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Recent Patents on Biotechnology


ISSN (Print): 1872-2083
ISSN (Online): 2212-4012

Review Article

Plant Extracts and Phytochemicals, a Promising Strategy Against Oral Lichen Planus: A Review on Clinical Trials

Author(s): Swati Gupta, Lekshmi R. Nath and Sabitha Mangalathillam*

Volume 17, Issue 1, 2023

Published on: 29 August, 2022

Page: [80 - 91] Pages: 12

DOI: 10.2174/1872208316666220718145421

Price: $65


Background: Oral lichen planus (OLP) is an autoimmune disease that distress keratinized cells of the oral epithelium. Topical corticosteroids and other potential therapies like immunosuppressives, hydroxychloroquine, azathioprine, mycophenolate, dapsone, retinoids, biologic agents are used for the management of OLP. However, their effectiveness, best dose, duration of treatment and safety remain mostly unidentified. Moreover, recurrence of disease and dose-related side effects are the other issues.

Objective: The primary objective of the review is to explore the existing clinical trials for the efficacy of phytochemicals in treating OLP in comparison to corticosteroids. A comprehensive information about their mode of action is also discussed.

Methods: We have discussed different clinical trials conducted on various phytochemicals and plant extracts/formulations like curcumin, lycopene, quercetin, glycyrrhizin, purslane, raspberry, aloe vera gel and aloe vera mouthwash for the treatment of OLP.

Results: The current therapy for the management of OLP has numerous adverse effects and requires a long-term treatment. Phytochemicals can be a very good alternative in overcoming these side effects and reducing the course of treatment.

Conclusion: Herbal extracts and their formulations can be an effective alternative to the current therapy due to their proven therapeutic effects, reduced side effects, long-term applicability, prevention of recurrence as well as progression into cancer.

Keywords: Oral lichen planus, phytochemicals, clinical trials, INF-γ, COVID-19, autoimmune.

