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Garg K, Kumar A, Kizhakkethil V, Kumar P, Singh S. Overlap in oncogenic and pro-inflammatory pathways associated with areca nut and nicotine exposure. CANCER PATHOGENESIS AND THERAPY 2024; 2:187-194. [PMID: 39027148 PMCID: PMC11252521 DOI: 10.1016/j.cpt.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 07/20/2024]
Abstract
Background Betel nut/areca nut/Areca catechu is one of the most commonly used psychoactive substance, and is also a major preventable cause of cancer. Unlike other psychoactive substances, such as nicotine, the mechanisms underlying addiction to areca nuts and related oncogenesis remain elusive. Recent reports suggest a possible overlap in the mechanisms of action of nicotine and areca nuts in the human body. Thus, this study aimed to investigate the interactome of human proteins associated with areca nut exposure and the intricate similarities and differences in the effects of the two psychoactive substances on humans. Methods A list of proteins associated with areca nut use was obtained from the available literature using terms from Medical Subject Headings (MeSH). Protein-protein interaction (PPI) networks and functional enrichment were analyzed. The results obtained for both psychoactive substances were compared. Results Given the limited number of common proteins (36/226, 16%) in the two sets, a substantial overlap (612/1176 nodes, 52%) was observed in the PPI networks, as well as in Gene Ontology. Areca nuts mainly affect signaling pathways through three hub proteins (alpha serine/threonine-protein kinase, tumor protein 53, and interleukin-6), which are common to both psychoactive substances, as well as two unique hub proteins (epidermal growth factor receptor and master regulator of cell cycle entry and proliferative metabolism). Areca nut-related proteins are associated with unique pathways, such as extracellular matrix organization, lipid storage, and metabolism, which are not found in nicotine-associated proteins. Conclusions Areca nuts affect regulatory mechanisms, leading to systemic toxicity and oncogenesis. Areca nuts also affect unique pathways that can be studied as potential markers of exposure, as well as targets for anticancer therapeutic agents.
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Affiliation(s)
- Krati Garg
- Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology (IIT) Delhi, Delhi 110016, India
| | - Anuj Kumar
- Division of Molecular Biology, ICMR-National Institute of Cancer Prevention and Research (ICMR-NICPR), Indian Council of Medical Research, Noida, Uttar Pradesh 201301, India
| | - Vidisha Kizhakkethil
- Department of Biotechnology, Vellore Institute of Technology (VIT), Vellore, Tamil Nadu 632024, India
| | - Pramod Kumar
- Division of Molecular Biology, ICMR-National Institute of Cancer Prevention and Research (ICMR-NICPR), Indian Council of Medical Research, Noida, Uttar Pradesh 201301, India
| | - Shalini Singh
- ICMR-National Institute of Cancer Prevention & Research (ICMR-NICPR), Indian Council of Medical Research, Noida, Uttar Pradesh 201301, India
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Constantin M, Chifiriuc MC, Bleotu C, Vrancianu CO, Cristian RE, Bertesteanu SV, Grigore R, Bertesteanu G. Molecular pathways and targeted therapies in head and neck cancers pathogenesis. Front Oncol 2024; 14:1373821. [PMID: 38952548 PMCID: PMC11215092 DOI: 10.3389/fonc.2024.1373821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
The substantial heterogeneity exhibited by head and neck cancer (HNC), encompassing diverse cellular origins, anatomical locations, and etiological contributors, combined with the prevalent late-stage diagnosis, poses significant challenges for clinical management. Genomic sequencing endeavors have revealed extensive alterations in key signaling pathways that regulate cellular proliferation and survival. Initiatives to engineer therapies targeting these dysregulated pathways are underway, with several candidate molecules progressing to clinical evaluation phases, including FDA approval for agents like the EGFR-targeting monoclonal antibody cetuximab for K-RAS wild-type, EGFR-mutant HNSCC treatment. Non-coding RNAs (ncRNAs), owing to their enhanced stability in biological fluids and their important roles in intracellular and intercellular signaling within HNC contexts, are now recognized as potent biomarkers for disease management, catalyzing further refined diagnostic and therapeutic strategies, edging closer to the personalized medicine desideratum. Enhanced comprehension of the genomic and immunological landscapes characteristic of HNC is anticipated to facilitate a more rigorous assessment of targeted therapies benefits and limitations, optimize their clinical deployment, and foster innovative advancements in treatment approaches. This review presents an update on the molecular mechanisms and mutational spectrum of HNC driving the oncogenesis of head and neck malignancies and explores their implications for advancing diagnostic methodologies and precision therapeutics.
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Affiliation(s)
- Marian Constantin
- Department of Microbiology, Institute of Biology of Romanian Academy, Bucharest, Romania
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, Bucharest, Romania
- Romanian Academy, Bucharest, Romania
| | - Coralia Bleotu
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Cellular and Molecular Pathology Department, Ştefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Corneliu Ovidiu Vrancianu
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, Bucharest, Romania
- DANUBIUS Department, National Institute of Research and Development for Biological Sciences, Bucharest, Romania
| | - Roxana-Elena Cristian
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- DANUBIUS Department, National Institute of Research and Development for Biological Sciences, Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Serban Vifor Bertesteanu
- ENT, Head& Neck Surgery Department, Carol Davila University of Medicine and Pharmacy, Coltea Clinical Hospital, Bucharest, Romania
| | - Raluca Grigore
- ENT, Head& Neck Surgery Department, Carol Davila University of Medicine and Pharmacy, Coltea Clinical Hospital, Bucharest, Romania
| | - Gloria Bertesteanu
- ENT, Head& Neck Surgery Department, Carol Davila University of Medicine and Pharmacy, Coltea Clinical Hospital, Bucharest, Romania
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Gil GF, Anderson JA, Aravkin A, Bhangdia K, Carr S, Dai X, Flor LS, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with chewing tobacco: a Burden of Proof study. Nat Commun 2024; 15:1082. [PMID: 38316758 PMCID: PMC10844244 DOI: 10.1038/s41467-024-45074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024] Open
Abstract
Chewing tobacco use poses serious health risks; yet it has not received as much attention as other tobacco-related products. This study synthesizes existing evidence regarding the health impacts of chewing tobacco while accounting for various sources of uncertainty. We conducted a systematic review and meta-analysis of chewing tobacco and seven health outcomes, drawing on 103 studies published from 1970 to 2023. We use a Burden of Proof meta-analysis to generate conservative risk estimates and find weak-to-moderate evidence that tobacco chewers have an increased risk of stroke, lip and oral cavity cancer, esophageal cancer, nasopharynx cancer, other pharynx cancer, and laryngeal cancer. We additionally find insufficient evidence of an association between chewing tobacco and ischemic heart disease. Our findings highlight a need for policy makers, researchers, and communities at risk to devote greater attention to chewing tobacco by both advancing tobacco control efforts and investing in strengthening the existing evidence base.
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Affiliation(s)
- Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Kayleigh Bhangdia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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Berniyanti T, Jamaludin MB, Eky YE, Bramantoro T, Palupi R. Duration and frequency of betel quid chewing affects periodontitis severity and life quality of people in Tanini Village, Kupang, Indonesia. Int J Dent Hyg 2024; 22:229-235. [PMID: 37722082 DOI: 10.1111/idh.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/18/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Chewing betel nuts can increase the risk of periodontal disease severity and potentially become malignant in the oral cavity. OBJECTIVE This study aimed to investigate the effect of the duration and frequency of betel quid chewing behaviour on periodontitis severity and the life quality of people in Tanini Village, Kupang Regency, Indonesia. METHODS The type of this study was an analytic observational study with a cross-sectional design. We used a questionnaire to obtain sociodemographic data. Oral Health Survey Basic Methods were used to measure debris index, plaque index, bleeding on probing, loss of attachment, and pocket depth. Behaviour and quality of life were measured by questionnaire and WHOQOL-BREF method as well. RESULTS The largest number of respondents were male. Duration of chewing had a significant relationship with the frequency of chewing and periodontal status. Periodontitis was higher compared to all categories. The lifestyle of the community greatly influenced their behaviour in betel nut chewing and also affected the severity of their periodontitis and OHIs significantly. CONCLUSION The lifestyle of betel nut chewing of the people in Tanini Village, greatly influences their behaviour. Prolonged and excessive use of betel nut induced significant adverse effects on human health. The longer and more often chew betel or areca nut, the higher the incidence of periodontitis, which significantly affects the quality of life as there is a possibility of the development of carcinogenesis, particularly in the oral cavity.
