Association between oral lichen planus and Epstein–Barr virus in Iranian patients

Abstract

Background:Oral lichen planus (OLP) is a common mucocutaneous disease with malignant transformation potential. Several etiologies such as humoral, autoimmunity, and viral infections might play a role, but still there is no definite etiology for this disease. The aim of this study was to investigate the presence of Epstein–Barr virus (EBV) genome in Iranian patients with OLP as compared to people with normal mucosa.Materials and Methods:The study was carried out on a case group including 38 tissue specimens of patients with histopathological confirmation of OLP and a control group including 38 samples of healthy mucosa. All samples were examined by nested polymerase chain reaction (PCR) method to determine the DNA of EBV.Results:Twenty-two (57.9%) female samples and 16 (42.1%) male samples with OLP were randomly selected as the case group, and 20 (52.6%) female samples and 18 (47.4%) male samples with healthy mucosa as the control group. There was a statistically significant difference in the percentage of EBV positivity between the case (15.8%) and the control groups (P < 0.05); in the case group, three female samples (13.6%) and three male samples (18.8%) were infected with EBV; the difference between the genders was not statistically significant (P = 0.50).Conclusion:Results emphasized that EBV genome was significantly higher among Iranian patients with OLP so antiviral therapy might be helpful.

The association between Epstein‐Barr virus and oral lichen planus: A systematic review and meta‐analysis

“…The general characteristics of the included studies are summarized in Table 1. Ten case‐control studies 13‐16,20‐23,28,29 comprising 690 subjects (386 OLP cases and 304 healthy controls) were included in the present review; of these, 8 studies were eligible for the meta‐analysis 13‐16,20,21,28,29 . The studies were published between 1996 and 2018.…”

“…Two studies were conducted in Sweden, 16,23 two studies in Iran, 20,22 one study in Denmark, 13 one study in Turkey, 14 one study in Ireland, 29 one study in Hungary, 15 one study in Brazil, 15 and one study in India 28 . Seven studies 13,15,16,20‐23 reported gender of the participants, in which females comprised two thirds of subjects. The age of the included participants ranged between 18 and 81 years.…”

“…The detection of EBV was evaluated using tissue samples in 7 studies, 14,16,20‐23,29 serum sample in two studies, 13,28 and exfoliated cells in one study 15 . Laboratory methods to detect EBV were highly variable across the studies: in situ hybridization in one study, 23 polymerase chain reaction (PCR) in 5 studies, 15,16,20‐22,29 enzyme‐linked immunosorbent assay (ELISA) in 2 studies, 13,28 and immunohistochemistry in one study 14 (Table 1).…”

“…A 2011‐study by Yildirim et al found that 35% of OLP patients were EBV‐ positive compared to 0.0% of the controls 14 . In line with that, Sand et al 16 and Shariati et al 20 found significantly higher prevalence of EBV in OLP patients compared to healthy controls 16,20 . Contrarily, studies by Veira et al 21 and Sahebjamee et al 22 did not find a significant association between EBV and OLP 21,22 .…”

“…EBV has been associated with several benign and malignant head and neck disorders, including infectious mononucleosis, hairy leukoplakia, Sjogren’s syndrome, Burkitt’s lymphoma, Hodgkin’s Lymphoma, and nasopharyngeal carcinoma 17‐19 . Recently, several observational studies have investigated the possible role of EBV in pathogenesis of OLP, and conflicting results were reported 5,13‐15,20,21 . The early work by Pedersen 13 showed an aberration in the humoral immune response to EBV in OLP patients; the authors concluded that EBV might have a role in OLP pathogenesis 13 .…”