Determination of serum bisphenol A levels in patients with lichen planus

Background and Aim: Lichen planus is an autoimmune disease of the skin, hair, nails and mucous membranes. Bisphenol A (BPA) is an industrial chemical used in the production of plastic products and epoxy resins. It is mainly used as a raw material in food and beverage packaging materials. In the literature, it is believed that BPA can be involved in the pathogenesis of autoimmüne diseases by many mechanisms. Among these estrogenic activity, the effect of dysregulation in cytokine secretion, inducing Th-1/Th-2 and Th-17/Treg polarization, increasing production of reactive oxygen species, destruction of liver immune tolerance mechanism, triggering epigenetic changes in DNA, production of (auto)antibodies and many of the evidence available. In this study, we aimed to determine the role of bisphenol A serum levels in etiopathogenesis of lichen planus. Methods: Forty patients with lichen planus and forty age and gender matched healthy indivuals were included in this non-randomized, controlled and prospective study. Serum BPA levels, BSA (body surface area) involvement of LP lesions, LP severity and relationship were evaluated. Results: In lichen planus patients, the median BPA serum level was 0 (0-980.5) ng/ml, and significantly higher compared to controls [0 (0-60.2) ng/ml], (p=0,001). A positive correlation was found between serum BPA and BSA (p<0,001). Moreover, BPA levels in patients with severe lichen planus was found to be significantly higher patients with mild to moderate in severity (p1<0,001, p2=0,003). The median fasting blood sugar level (p=0,021) and median TSH value (p=0,004) was significantly higher in the patient group. Conclusion: Nowadays, as the prevalance of autoimmune diseases continues to rise, the increased production of BPA worldwide can be considered as an environmental factor in autoimmune disease pathogenesis. We have determined that BPA exposure is an important part in the mosaic of autoimmunity, where it is known that autoimmunity plays a fundamental role in the pathogenesis of LP. Key words: Lichen planus, bisphenol A (BPA), autoimmunity, xenoestrogen