Avaliação salivar do perfil imune-inflamatório do líquen plano oral e sua relação com parâmetros clínicos de severidade da doença: estudo caso - controle

Abstract

INTRODUCTION: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease of autoimmune nature, which can present in various clinical forms. Although its etiology and clinical behavior are uncertain, studies have highlighted a potential relationship between its pathogenesis and severity with the salivary concentration of mediators involved in the inflammatory process. OBJECTIVE: To evaluate the salivary concentration of pro-inflammatory and anti-inflammatory mediators in patients diagnosed with clinical and microscopic OLP and healthy controls. METHODOLOGY: A case-control study was conducted to investigate the salivary immune-inflammatory profile of patients diagnosed with clinical and microscopic OLP (case group; n=31), according to the criteria established by the American Academy of Oral and Maxillofacial Pathology (AAPOM/2016), and healthy individuals (control group; n=23). All patients were clinically evaluated to record clinical, demographic, and pathological data, as well as for unstimulated saliva collection. Regarding the clinical manifestation, OLP patients were categorized into severe cases (erosive/ulcerated clinical pattern; symptomatic) and non-severe cases (reticular and plaque; asymptomatic). Pro-inflammatory cytokines IL-1, IL-2, IL-6, IL-8, IL-17, IFN-γ, TNF-α, and anti-inflammatory cytokines IL-4 and IL-10 were measured by Cytometric Bead Array (CBA). Mediators associated with oxidative stress (nitrite and MPO) were quantified using the Griess colorimetric method. RESULTS: OLP patients were predominantly female (93.5%) and Caucasian (58.0%). Regarding disease severity, 13 (n=42%) patients were classified as severe cases. The salivary concentration of IL-6, IL-10, and nitrite was significantly higher in OLP patients compared to the control group (p<0.05). Moreover, although not statistically significant, the mean concentrations of IL-17, IL-2, IL-4, and MPO were higher in severe disease cases. Patients with OLP associated with moderate or severe pain exhibited significantly higher nitrite levels compared to controls (p<0.05). CONCLUSION: Salivary levels of the pro-inflammatory mediators IL-6 and nitrite, and the anti-inflammatory cytokine IL-10 were higher in patients with Lichen Planus Oral (LPO) compared to healthy individuals. Furthermore, the salivary concentration of nitrite was higher in LPO cases with greater pain scores. The presence of elevated nitrite levels in saliva may help determine the intensity of symptoms, such as pain and discomfort, which directly affect the well-being and functional capacity of patients. Therefore, monitoring salivary nitrite levels can be crucial for assessing the severity of the disease and, consequently, adapting therapeutic strategies to improve the quality of life of patients with LPO.