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Affiliation(s)
- Titiek Berniyanti
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga Surabaya, Surabaya, Indonesia
| | | | | | - Taufan Bramantoro
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga Surabaya, Surabaya, Indonesia
| | - Retno Palupi
- Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga Surabaya, Surabaya, Indonesia
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Aijaz A, Nanwal R, Almalki SA, Jalli VV, Butolia HK, Arya S. Unveiling Mysteries of Quid-Induced Lichenoid Reactions: A Cross-Sectional Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S317-S319. [PMID: 38595604 PMCID: PMC11001064 DOI: 10.4103/jpbs.jpbs_507_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 04/11/2024] Open
Abstract
Lichenoid reactions occur exclusively in people who chew tobacco, areca nut, or both, in raw or any manufactured or processed form. The lesion is described as a lichen-planus-like lesion and is termed as quid-induced lichenoid reaction (QILR). In this cross-sectional study, amongst 935 quid consumers, 82 patients were diagnosed with QILR and it was seen that 65 patients used processed forms of tobacco and areca nut. Thereby, it could be concluded that QILR might occur because of flavors used in processing of tobacco and areca nut.
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Affiliation(s)
- Amreen Aijaz
- Pediatric Dentist, Kings Dental Centre, Doha, Qatar
| | - Renu Nanwal
- Department of Orthodontics, Daswani Dental College and Research Center, Kota, Rajasthan, India
| | - Sultan Abdulrahman Almalki
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al-kharj, Saudi Arabia
| | - Vishwanath V. Jalli
- Department of Oral Medicine and Radiology, Government Dental College and Research Institute, Vims, Cantonment, Ballari, Karnataka, India
| | - Hemant Kumar Butolia
- Department of Oral Pathology, Rajasthan Dental Collage and Hospital, Jaipur, Rajasthan, India
| | - Sugandha Arya
- Department of Oral Medicine and Radiology, RR Dental College and Hospital, Udaipur, Rajasthan, India
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Penjor T, Gurung MS, Robson MG, Siriwong W. Prevalence of Current Areca Nut Use and Its Associated Factors among Bhutanese Aged 15-69 Years: Analysis of the Nationally Representative STEPS Survey 2019. WHO South East Asia J Public Health 2024; 13:35-39. [PMID: 39167134 DOI: 10.4103/who-seajph.who-seajph_181_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/06/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Areca nut (AN) use receives less global attention than tobacco use. Studies have linked AN consumption to a range of adverse health effects, including oral cavity and pharyngeal cancers, periodontal diseases, cardiovascular diseases, diabetes, hypertension, and addiction. The masticatory use of AN is rampant in Bhutan. There is a paucity of local evidence and limited empirical studies to understand the factors associated with current AN use in Bhutan. METHODS This analysis uses secondary data from the Bhutan STEPS Survey 2019 that included 5575 participants aged 15-69 years, selected using multistage stratified cluster sampling. The outcome variable of interest was current AN use. Weighted analysis was done to calculate the prevalence of AN use. Factors associated with AN use were assessed using multivariable logistic regression models. RESULTS The prevalence of current AN use was 56.82% (95% confidence interval [CI]: 54.27-59.33). A significantly higher prevalence of 63.58% (95% CI: 60.58-66.48) was found in the age group of 25-39 years. Tobacco users were 17% more likely to use AN as compared to those who do not consume tobacco (adjusted odds ratio: 1.17, 95% CI: 1.08-1.26). Current alcohol consumers were 45% more likely to consume AN as compared to lifetime alcohol abstainers. CONCLUSIONS Age, alcohol use, and tobacco use were associated with current AN use in Bhutan. There is a need to regulate access to AN while targeting young and middle-aged individuals with public health and behavioral interventions.
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Affiliation(s)
- Tashi Penjor
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Policy and Planning Division, Ministry of Health, Thimphu, Bhutan
| | | | - Mark G Robson
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Department of Plant Biology, School of Environmental and Biological Sciences Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Wattasit Siriwong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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7
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Sozio SJ, Jhawar SR, Li S, Liu H, Sayan M, Parikh R, Chundury A, Kim S. Prognosis of South Asian Buccal Mucosa Cancer Patients in the United States: Association of Race with Overall Survival. Asian Pac J Cancer Prev 2024; 25:241-248. [PMID: 38285790 PMCID: PMC10911709 DOI: 10.31557/apjcp.2024.25.1.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Squamous Cell Carcinoma (SCC) of the buccal mucosa and gingiva accounts for approximately 10% of oral and pharyngeal cancers diagnosed in the United States each year, with a disproportionally higher incidence in individuals of South Asian descent. However, little has been documented regarding trends pertaining to overall survival. Thus, this research serves to identify predictors of survival and determine if overall survival (OS) differs for South Asians compared to other races once they develop non-metastatic buccal mucosa or gingiva squamous cell carcinoma. METHODS A population-based, cohort study of patients registered in the National Cancer Database® (NCDB) between the years 2004-2016 was performed. Kaplan-Meyer Survival Curves were executed to examine overall survival, while univariable (UVA) and multivariable analysis (MVA) was performed to determine the effect of multiple variables on OS. RESULTS South Asians had longer median OS at 88.7 months, compared to 58.6 months and 38.3 months for Caucasians and African Americans respectively (p<0.001). In UVA, race was highly significant, but when the cohort was selected to include only those who had undergone surgical resection, no statistically significant difference remained. On MVA, lack of surgery, older age, higher grade, higher T and N stage, use of chemotherapy, higher comorbidity scores were associated with worse OS, but race was not significant. CONCLUSION South Asians in the US with non-metastatic buccal mucosa or gingiva SCC have better OS compared to Caucasians or African Americans, likely due to younger age at diagnosis (median 59 vs. 71 and 62 years old) and more frequent surgical resection (75% vs. 72% and 64%). In MVA, South Asians have similar OS as Caucasians.
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Affiliation(s)
- Stephen Joseph Sozio
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.
| | - Sachin R. Jhawar
- Department of Radiation Oncology, Ohio State University Comprehensive Cancer Center, Columbus, OH, United States.
| | - Shengguo Li
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, United States.
| | - Hao Liu
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, United States.
| | - Mutlay Sayan
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, MA, United States.
| | - Rahul Parikh
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.
| | - Anupama Chundury
- Department of Radiation Oncology, Loyola University, United States.
| | - Sung Kim
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States.
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8
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Dangore-Khasbage S, Bhowate RR, Khubchandani M. Chemical Composition of Areca Nut and Its Adverse Effects on Human Health. Cureus 2023; 15:e43739. [PMID: 37731445 PMCID: PMC10507371 DOI: 10.7759/cureus.43739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Areca nut (AN) is one of the addictive substances consumed widely in the world. The composition of AN is very complex, and each component has variable properties. This study aims to review the composition of AN and its adverse effects on humans. For this review, the literature search was performed by an electronic search of the Pubmed/Medline, Scopus, and Google Scholar databases using proper MESH headings and retrieved the articles published from 1997 to 2022. The eligibility criteria included human studies, a form of AN, the composition of AN, harmful effects of AN, the effect of AN on the oral cavity, the effect of AN on vital organs, and articles published in English. Data were extracted regarding the composition of AN, forms of AN, and harmful effects of AN on the oral cavity and on other systems. A total of 449 articles were identified from various databases, and 36 studies were selected that met the inclusion criteria. The active components of AN, which produce harmful effects, are primarily alkaloids, polyphenols, tannins, and certain trace elements. AN is consumed in different forms, and based on the form, its composition also varies. AN is known to cause deleterious effects on the oral cavity as well as various body organs. The most dangerous and widely reported impacts of AN on the oral cavity are the development of oral submucous fibrosis, a premalignant condition, and oral malignancy. However, during the chewing process, excretory products of AN are released and circulate in the body of "chronic habitual" and affect the other body parts. Thus, AN consumption may contribute to cardiac, liver, endocrinal, metabolic, respiratory, and reproductive system disorders also. AN composition is complex, and its consumption is harmful to human health. In regard to controlling the issue of the harmful effects of this habit, preventive measures should be established.