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Canto AM, Müller H, Freitas RR, Santos PS. Oral lichen planus (OLP): Clinical and complementary diagnosis. An Bras Dermatol 2010; 85(5): 669-75.
[] [PMID: 21152791]
Sugerman PB, Savage NW, Walsh LJ, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med 2002; 13(4): 350-65.
[] [PMID: 12191961]
Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: A literature review and update. Arch Dermatol Res 2016; 308(8): 539-51.
[] [PMID: 27349424]
Nogueira PA, Carneiro S, Ramos-e-Silva M. Oral lichen planus: An update on its pathogenesis. Int J Dermatol 2015; 54(9): 1005-10.
[] [PMID: 26147778]
Eisen D, Ellis CN, Duell EA, Griffiths CE, Voorhees JJ. Effect of topical cyclosporine rinse on oral lichen planus. A double-blind analysis. N Engl J Med 1990; 323(5): 290-4.
[] [PMID: 2195345]
Chainani-Wu N, Collins K, Silverman S Jr. Use of curcuminoids in a cohort of patients with oral lichen planus, an autoimmune disease. Phytomedicine 2012; 19(5): 418-23.
[] [PMID: 22305276]
Airas L. Hormonal and gender-related immune changes in multiple sclerosis. Acta Neurol Scand 2015; 132(199): 62-70.
[] [PMID: 26046561]
Zhang MA, Rego D, Moshkova M, et al. Peroxisome proliferator-activated receptor (PPAR) α and -γ regulate IFNγ and IL-17A production by human T cells in a sex-specific way. Proc Natl Acad Sci USA 2012; 109(24): 9505-10.
[] [PMID: 22647601]
Voskuhl RR, Gold SM. Sex-related factors in multiple sclerosis susceptibility and progression. Nat Rev Neurol 2012; 8(5): 255-63.
[] [PMID: 22450508]
Antulov R, Weinstock-Guttman B, Cox JL, et al. Gender-related differences in MS: A study of conventional and nonconventional MRI measures. Mult Scler 2009; 15(3): 345-54.
[] [PMID: 19028830]
Olesen KM, Ismail N, Merchasin ED, Blaustein JD. Long-term alteration of anxiolytic effects of ovarian hormones in female mice by a peripubertal immune challenge. Horm Behav 2011; 60(4): 318-26.
[] [PMID: 21722643]
Murray E, Sharma R, Smith KB, et al. Probiotic consumption during puberty mitigates LPS-induced immune responses and protects against stress-induced depression and anxiety-like behaviors in adulthood in a sex-specific manner. Brain Behav Immun 2019; 81: 198-212.
[] [PMID: 31212008]
Bernstein ML. The diagnosis and management of chronic nonspecific mucosal lesions. J Calif Dent Assoc 1999; 27(4): 290-9.
[PMID: 10528562]
Rotim Z, Bolanca Z, Rogulj AA, Andabak M, Boras VV, Vrdoljak DV. Oral lichen planus and oral lichenoid reaction-an update. Acta Clin Croat 2015; 54(4): 516-20.
[PMID: 27017728]
Müller S. Oral lichenoid lesions: Distinguishing the benign from the deadly. Mod Pathol 2017; 30(s1): S54-67.
[] [PMID: 28060366]
Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: Etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci 2007; 49(2): 89-106.
[] [PMID: 17634721]
Gandolfo S, Richiardi L, Carrozzo M, et al. Risk of oral squamous cell carcinoma in 402 patients with oral lichen planus: A follow-up study in an Italian population. Oral Oncol 2004; 40(1): 77-83.
[] [PMID: 14662419]
Le Cleach L, Chosidow O. Clinical practice. Lichen planus. N Engl J Med 2012; 366(8): 723-32.
[] [PMID: 22356325]
López-López J, Omaña-Cepeda C, Jané-Salas E. Oral precancer and cancer. Med Clin 2015; 145(9): 404-8.
[PMID: 25638423]
Richards D. Malignant transformation rates in oral lichen planus. Evid Based Dent 2018; 19(4): 122.
[] [PMID: 30573869]
Fitzpatrick SG, Hirsch SA, Gordon SC. The malignant transformation of oral lichen planus and oral lichenoid lesions: A systematic review. J Am Dent Assoc 2014; 145(1): 45-56.
[] [PMID: 24379329]
Gonzalez-Moles MA, Scully C, Gil-Montoya JA. Oral lichen planus: Controversies surrounding malignant transformation. Oral Dis 2008; 14(3): 229-43.
[] [PMID: 18298420]
Larsson A, Warfvinge G. Malignant transformation of oral lichen planus. Oral Oncol 2003; 39(6): 630-1.
