Дисертації: "Oral lichen planu"

1

Siponen, M. (Maria). "Oral lichen planus – etiopathogenesis and management." Doctoral thesis, Oulun yliopisto, 2017. http://urn.fi/urn:isbn:9789526214702.

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Abstract Oral lichen planus (OLP) is a chronic immune-mediated mucosal disease with unknown etiology. According to the current view, the pathogenesis of OLP involves activation of T-cell mediated immunity against the epithelial keratinocytes. A proportion of OLP patients are affected by painful symptoms, and the risk of oral cancer is increased in OLP. There is no curative treatment for OLP. Topical corticosteroids are used most commonly in the management of OLP. However, the evidence base for the effectiveness of any therapy is weak. The objective of this thesis was to study novel aspects of OLP etiopathogenesis and management. An epidemiologic, retrospective case-control study was conducted to determine whether systemic diseases, in particular thyroid diseases, are associated with OLP. In addition, a randomized controlled trial comparing the effectiveness of topical tacrolimus, triamcinolone acetonide and placebo in symptomatic OLP was carried out. Furthermore, immunohistochemical expression of toll-like receptors 4 and 9, hyaluronan and its principal receptor CD44 antigen, hyaluronan synthases 1-3, hyaluronidases 1-2 and cathepsin K was studied in OLP tissue samples and in healthy oral mucosa. The effect of topical tacrolimus on the expression of these molecules in OLP was also studied. The results of the present study showed that a history of hypothyroidism was associated with an approximately twofold risk of having OLP. Furthermore, both tacrolimus and triamcinolone acetonide were more efficient than placebo in reducing the signs and symptoms of OLP. No statistically significant differences were noted in the efficacy between tacrolimus and triamcinolone acetonide. In addition, the expression of the studied molecules was altered in the epithelium or stroma in OLP compared to healthy oral mucosa. Tacrolimus treatment decreased the expression of CD44 antigen in the stroma and the expression of cathepsin K in the epithelium in OLP. In conclusion, the present study extends our knowledge about systemic associated factors and management of OLP. In addition, the results improve our understanding of molecular level changes that occur in OLP
Tiivistelmä Suun punajäkälä on krooninen immuunivälitteinen limakalvotauti, jonka etiologia on tuntematon. Taudin syntymekanismiin liittyy tämän hetkisen näkemyksen mukaan T-soluvälitteisen immuniteetin aktivoituminen epiteelin keratinosyyttejä vastaan. Suun punajäkälä aiheuttaa osalle potilaista kivuliaita oireita ja lisää suusyövän riskiä. Parantavaa hoitoa tautiin ei ole. Yleisimmin suun punajäkälän oireiden hoidossa käytetään paikallisia kortikosteroidivalmisteita. Kuitenkin eri hoitomuotojen tehosta on vain heikkoa näyttöä. Tämän väitöskirjatyön tarkoituksena oli tutkia uusia näkökohtia liittyen suun punajäkälän etiopatogeneesiin ja hoitoon. Epidemiologisessa tapaus-verrokkitutkimuksessa selvitettiin, liittyvätkö yleissairaudet, erityisesti kilpirauhassairaudet, suun punajäkälään. Lisäksi satunnaistetussa kontrolloidussa tutkimuksessa verrattiin paikallisen takrolimuusin, triamsinoloniasetonidin ja lumelääkkeen tehoa oireisesta suun punajäkälästä kärsivillä potilailla. Tutkimuksessa selvitettiin myös tollin kaltaisten reseptorien 4 ja 9, hyaluronaanin ja sen pääasiallisen reseptorin CD44-antigeenin, hyaluronaanisyntaasien 1–3, hyaluronidaasien 1–2 sekä katepsiini K:n immunohistokemiallista ilmentymistä suun punajäkälänäytteissä ja terveessä suun limakalvossa. Lisäksi tutkittiin takrolimuusihoidon vaikutusta näiden molekyylien ilmentymiseen suun punajäkälässä. Tämän tutkimuksen tulokset osoittivat, että kilpirauhasen vajaatoimintaan liittyi noin kaksinkertainen riski sairastaa suun punajäkälää. Lisäksi havaittiin, että suun punajäkälässä sekä takrolimuusi että triamsinoloniasetonidi ovat tehokkaampia kuin lumelääke oireiden ja kliinisen taudinkuvan lievittämisessä. Takrolimuusin ja triamsinoloniasetonidin tehossa ei todettu tilastollisesti merkitseviä eroja. Lisäksi suun punajäkälänäytteissä tutkittujen molekyylien ilmentyminen oli muuttunut joko epiteelissä tai stroomassa verrattuna terveeseen limakalvoon. Takrolimuusihoito vähensi CD44-antigeenin ilmentymistä stroomassa ja katepsiini K:n ilmentymistä epiteelissä suun punajäkälässä. Yhteenvetona voidaan todeta, että tämä tutkimus lisää tietoa suun punajäkälään liittyvistä systeemisistä tekijöistä ja suun punajäkälän hoidosta. Lisäksi löydökset lisäävät ymmärtämystä suun punajäkälässä tapahtuvista molekyylitason muutoksista

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2

Marshall, Alison Shona. "The role of chemokines in oral lichen planus." Thesis, University College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.413748.

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3

Zhao, Zhen Zhen. "Mast cell-related mechanisms in oral lichen planus /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16304.pdf.

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4

Jungell, Peter. "Oral lichen planus an ultrastructural and immunohistochemical study /." Helsinki : [s.n.], 1989. http://catalog.hathitrust.org/api/volumes/oclc/21180820.html.

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Thesis--University of Helsinki, 1989.
At head of title: Department of Oral Surgery, Institute of Electron Microscopy, University of Helsinki, and Fourth Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. Includes bibliographical references (p. 58-71).

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Lage, Denise 1979. "Doenças liquenoides da pele e mucosa oral = análise histológica e imuno-histoquímica = Lichenoid diseases of the skin and oral mucosa : histological and immunohistochemical analysis." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312892.

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Orientador: Maria Letícia Cintra
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-24T06:34:44Z (GMT). No. of bitstreams: 1 Lage_Denise_D.pdf: 12121159 bytes, checksum: f93ebe72b9dc8acf40f7ff2245de6a21 (MD5) Previous issue date: 2014
Resumo: O líquen plano (LP) pode afetar a pele e/ou as mucosas. Histologicamente apresenta infiltrado linfo-histiocitário na junção epitélio-tecido conjuntivo e apoptose de células epiteliais basais. No LP oral (LPO), ocorre erosão frequente pela maior intensidade da necrose. O LP cutâneo (LPC) e o LPO apresentam características histopatológicas similares, mas o curso clínico é diverso. O LPC costuma ter seu curso limitado, enquanto o LPO é frequentemente recidivante. A erupção liquenoide a droga (ELD) desenvolve-se após semanas da ingestão do medicamento e a resolução do quadro é lenta após a interrupção, dificultando o diagnóstico diferencial com o LP idiopático. Os achados clínicos e histológicos podem ser indistinguíveis daqueles do LP, mas a patogênese da ELD não é conhecida. Diferenças locais no sistema imune da mucosa oral e pele poderiam explicar a diversidade no comportamento clínico do LP. Quanto à ELD, há poucas publicações sobre as alterações imunes que atuam no seu desenvolvimento. A citotoxidade celular é mediada, dentre outros mecanismos, por grânulos contendo granzima B e perforina, produzidos por linfócitos T citotóxicos e células natural killers. Com o objetivo de estudar a citotoxicidade celular na patogênese destas doenças, foram analisadas 29 amostras de LPO, 16 de LPC e 6 de ELD. Os cortes foram corados pela H&E e técnica de imuno-histoquímica, para a demonstração de linfócitos CD4 e CD8, macrófagos HAM 56+ e MAC 387+, granzima B, perforina e ICAM-1. As amostras de LPO apresentaram maior densidade de células granzima B+ e perforina+, em comparação às do LPC. Nos dois grupos de doenças, quanto maior era o número de células perforina+, maior era o de células granzima B+. Maior número de células CD4-positivas foi encontrado nas lesões ativas, quando comparado com o das regressivas, no LPO, mas não no LPC. À comparação entre o LPC e a ELD, quanto maior o número de células CD8-positivas, maior era o número de células que expressavam a perforina no grupo LPC. Quanto maiores eram os valores da granzima B, maiores os da perforina, no grupo LPC. Quanto maiores eram os valores da granzima B, maiores os de células apoptóticas agregadas, no grupo da ELD. Nas amostras do LPC, quanto maiores os valores das células T, maiores os dos macrófagos HAM56-positivos e vice-versa. Nas amostras da ELD, foi encontrada correlação negativa entre o número de células T e o de histiocitos jovens (MAC 387+). Havia correlação positiva entre o número de células T e o de células CD8, no grupo da ELD. O mesmo não ocorreu, no grupo do LPC. Concluindo, a expressão aumentada dos grânulos citotóxicos no LPO pode estar associada à maior gravidade da doença na mucosa. Os resultados favorecem um papel mais importante da granzima B e linfócitos TCD8+, no mecanismo patogenético da ELD, comparativamente com o da perforina, de maior importância no LPC. É possível que a ação da granzima B esteja ligada ao número abundante de clusters encontrado na ELD. Embora o LPC e a ELD apresentem semelhanças clínicas e histológicas, a etiopatogênese parece ser distinta
Abstract: Lichen planus (LP) can affect the skin and/or mucous membranes. Histologically it presents lymphohistiocytic infiltrate in the epithelium-connective tissue junction and apoptosis of basal epithelial cells. In oral LP (OLP), erosion occurs frequently by higher intensity of necrosis. Cutaneous LP (CLP) and OLP present similar histopathological features, but the clinical course is diverse. Spontaneous remission is common in CLP, but OLP follows a prolonged course, with periods of remission and relapse. Lichenoid drug eruption (LDE) develops after weeks of drug intake and the resolution of lesions is slow after drug discontinuation, hampering the differential diagnosis with (idiopathic) LP. Clinical and histological findings of LDE may be indistinguishable from those of LP, but LDE pathogenesis is poorly understood Local differences in the immune system of the skin and oral mucosa could explain the diversity in the clinical behavior of CLP and OLP. Regarding LDE, there are few publications on the immune changes that act in its development. Cellular cytotoxicity is mediated, among other mechanisms, by granules containing perforin and granzyme B, produced by cytotoxic T lymphocytes and NK cells. In order to study cellular cytotoxicity in the pathogenesis of these diseases, we analyzed 29 samples of OLP, 16 of CLP and 6 of LDE. The sections were stained for H&E and immunohistochemically targeted with CD4, CD8, HAM 56, MAC387, granzyme B, perforin and ICAM-1. OLP specimens exhibited higher density of cytotoxic granules (perforin and granzyme B) when compared with CLP. In both groups of diseases, the greater the number of perforin+ cells, the greater was the number of granzyme B+ cells. Increased number of CD4+ cells was found in active lesions as compared with the regressive ones in OLP but not in the CLP. The comparison between CLP and LDE revealed that the greater the number of CD8+ cells, the greater the number of cells expressing perforin in CLP group. The higher were the values of granzyme B, the higher the perforin values in the CLP group; the higher were the values of granzyme B, the higher the number of clusters of apoptotic cells in the LDE group. Within CLP group, the higher were the values of T cells, the greater the number of HAM56+ macrophages and vice versa. In LDE samples, negative correlation was found between the number of T cells and young histiocytes (MAC 387+). There was a positive correlation between the number of T cells and CD8 cells in LDE group, but not in CLP group. Concluding, increased expression of cytotoxic granules in OLP may be associated with greater mucosa severity. The results favor a greater role of granzyme B and CD8+ lymphocytes in the pathogenic mechanism of LDE, when compared with perforin, of greater importance in CLP. It is possible that the action of granzyme B is connected to the abundant number of clusters found in LDE. Although CLP and LDE present clinical and histological similarities, the etiopathogenesis appears to be distinct
Doutorado
Anatomia Patologica
Doutora em Ciências Médicas

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Erfanian, Nima, and Kaiser Ghodbeni. "Clinical Description of Patients Diagnosed with Oral and Genital Lichen Planus, a Register Study." Thesis, Umeå universitet, Institutionen för odontologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-143876.

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ABSTRACT The aim of this study is to chart a cohort of patients in the county of Västerbotten in Sweden who have been diagnosed with lichen planus. In addition to charting, the cohort has also been compared to similar previously studied groups. The studied group consist of patients who have been referred to the Department of Medical Biosciences and Pathology between years 2009-2015 with suspicious diagnosis of LP. After exclusion, 214 patients remained of which 130 were diagnosed with Oral LP and 84 with Genital LP. Different data such as age, medications and diseases was extracted from the dental journals. In this cohort women were more likely to be affected by LP. The mean age for females was 63 years and 53 years for men. In the studied group 17 % were being treated for hypertension, 14 % were treated with 5 or more different medications. Tobacco use was found in 17 % and 12 % were diagnosed with an autoimmune disease. The results from the studied cohort were in accordance with similar populations in previous studies. There is an undergoing discussion whether OLP and LP are the same disease that affects different sites.

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Olivieri, Charles-Vivien. "Inflammations orales et infection par le virus d’Epstein-Barr : vers un nouveau paradigme en pathogenèse orale." Thesis, Université Côte d'Azur (ComUE), 2018. http://www.theses.fr/2018AZUR4201/document.

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La cavité buccale constitue une porte d’entrée et un site réservoir majeur pour une diversité de virus. Mis à part l’herpèsvirus simplex, peu d’études virologiques détaillent le rôle des virus pathogènes de la sphère orale dont le virus d’Epstein-Barr. Le consensus est que les inflammations orales surviennent principalement en réaction à des infections bactériennes et fongiques provoquant une dysbiose du biofilm oral. Toutefois, ce modèle n’est pas parfait et il explique mal les récidives observées après décontamination, le découplage entre dysbiose et poussées inflammatoires, la proximité de dents atteintes et saines dans un environnement bactérien similaire. L’hypothèse d'un mécanisme synergique combinant virus et bactéries a été proposée pour la parodontite. Selon ce modèle, l’action complémentaire des 2 types d’agents infectieux sur le microenvironnement immunitaire favoriserait la chronicité inflammatoire et l’évolution de la maladie. Nos travaux se concentrent sur l’étude de l’infection de la cavité orale par EBV. EBV est un virus ubiquitaire infectant l’homme de manière persistante. La cavité orale est le site privilégié pour sa réplication avec une production salivaire quasi-constante. Outre un rôle transformant majeur, l’implication de EBV est aussi suspectée pour plusieurs maladies inflammatoires. Tout d’abord, nous nous sommes intéressés au lichen plan oral (LPO), une maladie auto-immune dont l'étiopathogénie n’est pas clairement établie. Sur des biopsies de patients atteints de LPO (n=99), nous avons démontré par hybridation in situ que le LPO est fréquemment infecté par EBV (74%), notamment les formes cliniques érosives. Nous montrons que le degré d’infiltration des lésions par des cellules infectées par EBV (EBV+) est corrélé avec les paramètres inflammatoires et que les cellules EBV+ infiltrées sont des plasmocytes. Cela apporte un élément nouveau dans la mesure où les plasmocytes sont reconnus comme des cellules immunitaires régulatrices majeures. Nous décrivons des profils cytokiniques différents entre LPO infectés ou non, sans qu’il soit possible à ce stade de pouvoir impliquer directement les plasmocytes. Nous confirmons par microscopie électronique que les plasmocytes hébergent les stades tardifs du cycle d’EBV et produisent des virions dans le LPO, suggérant un mécanisme d’amplification locale de l'infection. Ensuite, nous nous sommes intéressés à la parodontite, maladie inflammatoire chronique commune qui détruit la structure parodontale et provoque le déchaussement dentaire. Cette maladie est clairement identifiée comme facteur aggravant de nombreuses maladies systémiques. Nos études avaient déjà mis en évidence un lien direct entre infection EBV et la sévérité de la parodontite. Mes travaux ont permis de montrer que le parodonte inflammatoire est infiltré par des cellules EBV+ qui semblent être majoritairement des plasmocytes. La présence de plasmocytes producteurs de virus au sein de la lésion inflammatoire pourrait expliquer l’infection des épithéliums adjacents. De plus, une étude clinique menée sur une petite cohorte de patients traités pour parodontite met en évidence une corrélation entre la diminution de la charge EBV salivaire et l’amélioration clinique de patients après traitement. Si ce résultat se confirme, il constituerait un argument supplémentaire en faveur d’une contribution de l’infection parodontale par EBV à la globalité de la charge EBV salivaire. En conclusion, nos données mettent en évidence la présence quasi constante d’EBV dans deux types de lésions orales inflammatoires. Cette infection virale contribue à aggraver une situation inflammatoire locale associée ou pas à une dysbiose bactérienne. L’observation majeure concerne la présence, souvent massive, de plasmocytes infectés dont le rôle reste à identifier. Ces observations constituent des avancées significatives qui permettent d’étayer un nouveau modèle de pathogénie orale associant virus et bactéries
The oral cavity is a major entry point and reservoir site for a variety of viruses. Apart from herpesvirus simplex, few virological studies detail the role of oral pathogenic viruses, including Epstein-Barr virus. The consensus is that oral inflammation occurs mainly in response to bacterial and fungal infections causing dysbiosis of the oral biofilm. However, this model is not perfect and does not explain well the recurrences observed after decontamination, the decoupling between dysbiosis and inflammatory outbreaks, the proximity of affected and healthy teeth in a similar bacterial environment. The hypothesis of a synergistic mechanism combining viruses and bacteria has been proposed for periodontitis. According to this model, the complementary action of the 2 types of infectious agents on the immune microenvironment would promote inflammatory chronicity and disease progression. Our work focuses on the study of oral cavity infection with EBV. EBV is a ubiquitous virus that persistently infects humans. The oral cavity is the preferred site for its replication with almost constant saliva production. In addition to a major transformative role, EBV's involvement is also suspected for several inflammatory diseases. First, we focused on oral plan lichen (OPL), an autoimmune disease whose etiopathogeny is not clearly established. On biopsies of patients with OPL (n=99), we demonstrated by in situ hybridization that OPL is frequently infected with EBV (74%), particularly in erosive clinical forms. We show that the degree of infiltration of lesions by EBV-infected cells (EBV+) is correlated with inflammatory parameters and that the infiltrated EBV+ cells are plasma cells. This brings a new element to the extent that plasma cells are recognized as major regulatory immune cells. We describe different cytokinic profiles between infected and uninfected OPL, although it is not possible at this stage to directly involve plasma cells. We confirm by electron microscopy that plasma cells host the late stages of the EBV cycle and produce virions in the OPL, suggesting a local amplification mechanism of infection. Then, we focused on periodontitis, a common chronic inflammatory disease that destroys the periodontal structure and causes tooth loosening. This disease is clearly identified as an aggravating factor in many systemic diseases. Our studies had already shown a direct link between EBV infection and the severity of periodontitis. My work has shown that the inflammatory periodontium is infiltrated by EBV+ cells, which appear to be predominantly plasma cells. The presence of virus-producing plasma cells within the inflammatory lesion may explain the infection of adjacent epithelia. In addition, a clinical study conducted on a small cohort of patients treated for periodontitis showed a correlation between the decrease in salivary EBV load and the clinical improvement of patients after treatment. If this result is confirmed, it would be an additional argument in favour of a contribution of periodontal EBV infection to the overall salivary EBV burden. In conclusion, our data show the almost constant presence of EBV in two types of inflammatory oral lesions. This viral infection contributes to worsening a local inflammatory situation associated or not with bacterial dysbiosis. The main observation concerns the presence, often massive, of infected plasma cells whose role remains to be identified. These observations represent significant advances that support a new model of oral pathogenesis combining viruses and bacteria

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Camargo, Alessandra Rodrigues de. "Líquen plano oral associado a Hepatite C." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-20032015-154058/.

