Oral sub mucous fibrosis: Exploring therapeutic strategies using -Anti TGF β drugs

Abstract

Objective: Oral submucous fibrosis (OSMF) is a chronic irreversible potentially malignant condition causing morbidity. Transforming Growth Factor beta (TGF-β1) plays the central role in its development. Hence early intervention is the key to limit progress of disease. The aim of this paper was to review the effective therapeutic agents available to neutralize the pathological effect of TGF-β1 in OSMF. Methods: An electronic search was conducted and we reviewed the records of the https://clinicaltrials.gov/, the registry of clinical trials that have been conducted internationally and in the United States in order to look for drugs associated with different types of fibrotic disorder. The studies related to pulmonary fibrosis were also included. We performed another search in the PubMed database and chose the successfully tested drugs from the result of our previous search and used the keywords "Name of the selected drug” "TGF” “Fibrosis." Results: A total of 89 studies were listed in the search and finally 9 studies were considered for the analysis. The search results indicated the potential benefit of two drugs namely nintedanib and pirfenidone. It was noted that nintedanib reversed TGF-β1-induced EMT in non-small cell lung cancer cells and pirfenidone treatment inhibited TGF-β1-induced up-regulation of phosphorylation of ERK1/2, p38 and Jun amino-terminal kinases (JNK) in a renal fibrosis rat model. Conclusion: It was concluded that pirfenidone and nintedanib were found to have promising role in treatment of pulmonary fibrosis also linked to pathological effect of TGF-β pathway. Therefore, we put forward the suggestion of designing preclinical studies, as well as clinical trials to test the effectiveness of these drugs in treating oral submucous fibrosis. Keywords: OSMF, potentially malignant condition, TGF-β1, Pirfenidone