[] [PMID: 12798408]
Mattsson U, Jontell M, Holmstrup P. Oral lichen planus and malignant transformation: Is a recall of patients justified? Crit Rev Oral Biol Med 2002; 13(5): 390-6.
[] [PMID: 12393758]
van der Meij EH, Schepman KP, Smeele LE, van der Wal JE, Bezemer PD, van der Waal I. A review of the recent literature regarding malignant transformation of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88(3): 307-10.
[] [PMID: 10503859]
Hertel M, Schmidt-Westhausen AM, Wendy S, et al. Onset of oral lichenoid lesions and oral lichen planus following COVID-19 vaccination: A retrospective analysis of about 300,000 vaccinated patients. Vaccines 2022; 10(3): 480.
[] [PMID: 35335112]
Rasul TF, Anderson J, Bergholz DR, Faiz A, Prasad RR. Gold dental implant-induced oral lichen planus. Cureus 2022; 14(2): e21852.
[PMID: 35273836]
Lurya E, Evdaev A. Herbal composition useful for treatment or oral cavity and a method for its local delivery thereof. WO Patent 087247A2 2001.
Najafi S, Sahebjamee M, Amanlou M. Treatment of oral lichen planus with a combination of triamcinolone and retinoic acid. US Patent 0249118, 2014.
Lavanya N, Jayanthi P, Rao UK, Ranganathan K. Oral lichen planus: An update on pathogenesis and treatment. J Oral Maxillofac Pathol 2011; 15(2): 127-32.
[] [PMID: 22529568]
Gupta S, Jawanda MK. Oral lichen planus: An update on etiology, pathogenesis, clinical presentation, diagnosis and management. Indian J Dermatol 2015; 60(3): 222-9.
[] [PMID: 26120146]
Al-Rawi N, Al-Kassam T, Majeed AH. Expression of matrix metalloproteinase-2 and 9 with their inhibitors, tissue inhibitors of metalloproteinase-1 and 2 in oral lichen planus. J Orofac Sci 2014; 6(1): 25-30.
Mittal N, Shankari GM, Palaskar S. Role of angiogenesis in the pathogenesis of oral lichen planus. J Oral Maxillofac Pathol 2012; 16(1): 45-8.
[] [PMID: 22438642]
Kamal R, Dahiya P, Goyal N, Kumar M, Sharma N, Saini HR. Mast cells and oral pathologies: A review. J Nat Sci Biol Med 2015; 6(1): 35-9.
[] [PMID: 25810632]
Mardani M, Ghabanchi J, Fattahi MJ, Tadbir AA. Serum level of vascular endothelial growth factor in patients with different clinical subtypes of oral lichen planus. Iran J Med Sci 2012; 37(4): 233-7.
[PMID: 23390328]
Tampa M, Caruntu C, Mitran M, et al. Markers of oral lichen planus malignant transformation. Dis Markers 2018; 2018: 1959506.
[] [PMID: 29682099]
Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus-A review. J Oral Pathol Med 2010; 39(10): 729-34.
[] [PMID: 20923445]
García-Pola MJ, González-Álvarez L, Garcia-Martin JM. Treatment of oral lichen planus. Systematic review and therapeutic guide. Med Clin 2017; 149(8): 351-62.
[PMID: 28756997]
Piñas L, García-García A, Pérez-Sayáns M, Suárez-Fernández R, Alkhraisat MH, Anitua E. The use of topical corticosteroides in the treatment of oral lichen planus in Spain: A national survey. Med Oral Patol Oral Cir Bucal 2017; 22(3): e264-9.
[] [PMID: 28160582]
Ungphaiboon S, Nittayananta W, Vuddhakul V, et al. Formulation and efficacy of triamcinolone acetonide mouthwash for treating oral lichen planus. Am J Health Syst Pharm 2005; 62(5): 485-91.
[] [PMID: 15745911]
Azizi A, Dadras OG, Jafari M, Moezi Ghadim N, Lawaf S, Sadri D. Efficacy of 0.1% triamcinolone with nanoliposomal carrier formulation inorabase for oral lichen planus patients: A clinical trial. Eur J Integr Med 2016; 3(3): 275-80.
Sotoodian B, Lo J, Lin A. Efficacy of topical calcineurin inhibitors in oral lichen planus. J Cutan Med Surg 2015; 19(6): 539-45.
[] [PMID: 26088501]
Scully C, Eisen D, Carrozzo M. Management of oral lichen planus. Am J Clin Dermatol 2000; 1(5): 287-306.
[] [PMID: 11702320]
Lo Muzio L, della Valle A, Mignogna MD, et al. The treatment of oral aphthous ulceration or erosive lichen planus with topical clobetasol propionate in three preparations: A clinical and pilot study on 54 patients. J Oral Pathol Med 2001; 30(10): 611-7.
