Efficacy of Platelet-Rich Plasma Therapy in Oral Lichen Planus: A Systematic Review

Abstract

Background and Objectives: Oral lichen planus (OLP) is an autoimmune, mucocutaneous, oral potentially malignant disorder (OPMD), which characteristically manifests with chronic, recalcitrant lesions, with frequent flare-ups and remissions. The precise etiopathogenesis of OLP is still debatable, although it is believed to be a T-cell-mediated disorder of an unidentified antigen. Despite the availability of various treatments, no cure for OLP exists due to its recalcitrant nature and idiopathic etiology. Platelet-rich plasma (PRP) has antioxidant, anti-inflammatory, and immunomodulatory properties, in addition to its regulatory action on keratinocyte differentiation and proliferation. These salient properties substantiate the possible role of PRP in the treatment of OLP. Our systematic review focuses on assessing the therapeutic potential of PRP as a treatment modality in OLP. Materials and Methods: We conducted a detailed literature search for studies assessing PRP as a therapeutic regimen in OLP, using the Google Scholar and PubMed/MEDLINE search engines. The search was limited to studies published from January 2000 to January 2023 and included a combination of Medical Subject Heading (MeSH) terms. ROBVIS analysis was carried out for the assessment of publication bias. Descriptive statistics were performed using Microsoft Excel. Results: This systematic review included five articles that met the inclusion criteria. Most of the included studies demonstrated that PRP treatment considerably ameliorated both objective and subjective symptoms in OLP subjects, with comparable efficacy to the standard corticosteroid treatment. Further, PRP therapy offers the added benefit of minimal adverse effects and recurrences. Conclusion: This systematic review suggests that PRP has significant therapeutic potential for treating OLP. However, further research with larger sample sizes is imperative to corroborate these findings.

Effect of platelet concentrates for pain and symptom management in oral lichen planus: an evidence-based systematic review

“…The observed differences could be attributed to variations in the duration of release and peak time of GFs reported across studies [ 36 , 37 ].The UE Shinnawi study [ 38 ] also supports this notion, showing a clear improvement in symptoms with blood derivatives after the first two weeks of treatment. Several other studies have assessed the efficacy of injection PCs in managing refractory erosive OLP patients who showed no response to corticosteroid treatment [ 39 ]. The results revealed that PCs therapy is an effective approach for treating atrophic-erosive lesions associated with this condition, which is generally unresponsive to corticosteroids.…”

Methotrexate-associated oral mucositis in children with acute lymphoblastic leukemia

“…Platelet-rich plasma (PRP) contains a platelet concentration five times higher than the baseline, cytokines, growth factors, adhesion molecules, a certain amount of red blood cells (RBCs) and white blood cells (WBCs) depending on the preparation method. It is obtained from fresh peripheral blood with a platelet concentration above the baseline value [51]. Platelet gel (PG) is derived from PRP and consists of platelet concentrate (PC) deposited in a semisolid network of polymerized fibrin.…”

Platelet-Rich Plasma (PRP) in Dermatology: Cellular and Molecular Mechanisms of Action

“…A high ratio between reactive oxygen species and intracellular antioxidants was related to inflammation in oral lichen planus. An in vitro study showed that VEGF within alphagranules activates nuclear factor (derived-erythrocyte) type 2 (Nrf2), which may prevent oxidative damage [93,94]. Additionally, the granules release anti-inflammatory cytokines such as IL-1 receptor antagonist (IL-1ra), soluble necrosis factor receptor (sTNF-R) I and II, IL-4, IL-10, IL-13, thereby providing anti-inflammatory effects in oral lichen planus [94][95][96].…”