Effect of serum and salivary levels of vitamins C and E on Oral Lichen Planus: A Systematic Review and Meta-Analysis
Keywords:
Lichen planus, Oral, Ascorbic Acid, Vitamin E, Systematic ReviewAbstract
Background: Lichen planus is a chronic inflammatory disorder and various factors are involved in its development. One of the most important factors is the immune system. The first line of treatment for this disease is the use of corticosteroids, and the use of antioxidants (vitamin C and E) may help. These vitamins have the ability to prevent the multiplication and release of destructive free radicals in the cell membrane, and its deficiency may cause disruption of the immune system and the occurrence of disease. Many studies have been conducted in this field, which necessitates the need for a systematic review. Therefore, this study will be conducted with the aim of the effect of vitamins C and E on lichen planus.
Method: This study was conducted as a systematic review. Keywords were searched for the "Oral Lichen Planus" AND ((Ascorbic Acid OR Vitamin C OR Hybrin OR Magnorbin OR Ascorbate OR Magnesium Ascorbicum) OR (Vitamin E OR Tocopherols OR Tocotrienols)) in various scientific databases up to the end of [insert date]. Based on the types of studies included, random-effects models were employed to estimate the effect sizes in the meta-analysis, utilizing a heterogeneity assessment methodology. The results of the studies, along with the overall estimated effect size, were presented in a forest plot. Heterogeneity among the studies was evaluated using the I² statistic. To address statistical heterogeneity, we applied a stratified analysis approach. Additionally, to assess publication bias, we created a funnel plot and conducted the Begg and Egger tests. Meta-analysis and meta-regression were performed using STATA version 16 software.
Results: After removing duplicates, a total of 1,185 articles were identified, of which 8 studies were included in the meta-analysis. The findings indicated a strong, positive, and statistically significant relationship between Vitamin C and Oral Lichen Planus, with a standardized mean difference (SMD) of -1.71 (95% Confidence Interval [CI]: -2.34, -1.05; p < 0.001; I² = 87.22%). Additionally, the meta-analysis examining the relationship between Vitamin E and Oral Lichen Planus also revealed a strong, positive, and statistically significant association, with an SMD of -0.96 (95% CI: -1.88, -0.04).
Conclusion: This study found a significant correlation between serum and salivary vitamin C levels and vitamin E levels in patients with oral lichen planus (OLP). However, serum vitamin E levels did not show a significant relationship with this condition. Additionally, a positive correlation between vitamin C and vitamin E was observed.
Downloads
References
Gurav T, Thakare A, Shinde P, Chavan M, Taori K, Jadhav V. Clinical Characteristics, Identification, and Treatment of Lichen Planus: A Case Report. Cureus. 2024;16(7):e65712.
Andabak-Rogulj A, Vindiš E, Aleksijević LH, Škrinjar I, Juras DV, Aščić A, et al. Different treatment modalities of oral lichen planus—a narrative review. Dentistry journal. 2023;11(1):26.
Gholizadeh N, Sheykhbahaei N. Micronutrients profile in oral lichen planus: a review literature. Biological trace element research. 2021;199:912-24.
Jacobo-Delgado YM, Torres-Juarez F, Rodríguez-Carlos A, Santos-Mena A, Enciso-Moreno JE, Rivas-Santiago C, et al. Retinoic acid induces antimicrobial peptides and cytokines leading to Mycobacterium tuberculosis elimination in airway epithelial cells. Peptides. 2021;142:170580.
Baby TK, Bindhu P, Pillai RK, Jayanthi P. Immunohistochemical expression of cyclooxygenase-2 in oral lichen planus and normal oral mucosa. Indian Journal of Pathology and Microbiology. 2022;65(1):8-12.
Deng X, Wang Y, Jiang L, Li J, Chen Q. Updates on immunological mechanistic insights and targeting of the oral lichen planus microenvironment. Frontiers in Immunology. 2023;13:1023213.
Abdolsamadi H, Rafieian N, Goodarzi MT, Feradmal J, Davoodi P, Jazayeri M, et al. Levels of salivary antioxidant vitamins and lipid peroxidation in patients with oral lichen planus and healthy individuals. Chonnam medical journal. 2014;50(2):58-62.
Tsunoda K, Kumagai A, Tsunoda N, Obara M, Kawai T, Ohashi Y, et al. Low serum levels of vitamin C in patients with oral lichen planus: a case-control study. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. 2022;34(4):440-4.
Kaur J, Politis C, Jacobs R. Salivary 8-hydroxy-2-deoxyguanosine, malondialdehyde, vitamin C, and vitamin E in oral pre-cancer and cancer: diagnostic value and free radical mechanism of action. Clinical oral investigations. 2016;20:315-9.
Pehlivan FE. Vitamin C: An antioxidant agent. Vitamin C. 2017;2:23-35.
Niki E. Interaction of ascorbate and alpha-tocopherol. Annals of the new York Academy of Sciences. 1987;498:186-99.
Rezazadeh F, Haghighat S. Serum Vitamin Profile in Oral Lichen Planus Patients in Southwest of Iran. BioMed research international. 2021;2021(1):8627435.
Jolly M, Nobile S. Vitamin status of patients with oral lichen planus. Australian dental journal. 1977;22(6):446-50.
Nagao T, Warnakulasuriya S, Ikeda N, Fukano H, Yamamoto S, Yano M, et al. Serum antioxidant micronutrient levels in oral lichen planus. Journal of oral pathology & medicine. 2001;30(5):264-7.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
