Perspectives on areca nut with some global implications: Symposium report

Areca nut and products made from the nut, evaluated by the International Agency for Research on Cancer as carcinogenic to humans since 2004, are being increasingly used in India and South East Asia and exported to many countries. There is thus an urgent need to identify best control policies and research gaps. On 1 February 2018, a group of experts shared their latest knowledge and perspectives on areca nut at Healis-Seksaria Institute for Public Health in Navi Mumbai, Maharashtra, India. By itself, areca nut has been implicated in oral and oesophageal cancer. Areca nut users are also at high risk of oral submucous fibrosis, a debilitating and potentially malignant condition. Users may also suffer adverse health outcomes due to smokeless tobacco, commonly mixed with areca nut. The use of areca nut commonly begins in childhood and often proceeds to use with tobacco. Gutka, a widely consumed, industrially made areca nut product containing tobacco, has been banned in all states and union territories of India, but it is still widely available. Areca nuts contain arecoline, an alkaloid that stimulates various brain receptors, promoting physical dependence. Areca nut alkaloids have also been implicated in carcinogenesis. Other chemicals, introduced during cultivation and processing of areca nuts, contribute to oral submucous fibrosis and cancer. The wide variety of products, different storage conditions and lack of regulation can lead to significant variation in the content of toxicants, carcinogens and alkaloids, making the psychological and physical dependence issues even more challenging. Regulation of product contents is needed as a part of control measures to supplement product bans.

Download Full-text

Molecular Pathogenesis of Oral Submucous Fibrosis: A Critical Appraisal

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1835 ◽

2019 ◽

Vol 12 (04) ◽

pp. 2027-2036 ◽

Cited By ~ 2

Author(s):

Arpita Rai ◽

Musarrat Siddiqui ◽

Shama Parveen ◽

Saba Parveen ◽

Abdur Rasheed ◽

...

Keyword(s):

Critical Appraisal ◽

Epithelial Mesenchymal Transition ◽

Oral Submucous Fibrosis ◽

Molecular Pathogenesis ◽

Areca Nut ◽

Mesenchymal Transition ◽

Potentially Malignant ◽

Submucous Fibrosis ◽

Malignant Condition

Oral submucous fibrosis (OSMF) is a chronic, potentially malignant condition of the oral mucosa and the habitual chewing of areca nut is believed to be the most potent etiological factor. The role of reactive oxygen species (ROS), epithelial-mesenchymal transition (EMT) and various cytokines and growth factors has been established in recent studies. The components of areca nut particularly, arecoline, flavonoids and copper have been found to affect fibroblasts, endothelial and epithelial cells through various biological pathways which are either down-regulated or up-regulated during different stages of the disease. However, the underlying molecular pathogenesis of OSMF is still partially understood.

Download Full-text

A Study to Analyze Different Patterns of Quid Usage among Subjects with Oral Submucous Fibrosis in Mangalore Population

Advances in Medicine ◽

10.1155/2016/6124059 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Vidya A. Holla ◽

L. K. Chatra ◽

Prashanth Shenai ◽

Devika Shetty ◽

Ashwini Baliga

Keyword(s):

Clinical Stage ◽

Oral Submucous Fibrosis ◽

Cross Sectional Study ◽

Areca Nut ◽

Age Group ◽

Cross Sectional ◽

Potentially Malignant ◽

Carcinogenic Effects ◽

Submucous Fibrosis ◽

Youth Population

Aim and Objectives. Oral submucous fibrosis (OSF) is a potentially malignant disorder associated with the usage of areca nut. Usage of processed forms of areca nut is popular among the youth and its carcinogenic effects are not well known. Due to large immigrant population, various patterns of areca nut usage are seen. The aim of this study is to assess the various quid chewing patterns and their association with severity of OSF.Materials and Methods. A cross-sectional study was carried out with 250 cases clinically and histologically diagnosed as having OSF lesion that were selected and subjected to a detailed habit history which was recorded through preformed questionnaire. The data obtained was statistically analyzed.Results. Among the 250 subjects, males were seen to be affected more than females within the age group of 26–35 years and were having clinical stage I OSF. A combination of processed areca nut and processed tobacco was used by the majority of the subjects with duration of 1 to 5 years, at a frequency of 3 to 5 quids per day.Conclusion. The present study confirms the association between oral submucous fibrosis and the quid containing processed areca nut and processed tobacco and also highlights the increasing youth population using the processed forms of areca nut.

