Impact of PDT and Topical Corticosteroids on Taste Perception and Salivary Oxidative Stress Markers in Patients With OLP
Oral lichen planus (OLP) is a long-term inflammatory disease affecting the lining of the mouth. It may cause pain, burning sensations, discomfort, and changes in the appearance of the oral mucosa. Some patients may also notice changes in their ability to recognize different tastes.
The aim of this study is to compare two treatments used for OLP: photodynamic therapy (PDT) and topical corticosteroid therapy. PDT is a light-based treatment in which a special gel containing 5-aminolevulinic acid is applied to the affected areas and then activated using a medical light device. Topical corticosteroids are anti-inflammatory medicines applied directly to the oral lesions.
Participants are randomly assigned to receive one of these two treatments. Their ability to recognize sweet, sour, salty, and bitter tastes is assessed using special taste strips before treatment and immediately after therapy is completed. The size of the oral lesions and the severity of symptoms, such as pain and burning, are also evaluated.
Saliva samples are collected before treatment, immediately after treatment, and 3, 6, and 12 months after therapy. These samples are used to measure cortisol and several substances related to inflammation and cellular stress, including malondialdehyde, advanced oxidation protein products, peroxynitrite, nitrotyrosine, and advanced glycation end products.
The results may help researchers better understand how photodynamic therapy and topical corticosteroids affect taste perception, oral symptoms, lesion healing, and biological changes in the saliva of patients with OLP. The findings may also support the selection of the most appropriate treatment in clinical practice.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa that is frequently associated with pain, burning sensations, and impaired quality of life. Alterations in gustatory function have also been reported in patients with OLP; however, the effects of different therapeutic approaches on taste perception and salivary biomarkers of oxidative, nitrosative, and carbonyl stress remain insufficiently investigated.
The aim of this randomized clinical trial is to evaluate and compare the effects of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) and topical corticosteroid therapy (CT) on gustatory function, clinical outcomes, and selected salivary biomarkers in patients with clinically and histologically confirmed OLP.
Participants are randomly allocated to one of two parallel treatment groups: (1) ALA-PDT using a 5% 5-aminolevulinic acid mucoadhesive emulgel followed by irradiation with a 630 nm LED light source, administered in five weekly sessions; or (2) topical corticosteroid therapy with clobetasol propionate applied twice daily for two weeks.
Gustatory function is assessed using standardized taste strips evaluating sweet, sour, salty, and bitter taste perception, with scores ranging from 0 to 4 for each taste modality and a total taste score ranging from 0 to 16. Taste perception is evaluated before treatment initiation and immediately after completion of therapy.
Salivary concentrations of cortisol, malondialdehyde (MDA), advanced oxidation protein products (AOPP), peroxynitrite, nitrotyrosine (NT), and advanced glycation end products (AGEs) are assessed before treatment, immediately after therapy completion, and at 3, 6, and 12 months following each therapeutic intervention. These measurements are intended to evaluate longitudinal changes in psychological stress and oxidative, nitrosative, and carbonyl stress associated with OLP and its treatment.
Additional clinical outcomes include changes in lesion size and subjective symptom severity assessed using a 10-point Visual Analog Scale (VAS).
This study aims to provide evidence on the comparative effectiveness of ALA-PDT and topical corticosteroid therapy in modulating taste perception, clinical manifestations, and salivary stress-related biomarkers in patients with OLP. The findings may contribute to a better understanding of the biological effects of both therapeutic approaches and support evidence-based treatment decision-making.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Podlaskie Voivodeship
-
Bialystok, Podlaskie Voivodeship, Poland, 15-089
- Medical University of Bialystok
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- age 18 years or older
- clinically and histologically confirmed diagnosis of oral lichen planus
Exclusion Criteria:
- pregnancy or lactation presence of systemic diseases, including dermatologic diseases, oncologic diseases, or severe liver disorders known allergies use of immunomodulatory or immunosuppressive drugs use of antidepressants use of bone anti-metabolites photosensitivity allergy to the components of the photosensitizer treatment for oral lichen planus within the previous 6 months inability to attend follow-up visits presence of oral lesions other than oral lichen planus
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Photodynamic therapy
Patients with clinically and histologically confirmed oral lichen planus receive photodynamic therapy using a proprietary 5% 5-aminolevulinic acid (ALA) mucoadhesive emulgel (patent P.443813, Poland). After drying the oral mucosa, a 2 mm layer of the ALA emulgel is applied to the lesion and surrounding tissue twice, 40 and 20 minutes prior to irradiation. The treated area is covered with an occlusive dressing secured with gauze. Irradiation is performed using a FotoSan® 630 LED lamp (CMS Dental, Denmark) with a wavelength of 630 nm for 6 minutes per cm² of lesion area. The treatment consists of five sessions conducted at weekly intervals. Gustatory function is assessed using standardized taste strips before the initiation of therapy and immediately after completion of the treatment. |
A 5% 5-aminolevulinic acid (ALA) mucoadhesive formulation is applied topically to oral lichen planus lesions.
The preparation is administered twice (40 and 20 minutes prior to light irradiation) under occlusive conditions to enhance tissue penetration.
|
|
Active Comparator: Corticosteroid therapy
Patients with clinically and histologically confirmed oral lichen planus receive topical corticosteroid therapy with clobetasol propionate cream (0.5 mg/g; Bausch Health, Poland). The medication is applied directly to the lesions twice daily for a period of two weeks, in accordance with standard clinical practice. Gustatory function is assessed using standardized taste strips before the initiation of therapy and immediately after completion of the treatment. |
Clobetasol propionate 0.05% (Clobederm) is applied topically to oral lichen planus lesions twice daily for a period of 5 weeks, according to standard clinical practice.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in taste function
Time Frame: Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
Change in gustatory function assessed using Taste Strips, including identification of sweet, sour, salty, and bitter tastes, and total taste score.
|
Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in pain intensity (VAS)
Time Frame: Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
Change in patient-reported pain intensity assessed using a 10-point (0-10) Visual Analog Scale (VAS) from baseline to post-treatment.
|
Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
|
Change in lesion size
Time Frame: Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
Change in oral lesion surface area (cm²) measured clinically between baseline and post-treatment.
|
Baseline (Day 1) and after treatment (Day 14 for CT group and Day 35 for PDT group)
|
|
Change in salivary biomarkers of stress and oxidative, nitrosative, and carbonyl damage
Time Frame: Measurements will be performed before treatment, immediately after therapy completion, and at 3, 6, and 12 months after treatment.
|
Salivary concentrations of cortisol, malondialdehyde (MDA), advanced oxidation protein products (AOPP), peroxynitrite, nitrotyrosine (NT), and advanced glycation end products (AGEs) will be measured to assess changes in stress-related responses and oxidative, nitrosative, and carbonyl damage associated with oral lichen planus and its treatment.
|
Measurements will be performed before treatment, immediately after therapy completion, and at 3, 6, and 12 months after treatment.
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Mouth Diseases
- Stomatognathic Diseases
- Lichenoid Eruptions
- Skin Diseases, Papulosquamous
- Skin Diseases
- Skin and Connective Tissue Diseases
- Lichen Planus
- Lichen Planus, Oral
- Amino Acids, Peptides, and Proteins
- Organic Chemicals
- Carboxylic Acids
- Polycyclic Compounds
- Amino Acids
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Betamethasone
- Keto Acids
- Levulinic Acids
- Aminolevulinic Acid
- Clobetasol
Other Study ID Numbers
Other Study ID Numbers
- APK.002.372.2021
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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