ΑΝΕΠΑΡΚΕΙΑ (8)
oral Lichen planus
1. IDA patients had significantly higher frequencies of all oral manifestations than healthy controls (p < 0.001 for all), in which burning sensation (76.0%), lingual varicosity (56.0%), dry mouth (49.3%), oral lichen planus (33.3%), and atrophic glossitis (26.7%) were the five leading oral manifestations.
Moreover, IDA patients had significantly lower mean vitamin B12 level (p = 0.003)
Wu YC, Wang YP, Chang JY, Cheng SJ, Chen HM, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. J Formos Med Assoc. 2014 Feb;113(2):83-7. doi: 10.1016/j.jfma.2013.11.010. Epub 2013 Dec 30. PMID: 24388269.
https://pubmed.ncbi.nlm.nih.gov/24388269/
1-2. 2016
- Erosive oral lichen planus (EOLP)
27 (29.3%) of 92 EOLP patients had vitamin B12 (< 200 pg/mL) deficiencies
EOLP patients had a significantly higher frequency of vitamin B12 deficiency than healthy control individuals (all p < 0.001).
Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with desquamative gingivitis Julia Yu-Fong Chang a,b,c , Yi-Ping Wang a,b,c , Yang-Che Wu a,b , Yu-Hsueh Wu a,b , Chih-Huang Tseng a,b , Andy Sun
file:///C:/Users/user/Downloads/hematinic-deficiencies-and-anemia-statuses-in-antigastric-parietal-cell-antibody-positive-erosive-oral-lichen-planus-patients-with-desquamative-gingivitis.pdf
- EOLP patients had significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy controls.
Chang JY, Chen IC, Wang YP, Wu YH, Chen HM, Sun A. Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity. J Formos Med Assoc. 2016 Nov;115(11):1004-1011. doi: 10.1016/j.jfma.2016.09.007. Epub 2016 Oct 29. PMID: 27802920.
https://pubmed.ncbi.nlm.nih.gov/27802920/
3-4. 2018
- we also discovered that 7.1% of 352 OLP patients have vitamin B12 deficiencies,
Furthermore, OLP or EOLP disease itself does cause the deficiencies of Hb, iron, and vitamin B12 in OLP or EOLP patients.
Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc. 2018 Sep;117(9):756-765. doi: 10.1016/j.jfma.2018.01.021. Epub 2018 Feb 19. PMID: 29472048.
https://pubmed.ncbi.nlm.nih.gov/29472048/
- EOLP patients had significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects.
Chang JY, Wang YP, Wu YH, Su YX, Tu YK, Sun A. Hematinic deficiencies and anemia statuses in anti-gastric parietal cell antibody-positive or all autoantibodies-negative erosive oral lichen planus patients. J Formos Med Assoc. 2018 Mar;117(3):227-234. doi: 10.1016/j.jfma.2017.12.009. Epub 2017 Dec 30. PMID: 29292055.
https://pubmed.ncbi.nlm.nih.gov/29292055/
5-6. 2020
- 236 OLP patients and 226 age-and-gender-matched healthy controls were enrolled in this study.
The frequencies of vitamin B12 deficiency in OLP patients was significantly higher than those of the healthy controls.
vitamin B12 levels in OLP patients should be monitored routinely.
Bao, Zx., Yang, Xw., Shi, J. et al. The profile of hematinic deficiencies in patients with oral lichen planus: a case-control study. BMC Oral Health 20, 252 (2020). https://doi.org/10.1186/s12903-020-01229-w
https://pubmed.ncbi.nlm.nih.gov/32912209/
- Serum vitamin B12 was significantly reduced (p value < 0) in patients with oral lichen planus when compared to healthy individuals. 43.33% of cases (26 out of 60) had B12 levels less than 187 pg/ml.
Oral lichen planus causes serum vitamin B12 deficiency.
Naik SR, Gupta P, Khaitan T, Shukla AK. Reduced levels of serum vitamin B12 in symptomatic cases of oral lichen planus: A cross-sectional study. J Oral Biol Craniofac Res. 2020 Oct-Dec;10(4):578-582. doi: 10.1016/j.jobcr.2020.07.010. Epub 2020 Aug 21. PMID: 32939337; PMCID: PMC7479352.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479352/
7-8. 2021
- reduced levels of vitamin B12 have been reported in OLP patients
Gholizadeh N, Sheykhbahaei N. Micronutrients Profile in Oral Lichen Planus: a Review Literature. Biol Trace Elem Res. 2021 Mar;199(3):912-924. doi: 10.1007/s12011-020-02221-9. Epub 2020 Jun 12. PMID: 32533293.