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O presente estudo teve como objetivo verificar a associação entre o líquen plano oral (LPO) e a infecção de hepatite C (HCV) crônica em duas populações distintas do município de São Paulo. Foram avaliados um total de 308 pacientes distribuídos em dois grupos de estudo: grupo HCV composto por 275 pacientes (132 homens e 143 mulheres; idade média = 49,8 anos) com infecção de HCV crônica; e o grupo LPO composto por 33 pacientes (10 homens e 23 mulheres; idade média = 52,9 anos) com LPO. No grupo HCV o diagnóstico da infecção crônica foi estabelecido através de sorologia para anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmado pela pesquisa de RNA-HCV através do teste PCR qualitativo (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). No grupo LPO o diagnóstico para lesões orais seguiu critérios estabelecidos pela World Health Organization (WHO) em 1978 e posteriormente modificados por van der Meij e van der Waal em 2003. Como critérios de exclusão para o grupo HCV pacientes que fizeram uso de interferon e/ou ribavirina por um período menor que 6 meses foram excluídos do estudo, assim como pacientes que encontravam-se em terapia antiviral para HCV. Neste grupo a presença de co-infecções - HIV, HBV, HTLV - também foi desconsiderada. No grupo LPO pacientes com diagnóstico clínico sugestivo de reação liquenóide por uso a drogas (RLD) e reação liquenóide por contato (RLC) foram excluídos da amostra, assim como pacientes tratados local ou sistemicamente para LPO por um período menor que 6 meses. Casos com achados histopatológicos de displasia liquenóide também foram desconsiderados. Para análise dos resultados duas comparações foram efetuadas: (1) no grupo HCV a prevalência de LPO foi determinada e comparada com a prevalência de LPO em nossa instituição (grupo controle); (2) no grupo LPO a prevalência da infecção de HCV foi determinada e comparada com a prevalência da infecção de HCV na população de São Paulo. A prevalência de LPO em pacientes com HCV crônica (grupo HCV) foi de 2,18% e de 1,54% no grupo controle (P = 0,39). A prevalência de HCV crônica em pacientes com diagnóstico de LPO (grupo LPO) foi de 3,03% e de 1,42% na população em geral (P = 0,39). Nenhuma diferença estatisticamente significante foi verificada quando os grupos foram comparados. Em nossa análise não foi verificada associação entre o LPO e a infecção de HCV crônica, nas duas populações avaliadas no município de São Paulo.
The objective of the present study was to verify the association between oral lichen planus (OLP) and chronic hepatitis C virus infection (HCV) in two distinct populations in the municipality of São Paulo. A total of 308 patients were evaluated distributed in two study groups: group HCV, comprising 275 patients (132 men and 143 women; average age = 49.8 years old) with chronic HCV infection; and group OLP, comprising 33 patients (10 men and 23 women; average age = 52.9 years old) with OLP. In group HCV, the diagnosis of chronic infection was established through serology for anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmed by RNA-HCV research through qualitative PCR testing (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). In group OLP, the diagnosis of oral lesions followed the criteria established by the World Health Organization (WHO) in 1978 and later modified by van der Meij and van der Waal in 2003. As exclusion criteria for group HCV, patients that made use of interferon and/or ribavirin for a period below 6 months were excluded from the study, as well patients that were under antiviral treatment for HCV. In this group the presence of co-infections - HIV, HBV, HTLV - was also discarded. In group OLP, patients with clinical diagnosis suggestive of drug-induced lichenoid reactions (DLR) and oral lichenoid lesions related to dental materials (LLDM) were excluded from the sample, as well as patients treated locally or systemically for OLP for a period below 6 months. Cases with histopathological findings of lichenoid dysplasia were also discarded. For result analysis, two comparisons were conducted: (1) in group HCV, OLP prevalence was determined and compared to OLP prevalence in our institution (control group); (2) in group OLP, the prevalence of HCV infection was determined and compared to the prevalence of HCV infection in the São Paulo population. OLP prevalence in patients with Chronic HCV (group HCV) was 2.18% and 1.54% in the control group (P = 0.39). Chronic HCV prevalence in patients with a diagnosis of OLP (group OLP) was 3.03% and 1.42% in the general population (P = 0.39). No statistically significant difference was verified when groups were compared. Our study did not verify an association between OLP and chronic HCV infection in the two populations assessed in the municipality of São Paulo.

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Zwet, Marwa. "The extent of the role of apoptosis in oral lichen planus – a morphometric study." University of the Western Cape, 2016. http://hdl.handle.net/11394/5491.

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Magister Chirurgiae Dentium (MChD)
Oral lichen planus (OLP) is a T-cell mediated chronic inflammatory disease with different clinical types that remains inscrutable in respect of its pathogenetic mechanisms and effective therapy. Increased apoptosis may influence the histopathological criteria of oral lichen planus (decrease in thickness of the epithelium and band of inflammatory infiltrate). Null hypothesis: The apoptotic rate does not correlate with a decrease in the epithelial thickness as well as the thickness of the band of inflammatory infiltrate in OLP. Aim: The present study aims to quantify apoptotic activity and to correlate the apoptotic rate with epithelial thickness as well as thickness of the inflammatory infiltrate of OLP cases diagnosed at Tygerberg Hospital from 2006 – 2015. Further, the epithelial thickness and thickness of the inflammatory infiltrate were also assessed for their association, if any. Materials and Methods: The study sample comprised 17 diagnostically verified cases of OLP. Sections stained with Haematoxylin and Eosin (H&E) were used to identify and count the number of apoptotic cells as well as measure the thickness of epithelium and the thickness of the lymphocytic inflammatory infiltrate by using software morphometric analysis (Zen Blue lite 2012). Statistical analysis was applied to analyse the correlation between apoptotic cells and histopathological features of OLP. Results: The present study's results showed no statistically significant association between the apoptotic rate, the epithelial thickness and the thickness of the lymphocytic inflammatory infiltrate.

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Altersved, Karin, and Agneta Wallén. "Patienters upplevelse av oral hälsa vid diagnosen erosiv oral lichen planus : En kvalitativ studie." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-26876.

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Hirota, Silvio Kenji. "Líquen plano oral: atiopatogenia. Transtornos de ansiedade e depressão e uso de medicamentos." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-11042008-124535/.

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Este estudo teve por objetivo investigar a associação transtornos de ansiedade e depressão e do uso de medicamentos com o líquen plano oral (LPO). O grupo de estudo compreendeu pacientes com diagnóstico clínico e histopatológico de LPO, segundo critérios da Organização Mundial de Saúde (WHO, 1978), com ou sem envolvimento cutâneo ou de outras mucosas. Um grupo controle composto por indivíduos sem lesão de líquen plano cutâneo e/ou mucoso, com perfil semelhante ao dos pacientes com LPO em relação ao sexo, idade e cor, foi incluído. Para avaliação de transtornos de ansiedade e depressão foram aplicadas duas escalas de auto-avaliação, respectivamente, o Inventário de Ansiedade Traço-Estado (IDATE-T) e a Escala de Rastreamento Populacional para Depressão - Center for Epidemiologic Studies Depression Scale (CES-D), ambas as escalas validadas internacionalmente. O uso diário de medicamentos foi analisado de acordo com os seguintes critérios: (1) classificação de medicamentos de acordo com o código ATC (Anatomical Therapeutic Chemical - classificação pela OMS, versão 2007), (2) quantidade de medicamentos utilizados - monofarmacia: 1 medicamento, polifarmacia menor: 2 a 4 medicamentos, e polifarmacia maior: 5 ou mais medicamentos, e (3) uso de medicamentos com potencial de induzir reação liquenóide a drogas. Sessenta e três pacientes LPO (média de idade = 54,2 anos, relação mulher/homem 6:1) e 35 do grupo controle (média de idade = 53,3 anos, relação mulher/homem 4:1) compuseram a casuística de pacientes avaliados. Os resultados demonstraram que não houve diferenças estatisticamente significantes (P > 0,05) entre o grupo LPO e o grupo controle com relação aos transtornos de ansiedade e depressão e o uso de medicamentos. Em conclusão, transtornos de ansiedade e depressão e o uso de medicamentos parecem não constituir fatores diretos na etiopatogenia do LPO. Todavia, esses fatores devem ser considerados na avaliação geral do paciente LPO, principalmente em termos de tratamento da lesão oral.
This study was aimed at investigating the possible association of the anxiety and depression disorders and the use of drugs with the oral lichen planus (OLP). The study group included patients with clinical and histopathologic diagnosis of OLP, according World Health Organization criteria (WHO, 1978), with or without skin and others mucosal involvement. A control group composed of individuals without skin and/or mucosal lichen planus, with similar characteristics to the OLP patients in respect to the sex, age and skin color, was included. For evaluation of anxiety and depression disorders a two self-administered scale the State-Trait Anxiety Inventory (STAI-T) and the Center for Epidemiologic Studies Depression Scale (CES-D) scales were applied, both internationally validated scales. The daily drug intake was analyzed according to the following criteria: (1) classification of drugs according the ATC code (Anatomical Therapeutic Chemical - classification by OMS, 2007 version), (2) amount of drugs used - monopharmacy: 1 drug, minor polipharmacy: 2 a 4 drugs, e major polipharmacy: 5 or more drugs, and (3) use of drugs with potential to induce a lichenoid drug reaction. Sixty-three patients (mean age = 54.4 years, ratio female/male = 6:1) and 35 individuals of control group (mean age = 53.3 years, ratio female/male = 4:1) composed the sample of patients evaluated. The results showed that there were no statistically significant differences (P> 0.05) between the OLP group and the control group with respect to anxiety and depression and the use of drugs. In conclusion, anxiety and depression disorders and the use of drugs seem to play no direct role in the etiopathogenesis of OLP. However, these factors should be considered for general evaluation of OLP patients, mainly for therapeutic purposes.

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Hanna, Carola, and Motlagh Tina Sabet. "Inflammatory markers in sera in patients diagnosed with mucosal lichen planus." Thesis, Umeå universitet, Tandläkarutbildning, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-154926.

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OBJECTIVE: Lichen planus is a disease that can affect both skin and mucosa, in some cases both at the same time. Among patients with lichen planus, the oral version of lichen planus (OLP) can be observed in 50 – 70 %. OLP is the most common chronic inflammatory disease of oral mucosa. Today it is known that OLP is an inflammatory condition but it is not known exactly what substances are prominent and active during this specific inflammatory process. The aim of this study was to examine inflammatory factors involved in OLP. METHODS: A total of 24 individuals were included in this prospective study. 15 of these were patients diagnosed with mucosal LP, whereas the other nine were healthy controls. Blood samples were taken from all participants and sent to Life Science Lab in Uppsala where they used Olinks inflammation panel to analyse inflammatory markers in the blood samples. RESULTS: There were differences in inflammatory factors in blood between the controls and patients with mucosal lichen planus. The inflammatory factors that contributed the most to this difference were IL-5, SCF, FGF-19 and FGF-21. CONCLUSIONS: Due to the differences between LP-patients and controls we can conclude that there are tendencies to an inflammatory process going on systemically involving different levels of mainly IL-5, SCF, FGF-19 and FGF-21. The inflammatory factors that contributed the most to the differences between the two groups are not the typical ones that have been the resulting elevated inflammatory factors in other previous studies.

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Pigatti, Fernanda Mombrini. "Expressão imuno-histoquímica de Bcl-2, Ki-67 e caspase-3 ativa em líquen plano oral e leucoplasia com diferentes graus de displasia." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/25/25150/tde-21032012-083313/.

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O líquen plano oral (LPO) é uma doença inflamatória crônica de causa desconhecida, e seu potencial de malignização é um tema bastante controverso. Diversos estudos têm sugerido que pacientes portadores de líquen plano apresentam um maior risco de desenvolver câncer. Contudo, muitos autores acreditam que não haja dados suficientes que provem uma associação entre líquen plano e câncer. Para esses autores, a maioria dos casos que sofreram transformação maligna é decorrente de falhas no diagnóstico inicial da lesão. Portanto, objetivou-se avaliar a expressão imuno-histoquímica das proteínas relacionadas à apoptose e proliferação celular, respectivamente caspase-3 ativa, Bcl-2 e Ki-67 no LPO e em displasias epiteliais na tentativa de explicar a polêmica em relação ao potencial de transformação maligna do LPO e enfatizar a importância de um acompanhamento de longo prazo dos pacientes com esta doença. Com esse propósito, foram selecionadas 14 amostras de LPO, 14 amostras de leucoplasia com displasia epitelial, além de 09 amostras de mucosa bucal normal como controle. A avaliação da expressão de caspase-3 ativa, Bcl-2 e Ki-67 foi conduzida de acordo com a técnica da imunoperoxidase. A contagem das células imunomarcadas nas amostras de LPO, de leucoplasia com displasia epitelial e de mucosa bucal normal resultou em número destas células por mm2 nas diferentes regiões (camada basal, camada suprabasal e infiltrado inflamatório) para cada imunomarcador. A expressão de Bcl-2 em células epiteliais, da camada basal, ocorreu mais frequentemente no grupo da leucoplasia com displasia epitelial, com diferença estatística entre o grupo do LPO e o grupo controle. Verificou-se também, uma alta expressão da proteína Bcl-2 em células inflamatórias de lesões de LPO e de leucoplasia com displasia epitelial. A expressão do marcador Ki-67 foi superior em todos os níveis teciduais analisados nas lesões de LPO e de leucoplasia com displasia epitelial quando comparados com o grupo controle. Concluiu-se que a expressão mais elevada das proteínas Bcl-2 e Ki-67 nos casos de LPO e de leucoplasia com displasia epitelial, podem revelar a possibilidade da presença de alterações moleculares morfologicamente imperceptíveis.
The oral lichen planus (OLP) is a chronic inflammatory disease of unknown cause, and its malignant potential is a very controversial issue. Several studies have suggested that patients with lichen planus have a higher risk of developing cancer. However, many authors believe that there is insufficient evidence to prove an association between lichen planus and cancer. For these authors, most of the cases that had undergone malignant transformation is due to flaws in the lesion initial diagnosis. Therefore, the aim was to evaluate the immunohistochemical expression of proteins related to apoptosis and cell proliferation, respectively active caspase-3, Bcl-2 and Ki-67 in epithelial dysplasia and LPO in an attempt to explain the controversy regarding the potential malignant transformation of OLP and emphasize the importance of a long-term monitoring of patients with this disease. For this purpose, we selected 14 samples of OLP, 14 samples of leukoplakia with epithelial dysplasia, and 09 samples of normal oral mucosa as controls. The evaluation of the expression of active caspase-3, Bcl-2 and Ki-67 was conducted in accordance with the immunoperoxidase technique. The immunostained cells counting in samples of OLP, epithelial dysplasia in leukoplakia and normal oral mucosa resulted in a number of these cells per mm2 in the different regions (basal layer, suprabasal layer and inflammatory infiltrate) for each immunostained. The expression of Bcl-2 in epithelial cells, the basal layer, occurred more frequently in the group of leukoplakia with epithelial dysplasia, with statistical difference between the group of OLP and the control group. There was a high expression of Bcl-2 protein in inflammatory cells in OLP lesions and leukoplakia with epithelial dysplasia. The expression of the marker Ki-67 was superior in all analyzed tissue levels in OLP lesions and leukoplakia with epithelial dysplasia when compared to the control group. It was concluded that the highest expression of Bcl-2 protein and Ki-67 in cases of OLP and leukoplakia with epithelial dysplasia, can reveal the possible presence of molecular changes morphologically imperceptible.

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Justi, Mirella Martins [UNESP]. "Pacientes com Líquen Plano Oral: estresse, enfrentamento e eficácia adaptativa." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/97511.

