Quantification of Plasma Fibrinogen Degradation Products in Areca Nut Chewers with and without Oral Submucous Fibrosis

Plasma fibrinogen degradation products with salivary coagulopathy in OSMF among Indians

Oral submucous fibrosis (OSMF) produces changes localized to oral cavity. Hence, it is reasonable to assume that saliva may have an important role in its etiology. This prospective case control study included 37 patients with OSMF which were compared with age and gender matched healthy controls. Salivary coagulopathy procedures as described by Chatuvedi et al. and quantification of plasma fibrinogen degradation products using a commercially available kit were carried out. The obtained data was analyzed using Chi-square tests and Tukey HSD test. The salivary coagulopathy was strongly indicated in saliva of OSMF patients and was dependent on the severity of disease. There were also increased levels of plasma fibrinogen degradation products compared to the controls and were found to have a statistically significant correlation with increasing clinical grades of oral submucous fibrosis (p≤ 0.05).

Estimation of plasma fibrinogen degradation products in oral submucous fibrosis: A clinico-pathological study

Background:

Oral submucous fibrosis (OSF) is a disease of the oral mucosa characterized by excessive accumulation of subepithelial collagen, thereby resulting in severe limitation of mouth opening. In OSF, in response to inflammation, the body produces more fibrinogen and its degradation products. The plasma fibrinogen degradation products (FDP) have been reported to be early indicators of fibrin deposition. The present study was intended to ascertain the role of FDP in OSF.

Materials and Methods:

A total of 40 subjects were included in the study. The subjects for the present study were selected from the Department of Oral Medicine and Radiology. The subjects were divided into two groups. The study group comprised 24 subjects diagnosed clinically and histopathologically as OSF and were further divided into three clinical and histological stages of OSF. The control group comprised 16 age- and gender-matched healthy individuals. Five milliliters of venous blood was drawn from the antecubital fossa of all the participants. The blood samples were centrifuged at 1000 rpm for 5 min to separate plasma, and the plasma FDP levels were assessed.

Results and Conclusion:

There was a significant difference in the plasma FDP levels between the study group and the control group. There was a significant linear increase of plasma FDP levels with an increase in severity of the clinical stage of OSF. Comparison with the histopathological grades of OSF also showed an increase in FDP levels with higher grades of OSF and there was a good correlation between the clinical staging and the histopathological grading of OSF.

Plasma fibrinogen degradation products in oral submucous fibrosis

CONTEXT

Plasma fibrinogen degradation products (FDPs) and oral submucous fibrosis (OSMF).

BACKGROUND

OSMF is a chronic, progressive, scarring disease of multifactorial etiology. Areca nut is found to be the main cause of this disease. But it has been found in the routine clinical practice that some individuals with the habit of areca nut chewing may not show any clinical evidence of OSMF, while some individuals without the habit of areca nut chewing are found to have OSMF. So, there must be some other factors associated with OSMF. Recently, plasma FDPs have been identified as an early indicator of disease in OSMF patients. A systematic review of their role would help to elucidate whether there is an association of these FDPs in the pathogenesis of OSMF or not.

OBJECTIVE

To review studies reported in the literature elucidating the role of these plasma FDPs in OSMF.

MATERIALS AND METHODS

Articles were searched in PubMed; MEDLINE using appropriate key words like "plasma fibrinogen degradation products" and "oral submucous fibrosis." Hand search of journals was also performed. Articles were reviewed and analyzed.

RESULTS

The search strategy revealed nine relevant articles which studied the role of these plasma FDPs in the etiopathogenesis of OSMF and further progression of this disease with the increased clinical grades and the risk of carcinoma, but the exact role of these factors is still obscure.

CONCLUSION

The data validate the role of plasma FDPs in the etiopathogenesis of OSMF. Studies with a large sample size are still required to evaluate the definite association between these FDPs and OSMF. It has the advantage of being a noninvasive method to evaluate the stage of OSMF patients, instead of using the invasive techniques like biopsy.