| (1) Oral lichen planus is clinically defined as a most prevalent noninflectional chronic inflammatory disease affecting skin and mucosa. The main features of histopathological investigation are: first, epithelial over keratinize or incomplete keratinize; proliferation is often seen in thorn layer; irregular epithelia with the shape of saw tooth. Second, liquidation and denaturation may result in disorder in basal cells, no clear boundary in basal membrane, and necrosis of basal cells as well. Third, in laminae middle there has intensive band-like lymphocytic infiltrate located in surface. Usually, it does not penetrate into deeper or lower level. Fourth, part of the cases have been shown that in epithelial thorn, basal and laminae layers of the membrane there exist circular or oval gluey petty objects with homogeneity and acidophilia which may be classified as the withered bare dead. Finally, the findings of five cases indicated that the epithelial slight non-typical proliferation existed. Contrary to normal behavior, the cells were not of uniform size, vivid and great in style. The nuclear was big and dense, the proportion of the nuclear syrup was increased, and the division might grow but in normal condition. Cells were in a mess, levels increased and poloidal vanished.(2) Using the methods of immunohistochemical S-ABC and in situ terminal deoxynucleotidyl transferase mediated d UTP nick end labeling(TUNEL), we found that normal oral mucosa epithelia nearly couldn’t express CD4+, CD8+T, only in basal level some scattered CD4+, CD8+T positive expression could be visualized. We also found that, moderate or large quantity of lymphocytic infiltrates existed in laminae level in oral lichen planus, in which 92.3%(60/65)clinical cases were involved.CD4+, CD8+T positive cells were obviously added when compared with health group, suggesting that the occurrence of oral lichen planus might be connected with the alteration of cellular immunity of pathological tissue. CD8+T Cells of oral lichen planus group were mainly expressed in superficial laminae layer adjacent to basal membrane damage, whereas CD4+T cells were expressed in deeper laminae level. The decreased ratio CD4/CD8 has statistical magnificence when compared with contrast group. In addition, the result of peripheral blood T lymphocytic subgroup can also prove it(P< 0.0 1).( 3) Using the method of immunohistochemical S-ABC, we concluded that of 20 oral lichen planus patients, Bax positive expression rate was 75.0% including 15 cases, 8 cases expressed strong positive(+++), 5cases moderate positive(++), and 2 cases mild positive(+). Moreover, positive cells were notably expressed in basal level and middle lower thorn level. With respect to Bax positive rate and intensity, there were significant differences between lesions and common skin. Of 10 cases in common skin, 3 cases were mild positive(+) and other cases were negative(-), hence the positive rate was 30.0%. Thus it is able to demonstrate that expression rate and intensity of oral lichen planus are greater than its apparent counterpart.(4)Adopting the method in situ terminal deoxynucleotidyl transferase mediated d UTP nick end labeling(TUNEL), we found that the apoptotic cells could be seen in both epithelial and laminae layer in oral mucosa, brown, clear and compact. In oral lichen planus, Epithelial apoptotic index was obvious higher than normal group. The apoptotic cells were often located in the place of liquidation and necrosis of basal level with expression rate 85%(55/65), whereas apoptotic cells of normal contrast group often in surface, thorn layer and band-like infiltrate with expression rate 80%(8/10).(5)By means of double antibody sandwich enzyme-linked immune sorbent assay, it has been certainly confirmed that the content of peripheral blood serum of TNF-a and IFN-γin oral lichen planus patients was greater than its apparent counterpart.(6)The method of monoclonal antibody rosette for T cell subsets was used, suggesting that when compared with health group, of 20 oral lichen planus patients, CD8+ obvious high(P<0.05), CD4+ no apparent difference(p>0.05). CD4+/CD8+ obvious drop(p<0.05), which were in full accordance with the result of immunohistochemical staining analysis.(7)Under transmission electron microscope, our findings suggested that, first, raw fibers of tension were filled in the thorn kytoplasm of oral mucosa in oral lichen planus patients, what’s more, they became thicker, enlarged, and disordered. The Endoplasmic reticulum dilated, non-fixation materials appeared, kurtosis vanished, and free ribosome went up. Second, most cell crgans reduced, nuclear block shaped, heterochromatin increased, and peripheral nuclear gap widened. In addition, vacuole was found around some nuclear, cells were out of shape, cell desmosome structure was deformed, and the gap of the cell evidently enlarged. Third, basal cells and semi-desmosome in basal membrane and desmosome cells were damaged. Partial cells were found deformed in a mess, dislocated. Besides, the gap of edema cell was enlarged, mitochondrial swelled in kytoplasm, and the kurtosis evidently decreased. Then, the nuclear enlarged, and apoptotic cells were increased as well. Furthermore, the apoptotic occurring frequency were higher than health group. Finally, the apoptosis was particularly featured in chromatin gathering just along one side with the shape of “C”, crescent or block, and the apoptotic body arising. Conclusion1. Features of oral lichen planus pathological histology are the cell injuredue to basal keratin, denaturation, liquidation on different degree and necrosis.2. The stronger expression of TNF-α、IFN-γ in peripheral blood in oral lichen planus patients has been confirmed that they may be one of the significant factors in oral lichen planus lesions.3. The strong expression of apoptosis inhibitor Bcl-2 in band-like lymphocytic infiltrate in lesions and apoptotic enhancer Bax in epithelial basal keratinocytes have been proved that the apoptotic abnormality plays a fundamental role as occurs with oral lichen planus. Results of Ultra micro structure of lesions tissue can also prove it.4. Laminae layer of lesions tissue and T lymphocytic subgroup in peripheral blood were altered in oral lichen planus patients, suggesting that immune function disorder plays a key role as occurs with oral lichen planus. Conclusion1.Features of oral lichen planus pathology histology are,first the cell injure because of basement keratin, denaturation on different degree, liquidation and necrosis,second T lymphocytes infiltration in lamina propria.2.The observabitity change of the intrinsic layer of the lesion tissue of the oral lichen planus sufferers and T- leukomonocyte subgroup in peripheral blood states that immune function disorder of the cell pays much attention to oral lichen planus attack.3.The strong expression of apoptosis inhibitory factor Bcl-2 in lymphocytic infiltration of lesion, and apoptosis enhancing factor Bax in epithele basement keratin indicate that the apoptosis abnormal is much closely related to the oral lichen planus occurrence and development. The observation of Ultramicro structure of the lesion tissue can also prove it.4.The much higher index of TNF-α、IFN-γ in peripheral blood of oral lichen planus sufferers indicate they may be one of the important factors of oral lichen planus lesion.5.In short, the immune function disorder of the oral lichen planus suffers is the premise of the disease. TNF-α、IFN-γ pay the role of breakaway, pro-inflammatory, stimulating the migration of Langerhans cell during the occurrence of the illness, which constitute the main part of the network unbalance of the regulation and control of the oral lichen planus immune. The disorder of the cell immune function and cell apoptosis abnormal are closely related to the oral lichen planus occurrence and development. |
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