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Made available in DSpace on 2014-06-11T19:29:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-02-13Bitstream added on 2014-06-13T19:58:29Z : No. of bitstreams: 1 justi_mm_me_bauru.pdf: 615674 bytes, checksum: 1b89b58761347726f7fd07653566c181 (MD5)
O Líquen Plano Oral (LPO) caracteriza-se como doença complexa e multideterminada, cujas manifestações mostram-se sensíveis à influência de variáveis biopsicossociais, devendo ser estudada e tratada de forma integrativa, conjugando conhecimentos e esforços interdisplinares. Estudos apontam que a doença é exacerbada de acordo com as condições de estresse, tensão e perturbação emocional dos portadores. Pesquisas atuais sobre o estresse e suas relações com o adoecimento, principalmente no campo da psicoimunologia, têm enfatizado que tais relações dependem de aspectos de personalidade ou modos de ser dos diferentes indivíduos, que configuram variados modos de enfrentamento dos eventos estressores, mantendo ou não os efeitos imunodepressores do estresse e incrementando ou não seu potencial patogênico. Considerando tais registros pode-se relacionar o LPO com o estresse - presente na vida moderna e, cada vez mais, indicado como o principal elemento desencadeador das doenças da adaptação. O enfrentamento também deve ser relacionado, pois configura-se na forma como ocorre o processo de adaptação do sujeito frente às exigências da vida atual. O objetivo geral consiste em realizar estudo longitudinal de 10 pacientes com diagnóstico de LPO e que participaram de psicoterapia breve grupal e de acompanhamento do tamanho de LPO em 2003, averiguando suas condições de saúde, ocorrência de lesões de LPO, eventos de estresse, enfrentamento e eficácia adaptativa, de 2003 a 2008. Para o procedimento de coleta de dados foram utilizadas duas entrevistas (EDAO-R; Entrevista Estresse, Enfrentameto e Saúde - elaborada para o estudo), medidas atuais de LPO e registros de avaliações anteriores realizadas em 2003 e que consistiram de realização de Psicoterapia Breve Operacionalizada (PBO), aplicação da EDAO-R e coleta de medidas de LPO no início e no final da PBO...
Oral lichen planus (OLP) is characterized as a complex and multifactorial disease, and its manifestations are sensible to the influence of biopsychosocial variables, and, therefore, must be studied and treated in an integrative way, joining interdisciplinary efforts and knowledge. Studies demonstrate that this disease is aggravated according to the patients' conditions of stress, tension and emotional disturbance. Present researches on stress and its relation with the condition of falling sick, mainly in the field of psychoimmunology, have emphasized that such relations are dependent of personality aspects or ways of being of different individuals, which figure several ways of confrontation of the stressful events, maintaining or not the stress immunodepressive effects and increasing or not its pathogenic potential. Considering such registers, it is possible to relate OLP to stress - present in the modern life and, more and more, indicated as the main triggering element of adaptation diseases. Confrontation must also be related to the disease, because it figures in the way as the individual adaptation process occurs face to the requirements of the modern life. The general purpose of this paper is to accomplish a longitudinal study of 10 patients with OLP diagnosis who took part in a group brief psychotherapy and had a continuous attendance controlling the size of the OLP lesions in 2003, investigating their health conditions, OLP lesions occurrences, sress events, confrontation and adaptative efficacy from 2003 to 2008. For the procedure of data gathering, the following items were used: two interviews (EDAO-R; Stress Interview, Confrontation and Health - specially elaborated for this study), present OLP measurements and anterior evaluation registers accomplished in 2003, which consisted in the accomplishment of BPO (Brief Pssychotherapy Operacionalized), EDAO-R application and OLP... (Complete abstract click electronic access below)

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Georgiou, Anastasia Fotini. "Oral lichen planus : presence of human papillomavirus investigated by polymerase chain reaction." Thesis, The University of Sydney, 2002. http://hdl.handle.net/2123/4624.

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Kirby, Alun Charlton. "The function and regulation of LFA-3 in oral mucosal inflammation." Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312826.

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Tadakamadla, Jyothi. "Development and validation of a quality of life instrument for patients with oral potentially malignant disorders: studies of impact in a population of Telugu speaking adults." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/370624.

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Oral Potentially Malignant Disorders (OPMDs) are those oral mucosal conditions that have a predilection for becoming malignant (Warnakulasuriya et al. 2007). Similar to oral cancer itself and other oral conditions, OPMDs can cause significant morbidity that affects physical, social and psychological wellbeing, thus affecting the quality of life (QoL) of those so afflicted. The literature on the assessment of QoL in patients with OPMD is very limited, especially from developing countries, which might be due to the unavailability of a disease-specific QoL instrument (Tadakamadla et al. 2015). This thesis developed and validated a disease-specific self-administered QoL questionnaire for OPMD patients. The study was conducted in two phases in the oral medicine clinics of Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, India. The first phase involved qualitative methodology for developing the OPMDQoL questionnaire. Qualitative data were collected through interviews and focus group discussions with 32 Telugu speaking patients with an OPMD who were undergoing treatment. Patients were those diagnosed with Oral Leukoplakia (OL), Oral Submucous Fibrosis (OSF) and Oral Lichen Planus (OLP) which are the most common OPMDs in the Indian subcontinent. Thematic analysis and coding of the qualitative data were conducted using Nvivo by two individuals independently to generate themes and the items for the questionnaire. Moreover, existing oral health-related QoL questionnaires, including those extant for patients with head and neck cancer, were reviewed to generate the items. A final list of 48 items was prepared, after inputs from oral physicians using a modified Delphi technique, from the 60 items that were generated through qualitative analysis and questionnaires. This was followed by the development of final questionnaire by item reduction using a clinical impact method which involved administration of the list of questions to 15 patients who rated the importance of each item. Based on these importance ratings, the final questionnaire (OPMDQoL) was developed: This consisted of 20 items under four domains: ‘difficulties with diagnosis’, ‘physical impairment and functional limitations’, ‘psychological and social wellbeing’ and the ‘effect of treatment on daily life’. Each item is scored using a five-point Likert scale, and the overall OPMDQoL and domain scores are calculated by summing the scores of each item with a higher score representing poorer QoL. In the second phase, the validity and reliability of OPMDQoL was assessed. OPMDQoL, Telugu translations of the Chronic Oral Mucosal Disease Questionnaire (COMDQ) (Ni Riordain et al. 2011b) and Short form 12 item (version 2) of the health survey questionnaire (SF-12v2) (Ware et al. 1996) were administered to 150 OPMD patients (50 each of OL, OSF and OLP) and to controls who were free from any type of OPMD. A thorough clinical examination was conducted and history, including lifestyle habits, was recorded from all patients. OPMDQoL demonstrated good discriminant validity as patients presented poorer scores than the controls. Also, it had good convergent validity evaluated by assessing its correlation with an existing questionnaire (COMDQ) designed for use in patients with any type of oral mucosal disease. An exploratory factor analysis was also conducted, and findings demonstrated a four-factor structure that conforms to the hypothesised four domains. The impact of the clinical diagnosis (OL, OSF or OLP) and of disease severity on disease-specific and generic QoL was then assessed. Patients with OL reported better OPMDQoL than those with OSF and OLP, while no differences were observed between the three OPMDs for the mental health components of the SF-12v2 questionnaire and for the ‘psychological and functional wellbeing’ domain of the OPMDQoL instrument. When domain scores were compared, OLP patients reported significantly higher scores for the domain ‘difficulties with diagnosis’ while OL patients presented lower scores for the dimension, ‘physical impairment and functional limitations’ than did patients with the other OPMD. Disease severity had a significant association with both OPMDQoL and with the mental health component of SF-12v2, QoL diminishing as disease severity increased. In conclusion, the newly developed OPMDQoL exhibited good validity and reliability in a sample of Telugu Speaking OPMD patients. Disease severity was found to be associated with poor QoL assessed using OPMDQoL. Taken together, the results of this work indicate that this questionnaire might be used in studies of disease progression and to evaluate response to therapy, in routine clinical practice. OPMDQoL can be used in different cultures and languages following cross-cultural adaptation and can also be used to compare the effectiveness of treatments.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Dentistry&Oral Hlth
Griffith Health
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Roosaar, Ann. "Oral mucosal lesions, tobacco use and the long-term outcome in a Swedish population /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-973-4/.

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Hayama, Fábia Hiromi. ""Estudo da expressão da p16 em casos de líquen plano bucal"." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-28082006-181239/.

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Realizar estudo imuno-histoquímico com os marcadores p16 e Ki-67 nas lesões de líquen plano bucal em pacientes assintomáticos e sintomáticos, verificando a presença e modo de marcação, analisando se existe correlação entre os resultados que possa indicar os riscos de transformação maligna. MATERIAL E MÉTODOS: nove pacientes assintomáticos e 12 sintomáticos de líquen plano bucal. Cinco amostras de hiperplasia fibrosa inflamatória foram empregadas como grupo controle. Foram utilizados anticorpos p16 (pré-diluído BioSB/EUA) e Ki-67 (clone MIB-1 DAKO/EUA) pela técnica Envision Labelled (DAKO). Os resultados foram analisados de acordo com os parâmetros baseados no estudo de Klaes et al. (2001) avaliando a porcentagem de células marcadas, a distribuição pela camada epitelial e a intensidade da marcação. A análise estatística procedeu ao estudo do risco relativo entre pacientes assintomáticos e sintomáticos com relação ao local da expressão celular (nuclear, citoplasmática ou ambas), com as localizações mais prevalentes da lesão (mucosa jugal e língua) e com os tipos clínicos mais comuns (reticular e atrófico). RESULTADOS: a correlação entre pacientes assintomáticos e sintomáticos foi estatisticamente significativa (p<0,05) quando avaliamos a distribuição da p16 pela camada epitelial com relação ao local da expressão celular e com a localização da lesão. Odds ratio da marcação nuclear foi de 4,091. A total (nuclear e citoplasmática) foi de 5,179. Já a marcação somente citoplasmática teve odds ratio de 8,461. A correlação com a localização resultou num odds ratio de 5,130 para a língua e 14,234 para a mucosa jugal. As outras categorias avaliadas, porcentagem e intensidade da p16, as características clínicas avaliadas e os resultados do Ki-67, não foram significativos em nenhum item avaliado. CONCLUSÕES: o risco relativo maior quando da marcação somente citoplasmática nos mostra que este é um importante sítio de expressão da p16, não devendo ser desprezado, como sugerido por alguns estudos. A localização apontada na literatura como de maior prevalência nos casos de transformação maligna é a língua, porém o risco relativo no nosso estudo foi maior na mucosa jugal. Como a distribuição foi o único item estatisticamente significativo, faz-se necessário estudo futuro para incluir ou excluir a presença do vírus do papiloma humano nas lesões de líquen plano bucal, visto que a proteína p16 vem sendo indicada para detectar anormalidades celulares nas amostras de cérvice uterina, sendo atribuída a sua superexpressão com a presença de HPV de alto riso, além de estudo da p16 nos casos de displasias liquenóides.
We realized immunohistochemical procedures with p16 and Ki-67 in lesions of oral lichen planus to verify the presence and kind of its immunoexpression amog the two groups of patients, asymptomatic and symptomatic, correlating the clinical and histopathological diagnosis with the immunohistochemical data in order to verify if oral lichen planus can be considered a lesion with risk of malignant transformation. MATERIAL AND METHOD: nine asymptomatic patients and 12 symptomatic of oral lichen planus. Five cases of inflammattory fibrous hyperplasia were included as control group. For immunohistochemical studies we used p16 (predilutedBioSB/USA) and Ki-67 (clone MIB-1DAKO/USA) by Envision Labelled techniques (DAKO). Results were annalyzed according to parameters based on Klaes et al. (2001) evaluating the immunomarked cell rates, the distribution through the epithelial layer and the immunoexpression intensity. The statistics analysis proceeded the study of relative risk between asymptomatic and symptomatic patients regarding to its cellular immunoexpression (nuclear, cytoplasmic or both), the more prevalent topography of the lesion (buccal mucosa and tongue) and clinical characteristics (atrophic and reticular types). RESULTS: the correlation between asymptomatic and symptomatic patients was statistically significant (p<0.05) when comparison was made of the distribution of p16 throug the epithelial layer by analysis its cellular imumunoexpression. The nuclear immunoexpression of p16 showed an odds ratio of 4.091. The nuclear and cytoplasmatic were 5.179. The odds ratio for cytoplasmatic expression was 8.461. The correlation between immunoexpression and topography resulted in an odds ratio of 5.130 for tongue and 14.234 for buccal mucosa. The other categories availed as percentage and intensity of the p16 immunoexpression, clinical characteristics, besides the Ki-67 results gave non significant results. CONCLUSIONS: The citoplasmatic expression results indicates that this immunoexpression must not be discarded, as suggested by some studies. The high relative risk saw in buccal mucosa rather than tongue was an unexpected result, because the localization pointed as with greater involvement in cases of malignat transformation is the tongue. The distribution was the only one that reached a statistically significant result, so further studies must be made in order to include or exclude the human papillomavirus presence in oral lichen planus lesions, since the p16 protein is currently nowadays used as an indicator of cellular abnormalities in cervical lesions, where its overexpression is related to the presence of high risk human papillomavirus, beyond study of p16 in the cases of liquenoid dysplasia.

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Bergdahl, Jan. "Burning mouth, oral lichenoid reactions and symptoms related to electricity or visual display units a psychological and clinical study /." Umeå, Sweden : Dept. of Oral Pathology and Psychiatry, Umeå University, 1995. http://books.google.com/books?id=EPFpAAAAMAAJ.

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Persson, Julia, and Mariken Brecheisen. "Oral Lichenoid Lesions - Differences in expression of TLR4 and TLR9 in Oral Lichen Planus and amalgam induced Oral Lichenoid Lesions." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19969.

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Oral lichen planus (OLP) är en idiopatisk kronisk inflammatorisk sjukdom som drabbar munslemhinnan hos ca 2 % av den svenska befolkningen. Amalgamfyllningar kan framkalla lichenoida kontaktlesioner (cOLL), som kliniskt kan vara svåra att särskilja från OLP. Det är dessutom inte möjligt att skilja mellan OLP och cOLL histologiskt. Det är viktigt att kunna särskilja OLP och cOLL då behandlingen av dem skiljer sig.Toll-like receptorer (TLR) finns på flera av kroppens celler. De är en del av det medfödda immunförsvaret men de har också kopplats till autoimmuna sjuksomar. En ökad förekomst av TLR i skivepitel har påvisats vid OLP.Syftet med denna studie är att undersöka variationer i uttrycket av TLR4 och TLR9 i OLP och cOLL. Vår hypotes är att en histologisk skillnad i OLP och cOLL ska kunna observeras p.g.a. skillnader i patogenesen mellan OLP och cOLL.Metod: Vävnadsprov med histologiskt verifierad lichenoid reaktion valdes från Biobanken, Oral Patologi, Malmö från patienter med de kliniskt ställda diagnoserna OLP (10) och cOLL (12). TLR4 och TLR9 identifierades med hjälp av immunhistokemisk färgning varefter reaktionens lokalisation och intensitet jämfördes mellan de två grupperna.Resultat: En signifikant skillnad observerades i infärgningen av TLR4 hos fibroblaster, lymfocyter och makrofager, där TLR4 var mer positiv i cOLL. Uttrycket av TLR9 hos lymfocyter var starkare vid OLP än cOLL.Slutsats: Våra resultat visade att det finns en skillnad i uttrycket av TLR4 och TLR9 i cOLL och OLP. Resultaten bekräftar att OLP och cOLL har olika patogenes, men ytterligare studier behövs för att klargöra hur.
Oral lichen planus (OLP) is an idiopathic chronic inflammatory disease that affects the oral mucosa in approximately 2% of the Swedish population. Amalgam fillings may induce contact oral lichenoid lesions (cOLL) that can be difficult to clinically distinguish from OLP. It is not possible to histologically distinguish between OLP and cOLL. As their treatments differ, the correct diagnosis is vital.Toll-like receptors (TLR) are expressed by most of the body's cells and are part of the innate immune system, however they have also been linked to certain autoimmune diseases. OLP exhibits an increased amount of TLR in the epithelium.The purpose of this study is to investigate the variations in the expression of TLR4 and TLR9 in OLP and cOLL. Our hypothesis is that a histological difference in OLP and cOLL can be observed due to TLRs different roles in maintaining the immune response.Method: Tissue samples with histologically confirmed lichenoid reactions were chosen from Biobank, Oral Pathology, Malmö, from patients with the clinical diagnosis OLP (10 subjects) and cOLL (12 subjects). TLR4 and TLR9 were identified by immunohistochemical staining and compared between the two groups.Results: A significant difference was observed in TLR4 staining of fibroblasts, lymphocytes and macrophages where the antibody was less expressive in OLP. In TLR9 staining lymphocytes were stronger expressed in OLP compared to cOLL.Conclusion: Our results showed that there was a difference in the expression of TLR4 and TLR9 in cOLL and OLP, this could be a result of OLP being an autoimmune disorder. Further studies on this subject are recommended on this subject. MeSH: "Dental Amalgam", "Dermatitis, Allergic Contact", "Immunohistochemistry", "Lichen Planus, Oral", "Toll-Like Receptor 4", "Toll-Like Receptor 9"

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Brecheisen, Mariken, and Julia Persson. "Oral Lichenoid Lesions: Differences in expression of TLR4 and TLR9 in Oral Lichen Planus and amalgam induced Oral Lichenoid Lesions." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19936.