Download Full-text

Oral Submucous Fibrosis: An Overview

Current Trends in diagnosis & Treatment ◽

10.5005/jp-journals-10055-0005 ◽

2017 ◽

Vol 1 (1) ◽

pp. 22-26

Author(s):

Ramandeep S Narang

Keyword(s):

Oral Cavity ◽

Severe Disease ◽

Oral Submucous Fibrosis ◽

Combination Drug ◽

Slaked Lime ◽

Potentially Malignant ◽

Submucous Fibrosis ◽

Upper Third ◽

Malignant Condition ◽

Combination Drug Treatment

ABSTRACT Oral submucous fibrosis (OSMF) is a chronic and potentially malignant condition of the oral cavity. It occurs predominantly in India and Southeast Asia. The pathogenesis of OSMF is not well established, but it is believed to be multifactorial. Chewing of betel quid (containing areca nut, tobacco, and slaked lime) has been recognized as one of the most important risk factors. It is characterized by a juxtaepithelial inflammatory reaction followed by fibroelastic changes in the lamina propria and associated epithelial atrophy. The disease affects most parts of the oral cavity as well as the upper third of the esophagus. The abnormal fibrosis causes blanching and stiffness of the mouth, with eventual immobility of the lips, cheeks, tongue, soft palate, and uvula. Treatment of OSMF is difficult; a combination drug treatment is administered. In patients with severe disease, physical therapy and/or surgery is added to drug therapy. How to cite this article Narang RS, Arora A. Oral Submucous Fibrosis: An Overview. Curr Trends Diagn Treat 2017;1(1):22-26.

Download Full-text

Exemplary Delineation of Osmf Turning Malicious

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672091 ◽

2017 ◽

Vol 05 (02) ◽

pp. 104-109

Author(s):

Anjali Narwal ◽

Mala Kamboj ◽

Shruti Gupta ◽

Esha Singh ◽

Pooja Sharma

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Oral Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Oral Mucosa ◽

Oral Submucous Fibrosis ◽

Potentially Malignant ◽

Submucous Fibrosis ◽

Malignant Condition

AbstractOral submucous fibrosis (OSMF) is a well-recognized, potentially malignant condition of the oral cavity that can affect any part of the oral mucosa. It is strongly associated with a risk of oral cancer, although the biology underlying this association is still unresolved. The purpose of this paper is to show the histopathological prototypical illustration of OSMF turning into oral squamous cell carcinoma.

Download Full-text

Research Achievements of Oral Submucous Fibrosis: Progress and Prospect

BioMed Research International ◽

10.1155/2021/6631856 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Hui Xu ◽

Feng-yuan Lyu ◽

Jiang-yuan Song ◽

Yu-ming Xu ◽

Er-hui Jiang ◽

...

Keyword(s):

Oral Submucous Fibrosis ◽

Treatment Strategies ◽

Areca Nut ◽

Health It ◽

Comprehensive Review ◽

Potentially Malignant Disorders ◽

Regional Problem ◽

Potentially Malignant ◽

New Ideas ◽

Submucous Fibrosis

Oral submucous fibrosis (OSMF) is a kind of chronic, insidious disease, and it is categorized into potentially malignant disorders (PMD), which poses a global and regional problem to public health. It is considered to be a multifactorial disease, such as due to areca nut chewing, trace element disorders, and genetic susceptibility. However, there is still no unanimous conclusion on its pathogenesis, diagnosis, and treatment strategies. Hence, this article provides a comprehensive review and prospect of OSMF research, providing scholars and clinicians with a better perspective and new ideas for the research and treatment of OSMF.

