Lichen Planus
Conditions
Brief summary
Lichen planus (LP) is a chronic inflammatory disease of unknown aetiology, affecting the skin and mucous membranes, characterised by a CD8+ cytotoxic T-cell infiltrate, associated with epithelial cell death and disruption of the basement membrane zone. In previous work, T cell antigen receptor (TCR) repertoire studies were performed. In all patients tested, whether with erosive or non-erosive LP, unique nucleotide sequences, called clonotypes, have been identified. They appear during the process of TCR gene rearrangement. These clonotypes are specific for human papillomavirus (HPV) in blood and lesions, suggesting antigenic stimulation of these clonotypes by a viral epitope of HPV, which crosses with an epitope on keratinocytes. The diagnosis of LP is made on the basis of clinical and histological criteria, but in some patients and in some anatomical locations, the diagnosis is difficult to make and LP may be confused with other skin conditions.
Detailed description
Lichen planus (LP) is a chronic inflammatory disease of unknown aetiology, affecting the skin and mucous membranes, characterised by a CD8+ cytotoxic T-cell infiltrate, associated with epithelial cell death and disruption of the basement membrane zone. Several triggers have been proposed for LP, including viral antigens. In previous work, T cell antigen receptor (TCR) repertoire studies were performed, i.e. investigating the diversity of TCRs expressed on the surface of an individual's lymphocyte population. In all patients tested, whether with erosive or non-erosive LP, unique nucleotide sequences, called clonotypes, have been identified. They appear during the process of TCR gene rearrangement. These clonotypes are specific for human papillomavirus (HPV) in blood and lesions, suggesting antigenic stimulation of these clonotypes by a viral epitope of HPV, which crosses with an epitope on keratinocytes. The diagnosis of LP is made on the basis of clinical and histological criteria, but in some patients and in some anatomical locations, the diagnosis is difficult to make and LP may be confused with other skin conditions.
Interventions
50 mL blood sample
OTHERSkin or mucous membrane brushing
brushing on skin or mucous membrane lesions
OTHERSkin or mucous membrane biopsy
6 mm biopsy
Sponsors
Institut Pasteur
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Subject coming at the time of diagnosis of the disease before any systemic treatment, or at the time of a progressive episode of the disease, without systemic treatment or after cessation of immunomodulatory or immunosuppressive treatment * Ability to give their consent in writing * Must understand spoken and written French * Affiliated to the French social security or assimilated regimes
Exclusion criteria
* Dermatosis exclusively localised in the skin folds or on the face (risk of scarring from biopsies)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Identification of TCR repertoire by flow cytometry | 3 years | Determination by flow cytometry and PCR testing for TCR repertoire bias |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Identification of characteristic biomarkers of lichen | 3 years | Identify complementary biomarkers characterising lichen by quantitative PCR |
| Identification of T CD8 clonotypes | 3 years | Measurement of the antigenic specificity of identified T CD8 clonotypes by flow cytometry |
Countries
France
Contacts
Primary ContactMarie-Lise Gougeon
Backup ContactSandrine Fernandes Pellerin
Outcome results
None listed