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Oral lichen planus (OLP) är en idiopatisk kronisk inflammatorisk sjukdom som drabbar munslemhinnan hos ca 2 % av den svenska befolkningen. Amalgamfyllningar kan framkalla lichenoida kontaktlesioner (cOLL), som kliniskt kan vara svåra att särskilja från OLP. Det är dessutom inte möjligt att skilja mellan OLP och cOLL histologiskt. Det är viktigt att kunna särskilja OLP och cOLL då behandlingen av dem skiljer sig.Toll-like receptorer (TLR) finns på flera av kroppens celler. De är en del av det medfödda immunförsvaret men de har också kopplats till autoimmuna sjuksomar. En ökad förekomst av TLR i skivepitel har påvisats vid OLP.Syftet med denna studie är att undersöka variationer i uttrycket av TLR4 och TLR9 i OLP och cOLL. Vår hypotes är att en histologisk skillnad i OLP och cOLL ska kunna observeras p.g.a. skillnader i patogenesen mellan OLP och cOLL.Metod: Vävnadsprov med histologiskt verifierad lichenoid reaktion valdes från Biobanken, Oral Patologi, Malmö från patienter med de kliniskt ställda diagnoserna OLP (10) och cOLL (12). TLR4 och TLR9 identifierades med hjälp av immunhistokemisk färgning varefter reaktionens lokalisation och intensitet jämfördes mellan de två grupperna.Resultat: En signifikant skillnad observerades i infärgningen av TLR4 hos fibroblaster, lymfocyter och makrofager, där TLR4 var mer positiv i cOLL. Uttrycket av TLR9 hos lymfocyter var starkare vid OLP än cOLL.Slutsats: Våra resultat visade att det finns en skillnad i uttrycket av TLR4 och TLR9 i cOLL och OLP. Resultaten bekräftar att OLP och cOLL har olika patogenes, men ytterligare studier behövs för att klargöra hur.
Oral lichen planus (OLP) is an idiopathic chronic inflammatory disease that affects the oral mucosa in approximately 2% of the Swedish population. Amalgam fillings may induce contact oral lichenoid lesions (cOLL) that can be difficult to clinically distinguish from OLP. It is not possible to histologically distinguish between OLP and cOLL. As their treatments differ, the correct diagnosis is vital.Toll-like receptors (TLR) are expressed by most of the body's cells and are part of the innate immune system, however they have also been linked to certain autoimmune diseases. OLP exhibits an increased amount of TLR in the epithelium.The purpose of this study is to investigate the variations in the expression of TLR4 and TLR9 in OLP and cOLL. Our hypothesis is that a histological difference in OLP and cOLL can be observed due to TLRs different roles in maintaining the immune response.Method: Tissue samples with histologically confirmed lichenoid reactions were chosen from Biobank, Oral Pathology, Malmö, from patients with the clinical diagnosis OLP (10 subjects) and cOLL (12 subjects). TLR4 and TLR9 were identified by immunohistochemical staining and compared between the two groups.Results: A significant difference was observed in TLR4 staining of fibroblasts, lymphocytes and macrophages where the antibody was less expressive in OLP. In TLR9 staining lymphocytes were stronger expressed in OLP compared to cOLL.Conclusion: Our results showed that there was a difference in the expression of TLR4 and TLR9 in cOLL and OLP, this could be a result of OLP being an autoimmune disorder. Further studies on this subject are recommended on this subject.

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Crawford, Fiona Carole. "The effectiveness of homeopathic Arsenicum album in the treatment of oral lichen planus." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/24499.

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Oral lichen planus(OLP) is a chronic mucosal condition commonly encountered in Oral Medicine departments. It can cause patients significant discomfort, and only a small percentage, undergo complete remission. Recalcitrant lesions can be treated with various systemic medications including steroids. There is to date only weak evidence to suggest that these treatments are superior to placebo. This study was performed to determine whether homeopathic arsenicum album is useful in the treatment of OLP. A randomised double-blind clinical trial comparing homeopathic arsenicum album with placebo was carried out in the oral medicine department of the Edinburgh Dental Institute. The study covered a six-week period and ninety four patients participated. They were randomly assigned to a 6c homeopathic preparation of arsenicum album or to placebo, with all participants receiving placebo for the first week. After a pre-treatment visit, clinical review took place two and six weeks after commencing therapy. The same clinician scored the extent of the oral condition at all visits, and alleviation of symptoms was evaluated using a visual analogue scale diary and the Glasgow Homeopathic Hospital outcome scale. Ninety-two patients completed the study. No significant difference between the groups was seen on the visual analogue scores and there was no significance difference between the two groups with regard to response to treatment. However patients who were good prescribers for arsenicum album did show a difference between the groups with regard to response to treatment, which although not achieving statistical significance was strongly suggestive of an association. In conclusion homeopathic arsenicum album may be useful in the treatment of OLP, but more extensive studies need to be performed.

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24

Mörée, Agnes. "Gold and mercury in the oral mucosa in patch-tested patients with oral lichen lesions." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19701.

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Danielsson, Karin. "Oral lichen planus : studies of factors involved in differentiation, epithelial mesenchymal transition and inflammation." Doctoral thesis, Umeå universitet, Institutionen för odontologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-55419.

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Background: Lichen planus is a chronic inflammation of skin and mucosa with unknown cause. Oral Lichen Planus, OLP, affects around 2% of the population. Autoimmunity has been suggested as a possible cause as the disease has autoimmune features such as female predominance, cyclic nature and cytotoxic T-cell infiltrate. It has been suggested that the intense inflammatory response seen in OLP is caused by factors on the keratinocyte surface triggering the immune system. Chronic inflammation is one of the hallmarks of oral lichen planus and chronic inflammation is connected to increased risk of tumor development. WHO classifies OLP as a potentially malignant condition with increased risk of developing Squamous cell carcinoma of head and neck, SCCHN, but malignant transformation of OLP is a matter of controversy. The aim of these studies was to further elucidate the autoimmune and premalignant character of OLP. Factors involved in malignant transformation, autoimmunity and inflammation were analyzed in normal oral mucosa, OLP and SCCHN. Factors studied were the signal transducers of Transforming growth factor-β the Smad proteins, microRNAs, COX-2, the receptor CXCR-3 and its ligands CXCL-10 and -11 and ELF-3. Material and methods: In the study on Smad protein expression formalin fixed and paraffin embedded biopsies from normal oral mucosa, OLP and SCCHN was used. For the remaining studies fresh frozen biopsies from OLP and normal controls was used. All of the fresh frozen OLP samples and their controls were micro dissected to be able to analyze the epithelial part only as well as sections of the whole biopsy. Methods used are immunohistochemistry, qRT-PCR and Western blot. Results: Analyses of smad proteins expression showed a clear increase of smad3 and smad7 in OLP compared to normal oral mucosa. The expressions of smad proteins in the tumors were more heterogeneous. Some of the SCCHN samples showed a similar expression as OLP while others did not. Micro RNA analyzes showed that miR-21 and miR-203 was significantly increased in OLP epithelium compared to normal oral epithelium while the expression of miR-125b and their potential targets p53 and p63 was decreased in OLP. The presence of COX-2 was significantly higher in OLP than normal controls. At the same time the expression of miR-26b, a suggested repressor of COX-2 was decreased in OLP compared to normal mucosa. The receptor CXCR-3 and its ligands CXCL-10 and -11 were increased in OLP. Expressions of the differentiation involved factor ELF-3 mRNA as well as protein were decreased in OLP. Conclusion: The factors studied are involved in differentiation, malignant transformation and inflammation. Some of the results in these studies indicate a similar expression pattern for OLP and SCCHN. Several of the factors studied are involved in differentiation and their deregulation suggests a disturbed differentiation pattern and this could indicate a premalignant character of OLP but malignant transformation of OLP lesions are relative rare. A lot of these factors are also involved in inflammatory processes and connected to autoimmune diseases and their deregulation in OLP could also support an autoimmune cause of the disease. Based on our studies a suggestion is that the disturbed differentiation pattern triggers the intense immune response directed against the epithelial cells seen in OLP.

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Michelsen, Carmen. "The use of microsatellite markers to assess the malignant potential of oral precancerous lesions and oral lichen planus." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq24207.pdf.

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Payeras, M?rcia Rodrigues. "Imunodetec??o do VEGF e das angiopoietinas 1 e 2 em l?quen plano oral = Immunodetection of VEGF and angiopoietins 1 and 2 in oral lichen planus." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2013. http://tede2.pucrs.br/tede2/handle/tede/1227.

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Made available in DSpace on 2015-04-14T13:30:28Z (GMT). No. of bitstreams: 1 451795.pdf: 9844032 bytes, checksum: abd171b9947156a56d52eef795138daf (MD5) Previous issue date: 2013-09-13
In this study we investigated the immunodetection of VEGF, ANG-1 and ANG-2, as well as the number of blood vessels in specimens of reticular (ROLP) and atrophic-erosive oral lichen planus (AEOLP). In addition, were included the control groups oral epithelial hyperplasia (OFH), oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) in order to find a relation between those angiogenics growth factors and biological behavior. Biopsy specimens diagnosed at the Oral Medicine Division of PUCRS, Brazil, were selected and distributed into the following groups ROLP (n=21); AEOLP (n=11); OFH (n=10); OED (n=10); and OSCC (n=10). They were subjected to immunohistochemical processing with primary antibodies anti-VEGF, anti-ANG-1 and anti-ANG-2. The results do not revelead significant difference in the immunodetection of ANG-1 and ANG-2 between the OLP groups. The ROLP group showed significantly higher immunodetection of VEGF (P=0.01) compared with the AEOLP group. There was no significant difference in the number of blood vessels between the OLP groups (P=0.393). In comparative analysis of OLP with control groups, ROLP and AEOLP cases were considered together, forming the OLP group (n=32). The comparison of immunodetection of those growth factors between the OLP group and each control group showed significantly higher values of ANG-1 in the OLP group compared to the OFH group (P=0.043) and no significant difference in ANG-2. VEGF immunodetection in the OLP group was significantly higher than in the OFH group (P=0.003) and significantly lower compared to the OSCC group (P=0.032). No correlation was observed between growth factors evaluated in the different groups studied. The results of immunodetection of VEGF, ANG-1 and ANG-2 and the lack of significant difference in the number of blood vessels between ROLP and AEOLP groups indicate that angiogenesis in OLP can not be associated to the different clinical forms of this disease. The lack of correlation between the growth factors in the different lesions indicates the involvement of other pro-angiogenic agents in vascular neoformation and reflects the complexity of this process. Furthermore, immunodetection of growth factors evaluated was similar between OLP and OED, suggesting that angiogenesis in OLP may behave similarly to the epithelial dysplastic lesions.
Neste estudo foi investigada a imunodetec??o do VEGF e das angiopoietinas (ANG) 1 e 2, bem como o n?mero de vasos sangu?neos em esp?cimes de l?quen plano oral reticular (LPOR) e atr?fico-erosivo (LPOAE). Al?m disso, foram inclu?dos os grupos-controle hiperplasia fibroepitelial (HFO), displasia epitelial (DEO) e carcinoma espinocelular (CEO) orais, a fim de encontrar uma rela??o entre esses fatores de crescimento angiog?nicos e comportamento biol?gico. Foram obtidos esp?cimes de bi?psias do arquivo do Servi?o de Estomatologia e Preven??o do C?ncer Bucomaxilofacial do Hospital S?o Lucas da PUCRS, os quais foram distribu?dos nos grupos LPOR (n=21); LPOAE (n=11); HFO (n=10); DEO (n=10); CEO (n=10) e, posteriormente, submetidos ao processamento imunoistoqu?mico com os anticorpos prim?rios anti-VEGF, anti-ANG-1 e anti-ANG-2. Os resultados n?o revelaram diferen?a significativa na imunodetec??o da ANG-1 e ANG-2 entre os grupos l?quen plano oral (LPO). No entanto, o grupo LPOR apresentou imunodetec??o significativamente superior do VEGF (p=0,01) comparado ao grupo LPOAE. Com rela??o ao n?mero de vasos sangu?neos, a compara??o entre os grupos LPO n?o mostrou diferen?a significativa entre ambos (p=0,393). Na an?lise comparativa com os grupos-controle, os casos de LPOR e LPOAE foram considerados em conjunto, formando o grupo LPO (n=32). A compara??o da imunodetec??o dos fatores de crescimento entre o grupo LPO com cada grupocontrole revelou valores significativamente superiores da ANG-1 no grupo LPO em rela??o ao grupo HFO (p=0,043) e aus?ncia de diferen?a significativa nos valores da ANG-2. A imunodetec??o do VEGF foi significativamente superior no grupo LPO em rela??o ao grupo HFO (p=0,003) e inferior quando comparada ao grupo CEO (p=0,032). N?o foi observada correla??o entre os fatores de crescimento avaliados nos diferentes grupos estudados. Os resultados observados na imunodetec??o do VEGF, ANG-1 e ANG-2 e a falta de diferen?a significativa no n?mero de vasos entre os grupos LPOR e LPOAE indicam que a angiog?nese no LPO possa n?o estar associada ?s diferentes formas cl?nicas desta doen?a. A falta de correla??o entre estes fatores de crescimento nos diferentes tipos de les?es estudadas indica o envolvimento de outras citocinas pr?-angiog?nicas, al?m daquelas avaliadas neste estudo, na neoforma??o vascular e reflete a complexidade deste processo. Por outro lado, a imunodetec??o dos fatores de crescimento avaliados foi semelhante entre os grupos LPO e DEO, sugerindo que a angiog?nese no LPO possa comportar-se de modo semelhante ao de les?es displ?sicas epiteliais.

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Justi, Mirella Martins. "Pacientes com Líquen Plano Oral : estresse, enfrentamento e eficácia adaptativa /." Bauru : [s.n.], 2009. http://hdl.handle.net/11449/97511.

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Orientador: Carmen Maria Bueno Neme
Banca: Liliam D'Aquino Tavano
Banca: Tania Gracy Martins do Valle
Resumo: O Líquen Plano Oral (LPO) caracteriza-se como doença complexa e multideterminada, cujas manifestações mostram-se sensíveis à influência de variáveis biopsicossociais, devendo ser estudada e tratada de forma integrativa, conjugando conhecimentos e esforços interdisplinares. Estudos apontam que a doença é exacerbada de acordo com as condições de estresse, tensão e perturbação emocional dos portadores. Pesquisas atuais sobre o estresse e suas relações com o adoecimento, principalmente no campo da psicoimunologia, têm enfatizado que tais relações dependem de aspectos de personalidade ou modos de ser dos diferentes indivíduos, que configuram variados modos de enfrentamento dos eventos estressores, mantendo ou não os efeitos imunodepressores do estresse e incrementando ou não seu potencial patogênico. Considerando tais registros pode-se relacionar o LPO com o estresse - presente na vida moderna e, cada vez mais, indicado como o principal elemento desencadeador das "doenças da adaptação". O enfrentamento também deve ser relacionado, pois configura-se na forma como ocorre o processo de adaptação do sujeito frente às exigências da vida atual. O objetivo geral consiste em realizar estudo longitudinal de 10 pacientes com diagnóstico de LPO e que participaram de psicoterapia breve grupal e de acompanhamento do tamanho de LPO em 2003, averiguando suas condições de saúde, ocorrência de lesões de LPO, eventos de estresse, enfrentamento e eficácia adaptativa, de 2003 a 2008. Para o procedimento de coleta de dados foram utilizadas duas entrevistas (EDAO-R; Entrevista Estresse, Enfrentameto e Saúde - elaborada para o estudo), medidas atuais de LPO e registros de avaliações anteriores realizadas em 2003 e que consistiram de realização de Psicoterapia Breve Operacionalizada (PBO), aplicação da EDAO-R e coleta de medidas de LPO no início e no final da PBO... (Resumo completo clicar acesso eletrônico abaixo)
Abstract: Oral lichen planus (OLP) is characterized as a complex and multifactorial disease, and its manifestations are sensible to the influence of biopsychosocial variables, and, therefore, must be studied and treated in an integrative way, joining interdisciplinary efforts and knowledge. Studies demonstrate that this disease is aggravated according to the patients' conditions of stress, tension and emotional disturbance. Present researches on stress and its relation with the condition of falling sick, mainly in the field of psychoimmunology, have emphasized that such relations are dependent of personality aspects or ways of being of different individuals, which figure several ways of confrontation of the stressful events, maintaining or not the stress immunodepressive effects and increasing or not its pathogenic potential. Considering such registers, it is possible to relate OLP to stress - present in the modern life and, more and more, indicated as the main triggering element of "adaptation diseases". Confrontation must also be related to the disease, because it figures in the way as the individual adaptation process occurs face to the requirements of the modern life. The general purpose of this paper is to accomplish a longitudinal study of 10 patients with OLP diagnosis who took part in a group brief psychotherapy and had a continuous attendance controlling the size of the OLP lesions in 2003, investigating their health conditions, OLP lesions occurrences, sress events, confrontation and adaptative efficacy from 2003 to 2008. For the procedure of data gathering, the following items were used: two interviews (EDAO-R; Stress Interview, Confrontation and Health - specially elaborated for this study), present OLP measurements and anterior evaluation registers accomplished in 2003, which consisted in the accomplishment of BPO (Brief Pssychotherapy Operacionalized), EDAO-R application and OLP... (Complete abstract click electronic access below)
Mestre

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Jeftha, Anthea. "A descriptive analysis of oral lichen planus from tertiary diagnostic centres in the Western Cape." Thesis, University of Western Cape, 2009. http://hdl.handle.net/11394/3282.

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Magister Scientiae Dentium - MSc(Dent)
Lichen planus is a systemic disease that follows a chronic course. The exact aetiology remains unknown but an immune mediated pathogenesis has been implicated. Oral lichen planus is a common form of this disease and can occur in isolation or it may include the skin, genitalia and lesions involving the scalp and hair follicles. Epidemiological studies on oral lichen planus are few. Those that have been conducted have been in developed nations such as North America and Europe as well as Asia and the Middle East. Few African studies report on the demographics of the affected patients. Factors such as patient demographics and trends of diseases are essential to investigate. Findings of such studies may be useful in determining additional patient based criteria that can assist in obtaining a definitive diagnosis and subsequently aid in the management protocols of the specific disease in question. This process is as essential for oral lichen planus as for other diseases. Oral lichen planus can have clinical similarities with other diseases of the oral mucosa. Similarities can also be seen histologically that may further complicate the process of defining the diagnosis. Oral lichen planus may not be commonly associated with frank morbidity, but severe discomfort can be experienced in some clinical variants. This disease has been described as “difficult to manage” Camacho-Alonso et al, 2007). Furthermore, there is an ongoing debate about its malignant potential (Sugerman & Savage; 2002; Scully and Carrozzo; 2008). These factors support the relevance of further investigation of oral lichen planus. This study will report the demographics of patients who have been diagnosed with oral lichen planus in a subset of the South African population, within the Western Cape. The description of the ethnic groups in South Africa was as described by Statistics South Africa, namely; “African” was used to describe Black individuals, “Coloured” was used to describe individuals of mixed ethnic origin, “Indian” was used to describe patients whose ethnic origin was of the Indian/Asian continent, the latter however excluded persons of Chinese decent and “White” described those persons of European origin. The ethnic distribution reported from within the literature will report on the terminology used by the respective authors and hence not follow the guidelines outlined above.

