title: Estimation of serum, salivary immunoglobulin G, immunoglobulin A levels and total protein, hemoglobin in smokeless tobacco chewers and oral submucous fibrosis patients.
abstract: BACKGROUND
  Oral submucous fibrosis (OSMF) is a debilitating, potentially cancerous oral condition. Although areca nut is the most important causative agent, it is also considered that the disease is immunologically mediated.
  
  
  OBJECTIVE
  To establish that autoimmunity and nutritional deficiency play a role in the etiopathogenesis of OSMF.
  
  
  OBJECTIVE
  To show that serum immunoglobulin markers (immunoglobulin-G [IgG], immunoglobulin-A [IgA]) and nutritional parameters such as total serum protein (TSP), Hemoglobin (Hb) play a role in causing OSMF and also to correlate serum, salivary IgG, IgA levels in OSMF patients.
  
  
  METHODS
  A case-control study was done with 50 patients (25 patients who were provisionally diagnosed as OSMF - Group I, and 25 patients who were chronic smokeless tobacco chewers and who did not have any intraoral lesion - Group II).
  
  
  METHODS
  Five milliliters of blood and saliva were collected from both the groups. Quantitative analysis of serum, and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hemoglobin (Hb) were estimated by spectrophotometry.
  
  
  METHODS
  Results were analyzed by independent samples t-test and one-way analysis of variance (ANOVA).
  
  
  RESULTS
  All patients of OSMF showed significant (P < 0.01) increase in serum IgG, IgA, and salivary IgG levels as compared to smokeless tobacco chewers. The salivary IgA levels showed a significant decrease in OSMF patients (P < 0.05). TSP and Hb levels showed significant (P < 0.01) decrease in OSMF patients as compared to smokeless tobacco chewers.
  
  
  CONCLUSIONS
  The elevation of immunoglobulin levels supports the concept of autoimmunity. The decrease in TSP and Hb suggests that nutritional deficiency plays a defined role in the occurrence as well as a further progression of OSMF.
authors.affiliation: Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India.
authors.forename: Chandrakanth
authors.initials: C
authors.lastname: Balakrishnan
authors.affiliation: Department of Oral Medicine and Radiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Aswath
keywords: Hemoglobin; immunoglobulin A; oral submucous fibrosis; serum and salivary immunoglobulin G; total serum protein