The potential contribution of metal dyshomeostasis to the occurrence of oral leukoplakia-through abnormal immune function

Oral leukoplakia is oral potentially malignant disorder with an unclear etiology. Emerging evidence indicates a link between metal dyshomeostasis and carcinogenesis. This study is the first to compare serum concentrations of calcium (Ca), magnesium (Mg), selenium (Se), copper (Cu), zinc (Zn), iron (Fe), lead (Pb) and manganese (Mn), as well as the peripheral blood immunological characteristics, between patients with oral leukoplakia and healthy controls, aiming to explore the potential association between metal dyshomeostasis and oral leukoplakia. This cross-sectional-case-control study recruited 89 participants at West China Hospital of Stomatology, including 59 patients with oral leukoplakia and 30 healthy controls. The concentrations of Ca, Mg, Se, Cu, Zn, Fe, Pb and Mn were measured by inductively coupled plasma-mass spectrometry (ICP-MS), and peripheral blood immunological characteristics were quantified using standard clinical chemistry methods. Compared with the control group, the serum Se level in oral leukoplakia patients was significantly decreased and negatively correlated with the degree of dysplasia. However, the Pb level was significantly increased. Patients with oral leukoplakia had abnormal immune function, with significantly decreased percentages of CD3 + T cell and CD8 + T cells, and significantly increased levels of IgA and antinuclear antibodies. Moreover, the Pb was significantly negatively correlated with cellular immunity, while Se was positively correlated with the count of CD8 + T cells. This study indicates a potential association between metal dyshomeostasis and oral leukoplakia, which may be mediated through the immune function, especially abnormal cellular immunity. These findings provide new insights into the etiology and treatment of oral leukoplakia.