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Affiliation(s)
- Suwarna Dangore-Khasbage
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul R Bhowate
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Monika Khubchandani
- Pediatric Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Diwan P, Nirwan M, Bahuguna M, Kumari SP, Wahlang J, Gupta RK. Evaluating Alterations of the Oral Microbiome and Its Link to Oral Cancer among Betel Quid Chewers: Prospecting Reversal through Probiotic Intervention. Pathogens 2023; 12:996. [PMID: 37623956 PMCID: PMC10459687 DOI: 10.3390/pathogens12080996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Areca nut and slaked lime, with or without tobacco wrapped in Piper betle leaf, prepared as betel quid, is extensively consumed as a masticatory product in many countries across the world. Betel Quid can promote the malignant transformation of oral lesions as well as trigger benign cellular and molecular changes. In the oral cavity, it causes changes at the compositional level in oral microbiota called dysbiosis. This dysbiosis may play an important role in Oral Cancer in betel quid chewers. The abnormal presence and increase of bacteria Fusobacterium nucleatum, Capnocytophaga gingivalis, Prevotella melaninogenica, Peptostreptococcus sp., Porphyromonas gingivalis, and Streptococcus mitis in saliva and/or other oral sites of the cancer patients has attracted frequent attention for its association with oral cancer development. In the present review, the authors have analysed the literature reports to revisit the oncogenic potential of betel quid and oral microbiome alterations, evaluating the potential of oral microbiota both as a driver and biomarker of oral cancer. The authors have also shared a perspective that the restoration of local microbiota can become a potentially therapeutic or prophylactic strategy for the delay or reversal of lip and oral cavity cancers, especially in high-risk population groups.
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Affiliation(s)
- Prerna Diwan
- Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi 110021, India; (M.N.); (M.B.); (S.P.K.); (R.K.G.)
| | - Mohit Nirwan
- Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi 110021, India; (M.N.); (M.B.); (S.P.K.); (R.K.G.)
| | - Mayank Bahuguna
- Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi 110021, India; (M.N.); (M.B.); (S.P.K.); (R.K.G.)
| | - Shashi Prabha Kumari
- Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi 110021, India; (M.N.); (M.B.); (S.P.K.); (R.K.G.)
| | - James Wahlang
- Department of Biochemistry, St. Edmund’s College, Shillong 793003, India;
| | - Rakesh Kumar Gupta
- Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi 110021, India; (M.N.); (M.B.); (S.P.K.); (R.K.G.)
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10
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Li Z, Fu Y, Hu Y, Zhu Y, Hu L, Shi C, Zhang Y, Zhang J, Zhou S. Low-dose arecoline regulates distinct core signaling pathways in oral submucous fibrosis and oral squamous cell carcinoma. BMC Oral Health 2023; 23:171. [PMID: 36966276 PMCID: PMC10039525 DOI: 10.1186/s12903-023-02887-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/15/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Betel nut chewing plays a role in the pathogenesis of oral submucous fibrosis (OSF) and oral squamous cell carcinoma (OSCC). As the major active ingredient of the betel nut, the effect of arecoline and its underlying mechanism to OSF and OSCC pathogenesis remain unclear. METHODS Next-generation sequencing-based transcriptome and dRRBS analysis were performed on OSF and OSCC cells under low-dose arecoline exposure. Functional analyses were performed to compare the different roles of arecoline during OSF and OSCC pathogenesis, and key genes were identified. RESULTS In this study, we identified that low-dose arecoline promoted cell proliferation of both NFs and OSCC cells via the acceleration of cell cycle progression, while high-dose arecoline was cytotoxic to both NFs and OSCC cells. We performed for the first time the transcriptome and methylome landscapes of NFs and OSCC cells under low-dose arecoline exposure. We found distinct transcriptome and methylome profiles mediated by low-dose arecoline in OSF and OSCC cells, as well as specific genes and signaling pathways associated with metabolic disorders induced by low-dose arecoline exposure. Additionally, low-dose arecoline displayed different functions at different stages, participating in the modulation of the extracellular matrix via Wnt signaling in NFs and epigenetic regulation in OSCC cells. After exposure to low-dose arecoline, the node roles of FMOD in NFs and histone gene clusters in OSCC cells were found. Meanwhile, some key methylated genes induced by arecoline were also identified, like PTPRM and FOXD3 in NFs, SALL3 and IRF8 in OSCC cells, indicating early molecular events mediated by arecoline during OSF and OSCC pathogenesis. CONCLUSIONS This study elucidated the contribution of low-dose arecoline to OSF and OSCC pathogenesis and identified key molecular events that could be targeted for further functional studies and their potential as biomarkers.
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Affiliation(s)
- Zhenming Li
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - You Fu
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Yuhua Hu
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yun Zhu
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Longwei Hu
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Chaoji Shi
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Yi Zhang
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
- Department of Endodontics and Operative Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jianjun Zhang
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China
- National Center for Stomatology, Shanghai, 200011, China
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Shanghui Zhou
- Department of Oral & Maxillofacial - Head & Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China.
- National Center for Stomatology, Shanghai, 200011, China.
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.
- Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China.
- Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
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11
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Huang HH, You GR, Tang SJ, Chang JT, Cheng AJ. Molecular Signature of Long Non-Coding RNA Associated with Areca Nut-Induced Head and Neck Cancer. Cells 2023; 12:cells12060873. [PMID: 36980216 PMCID: PMC10047708 DOI: 10.3390/cells12060873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/26/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
The areca nut is a high-risk carcinogen for head and neck cancer (HNC) patients in Southeast Asia. The underlying molecular mechanism of areca nut-induced HNC remains unclear, especially regarding the role of long non-coding RNA (lncRNA). This study employed a systemic strategy to identify lncRNA signatures related to areca nut-induced HNC. In total, 84 cancer-related lncRNAs were identified. Using a PCR array method, 28 lncRNAs were identified as being dysregulated in HNC cells treated with areca nut (17 upregulated and 11 downregulated). Using bioinformatics analysis of The Cancer Genome Atlas Head-Neck Squamous Cell Carcinoma (TCGA-HNSC) dataset, 45 lncRNAs were differentially expressed in tumor tissues from HNC patients (39 over- and 6 under-expressions). The integrated evaluation showed 10 lncRNAs dysregulated by the areca nut and altered expression in patients, suggesting that these panel molecules participate in areca nut-induced HNC. Five oncogenic (LUCAT1, MIR31HG, UCA1, HIF1A-AS2, and SUMO1P3) and tumor-suppressive (LINC00312) lncRNAs were independently validated, and three key molecules were further examined. Pathway prediction revealed that LUCAT1, UCA1, and MIR31HG modulate multiple oncogenic mechanisms, including stress response and cellular motility. Clinical assessment showed that these lncRNAs exhibited biomarker potentials in diagnosis (area under the curve = 0.815 for LUCAT1) and a worse prognosis (both p < 0.05, survival analysis). Cellular studies further demonstrated that MIR31HG facilitates areca nut-induced cancer progression, as silencing this molecule attenuated arecoline-induced invasion ability in HNC cells. This study identified lncRNA signatures that play a role in areca nut-induced HNC. These molecules may be further applied in risk assessment, diagnosis, prognosis, and therapeutics for areca nut-associated malignancies.
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Affiliation(s)
- Hung-Han Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Guo-Rung You
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shang-Ju Tang
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Joseph T. Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (J.T.C.); (A.-J.C.); Tel.: +886-3-328-1200 (J.T.C.); +886-3-2118-800 (A.-J.C.)
| | - Ann-Joy Cheng
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- Correspondence: (J.T.C.); (A.-J.C.); Tel.: +886-3-328-1200 (J.T.C.); +886-3-2118-800 (A.-J.C.)
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12
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Subasinghe SKJ, Hettiarachchi PVKS, Jayasinghe RD. Prevalence, Habit Pattern, and Awareness on Harmful Effects of Tobacco/Areca Nut Use among Patients Visiting a Tertiary Care Center in Sri Lanka. South Asian J Cancer 2023. [DOI: 10.1055/s-0043-1761442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background The carcinogenicity of tobacco and areca nut is well established worldwide. Areca nut is the fourth most common psychoactive substance identified recently. The effects of areca nut on the autonomic nervous system make the users dependent on the habit which has been an emerging health issue among Sri Lankan adults and adolescents. This study aimed to evaluate the prevalence and patterns of these risk habits among the patients attending a tertiary care center in Sri Lanka, and their awareness of the harmful effects of the habit.
Method A hospital-based cross-sectional study was conducted among 512 patients using an interviewer-administered questionnaire.