Download Full-text

A Comprehensive Review of Etiopathogenesis of Oral Submucous Fibrosis

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1227 ◽

2015 ◽

Vol 6 (2) ◽

pp. 76-79

Author(s):

Sukhjinder Kaur Kalra ◽

Alok A Lathi ◽

Shilpa A Lathi

Keyword(s):

Oral Submucous Fibrosis ◽

Areca Nut ◽

Betel Nut ◽

Exact Role ◽

Comprehensive Review ◽

Submucous Fibrosis ◽

Betel Nut Chewing ◽

Malignant Condition ◽

Head Neck

ABSTRACT Accepted as an Indian disease, oral submucous fibrosis, is considered not only a chronic debilitating disease but a poten tially malignant condition of oral cavity, strongly associated with the habit of betel nut chewing, that has been sporadically detected in many other western countries and various conti nents, posing a reason for concern in order to create awareness for such debilitating disease. This article provides an overview of the recent concepts and exact role of areca nut alkaloids and other etiological factors in the pathogenesis of oral submucous fibrosis (OSMF). How to cite this article Kalra SK, Lathi AA, Lathi SA. A Com prehensive Review of Etiopathogenesis of Oral Submucous Fibrosis. Int J Head Neck Surg 2015;6(2):76-79.

Download Full-text

Influence of Risk Habits on Demographic Factors and its Impact on Oral Submucous Fibrosis

10.53350/pjmhs2115113058 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3058-3061

Author(s):

Shahrayne Rashid ◽

Saadia Manzar ◽

Farhat Kazmi ◽

Hazik Bin Shahzad ◽

Zeeshan Aslam Jan ◽

...

Keyword(s):

Paradigm Shift ◽

Oral Submucous Fibrosis ◽

Tertiary Care ◽

Mouth Opening ◽

Cross Sectional Study ◽

Control Measures ◽

Significant Finding ◽

Areca Nut ◽

Cross Sectional ◽

Submucous Fibrosis

Objective: To establish a correlation and evaluate paradigm shift of demographic parameters in oral submucous fibrosis patients due to use of areca nut and tobacco. Study Design: Cross sectional study. Place and Duration of the Study: Outpatient Department of Tertiary Care Teaching Hospital, Lahore from 1st November 2019 to 30th June 2021. Methodology: All patients with compliant of limited mouth opening and diagnosed clinically with oral submucous fibrosis were included. Biographical data was collected based on age, gender, literacy rate, socioeconomic conditions and habit of consumption of areca nut-based products and tobacco. Results: Prevalence of OSMF was 0.45% with mean age of 29.26±14.12 years. Areca nut alone is consumed more by females (44.12%) whereas combination of tobacco and areca nut use was higher in males (87.76%). Risk habits were found to be highest in uneducated/primary education (63.01%) and in low socioeconomic group (59.03%). Conclusion: Comparing the last two decades, there is paradigm shift in age of contracting OSMF towards younger age. Significant finding of areca nut use by females also draws attention for control measures. Harmful effects of areca nut and tobacco products should be highlighted and included in educational and community programs. Keywords: Oral submucous fibrosis, Potentially malignant disorders, Areca nut, Oral squamous cell carcinoma

Download Full-text

Targeting lncRNA H19/miR-29b/COL1A1 Axis Impedes Myofibroblast Activities of Precancerous Oral Submucous Fibrosis

International Journal of Molecular Sciences ◽

10.3390/ijms22042216 ◽

2021 ◽

Vol 22 (4) ◽

pp. 2216

Author(s):

Cheng-Chia Yu ◽

Yi-Wen Liao ◽

Pei-Ling Hsieh ◽

Yu-Chao Chang

Keyword(s):