[] [PMID: 11722711]
Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: An overview of clinical efficacy and safety. Clin Interv Aging 2006; 1(4): 327-48.
[] [PMID: 18046911]
Morita M, Asoda S, Tsunoda K, et al. The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: A case report Odontology 2017; 105(2): 262-6.
[PMID: 27368962]
Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey. JAMA 1998; 280(18): 1569-75.
[] [PMID: 9820257]
Goldbeck WS, Dorozynski A, Lie LG, et al. Complementary medicine is booming worldwide. BMJ 1996; 313(7050): 131-3.
[] [PMID: 8688771]
Thanya K, Lakshmi T. Ethnobotanical approach for oral lichen planus: A review. Int J Drug Dev Res 2013; 5(4): 54-7.
Ghahremanlo A, Boroumand N, Ghazvini K, Hashemy SI. Herbal medicine in oral lichen planus. Phytother Res 2019; 33(2): 288-93.
[] [PMID: 30421555]
Lv KJ, Chen TC, Wang GH, Yao YN, Yao H. Clinical safety and efficacy of curcumin use for oral lichen planus: A systematic review. J Dermatolog Treat 2019; 30(6): 605-11.
[] [PMID: 30388912]
White CM, Chamberlin K, Eisenberg E. Curcumin, a turmeric extract, for oral lichen planus: A systematic review. Oral Dis 2019; 25(3): 720-5.
[] [PMID: 30614166]
Ali S, Wahbi W. The efficacy of aloe vera in management of oral lichen planus: A systematic review and meta-analysis. Oral Dis 2017; 23(7): 913-8.
[] [PMID: 28029732]
Chainani-Wu N, Silverman S Jr, Reingold A, et al. A randomized, placebo-controlled, double-blind clinical trial of curcuminoids in oral lichen planus. Phytomedicine 2007; 14(7-8): 437-46.
[] [PMID: 17604143]
Keshari D, Patil K, Mahima VG. Efficacy of topical Curcumin in the management of oral lichen planus: A randomized controlled-trial. J Adv Clin Res Insights 2015; 2: 197-203.
Kia SJ, Shirazian S, Mansourian A, Khodadadi FL, Ashnagar S. Comparative efficacy of topical curcumin and triamcinolone for oral lichen planus: A randomized, controlled clinical trial. J Dent 2015; 12(11): 789-96.
[PMID: 27507989]
Thomas AE, Varma B, Kurup S, et al. Evaluation of efficacy of 1% curcuminoids as local application in management of oral lichen planus - Interventional study. J Clin Diagn Res 2017; 11(4): ZC89-93.
[] [PMID: 28571271]
Nosratzehi T, Arbabi-Kalati F, Hamishehkar H, Bagheri S. Comparison of the effects of curcumin mucoadhesive paste and local corticosteroid on the treatment of erosive oral lichen planus lesions. J Natl Med Assoc 2018; 110(1): 92-7.
[] [PMID: 29510851]
Mansourian A, Momen-Heravi F, Saheb-Jamee M, Esfehani M, Khalilzadeh O, Momen-Beitollahi J. Comparison of aloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: A randomized double-blinded clinical trial. Am J Med Sci 2011; 342(6): 447-51.
[] [PMID: 21681079]
Reddy RL, Reddy RS, Ramesh T, Singh TR, Swapna LA, Laxmi NV. Randomized trial of aloe vera gel vs. triamcinolone acetonide ointment in the treatment of oral lichen planus. Quintessence Int 2012; 43(9): 793-800.
[PMID: 23041995]
Ahmed SS, Gadalla LM, Elmeadawy SH, Badria F. The efficacy of aloe vera gel in treatment of oral lichen planus. Int Dent Med J Adv Res 2018; 4(1): 1-6.
Saawarn N, Shashikanth MC, Saawarn S, Jirge V, Chaitanya NC, Pinakapani R. Lycopene in the management of oral lichen planus: A placebo-controlled study. Indian J Dent Res 2011; 22(5): 639-43.
[] [PMID: 22406705]
Amirchaghmaghi M, Delavarian Z, Iranshahi M, et al. A randomized placebo-controlled double blind clinical trial of quercetin for treatment of oral lichen planus. J Dent Res Dent Clin Dent Prospect 2015; 9(1): 23-8.
[] [PMID: 25973150]
Agha-Hosseini F, Borhan-Mojabi K, Monsef-Esfahani HR, Mirzaii-Dizgah I, Etemad-Moghadam S, Karagah A. Efficacy of purslane in the treatment of oral lichen planus. Phytother Res 2010; 24(2): 240-4.
[] [PMID: 19585472]
