Correlation of serum ANA and direct immunofluorescence studies in elderly Thai patients with red and white oral lesions.

OBJECTIVES: This study investigated the presence of serum antinuclear antibodies (ANA) profile and direct immunofluorescence (DIF) evaluation in elderly Thai patients with red and white oral lesions. MATERIALS AND METHODS: Thirty-two patients with red and white oral lesions were divided into two groups: group I consisted of 10 cases not taking medications, while group II consisted of 12 cases taking medications, and 30 healthy subjects as a control group. Blood samples were used to determine the ANA profile. DIF was investigated in the lesion containing groups. RESULTS: Serum ANA was found in six cases (60%) in group I, eight cases (66.7%) in group II, and 19 cases (63.3%) in the control group. There were no significant differences between group I and group II and the control group (P > 0.05). Serum ANA was most commonly found in patients taking hypolipidemics (80%), followed by antihypertensives (71.4%), NSAIDs (50%), hypoglycemics (50%), and others (66.7%). The anticytoplasmic staining frequency in group II was higher compared with group I and the control group. Anti-dsDNA antibodies were not found in any group. CONCLUSIONS: Elderly patients with red and white oral lesions who were taking medications had a higher serum ANA frequency than group I and the control group.

Oral lichenoid lesions and serum antinuclear antibodies in Thai patients.

OBJECTIVES: The aim of this study was to investigate the presence of serum antinuclear antibodies (ANA) in Thai oral lichenoid drug reaction (OLDR) and oral lichen planus (OLP) patients. MATERIALS AND METHODS: This study comprised 20 patients diagnosed with OLDR, 23 patients with OLP, and 24 healthy control subjects. Participants' blood samples were assayed for ANA staining patterns and serum ANA titer levels by immunofluorescence using human epithelial type 2 (HEp-2) as a substrate. The serum ANA titer levels were defined as low (1:40-1:80), medium (1:160-1:320), and high (>1:640). RESULTS: Serum ANA were detected in 73.9%, 70%, and 25% of OLP, OLDR, and control subjects, respectively. There was a statistically significant difference between the number of serum-ANA-positive subjects in the OLP or OLDR groups and the control group (P < 0.01), but no significant difference between the OLP and OLDR groups. The speckled pattern was the most commonly found staining pattern, present in 60.9%, 55.0%, and 20.8% of the OLP, OLDR, and control subjects, respectively. The number of subjects with low ANA titers in the OLP and OLDR groups was significantly higher than that of the control group (P < 0.01). Medium ANA titers were found in 15%, 4.4%, and 4.2% of the OLDR, OLP, and control subjects, respectively, while high ANA titers were not found in any group. CONCLUSIONS: The number of serum-ANA-positive OLP and OLDR patients was significantly higher than the control group. Speckled pattern and low titer levels were the most common findings in both OLP and OLDR groups.

Oral Candida carriage and immune status in Thai human immunodeficiency virus-infected individuals.

Oral candidiasis is a common opportunistic infection among human immunodeficiency virus (HIV)-infected individuals, with growing concerns about the emergence of non-albicans species with resistance to antifungal agents. This cross-sectional study determined the prevalence of oral Candida species in Thai HIV-infected adults and factors affecting their colonization. Candida species were identified from oral rinse samples of 60 HIV-infected participants of the MTCT-Plus initiative and 49 healthy controls by culture-based and molecular assays. The prevalence of oral Candida carriage was similar in HIV-infected patients (56.6 %) and in controls (55.1 %, P = 0.87). Candida albicans was the most predominant species in both groups (94.1 % of Candida carriers in HIV, 88.9 % in control). Interestingly, Candida dubliniensis was the second most common species in controls (29.6 %) and the third in HIV-infected patients (11.8 %, P = 0.08). Multivariate analysis showed that, amongst HIV-infected individuals, CD4 count <200 cells mm(-3) was associated with increased prevalence of oral carriage of both C. albicans (P = 0.03) and non-albicans species (P = 0.03). Moreover, patients with tuberculosis infection had a higher prevalence of the non-albicans species than those without (P = 0.03). Intriguingly, contraceptive use was also associated positively with non-albicans and multi-species carriage (P = 0.04 for both). However, use of antiretroviral drugs protected the patients from Candida carriage (P = 0.03), especially from C. albicans (P = 0.02). In conclusion, while HIV-infected individuals had a similar prevalence of oral Candida carriage to that of the control group, host immune status, tuberculosis infection, and contraceptive use may influence oral colonization of Candida, especially of the non-albicans species.

Immunoregulatory molecule B7-H1 (CD274) contributes to skin carcinogenesis.

