Presence of anti-basal cell antibodies in oral lichen planus.

Abstract

An autoimmune hypothesis for oral lichen planus (OLP) has been proposed, but no anti-basal cell antibodies (anti-BCA) have been found in the sera of patients with OLP. Our purpose was to test whether the negative results of anti-BCA assays in sera have been due to the insensitivity of the substrates. Rat esophagus, monkey esophagus, as well as human oral mucosa and skin were used to detect anti-BCA in sera of OLP patients. By indirect immunofluorescence technique, the rat esophagus was found to be the most sensitive substrate. Therefore it was used as the only substrate to test the presence of anti-epithelial cell antibodies (anti-ECA) in a large group of patients with OLP and other oral mucosal diseases or normal control subjects. The results showed that anti-ECA were detected in 54% (34 of 63) of patients with OLP, 71% (15 of 21) of patients with aphthous ulcers, 29% (6 of 21) of patients with oral carcinoma, 20% (2 of 10) of patients with traumatic ulcer, and 7% (1 of 15) of patients with periodontitis but none of the healthy control subjects (n = 41). The presence of anti-BCA in OLP patients' sera was persistent and lasted for a few months or years. There was a decrease in the serum anti-BCA titers in six of eight anti-BCA-positive OLP patients after topical application of triamcinolone. These anti-BCA that persist longer in OLP patients' sera may be autoantibodies that are raised against altered basal cell-specific antigens.