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Teixeira, Lívio António Neves. "Lesões pré-malignas." Master's thesis, [s.n.], 2015. http://hdl.handle.net/10284/5123.

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Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária
O cancro oral é a forma de cancro mais comum da cabeça e pescoço, e nos últimos anos, tem-se observado ao aumento da sua incidência, bem como, aumento da sua mortalidade. Numa fase inicial do carcinoma espinocelular oral, a forma mais prevalente de cancro oral, as manifestações clínicas e os sintomas são mínimos, sendo por isso importante o conhecimento por parte do médico dentista desta patologia, para o seu diagnóstico atempado e tratamento precoce, devido ao seu grande impacto na saúde de um paciente. Sabe-se que, praticamente todos os cancros orais são precedidos por alterações clínicas visíveis na mucosa oral, denominadas lesões potencialmente malignas. Uma lesão pré-maligna consiste numa doença, síndrome ou um achado clínico, que se não tratado pode conduzir a cancro. Na cavidade oral, existem inúmeras lesões visíveis que podem alertar o médico dentista para uma possível perturbação potencialmente maligna. O diagnóstico precoce das lesões orais, é um assunto importante devido às complicações sérias que podem ocorrer quando o tratamento é atrasado, particularmente tratando-se de lesões potencialmente malignas. O seu diagnóstico e tratamento precoce, permite portanto a deteção ou prevenção do cancro, diminuindo a sua incidência e melhorando a sobrevida daqueles com carcinoma espinocelular oral. As lesões orais potencialmente malignas são um problema de saúde grave, com uma prevalência considerável, onde a deteção precoce influencia grandemente o prognóstico destes pacientes. Este trabalho tem como objetivo uma abordagem das lesões potencialmente malignas, proporcionando ao médico dentista informação atualizada e relevante, tendo como intuito promover um diagnóstico mais precoce, sensibilizar para um diagnóstico diferencial, bem como as várias modalidades de tratamento e orientação destes pacientes. Serão abordadas as lesões pré-malignas mais prevalentes, que de acordo com os estudos são a leucoplasia, a eritroplasia, o líquen plano e a fibrose submucosa. Deste modo, foi realizada uma revisão da literatura, tendo em consideração as publicações científicas nos últimos 5 anos. Foi conduzida uma pesquisa nas bases de dados da Pubmed e ScienceDirect, com os termos “oral premalignant lesions”, “oral leukoplakia”, “oral erythroplasia”, “oral submucosal fibrosis” e “oral lichen planus”. Oral cancer is the most common form of head and neck cancer, and in recent years, it has been observed that it’s incidence as been increaseing, as well as its mortality. At the early stage of oral squamous cell carcinoma, the most prevalent form of oral cancer, the clinical manifestations and symptoms are minimal, so it is important to the dentists, to know this pathology, for its timely diagnosis and early treatment due to its great impact on the health of a patient. It is known that virtually all oral cancers are preceded by visible clinical changes in the oral mucosa, called potentially malignant lesions. A pre-malignant lesion is a disease, syndrome or clinical finding that if left untreated can lead to cancer. In the oral cavity, there are numerous visible injuries that can alert the dentist for a possible potentially malignant disorder. Early diagnosis of oral lesions is an important issue because of the serious complications that can occur when treatment is delayed, particularly in the case of potentially malignant lesions. The early diagnosis and treatment therefore allows the detection or preventing cancer, reducing the incidence and improving survival of those using oral squamous cell carcinoma. Potentially malignant oral lesions are a major health problem, with considerable prevalence, and the early detection greatly influences its prognosis. This paper aims to approach the potentially malignant lesions, providing the dentist updated and relevant information, and therefor to contribute to an earlier diagnosis, to raise awareness of a differential diagnosis and the various treatment modalities and guidance of these patients. It will be addressed the most prevalent premalignant lesions, in particular leukoplakia, erythroplasia, lichen planus and submucosal fibrosis. Thus, a review of the recent literature was performed taking into account the scientific publications in the last 5 years. It was conducted a search in the databases PubMed and ScienceDirect, using the terms "oral premalignant lesions," "oral leukoplakia", "oral erythroplasia", "oral submucosal fibrosis" and "oral lichen planus."

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Hakimi, Basir. "Microbiological findings in subjects with asymptomatic oral lichen planus : a cross-sectional comparative study /." [S.l.] : [s.n.], 2009. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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32

Ebrahimi, Majid. "Studies of p63 and p63 related proteins in patients diagnosed with oral lichen planus." Doctoral thesis, Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1437.

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33

Bloor, Balvinder Kaur. "Differentiation-specific keratins in human oral mucosal disease- keratoses, lichen planus, dysplasia and carcinoma." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299445.

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Camargo, Alessandra Rodrigues de. "População de células T CD8+ e Foxp3+ no líquen plano oral associado à infecção crônica de hepatite C." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/23/23141/tde-28052013-200538/.

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A experiência adquirida na realização de estudos epidemiológicos sobre o líquen plano oral associado à infecção crônica de hepatite C nos faz acreditar que as lesões atróficas/erosivas associadas ao vírus C tendem a apresentar características clínicas atípicas, por vezes exacerbadas e com resposta piorada à terapêutica proposta. Acreditando que existiria uma contrapartida histopatológica que justificasse o comportamento clinico evidenciado, o presente estudo propôs-se a estudar as populações de células T CD8+ e Foxp3+ no líquen plano oral associado à infecção crônica de hepatite C e compará-las com as populações do líquen plano oral idiopático. Foram selecionados 11 blocos de líquen plano oral associado à infecção crônica de hepatite C (Grupo 1) e 19 blocos parafinados de líquen plano oral idiopático (Grupo 2) dos arquivos do Laboratório de Patologia Cirúrgica da Disciplina de Patologia Bucal da Faculdade de Odontologia da Universidade de São Paulo e do Laboratório de Patologia Bucal, do Departamento de Patologia, da Universidade Federal de Santa Catarina. Para ambos os grupos foram realizados ensaios imunohistoquímicos com marcação dos anticorpos anti-CD8 e anti-Foxp3. As células marcadas foram contabilizadas e os resultados tratados estatisticamente. No Grupo 1, 64% dos pacientes eram do sexo feminino; 82% leucodermas e a média de idade era de 59 anos (variação 46 aos 75 anos). No Grupo 2, 63% dos pacientes eram do sexo feminino; 71% leucodermas e a média de idade era de 50,2 anos (variação 32 aos 66 anos). Quando os dados entre os Grupos 1 e 2 foram comparados, não houve correlação estatisticamente significante entre as contagens de células T CD8+, contagens de células T Foxp3+ ou na relação CD8+/Foxp3+ por mm2. As lesões atróficas/erosivas do Grupo 1 apresentaram densidade aumentada de células T CD8+ (p=0,034) e aumento na relação CD8+/Foxp3+ por mm2 (p=0,018), em relação ao Grupo 2. O estudo realizado não encontrou diferenças nas densidades de células T CD8+ e Foxp3+ no infiltrado do líquen plano oral associado ao vírus C em relação ao líquen plano idiopático. Por outro lado, as diferenças encontradas na quantidade de células T CD8+ e na relação CD8/Foxp3, em lesões atróficas/erosivas, parecem justificar as características clínicas evidenciadas em estudos prévios.
Our previous studies with oral lichen planus associated with chronic hepatitis C virus infection leads us to believe that atrophic/erosive forms of oral lesions tend to present unusual clinical features, sometimes exacerbated with a worsened response to treatment. Considering that this exacerbated aspect could indicate a similar exacerbate histopathological feature, the aim of this study was evaluated the populations of CD8(+) and Foxp3(+) T cells in oral lichen planus associated with chronic hepatitis C virus infection and correlated the findings with idiopathic forms of these lesions. The sample consisted of 11 cases of oral lichen planus associated with chronic hepatitis C virus infection (Group 1) and 19 cases of idiopathic oral lichen planus (Group 2) obtained from the Laboratories of Oral Pathology of the University of São Paulo and the Federal University of Santa Catarina. In both groups immunohistochemistry staining were performed using anti-CD8 and anti-Foxp3 antibodies. Positive cells were counted per area and the results were subjected to statistical analysis. In Group 1, 64% of the patients were female, 82% caucasian with mean age of 59 years (range from 46 to 75 years). In Group 2, 63% of the patients were female, 71% caucasian with mean age 50.2 years (range from 32 to 66 years). When Groups 1 and 2 were compared, no significant correlation between the frequencies of CD8(+), Foxp3(+) T cells and the ratio of CD8(+)/Foxp3(+) counts per mm2 was found. The atrophic/erosive lesions in Group 1 showed an increased frequency of CD8(+) T cells (p = 0.034) and an increased ratio of CD8(+)/Foxp3(+) counts per mm2 (p = 0.018) compared to Group 2. In conclusion, our data indicated no differences in the frequencies of CD8(+) and Foxp3(+) T cells in the inflammatory infiltrate of oral lichen planus associated with chronic hepatitis C virus infection compared to idiopathic lesions. However, the differences in the counts of CD8(+) T cells and the ratio of CD8(+)/Foxp3(+) in atrophic/erosive lesions seemed justify the clinical features in previous studies.

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Resende, João Paulo Marinho de. "Tratamento do líquen plano oral recalcitrante com tacrolimo 0,1 %." Universidade Federal de Juiz de Fora (UFJF), 2009. https://repositorio.ufjf.br/jspui/handle/ufjf/2733.

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O Líquen Plano Oral (LPO) é considerado uma doença inflamatória auto imune de curso crônico e sua presença pode estar relacionada com o aumento do estresse emocional. A sua relevância clínica está na possibilidade, ainda controversa, de se transformar em um carcinoma de células escamosas e de sua etiologia ainda obscura e desconhecida. Esse trabalho se propôs a tratar lesões de LPO que foram recalcitrantes aos tratamentos convencionais com corticosteróides, utilizando-se o Tacrolimo 0,1% (Protopic®) de uso tópico, aplicado duas vezes ao dia, por um período de oito semanas. Foram selecionados quinze pacientes (n = 15), que preencheram uma ficha de anamnese e uma escala visual de dor antes e depois do tratamento. Todos os pacientes se submeteram a uma biópsia inicial para o diagnóstico da doença e outra final para avaliar a ação da medicação sobre o infiltrado inflamatório. Foi realizado controle semanal, observando-se os aspectos clínicos, a sintomatologia dolorosa e a ocorrência de efeitos colaterais que quando presentes foram leves e transitórios. A análise dos resultados mostrou doze pacientes (80%) com remissão completa ou quase que completa das lesões e da sintomatologia dolorosa, dois pacientes (13,33%) apresentaram as lesões mais claras e apenas um paciente (6,67%) não obteve nenhuma alteração clínica e da sintomatologia dolorosa. Quanto à análise da regressão das características histológicas do LPO, notamos uma regressão moderada ou acentuada em doze pacientes (80%) e ausente ou leve em três pacientes (20%). Esses resultados nos fazem concluir que o Tacrolimo 0,1% (Protopic®) é uma medicação eficaz e segura, que melhora o aspecto clínico da lesão, diminui a sintomatologia dolorosa e reduz as características histopatológicas do LPO.
The oral lichen planus (OLP) has been considered a chronic-course auto immune inflammatory disease and its presence may be related to increased emotional stress. The clinical relevance of OLP is the possibility, in developing a squamous cell carcinoma which its etiology is still obscure and unknown. The aim of the present study is to treat OLP lesions that were recalcitrant to conventional treatment with corticosteroids, using topical Tacrolimus 0.1% (Protopic®), applied twice a day, for a period of eight weeks. Fifteen patients were selected who had filled out a history form and a visual scale for pain before and after treatment. All patients were submitted to an initial biopsy for the diagnosis of the disease and another one at the end to evaluate the effect of medication on the infiltrate. A weekly control was carried out, observing the clinical aspects, painful symptoms and the occurrence of side effects which, where present, were mild and transient. The results showed twelve patients (80%) with total or nearly total remission of painful symptoms and lesions, two patients (13.33%) showed the clearer lesions and only one patient (6.67%) did not obtain any change in clinical symptoms and pain. Throught the analysis of the histopathological features regression of OLP, if could be noticed a moderate or accented regression in twelve patients (80%) and an absent or mild regression in three patients (20%). Based on the our results, it was possible to conclude that the Tacrolimus 0.1% (Protopic®)is a safe and effective medication that improves the clinical aspect of the injury, reduces the painful symptoms and reduces the histopathological features of the OLP.

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Artico, Gabriela. "Prevalência de Candida spp e xerostomia em pacientes com líquen plano oral. Um estudo grupo-controle." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-06032012-155104/.

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Enquanto lesões cutâneas do líquen plano (LP) são autolimitantes, suas manifestações orais (LPO) têm comportamento crônico, raramente apresentam remissão espontânea, e podem sofrer transformação maligna, embora subsista controvérsia sobre esta ultima questão. A este respeito, alguns autores têm dado ênfase ao envolvimento da Candida spp. na malignização LPO devido à capacidade deste fungo em produzir enzima carcinogênica N-nitrobenzilmetilamina e sua relativa freqüência em lesões LPO. Adicionalmente, foi investigada a xerostomia que, além de ocorrer com maior freqüência em indivíduos da faixa etária em que o LPO é mais prevalente, é considerado fator predisponente à candidose. Portanto, a correlação entre xerostomia e colonização por Candida spp. apresente relevância de ser investigada. O presente estudo objetivou comparar a prevalência de Candida spp. e xerostomia em 37 pacientes com lesões LPO (grupo LPO) com a de 26 pacientes com lesões inflamatórias não-LPO (grupo não-LPO) e com a de 28 indivíduos sem lesões orais (grupo controle-saudável). Pacientes LPO foram predominantemente indivíduos do sexo feminino com média idade de 50 anos. Presença de xerostomia foi evidenciada em 35,1% dos pacientes do grupo LPO, em 38,5% do grupo não-LPO e em 25% do grupo controle-saudável, não havendo diferença estatisticamente significante entre os três grupos (p > 0,05). Nos três grupos, medicação sistêmica e presença de distúrbios emocionais (ansiedade e depressão) não foram estatisticamente significante associados como fatores ao desenvolvimento de xerostomia (p > 0,05). A presença de xerostomia não foi fator estatisticamente significante de predisposição à colonização por Candida spp. nos três grupos. Colonização por Candida spp foi maior no grupo controle-saudável (53,5%) que nos outros grupos (29,7% no LPO e 26,9% no não-LPO), porém, não houve diferença estatisticamente significante (p > 0,05). Formas clínicas do LPO não foram fatores de predisposição à colonização por Candida spp. Espécie mais freqüentemente isolada nos três grupos foi Candida albicans. Formas não-albicans, especificamente a C. dubliniensis, foram encontradas em três indivíduos do grupo controle-saudável.
While cutaneous lesions of lichen planus (LP) are self-limiting, its counterpart oral manifestations (OLP) are chronic, hardly ever undergo spontaneous remission, and may suffer malignant transformation, though this latter issue still bears some controversy. In this respect, some authors have believed that Candida spp. might play a part in the OLP process of malignant transformation since this fungi has the ability to produce carcinogenic N-nitrobenzilmetilamina enzyme and has been found in OLP lesions. Apart that, xerostomia is considered a predisposing factor to candidosis and occurs more frequently in individuals at an aging in which OLP is more prevalent. Therefore, the correlation between xerostomia and candidosis may be worth it investigating. This study aimed at comparing the prevalence of Candida spp. and xerostomia in 37 patients with OLP lesions (OLP group) with that of 26 patients with inflammatory non-OLP disease (non-OLP group) and with that of 28 subjects without oral mucosal lesions (healthy-control group). OLP patients occurred predominantly in females at a mean age of 50 years. Presence of xerostomia was seen in 35.1% of patients in the OLP group, in 38.5% of the non-OLP and in 25% of the healthy-control group with no statistically significant difference among the three groups (p > 0.05). In all the groups, systemic medication and the presence of psychological disorder (anxiety and depression) were not statistically significant factors associated with the development of xerostomia. The presence of xerostomia was not a statistically significant factor at predisposing the colonization by Candida spp. in the three groups (p > 0.05). Colonization by Candida species was higher in healthy-control group (53.5%) than in other groups (29.7% in OLP and 26.9% in non- LPO), but the difference among them did not reach a statistical significance (p > 0. 05). Clinical forms of OLP were not predisposing factors to the colonization by Candida spp. The most frequently isolated species in the three groups were Candida albicans. Non-albicans forms, specifically C. dubliniensis, was found in three patients in the healthy-control group.

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Torrezani, Anna. "Estudo da expressão de genes relacionados à resposta inflamatória e autoimune em lesões de líquen plano oral do tipo reticular por meio de PCR-array." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-18032015-111145/.

