Psychological factors and salivary biomarkers (cortisol and opiorphin) in erosive oral lichen planus: A case-control study

Background. Oral lichen planus (OLP) is a persistent inflammatory condition associated with the immune system. Its etiology remains unclear; nevertheless, it seems that individuals with OLP have elevated levels of stress, anxiety, depression, and salivary cortisol. On the other hand, it is expected that the extent of salivary opiorphin changes in the orofacial pain and inflammatory lesions will be high. Moreover, stress, anxiety, depression, salivary cortisol, and salivary opiorphin may affect the perception of pain in OLP patients. Methods. This case‒control study included 42 participants: 21 patients with OLP and 21 healthy individuals. The Beck Depression Inventory (BDI), the Perceived Stress Scale (PSS) 14, the Visual Analog Scale (VAS), and the Beck Anxiety Inventory (BAI) were employed to evaluate depression, stress, perceived pain, and anxiety in the case group, respectively. Salivary samples were also collected. Statistical analysis was conducted using SPSS and MEDCALC software at the 0.05 significance level. Results. The level of salivary opiorphin was significantly lower in the case group (P<0.0001). Also, salivary cortisol in the case group was significantly higher (P<0.0001). The correlation between patient age and salivary opiorphin level was significant (P=0.03). Salivary opiorphin levels decreased with age. In addition, opiorphin was significantly higher in men than in women (P=0.02). Conclusion. The present study found that in patients with erosive OLP, salivary opiorphin levels were lower and salivary cortisol levels were higher than in healthy individuals.