Correlation of Clinical and Histopathological Grades in Oral Submucous Fibrosis Patients with Oxidative Stress Markers in Saliva

Abstract

This study aimed to correlate the oxidative stress marker levels in saliva with the clinical stage based on mouth opening, fibrotic bands and histopathological grades of oral submucous fibrosis (OSF) patients. The study included patients clinically diagnosed with OSF (n = 63) and equal number of age and gender matched controls. Patients with OSF were defined by mouth opening stage, fibrotic bands and histopathological grades. Unstimulated saliva from both control and OSF patients were analysed for oxidative markers like lipid peroxides (LPO), non-enzymic antioxidants [reduced glutathione (GSH), vitamin A, vitamin E, vitamin C] and enzymatic antioxidants [glutathione peroxidase (GPx), superoxide dismutase (SOD)] and correlated with different stages and grades. Total salivary protein and LPO were significantly increased in OSF group with no significant change in the levels of GSH compared to controls. In OSF patients, a significant decrease in the levels of vitamins A, C and E was observed. The activities of salivary SOD and GPx were significantly decreased in OSF patients compared to controls. These changes significantly correlated with the increasing and differing grades of OSF that reflects increased oxidative stress with the progress of OSF.

A Meta-Analysis in Assessing Oxidative Stress Using Malondialdehyde in Oral Submucous Fibrosis

“…The included studies had found a statistically significant increase in serum MDA levels in OSMF patients compared with controls (p < 0.001). 1,18,20,22,26,28,29,30,31,32,33,34,35,36,37,38 Similarly, other studies also observed a significant difference p-value <0.01 4 and p-value <0.05. 39,40 A few studies have also reported significantly higher salivary MDA levels in OSMF compared with healthy subjects (p < 0.001).…”

“…Correlation analysis of lipid peroxides levels with histological grades showed a positive correlation (p < 0.01). 36 The authors concluded that the lipid peroxidation increases with the disease severity, reflecting the extent of tissue injury. 5,20,26,30,39 Abbreviations: Hl, hemolysate; Mi, mitochondria; Pl, plasma; Sa, saliva; Se, serum; Ti, tissue.…”

“…Another two studies displayed the increase in mean plasma MDA level was insignificant between clinical stages II and III. 20 29 Divyambika et al 36 stated that salivary lipid peroxides level was correlating with the severity of mouth opening, fibrosis, and histologic grades of OSMF. Correlation analysis of lipid peroxides levels with histological grades showed a positive correlation ( p < 0.01).…”

“…Correlation analysis of lipid peroxides levels with histological grades showed a positive correlation ( p < 0.01). 36 The authors concluded that the lipid peroxidation increases with the disease severity, reflecting the extent of tissue injury. 5 20 26 30 39 Shetty et al 1 reported that the tissue levels of MDA were consistently higher in histological grades 1 and grade 2 OSMF but decreased in grade 3 compared with controls.…”

Oral Submucous Fibrosis: A Review on Etiopathogenesis, Diagnosis, and Therapy

“…Multiple biomarkers may increase OSF diagnosis specificity and sensitivity and could include 8-OHdG, MDA, vitamin C, and vitamin E [99]. In another study, total salivary protein and lipid peroxides were higher but vitamins A, C, and E and salivary SOD and GPx were lower in OSF patients than the controls [100]. Thus, oxidative stress is correlated with OSF progress.…”