Immunological studies in oral submucous fibrosis

Oral submucous fibrosis (OSMF) is a high risk precancerous condition. The possible role of immunological factors in the pathogenesis of this condition was evaluated in 113 cases and 25 controls. The male/female ratio was 1.5/1. The mean age of males was significantly lower than that of females. The mean ESR levels were within normal limits, but for a higher than 20 mm fall per hr. in 40% of the cases. The serum IgA, IgG, and IgM levels were elevated significantly as compared to the controls. Circulating auto-antibodies and tissue-deposited antibodies were also found in 33% and 40% of the cases, respectively. From the analysis of the results, it is difficult to ascribe an auto-immune basis for the causation of OSMF. The female bias and elder age group, the factors generally considered in favour of an immune disorder, was not found in our study. However, raised ESR in 40% and serum globulin levels in 47% of the patients, distinctly higher levels of serum immunoglobulins, and positivity for circulating and tissue deposited antibodies in 33% and 34% of the cases respectively, do indicate an immunological basis. Therefore, further studies are required to ascertain the role of cellular immune mechanism and genetic parameters to explain the etiopathogenesis of this complex clinical entity.