https://pubmed.ncbi.nlm.nih.gov/32533293/
- patients with lichen sclerosus of the vulva also had a higher deficiency of vitamin B12
Dunaievska, V., & Manzhalii, E. (2021). Nutritional status disorders in women with lichen sclerosus of the vulva. REPRODUCTIVE ENDOCRINOLOGY, (62), 75–79. https://doi.org/10.18370/2309-4117.2021.62.75-79
http://reproduct-endo.com/article/view/249883
ΑΝΤΙΜΕΤΩΠΙΣΗ (μερική, όχι πλήρη, βελτίωση): 1 κλινική δοκιμή
1. 10 GPCA-positive OLP patients treated with vitamin B12 only showed a significant improvement in oral signs and symptoms of Pernicious Anemia in 100% of patients and a significant improvement in oral signs and symptoms of OLP in 13–20% of patients (1-2 patients αντίστοιχα).
http://europepmc.org/article/MED/20659263
https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/20659263/
- -- - - - -
Vitamin B12 and homocysteine
In examining the relationship of serum vitamin B12 levels to homocysteine levels,1 Julie Robertson and colleagues highlight the utility of homocysteine in the clinical investigation of vitamin B12 deficiency.
Both methylmalonic acid and homocysteine are elevated in vitamin B12 deficiency. The measurement of methylmalonic acid requires not readily available methods, whereas homocysteine is readily measured.
the sensitivity of homocysteine levels for identifying vitamin B12 deficiency is greater than 95%.2,3,4
https://www.cmaj.ca/content/173/11/1360.1
Moreover, measurement of both serum methylmalonic acid and homocysteine levels is discovered to be a more sensitive method of screening for vitamin B12 deficiency with the sensitivity being 99.8% and thus can be used for detecting subclinical vitamin B12 deficiency.
https://pubmed.ncbi.nlm.nih.gov/29472048/
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0929664618300524?returnurl=null&referrer=null
Supplementation with vitamin B12 decreases homocysteine and methylmalonic acid but also serum folate
https://pubmed.ncbi.nlm.nih.gov/10337865/
Homocysteine can be lowered easily and inexpensively with a trio of B vitamins — B6, B12, and folic acid. Problem solved? Not so fast. Lowering homocysteine doesn't mean much unless those reduced levels translate into reduced risk for the problems that elevated levels are thought to cause. Otherwise, you're just treating a blood test.
These results aren't the last word. Often, larger studies are needed. Perhaps larger doses of the B vitamins for a longer period of time will pay off. Also, relatively few people in these studies had high levels of homocysteine to begin with. Some doctors aren't waiting for the final word and are recommending vitamin therapy when people have homocysteine levels of 20 micromoles per liter (mol/L) or above, especially if those people have or are at risk for atherosclerosis
https://www.health.harvard.edu/staying-healthy/In_brief_B_vitamins_and_homocysteine
Causes of Elevated Homocysteine
Deficiency of folic acid or vitamins B6/B12
https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000165142.37711.E7
oral Lichen planus
1. IDA patients had significantly higher frequencies of all oral manifestations than healthy controls (p < 0.001 for all), in which burning sensation (76.0%), lingual varicosity (56.0%), dry mouth (49.3%), oral lichen planus (33.3%), and atrophic glossitis (26.7%) were the five leading oral manifestations.
Moreover, IDA patients had significantly lower mean vitamin B12 level (p = 0.003)
Wu YC, Wang YP, Chang JY, Cheng SJ, Chen HM, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. J Formos Med Assoc. 2014 Feb;113(2):83-7. doi: 10.1016/j.jfma.2013.11.010. Epub 2013 Dec 30. PMID: 24388269.
https://pubmed.ncbi.nlm.nih.gov/24388269/
1-2. 2016
- Erosive oral lichen planus (EOLP)
27 (29.3%) of 92 EOLP patients had vitamin B12 (< 200 pg/mL) deficiencies
EOLP patients had a significantly higher frequency of vitamin B12 deficiency than healthy control individuals (all p < 0.001).
Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with desquamative gingivitis Julia Yu-Fong Chang a,b,c , Yi-Ping Wang a,b,c , Yang-Che Wu a,b , Yu-Hsueh Wu a,b , Chih-Huang Tseng a,b , Andy Sun
file:///C:/Users/user/Downloads/hematinic-deficiencies-and-anemia-statuses-in-antigastric-parietal-cell-antibody-positive-erosive-oral-lichen-planus-patients-with-desquamative-gingivitis.pdf
- EOLP patients had significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy controls.
Chang JY, Chen IC, Wang YP, Wu YH, Chen HM, Sun A. Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity. J Formos Med Assoc. 2016 Nov;115(11):1004-1011. doi: 10.1016/j.jfma.2016.09.007. Epub 2016 Oct 29. PMID: 27802920.
https://pubmed.ncbi.nlm.nih.gov/27802920/
3-4. 2018
- we also discovered that 7.1% of 352 OLP patients have vitamin B12 deficiencies,
Furthermore, OLP or EOLP disease itself does cause the deficiencies of Hb, iron, and vitamin B12 in OLP or EOLP patients.
Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc. 2018 Sep;117(9):756-765. doi: 10.1016/j.jfma.2018.01.021. Epub 2018 Feb 19. PMID: 29472048.
https://pubmed.ncbi.nlm.nih.gov/29472048/
- EOLP patients had significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects.
