الفهرس 
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Abstract
Oral lichen planus is an immune-mediated disease that affects the oral mucous membranes. It follows a cyclic pattern of exacerbations or flares followed by periods of quiescence, unlike LP of the skin, which has been reported to have a high rate of spontaneous remission.
There are various mechanisms that are involved in the immune pathogenesis of OLP, these mechanisms include: antigen-specific cell mediated immune response, nonspecific autoimmune responses (cellular or humoral reactions).
Topical corticosteroids are beneficial in the management of OLP because of their anti-inflammatory effect and anti-immunologic properties of suppressing T-cell function.
Interleukin-17A is a CD4+ T cell-derived cytokine that promotes inflammatory responses in cell lines and plays an important role in various immune-mediated disorders including; rheumatoid arthritis, asthma, multiple sclerosis, psoriasis, and transplant rejection. IL-17 can also contribute to OLP pathogenesis by enhancing T cell mediated reactions and encouraging the release of cytokines from the immune cells.
Whole human saliva is a complex fluid which includes serum constituents, considerable amount of desquamated epithelial cells, microorganisms and cellular components. Collecting a sample of saliva is a simple, noninvasive and safe for both the health worker and the patient, allowing for simple and cost-efficient storage. These characteristics make it possible to monitor various biomarkers in children, the elderly and for those patients who do not collaborate in taking blood or urine samples.
The purpose of this study was to measure the level of IL-17 in the saliva of patients having atrophic and erosive oral lichen planus lesions and to evaluate the effect of topical triamcinolone acetonide 0.1% used for treatment of oral lichen planus on the level of IL-17 in the saliva.
The present study was performed on a total of 40 individuals that were selected from the outpatient clinic of Oral Medicine, Periodontology and Diagnosis Department, Faculty of Dentistry, Ain Shams University.
They were divided into 3 groups: group (I) included 20 patients having erosive/atrophic OLP received topical steroid (triamcinolone acetonide0.1%) four times per day (after each meal and at bed time) for four weeks, group (II) included 10 patients having reticular OLP and group (III) included 10 individuals as healthy controls. Patients were subjected to full history taking and clinical examination including clinical score and assessment for degree of pain visual analogue scale in the erosive/atrophic group.
Collection of unstimulated whole saliva (UWS) was performed for the three groups, for group I it was collected before and after the treatment, for group II and III it was collected once. The salivary samples were analyzed using ELISA kit for the detection of IL-17 salivary levels in the three study groups.
The present study demonstrated that there was a statistically significant difference between the mean and standard deviation values of the clinical score between group I before treatment and group I after treatment and between group I before and after treatment and group II and group III (p<0.001).
Regarding the pain visual analogue scale, in group I., there was an extreme statistically significant difference from baseline throughout the treatment period. Also there was an extreme statistically significant difference in the pain visual analogue scale between group (I) and group (II) and between group (I) and group (III).
IL-17 level in saliva was statistically significant higher in the erosive/atrophic group than both the reticular and healthy control groups. There was an extreme statistically significant difference in the salivary levels of IL-17 in the erosive/atrophic group before and after treatment with triamcinolone acetonide 0.1%.
There was a strong positive correlation between the clinical score values and the salivary levels of IL-17 before and after treatment in the erosive atrophic group. There was also a strong positive correlation between the pain visual analogue scale and the salivary levels of IL-17 before and after treatment in the erosive/atrophic group.
All these results suggested that IL-17 may play a major role in the pathogenesis of OLP and its salivary level may be of diagnostic value for the severity of the condition of the erosive/atrophic OLP.