Research progress on oral lichenoid drug reactions / 口腔疾病防治

@#Oral lichenoid drug reactions (OLDRs) are inflammatory reactions of the oral mucosa caused by the use of specific drugs in sensitive individuals and are classified as oral lichenoid lesions (OLLs). Its clinical and pathological manifestations do not have significant specificity compared to other types of OLL. Various types of drugs have been reported to induce OLDR, including antihypertensive drugs, nonsteroidal anti-inflammatory drugs, hypoglycemic drugs, antipsychotics, and immunosuppressants, among other drugs. Apart from local or systemic administrate glucocorticoids, the most effective treatment measure is to stop using suspicious drugs. Most patients can achieve significant relief from mucosal ulcers and erosion, but white lines may still remain. OLDR has been widely reported in the literature. However, due to a lack of systematic understanding, we do not have a recognized standard for the diagnosis and treatment of this disease. There are still doubts about the causal relationship between related drugs and oral lichen-like lesions. In response to the abovementioned problems, we searched the literature on drug-related oral lichen planus and lichen-like lesions at home and abroad over the past 20 years, most of which were case reports and only a few of which were case-control studies. This article describes the current research status of lichenoid lesions from four perspectives: concepts, suspicious drugs, clinical and pathological manifestations, and treatment prognosis. We hope to provide a theoretical reference for the prevention, diagnosis, and clinical treatment of related lichenoid lesions. A literature review demonstrated that there are still many unclear issues related to the etiology, pathogenesis, clinical diagnosis and treatment, treatment prognosis, and other aspects of this disease, and further clinical and basic research is needed for in-depth exploration.

Co-expression of circRNA in oral leukoplakia and oral lichen planus / 口腔疾病防治

Objective@# To find any differentially expressed circRNAs in oral leukoplakia (OLK) and oral lichen planus (OLP), to investigate the possible role of circRNAs in the pathogenesis of these two diseases.@*Methods@# This study obtained hospital ethical approval. High-throughput sequencing was used to detect differentially expressed circRNAs in OLK, OLP, oral squamous cell carcinoma and normal oral mucosal tissues. CircRNAs were verified by qRT-PCR, enzyme tolerance assays and Sanger sequencing. GO functional analysis and KEGG pathway analysis were performed to predict the functions of circRNAs in OLP. TargetScan and miRanda were applied to predict targeted miRNAs and mRNAs of circRNAs, and ceRNA networks were mapped. @*Results@#A total of 49 circRNAs were differentially expressed in OLK and OLP together, including 30 upregulated and 19 downregulated circRNAs. The five circRNAs confirmed with RT-qPCR, including circHLA-C, circRNF13, circTTN, circSEPN2 and circALDH3A2, were all abnormally expressed in OLK and OLP, among which circHLA-C was a key circRNA with trans splice sites, which was validated by expanding the sample size. ROC curve analysis showed that the area under the circHLA-C curve for predicting OLK was 0.955, and the area under the circHLA-C curve for predicting OLP was 0.988. GO functional analysis showed enrichment of many biological processes related to the immune process. The KEGG pathway with the highest enrichment score was "Natural killer cell mediated cytotoxicity". HLA-C was significantly enriched in these processes/pathways. CeRNA network analysis showed that circHLA-C interacted with a variety of miRNAs, such as hsa-miR-26a-5p, hsa-miR-129-5p, and hsa-miR-29a-3p.@*Conclusion@#Many circRNAs were differentially expressed in both OLK and OLP, circHLA-C being the most elevated. CircHLA-C is valuable for the early diagnosis of OLK and OLP and may serve as a potential biomarker for the diagnosis and prognosis of OLK and OLP.