Vickers ER, Woodcock KL. Raspberry leaf herbal extract significantly reduces pain and inflammation in oral lichen planus patients - A case series analysis. Open J Dent Oral Med 2015; 3(3): 73-81.
Da Nagao Y, Sata M, Suzuki H, Tanikawa K, Itoh K, Kameyama T. Effectiveness of glycyrrhizin for oral lichen planus in patients with chronic HCV infection. J Gastroenterol 1996; 31(5): 691-5.
[] [PMID: 8887036]
Bradford PG. Curcumin and obesity. Biofactors 2013; 39(1): 78-87.
[] [PMID: 23339049]
Noorafshan A, Ashkani-Esfahani S. A review of therapeutic effects of curcumin. Curr Pharm Des 2013; 19(11): 2032-46.
[PMID: 23116311]
Shehzad A, Rehman G, Lee YS. Curcumin in inflammatory diseases. Biofactors 2013; 39(1): 69-77.
[] [PMID: 23281076]
Mangalathillam S, Rejinold NS, Nair A, Lakshmanan VK, Nair SV, Jayakumar R. Curcumin loaded chitin nanogels for skin cancer treatment via the transdermal route. Nanoscale 2012; 4(1): 239-50.
[] [PMID: 22080352]
Anthwal A, Thakur BK, Rawat MS, Rawat DS, Tyagi AK, Aggarwal BB. Synthesis, characterization and in vitro anticancer activity of C-5 curcumin analogues with potential to inhibit TNF-α-induced NF-κB activation. BioMed Res Int 2014; 2014: 524161.
[] [PMID: 25157362]
Lysitsa S, Samson J, Gerber-Wicht C, Lang U, Lombardi T. COX-2 expression in oral lichen planus. Dermatology 2008; 217(2): 150-5.
[] [PMID: 18536521]
Cortés-Ramírez DA, Rodríguez-Tojo MJ, Gainza-Cirauqui ML, Martínez-Conde R, Aguirre-Urizar JM. Overexpression of cyclooxygenase-2 as a biomarker in different subtypes of the oral lichenoid disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(6): 738-43.
[] [PMID: 21112532]
Joe B, Vijaykumar M, Lokesh BR. Biological properties of curcumin-cellular and molecular mechanisms of action. Crit Rev Food Sci Nutr 2004; 44(2): 97-111.
[] [PMID: 15116757]
Ashrafizadeh M, Zarrabi A, Hushmandi K, et al. Toward regulatory effects of curcumin on transforming growth factor-beta across different diseases: A review. Front Pharmacol 2020; 11: 585413.
[] [PMID: 33381035]
Lu R, Zhang J, Sun W, Du G, Zhou G. Inflammation-related cytokines in oral lichen planus: An overview. J Oral Pathol Med 2015; 44(1): 1-14.
[] [PMID: 24329772]
Vogler BK, Ernst E. Aloe vera: A systematic review of its clinical effectiveness. Br J Gen Pract 1999; 49(447): 823-8.
[PMID: 10885091]
Steenkamp V, Stewart MJ. Medicinal applications and toxicological activities of aloe products. Pharm Biol 2007; 5(45): 411-20.
Surjushe A, Vasani R, Saple DG. Aloe vera: A short review. Indian J Dermatol 2008; 53(4): 163-6.
[] [PMID: 19882025]
Levy J, Sharoni Y. The functions of tomato lycopene and its role in human health. HerbalGram 2004; 62: 49-56.
Stahl W, Sies H. Lycopene: A biologically important carotenoid for humans? Arch Biochem Biophys 1996; 336(1): 1-9.
[] [PMID: 8951028]
Jiang LN, Liu YB, Li BH. Lycopene exerts anti-inflammatory effect to inhibit prostate cancer progression. Asian J Androl 2018; 21(1): 80-5.
[PMID: 30198495]
Ying B, Yang T, Song X, et al. Quercetin inhibits IL-1 beta-induced ICAM-1 expression in pulmonary epithelial cell line A549 through the MAPK pathways. Mol Biol Rep 2009; 36(7): 1825-32.
[] [PMID: 18982426]
Yu ES, Min HJ, An SY, Won HY, Hong JH, Hwang ES. Regulatory mechanisms of IL-2 and IFN gamma suppression by quercetin in T helper cells. Biochem Pharmacol 2008; 76(1): 70-8.
[] [PMID: 18468581]
Pastorino G, Cornara L, Soares S, Rodrigues F, Oliveira MBPP. Liquorice (Glycyrrhiza glabra): A phytochemical and pharmacological review. Phytother Res 2018; 32(12): 2323-39.
[] [PMID: 30117204]
Movahedian A, Ghannadi A, Vashirnia M. Hypocholesterolemic effects of purslane extract on serum lipids in rabbits fed with high cholesterol levels. Int J Pharmacol 2007; 3(3): 285-9.
Simopoulos AP, Tan DX, Manchester LC, Reiter RJ. Purslane: A plant source of omega-3 fatty acids and melatonin. J Pineal Res 2005; 39(3): 331-2.
[] [PMID: 16150116]

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