Role of oxidative stress in the pathogenesis of oral submucous fibrosis: A preliminary prospective study

Abstract

Background:In the current scenario pathogenesis of majority of the diseases is deeply linked with the oxidative stress, irrespective of its etiology. Enumerable data suggests that reactive oxygen species play a key role in multistage carcinogenesis. Oral submucous fibrosis (OSMF) is considered as a potentially malignant disorder. Its increased incidence over recent years in the Indian subcontinent is a major health concern to oral physicians. However, the role of oxidative stress has not been widely investigated in OSMF.Aims:Is to evaluate both antioxidant and oxidant status in OSMF and to compare with controls.Settings and Design:Twenty patients and 20 controls of the same age group were enrolled in the study.Subjects and Methods:Five milliliters of blood were collected from each individual and serum was separated. Malondialdehyde (MDA) estimation using thiobarbituric acid (TBA) method, and antioxidant activity (AOA) using principle of TBA reactive substances was done using this serum, with a calorimetric method.Statistical Analysis Used:Student's t-test and ANOVA test.Results:The mean serum AOA status was seen to significantly decrease in OSMF patients, as compared to controls (P = 0.013). The increase in mean serum MDA level was highly significant in OSMF patients, as compared to controls (P < 0.001).Conclusion:The disparity between AOA and MDA levels in the patients clearly demonstrates the role of oxidative stress in the disease process. The results also suggest the use of antioxidants in the management of OSMF.

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).…”

Overview of Oral Potentially Malignant Disorders: From Risk Factors to Specific Therapies

“…Recent evidences show that the malignant transformation could be caused by the alkaloids of areca nut that are capable of stimulating fibroblasts' growth, the production of cytokines (especially involving the TGF-β signaling) and immune cells' activation. These mechanisms provoke microenvironment alteration and cellular dysregulation of proliferation, survival, differentiation, DNA repair function and tumor transformation [65,66]. The current therapy options have the aim to reduce symptoms and to improve the patients' quality of life.…”

Oral Submucous Fibrosis: A Review on Biomarkers, Pathogenic Mechanisms, and Treatments

“…Arecoline stimulates the fibroblast cells to express growth factors and cytokines that enhance the collagen deposition and repress the collagen degradation. Clinical studies reported transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), beta fibroblast growth factor (bFGF) [ 104 ], alpha-smooth muscle actin (α-SMA) [ 105 ], tumor necrosis factor-α (TNF-α) [ 106 ], serum c-reactive protein [ 107 ], ROS level [ 108 ], matrix metalloproteinases (MMP), and the tissue inhibitors of metalloproteinases (TIMP) [ 109 ] were expressed abnormally in OSF group.…”

“…However, this mechanism is disrupted in OSF. Arecoline also increases the ROS level in OSF patients’ serum [ 108 ]. Serum ROS attacks the structure of the blood vessels in endothelial cells, induced cell senescence [ 113 ], and DNA double-stranded breaks [ 114 ].…”