RESUMO
Oral lichen planus (OLP) is a chronic Th1-mediated inflammatory mucocutaneous disease of the skin and oral mucosa that can have various clinical presentations. Lesions are usually bilateral and often painful. While cutaneous Lichen Planus (LP) lesions are self-limiting, the oral lesions are chronic and rarely remissive. The diagnosis of oral lichen planus (OLP) is often challenging, and confirmation by histopathological criterion is generally advised. The aim of our study was to identify the cytokines present in OLP-suggestive lesions and in non-specific inflammatory lesions (NSIL) used as controls. Moreover, assess cytokines protein levels and oral microbiota composition in whole saliva samples. Histopathological analysis, immunohistochemistry and gene expression were used as techniques to analyze the oral mucosal tissue samples. ELISA was conducted to analyze salivary cytokine levels and 16S rRNA sequencing was used to determine the salivary microbiome. As a result we observed larger number of infiltrated lymphocytes (p = 0.025), as well, more T CD4 lymphocytes in the epithelial tissue (p = 0.006) in OLP samples compared to NSIL. In addition, the OLP samples displayed more apoptotic cells compared to NSIL (p = 0.047). Regarding the cytokine analysis, IFN-γ and IL-33 were more expressed in OLP lesions than in NSIL samples (p < 0.001; p = 0.026). Furthermore, our results demonstrated higher levels of IFN-γ protein expression in the saliva of OLP group compared to controls (p = 0.0156). We also observed noted differences in the oral microbiota composition between OLP and NSIL saliva samples. In conclusion, OLP lesions presented larger numbers of apoptotic and inflammatory cells, higher levels of IFN-γ and IL-33 compared to NSIL, and these lesions also differ regarding oral microbiota composition. These results are consistent with the Th-1-mediated chronic inflammation nature of oral lichen planus investigated lesions and displayed unique features that could be used as a diagnostic tool.
Assuntos
Citocinas/genética , Líquen Plano Bucal/diagnóstico , Saliva/metabolismo , Saliva/microbiologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Citocinas/metabolismo , Feminino , Expressão Gênica , Humanos , Interferon gama/genética , Interferon gama/metabolismo , Interleucina-17/genética , Interleucina-33/genética , Líquen Plano Bucal/microbiologia , Líquen Plano Bucal/patologia , Masculino , Microbiota , Pessoa de Meia-Idade , Mucosa Bucal/microbiologia , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/metabolismoRESUMO
Este trabalho tem como objetivo apresentaçäo de caso clínico de Tumor Odontogênico Adenomatóide de paciente, do sexo feminino, 16 anos, leucoderma, que apresentava história de crescimento de mais ou menos dois anos, assimetria facial, sem relato de dor. Foi realizada a radiografia panorâmica, bem como periapicais e oclusal, apresentando imagem radiolúscida bem definida circunscrita envolvendo 14, 13, 12. Diagnóstico inicial: A hipótese de disgnóstico foi de Cisto Glóbulo Maxilar. O resultado do anatomo-patológico foi de Tumor Odontogênico Adenomatóide. Após a revisäo da literatura, podemos observar a dificuldade de diagnosticar corretamente este tipo de tumor que na maior parte dos casos é diagnosticado no inicial erroneamente. Concluindo, fizemos a proposta da manutençäo dos dentes envolvidos com resultados altamente satisfatórios apesar da grande mobilidade inicialmente apresentada por estes dentes