Evaluating Tumor Necrosis Factor (TNF)-Alpha Pro-inflammatory Cytokines in Healthy and Oral Squamous Cell Carcinoma Patients With and Without Diabetes.

Background Tumor necrosis factor-alpha (TNF-α) has a pivotal role in the pathogenesis and prognosis of cancer as well as diabetes mellitus (DM). Many oral squamous cell carcinoma (OSCC) patients are reported to have associated comorbidities such as type 2 diabetes mellitus (T2DM). Furthermore, T2DM exaggerates inflammation due to a lack of insulin action. Therefore, OSCC patients with T2DM may progress to the advanced stage more rapidly resulting in reduced survival even after glycemic control creating a challenge to oncologists in managing these patients. Unfortunately, it is difficult to predict the course of disease in these patients just based on clinical and radiological parameters. Considering the impact of TNF alpha in both disease progression, it is an interesting biological marker to explore. Further, saliva being a noninvasive biological fluid can help measure the TNF-α levels, thereby predicating the prognosis of OSCC. Unfortunately, there is limited information about the salivary TNF-αnf levels in OSCC patients with DM. Aim The aim of this study was to compare the salivary TNF-α in OSCC patients with and without DM. Methods Saliva samples were obtained from healthy individuals, OSCC patients with DM, and OSCC patients without DM. The quantification of TNF-α levels was performed using the EliKine™ Human TNF-α ELISA Kit, an enzyme-linked immunosorbent assay. The data were reported as means and standard deviations. To assess variations in salivary TNF-α levels among these groups, the Kruskal- Wallis test was employed. Results The study included a total of 30 participants with 10 in each group. There were 18 males and 12 females with a mean age of 37.2± 4.7 years. The TNF-α levels between the control group (51+42±1.4 pg/ml), OSCC patients without DM (67.43 ±1.7 pg/ml), and OSCC patients with DM (268±8.5 pg/ml) were noted. The mean salivary TNF-α level was statistically higher in OSCC with DM compared to the control and OSCC without DM group.  Conclusion The investigation compared the salivary TNF-α in OSCC patients with and without DM and has uncovered substantial differences in TNF-α concentrations within the examined cohorts, providing insights into the potential involvement of TNF-α in the context of OSCC, especially in patients with DM. Nevertheless, additional research is imperative to establish associations between TNF-α levels, the prognosis of OSCC, and the impact of DM.