Type I Collagen ◽

Transforming Growth Factor ◽

Smooth Muscle Actin ◽

Oral Submucous Fibrosis ◽

Ectopic Expression ◽

Collagen Gel ◽

Type I ◽

Migration Ability ◽

Potentially Malignant ◽

Submucous Fibrosis

Oral submucous fibrosis (OSF) is known as a potentially malignant disorder, which may result from chemical irritation due to areca nuts (such as arecoline). Emerging evidence suggests that fibrogenesis and carcinogenesis are regulated by the interaction of long noncoding RNAs (lncRNAs) and microRNAs. Among these regulators, profibrotic lncRNA H19 has been found to be overexpressed in several fibrosis diseases. Here, we examined the expression of H19 in OSF specimens and its functional role in fibrotic buccal mucosal fibroblasts (fBMFs). Our results indicate that the aberrantly overexpressed H19 contributed to higher myofibroblast activities, such as collagen gel contractility and migration ability. We also demonstrated that H19 interacted with miR-29b, which suppressed the direct binding of miR-29b to the 3′-untranslated region of type I collagen (COL1A1). We showed that ectopic expression of miR-29b ameliorated various myofibroblast phenotypes and the expression of α-smooth muscle actin (α-SMA), COL1A1, and fibronectin (FN1) in fBMFs. In OSF tissues, we found that the expression of miR-29b was downregulated and there was a negative correlation between miR-29b and these fibrosis markers. Lastly, we demonstrate that arecoline stimulated the upregulation of H19 through the transforming growth factor (TGF)-β pathway. Altogether, this study suggests that increased TGF-β secretion following areca nut chewing may induce the upregulation of H19, which serves as a natural sponge for miR-29b and impedes its antifibrotic effects.

Download Full-text

To Study the Prevalence of Areca Nut Induced Oral Submucous Fibrosis in Patients Visiting Dental OPD of Shalinitai Meghe Hospital and Research Center Nagpur: A Demographic Study

Indian Journal of Forensic Medicine & Toxicology ◽

10.37506/ijfmt.v14i4.12597 ◽

2020 ◽

Keyword(s):

Oral Submucous Fibrosis ◽

Research Center ◽

Areca Nut ◽

Demographic Study ◽

Submucous Fibrosis

Download Full-text

Evaluation of Fibrotic Changes in OSMF:A Retrospective Study Using Special Stains and Polarizing Microscopy

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18843 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1518

Author(s):

Parvez Ikram ◽

Nadeem Jeddy

Keyword(s):

Connective Tissue ◽

Large Scale ◽

Oral Submucous Fibrosis ◽

Muscle Layer ◽

Inclusion Criteria ◽

Polarizing Microscopy ◽

Potentially Malignant ◽

Tissue Changes ◽

Submucous Fibrosis ◽

Picrosirius Red

Background: Oral submucous fibrosis (OSMF), a potentially malignant oral disorder has the highest rate of malignant transformation of about 7-13%. The connective tissue changes that occur in this disease are characteristic and are stained with special stains.Objective: The study was done to compare common and special stains under light microscopy and polarizing microscopy to evaluate the levels of fibrosis in oral submucous fibrosis and assess the type of collagen present in the stromal area.Materials and Methods: Fifty tissue blocks were selected from the archives and were prepared and stained with H&E, Masson's trichrome, Van Gieson and Picrosirius red and studied under light microscope and polarizing microscope respectively.Results: H and E stained slides were useful in diagnosing the lesion but was not able to highlight the level of fibrosis. Masson's trichrome and Van Gieson stained slides showed the depth of the lesion which extended even to the deeper muscle layer. The type of collagen present was definitively seen by the birefringence in polarizing microscopic study. Interobserver variation was less and all the values regarding the effectiveness of the special stains in detecting the level of fibrosis were statistically significant.Conclusion: Special stains can be used routinely in laboratories to demonstrate connective tissue lesions especially in cases of OSMF. Depth of the lesion and the area of involvement help in treatment planning to be delivered. Large scale studies with more categories and inclusion criteria are required along with the special stains to assess the other alterations in OSMF.

Download Full-text