Results The sample consisted of 167 (33%) tobacco consumers. The average age of the initiation of tobacco consumption was 23.66 years (standard deviation ± 8.04). Age (p = 0.001), gender (p = 0.001), income (p = 0.005), and educational level (p = 0.001) are significantly associated with tobacco consumption. There is a strong likelihood for tobacco consumers to consume areca nut (odds ratio [OR] 30.58, 95% confidence interval [CI] 17.05–54.88) and alcohol (OR 11.16, 95% CI 6.91–17.98) at any stage in their lives. The majority of the tobacco consumers (61%) were smokeless tobacco users. Areca nut consumers are 0.44 times more likely to know its carcinogenic effects than nonconsumers (95% CI 0.28–0.69). Tobacco consumers are more likely to be aware of the harmful effects of tobacco consumption than nonconsumers (OR 1.11, 95% CI 0.45–2.74). Sixty percent have made at least one attempt to quit the habit. Sixty-two percent of the unsuccessful quitters reported the reason as “addiction.”
Conclusion Prevalence of smokeless tobacco consumption prevails at a high level among Sri Lankans. Tobacco and areca nut users are more likely to be aware of its harmful effects than the nonconsumers but unable to quit the habit due to the psychoactive properties of tobacco and areca nut.
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Affiliation(s)
| | | | - Ruwan Duminda Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Center for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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13
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Senevirathna K, Pradeep R, Jayasinghe YA, Jayawickrama SM, Illeperuma R, Warnakulasuriya S, Jayasinghe RD. Carcinogenic Effects of Areca Nut and Its Metabolites: A Review of the Experimental Evidence. Clin Pract 2023; 13:326-346. [PMID: 36961055 PMCID: PMC10037666 DOI: 10.3390/clinpract13020030] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
Oral cancers (OC) are among the most frequent malignancies encountered in Southeast Asia, primarily due to the prevalent habit of betel quid (BQ) and smokeless tobacco use in this region. Areca nut (AN), the primary ingredient in BQ, contains several alkaloids, including arecoline, arecaidine, guvacoline, and guvacine. These have been associated with both the AN abuse liability and carcinogenicity. Additionally, variations in AN alkaloid levels could lead to differences in the addictiveness and carcinogenic potential across various AN-containing products. Recent studies based on animal models and in vitro experiments show cellular and molecular effects induced by AN. These comprise promoting epithelial-mesenchymal transition, autophagy initiation, tissue hypoxia, genotoxicity, cytotoxicity, and cell death. Further, clinical research endorses these undesired harmful effects in humans. Oral submucosal fibrosis, a potentially malignant disease of the oral cavity, is predominantly reported from the geographical areas of the globe where AN is habitually chewed. OC in chronic AN users presents a more aggressive phenotype, such as resistance to anti-cancer drugs. The available evidence on the carcinogenicity of AN based on the findings reported in the recently published experimental studies is discussed in the present review.
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Affiliation(s)
- Kalpani Senevirathna
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Roshan Pradeep
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Yovanthi Anurangi Jayasinghe
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Shalindu Malshan Jayawickrama
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Rasika Illeperuma
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College, London SE1 9RA, UK
| | - Ruwan Duminda Jayasinghe
- Centre for Research in Oral Cancer (CROC), Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
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14
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Myers AL. Metabolism of the areca alkaloids - toxic and psychoactive constituents of the areca (betel) nut. Drug Metab Rev 2022; 54:343-360. [PMID: 35543097 DOI: 10.1080/03602532.2022.2075010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Areca nut (AN) is consumed by millions of people for its therapeutic and psychoactive effects, making it one of the most widely self-administered psychoactive substances in the world. Even so, AN use/abuse is associated with myriad oral and systemic side effects, affecting most organ systems in the body. Alkaloids abundant in the nut (e.g. arecoline, arecaidine, guvacoline, and guvacine), collectively called the areca alkaloids, are presumably responsible for the major pharmacological effects experienced by users, with arecoline being the most abundant alkaloid with notable toxicological properties. However, the mechanisms of arecoline and other areca alkaloid elimination in humans remain poorly documented. Therefore, the purpose of this review is to provide an in-depth review of areca alkaloid pharmacokinetics (PK) in biological systems, and discuss mechanisms of metabolism by presenting information found in the literature. Also, the toxicological relevance of the known and purported metabolic steps will be reviewed. In brief, several areca alkaloids contain a labile methyl ester group and are susceptible to hydrolysis, although the human esterase responsible remains presumptive. Other notable mechanisms include N-oxidation, glutathionylation, nitrosamine conversion, and carbon-carbon double-bond reduction. These metabolic conversions result in toxic and sometimes less-toxic derivatives. Arecoline and arecaidine undergo extensive metabolism while far less is known about guvacine and guvacoline. Metabolism information may help predict drug interactions with human pharmaceuticals with overlapping elimination pathways. Altogether, this review provides a first-of-its-kind comprehensive analysis of AN alkaloid metabolism, adds perspective on new mechanisms of metabolism, and highlights the need for future metabolism work in the field.
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Affiliation(s)
- Alan L Myers
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center, Houston, TX, USA
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15
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Lu HJ, Chuang CY, Su CW, Chen MK, Yang WE, Yeh CM, Tang CH, Lin CW, Yang SF. Role of TNFSF15 variants in oral cancer development and clinicopathologic characteristics. J Cell Mol Med 2022; 26:5452-5462. [PMID: 36226563 PMCID: PMC9639028 DOI: 10.1111/jcmm.17569] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 12/04/2022] Open
Abstract
Tumour necrosis family superfamily (TNFSF) member 15 (TNFSF15), encoded by TNFSF15, regulates immune responses and inflammation. However, the roles of TNFSF15 single‐nucleotide variants (SNVs; formerly SNPs) in oral cavity squamous cell carcinoma (OCSCC) remain unclear. This case–control study included 2523 participants (1324 patients with OCSCC [52.5%] and 1199 healthy controls [47.5%]). The effects of TNFSF15 rs3810936, rs6478108 and rs6478109 on cancer development and prognosis were analysed by real‐time PCR genotype assay. The Genotype‐Tissue Expression (GTEx) and The Cancer Genome Atlas (TCGA) databases were used to validate our findings. The results demonstrated that the patients with altered TNFSF15 SNVs had poorer histological differentiation than did those with wild‐type alleles. TNFSF15 SNVs were significantly associated with moderate‐to‐poor histological differentiation in univariate logistic regression. In the GTEx database, the expression of altered TNFSF15 SNVs in whole blood was lower than that of wild‐type alleles. However, the expression of altered SNVs in the upper aerodigestive mucosa was higher than that of wild‐type alleles. In the TCGA database, the patients with higher TNFSF15 expression had shorter overall survival than did those with lower TNFSF15 expression, especially for human papillomavirus‐negative and advanced staging groups. In conclusion, although TNFSF15 SNVs did not affect OCSCC development, the patients with altered TNFSF15 SNVs exhibited poorer histological differentiation. The patients with higher TNFSF15 expression had poorer prognosis than did those with lower TNFSF15 expression.
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Affiliation(s)
- Hsueh-Ju Lu
- Division of Hematology and Oncology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chun-Yi Chuang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Wen Su
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Mu-Kuan Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan.,Oral cancer Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Wei-En Yang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Ming Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Oral cancer Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Hsin Tang
- School of Medicine, China Medical University, Taichung, Taiwan.,Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Chiao-Wen Lin
- Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shun-Fa Yang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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16
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Young K, Bulosan H, Baksa J, Jeong Y, Buenconsejo-Lum LE, Birkeland AC. Oral Cancer Disparities in the Outer US-affiliated Pacific Islands. Laryngoscope 2022. [PMID: 36165583 PMCID: PMC10040458 DOI: 10.1002/lary.30419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE/HYPOTHESIS Oral cancers in the US-affiliated Pacific Islands are poorly described despite disproportionately higher incidences in certain jurisdictions. This study attempts to better characterize the incidence, staging, and management of oral cancers in this region. STUDY DESIGN Retrospective Epidemiological Study. METHODS A retrospective review was conducted across the US-affiliated Pacific Islands between 2007 and 2019. Patient data were obtained for individuals with primary head and neck cancers from the Pacific Regional Central Cancer Registry database. All cohorts were age-adjusted to the 2000 US Standard Population. Further analysis was performed on oral cavity cancers due to their clear predominance within the sample. RESULTS A total of 585 patients with primary head and neck cancers were included. The average age was 54.5 ± 12.9 years, and most patients were male (76.8%). Oral cancer subsite analysis revealed the proportional incidence of buccal mucosa was higher in 5 of 9 jurisdictions when compared with the United States (p < 0.001). Tongue and lip cancers were not found to have significantly higher incidence proportions. Patients in the Pacific Islander group were less likely to be detected at earlier stages for cancers of the cheek and other mouth (p < 0.001), tongue (p < 0.001), and lips (p < 0.001) compared with the United States. CONCLUSIONS Many Pacific Island populations are burdened with higher incidences of oral cancer with later staging. Further investigation is recommended to evaluate oral cancer-related outcomes and mortality in this region. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.
