Assessment of Organ-Specific Fibrotic Biomarkers in Patients With Oral Submucous Fibrosis

Oral submucous fibrosis is a potentially malignant disorder with a high malignant transformation rate. Areca nut, being the chief etiologic factor, when chewed, is known to be swallowed and absorbed into circulation resulting in several systemic effects. This is the first kind of report presenting serum organ-specific fibrosis biomarkers suggestive of functional and fibrotic changes in the visceral organs.

Various fibrotic biomarkers such as kidney injury molecule-1 (KIM-1), alanine aminotransferace (ALT), aspartate aminotransferase (AST), and its ratio to platelet index (APRI), suppression of tumorigenicity-2 (ST2), Krebs von den Lungen-6 (KL-6) and von Willebrand factor (vWF) were analyzed.

The present study evaluated potential systemic fibrotic involvement, modest elevations in ST2 and KL-6 levels in advanced OSF compared to early cases; however, all values remained within normal physiological limits. No significant differences were found between the OSF and healthy groups across all biomarkers. There was no renal involvement, no significant association between liver fibrosis and its systemic biomarkers, and there was minimal vascular involvement. Collectively, these findings support the hypothesis that OSF may be a localized fibrotic disorder with no detectable systemic biomarker alterations in its early to moderate stages.

This study provides an important step in bridging localized oral pathology and systemic disease monitoring. No significant systemic fibrosis was observed but methodology, findings, and recommendations offer a strong basis for future research. Despite the presence of evidence that favors a localized disease model for OSF in its early and advanced stages, systemic monitoring in future clinical paradigms is acknowledged.