B7-H1 (CD274), a member of the B7 family of coinhibitory molecules, is often induced in human tumors and its expression is closely correlated with a poor prognosis or higher malignancy grade. Tumor-associated B7-H1 is implicated in mechanisms of immune escape. Under inflammatory conditions, B7-H1 is also inducible in normal epithelial cells, but little is known about its involvement in the conversion of normal cells to tumor cells. We recently found that skin-specific expression of B7-H1 accelerates chemically induced carcinogenesis of squamous cell carcinoma (SCC), despite impaired skin inflammatory responses, in B7-H1 transgenic (B7-H1tg) mice. B7-H1tg-derived keratinocytes (KC) and SCCs exhibited a marked reduction of E-cadherin, and B7-H1tg-originated SCCs showed elevated expression of the transcription factors Slug and Twist, suggesting that B7-H1 overexpression in KCs promotes the epithelial-mesenchymal transition and accelerates carcinogenesis. This review discusses the diverse functions of B7-H1 in carcinogenesis and cancer progression, and considers future directions for developing cancer therapy targeting B7-H1.

A multicenter study of oral lichen planus in Thai patients.

AIM: Oral lichen planus is an oral mucosal disease that affects middle-aged patients. The characteristics of oral lichen planus in Thai patients from a multicenter were studied. METHODS: Data of 533 patients from the oral medicine clinics at Chulalongkorn and Mahidol (central Thailand), Chiang Mai (northern Thailand), and Khon Kaen (northeastern Thailand) universities during 2002-2007 were analyzed. The diagnosis of patients with oral lichen planus was clinically and/or histopathologically confirmed. RESULTS: There was a greater number of female patients than males (4:1). There were significant differences in age, sex, and some systemic diseases among the oral lichen planus patients from the three centers. Burning sensation was the most common symptom (72.9%), followed by pain (26.5%), roughness (6.4%), and then no other symptoms (7.9%). The most common site of lesions was found at the buccal mucosa (87.1%). Atrophic oral lichen planus was common in Thai patients. There were significant differences in the types of oral lichen planus, including reticular, atrophic, and ulcerative oral lichen planus among these patients from the three centers (P = 0.000). Nine cases (1.7%) showed dysplasia, but one case (0.2%) developed squamous cell carcinoma. CONCLUSION: Patients with oral lichen planus from the central, northern, and northeastern parts of Thailand presented with distinct characteristics. The malignant transformation of oral lichen planus was low in Thai patients.

Expression of IFN-gamma before and after treatment of oral lichen planus with 0.1% fluocinolone acetonide in orabase.

BACKGROUND: Oral lichen planus (OLP) is a common chronic inflammatory mucosal disease in which T-cell-mediated immune responses are implicated in the pathogenesis. The purpose of this study was to investigate the effect of 0.1% fluocinolone acetonide in orabase (FAO) on the in situ expression of IFN-gamma in patients with OLP. METHODS: Twenty OLP patients were enrolled in this study. Biopsy specimens and serum samples were obtained before and 1-month after the treatment with 0.1% FAO. In situ expression and serum levels of IFN-gamma were determined using immunohistochemistry and ELISA, respectively. RESULTS: The number of IFN-gamma-positive mononuclear cells in OLP lesions before the treatment was significantly higher as compared with that after the treatment. Similarly, the mean number of total mononuclear cells was clearly decreased after the treatment. However, the serum levels of IFN-gamma were not detectable. CONCLUSIONS: Our results suggest that IFN-gamma expression in OLP tissue may involve in the immunopathogenesis and the treatment with 0.1% FAO had an immunomodulating effect on the decrease of IFN-gamma.

The expression of B7-H1 on keratinocytes in chronic inflammatory mucocutaneous disease and its regulatory role.

PD-1 and its ligands, B7-H1/PD-L1 and B7-DC/PD-L2, have been identified recently as CD28-B7 family molecules that are implicated in immune regulation. Lichen planus (LP) is a T cell-mediated chronic inflammatory mucocutaneous disease. We investigated the expression and function of PD-1 and its two ligands in LP. Immunohistochemical examination revealed the abundant expression of PD-1 and B7-H1 in infiltrating T cells and macrophages, and lower-level expression of B7-DC on macrophages in the subepithelium. Interestingly, substantial expression of B7-H1 on keratinocytes (KCs) was found close to the numerous T cell infiltrates in the subepithelium. Unstimulated cultured KCs expressed both B7-H1 and B7-DC, and their expression was upregulated by proinflammatory cytokines, particularly IFN-gamma. The T-cell proliferative responses and IFN-gamma production that were induced by IFN-gamma-treated KCs were augmented preferentially by anti-B7-H1 mAb, but not by anti-B7-DC mAb. These results indicate the regulatory role of B7-H1 on KCs in the interactions with T cells. Our results suggest that the induction of B7-H1 on KCs may play an important role in tolerance induction in the inflamed oral mucosa and skin.