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Affiliation(s)
- Kurtis Young
- Department of Surgery, University of Hawai'i at Mānoa John A. Burns School of Medicine, Honolulu, Hawai, USA
| | - Hannah Bulosan
- Department of Surgery, University of Hawai'i at Mānoa John A. Burns School of Medicine, Honolulu, Hawai, USA
| | - Janos Baksa
- Department of Surgery, University of Hawai'i at Mānoa John A. Burns School of Medicine, Honolulu, Hawai, USA
| | - Youngju Jeong
- Department of Surgery, University of Hawai'i at Mānoa John A. Burns School of Medicine, Honolulu, Hawai, USA
| | - Lee E Buenconsejo-Lum
- Department of Surgery, University of Hawai'i at Mānoa John A. Burns School of Medicine, Honolulu, Hawai, USA
| | - Andrew C Birkeland
- Division of Otolaryngology, University of California Davis Medical Center, Sacramento, California, USA
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17
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Chen HC, Chen YY, Chao MR, Chang YZ. Validation of a high-throughput method for simultaneous determination of areca nut and tobacco biomarkers in hair using microwave-assisted extraction and isotope dilution liquid chromatography tandem mass spectrometry. J Pharm Biomed Anal 2022; 216:114775. [PMID: 35490505 DOI: 10.1016/j.jpba.2022.114775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/10/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022]
Abstract
For people with habits of chewing betel nuts and smoking, the probability of suffering from oral cancer is ten to a hundred times higher than others. Due to the serious health consequences of areca nut and tobacco, a reliable cessation program is needed. Hair is the best option to document long-term exposure. Unfortunately, the research on betel nut in hair did not attract much attention. In this study, a high-throughput method based on microwave-assisted extraction (MAE) and isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS) was developed to measure the four biomarkers of betel nuts and cigarettes, including areca alkaloids (arecoline), tobacco alkaloids (nicotine), and their metabolites (arecaidine and cotinine). The hair sample was washed, cut, weighed, and incubated for 3 min MAE with methanol/trifluoroacetic acid, then evaporated and reconstituted for LC-MS/MS analysis. The total experiment time was 50 min. The lower limits of quantification (LOQ) were 5-10 pg/mg. The intra-day and inter-day precision were 2.2-7.6%. Intra-day and inter-day accuracy were - 6.1-8.2%. The method showed good linearity (r2 > 0.995) over LOQ - 1000 pg/mg concentration ranges. It was successfully applied to analyze 11 subjects of regular areca nut chewers, also smokers. Eight samples were black hair; three samples were naturally black hair with partially gray hair. Measured concentrations in black hair were in the range 56.9 pg/mg to 3.2 ng/mg for arecoline, 12.8 pg/mg to 222.2 pg/mg for arecaidine, 3.8 ng/mg to 33.4 ng/mg for nicotine and 1.1 ng/mg to 6.1 ng/mg for cotinine. The results showed lower levels in gray hair. This method was utilized successfully to analyze pg/mg levels of arecoline, arecaidine, nicotine, and cotinine, and good recoveries were obtained. The mean concentration of arecaidine and cotinine in hair was 15% and 20% of arecoline and nicotine, respectively. A good positive correlation was found between the concentrations of these compounds and self-report. This method improved extraction speed, concentration, and analysis of samples and is useful for monitoring betel nut and smoking cessation programs.
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Affiliation(s)
- Hsiu-Chuan Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Ya-Yi Chen
- Department of Stomatology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Yan-Zin Chang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; Drug Testing Center, Department of Clinical Laboratory, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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18
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The World of Oral Cancer and Its Risk Factors Viewed from the Aspect of MicroRNA Expression Patterns. Genes (Basel) 2022; 13:genes13040594. [PMID: 35456400 PMCID: PMC9027895 DOI: 10.3390/genes13040594] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 01/27/2023] Open
Abstract
Oral cancer is one of the leading causes of death worldwide, with a reported 5-year survival rate of around 50% after treatment. Epigenetic modifications are considered to have a key role in oral carcinogenesis due to histone modifications, aberrant DNA methylation, and altered expression of miRNAs. MicroRNAs (miRNAs) are small non-coding RNAs that have a key role in cancer development by regulating signaling pathways involved in carcinogenesis. MiRNA deregulation identified in oral cancer has led to the idea of using them as potential biomarkers for early diagnosis, prognosis, and the development of novel therapeutic strategies. In recent years, a key role has been observed for risk factors in preventing and treating this malignancy. The purpose of this review is to summarize the recent knowledge about the altered mechanisms of oral cancer due to risk factors and the role of miRNAs in these mechanisms.
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19
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Chang YJ, Muthukumaran RB, Chen JL, Chang HY, Hung YC, Hu CW, Chao MR. Simultaneous determination of areca nut- and tobacco-specific alkaloids in saliva by LC-MS/MS: Distribution and transformation of alkaloids in oral cavity. JOURNAL OF HAZARDOUS MATERIALS 2022; 426:128116. [PMID: 34968842 DOI: 10.1016/j.jhazmat.2021.128116] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Areca nut and tobacco are frequently used in combination. Cigarette smoking and betel quid (BQ) chewing habits impose greater oral cancer risk than either habit alone. Saliva is a better noninvasive diagnostic material as it is in direct contact with oral mucosa and cancerous lesions. This study describes the application of isotope-dilution LC-MS/MS for simultaneous quantitation of five areca nut-specific alkaloids (ASAs) and three tobacco-specific alkaloids (TSAs) in human saliva. With this method, we demonstrate that the distribution of ASAs vary significantly in smokers who chew BQ habitually, due to the hydrolysis of ASAs and metabolic activity in the oral cavity. The alkaline condition formed due to slaked lime in BQ, plays an important role in the distribution of ASAs and TSAs, by catalyzing the hydrolysis of ester forms of ASAs to their respective carboxylic acid forms besides facilitating the TSA (i.e., nicotine) absorption in the oral cavity. Moreover, our results reveal that oral mucosa rather than saliva contributes to the metabolism of ASAs at oral cavity. Less than 2.1% of ASAs were metabolized by saliva, as determined by in vitro test. Our findings may provide a better insight into the pathobiology of oral carcinogenesis due to BQ chewing.
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Affiliation(s)
- Yuan-Jhe Chang
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | | | - Jian-Lian Chen
- School of Pharmacy, China Medical University, Taichung 404, Taiwan
| | - Hsin-Yi Chang
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan
| | - Yu-Cheng Hung
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan.
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan; Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
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20
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Chu M, Fu G, Deng J, Wang R, Fan Q, Chen Z, Lu J, Liu XA. Evaluation of the inhalation toxicity of arecoline benzoate aerosol in rats. J Appl Toxicol 2022; 42:1396-1410. [PMID: 35170056 DOI: 10.1002/jat.4303] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/05/2022] [Accepted: 02/09/2022] [Indexed: 11/10/2022]
Abstract
Arecoline is a pharmacologically active alkaloid isolated from Areca catechu. There are no published data available regarding the inhalation toxicity of arecoline in animals. This study aimed to evaluate the inhalation toxicity of arecoline in vitro and in vivo. For this purpose, arecoline benzoate (ABA) salt was prepared to stabilize arecoline in an aerosol. The MTT assay determined the half-maximal inhibitory concentration values of ABA and arecoline in A549 cell proliferation to be 832 μg/ml and 412 μg/ml, respectively. The toxicity of acute and subacute inhalation in Sprague-Dawley rats was evaluated using the guidelines of the Organization for Economic Cooperation and Development. For acute inhalation, the median lethal concentration value of ABA solvent was >5175 mg/m3 . After the exposure and during the recovery period, no treatment-related clinical signs were observed. In the 28-Day inhalation toxicity test, daily nose-only exposure to 2510 mg/m3 aerosol of the ABA solvent contained 75 mg/m3 ABA for male rats and 375 mg/m3 ABA for female rats, which caused no observed adverse effects, except for the decreased body weight gain in male rats exposed to 375 mg/m3 ABA. In this study, the no observed adverse effect level (NOAEL) for the 28-Day repeated dose inhalation of ABA aerosol was calculated to be around 13 mg/kg/day for male rats and 68.8 mg/kg/day for female rats, respectively.
