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Expression of Bak and Bak/Mcl-1 ratio can predict photodynamic therapy outcome for oral verrucous hyperplasia and leukoplakia

Authors

  • Chuan-Hang Yu,

    1. School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
    2. Department of Dentistry, Oral Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan
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  • Hsin-Ming Chen,

    1. Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
    2. Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    3. Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Hung-Pin Lin,

    1. Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    2. Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Chun-Pin Chiang

    Corresponding author
    1. Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
    2. Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
    3. Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
    • School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
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Correspondence: Chun-Pin Chiang, Department of Dentistry, National Taiwan University Hospital, No. 1 Chang-Te Street, Taipei, 10048 Taiwan. Tel: +886 2 23123456 ext. 66855, Fax: +886 2 23893853, E-mail: cpchiang@ntu.edu.tw

Abstract

Background

Our previous studies showed that topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is very effective for oral verrucous hyperplasia (OVH) and relatively less effective for oral leukoplakia (OL) lesions. Nevertheless, there has been no report on the association of the expression of apoptosis-related proteins in OVH and OL biopsy tissues prior to PDT with PDT treatment outcomes.

Methods

This study used immunohistochemistry to evaluate whether the expression of Bak, Mcl-1, caspase-3, caspase-8, caspase-9, p53, p21, or PCNA protein in biopsy specimens of OVH and OL lesions could be used to predict the clinical outcomes of 18 OVH and 40 OL lesions treated with topical ALA-PDT. The marker labeling score (LS) was defined as labeling index (positive cells/total cells) multiplied by staining intensity. The lesions after ALA-PDT treatment were divided into complete response (CR) group and partial or no response (PR/NR) group.

Results

The mean Bak LS and the mean Bak/Mcl-1 LS ratio were significantly higher in the CR group than in the PR/NR group. However, there was no significant difference in the Mcl-1, caspase-3, caspase-8, caspase-9, p53, p21, or PCNA protein LS between the CR and PR/NR groups.

Conclusion

We conclude that the Bak LS or Bak/Mcl-1 LS ratio may be a useful biomarker to predict the clinical outcomes of OVH and OL lesions treated with topical ALA-PDT. Pre-PDT epithelial cell levels of Mcl-1, caspase-3, caspase-8, caspase-9, p53, p21, and PCNA may not have a significant influence on the clinical outcome of OVH and OL lesions treated with topical ALA-PDT.

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