Salivary TNF-[Alpha] And sCD44 As Markers For Disease Activity And Malignant Transformation In Oral Lichen Planus.

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Background: Testing the validity of utilizing salivary markers as monitors for disease activity, therapeutic progress and potential malignant transformation of oral lichen planus (OLP) lesions. Materials and Methods: Seventy two subjects were recruited and divided into 3 groups according to clinical presentation. Group I: 45 OLP patients, no histopathologic signs of dysplasia; 15 reticular type and 30 with symptomatic OLP (15 atrophic and 15 erosive types), group II: 12 OLP patients with dysplastic changes and group III: 15 controls free from oral mucosal disease. Biopsy was carried out for group I before and after corticosteroid administration and from surgical sites in controls. All individuals provided whole unstimulated salivary specimens. TNF-α levels were determined in tissue and salivary specimens of groups I and III, utilizing R&D system ELISA kits (Mineapolis, USA). Salivary total soluble (s) CD44 was estimated in all groups, utilizing an ELISA assay (Bender MedSystems, Vienna, Austria). Results:Oral lichen planus patients showed highly significant increase in levels of both investigated markers, compared to healthy controls, whether in tissues or saliva. After corticosteroid administration, TNF-α levelin oral lichen planus patients dropped significantly simultaneously in tissues and saliva, however, they were still higher than the controls. Levels of salivary sCD44 were significantly higher in group II than groups I & III; with evident correlation betweenvalues above 19.2 ng/ml and presence of dysplastic changes. Conclusion: Salivary TNF-α level might furnish a reliable marker for OLP disease activity and therapeutic progress, while salivary sCD44 could be considered a valuable, reliable, non-invasive marker for dysplastic changes in OLP.

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