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Affiliation(s)
- Ming Chu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, China.,Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Guofeng Fu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, China.,Laboratory of Life Sciences, Shenzhen Icybetel Biotechnology Co, Ltd, Shenzhen, China
| | - Jingjing Deng
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, China
| | - Ruoxi Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Qiming Fan
- GuangdongZhongkeEnHealth Science and Technology Co., Ltd., Foshan, China
| | - Zuxin Chen
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS); Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China; University of Chinese Academy of Sciences, Beijing, China
| | - Jin Lu
- Laboratory of Life and Health Sciences, Shenzhen First Union Technology Co., Ltd, Shenzhen, China.,Laboratory of Life Sciences, Shenzhen Icybetel Biotechnology Co, Ltd, Shenzhen, China
| | - Xin-An Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China; University of the Chinese Academy of Sciences, Beijing, China
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21
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Molecular Mechanisms of Malignant Transformation of Oral Submucous Fibrosis by Different Betel Quid Constituents-Does Fibroblast Senescence Play a Role? Int J Mol Sci 2022; 23:ijms23031637. [PMID: 35163557 PMCID: PMC8836171 DOI: 10.3390/ijms23031637] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023] Open
Abstract
Betel quid (BQ) is a package of mixed constituents that is chewed by more than 600 million people worldwide, particularly in Asia. The formulation of BQ depends on a variety of factors but typically includes areca nut, betel leaf, and slaked lime and may or may not contain tobacco. BQ chewing is strongly associated with the development of potentially malignant and malignant diseases of the mouth such as oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC), respectively. We have shown recently that the constituents of BQ vary geographically and that the capacity to induce disease reflects the distinct chemical composition of the BQ. In this review, we examined the diverse chemical constituents of BQ and their putative role in oral carcinogenesis. Four major areca alkaloids—arecoline, arecaidine, guvacoline and guvacine—together with the polyphenols, were identified as being potentially involved in oral carcinogenesis. Further, we propose that fibroblast senescence, which is induced by certain BQ components, may be a key driver of tumour progression in OSMF and OSCC. Our study emphasizes that the characterization of the detrimental or protective effects of specific BQ ingredients may facilitate the development of targeted BQ formulations to prevent and/or treat potentially malignant oral disorders and oral cancer in BQ users.
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22
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Sanjeeta N, Banerjee S, Mukherjee S, Devi TP, Nandini DB, Aparnadevi P. Correlation of the activities of antioxidant enzymes superoxide dismutase and glutathione reductase with micronuclei counts among areca nut chewers of Manipuri population using exfoliative cytology: A preliminary study. J Cancer Res Ther 2022; 18:984-989. [DOI: 10.4103/jcrt.jcrt_1227_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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23
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Pachuau L, Zami Z, Nunga T, Zodingliana R, Zoramthari R, Lalnuntluanga R, Sangi Z, Rinmawii L, Kumar NS, Lalhruaitluanga H. First-degree family history of cancer can be a potential risk factor among head and neck cancer patients in an isolated Mizo tribal population, northeast India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2021.100954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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24
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Porcheri C, Mitsiadis TA. New Scenarios in Pharmacological Treatments of Head and Neck Squamous Cell Carcinomas. Cancers (Basel) 2021; 13:cancers13215515. [PMID: 34771677 PMCID: PMC8583200 DOI: 10.3390/cancers13215515] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 12/24/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most frequent types of cancer with a lethal outcome in half of the diagnosed cases. Mostly, HNSCC develops in the oral cavity, and its development is associated with tobacco and areca nut/betel quid usage, alcohol consumption, and HPV infection. Oral squamous cell carcinoma, as other head and neck cancers, presents a high degree of intratumor heterogeneity, which makes their treatment difficult, and directly correlates with drug resistance. Since the classical treatments for HNSCC oftentimes do not resolve the clinical picture, there is great need for novel therapeutic approaches, models for drug testing, and new drug delivery systems.
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25
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Singh AG, Roy S, Oza S, Singhavi H, Chatterjee K, Chaturvedi P. A contemporary narrative review to guide molecular epidemiology of oral submucous fibrosis. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2021; 12:61-70. [PMID: 34552689 PMCID: PMC8449189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
Oral submucous Fibrosis (OSMF) is a chronic disease that mainly affects the upper part of the aerodigestive tract. Areca nut and betel quid chewing has been established as the most significant causative factor for this condition. While OSMF is a predominantly Asian disease, the migrant populations from the region have taken the disease across the globe. Additionally, areca nut is now easily accessible in flavors and aggressively marketed. Many research activities have been undertaken for decades to understand the etiopathogenesis and risk factors of OSMF. Although OSMF is a slowly progressing disease, it has the potential to transform to an oral malignancy. This article is an attempt to review the literature and provide an update on its prevalence, etiopthogenesis and its diagnosis. We also highlight certain clinical, histopathological and molecular features that aid in the diagnosis and prognostication of OSMF, highlighting the importance of identifying the possibly high risk OSMF that is prone to malignant transformation. Using this information, future directions can be developed to include treatmentof OSMF through a dynamic gene-specific approach.
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Raimondeau P, Manzi S, Brucato N, Kinipi C, Leavesley M, Ricaut FX, Besnard G. Genome skims analysis of betel palms (Areca spp., Arecaceae) and development of a profiling method to assess their plastome diversity. Gene 2021; 800:145845. [PMID: 34274465 DOI: 10.1016/j.gene.2021.145845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
The betel nut (Areca catechu L., Arecaceae) is a monoecious cultivated palm tree that is widespread in tropical regions. It is mainly cultivated for producing areca nuts, from which seeds are extracted and chewed by local populations principally in the Indo-Pacific region. Seeds contain alkaloids which are central nervous system stimulants and are highly addictive. Wild relatives of the betel nut are distributed in South Asia and Australasia, with ca. 40-50 Areca species currently recognized. The geographic origin(s) of the betel nut and its subsequent diffusion and diversification remains poorly documented. Here, a genome skimming approach was applied to screen nucleotidic variation in the most abundant genomic regions. Low coverage sequencing data allowed us to assemble full plastomes, mitochondrial regions (either full mitogenomes or the full set of mitochondrial genes) and the nuclear ribosomal DNA cluster for nine representatives of the Areca genus collected in the field and herbarium collections (including a 182-years old specimen collected during the Dumont d'Urville's expedition). These three genomic compartments provided similar phylogenetic signals, and revealed very low genomic diversity in our sample of cultivated betel nut. We finally developed a genotyping method targeting 34 plastid DNA microsatellites. This plastome profiling approach is useful for tracing the spread of matrilineages, and in combination with nuclear genomic data, can resolve the history of the betel nut. Our method also proves to be efficient for analyzing herbarium specimens, even those collected >100 years ago.
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Affiliation(s)
- Pauline Raimondeau
- Laboratoire Évolution & Diversité Biologique (EDB, UMR 5174), Université de Toulouse, CNRS-IRD-UPS, 118 route de Narbonne, Bât. 4R1, 31062 Toulouse, France
| | - Sophie Manzi
- Laboratoire Évolution & Diversité Biologique (EDB, UMR 5174), Université de Toulouse, CNRS-IRD-UPS, 118 route de Narbonne, Bât. 4R1, 31062 Toulouse, France
| | - Nicolas Brucato
- Laboratoire Évolution & Diversité Biologique (EDB, UMR 5174), Université de Toulouse, CNRS-IRD-UPS, 118 route de Narbonne, Bât. 4R1, 31062 Toulouse, France
| | - Christopher Kinipi
- Strand of Anthropology, Sociology and Archaeology, School of Humanities and Social Sciences, University of Papua New Guinea, PO Box 320, University 134, National Capital District, Papua New Guinea
| | - Matthew Leavesley
- Strand of Anthropology, Sociology and Archaeology, School of Humanities and Social Sciences, University of Papua New Guinea, PO Box 320, University 134, National Capital District, Papua New Guinea; CABAH & College of Arts, Society and Education, James Cook University, PO Box 6811, Cairns, QLD 4870, Australia
| | - François-Xavier Ricaut
- Laboratoire Évolution & Diversité Biologique (EDB, UMR 5174), Université de Toulouse, CNRS-IRD-UPS, 118 route de Narbonne, Bât. 4R1, 31062 Toulouse, France
| | - Guillaume Besnard
- Laboratoire Évolution & Diversité Biologique (EDB, UMR 5174), Université de Toulouse, CNRS-IRD-UPS, 118 route de Narbonne, Bât. 4R1, 31062 Toulouse, France.
