Salivary Expression of HIF-1 α in Oral Submucous Fibrosis

Abstract

Background: Oral submucous fibrosis (OSMF), a chronic debilitating condition distinguished by juxtaepithelial fibrosis or extensive fibrosis of submucosa and reduced vascularity, results in compromised blood supply causing tissue hypoxia. This brings about the transcription of a set of genes associated with angiogenesis, breakdown of iron/glucose, cell division and cell stability. Hypoxia Inducible Factor-1α (HIF-1α) is the main biomarker intervening in this reaction. The aim of research was to measure the salivary levels of HIF-1α in OSMF patients and healthy controls.

Methods: This study included 60 participants (30 Oral submucous fibrosis cases and 30 healthy controls). The consecutive sampling technique was used for the recruitment of the study participants. The enzyme-linked immunosorbent assay (ELISA) was used to evaluate HIF-1α levels in saliva. In order to determine data normality, the Kolmogorov-Smirnov test was used. Independent t test was applied to compare salivary levels of HIF-1α between cases and controls and p-value of less than 0.05 was considered statistically significant.

Results: The mean salivary HIF-1α value for the oral submucous fibrosis group was 20.18±7.78, compared to healthy controls 13.62±8.86. A statistically significant difference was seen between levels of HIF-1α in the OSMF and control group (p=0.003). The mean mouth opening for cases was 22.94±9.51 mm and for controls 42.00±5.19 mm. There was no correlation among salivary levels of HIF-1α in both the case and control groups (-0.059, -0.030) respectively.

Conclusion: Higher levels of HIF-1α were seen in the OSMF group in comparison to healthy individuals suggesting that HIF-1α may play a role in malignant transformation of OSMF.

Keywords: Oral Submucous Fibrosis; Saliva; Hypoxia Inducible Factor-1α.