Sun Andy, Chia Jean-San, Chang Yu-Fong, Chiang Chun-Pin
School of Dentistry, College of Medicine, National, Taiwan University, Taiwan.
J Oral Pathol Med. 2002 Apr;31(4):196-203. doi: 10.1034/j.1600-0714.2002.310402.x.
Oral lichen planus (OLP) is a T cell-mediated inflammatory disease. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that has effects on cellular and humoral immunities. Previous studies have shown that keratinocytes and tissue-infiltrating mononuclear cells from OLP lesions can secrete IL-6. In some OLP patients, the high serum IL-6 levels are reduced after treatment, suggesting that IL-6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP.
In this study, we used a solid phase, two-site sequential chemiluminescent immunometric assay to determine the baseline serum levels of IL-6 in a group of 180 patients with erosive OLP (EOLP), nonerosive OLP (NEOLP), erythema multiforme (EM), traumatic ulcers (TU), oral submucous fibrosis (OSF), pemphigus vulgaris (PV), or Sjögren's syndrome (SS), and in 77 normal control subjects. Some OLP patients were treated with levamisole plus Chinese medicinal herbs or levamisole only for 0.5-5.5 months and their serum IL-6 levels were measured after treatment.
We found that approximately 99% of the normal control subjects and the patients with EM, TU, or OSF had a normal serum IL-6 level less than 5.0 pg/ml. However, 15% (22/149) OLP patients, 15% (20/136) EOLP patients, 20% (5/25) major type EOLP patients, 14% (15/111) minor type EOLP patients, 15% (2/13) NEOLP patients, 14% (1/7) EM patients, 43% (3/7) PV patients, and 100% (6/6) SS patients had a serum IL-6 level greater than 5.0 pg/ml. The mean serum IL-6 level in patients with OLP (3.4 +/- 3.1 pg/ml, P < 0.001), EOLP (3.4 +/- 3.2 pg/ml, P < 0.001), major type EOLP (4.9 +/- 3.5 pg/ml, P < 0.001), minor type EOLP (3.0 +/- 3.0 pg/ml, P < 0.01), or NEOLP (4.2 +/- 1.5 pg/ml, P < 0.001) was significantly higher than that in normal control subjects (2.0 +/- 1.5 pg/ml). A significant difference in the mean serum IL-6 level was also found between major type and minor type EOLP patients (P < 0.01). The mean reduction of serum IL-6 level in OLP patients treated with levamisole plus Chinese medicinal herbs was significantly higher (7.4 +/- 4.7 pg/ml) than that in OLP patients treated with levamisole only (3.8 +/- 2.3 pg/ml, P < 0.05), suggesting that the combination therapy was superior to levamisole only.
We conclude that levamisole and levamisole plus Chinese medicinal herbs can modulate the serum IL-6 level in OLP patients. IL-6 may be a useful marker in evaluating therapeutic effects and in monitoring the disease status of OLP.
口腔扁平苔藓（OLP）是一种T细胞介导的炎症性疾病。白细胞介素-6（IL-6）是一种促炎细胞因子，对细胞免疫和体液免疫均有影响。既往研究表明，OLP病损中的角质形成细胞和组织浸润单核细胞可分泌IL-6。部分OLP患者治疗后血清IL-6高水平降低，提示IL-6可能是评估OLP治疗效果及病情监测的有用指标。
本研究采用固相双位点顺序化学发光免疫分析法，测定180例糜烂型OLP（EOLP）、非糜烂型OLP（NEOLP）、多形红斑（EM）、创伤性溃疡（TU）、口腔黏膜下纤维化（OSF）、寻常型天疱疮（PV）或干燥综合征（SS）患者及77例正常对照者的血清IL-6基线水平。部分OLP患者接受左旋咪唑加中药或单纯左旋咪唑治疗0.5 - 5.5个月，治疗后检测血清IL-6水平。
我们发现，约99%的正常对照者以及EM、TU或OSF患者血清IL-6水平正常，低于5.0 pg/ml。然而，15%（22/149）的OLP患者、15%（20/136）的EOLP患者、20%（5/25）的重型EOLP患者、14%（15/111）的轻型EOLP患者、15%（2/13）的NEOLP患者、14%（1/7）的EM患者、43%（3/7）的PV患者及100%（6/6）的SS患者血清IL-6水平高于5.0 pg/ml。OLP患者（3.4±3.1 pg/ml，P < 0.001）、EOLP患者（3.4±3.2 pg/ml，P < 0.001）、重型EOLP患者（4.9±3.5 pg/ml，P < 0.001）、轻型EOLP患者（3.0±3.0 pg/ml，P < 0.01）或NEOLP患者（4.2±1.5 pg/ml，P < 0.001）的血清IL-6平均水平显著高于正常对照者（2.0±1.5 pg/ml）。重型和轻型EOLP患者的血清IL-6平均水平也存在显著差异（P < 0.01）。接受左旋咪唑加中药治疗的OLP患者血清IL-6水平的平均降低幅度（7.4±4.7 pg/ml）显著高于单纯接受左旋咪唑治疗的患者（3.8±2.3 pg/ml，P < 0.05），提示联合治疗优于单纯左旋咪唑治疗。
我们得出结论，左旋咪唑及左旋咪唑加中药可调节OLP患者的血清IL-6水平。IL-6可能是评估OLP治疗效果及病情监测的有用指标。