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Athukorala IA, Tilakaratne WM, Jayasinghe RD. Areca Nut Chewing: Initiation, Addiction, and Harmful Effects Emphasizing the Barriers and Importance of Cessation. JOURNAL OF ADDICTION 2021; 2021:9967097. [PMID: 34123457 PMCID: PMC8192186 DOI: 10.1155/2021/9967097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022]
Abstract
Areca nut is a highly addictive substance with carcinogenic properties and causes many harmful effects to the human body. Alkaloids are the major chemicals found in areca nut, and their mechanism of action has been studied for several years. About 600 million people around the world use areca nut, and its usage is higher in Asian countries. Areca nut chewers get used to the habit mainly due to social influence, stress, or lack of awareness. Some studies have reported a dependence syndrome related to areca nut chewing. Even though there are many ongoing research studies regarding tobacco addiction, less concern has been given to the areca nut addiction. There are only few studies related to areca nut cessation, and even those few cessation programs are mainly designed using tobacco cessation methodology. Sociocultural influence, behavioral factors, and accessibility are the main barriers to cessation. Behavior changing interventions proved to be more effective in areca nut cessation, but recently studies on pharmacological therapies are also emerging.
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Affiliation(s)
- I. A. Athukorala
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - R. D. Jayasinghe
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Pele M, Herawati T, Yona S. Factors influencing transmission of tuberculosis in Ngeu Nata culture among Ngada community in Kupang, East Nusa Tenggara, Indonesia: Cross sectional study. J Public Health Res 2021; 10. [PMID: 34060740 PMCID: PMC9309630 DOI: 10.4081/jphr.2021.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/04/2022] Open
Abstract
Background Eating “sirih/Betel” (Ngeu Nata) as a culture in Ngada society can become one
of the primary source of Tuberculosis (TB) transmission due to share leaves
and betel liquid reservoirs together with other people. If one of the people
who share leaves is a TB patient, it can transmit TB to other person. The
purpose of this study was to identify the factors that influence TB
transmission in Ngeu Nata culture using the health belief model
approach. Design and Methods This study used cross-sectional, involving 110 respondents, selected by
consecutive sampling. The respondents were Bajawa ethnicity, age 36-67, at
least consume Betel one a day together with other person in Ngada district,
East Nusa Tenggara. Results The results showed that most respondents had high transmission behavior in
betel eating culture (51.8%). Factors related to TB transmission behavior:
medical history of TB (p=0.028), knowledge about TB (p=0.038), the perceived
of severity of TB (p=0.037); the perceived of benefits (p=0.039) and the
perceived of barrier (p=0.038). The dominant factor was knowledge, (OR 2,365
(95% CI) 1,015-5,510). Conclusions Implication: nurses should include aspect of Ngeu Nata cultural in designing
TB education for Bajawa ethnicity in order to prevent TB transmission in
Ngada district, East Nusa Tenggara.
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Affiliation(s)
- Maria Pele
- Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Tuti Herawati
- Department of Medical Surgical Nursing, Faculty of Nursing Universitas Indonesia, Depok, West Java.
| | - Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing Universitas Indonesia, Depok, West Java.
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Jain TK, Singh G, Goyal S, Malhotra H, Yadav A, Kumbhaj P, Yadav D, Khunteta N. Is F-18 FDG PET/computed tomography a useful tool to restage the patients with tongue carcinoma? Nucl Med Commun 2021; 42:429-436. [PMID: 33306624 DOI: 10.1097/mnm.0000000000001336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the diagnostic performance of contrast-enhanced F-18 fluoro-2-deoxyglucose (F-18 FDG) PET/computed tomography (CT) in restaging of tongue carcinoma. MATERIAL AND METHODS Retrospectively analysis of carcinoma tongue patients (n = 110) who were treated and referred for FDG PET/CT. Histopathological examination and clinical or imaging follow-up were taken as gold standard. RESULTS Of 110 patients, FDG PET/CT detected FDG avid lesions in 69 (62.7%) patients. Sensitivity, specificity and diagnostic accuracy of FDG PET/CT were 92.9%, 90.0% and 91.8%, respectively, for residual/recurrence disease detection (P < 0.05). Additionally, in six patients, metachronous primaries were also detected [lung (4), esophagus and lymphoma (1) each]. The mean maximum standardized uptake value (SUVmax) with 95% confidence interval for primary site recurrence, regional lymph nodes and metastatic lesions was 11.51 (9.53-13.48), 69 (62.7%) (7.88-11.48) and 8.94 (3.11-14.76), respectively. CONCLUSION FDG PET/CT demonstrates high diagnostic accuracy for detection of residual/recurrent disease in treated tongue cancer patients and PET/CT should be considered as first-line diagnostic investigation in these patients.
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Affiliation(s)
| | | | | | | | | | | | - Dinesh Yadav
- Surgical Oncology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
| | - Nitin Khunteta
- Surgical Oncology, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
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Sahu RK, Patro S, Nayak B, Bardhan D, Panda S, Rajguru JP. Habit-associated salivary pH changes in oral submucous fibrosis: A cross-sectional study. Natl J Maxillofac Surg 2021; 12:78-82. [PMID: 34188405 PMCID: PMC8191565 DOI: 10.4103/njms.njms_39_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/15/2020] [Accepted: 10/08/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Salivary pH plays a significant role in the pathogenesis of various oral diseases and conditions. Chewing of areca nut and various tobacco products changes salivary pH. Aim: The aim of the study was to measure the effect of habitual chewing of areca nut and various tobacco products on salivary pH. Materials and Methods: The present study included 360 individuals (chewers and nonchewers) of age group between 20 and 30 years who visited the Outpatient Department of Hi-Tech Dental College and Hospital. The patient's salivary pH was measured with the help of a digital pH meter before and after chewing areca nut and various tobacco products. Results: It was observed that, in all the groups of chewers, pH decreased after chewing except in the gutkha and lime chewing group, where pH increased (pH before chewing was 7.43 ± 0.41 and after chewing was 7.51 ± 0.399), the difference was strongly significant (P < 0.001). pH was found to be less in lime and tobacco chewers (6.83 ± 0.33) and more in tobacco, betel nut, and lime chewers (7.50 ± 0.41) in comparison to other groups before chewing; the difference was strongly significant (P < 0.001). In the mean ± standard deviation, increase in pH was found among chewers (7.32 ± 0.49) as compared to nonchewers (6.99 ± 0.14), which is the control group, and the data were statically significant (P < 0.001). Conclusion: pH is altered in areca nut and various tobacco chewers, rendering the oral mucosa vulnerable to the toxic effects of areca nut and various tobacco products.
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Affiliation(s)
- Rohit Kumar Sahu
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Sangram Patro
- Department of Oral and Maxillofacial Surgery, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Bikash Nayak
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Debajyoti Bardhan
- Department of Oral Medicine and Radiology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Swagat Panda
- Department of Conservative and Endodontics, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Jagdish Prasad Rajguru
- Department of Oral and Maxillofacial Pathology, Hi-Tech Dental College and Hospital, Bhubaneswar, Odisha, India
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31
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Chou YT, Li CH, Sun ZJ, Shen WC, Yang YC, Lu FH, Chang CJ, Wu JS. A Positive Relationship between Betel Nut Chewing and Significant Liver Fibrosis in NAFLD Subjects, but Not in Non-NAFLD Ones. Nutrients 2021; 13:nu13030914. [PMID: 33799865 PMCID: PMC7998430 DOI: 10.3390/nu13030914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Betel nut chewing is associated with oral cancer, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma (HCC). The aim of this study was to explore the association of betel nut chewing with liver fibrosis in subjects with and without nonalcoholic fatty liver disease (NAFLD). Method: A total of 5967 subjects were enrolled. NAFLD was diagnosed with ultrasonography. Betel nut chewing was classified into non-chewing, ex-chewing, and current chewing, and cumulative dosages were calculated. The aspartate aminotransferase (AST)/platelet ratio index and NAFLD fibrosis scores (NFS) were calculated for evaluation of liver fibrosis. Results: NAFLD increased the associated risk of liver fibrosis in those with (odds ratio (OR): 5.51, 95% confidence interval (CI): 3.09–9.80) and without betel nut chewing (OR: 2.33, 95% CI: 1.64–3.29). In subjects without NAFLD, betel nut chewing was not associated with liver fibrosis (OR: 1.12, 95% CI: 0.44–2.86). In subjects with NAFLD, cumulative betel nut chewing and ex- and current chewing were positively associated with NFS and significant liver fibrosis. Conclusions: In subjects with NAFLD, betel nut chewing, even ex-chewing, was associated with a higher risk of liver fibrosis, where higher cumulative levels were found to increase the risk of significant liver fibrosis. However, the associated risk of liver fibrosis due to betel nut chewing was insignificant in subjects without NAFLD.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-T.C.); (C.-H.L.)
