title: Anti-angiogenic therapy (bevacizumab) in the management of oral lichen planus.
abstract: Oral lichen planus (OLP), a mucocutaneous chronic inflammatory disease, is conventionally managed using topical corticosteroid therapy. Given the fact that OLP is strongly linked to angiogenesis, anti-angiogenic drugs, such as bevacizumab, might be introduced as an alternative treatment for contraindicated, non-responsive patients. The aim of the present study was to report the short-term effectiveness and safety of intralesional bevacizumab injection in the management of atrophic/erosive OLP. A case series study was conducted in patients with atrophic/erosive OLP in the buccal mucosa, assigned to receive either 2.5 mg of bevacizumab, by intralesional injection (n = 20, test), or topical 0.1% triamcinolone acetonide ointment (n = 20, control). The size, score, and pain intensity of the lesions were assessed pre- and post-treatment. Tissue biopsies were collected for histopathologic, immunohistochemical, and ultrastructural examination. After 1 wk, the test group had significant reductions both in lesion seize and in pain scores compared with controls. A marked decrease in vascular endothelial growth factor (VEGF) and interleukin-8 immunoexpression was noted in tissue biopsies from bevacizumab-treated lesions compared with control lesions. Furthermore, ultrastructural examination of OLP tissue specimens revealed significant healing signs associated with bevacizumab treatment. Short-term data suggest that intralesional bevacizumab injection effectively and safely achieved resolution of atrophic/erosive OLP lesions without disease exacerbations during a 3-month follow-up period.
authors.affiliation: Oral Medicine, Periodontology, Radiology and Diagnosis, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
authors.forename: Maha M
authors.initials: MM
authors.lastname: Mahmoud
authors.affiliation: Oral Pathology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Afifi
mesh_terms: D000068258:Bevacizumab; D006801:Humans; D016209:Interleukin-8 / Q000627:therapeutic use; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D014222:Triamcinolone Acetonide; D042461:Vascular Endothelial Growth Factor A / Q000627:therapeutic use
chemical_list: D016209:Interleukin-8; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide
keywords: IL-8; VEGF; angiogenesis; bevacizumab; oral lichen planus