Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. Two major clinical subtypes of OLP are described, namely reticular and erosive OLP. Erosive OLP is often refractory to topical and systemic therapy. Reticular OLP is characterized by keratotic lines (Wickham's striae) that produce a “lacy” pattern, while erosive OLP shows painful erosions, which can extremely affect the quality of life of the patients. The pathogenesis of OLP is not completely understood, but several factors seem to play a pivotal role, including IFN-gamma inducible chemokines and IL-17. Furthermore, some authors detected in refractory cases of OLP serum IgG antibodies against desmoglein 3, BP180, and BP230 by ELISA. Our goal was to define the antigenic specificities of serum IgG antibodies in a series of patients with OLP and oral pemphigus vulgaris (PV). In the present study, we analyzed a cohort of 66 OLP patients, 54 with reticular OLP and 12 with erosive OLP. In the erosive group, we detected serum IgG autoantibodies against BP180 or BP230 in 4 patients (33,3 %) by ELISA. In contrast to erosive OLP, only 2 patients (3,7 %) with reticular OLP showed circulating IgG antibodies against BP180 or BP230. Bullous pemphigoid was ruled out by direct immunofluorescence. In contrast to previous reports, serum levels of IgG antibodies against BP180 and BP230 did not correlate with the severity of clinical symptoms. Since PV patients also have oral mucosal involvement, the oral PV patients were used as a control group. Of 55 patients with PV examined, none showed the presence of BP180 or BP 230 antibodies. In contrast to OLP patients, most oral PV patients had an adequate response to the therapy. In summary, we speculated that IgG autoantibodies in refractory OLP are induced in response to damage caused by chronic mucosal inflammation, which leads to loss of tolerance against components of the basal membrane zone.

ESDR057 - Detection of IgG autoantibodies against BP180 and BP230 in patients with oral lichen planus

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