Direct immunofluorescence and immune function in patients with oral lichen planus

Fei Mao; Yunmei Dong; Zhen Wang; Luyao Cai; Dan Pan; Chengli Zhang; Taiwen Li; Yu Zhou

doi:10.1016/j.jds.2021.10.002

Direct immunofluorescence and immune function in patients with oral lichen planus

J Dent Sci. 2022 Apr;17(2):795-801. doi: 10.1016/j.jds.2021.10.002. Epub 2021 Oct 18.

Authors

Fei Mao¹, Yunmei Dong¹, Zhen Wang¹, Luyao Cai¹, Dan Pan¹, Chengli Zhang¹, Taiwen Li¹, Yu Zhou¹

Affiliation

¹ State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, PR China.

Abstract

Background/purpose: Direct immunofluorescence and immune function and patients with oral lichen planusThe etiology of oral lichen planus (OLP) is unknown, our purpose was to evaluate the diagnostic value of direct immunofluorescence (DIF) and to investigate the immune functions in OLP.

Materials and methods: We enrolled 65 patients with suspected lesions of OLP and 47 controls. In all participants, clinical and serologic testing were conducted. The histopathologic and DIF tests were conducted in 65 patients. The severity of OLP was evaluated by reticular/hyperkeratotic, erosive/erythematous, ulcerative (REU) scoring system.

Results: By hematoxylin and eosin (H&E) staining and DIF examination, 71.2% (42/59) were diagnosed as OLP, 28.8% (17/59) were diagnosed as non-OLP. DIF demonstrated 64.3% positive reactivity with 2 distinct distribution patterns and 8 staining patterns. Compared to the controls, serum IgA in OLP was higher (P < 0.01), and serum CD3+ cells, IgM, IgE, C3 and C4 were lower (P < 0.05). Pearson correlation analysis in OLP revealed correlations between REU score and IgM, IgA of DIF (r = 0.54, P = 0.026; and r = 0.56, P = 0.020, respectively), between serum IgG and IgG of DIF (r = 0.51, P = 0.038), between serum CD4+ and the ratio of CD4+/CD8+, IgM in DIF (r = -0.50, P = 0.048; and r = -0.54, P = 0.031, respectively), between serum CD8+ and IgM, IgA in DIF (r = 0.52, P = 0.038; and r = -0.50, P = 0.047, respectively).

Conclusion: A combination of H&E test and DIF is useful for the diagnosis of OLP. Compared to controls, immune changes happen to patients with OLP. There are significant associations between the OLP lesions and general cellular and humoral immune status, localized humoral immune response.

Keywords: Direct immunofluorescence; Histopathologic; Oral lichen planus; REU score; Serologic testing.