Chang JY, Wang YP, Wu YH, Su YX, Tu YK, Sun A. Hematinic deficiencies and anemia statuses in anti-gastric parietal cell antibody-positive or all autoantibodies-negative erosive oral lichen planus patients. J Formos Med Assoc. 2018 Mar;117(3):227-234. doi: 10.1016/j.jfma.2017.12.009. Epub 2017 Dec 30. PMID: 29292055.
https://pubmed.ncbi.nlm.nih.gov/29292055/
5-6. 2020
- 236 OLP patients and 226 age-and-gender-matched healthy controls were enrolled in this study.
The frequencies of vitamin B12 deficiency in OLP patients was significantly higher than those of the healthy controls.
vitamin B12 levels in OLP patients should be monitored routinely.
Bao, Zx., Yang, Xw., Shi, J. et al. The profile of hematinic deficiencies in patients with oral lichen planus: a case-control study. BMC Oral Health 20, 252 (2020). https://doi.org/10.1186/s12903-020-01229-w
https://pubmed.ncbi.nlm.nih.gov/32912209/
- Serum vitamin B12 was significantly reduced (p value < 0) in patients with oral lichen planus when compared to healthy individuals. 43.33% of cases (26 out of 60) had B12 levels less than 187 pg/ml.
Oral lichen planus causes serum vitamin B12 deficiency.
Naik SR, Gupta P, Khaitan T, Shukla AK. Reduced levels of serum vitamin B12 in symptomatic cases of oral lichen planus: A cross-sectional study. J Oral Biol Craniofac Res. 2020 Oct-Dec;10(4):578-582. doi: 10.1016/j.jobcr.2020.07.010. Epub 2020 Aug 21. PMID: 32939337; PMCID: PMC7479352.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479352/
7-8. 2021
- reduced levels of vitamin B12 have been reported in OLP patients
Gholizadeh N, Sheykhbahaei N. Micronutrients Profile in Oral Lichen Planus: a Review Literature. Biol Trace Elem Res. 2021 Mar;199(3):912-924. doi: 10.1007/s12011-020-02221-9. Epub 2020 Jun 12. PMID: 32533293.
https://pubmed.ncbi.nlm.nih.gov/32533293/
- patients with lichen sclerosus of the vulva also had a higher deficiency of vitamin B12
Dunaievska, V., & Manzhalii, E. (2021). Nutritional status disorders in women with lichen sclerosus of the vulva. REPRODUCTIVE ENDOCRINOLOGY, (62), 75–79. https://doi.org/10.18370/2309-4117.2021.62.75-79
http://reproduct-endo.com/article/view/249883
ΑΝΤΙΜΕΤΩΠΙΣΗ (μερική, όχι πλήρη, βελτίωση): 1 κλινική δοκιμή
1. 10 GPCA-positive OLP patients treated with vitamin B12 only showed a significant improvement in oral signs and symptoms of Pernicious Anemia in 100% of patients and a significant improvement in oral signs and symptoms of OLP in 13–20% of patients (1-2 patients αντίστοιχα).
http://europepmc.org/article/MED/20659263
https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/20659263/
- -- - - - -
Vitamin B12 and homocysteine
In examining the relationship of serum vitamin B12 levels to homocysteine levels,1 Julie Robertson and colleagues highlight the utility of homocysteine in the clinical investigation of vitamin B12 deficiency.
Both methylmalonic acid and homocysteine are elevated in vitamin B12 deficiency. The measurement of methylmalonic acid requires not readily available methods, whereas homocysteine is readily measured.
the sensitivity of homocysteine levels for identifying vitamin B12 deficiency is greater than 95%.2,3,4
https://www.cmaj.ca/content/173/11/1360.1
Moreover, measurement of both serum methylmalonic acid and homocysteine levels is discovered to be a more sensitive method of screening for vitamin B12 deficiency with the sensitivity being 99.8% and thus can be used for detecting subclinical vitamin B12 deficiency.
https://pubmed.ncbi.nlm.nih.gov/29472048/
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0929664618300524?returnurl=null&referrer=null
Supplementation with vitamin B12 decreases homocysteine and methylmalonic acid but also serum folate
https://pubmed.ncbi.nlm.nih.gov/10337865/
Homocysteine can be lowered easily and inexpensively with a trio of B vitamins — B6, B12, and folic acid. Problem solved? Not so fast. Lowering homocysteine doesn't mean much unless those reduced levels translate into reduced risk for the problems that elevated levels are thought to cause. Otherwise, you're just treating a blood test.
These results aren't the last word. Often, larger studies are needed. Perhaps larger doses of the B vitamins for a longer period of time will pay off. Also, relatively few people in these studies had high levels of homocysteine to begin with. Some doctors aren't waiting for the final word and are recommending vitamin therapy when people have homocysteine levels of 20 micromoles per liter (mol/L) or above, especially if those people have or are at risk for atherosclerosis
https://www.health.harvard.edu/staying-healthy/In_brief_B_vitamins_and_homocysteine
Causes of Elevated Homocysteine
Deficiency of folic acid or vitamins B6/B12
https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000165142.37711.E7
