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Tuesday, November 9, 2010

Stress and Oral Lichen Planus

Oftentimes, patients are told that OLP is caused by or aggravated by stress. I understand where this idea comes from when I look at medical articles that say the same thing.

It has been a source of major frustration for me to accept the idea that stress is a cause or contributor to OLP. After all, there are plenty of times life is stressful for all of us and it does not bring on OLP. There have been plenty of times when I've gone through major stress and not have a flare up of OLP. In fact, I have found the stress in my life increases when I have an outbreak of uncontrolled OLP.

Not too long ago I realized that the kind of stress that might trigger an episode of OLP in those predisposed to it, would be of a physiological nature.


Picture shows OLP involvement in the soft palate, the tonsil, uvula, and the retromolar pad. This was very painful to endure at the time.

Here is an abstract of a new article I found interestingon the relationship of "oxidative stress" to Oral Lichen Planus.



Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus

Objective:
The aim of this study was to assess oxidative stress and antioxidant profile in patients with oral lichen planus (OLP) using serum and salivary samples and to compare these biomarkers in a group of healthy subjects.

Patients and methods:
Twenty-one recently diagnosed patients with OLP and 20 healthy controls with matched periodontal status were recruited to the study. Total antioxidant activity (TAA) and lipid peroxidation product malondialdehyde (MDA) in both serum and saliva were determined. Univariate comparisons between the two groups were made for quantitative and categorical variables to determine any significant differences.

Results:
In OLP patients, total antioxidant defense (TAA) was significantly lower than that in healthy subjects in their serum samples (P?=?0.01). Salivary MDA levels were significantly higher in the OLP group compared with healthy subjects (P?=?0.03). A significant correlation was found between serum and saliva TAA estimates in patients with OLP (r?=?0.714 and P?=?0.0001) and in the control group (r?=?0.69 and P?=?0.001). Significant correlation was also found between serum and saliva MDA values in control group (r?=?0.464 and P?=?0.04). A significant inverse correlation was found between salivary MDA and TAA values in the control group (r?=?-0.598 and P?=?0.005).

Conclusions:
The findings of this study suggest an increased oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP. These findings may reflect the disease phenomenon of OLP rather than a causal effect and their role in pathogenesis and transformation of OLP to cancer, if any, needs further elucidation.

PMID: 21039889

Medline AbstractJ Oral Pathol Med (2010)


Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus.
S Ergun, SC Trosala,
S Warnakulasuriya,
S Ozel, AE Onal,
D Ofluoglu,
Y Guven,
H Tanyeri
J Oral Pathol Med, October 7, 2010; .            

       
Department of Oral Medicine and Surgery,
Faculty of Dentistry,
Istanbul University,
Istanbul, Turkey

Department of Biochemistry,
Faculty of Dentistry,
Istanbul University,
Istanbul, Turkey

Department of Oral Medicine and WHO Collaborating Centre for Oral Cancer,
King's College London Dental Institute,
London, UK

Department of Biostatistics and Medical Informatics,
Istanbul Faculty of Medicine,
Istanbul University,
Istanbul, Turkey

Department of Public Health,
Istanbul Faculty of Medicine,
Istanbul University,
Istanbul, Turkey

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