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O líquen plano oral (LPO) é uma doença inflamatória crônica que afeta em torno de 1 a 2% da população mundial adulta, entre 30 e 60 anos, principalmente mulheres. As lesões podem estar presentes em diversos sítios, porém tem predileção pela mucosa jugal, gengiva e bordas laterais da língua, todas bilateralmente. As manifestações de LPO são frequentes, e podem se caracterizar clinicamente em seis tipos: reticular, em placas, papular, atrófico, erosivo-ulcerativo e bolhoso, porém o mais comum é o reticular. O presente estudo teve como objetivo avaliar a expressão de genes relacionados à resposta inflamatória e autoimunidade no líquen plano oral (LPO) em pacientes com a variante exclusivamente reticular comparado a controle saudável. Foram incluídos consecutivamente 10 pacientes com LPO que preencheram os critérios de inclusão adotados, sendo 9 mulheres e um homem, e 6 indivíduos controle, sendo 4 mulheres e 2 homens pareados por sexo, idade e uso de medicações sistêmicas. Amostras de mucosa bucal foram coletadas por meio de biópsia incisional em ambos os grupos de pacientes e submetidas à extração de RNA para posterior análise da expressão gênica por PCR-array selecionada para este estudo. Os resultados obtidos foram o aumento da expressão de 8 genes, CXCL 9 e CXCL 10 vão de acordo com a literatura, corroborando com nosso estudo e de certa forma reafirmar mais necessidade de estudos bem desenhados .
The oral lichen planus (OLP) is a chronic inflammatory disease that affects around 1-2% of the adult population between 30 and 60 years, mainly women. The lesions may be present in several sites, but has a predilection for the buccal mucosa, gums and lateral borders of the tongue, all bilaterally. The manifestations of OLP are frequent, and may be characterized clinically in six types: reticular, plaque-like, papular, atrophic, erosive-ulcerative and bullous, but the most common is the reticular . The present study aimed to evaluate the expression of genes related to inflammatory response and autoimmunity in oral lichen planus (OLP) in patients with exclusively reticular variant compared to healthy control. 10 consecutive patients with OLP who met the inclusion criteria, 9 women and one man, and six control subjects were included were 4 women and 2 being proportionally matched by sex, age and use of systemic medications men. Samples of oral mucosa were collected by incisional biopsy in both groups of patients and subjected to RNA extraction for analysis of gene expression by selected for this study-PCR array. The results were the overexpression of genes 8, where only two of them go according to the literature, corroborating our study and somehow reaffirm need for more well-designed studies.

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Sousa, Fernando Augusto Cervantes Garcia de. "Estudo do potencial de transformação maligna do líquen plano bucal : análise histológica, histoquímica e imunoistoquímica /." São José dos Campos : [s.n.], 2009. http://hdl.handle.net/11449/104570.

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Resumo: O objetivo deste trabalho foi analisar possíveis alterações dos mecanismos de proliferação celular e apoptose no líquen plano bucal, comparando-as com as observadas na displasia epitelial e no carcinoma epidermóide, visando avaliar o seu potencial de transformação maligna. Foram selecionados 24 casos de cada lesão e a partir deles, novos cortes histológicos foram obtidos, sendo parte submetidos à técnica de AgNOR e parte à técnica imunoistoquímica da estreptoavidina-biotina-peroxidase para análise da expressão das proteínas PCNA, p53, bax e bcl-2. A média de NORs/núcleo no líquen plano bucal, na displasia epitelial e no carcinoma epidermóide bucal foram, respectivamente, 1,74±0,32, 2,42±0,62 e 2,41±0,61. A análise de variância revelou haver diferença estatisticamente significante entre o líquen plano bucal e as demais lesões (p<0,05). Quanto à PCNA, p53, bax e bcl-2, o teste de qui-quadrado não revelou haver diferença significante entre a expressão da p53 e da bcl-2. Contudo, a expressão da PCNA foi significativamente menor no líquen plano bucal do que nas demais lesões. Não houve diferença estaticamente significante entre a expressão da PCNA e da bax na displasia epitelial e no carcinoma epidermóide bucal. Conclui-se que alterações na expressão destas proteínas podem ser observadas tanto no líquen plano bucal quanto na displasia epitelial e no carcinoma epidermóide bucal, sugerindo o potencial de transformação maligna desta lesão e enfatizando a importância do acompanhamento em longo prazo dos pacientes. Neste contexto, a análise das NORs se mostrou ferramenta útil em avaliar os casos de líquen plano bucal que apresentem maior risco de transformação maligna.
Abstract: The purpose of this study was to analyze possible alterations in the mechanisms of cell proliferation and apoptosis in oral lichen planus, comparing them with those observed in epithelial dysplasia and squamous cell carcinoma, aiming to establish its malignant transformation potential. Twenty-four cases of each lesion were selected and new histological cuts were obtained, being part of the cuts submitted to the AgNOR and part to the immunohistochemical technique of streptoavidine-biotin technique for analysis of the expression of the PCNA, bax and bcl-2 proteins. The NORs/nucleous mean for oral lichen planus, epithelial dysplasia and squamous cell carcinoma was respectively 1.74±0.32, 2.42±0.62 and 2.41±0.61. Analysis of variance showed statistically significant difference between the oral lichen planus and the others lesions (p<0.05). Regarding PCNA, p53, bax and bcl-2, chi-squared test showed no significant differences between the expression of p53 and bcl-2. However, the expression of PCNA was significantly lower in oral lichen planus than in epithelial dysplasia and oral squamous cell carcinoma. No significant differences between the expression of PCNA and bax in epithelial dysplasia and oral squamous cell carcinoma were observed. It was concluded that alterations in the expression of these proteins can be observed in oral lichen planus, suggesting the potential of malignant transformation of this lesion and emphasizing the importance of follow-up of patients. Within this context, the NORs analysis is a useful tool to evaluate the oral lichen planus cases with high risk of malignant transformation.
Orientador: Luiz Eduardo Blumer Rosa
Coorientador: Yasmin Rodarte Carvalho
Banca: Adriana Aigotti Haberbeck Brandão
Banca: Fábio Daumas Nunes
Banca: Carlos Eduardo Dias Colombo
Banca: Horácio Faig Leite
Doutor

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Sousa, Fernando Augusto Cervantes Garcia de [UNESP]. "Estudo do potencial de transformação maligna do líquen plano bucal: análise histológica, histoquímica e imunoistoquímica." Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/104570.

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O objetivo deste trabalho foi analisar possíveis alterações dos mecanismos de proliferação celular e apoptose no líquen plano bucal, comparando-as com as observadas na displasia epitelial e no carcinoma epidermóide, visando avaliar o seu potencial de transformação maligna. Foram selecionados 24 casos de cada lesão e a partir deles, novos cortes histológicos foram obtidos, sendo parte submetidos à técnica de AgNOR e parte à técnica imunoistoquímica da estreptoavidina-biotina-peroxidase para análise da expressão das proteínas PCNA, p53, bax e bcl-2. A média de NORs/núcleo no líquen plano bucal, na displasia epitelial e no carcinoma epidermóide bucal foram, respectivamente, 1,74±0,32, 2,42±0,62 e 2,41±0,61. A análise de variância revelou haver diferença estatisticamente significante entre o líquen plano bucal e as demais lesões (p<0,05). Quanto à PCNA, p53, bax e bcl-2, o teste de qui-quadrado não revelou haver diferença significante entre a expressão da p53 e da bcl-2. Contudo, a expressão da PCNA foi significativamente menor no líquen plano bucal do que nas demais lesões. Não houve diferença estaticamente significante entre a expressão da PCNA e da bax na displasia epitelial e no carcinoma epidermóide bucal. Conclui-se que alterações na expressão destas proteínas podem ser observadas tanto no líquen plano bucal quanto na displasia epitelial e no carcinoma epidermóide bucal, sugerindo o potencial de transformação maligna desta lesão e enfatizando a importância do acompanhamento em longo prazo dos pacientes. Neste contexto, a análise das NORs se mostrou ferramenta útil em avaliar os casos de líquen plano bucal que apresentem maior risco de transformação maligna.
The purpose of this study was to analyze possible alterations in the mechanisms of cell proliferation and apoptosis in oral lichen planus, comparing them with those observed in epithelial dysplasia and squamous cell carcinoma, aiming to establish its malignant transformation potential. Twenty-four cases of each lesion were selected and new histological cuts were obtained, being part of the cuts submitted to the AgNOR and part to the immunohistochemical technique of streptoavidine-biotin technique for analysis of the expression of the PCNA, bax and bcl-2 proteins. The NORs/nucleous mean for oral lichen planus, epithelial dysplasia and squamous cell carcinoma was respectively 1.74±0.32, 2.42±0.62 and 2.41±0.61. Analysis of variance showed statistically significant difference between the oral lichen planus and the others lesions (p<0.05). Regarding PCNA, p53, bax and bcl-2, chi-squared test showed no significant differences between the expression of p53 and bcl-2. However, the expression of PCNA was significantly lower in oral lichen planus than in epithelial dysplasia and oral squamous cell carcinoma. No significant differences between the expression of PCNA and bax in epithelial dysplasia and oral squamous cell carcinoma were observed. It was concluded that alterations in the expression of these proteins can be observed in oral lichen planus, suggesting the potential of malignant transformation of this lesion and emphasizing the importance of follow-up of patients. Within this context, the NORs analysis is a useful tool to evaluate the oral lichen planus cases with high risk of malignant transformation.

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Leal, Katherine Lord?lo. "Levantamento epidemiol?gico de les?es orais potencialmente malignas em um centro de refer?ncia na Bahia." Universidade Estadual de Feira de Santana, 2013. http://localhost:8080/tede/handle/tede/240.

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Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB
It is mandatory to recognize its previous wounds of mouth cancer, the alleged "potentially malignant injuries" - leukoplakia, cheilitis, erythroplakia and oral lichen planus - with the objective of avoiding its development. A transversal cut study was performed in order to estimate the prevalence of potentially malignant lesions diagnosed at the Centro de Refer?ncia de Les?es Bucais of Universidade Estadual de Feira de Santana and as a means to register the accompaniment of the patients through potential clinical outputs of these lesions informed on the patient's reports from 1996 to 2012. A descriptive analysis of all variables was carried out, followed by the X2 Test of Pearson, which was used as a way of calculating the statistic significance. As a measure of association between the mouth lesion and the studied patient's likely risk factors, the Prevalence Reason calculation was performed within a population interval of 1 standard deviation. Leukoplakia was the most prevalent injury (43,6%) and erythroplakia the least one (13,7%). A statistic significance was observed among all associations of injuries with the variables related to the patient (p<0,05), as well as the lesions and the consummation of its probable risk factors (p=0,00). In the Prevalence Reason calculation, significant results were observed, among which: the leukoplakia and the exposition solely to alcohol (RP=2,47; IP=1,72-3,55); the erythroplakia and the exposition solely to alcohol (RP=2,51; IP=1,38-4,55) and to alcohol and tobacco (RP=1,8; IP=1,23-2,64); the actinic cheilitis and the exposition to solar radiation (RP=2; IP=1,61-2,50) and the solely to tobacco (RP=2,51; IP=1,75-3,59); and the oral lichen planus and the exposition solely to tobacco (RP=2,46; IP=1,80-3,36) and to alcohol and tobacco (RP=3,04; IP=2,11-4,35). Out of the total number of patients, 4,6% of them presented a new wound, among which 52,6% of them were recurrent, half presented by oral lichen planus. Concerning the clinical output, 58,3% of all cases accompanied presented an injury permanence state and 26,9% were in the process of evolving to healing, no case of evolution to mouth cancer was detected. It is mandatory to stimulate the production of studies in such field for they will support protection, prevention, control, and the treatment of the mouth lesions here explored.
Faz-se mister o reconhecimento das les?es precursoras do c?ncer bucal, as ?les?es potencialmente malignas? - leucoplasia, eritroplasia, queilite act?nica e l?quen plano - no intento de prevenir a sua progress?o. Este estudo do tipo corte transversal objetivou estimar a preval?ncia das les?es orais potencialmente malignas diagnosticadas no Centro de Refer?ncia de Les?es Bucais da Universidade Estadual de Feira de Santana e registrar o acompanhamento dos pacientes acometidos, no que se refere aos poss?veis desfechos cl?nicos dessas les?es notificados em seus prontu?rios, no per?odo de 1996 a 2012. Foi feita uma an?lise descritiva de todas as vari?veis do estudo, seguido do uso do Teste X2 (Qui-Quadrado) de Pearson para o c?lculo da medida de signific?ncia estat?stica e como medida de associa??o entre a les?o oral e os prov?veis fatores de risco dos participantes do estudo, realizou-se o c?lculo da Raz?o de Preval?ncia utilizando-se o intervalo populacional com 1 desvio padr?o. A leucoplasia foi a les?o mais prevalente (43,6%) e a eritroplasia, a menos (13,7%). Observou-se signific?ncia estat?stica entre todas as associa??es das les?es com as vari?veis relacionadas ao paciente (p<0,05), como tamb?m entre as les?es e o consumo dos seus poss?veis fatores de risco (p=0,00). No c?lculo da Raz?o de Preval?ncia, verificaram-se resultados significantes entre: a leucoplasia e a exposi??o apenas ao ?lcool (RP=2,47; IP=1,72-3,55); a eritroplasia e a exposi??o apenas ao ?lcool (RP=2,51; IP=1,38-4,55) e ao ?lcool e tabaco (RP=1,8; IP=1,23-2,64); a queilite act?nica e a exposi??o ? radia??o solar (RP=2; IP=1,61-2,50) e a apenas ao tabaco (RP=2,51; IP=1,75-3,59); e o l?quen plano e a exposi??o apenas ao tabaco (RP=2,46; IP=1,80-3,36) e ao ?lcool e tabaco (RP=3,04; IP=2,11-4,35). Do total dos pacientes, 4,6% apresentou nova les?o, dentre as quais, 52,6% eram recidivantes, metade representada pelo l?quen plano. No tocante ao desfecho cl?nico, 58,3% dos casos acompanhados, apontaram estado de perman?ncia da les?o e 26,9%, processo de evolu??o ? cura, n?o tendo sido verificado nenhum caso de evolu??o para o c?ncer oral. Torna-se imperativo a produ??o de estudos neste ?mbito, que venham subsidiar pol?ticas de prote??o, preven??o, controle e tratamento dessas les?es orais aqui exploradas.

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Luiz, Ana Claudia. "Diagnóstico das reações liquenóides de contato envolvendo teste de hipersensibilidade de contato ao amálgama e tratamento pela substituição do material restaurador." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-02012008-114756/.

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O objetivo do presente estudo foi diferenciar reações liquenóides de contato (RLC) de lesões de líquen plano oral (LPO) em pacientes do nosso ambulatório. De um total de 45 pacientes (36 mulheres e 9 homens; média idade = 48,7 anos) com lesões sugestivas de LPO, 18 apresentavam características clínicas compatíveis com RLC, ou seja, lesões próximas ou em contato direto com restaurações em amálgama. Estes pacientes foram classificados em classe I (discreta relação da lesão com amálgama), classe II (moderada relação) e classe III (intensa relação). Todos os pacientes com RLC foram encaminhados para realização de teste epicutâneo padrão (alérgenos \"standard\", Grupo Brasileiro de Dermatites de Contato) e específico (materiais odontológicos, Trolab, Hermal, Alemanha). A substituição do amálgama foi indicada para pacientes classe II e III; em pacientes classe I o tratamento foi indicado somente quando apresentavam teste epicutâneo positivo. Dois pacientes foram excluídos deste estudo por não comparecimento às consultas e 1 por não apresentar resultado anátomo-patológico compatível com LPO. Em pacientes classe I (3 casos), apenas um caso apresentou teste epicutâneo positivo, sendo que a substituição da restauração não resultou em melhora clínica da lesão. Em pacientes classe II (9 casos), teste epicutâneo positivo em 8 casos, a substituição resultou em melhora parcial em 7 casos e total em 2 caso. Em pacientes classe III (3 casos), teste epicutâneo positivo em 2 casos, a substituição resultou em melhora total de todos os casos. Existe um número representativo de pacientes com RLC em nosso meio, sendo que estas lesões podem apresentar associação discreta, moderada ou intensa com o amálgama. Pacientes com associação discreta (classe I) não têm benefício após substituição do material restaurador, enquanto pacientes classe II e III beneficiam-se após substituição do amálgama, obtendo resolução parcial ou total das lesões. A caracterização clínica de lesões LPO associada ao amálgama seguida da substituição do material restaurador tem valor superior aos testes epicutâneos em termos de diagnóstico de RLC.
The purpose of this study was to characterize oral lichenoid reactions (OLR) in our clinic. In a group of 45 patients (36 female and 9 male; mean age = 48.7) with oral lichen planus (OLP), 18 were identified as having OLR because these patients had their OLR lesions related to amalgam fillings. These OLR lesions were clinically graded according to their proximity with the amalgam fillings: class I (weak association with amalgam fillings), class II (moderate association), and class III (strong association). All patients were skin patch tested for both standard allergens (Standard - Brazilian Group of Contact Dermatitis, Brazil) and specific allergens (Dental material - TROLAB, Hermal, Germany). Amalgam restoration was replaced in all class II and III patients and in class I only when patients were positive skin patch test. Two patients were excluded from the study because they missed follow ups and one because histopathological analysis does not show OLP features. From 3 cases class I only 1 had positive skin patch test, but did not have improvement of the oral lesions after amalgam replacement. Class II patients (9 cases) positive skin patch test in 8 cases, resulted in substantial improvement in 7 cases and complete resolution in 2 case after amalgam replacement. Class III patients (3 cases) positive patch test in 2 cases, result in complete improvement in all cases after amalgam replacement. We can conclude that there are a representative number of patients with ORL in our clinic showing either a weak, moderate or strong association with amalgam fillings. Patients with a weak association (class I) did not have benefit after amalgam replacement, while patients with a moderate and strong association (class II and III) had benefit after amalgam replacement with substantial improvement or complete resolution of the lesions. Clinical characterization of the association between OLP lesions and amalgam filling, followed by its replacement, outperformed skin patch testing for diagnosing ORL lesions.

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Monteiro, Barbara Vanessa de Brito. "An?lise da resposta Th17 em l?quen plano oral." Universidade Federal do Rio Grande do Norte, 2012. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17122.

