Department of Dermatovenereology, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia.
Department of Anesthesiology, Reanimation and Intensive Care, Medical Faculty, University of Rijeka, Clinical Hospital Center Rijeka, Tome Strižića 3, 51000 Rijeka, Croatia.
Int J Mol Sci. 2023 Feb 3;24(3):3038. doi: 10.3390/ijms24033038.
Lichen planus is a chronic disease affecting the skin, appendages, and mucous membranes. A cutaneous lichen planus is a rare disease occurring in less than 1% of the general population, while oral illness is up to five times more prevalent; still, both forms equally impair the patient's quality of life. The etiology of lichen planus is not entirely understood. Yet, immune-mediated mechanisms have been recognized since environmental factors such as hepatitis virus infection, mechanical trauma, psychological stress, or microbiome changes can trigger the disease in genetically susceptible individuals. According to current understanding, lichen planus immunopathogenesis is caused by cell-mediated cytotoxicity, particularly cytotoxic T lymphocytes, whose activity is further influenced by Th1 and IL-23/Th-17 axis. However, other immunocytes and inflammatory pathways complement these mechanisms. This paper presents a comprehensive insight into the actual knowledge about lichen planus, with the causal genetic and environmental factors being discussed, the immunopathogenesis described, and the principal effectors of its inflammatory circuits identified.
扁平苔藓是一种影响皮肤、附属器和黏膜的慢性疾病。皮肤扁平苔藓在普通人群中发病率不到 1%,是一种罕见疾病,而口腔疾病的发病率则高达五倍;然而,这两种形式都会同样损害患者的生活质量。扁平苔藓的病因尚不完全清楚。然而,自从人们认识到免疫介导的机制以来,环境因素如肝炎病毒感染、机械性创伤、心理压力或微生物组变化可以在遗传易感个体中引发这种疾病。根据目前的认识,扁平苔藓的免疫发病机制是由细胞介导的细胞毒性引起的,特别是细胞毒性 T 淋巴细胞,其活性进一步受到 Th1 和 IL-23/Th-17 轴的影响。然而,其他免疫细胞和炎症途径补充了这些机制。本文对扁平苔藓的现有知识进行了全面的了解,讨论了因果遗传和环境因素、描述了其免疫发病机制,并确定了其炎症回路的主要效应物。