Oral Submucous Fibrosis (OSMF), first described in the early 1950s, is a potentially malignant disease observed predominantly in people of Asian descent. It is a chronic progressive disorder and its clinical presentation depends on the stage of the disease at the time of diagnosis. OSMF is characterized by progressive inflammation and fibrosis of the lamina propria and deeper connective tissues, followed by stiffening of an otherwise compliant mucosa resulting in difficulty opening the mouth. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get Original Essay Globally, OSMF estimates show confinement in Southeast Asia, with an overall prevalence rate in India of about 0.2% to 0.5%, and a gender prevalence which varies from 0.2 to 2.3% in males and from 1.2 to 4.57% in females. The morbidity rate is high in OSMF because there is a progressive inability to open the mouth which results in feeding difficulties and subsequent nutritional deficiencies. Among other potentially malignant oral disorders (PMOD), OSMF has one of the highest rates of malignant transformation into oral squamous cell carcinoma (OSCC), with a rate of 7.6%, so the mortality rate is also high . Research reports state that OSCC originating from OSMF is clinically more invasive and also has higher metastasis and recurrence rates than OSCC not originating from OSMF(5)(6). The pathogenesis of the disease is believed to be multifactorial. Numerous factors trigger the pathological process by causing a juxtaepithelial inflammatory reaction in the oral mucosa. Factors include chewing areca nuts, ingesting chili peppers, genetic and immunological processes, and nutritional deficiencies of iron, zinc, and essential vitamins. Furthermore, a possible autoimmune basis of the disease has been proposed with the demonstration of various autoantibodies and an association with human leukocyte-specific antigen (HLA). Of all these, areca nut is one of the main etiological factors. Constant local irritation by pan masala, gutkha or areca nut can therefore lead to chronic injury-related inflammation, oxidative stress and cytokine production. Local trauma and lesions to the oral mucosa are due to the abrasive nature of the areca nut. Other deleterious effects of such reactions cause chronic inflammation leading to activation of macrophages and T cells and increased level of cytokines such as interleukin-6 (IL-6), tumor necrosis factor (TNF), interferon alpha (IFN-α) and transforming growth factor beta (TGF-β). Progranulin (PGRN) also known as granulin-epithelin precursor, is a glycoprotein of 576 amino acids, pleiotropic in nature, and is known to play an important role in the maintenance and regulation of tissue development, embryogenesis, infectious diseases , inflammatory conditions, wound healing and tumorigenesis. PGRN has been extensively studied in the context of rheumatoid arthritis, a chronic inflammatory autoimmune disease mediated by TNF-α. Various studies have been conducted for the estimation of PGRN in different tumors and also in some inflammatory diseases. The functions of progranulin are multiple; progranulin levels have yet to be explored in the context of submucosal fibrosis and oral cancer. Please note: this is just a sample. Get a custom paper from our expert writers now. Get a Custom Assay Enzyme-linked immunosorbent assay (ELISA) is a well-established method used to estimate PGRN levels directly from biological specimen (serum and saliva) with very little sample preparation.