Variable innate lymphoid cells predominancy in oral lichen planus latently led to diverse clinical outcomes: a proof-of-concept study

Xi Ye Li^1,2Lei Pan³Yiwen Deng^1,2Jun-jun Chen^1,2Zhen Tian^2,4Guo-yao Tang⁵Shu-yun Ge^1,2*Yu-Feng Wang^1,2*

• ¹Department of Oral Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ²Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China
• ³Second Dental Clinic, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ⁴Department of Pathology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ⁵Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai Municipality, China

To search for a new classification scheme for oral lichen planus (OLP) and oral lichenoid lesions (OLL) based on innate lymphoid cells (ILCs) , and evaluate the clinical significance of this classification for diagnosis and treatment.study is based on a clinical cohort and applies flow cytometry to prospectively analyze the ILC subgroups and proportions in OLP and OLL lesions; Using SPSS 26.0 software, attempt cluster analysis to classify diseases at the cellular level based on the phenotype and quantity of ILCs cells; Analyze the correlation between the new classification of diseases and clinical risk factors based on the patient's clinical background information and classification results; And evaluate the differences in therapeutic effects among patients in different groups in corresponding clinical cohorts.In the OLP and OLL groups, the ILC compartment consisted mainly of ILC1 (75.02 ±27.55%, and 72.99±25.23%) , ILC2 (1.49±4.12%, and 1.72±3.18%) and ILC3 (16.52±19.47%, and 18.77±18.12%) were also observed. By using k-means clustering and two-step clustering , patients could be clustered into 3 groups that did not respond equally to the same treatment. Under k-means clustering, there was a statistically significant difference in REU scores between the ILC1 advantage group and the OLL subgroup before and after treatment (P=0.02), which was not found under two-step clustering. This indicated that k-means clustering may have more value for the clinical application of OLL. In the ILC1 absolutely advantage group, using HCQ+TGP for one month could effectively treat the patients no matter using k-means clustering or two-step clustering (P≤0.001), while the other groups did not.This study provides a preliminary OLP and OLL classification method based on ILC subgroups, which can guide the cytological classification of diseases to a certain extent. Further clinical application value needs to be verified by subsequent cohort studies.