May cause Gutkha epilepsy

Evaluation of autoantibodies in oral submucosal fibrosis

Oral submucosal fibrosis (OSMF) is a potentially malignant disease that affects a portion of the oral cavity, sometimes pharynx, in association with juxta epithelial fibrosis that progressively causes trismus leading to dysphagia. It is mainly seen in the Asian countries with greater prevalence in India.

The etiology of OSMF is considered to be multifactorial. However, it is strongly linked to the use of Arecanut in various forms and also in combination with other compounding factors. Autoimmunity has been suggested as one of the factors that has not yet been proven.

Few studies show that autoantibodies, including antinuclear antibodies, are common (ANA), anti-smooth muscle (SMA), anti-thyroid microsomal (TMA), and anti-reticulin antibodies in OSMF patients. These results were inconsistent with further studies that require further research in the area.

One study focused on quantifying the levels of circulating immune complexes (CIC) established in patients with oral cancer and oral precancerous diseases. The levels were compared to normal controls and chronic chewing of betelquid with no evidence of any disease. Both patients with oral cancer and oral precancerous lesions had an increased CIC when compared to both control groups. The most interesting observations were (a) the CIC values ​​in the chew controls were significantly increased compared to normal controls. and (b) the CIC levels in patients with premalignant lesions were increased almost to the same values ​​as in oral cancer patients.

HLA typing was performed on areca nut chews. However, no specific evidence could be found for patterns of HLA antigen frequencies when chewing with or without disease. It is not necessarily an HLA-associated susceptibility in oral submucosal fibrosis.

Due to the fewer number of articles published on autoantibodies, this study is being conducted to evaluate the presence of such autoantibodies in OSMF patients, paving the way for a new arena of treatment on par with the etiology of this persistent condition.