Depression, anxiety, and stress in oral lichen planus: a systematic review and meta-analysis

Porras‐Carrique, Teresa De; González‐Moles, Miguel Ángel; Warnakulasuriya, Saman; Ramos‐García, Pablo

doi:10.1007/s00784-021-04114-0

Cited by 48 publications

(41 citation statements)

References 42 publications

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“…This study is a secondary analysis of our previous study in which a prevalence of anxiety, 51%, depression, 48%, and sleep disturbance, 50.5%, were found in OLP patients compared with healthy controls. The prevalence of anxiety identified in this study was similar to that reported in a recent metanalysis of De Porras-Carrique (54.7%) while the prevalence of depression then found was lower (31.19%) [ 5 ]. The high prevalence of depression in our sample may be explained by virtue of an analysis of Italian data in a recent epidemiological study of the European Observatory on Health System and Policies (2019), in which a higher proportion of the Italian population aged over 65 presented symptoms of depression (41%) compared to the European population (29%) [ 34 ].…”

Section: Discussionsupporting

confidence: 89%

“…The patients commonly reported a complex symptomatology characterized by pain/burning and additional oral symptoms, such as xerostomia, dysgeusia and globus, with nK-OLP patients reporting a higher level of pain compared with K-OLP patients [ 4 ]. A greater prevalence of anxiety, depression and stress has been reported in OLP patients compared with the general population, which may contribute not only to the onset but also to the exacerbation of the disease, impairing in turn the patient’s quality of life [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

et al. 2022

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Background Oral lichen planus (OLP) is an immune-mediated inflammatory chronic disease of the oral mucosa, with different patterns of clinical manifestations which range from keratotic manifestations (K-OLP) to predominantly non-keratotic lesions (nK-OLP). The aim of the study was to analyze the differences in the clinical, psychological profile and symptoms between Italian patients of the North and Central-South with K-OLP and nK-OLP. Methods 270 K-OLP and 270 nK-OLP patients were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. Results The Central-South K-OLP (CS-K-OLP) patients reported a higher frequency of pain/burning compared with the K-OLP patients of the North (N-K-OLP) with higher scores in the NRS and T-PRI (p value < 0.001**). The CS-K-OLP and the CS-nK-OLP patients showed higher scores in the HAM-D, HAM-A, PSQI and ESS compared with the Northern patients (p value < 0.001**). Multivariate logistic regression revealed that the NRS and T-PRI showed the greatest increase in the R2 value for the CS-K-OLP (DR2 = 9.6%; p value < 0.001**; DR2 = 9.7% p value < 0.001**; respectively) and that the oral symptoms (globus, itching and intraoral foreign body sensation) and PSQI showed the greatest increase in the R2 value for the CS-nK-OLP (DR2 = 5.6%; p value < 0.001**; DR2 = 4.5% p value < 0.001** respectively). Conclusions Pain and mood disorders are predominant in patients with OLP in the Central-South of Italy. Clinicians should consider that the geographical living area may explain the differences in oral symptoms and psychological profile in OLP.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

et al. 2022

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“…These diseases either exhibit a long disease course or relapse easily, and also seriously affects the patient’s quality of life. Therefore, the prevalence of depression, anxiety, and stress is high in patients with oral inflammatory diseases ( 4 , 5 ). Although the pathogenesis of these diseases is largely unknown, an increase in various pro-inflammatory cells and cytokines has been shown to be involved in the development and perpetuation of these diseases ( 6 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

Regulatory T cell therapy suppresses inflammation of oral mucosa

et al. 2022

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Oral inflammatory diseases, including oral lichen planus (OLP) and recurrent aphthous ulcer (RAU), seriously affect the patient’s quality of life. Due to the lack of ideal disease models, it is difficult to determine whether novel immunotherapy strategies are effective in treating oral inflammatory diseases. Here, we show that the deficiency of Foxp3 or IL-2 caused oral mucosa inflammation in mice, proving that Treg cells are important in maintaining the immune homeostasis in the oral mucosa. Then we determined that adoptive transfer of CD4+CD25-CD45Rbhigh T cells could induce oral inflammation in Rag1-/- mice, and co-transfer of Treg cells together with CD4+CD25-CD45Rbhigh T cells could suppress the development of oral inflammation in this mouse model. Our study showed that adoptive transfer of CD4+CD25-CD45Rbhigh T cells into Rag1-/- mice could be a novel disease model of oral inflammation. Our data provides direct evidence that Treg cell therapy is effective in suppressing oral mucosa inflammation in mice. Therefore, Treg cell therapy may be a promising novel strategy to treat oral inflammatory diseases.

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“…Stress related factors that cause psychological anxiety and depression are closely related to oral diseases ( 6 ). Many oral diseases are accompanied by a high incidence of anxiety and depression ( 7 , 8 ), and the prevalence of depression in oral squamous cell carcinoma reportedly exceeds 65% ( 9 ). Meanwhile, current evidence suggests that bad mental attitudes are not conducive to the prognosis of oral disease ( 10 ), while inflammatory mediators were found to be increased locally in the tumors of stressed rats ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Multi-omics analysis reveals the effects of microbiota on oral homeostasis

Long

et al. 2022

Front. Immunol.

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The oral epithelium’s normal morphological structure and function play an important role in maintaining oral homeostasis, among which microbiota and chronic stress are key contributing factors. However, the effects of microbiota and chronic stress on the morphological structures and molecular function of oral homeostasis remain unclear. In this study, morphological staining was used to compare the tongue structure of specific pathogen-free and germ-free mice, and an integrated multi-omics analysis based on transcriptomics, proteomics, and metabolomics was performed to investigate the regulatory mechanisms of microbiota and chronic stress on oral homeostasis. We found that the morphological structure of the tongue in germ-free mice was disordered compared with in specific pathogen-free mice, especially in the epithelium. Multi-omics analysis indicated that differentially expressed molecules of the tongue between germ-free and specific pathogen-free mice were significantly enriched in the mitochondrial metabolic process and immune response. Interestingly, microbiota also significantly influenced the permeability of the oral epithelial barrier, represented by the differential expression of keratinization, and cell adhesion molecules. It was worth noting that the above changes in the tongue between specific pathogen-free and germ-free mice were more significant after chronic stress. Collectively, this is the first study to reveal that the microbiota might maintain oral homeostasis by reshaping the structure of the oral epithelial barrier and changing the function of molecular biology, a process that may be driven by the immune response and mitochondrial metabolic process of oral tissue. Furthermore, chronic stress can enhance the regulatory effects of microbiota on oral homeostasis.

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Depression, anxiety, and stress in oral lichen planus: a systematic review and meta-analysis

Cited by 48 publications

References 42 publications

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine)

Regulatory T cell therapy suppresses inflammation of oral mucosa

Multi-omics analysis reveals the effects of microbiota on oral homeostasis

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