Oral lichen planus (OLP) is a chronic disease of uncertain etiology, although it is generally considered as an immune-mediated disease that affects the mucous membranes and even the skin and nails. Over the years, this disease was attributed to a variety of causes, including different types of microorganisms. This review analyzes the present state of the art of the disease, from a microbiological point of view, while considering whether or not the possibility of a microbial origin for the disease can be supported. From the evidence presented here, OLP should be considered an immunological disease, as it was initially proposed, as opposed to an illness of microbiological origin. The different microorganisms so far described as putative disease-causing agents do not fulfill Koch’s postulates; they are, actually, not the cause, but a result of the disease that provides the right circumstances for microbial colonization. This means that, at this stage, and unless new data becomes available, no microorganism can be envisaged as the causative agent of lichen planus.

/pdf/oral-lichen-planus-a-microbiologist-point-of-view-5g5ha2c23w.pdf

Oral lichen planus: a microbiologist point of view.

This case-control study aimed to investigate the expression of natural killer cells (NKCs) and the integrated optical density (IOD) of vascular endothelial growth factor (VEGF) and to quantify microvascular density (MVD) in endometrial biopsies from women with endometrial hyperplasia (EH) relative to normal subjects. Histological data from four groups were analyzed. The study population included 30 women with simple EH without atypia, 25 patients with complex EH without atypia, 25 with complex EH with atypia and 25 healthy women with non-hyperplastic endometrium (control group). Paraffin sections were immunostained with antibodies against CD56, VEGF-A and CD34 using an Avidin-Biotin-Peroxidase technique. The evaluation of NKC density and IOD of VEGF expression and measurement of MVD were performed using light microscopy examination and image analysis techniques. Increased numbers of NKCs were documented in cases of complex EH with atypia compared with the other groups (p<0.001). The number of NKCs was lower in cases of hyperplasia without atypia compared with the controls, but the difference was not significant. The IOD of VEGF-A and MVD increased significantly with progression from the non-hyperplastic endometrium through the three groups of EH (p<0.001). We observed a significant correlation between the MVD and the IOD of VEGF-A in the studied groups (r=0.434; p<0.001). Additionally, NKCs density was correlated significantly with IOD of VEGF-A (r=0.661; p<0.001) and with the MVD (r=0.473; p<0.001). These results suggest that NKC-count, IOD of VEGF and endometrial MVD are all related to the histological changes of the endometrium and that endometrial hyperplasia exhibits distinct immunological backgrounds in the context of NKC infiltration and VEGF production.

Enhanced expression of vascular endothelial growth factor and increased microvascular density in women with endometrial hyperplasia: a possible relationship with uterine natural killer cells

According to the latest statistics, oral squamous cell carcinoma is the 9th most common cancer to diagnose worldwide, especially in males and in the developing countries and cause for high mortality and morbidity. Oral potentially malignant disorders (OPMD's) are an important entity associated as precusors for most of these cases which are reversible. Hence, early detection of OPMD's can be very useful. Exfoliative cytology is a practically very easy and patient-friendly method to collect cells from these lesions. They can be subjected to a variety of analysis to help us detect oral cancer in advance. This review describes all the techniques have been used in early detection right from the conventional techniques to molecular diagnostics.

https://biblio.ugent.be/publication/8636005/file/8636006.pdf

The role of exfoliative cytology and molecular biology in oral potentially malignant disorders

Objectives
DNA aneuploidy has been reported to be a predictor of poor prognosis in both premalignant and malignant lesions. In oral lichen planus (OLP), this hypothesis remains to be proved. This study aimed to determine the rate of occurrence of DNA aneuploidy in patients with OLP by high-resolution DNA flow cytometry.

Methods
Patients with OLP were consecutively enrolled. Tissue samples were subdivided for formalin fixation and routine histological assessment and for immediate storage at −20°C for later DNA ploidy analysis, which was performed by DAPI staining of the extracted nuclei and excitation with a UV lamp. The DNA aneuploid sublines were characterized by the DNA Index.

Results
A DNA aneuploid status was observed in two of 77 patients with OLP (2.6%). When considering the clinical aspect of the OLP lesions, both DNA aneuploid cases had a reticular clinical aspect.

Conclusions
DNA aneuploidy is an uncommon event in OLP and less frequent compared to other non-dysplastic and non-OLP oral potentially malignant disorders. The extremely low rate of DNA aneuploidy could represent an occasional finding or reflect the low rate of malignant transformation observed in patients with OLP even if the real prognostic value of DNA ploidy analysis in patients with OLP remains to be confirmed.

High-resolution DNA content analysis of microbiopsy samples in oral lichen planus.

BACKGROUND AND AIM : Oral lichen planus (OLP) is a chronic, autoimmune, inflammatory disease. The progression of OLP to oral squamous cell carcinoma (OSCC) has generated a longstanding controversy about the details of this malignant transformation potential. This study aimed to do a systematic review on the molecular markers related to the malignant transformation of OLP. METHODS : We searched the databases PubMed, Google Scholar, Science Direct, Scopus, Cochrane and Thomson Reuters Web of Science (1990-2015) with the MeSH key words of: (“oral lichenoid reaction”, “oral lichenoid lesion”, “oral lichenoid eruption”, “oral lichen planus” “lichen planus”, “lichenoid”) AND (“malignant transformation”, “premalignant character”, “cancerization”, “pre-neoplasm”, “squamous cell carcinoma”). The reviewers screened the identified publications in three steps according to title, abstract and full text, extracted all the investigated markers in screened articles and finally classified the markers according to the frequency. Extracted data were saved in Excel software. RESULTS : Out of 570 articles, 66 were finally enrolled in the study. The most frequent evaluated markers were p53, cyclooxygenase-2 (COX-2), Ki67, B-cell lymphoma-2 (Bcl-2), Bax, p21, and caspase-3. CONCLUSION: The present study concluded that there were some documented evidences for association between malignant transformation of OLP and seven molecular markers (p53, COX-2, Ki67, Bcl-2, Bax, p21, and caspase-3).

http://johoe.kmu.ac.ir/article_84883_ab5a2c5bdb14c0478e8f3d74bd84fbff.pdf

Molecular markers as an indicator in the malignant potential of oral lichen planus: A systematic review

Background: Oral lichen planus (OLP) is one of the potentially malignant disorders (PMDs) with a malignancy rate of 0.2-2%. Aneuploidy is considered to be one of the important markers for malignant transformation and DNA-image cytometry (DIC) has been successfully employed in oral mucosal PMDs and also in tumors of the cervix, lung and biliary tract. Aims: In this study, we intend to assess the ploidy status of exfoliated cells in OLP using DIC. Materials and Methods: Exfoliated cells from 48 patients with different subtypes of OLP (reticular, plaque type, erosive and atrophic) and 10 controls were stained using Feulgen reaction and assessed for integrated optical density using image analysis software and the ploidy status was assessed. Results: All the patients in the control group and most of the patients (93.5%) who had reticular or plaque type of OLP (29 out of 31) exhibited diploid nuclei in the smears, whereas 11 patients who had erosive or atrophic types of OLP showed aneuploid nuclei. Conclusions: The patients with erosive or atrophic types of OLP are at more risk and assessment of ploidy status by exfoliative cytology can be used as an adjuvant for diagnosis.

Evaluation of ploidy status using DNA-image cytometry of exfoliated mucosal cells in oral lichen planus

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Evaluation of ploidy status using DNA-image cytometry of exfoliated mucosal cells in oral lichen planus