Hypoxia and angiogenesis across clinical stages of oral submucous fibrosis: implications for oral carcinogenesis

“Oral Submucous Fibrosis” (OSF) is a progressive “potentially malignant disorder” which is characterized by fibrosis and epithelial atrophy, resultant to hypoxia. The resulting hypoxic microenvironment is thought to trigger angiogenic responses that promote disease progression and malignant transformation. This study assessed whether hypoxia (HIF-1α) and angiogenesis (CD105) correlate with clinical stages in OSF. A total of 105 tissue samples (30 normal oral mucosa; 75 OSF) were analysed using immunohistochemistry. HIF-1α immunoreactice score and CD105 based microvascular metrics, microvessel density “(MVD)”, total vascular area “(TVA)”, and mean vascular area “(MVA)” were quantified. HIF-1α expression increased progressively across stages of OSF (p = 0.046). Similarly, CD105 expression, reflected by MVD, TVA, and MVA, demonstrated progressive elevation with disease advancement (p = 0.0001). Both markers demonstrated a positive correlation. (r = _, p < 0.05). The concurrent upregulation of HIF-1α and CD105 across clinical stages underscores a dynamic interrelationship between hypoxia and angiogenesis in OSF. These findings support integrating molecular markers into staging systems to enhance early association with “malignant transformation”.