A distinct inflammatory and fibrogenic cytokine milieu in oral submucous fibrosis

Oral submucous fibrosis (OSF) is regarded as a potentially life-threatening disease owing to strikingly high percentage of malignancy. The immune system has been a vital determining aspect for the disease progression and consequence. Fibrosis in OSF is usually preceded by infiltration of inflammatory leukocytes followed by release of various cytokines which trigger fibroblastic proliferation and deposition of excessive collagen fibers. Cytokines hence play a major role in regulation of the disease outcome. The assessment of these signalling proteins is essential in order to comprehend the disbalances that occur in the immune system with respect to OSF and its progression. Thus, in this study inflammatory and fibrogenic cytokine analysis was performed by employing flow cytometry in the biopsy specimens of OSF and control groups after institutional scientific and ethical clearance. A nonparametric paired t-test was carried out to determine the upregulation and downregulation of these molecules and their statistical significance. Some of the cytokines showed increase in their levels in a transient manner in different stages of OSF compared to control group. A few showed considerable downregulation in the late stage of OSF compared to early stage. The dynamic changes in the levels of the specific immune system molecules orchestrate the pathogenesis of OSF and subsequently aid in determination of therapeutic strategies for the treatment of the disease. The promising results observed in this study demands future studies in this direction.