Effect of auricular point therapy on the psychological state and plasma β-endorphin level of patients with burning mouth syndrome / 口腔疾病防治

Objective@# To observe the clinical effects of auricular point therapy on burning mouth syndrome (BMS) and its effect on the psychological state of patients and plasma β-endorphin. @*Methods @# A total of 105 patients diagnosed with BMS were randomly divided into an auricular acupoint application group (50 cases) and a drug treatment group (55 cases). The treatment course lasted one month. The patients in the auricular acupoint application group selected 3 points on their tongue, heart and Shenmen through traditional Chinese medical dialectics used for patients with BMS. Wangbuliu seeds were applied, two ears were pressed alternately and one ear was applied each time. The patient was instructed to press the treatment site three times a day, 1-2 min each time, until the auricle skin became reddish and hot. The patients in the drug treatment group took vitamin E 100 mg+oryzanol 10 mg+vitamin B2 10 mg orally three times a day. Before and after treatment, the pain intensity and mental and psychological state of the patients were evaluated. The patient's plasma was detected before and after β-endorphin treatment. @* Results@#The pain sensation intensity of the two groups decreased after treatment (P<0.001). After treatment, the scores of somatization (t = 2.118, P = 0.037), fear (t = 2.084, P = 0.039) and diet and sleep (t = 2.047, P = 0.043) in the auricular acupoint application group were significantly improved compared with the level before treatment. The level of β-endorphin in plasma was increased, and the difference was statistically significant (t = 2.247, P = 0.027) in the auricular acupoint application group after treatment. @*Conclusion@#Auricular point therapy is an effective method for patients with BMS, improving psychological state and promoting the synthesis of plasma β-endorphin may be one of its mechanisms.

Role and mechanism of microRNAs in oral lichen planus / 口腔疾病防治

@#Oral lichen planus (OLP) is a chronic inflammatory disease of the mucosa, some of which will develop into oral squamous cell carcinoma (OSCC). However, the pathogenesis of OLP remains unknown, but autoimmunity has been suggested as a potential cause. MicroRNAs (miRNAs), which are small noncoding RNAs, have been reported to be involved in a series of physiological events as well as the progression of diseases. The evidence indicates that miRNAs may be highly related to both the initiation and malignant progression of OLP. MiR-146a, miR-26b, miR-155, miR-19a and miR-125a are able to trigger OLP by regulating autoimmunity, and miR-137, miR-125b, and miR-27b may accelerate the carcinogenesis of OLP. These miRNAs may be potential targets for prognosis and treatment. Subsequent studies are expected to focus on a more comprehensive exploration of the role of miRNAs in OLP (including specific action pathways and other OLP-related miRNAs), as well as the potential for miRNAs to predict the treatment outcome of OLP. This review provides an updated summary of the roles of miRNAs in OLP to provide new ideas and approaches to OLP research.

Clinical effect of auricular point therapy on burning mouth syndrome / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of auricular acupoint application in the treatment of burning mouth syndrome(BMS).@*Methods@#A total of 155 patients diagnosed with BMS were randomly divided into the auricular acupoint application group (50 patients), drug treatment group (55 patients), and auricular acupoint application combined with drug treatment group (50 patients). One month represented one course of treatment. The changes in pain intensity were evaluated before treatment as well as one month and three months after treatment.@* Results@#The VAS scores in the auricular acupoint application group (t=8.949), the drug treatment group (t=10.52) and the auricular acupoint application combined with drug treatment group (t=19.33) all decreased 1 month after treatment, with a statistically significant difference compared with the scores before treatment (P < 0.01). The VAS scores of the auricular acupoint application combined with drug treatment group decreased significantly, and the difference was statistically significant compared with the scores in the drug treatment group (t=3.91, P=0.000 2). 3 months after treatment, the VAS scores of the three group decreased compared with that before treatment, but increased compared with that 1 month after treatment, and the VAS score of the drug treatment group increased most obviously, but the difference was not statistically significant compared with that of the auricular acupoint application group (t=2.047, P=0.043), other pairwise comparison differences were not statistically significant. There was no statistically significant difference in VAS score in the auricular acupoint application group (t=1.752) and in the drug treatment group (t=0.174) compared with that before treatment (P > 0.05). Compared with before treatment, the VAS score in the auricular acupoint application combined with drug treatment group also decreased significantly (t=3.282, P < 0.05). @*Conclusion@#Auricular point application is a safe and effective treatment for burning mouth syndrome, and the long-term effect is better when combined with drugs.