Cytokine profiles in serum of patients with oral lichen planus.

OBJECTIVE: Oral lichen planus (OLP) is a chronic inflammatory disorder of oral mucosa, which represents T-cell-mediated autoimmune diseases. The inflammatory response in OLP is characterized by the accumulation and expansion of T-helper 1 (Th1) lymphocytes. Several lines of evidence have suggested that a complex cytokine network plays an important role in the exacerbation and perpetuation of OLP. The aim of this study was to evaluate Th1 and T-helper 2 (Th2) cytokine profile in serum of patients with OLP in comparison to healthy controls. METHODS: Thirty patients with OLP, and 30 healthy controls participated in the study. Tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-5 and IL-10 levels have been measured in flow cytometry by bead based cytokine measurement. RESULTS: Although no statistical differences were observed in the serum levels of TNF-α, IFN-γ, IL-5 and IL-4 between OLP patients and controls (p>0.05), there were statistically significant differences in the serum levels of IL-2 and IL-10 (p<0.05 and p<0.01, respectively). A significantly decreased tendency towards the levels of IL-2 were observed in OLP patients when compared to controls (p<0.05), and the mean level of IL-10 in serum increased remarkably in the OLP patients than those in the controls (p<0.01). CONCLUSIONS: The finding of higher serum levels of IL-10 in patients in presence of low serum IL-2 levels, shows us that there is a dominance of Th2 response. This makes us think that there is a change in Th1/Th2 balance. Dominance of the Th2 response may indicate that OLP could be a result of a delayed type hypersensitivity.

Evaluation of cytotoxic T-cell activation, chemokine receptors, and adhesion molecules in blood and serum in patients with oral lichen planus.

BACKGROUND: Our purpose is to study cytotoxic T-cell activation (through evaluation of CD8+CD40+ and CD8+CD154+ cells), chemokine receptors (through evaluation of CD8+CD184+ and CD8+CD195+ cells), and adhesion molecules (through evaluation of CD8+CD152+ cells) which play a part in cell activation in blood and serum samples of patients with OLP and then to compare them with healthy controls. METHODS: Thirty patients with OLP, and 30 matched healthy controls participated. The mean ages of OLP patients and controls were 51,10 ± 12,25 and 48,09 ± 11,92, respectively. Percentage of apoptotic cells, granzyme-B+, CD8+, CD8+CD40+, CD8+CD152+ (CTLA-4), CD8+CD154+(CD40L), CD8+CD184+(CXCR-4) and CD8+CD195+(CCR-5) were detected by immunophenotyping on flow cytometry. Apoptosis measurements were accomplished with Annexin V/Propidium Iodide kit. RESULTS: A higher percentage of CD8+CD154+ and granzyme-B+ and a lower percentage of CD8+, CD8+CD184+ and apoptotic cells were found in OLP patients than in controls. No statistical differences were observed in the percentages of the other markers between groups. CONCLUSIONS: It is observed that because of increase in granzyme B+ and CD154 which is the activation marker, CD8+ cells present efforts to sustain their activity even though decrease in their cell number. Lower levels of CD8+CD184+ cells in OLP than control is evaluated as a factor that makes OLP to be localised in our study. In addition, our findings lead us to think that there may be some changes in apoptosis pathways of the cells. But this needs to be clarified by further studies exploring the mechanisms of the apoptosis in OLP patients.

Serum cytokine and T regulatory cell levels in patients with burning mouth syndrome.

