The evaluation of the chemopreventive effect of β-carotene (A-Viton®) on oral premalignant lesions through the estimation of the expression of p53 levels

Background: Oral premalignant lesions (OPL) include a wide range of lesions including leukoplakia, dysplastic leukoplakia, erythroplakia, oral submucous fibrosis, dysplastic lichenoid lesions, and oral lichen planus. Proper diagnosis and management of oral premalignant lesions (OPL) are very important; as 17% of these lesions have been reported to be transformed into malignant lesions within first 7 years of their diagnosis. Vitamin A has always been known for its chemopreventive effect in several diseases through the modulation of cell proliferation and, it is also known for being a potent antioxidant and anti-inflammatory agent. Any alterations in p53 protein results in its accumulation in the cell nuclei; may play a critical role in carcinogenesis, including oral premalignant lesions and oral malignant lesions, i.e., p53 protein is one of the determinants in the progression of oral dysplasia to invasive malignancy.
Methods: Fifteen patients having oral premalignant lesions of mild and moderate dysplasia; diagnosed both clinically and histologically, were given a chemopreventive therapy in the form of βeta- carotene (Vit. A) for four months. The levels of p53 protein immunostaining were measured pre- and post-treatment.
Results: The mean value of optical staining density of P53 in pre-treatment specimen was (59.78 ± 10.22) compared to (39.74 ± 3.36) in post-treatment cases; this value was higher in pre-treatment cases than post-treatment cases. The p-value was 0.0003.Thus when statistically compared the difference is considered statistically significant.
Conclusion: The expression of P53 protein in (OPL) is found to be inversely related to the clinical as well as histopathological response to beta-carotene supplementation.