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Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
Th17 cells have been strongly associated with the pathogenesis of several autoimmune and inflammatory diseases. IL-17 and IL-23 are important cytokines associated with this lineage. The aim of this study was to analyze, through immunohistochemical methods, the immunoexpression of IL-17 and IL-23 in the inflammatory infiltrate of oral lichen planus (OLP) lesion compared to that of inflammatory fibrous hyperplasia (IFH) and between clinical forms reticular and erosive of OLP. The sample included 41 cases of OLP, of which 23 were reticular and 18 erosive and 10 cases of IFH. The results were subjected to nonparametric statistical tests with a 5% significance level. In OLP lesions histomorphological analysis, the most common findings were: hyperparakeratinization, specimens with atrophic epithelium in erosive clinical form (p = 0.011), epithelial projections in most of reticular type of lesions, in addition Civatte bodies were identified in most samples of both clinical forms. For immunohistochemistry analysis, five fields with strong immunoreactivity for IL-17 and IL-23 were photomicrographed at 400x magnification, images were transferred to a computer where with ImageJ software?, lymphocytes that exhibited cytoplasmic immunostaining for these cytokines were counted. A mean was established after for each case. There was no statistically significant difference in the number of imunopositive lymphocytes for IL-17 and IL-23 among the group of OLP and IFH group, however a larger amount of lymphocytes imunopositive for IL-17 was found in the LPO group (p = 0.079) and significantly higher amounts of those lymphocytes were found in the erosive OLP when compared to the group of reticular OLP and IFH (p = 0.019). Furthermore, a marker epithelial immunopositivity for IL-17 was observed in OLP group. Although the results of this study do not permit the forceful assertion about the participation of Th17 lineage in OLP lesions, the findings of immunopositive lymphocytes counting for IL-17 and IL-23, which are potent proinflammatory cytokines, together with the the marked epithelial immunopositivity found for IL-17 in this study, suggest a possible role of this lineage in the pathogenesis of this disorder
As c?lulas Th17 t?m sido fortemente associadas com a patogenia de diversas doen?as autoimunes e inflamat?rias. A IL-17 e a IL-23 s?o importantes citocinas associadas com esta linhagem. O objetivo do presente trabalho foi analisar, atrav?s de m?todos imunohistoqu?micos, a imunoexpress?o da IL-17 e da IL-23 no infiltrado inflamat?rio das les?es de l?quen plano oral (LPO) comparando ao da hiperplasia fibrosa inflamat?ria (HFI) e entre as formas cl?nicas reticular e erosiva do LPO com o intuito de esclarecer se a linhagem Th17 participa da patog?nese do LPO. Na amostra foram inclu?dos 41 casos de LPO, dos quais 23 eram reticulares e 18 erosivos, al?m de 10 casos de HFI. Os resultados foram submetidos a testes estat?sticos n?o param?tricos com n?vel de signific?ncia de 5%. Na an?lise histomorfol?gica das les?es de LPO, observou-se predom?nio de: les?es hiperparaceratinizadas, esp?cimes com epit?lio atr?fico na forma cl?nica erosiva (p=0,011), proje??es epiteliais nas les?es do tipo reticular, al?m de corpos de Civatte identificados na maior parte da amostra de ambas as formas cl?nicas. Para o estudo imuno-histoqu?mico, cinco campos com forte imunorreatividade para a IL-17 e para a IL-23 foram fotomicrografados sob o aumento de 400x, as fotos foram transferidas para um computador onde com o aux?lio do software ImageJ?, realizou-se a contagem dos linf?citos que exibiram imunomarca??o citoplasm?tica para estas citocinas. Posteriormente, foi estabelecida uma m?dia para cada caso. N?o foram observadas diferen?as estatisticamente significativas na quantidade de linf?citos imunopositivos para a IL-17 e para a IL-23 entre o grupo do LPO e da HFI, no entanto uma maior quantidade desses linf?citos para a IL-17 foi encontrada no grupo do LPO (p=0,079) e uma quantidade significativamente maior de linf?citos imunopositivos para a IL- 23 foi encontrada entre o grupo do LPO erosivo e da HFI (p=0,019). Al?m disto, foi observada uma marcante imunopositividade epitelial para a IL-17 no grupo do LPO. Ainda que os resultados do presente estudo n?o permitam a afirma??o contundente da participa??o da linhagem Th17 nas les?es de LPO, os achados da contagem dos linf?citos imunopositivos para a IL-17 e para a IL-23, que s?o potentes citocinas pr?-inflamat?rias, somados ? marcante imunopositividade epitelial encontrada para a IL-17 neste estudo, sugerem uma poss?vel participa??o desta linhagem na patog?nese desta desordem

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Mendes, Gabriela Geraldo. "Estudo imuno-histoquímico da expressão de metalotioneína e proteína p16 em líquen plano e reações liquenóides orais." Universidade Federal de Uberlândia, 2015. https://repositorio.ufu.br/handle/123456789/12419.

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Fundação de Amparo a Pesquisa do Estado de Minas Gerais
Lichen planus is a chronic inflammatory disease mediated by T cells of unknown cause. Skin, nails and mucous membranes can be affected, and the disease is more common in middleaged adults, especially in women. Oral lichen planus (OLP) manifests as reticular (white) and erosive (red) lesions that are eventually painful. Histologically, it is characterized by dense lymphocytic infiltrate beneath the epithelium, apoptosis of keratinocytes, liquefaction of the basal layer, epithelial hyperplasia and hyperkeratosis. Oral lichenoid reactions (OLR) are distinguished from OLP by the presence of precipitating factors, unilateral lesions and diffuse inflammatory infiltrate. Metallothionein is a protein involved in anti-oxidative response and anti-apoptotic pathways. Ki-67 is a cellular proliferation marker and is expressed only in cells that are in cell division (phases G1, S, G2 and M of the cell cycle). The tumor suppressor gene p16 is involved in the pRb pathway and participates in the regulation of the cell cycle, repairing possible damage to DNA. The aim of this study was to evaluate possible molecular differences, related to oxidative stress and cell proliferation between OLP and OLR, and the two major forms of OLP in order to better understand the pathogenesis of these lesions and facilitate the differential diagnosis between them. Immunohistochemistry for metallothionein, Ki-67 and p16 detection was performed in 42 and 23 cases of OLP and OLR, respectively. Reactivity for metallothionein was more frequently observed in OLP cases than in OLR cases (p = 0,01; Mann-Whitney U test). Significant difference was found between the reticular and atrophic lesions of OLP for p16 protein (p = 0,04; Mann-Whitney U test). There was no significant difference between the lesions in relation to Ki-67 antigen. The results of this study suggest that metallothionein protein may be a useful marker of differential diagnosis between OLP and OLR, and that p16 protein may be a differential marker of reticular and atrophic/erosive lesions of OLP.
O líquen plano é uma doença inflamatória crônica, mediada por células T e de causa desconhecida. Pele, unhas e mucosas podem ser afetadas, e a doença é mais comum em adultos de meia-idade, especialmente em mulheres. Histologicamente, é caracterizada por denso infiltrado linfocitário subepitelial em banda, apoptose de queratinócitos, liquefação da camada basal, hiperplasia e hiperqueratose epitelial. O líquen plano oral (LPO) se manifesta clinicamente como lesões reticulares (brancas) e atróficas/erosivas (vermelhas), que são eventualmente dolorosas. Reações liquenóides orais (RLO) distinguem-se do LPO pela presença de fatores precipitantes, lesões unilaterais e infiltrado inflamatório difuso. A metalotioneína é uma proteína envolvida em resposta antioxidante e vias anti-apoptóticas. Ki- 67 é um marcador de proliferação celular e é expresso somente em células que estão em divisão celular (fases G1, S, G2 e M do ciclo celular). O gene supressor de tumor p16 está envolvido na via de sinalização pRb e atua na regulação do ciclo celular, reparando possíveis danos ao DNA. O objetivo deste estudo foi avaliar possíveis diferenças moleculares, relacionadas ao estresse oxidativo e proliferação celular entre LPO e RLO, bem como as duas formas clínicas principais de LPO, a fim de melhor compreender a patogênese dessas lesões e facilitar o diagnóstico diferencial entre elas. Imuno-histoquímica para detecção de metalotioneína, Ki-67 e p16 foi realizada em 42 e 23 casos de LPO e RLO, respectivamente. Reatividade para metalotioneína foi mais frequente em casos de LPO do que em casos de RLO (p = 0,01; Mann-Whitney U). Foram observadas diferenças significativas entre as lesões reticulares e atróficas/erosivas de LPO para a proteína p16 (p = 0,04; Mann-Whitney U). Não houve diferença significativa entre as lesões em relação ao antígeno Ki-67. Os resultados deste estudo sugerem que a proteína metalotioneína pode ser um marcador útil do diagnóstico diferencial entre LPO e RLO, e que a proteína p16 pode ser um marcador diferencial das lesões reticulares e atróficas/erosivas de LPO.
Mestre em Biologia Celular e Estrutural Aplicadas

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Martins, Joana Dourado. "Associa??o entre a ansiedade e depress?o e o l?quen plano bucal." Universidade Estadual de Feira de Santana, 2014. http://localhost:8080/tede/handle/tede/75.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
Introduction: Oral lichen planus is a chronic inflammatory disease, potentially malignant. Objective: To evaluate the association between psychological states (anxiety and depression) and oral lichen planus. Methods: In a first study, a systematic review by consulting the electronic databases was performed (PubMed, Science Direct and LILACS) in the period between October 2013 and January 2014, using a predefined protocol. A critical evaluation of the literature was conducted in three stages by two reviewers independently, strictly observing the established inclusion and exclusion criteria. The quality of the articles was assessed based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). For the second study, in a case-control model were established two groups, the cases group composed of individuals with a clinical diagnosis / histopathological of LPB and the control group, made up of individuals obtained the same reference population of cases, no history oral lichen planus, admitted at random and matched by sex and age in those cases. Both groups were subjected to thorough clinical examination of the oral cavity, interview and psychometric tests (Anxiety Inventory and Beck Depression). Data were statistically analyzed using the Data Analysis and Statiscal Software (StataSE- StataCorp LP) version 10. Results: For the systematic review, seven articles were selected at the end of the analysis and in four of them were observed a significant association between psychological changes and the development of oral lichen planus. The analysis of the quality of the articles through the STROBE showed an average of 11.3 items included, with a standard deviation of 2.2. For the case-control, there was an association between psychological disorders and OLP (p <0.001), and the crude OR of the principal association 5.06 (95% CI: [2.02 to 12.08]), while in subgroup analysis, the multivariate model adjusted for occupation and indicated an adjusted OR of 3.67 (95% CI: [1.05 to 3.46]), also statistically significant. Conclusion: Based on the results obtained in the studies, safeguarding the necessary limitations of the proposed models, there was an association between OLP and the presence of anxiety and depression.
Introdu??o: O l?quen plano bucal ? uma doen?a inflamat?ria cr?nica, potencialmente maligna. Objetivo: Avaliar a associa??o entre os estados psicol?gicos (ansiedade e depress?o) e o l?quen plano bucal. M?todos: Em um primeiro estudo, foi realizada uma revis?o sistem?tica consultando as bases de dados eletr?nicas (PubMed, Science Direct e LILACS) entre o per?odo de outubro de 2013 a janeiro de 2014, utilizando um protocolo previamente definido. A avalia??o cr?tica dos artigos foi realizada em tr?s est?gios por dois revisores, de forma independente, obedecendo rigorosamente aos crit?rios de inclus?o e exclus?o estabelecidos. A qualidade dos artigos foi avaliada com base no Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Para o segundo estudo, em um modelo de caso-controle foram estabelecidos dois grupos, o grupo casos, composto de indiv?duos com diagn?stico cl?nico/histopatol?gico de LPB e o grupo controle, formado por indiv?duos obtidos da mesma popula??o de refer?ncia dos casos, sem hist?ria de l?quen plano bucal, admitidos de forma aleat?ria e pareados por sexo e idade em rela??o aos casos. Os dois grupos foram submetidos a exame cl?nico minucioso da cavidade bucal, entrevista e testes psicom?tricos (Invent?rios de Ansiedade e Depress?o de Beck). Os dados obtidos foram analisados estatisticamente utilizando o Data Analysis and Statiscal Software (StataSE- StataCorp LP) vers?o 10. Resultados: Para a revis?o sistem?tica, sete artigos foram selecionados ao final da an?lise e em quatro deles foram observadas uma associa??o significativa entre as altera??es psicol?gicas e o desenvolvimento do l?quen plano bucal. A an?lise da qualidade dos artigos atrav?s do STROBE mostrou uma m?dia de 11,3 itens inclu?dos, com desvio-padr?o de 2,2. Para o estudo de caso-controle, houve associa??o entre os dist?rbios psicol?gicos e o LPB (p<0,001), sendo a OR bruta da associa??o principal 5,06 (IC95%: [2,02-12,08]), enquanto na an?lise de subgrupos, o modelo multivariado e ajustado para ocupa??o indicou uma OR ajustada de 3,67 (IC95%: [1,05-3,46]), tamb?m estatisticamente significante. Conclus?o: Com base nos resultados obtidos nos estudos, resguardando as devidas limita??es dos modelos propostos, houve uma associa??o entre o LPB e a presen?a da ansiedade e depress?o.

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Pereira, Joabe dos Santos. "An?lise de c?lulas T regulat?rias FoxP3+ no l?quen plano oral." Universidade Federal do Rio Grande do Norte, 2010. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17110.

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T regulatory cells have the function of controlling immune responses and maintaining self-tolerance. The FoxP3 has been considered the most specific marker for Treg cells. The aiming of this paper was to evaluate the immunoexpression of FoxP3 in the inflammatory infiltrate from oral lichen planus (OLP) and to compare it with the infiltrate in fibrous inflammatory hyperplasia (FIH) and then, between reticular and erosive forms of OLP. The samples were composed by 32 cases of OLP (17 reticular and 15 erosive) beyond 10 cases of FIH that were submitted to immunohistochemistry staining for FoxP3. Localization of the staining was classified in underepithelial and intraepithelial and the amount of FoxP3+ cells was evaluated through cells counting in 10 consecutive fields, at 400x power magnification. The values were expressed in mean ? standart deviation, and submitted to statistical tests with 5% of significance level. It was observed a statistical significant difference in the amount of FoxP3+ Treg cells between the two combined forms of OLP (1,6 ? 2,2) and the FIH (0,5 ?0,4) (P<0,05). This maybe could be explained by immunological mechanism of OLP, which involves a permanent antigenic induction likely with consequent perpetuation of lesion, eliciting the proliferation and constant recruitment of Treg cells. Otherwise, FIH presents a different etiopathogenesis, in which there is also generation of a variable inflammatory infiltrate, however qualitatively distinct from that seen in OLP. The erosive form of OLP exhibited a greater number (1,7 ? 2,4) of FoxP3+ Treg cells than reticular form (1,5 ? 2,1). These alterations could have relation with the great disease activity verified in erosive OLP, or also, with abnormalities in the regulatory function of Treg cells that could cause the increase observed. Considering the capacity already well established in the literature, both about Treg cells in modulating immune responses, as in the oral mucosa in showing great potential for regeneration, it is suggested that the possibility of development and implantation of immunotherapeutic strategies that regulate the frequency and function of these cells, may help in future treatment of immune-mediated inflammatory diseases such as OLP
As c?lulas T regulat?rias (Treg) possuem a fun??o de controlar respostas imunes e manter a autotoler?ncia. O FoxP3 tem sido considerado o marcador mais espec?fico para c?lulas Treg. O objetivo deste estudo foi avaliar a imunoexpress?o do FoxP3 no infiltrado inflamat?rio do l?quen plano oral (LPO) comparado ao da hiperplasia fibrosa inflamat?ria (HFI) e posteriormente entre as formas reticular e erosiva do LPO. A amostra foi composta por 32 casos de LPO (17 reticulares e 15 erosivos) al?m de 10 casos de HFI que foram submetidos ? marca??o imunoistoqu?mica para o FoxP3. A localiza??o da marca??o foi classificada em justaepitelial ou intraepitelial e a quantidade das c?lulas FoxP3+ foi avaliada atrav?s da contagem destas em 10 campos consecutivos, com aumento de 400x. Os valores foram expressos em m?dia ? desvio-padr?o, e submetidos aos testes estat?sticos com n?vel de signific?ncia de 5%. Observou-se uma diferen?a estatisticamente significativa na quantidade de c?lulas Treg FoxP3+ entre os dois tipos de LPO reunidos (1,6 ? 2,2) e a HFI (0,5 ? 0,4) (P<0,05). Isto talvez possa ser explicado pelo mecanismo imunol?gico do LPO, que envolve uma prov?vel indu??o antig?nica permanente com conseq?ente perpetua??o da les?o, suscitando a prolifera??o e recrutamento constante das c?lulas Treg. Em contrapartida, a HFI apresenta uma etiopatogenia diferente, na qual tamb?m h? gera??o de um infiltrado inflamat?rio vari?vel, por?m qualitativamente distinto do verificado no LPO. A forma erosiva do LPO exibiu um maior n?mero (1,7 ? 2,4) de c?lulas Treg FoxP3+ que a forma reticular (1,5 ? 2,1). Estas altera??es podem ter rela??o com a maior atividade da doen?a verificada no LPO erosivo, ou ainda, com anormalidades na fun??o reguladora das c?lulas Treg que ocasionariam o aumento observado. Considerando-se a capacidade j? bem estabelecida na literatura, tanto das c?lulas Treg modularem as respostas imunol?gicas, quanto da mucosa oral em exibir um grande potencial de regenera??o, sugere-se que a possibilidade de desenvolvimento e implanta??o de estrat?gias imunoterap?uticas que regulem a freq??ncia e a fun??o destas c?lulas, possa futuramente auxiliar no tratamento de doen?as inflamat?rias mediadas imunologicamente, como o LPO

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46

Gallo, Camila de Barros. "Estudo de polimorfismos de nucleotídeo único em genes de receptores Toll-like em pacientes com líquen plano oral e pacientes com carcinoma epidermóide de boca." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-13042013-115635/.

