characterized by hyperkeratinization and severe inflammatory changes, in order to elucidate the role of inflammation in keratin expression of oral epithelia. Tissue sections were stained with antikeratin antibodies directed to groups of keratins (AE1 and AE2) and to single keratin proteins (Nos. 5, 8, 13, and 19). The keratin pattern in OLP lesions differed in some respects from that of leukoplakias and frictional keratoses as characterized in previous studies. No consistent patterns for use in a diagnostic context were found. However, the changes in OLP lesions did not mimic those previously described in inflamed gingival specimens and in oral epithelial dysplasias. Thus, the results encourage further studies on the potential diagnostic use of keratin expression in premalignant oral lesions. Furthermore, the study suggests that the inflammatory reaction seen in OLP lesions does not influence keratin expression in a way comparable with the suggested influence of inflammation in gingival specimens.

Topics: Antibodies, Monoclonal; Atrophy; Connective Tissue; Epithelium; Gingivitis; Humans; Keratins; Lichen Planus, Oral; Mouth Mucosa; Staining and Labeling