Jiang Lanlan, Huang Yuxiao, Fang Meifei, Chen Xinyu, Feng Doudou, Liu Jiaxuan, Jiang Qiaozhi, Tao Renchuan
Department of Periodontics and Oral Medicine, College & Hospital of Stomatology, Guangxi Medical University, Guangxi, China.
Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, Guangxi, China.
Heliyon. 2024 Jan 4;10(1):e24043. doi: 10.1016/j.heliyon.2024.e24043. eCollection 2024 Jan 15.
This study aimed to investigate the expression of T helper 1 (Th1)/Th2/Th17- related cytokines and human beta defensins 2 and 3 (hBD-2 and -3) in the saliva of patients with erosive oral lichen planus (EOLP) and to explore their role in the pathogenesis of EOLP and the effects of glucocorticoids on EOLP.
A total of 30 patients with EOLP and 20 age- and sex-matched healthy individuals were included in this study. The patients were treated with prednisone at a dose of 0.4 mg/(kg·d) for 1 week and examined before and after treatment. Unstimulated whole saliva samples were collected to determine the levels of cytokines (interleukin 1 beta [IL-1β], tumour necrosis factor alpha [TNF]-α, interferon gamma [IFN-γ], IL-4, IL-6, IL-10 and IL-17) by cytometric bead array and those of hBD-2 and -3 b y enzyme-linked immunosorbent assay. In addition, oral rinse samples were collected to detect load.
The levels of salivary IL-1β, IL-6, hBD-2 and hBD-3 were higher and the IFN-γ/IL-4 and IL-1β/IL-6 ratios were lower in patients with EOLP than in healthy individuals. In patients with EOLP, hBD-2 levels were positively correlated with IFN-γ levels and negatively correlated with IL-17 levels, whereas hBD-3 levels were negatively correlated with IL-17 and IL-10 levels. In addition, the prevalence of EOLP was positively correlated with IL-6 levels and negatively correlated with the IFN-γ/IL-4 ratio. The levels of IL-1β, TNF-α, IFN-γ, IL-6, hBD-2 and hBD-3 and the IFN-γ/IL-4 ratio decreased after treatment with prednisone for 1 week. The levels of IL-6, hBD-2 and hBD-3 were significantly higher in EOLP patients than in healthy individuals; while TNF-α levels and the IFN-γ/IL-4 ratio were significantly lower in EOLP patients than in healthy individuals. Furthermore, the oral counts of spp. (colony forming unit [CFU]) were negatively correlated with TNF-α levels. Numerical Rating Scale(NRS) and Sign scores decreased in EOLP patients after treatment. Approximately 80 % of patients were effectively treated. Salivary TNF-α levels were significantly higher in the treatment-ineffective group than in the treatment-effective group before treatment with prednisone, and differences in salivary IL-6 levels before and after treatment were significantly higher in the treatment-effective group than in the treatment-ineffective group.
High expression of IL-1β, IL-6, hBD-2 and Th1/Th2 imbalance in saliva may be associated with the pathogenesis of EOLP. IFN-γ/IL-4 balance may serve as a protective factor for EOLP. Glucocorticoids significantly alleviate the symptoms of EOLP and inhibit the expression of Th1/Th2 cytokines.
本研究旨在探讨糜烂型口腔扁平苔藓（EOLP）患者唾液中辅助性T细胞1（Th1）/辅助性T细胞2（Th2）/辅助性T细胞17（Th17）相关细胞因子及人β-防御素2和3（hBD-2和hBD-3）的表达情况，探讨其在EOLP发病机制中的作用以及糖皮质激素对EOLP的影响。
本研究共纳入30例EOLP患者和20例年龄、性别匹配的健康个体。患者接受剂量为0.4 mg/（kg·d）的泼尼松治疗1周，并在治疗前后进行检查。收集非刺激性全唾液样本，采用细胞计数珠阵列法测定细胞因子（白细胞介素1β[IL-1β]、肿瘤坏死因子α[TNF]-α、干扰素γ[IFN-γ]、IL-4、IL-6、IL-10和IL-17）水平，采用酶联免疫吸附测定法测定hBD-2和hBD-3水平。此外，收集口腔冲洗样本以检测 载量。
EOLP患者唾液中IL-1β、IL-6、hBD-2和hBD-3水平高于健康个体，IFN-γ/IL-4和IL-1β/IL-6比值低于健康个体。在EOLP患者中，hBD-2水平与IFN-γ水平呈正相关，与IL-17水平呈负相关，而hBD-3水平与IL-17和IL-10水平呈负相关。此外，EOLP的患病率与IL-6水平呈正相关，与IFN-γ/IL-4比值呈负相关。泼尼松治疗1周后，IL-1β、TNF-α、IFN-γ、IL-6、hBD-2和hBD-3水平及IFN-γ/IL-4比值降低。EOLP患者的IL-6、hBD-2和hBD-3水平显著高于健康个体；而EOLP患者的TNF-α水平和IFN-γ/IL-4比值显著低于健康个体。此外， spp.（菌落形成单位[CFU]）的口腔计数与TNF-α水平呈负相关。EOLP患者治疗后数字评定量表（NRS）和体征评分降低。约80%的患者得到有效治疗。泼尼松治疗前，治疗无效组唾液TNF-α水平显著高于治疗有效组，治疗有效组治疗前后唾液IL-6水平差异显著高于治疗无效组。
唾液中IL-1β、IL-6、hBD-2高表达及Th1/Th2失衡可能与EOLP的发病机制有关。IFN-γ/IL-4平衡可能是EOLP的保护因素。糖皮质激素可显著缓解EOLP症状并抑制Th1/Th2细胞因子的表达。
