Possible Mechanisms Involved in the Cooccurrence of Oral Lichen Planus and Hashimoto’s Thyroiditis

Abstract

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disorder mediated by T cells, with a multifactorial etiology. Hashimoto’s thyroiditis (HT) is a common autoimmune disease characterized by hypothyroidism. Although many clinical studies conducted over the past several decades have reported the cooccurrence of OLP and HT, the underlying mechanism remains unclear. This review summarizes potential mechanisms that might be involved in the cooccurrence of OLP and HT. We find that OLP and HT share a common or overlapping pathogenesis in terms of immune, heredity, environmental, and hormonal factors, which might cause cooccurrence. Furthermore, considering the latency of HT, a routine screen for thyroid diseases, particularly HT, is suggested for confirmed OLP patients.

Association between oral health and thyroid disorders: A population‐based cross‐sectional study

“…Recently, there have been reports that oral lichen planus as a chronic T‐cell‐mediated mucosal inflammatory disease has a significant association with Hashimoto thyroiditis. Consequently, the immune response in the oral cavity may also be related to thyroid disease and dysfunction (Wu et al., 2020). Collectively, oral health status may be highly associated with the pathological and functional status of the thyroid gland, and it is expected that early detection and intervention in patients at a high risk for thyroid‐related diseases can be performed by checking and controlling oral health conditions.…”

Association of Hashimoto’s thyroiditis and anti-thyroid antibodies with oral lichen planus: A cross-sectional study

“…eventually leading to more cryptic epitope exposure and OLP lesions (25). The active systemic immune state during the course of autoimmune diseases is also a possible precipitating factor.…”

“…Previous studies ( 20 , 24 ) have inferred that OLP is related to HT, and this hypothesis has a theoretical basis. OLP and HT, as autoimmune diseases related to T-cell-mediated immune responses, seem to have some common immune triggers and pathogenic processes ( 25 ). Simultaneously, oral mucosal epithelial cells express antigens recognized by HT autoantibodies (TPOAb and TgAb) or antigens with structures similar to their recognized antigens ( 25 ).…”

“…OLP and HT, as autoimmune diseases related to T-cell-mediated immune responses, seem to have some common immune triggers and pathogenic processes ( 25 ). Simultaneously, oral mucosal epithelial cells express antigens recognized by HT autoantibodies (TPOAb and TgAb) or antigens with structures similar to their recognized antigens ( 25 ). These might also be involved in the concurrent occurrence of these two diseases.…”

“…Patients with HT are more likely to suffer from other autoimmune diseases, such as OLP. Circulating thyroid antibodies may target oral/skin keratinocytes or cross-react with proteins on keratinocyte membranes, which stimulate cytotoxic T cells to release chemokines to promote the development of OLP lesions and attract more immune cells into developing lesions, eventually leading to more cryptic epitope exposure and OLP lesions ( 25 ). The active systemic immune state during the course of autoimmune diseases is also a possible precipitating factor.…”