Liver-Expressed antimicrobial peptide as an early predictor of dysplasia in oral submucous fibrosis: An experimental trial

Abstract

Background: Liver-expressed antimicrobial peptide 1(LEAP1) plays a major role in dysplasia. Oral potentially malignant disorders (OPMDs) are on the rise, and the rate of malignant transformation is alarming. Iron (Fe) deficiency in anemia of chronic disease may be because of the presence of oral submucous fibrosis (OSMF). The metabolism of Fe is altered in dysplasia, leading to dysregulation of Fe homeostasis. Aim and Objective: This study aimed to estimate the levels of serum LEAP1 in subjects having OSMF and OSMF with dysplasia and to establish the role of LEAP1 in dysplasia associated with OSMF and in iron homeostasis. Materials and Methods: This study was registered with the CTRI [Clinical Trial Registry of India (REF/2019/06/026566)] as a clinical trial. Twenty participants were selected. Ten participants with OSMF and 10 with OSMF along with dysplastic changes were chosen and categorized as group I and group II. Serum LEAP was estimated in the 20 subjects with clinically diagnosed OSMF. Baseline hematologic investigations like complete blood count (CBC), peripheral smear, and LEAP1 were done. Statistics: Statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) software version 11.5 (IBM, New York, USA). To assess the correlation between serum LEAP1 and OSMF, the one-way analysis of variance (ANOVA) test was used. To obtain the interconnection between serum LEAP1 and dysplasia, independent t-test was used. By calculating the effect size, clinical significance was established. Results: Serum LEAP1 levels in group I (OSMF with dysplasia) showed a remarkable increase in the value in comparison with group II (OSMF without dysplasia). The correlation between the values of serum LEAP1 and dysplasia was significant with P < 0.001. Clinical Significance: Alterations in the iron metabolism are observed in dysplasia; hence, LEAP1 can be a novel marker in the early detection of cancer and can lead to effective treatment and increased survival rate in oral cancer. Conclusion: This research explores new avenues by linking LEAP1 levels to the presence of dysplasia. We can conclude that improvement in the body's iron stores leads to a decrease in serum LEAP1. Therefore, to assess iron storage in OSMF serum, LEAP1 can be used as a novel diagnostic marker.

Keywords

• anemia of chronic disease
• dysplasia
• liver-expressed antimicrobial peptide 1
• oral submucous fibrosis