The Use of Anti-Oxidants in the Treatment of Persistent, Non-Responsive Oral Lichen Planus: A Randomized Control Clinical Trial
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology. Typical management of OLP involves topical corticosteroids. Recent literature shows an association between high levels of various oxidative stress markers, such as malondialdehyde (MDA), and OLP. A combination antioxidant gel consisting of phloretin and ferulic acid has been shown to have beneficial effects. In order to test the efficacy of this particular combination of antioxidants in managing OLP and to contribute to the literature linking oxidative stress to signs and symptoms of OLP, we conducted a double-blinded, placebo-controlled randomized clinical trial. A total of 33 patients with biopsy-confirmed OLP being treated for at least 6 weeks and presenting with persistent or non-responsive symptoms and lesions were given either a placebo (PLC, n = 16) or a test gel (AO, n = 17) and instructed to use three times a day for 4 weeks. Symptom scoring using a VAS, lesional scoring using an OLP scoring system, and salivary levels of oxidative stress markers, 8-hydroxy-deoxyguanosine (8-OH-dG) and malondialdehyde (MDA) were measured at baseline, 2 weeks, and 4 weeks.
VAS for the AO group decreased to 14.25 ± 14.05 at 2 weeks and 16.75 ± 22.14 at 4 weeks from 33.25 ± 28.82 at baseline, OLP lesional scores decreased to 6.26 ± 4.10 at 2 weeks and was 6.53 ± 4.63 at 4 weeks from 7.79 ± 5.18 at baseline, 8-OH-dG decreased 17.9% from 216.88 ± 132.01 at baseline to 178 ± 116.56 at 4 weeks, and MDA increased from 3.24 ± 1.07 to 4.63 ± 1.82 at 4 weeks. The changes were not statistically different from the PLC group in terms of VAS, OLP lesion score, salivary 8- OH-dG, and salivary MDA at any time point (p >0.05) except for at 4 weeks for MDA (p <0.05. The study revealed that a topical combination antioxidant gel did not differ from a placebo in any of the parameters measured. However, patients did not report any severe flare-ups and had better patient acceptance to topical steroids. To our knowledge, this is the first study to report on salivary 8-OH-dG and MDA levels in patients with oral lichen planus undergoing treatment.
VAS for the AO group decreased to 14.25 ± 14.05 at 2 weeks and 16.75 ± 22.14 at 4 weeks from 33.25 ± 28.82 at baseline, OLP lesional scores decreased to 6.26 ± 4.10 at 2 weeks and was 6.53 ± 4.63 at 4 weeks from 7.79 ± 5.18 at baseline, 8-OH-dG decreased 17.9% from 216.88 ± 132.01 at baseline to 178 ± 116.56 at 4 weeks, and MDA increased from 3.24 ± 1.07 to 4.63 ± 1.82 at 4 weeks. The changes were not statistically different from the PLC group in terms of VAS, OLP lesion score, salivary 8-OH-dG, and salivary MDA at any time point (p >0.05) except for at 4 weeks for MDA (p <0.05. The study revealed that a topical combination antioxidant gel did not differ from a placebo in any of the parameters measured. However, patients did not report any severe flare-ups and had better patient acceptance to topical steroids. To our knowledge, this is the first study to report on salivary 8-OH-dG and MDA levels in patients with oral lichen planus undergoing treatment.
Subject
Oral Lichen Planusantioxidants
oxidative stress
phloretin
ferulic acid
malondialdehyde
8-2'-deoxy-hydroxyguanosine
Citation
Ha, Cuong Huy (2015). The Use of Anti-Oxidants in the Treatment of Persistent, Non-Responsive Oral Lichen Planus: A Randomized Control Clinical Trial. Master's thesis, Texas A & M University. Available electronically from https : / /hdl .handle .net /1969 .1 /155162.