J Clin Exp Dent. 2015 Oct 01;7(4):e477-82. doi: 10.4317/jced.52376. eCollection 2015 Oct.
Role of serum interleukin-6 in deciding therapy for multidrug resistant oral lichen planus.
Journal of clinical and experimental dentistry
Sinny Goel, Akanksha Marwah, Smita Kaushik, Vijay K Garg, Sunita Gupta
Affiliations
Affiliations
- MDS, Postgraduate student, Dept. of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, Delhi.
- MSc. Research associate, Dept. of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, Delhi.
- MD, Professor, Dept. of Biochemistry, Maulana Azad Medical College, Delhi.
- MD, MNAMS, Director Professor & Head, Department of Dermatology & STD, Maulana Azad Medical College and Associated Lok Nayak Hospital.
- MDS, MBA (HCA), FICD (USA), Professor and Head, Dept. of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, Delhi.
PMID: 26535093
PMCID: PMC4628801 DOI: 10.4317/jced.52376
Abstract
BACKGROUND: Oral lichen planus (OLP) is a T cell mediated immune response. T cells locally present in the involved tissues release cytokines like interleukin-6 (IL-6), which contributes to pathogenesis of OLP. Also IL-6 has been associated with multidrug resistance protein (MRP) expression by keratinocytes. Correspondingly, upregulation of MRP was found in OLP. We conducted this study to evaluate the effects of various drugs on serum IL-6 in OLP; and correlation of these effects with the nature of clinical response and resistance pattern seen in OLP lesions with various therapeutic modalities. Thus we evaluated the role of serum IL-6 in deciding therapy for multidrug resistant OLP.
MATERIAL AND METHODS: Serum IL-6 was evaluated in 42 erosive OLP (EOLP) patients and 10 normal mucosa and 10 oral squamous cell carcinoma cases using ELISA technique. OLP patients were randomly divided into 3 groups of 14 patients each and were subjected to Pimecrolimus local application, oral Mycophenolate Mofetil (MMF) and Methotrexate (MTX) alongwith Pimecrolimus local application. IL-6 levels were evaluated before and after treatment.
RESULTS: Serum IL-6 levels were raised above 3pg/ml in 26.19% erosive OLP (EOLP) cases (mean- 3.72±8.14). EOLP (5%) cases with IL-6 levels above 5pg/ml were resistant in MTX group. However significant decrease in serum IL-6 corresponding with the clinical resolution was seen in MMF group.
CONCLUSIONS: Significantly raised IL-6 levels in EOLP reflect the chronic inflammatory nature of the disease. As serum IL-6 levels significantly decreased in MMF group, correspondingly no resistance to treatment was noted. However with MTX there was no significant decrease in IL-6 and resistance to treatment was noted in some, especially plaque type lesions. Thus IL-6 can be a possible biomarker in deciding the best possible therapy for treatment resistant OLP.
KEY WORDS: Lichen planus, biological markers, cytokines, enzyme-linked immunosorbent assay, immunosuppressive agents.
References
- J Oral Pathol Med. 2012 Apr;41(4):315-21 - PubMed
- Cancer Treat Rev. 2012 Nov;38(7):904-10 - PubMed
- Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Dec;98(6):673-8 - PubMed
- Acta Derm Venereol. 2002;82(1):63-4 - PubMed
- Cytokine. 2008 Feb;41(2):144-9 - PubMed
- Arch Dis Child. 2003 Nov;88(11):969-73 - PubMed
- Pharmacol Ther. 2014 Feb;141(2):125-39 - PubMed
- Arch Dermatol Res. 1999 Sep;291(9):485-90 - PubMed
- J Invest Dermatol. 2005 Jan;124(1):28-37 - PubMed
- Br J Dermatol. 2008 Sep;159(4):936-41 - PubMed
- Arch Dermatol. 2007 Apr;143(4):511-5 - PubMed
- J Eur Acad Dermatol Venereol. 2011 Sep;25(9):1061-7 - PubMed
- Br J Dermatol. 2012 Jul;167(1):36-43 - PubMed
- J Oral Pathol Med. 1991 Jul;20(6):275-9 - PubMed
- J Am Acad Dermatol. 2007 Nov;57(5):806-13 - PubMed
- J Eur Acad Dermatol Venereol. 2013 Mar;27(3):e410-3 - PubMed
- Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Aug;100(2):164-78 - PubMed
- J Oral Pathol. 1987 Aug;16(7):356-61 - PubMed
- J Invest Dermatol. 2004 Jan;122(1):87-94 - PubMed
- Clin Pharmacol Ther. 2010 Apr;87(4):483-7 - PubMed
- J Eur Acad Dermatol Venereol. 2007 Feb;21(2):259-60 - PubMed
- J Am Acad Dermatol. 2003 Dec;49(6):1063-6 - PubMed
- Oral Surg Oral Med Oral Pathol. 1991 Dec;72 (6):665-70 - PubMed
- Inflamm Bowel Dis. 2011 Jun;17(6):1438 - PubMed
- J Periodontol. 2005 Apr;76(4):627-35 - PubMed
- Immunopharmacology. 1993 Jul-Aug;26(1):11-20 - PubMed
- J Oral Pathol Med. 2002 Apr;31(4):196-203 - PubMed
- Oral Dis. 2012 Apr;18(3):236-43 - PubMed
- J Oral Pathol Med. 1994 Jan;23(1):28-35 - PubMed
Publication Types