BACKGROUND: Burning mouth syndrome is a disorder usually associated with an unexplained, prolonged sensation of burning inside the oral cavity. Although the etiology is unknown, neural and psychologic factors and cytokines may be implicated in the pathogenesis of burning mouth syndrome. The aim of this study was to investigate the relationship between serum cytokine and T regulatory cell levels in patients with burning mouth syndrome with regard to depression and anxiety. METHODS: Thirty patients with burning mouth syndrome and 30 matched controls participated in the study. Serum cytokine levels were measured with cytometric bead array and T regulatory cells were defined as CD4(+)CD25(+)Foxp-3(+) cells by flow cytometry. The level of anxiety and depression were analyzed by means of the Speilberger State-Trait Anxiety Inventory and Zung Self-Rating Depression Scale. Visual analogue scale was used in the quantification of burning levels of patients. RESULTS: Serum IL-2 and TNF-alpha levels were significantly decreased in patients with burning mouth syndrome compared with controls [mean 16.79 +/- 8.70 vs. 37.73 +/- 41.05 pg / ml (P < 0.05) and mean 39.09 +/- 29.40 vs. 70.83 +/- 42.44 pg / ml (P < 0.01) respectively]. CONCLUSIONS: IL-2 and TNF-alpha might play a role in burning mouth syndrome. Burning mouth syndrome may occur as a sign of predisposition to autoimmunity. Presence of low levels of CD28(+) supports the provision that BMS might be a pre-autoimmune disease.

Efficacy of moclobemide in burning mouth syndrome: a nonrandomized, open-label study.

AIMS: To compare burning mouth syndrome (BMS) patients with age- and gender-matched controls for psychologic conditions, to analyze the effect of menstrual state on the intensity of burning, and to assess the efficacy of an antidepressant medication on the burning pain and psychologic status. METHODS: Ninety-four patients with BMS and 94 matched control subjects participated in the study. Anxiety and depression were analyzed by means of the Spielberger State-Trait Anxiety Inventory and Zung Self-Rating Depression Scale, and the severity of the burning sensation was measured by means of a visual analog scale (VAS). In female BMS patients and controls, the menstrual state was noted (menstruating, menopausal, or postmenopausal). BMS patients were treated with the antidepressant moclobemide (150 mg 2 times daily) for 3 months. Thereafter, anxiety, depression, and burning pain intensity were reassessed. Patient-perceived satisfactory improvement for burning sensation was assessed using a 5-point categorical rating of change scale. RESULTS: BMS patients had significantly higher anxiety and depression scores than controls (P < .05). After treatment, anxiety and depression scores as well as the VAS values for burning pain decreased significantly (P < .001). Thirty-seven patients reported good to very good improvement, and 44 reported satisfactory improvement. No adverse reactions were reported. CONCLUSIONS: The study confirmed earlier reports that BMS patients have higher anxiety and depression levels than controls. An antidepressant medication may be effective in alleviating the burning pain, at least in the short-term.

Distribution and phospholipase activity of Candida species in different denture stomatitis types.

The aim of this study was to evaluate the correlation between frequency and phospholipase activity of Candida species and denture stomatitis according to Newton's classification. Seventy-five complete denture wearers were evaluated for the presence of yeasts on the palatal mucosa by culture method. In addition, the number of yeast isolates producing phospholipase and amount of this enzyme were determined using egg yolk agar plate method. According to Newton's classification, 25 denture wearers were with healthy palatal mucosa while 50 were with any types of denture stomatitis. The frequency of yeasts was linked to whether subjects had Type II or Type III, but not Type I denture stomatitis. Candida albicans was the most frequently isolated species in denture wearers with and without clinical signs of denture stomatitis and it was the only species produced phospholipase. Although the amount of phospholipase produced by the C. albicans isolates from denture wearers in control and Type II and III DS groups was not significantly different, there was statistically significant difference in the number of C. albicans isolates producing phospholipase between patients with and without clinical signs of DS.

Oral-clinical findings and management of epidermolysis bullosa.

Epidermolysis bullosa (EB) is a diverse group of disorders that have as a common feature blister formation with tissue occuring at variable depths in the skin and/or mucosa. This article reports two cases of EB and review oral-clinical findings of the EB types and approaches for managing the oral-clinical manifestations. While systemic treatment remains primarily palliative, it is possible to prevent destruction and subsequent loss of the dentition through appropriate interventions and dental therapy.