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Polimorfismos em genes de receptores Toll-like (TLR) podem modular o risco de desenvolvimento de infecção, inflamação crônica e câncer. O objetivo deste estudo foi investigar a associação de polimorfismos em TLR ao risco aumentado de desenvolvimento de câncer de cabeça e pescoço, o carcinoma epidermóide (CEC) de boca e de laringe, e lesões bucais com potencial de transformação maligna, como o líquen plano oral (LPO), incluindo lesões idiopáticas e lesões liquenóides (LLO). Para tal foi conduzido um estudo caso-controle com 40 pacientes com CEC de boca, 35 com CEC de laringe, 175 com LPO (129 idiopático e 46 LLO) e 89 controles saudáveis, todos de origem basca. Oito SNP nos TLR1, TLR2, TLR4, TLR6, TLR9 e TLR10 foram genotipados por ensaios TaqMan® ou pirosequenciamento. A análise estatística por meio do teste qui-quadrado mostrou que a variante A, para o SNP TLR2-rs4696480 aumentou significativamente o risco para o desenvolvimento de CEC de boca (p=0.03) e LLO (p=0.0223). O genótipo AT representa risco de desenvolvimento de CEC de boca aumentado em 5.3 vezes quando comparado ao genótipo TT (OR=5.3, IC95%=1.19-13.63), e genótipo AA em 6.6 vezes (OR=6.6, IC95%=1.30-33.89). Quanto ao desenvolvimento de LLO, o genótipo AT representa um aumento no risco de 4.6 vezes comparado ao genótipo TT (OR=4.6, IC95%=1.55-13.38) e o genótipo AA em 4.1 vezes (OR=4.1, IC95%=1.33-12.88). Embora os genótipos AT e AA ocorram com significativa frequência no grupo LPO idiopático (p=0.045), este SNP não foi correlacionado estatisticamente à susceptibilidade de desenvolvimento deste. O SNP TLR2-rs4696480 pode ser relevante para o risco de desenvolvimento de CEC de boca e LLO nesta população, incentivando novos estudos sobre a possível associação destes grupos de doenças e SNP no gene do TLR2, colaborando com a demonstração de polimorfismos de TLR como marcadores úteis do prognóstico e prevenção do câncer de boca.
Polymorphisms in toll-like receptor (TLR) genes may modulate the risk of infection, chronic inflammation and cancer. This study investigated whether TLR polymorphisms were associated with an increased risk of head and neck cancer, including oral (OSCC) and laryngeal squamous cell carcinoma (LSCC); and oral premalignant disorders such as oral lichenoid disease (OLD), including oral lichen planus (OLP) and oral lichenoid lesions (OLL). This case-control study included 40 OSCC, 35 LSCC, 175 OLD (129 OLP and 46 OLL) patients and 89 healthy controls, all of them from the Basque Country. Genetic polymorphisms in TLR1, TLR2, TLR4, TLR6, TLR9, and TLR10 were genotyped by TaqMan® assays or pyrosequencing. Chi-square analysis showed that the variant A for the SNP TLR2-rs4696480 increased OSCC (p=0.03) and OLL (p=0.0223) risk significantly. AT genotype increases the risk of developing an OSCC by 5.3 times compared with TT genotype (OR=5.3, 95%CI=1.19-13.63), and the AA by 6.6 times (OR=6.6, 95%CI=1.30-33.89). AT genotype increases the risk of developing OLL by 4.6 times compared with TT genotype (OR=4.6, 95%CI=1.55-13.38) and the AA by 4.1 times (OR=4.1, 95%CI=1.33-12.88). Although these mutated genotypes were significantly frequent in the OLP group (p=0.045), this SNP was not correlated with OLP susceptibility. TLR2-rs4696480 polymorphism may be relevant to OSCC and OLL susceptibility in this population; encouraging further studies to assess the possible association of this group of potentially malignant disorders and oral cancer with TLR2 SNP, which may help to demonstrate that TLR polymorphisms may be useful markers to prognosis and cancer prevention.

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47

Barbosa, Hyrlana Leal. "L?QUEN PLANO BUCAL E A INFEC??O PELO V?RUS DA HEPATITE C." UNIVERSIDADE ESTADUAL DE FEIRA DE SANTANA, 2007. http://localhost:8080/tede/handle/tede/51.

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Lichen planus (LP) is a chronic inflammatory disease that affects skin and/or mucous and whose origin still is unknown. In the mouth the disease is called oral lichen planus (OLP). The association between OLP and the hepatitis C virus (HCV) infection has been widely argued in literature with controversial results. The aim of this age- and sex-matched case-control study was evaluate the association between OLP and HCV infection. Thirty individuals with OLP diagnosed in the Reference Center of Oral Disease of the State University of Feira de Santana, comprised of the test group (OLP group), and thirty healthy individuals proceeding from the same population were included in the control group. None out of the OLP group or control group were seropositive for anti-HCV. The results showed there is not association between OLP and HCV infection. Analyses add between the association of the LPB and the presence of systemic diseases, drugs use, menopause and habits to smoke and to consume alcoholic beverage did not shown significance statistics. On the basis of the results of the present study were not possible to establish the association between OLP and HCV infection. In conclusion, further new longitudinal studies may be performed in attempt to clarify this matter.
L?quen plano (LP) ? uma doen?a inflamat?ria cr?nica que afeta, principalmente, pele e/ou mucosas e cuja origem ainda ? desconhecida. Na boca a doen?a ? denominada de l?quen plano bucal (LPB). A associa??o entre o LPB e a infec??o pelo v?rus da hepatite C (VHC) tem sido amplamente discutida na literatura, com resultados controversos. Com o prop?sito de verificar a associa??o entre o LPB e a infec??o pelo VCH, foi conduzido um estudo tipo caso-controle, pareado por idade e selecionados trinta indiv?duos portadores de LPB, diagnosticados no Centro de Refer?ncia em Les?es Bucais da Universidade Estadual de Feira de Santana, que compuseram o grupo de casos, e outros trinta indiv?duos provenientes da mesma popula??o, que n?o apresentavam les?es bucais. Os resultados encontrados indicaram n?o haver associa??o entre o LPB e a infec??o pelo VHC visto que n?o foram encontrados indiv?duos com sorologia reagente para o v?rus. An?lises adicionais entre a associa??o do LPB e a presen?a de doen?as sist?micas e menopausa, uso de medicamentos e h?bitos de fumar e consumir bebidas alco?licas n?o mostraram signific?ncia estat?stica. Com base nos resultados do presente estudo n?o foi poss?vel estabelecer a associa??o entre o LPB e a VHC e, portanto, sugere-se a realiza??o de novos estudos longitudinais, que possam esclarecer tal poss?vel rela??o.

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48

Jalouli, Jamshid. "Human Papilloma Virus, Epstein-Barr Virus, and Herpes Simplex Virus Type-1 in Oral Squamous Cell Carcinomas from Three Populations." Doctoral thesis, Uppsala universitet, Käkkirurgi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-128912.

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Most oral squamous cell carcinoma (OSCC) is believed to develop via a multistep process of cumulative gene damage in epithelial cells. Increasing incidence of OSCC and evidence that traditional risk factors may not be responsible directed us to investigate the prevalence of virus in pre- and malignant samples.The integration of the DNA from human papillomavirus (HPV), Epstein-Barr virus (EBV), and Herpes simplex (HSV) into the human genome is associated with the expression of oncogenes and the down-regulation of tumor-suppressor genes in OSCC carcinogenesis. This thesis compared samples from India and Sudan, two countries on two continents having a documented high incidence of oral cancer, with specimens from Sweden, with its known low incidence of oral cancer. Each region has, in addition to smoking, a unique non-smoked tobacco habits with documented carcinogenic effects. These countries also typify areas of low and high socioeconomic living conditions with their expected impact on disease development. The study populations were selected from tobacco users and nonusers with OSCC, oral sub-mucous fibrosis (India), oral lichen planus (Sweden), oral leukoplakia with and without dysplasia and snuff-induced lesions (Sweden and Sudan). An expedient method was developed for extracting DNA from old formalin-fixed and paraffin-embedded biopsies. The prevalence of HPV, EBV, and HSV was investigated using PCR/DNA sequencing and southern blot hybridization analysis. We found HPV and EBV to be most prevalent in samples of tissue characterized as normal, with decreasing prevalence in dysplastic and malignant lesions. This intriguing finding that prevalence decreases as neoplastic development proceeds warrants further investigation. Our data do not at first sight support the conclusion that viruses and tobacco use jointly interact with cell mechanisms in the development of oral cancer.

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49

Torrezani, Anna. "Uso de tacrolimus tópico em pacientes com gengivite descamativa: um estudo aberto." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-06062011-145351/.

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O presente estudo teve como objetivo avaliar a eficácia do imunossupressor tópico tacrolimus a 0,1%, aplicado de forma oclusiva com o auxílio de moldeiras individualizadas de silicone em pacientes com gengivite descamativa decorrentes do líquen plano oral (LPO) e do penfigóide das membranas mucosas (PMM). Foram selecionados consecutivamente 18 pacientes que preencheram os critérios de inclusão adotados, sendo 17 mulheres (8 LPO / 9 PMM) e 1 homem com LPO. Após o estabelecimento do diagnóstico os pacientes foram avaliados por um mesmo avaliador quanto aos sinais e sintomas, utilizando-se para isso duas escalas visuais analógicas, uma para dor e outra para ardência, além de um periograma especialmente desenhado para avaliação clínica, demarcando as áreas onde haviam a presença de lesões gengivais no dia zero e no dia 90. Após adequação periodontal os pacientes eram moldados para confecção de uma moldeira individual de silicone para servir de suporte oclusivo para a medicação estudada. A terapêutica adotada foi dividida em duas fases de 45 dias totalizando 90 dias. Na primeira fase os pacientes foram orientados a usar de 1 a 2 gramas da medicação em cada moldeira, duas vezes ao dia por 20 minutos e na segunda fase somente uma vez ao dia. Os possíveis efeitos colaterais eram monitorados durante as consultas de retorno a cada 15 dias. Ao final dos 90 dias avaliamos o percentual de remissão dos sinais, classificada como completa (100%), excelente (75% a 99%), boa (50% a 74%), regular (1 a 44%), inalterada ou com piora do quadro. Nos pacientes estudados obtivemos remissão completa em 4 (30,76%), 4 com remissão excelente (30,76%), 4 com remissão boa (30,76%) e um com remissão regular (7,69%). Em relação aos sintomas da dor obtivemos uma redução média de 60% e em relação a ardência uma redução média de 65,5%. Os pacientes com LPO obtiveram uma redução média da dor de 42,5% e da ardência de 58%, nos pacientes com PMM a redução da dor foi de 92,8% e da ardência de 80,7%. A comparação dos escores de dor antes e após o tratamento apresentou valor de p<0,01 quando realizado o teste de Wilcoxon para amostras pareadas. O mesmo resultado (p<0,01) foi encontrado quando comparados os escores de ardência. Os valores obtidos demonstraram que a diminuição dos escores de dor e ardência foi estatisticamente significante. Como efeitos colaterais observamos que todos relataram alteração transitória de paladar e um paciente com LPO desenvolveu candidose. Concluímos que o tacrolimus a 0,1% aplicado topicamente com moldeiras individuais de silicone foi eficaz no tratamento das gengivites descamativas quanto a dor, ardência e remissão clínica das lesões gengivais em pacientes com LPO e PMM.
The objective of this study was to evaluate the efficacy of application of the topical immunosuppressor 0.1 % tacrolimus in patients with desquamative gingivitis (DG) associated with oral lichen planus (OLP) and mucous membrane pemphigoid (MMP). We selected 18 patients that fulfilled the inclusion criteria: 17 females (8 OLP/ 9MMP) and one male (OLP). After diagnosis, all subjects were evaluated by the same researcher, who assessed pain and burning using two visual analogical scales, one for pain and the other for burning, in conjunction with a diagram of the gingival mucosa. Measurements were made on day zero and day 90. After the periodontal assessment, individualized silicone rubber trays were prepared in order to deliver the drug. The therapeutic strategy was divided in two phases of 45 days for a total of 90 days. In the first treatment phase it was recommended that all patients use one or two grams of 0.1 % tacrolimus in his/her tray for twenty minutes, twice daily; in the second phase, the treatment was to be used only once daily. All side effects were monitored during biweekly return visits. At the end of 90 days, the response to therapy was assessed according to the following scale, as a percentage of remission: complete (100 %), excellent (75 % to 99 %), good (50 % to 74 %), poor (1 % to 49 %), no response (0 %) and worsened. We observed complete remission in 4 patients (30.76 % of the experimental group), excellent in 4 patients (30.76 %), good in 4 patients (30.76 %), and poor in one (7.69%). Pain was reported to be reduced by 60 % while burning was reduced by 65.5 %. OLP patients showed an average reduction by 42.5% of pain and 58% of burning. MMP patients showed an average reduction by 92.8% of pain and 80.7% of burning. After treatment, the data were analyzed by Wilcoxons test; significant differences (p < 0.01) were found for both pain and burning. Side effects included transitory alteration of taste, and one patient was diagnosed with candidiasis. From this study, we conclude that topical application of 0.1% tacrolimus using silicone rubber trays is an effective treatment for desquamative gingivitis, decreasing pain, burning and clinical lesions in OLP and MMP patients.

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50

Barbosa, Nat?lia Guimar?es. "Estudo cl?nico e n?veis de ansiedade em uma s?rie de casos de l?quen plano oral." Universidade Federal do Rio Grande do Norte, 2012. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17120.

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Oral Lichen Planus (OLP) is a relatively common, cronic inflammatory disease. Its etiopathogenesis is no completely understood and several factors have proposed in attempt to explain the appearance, variety of clinical manifestations and periods of exacerbation and remission of the symptons of the lesions. The objective of the present study was to assess the presence of local factors, systemic diseases and levels of anxiety in patients with OLP, investigating their association with the clinical characteristics of the lesions. The sample consisted of 37 patients with histopathologically confirmed OLP that were submitted to a clinical exam to evaluate the presence of smoking habits, consumption of alcoholic beverages, diabetes mellitus, hypertension and hepatitis C virus (HCV) infection. The existence of skin lesions, as well as the time course, clinical form, symptomatology, number and location of the oral lesions were also registered. The trait anxiety was measured by Spielberger s Stai-Trait Anxiety Inventory (STAI), and to associate the variables we used the chi-square or Fisher s exact test. It was observed that females were the most affected (75%) and the mean age of the patients was 53,3 years. Most cases were non-smoker (97,3%) and none was drinker. Diabetes mellitus and hypertension were present in 10,8% e 16,2% of the sample, respectively and only one patient was HCV-seropositive (2,7%). Moderate levels of anxiety were seen in most cases (78,4%) and 21,6% had elevated levels. The oral lesions persisted in 95% of the cases for a period of 6 months to 13 years. The erosive form was the most prevalent (57,1%) and symptons were reported by 45,7% of the patients. Multiple lesions were frequent (60%), affecting mainly the buccal mucosa, followed by gums e tongue. There was no significant association of the presence of diabetes mellitus, hypertension and levels of anxiety with the clinical form or symptomatology of the oral lesions (p>0,005), despite a trend in patients with hypertension to have erosive lesions. It was concluded that, in the sample studied, moderate levels of anxiety were commonly observed, and the HCV infection apparently is not related to the onset of the OLP. In this study, the presence of diabetes mellitus, hypertension and levels of anxiety seem not to be associated with the clinical characteristics of the lesions of OLP
O L?quen Plano Oral (LPO) ? uma doen?a inflamat?ria cr?nica relativamente comum. Sua etiopatogenia n?o est? completamente esclarecida e diversos fatores foram propostos na tentativa de explicar o surgimento, variedade de aspectos cl?nicos e os per?odos de remiss?o e exacerba??o dos sintomas das les?es. O objetivo deste trabalho foi estudar a presen?a de fatores locais, altera??es sist?micas e n?veis de ansiedade em pacientes com LPO, investigando sua associa??o com as caracter?sticas cl?nicas das les?es. A amostra foi constitu?da por 37 pacientes com LPO confirmado histopatologicamente, os quais foram submetidos a exame cl?nico para avaliar a presen?a do tabagismo, consumo de bebidas alco?licas, diabetes mellitus, hipertens?o arterial e infec??o pelo v?rus da hepatite C (HCV). A exist?ncia de les?es cut?neas, bem como o tempo de evolu??o, padr?o cl?nico, sintomatologia, quantidade e localiza??o das les?es orais tamb?m foram registradas. O tra?o ansioso foi mensurado atrav?s do Invent?rio de Ansiedade Tra?o-Estado (IDATE) de Spielberger, e para associar as vari?veis, foram utilizados o teste qui-quadrado de Pearson ou o teste exato de Fisher. Observou-se que o g?nero feminino foi o mais afetado (75%) e a m?dia de idade dos pacientes foi 53,3 anos. A maioria dos casos eram n?o-fumantes (97,3%) e nenhum era etilista. A diabetes mellitus e a hipertens?o arterial estiveram presentes em 10,8% e 16,2% da amostra, respectivamente e apenas um paciente era HCV-soropositivo (2,7%). N?veis moderados de ansiedade foram vistos na maioria dos casos (78,4%) e 21,6% tinham n?veis elevados. As les?es orais persistiram em 95% da amostra por per?odo de 6 meses a 13 anos. A forma erosiva foi a mais prevalente (57,1%) e os sintomas foram relatados por 45,7% dos casos. Les?es m?ltiplas foram freq?entes (60%), surgindo principalmente na mucosa jugal, seguida da gengiva e l?ngua. N?o houve associa??o estatisticamente significativa da presen?a de diabetes mellitus, hipertens?o arterial e os n?veis de ansiedade com a forma cl?nica e a sintomatologia das les?es (p>0.005), apesar da tend?ncia dos pacientes hipertensos a apresentar les?es erosivas. Concluiu-se que, na amostra estudada, n?veis moderados de ansiedade foram frequentemente observados, e a infec??o pelo HCV aparentemente n?o est? relacionada ao surgimento do LPO. Neste estudo, a presen?a da diabetes mellitus, hipertens?o arterial e os n?veis de ansiedade parecem n?o estar associados ?s caracter?sticas cl?nicas das les?es de LPO

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