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
| | - Chung-Hao Li
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Y.-T.C.); (C.-H.L.)
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
| | - Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin 64043, Taiwan
| | - Wei-Chen Shen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
- Correspondence: (C.-J.C.); (J.-S.W.); Tel.: +886-6-2353535 (ext. 5210) (J.-S.W.)
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan; (Z.-J.S.); (W.-C.S.); (Y.-C.Y.); (F.-H.L.)
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin 64043, Taiwan
- Correspondence: (C.-J.C.); (J.-S.W.); Tel.: +886-6-2353535 (ext. 5210) (J.-S.W.)
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Sozio SJ, Jhawar S, Wang Y, Sayan M, Parikh R, Kim S. Comparing the Incidence of Buccal Mucosa Cancer in South Asian, White, and Black Populations Residing in the United States: A Cross-Sectional Analysis. Asian Pac J Cancer Prev 2021; 22:195-199. [PMID: 33507699 PMCID: PMC8184205 DOI: 10.31557/apjcp.2021.22.1.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Recreational use of the betel nut, which is common among the South Asian population, is a known risk factor for developing Head and Neck cancer. As South Asians comprise a significant proportion of the United States population, we seek to determine if those living within the country experience a higher rate of head and neck cancers compared to other races. Methods: Data of patients diagnosed with head & neck cancers from 2010-2016 was collected from the National Cancer Database® and compared to race-matched US census data for each corresponding year to calculate incidence. Pairwise comparisons were performed between the incidence for South Asians versus Whites and South Asians versus Blacks using one sided Chi-square tests. Results: South Asians experienced a significantly higher incidence of buccal mucosa/vestibule cancers when compared to Whites or Blacks for every year between 2010-2016, but a comparatively lower incidence of larynx or oropharynx cancers. Conclusions: South Asians residing within the United States have a higher incidence of buccal mucosa/vestibule cancers, but a lower incidence of more common cancers, such as larynx or oropharynx cancer. This may suggest that the etiology behind the high buccal mucosa/vestibule cancer incidence is due to a social habit, as opposed to an inherent racial susceptibility.
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Affiliation(s)
- Stephen J Sozio
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, NJ, USA
| | - Sachin Jhawar
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Yaqun Wang
- Rutgers School of Public Health, Department of Biostatistics and Epidemiology, Piscataway, NJ, USA
| | - Mutlay Sayan
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, NJ, USA
| | - Rahul Parikh
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, NJ, USA
| | - Sung Kim
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, NJ, USA
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Oxidative stress and oral cavity cancer. Cancer 2021. [DOI: 10.1016/b978-0-12-819547-5.00006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bolognesi C, Bruzzone M, Ceppi M, Marcon F. Micronuclei and upper body cancers (head, neck, breast cancers) a systematic review and meta-analysis. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2021; 787:108358. [PMID: 34083052 DOI: 10.1016/j.mrrev.2020.108358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/10/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
Abstract
A systematic review and a meta-analysis were performed on 19 studies on head and neck cancer (HNC) and 21 studies on breast cancer (BC) to evaluate the application of micronucleus (MN) assay as a predictive and prognostic test for cancer risk. In these studies the MN test was applied in peripheral lymphocytes and buccal cells of patients and healthy subjects with family history of cancer. The meta-analysis on MN applied in buccal cells of HNC patients was performed on two subgroups of studies. A significant increase of MN frequency in patients compared to healthy controls was observed for the subgroup on oral cancer (243 cases/370 controls, meta-MR = 4.71 95 %CI:2.75-8.06) and HNC (204 patients/163 controls metaMR=2.28 95 %CI:2.02-2.58). A metaMR = 3.27 (95 %CI:1.41-7.59) was obtained for MN applied in peripheral lymphocytes on HNC (160 cases/160 controls). For BC, the analysis of MN in peripheral lymphocytes showed significantly higher values in patients (n = 761) than in controls (n = 788) (meta-MR1.90 95 % CI:1.44-2.49). No statistically significant increase of baseline MN was detected in studies on groups of healthy subjects with BC family history (n = 224) or with BRCA1/2 mutations (n = 101) with respect to the controls. After ex-vivo challenge with ionizing radiation, the meta-analysis revealed a slightly statistically significant increase in MN only in BC patients (n = 614) compared to controls (n = 622)(meta-MR = 1.11 95 %CI:1.02-1.21); no increase was observed in healthy subjects with BC family history carrying or not BRCA1/2 mutations. Significant difference between BC patients (n = 183) and controls (n = 165) was observed by the meta-analysis of data on MN in buccal cells (MR = 3.89 95 %CI:1.54-9.78). The MN assay in buccal cells has some perspective of clinical application in HNC.
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Affiliation(s)
- Claudia Bolognesi
- Environmental Carcinogenesis Unit, Ospedale Policlinico San Martino, Genoa, Italy.
| | - Marco Bruzzone
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16131 Genoa, Italy
| | - Marcello Ceppi
- Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16131 Genoa, Italy
| | - Francesca Marcon
- Dept. Environment and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Patel R, Shah J, Dudhia B, Patel P. Role of areca nut and smokeless tobacco-related habit in altering physical properties of saliva – A comparative study. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_226_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nath M, Bhattacharjee K, Choudhury Y. Vildagliptin, a dipeptidyl peptidase-4 inhibitor, reduces betel-nut induced carcinogenesis in female mice. Life Sci 2020; 266:118870. [PMID: 33310040 DOI: 10.1016/j.lfs.2020.118870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/11/2020] [Accepted: 12/01/2020] [Indexed: 12/27/2022]
Abstract
AIM Betel-nut, a popular masticatory among Southeast Asian populations is a class I carcinogen, previously associated with dyslipidemia and aberrant lipid metabolism, and is reported to be used more frequently by females, than males. This study investigates the potential of repurposing the anti-diabetic drug, vildagliptin, a dipeptidyl peptidase-4 inhibitor, for alleviating the oncogenic condition in female Swiss Albino mice administered an aqueous extract of betel-nut (AEBN) orally (2 mg ml-1) for 24 weeks. MAIN METHODS Tissues were investigated by histopathological, immunohistochemical and apoptosis assays. Biochemical analyses of oxidative stress markers and lipid profile were performed using different tissues and sera. The expressions of different proteins involved in lipid metabolism and oncogenic pathways were evaluated by Western blotting. KEY FINDINGS AEBN induced carcinogenesis primarily in the liver by significantly impairing AMPK signaling, inducing oxidative stress, activating Akt/mTOR signaling, increasing Ki-67 immunoreactivity and cyclin D1 expression, and significantly diminishing apoptosis. Co-administration of AEBN with vildagliptin (10 mg kg-1 body weight) for 8 weeks reduced liver dysplasia, and significantly decreased free palmitic acid, increased free oleic acid, normalized lipid profile, decreased oxidative stress, cyclin D1 expression, Ki-67 immunoreactivity, and Bcl2 expression, and increased the ratio of apoptotic/non-apoptotic cells. Mechanistically, vildagliptin elicited these physiological and molecular alterations by restoring normal AMPK signaling and reducing the cellular expressions of FASN and HMGCR, restoring AMPK-dependent phosphorylation of p53 at Ser-15 and reducing Akt/mTOR signaling. SIGNIFICANCE These results indicate that vildagliptin may alleviate betel-nut induced carcinogenesis in the liver of female mice.
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Affiliation(s)
- Moumita Nath
- Department of Biotechnology, Assam University, Silchar 788011, Assam, India
| | | | - Yashmin Choudhury
- Department of Biotechnology, Assam University, Silchar 788011, Assam, India.
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Genetic toxicology and toxicokinetics of arecoline and related areca nut compounds: an updated review. Arch Toxicol 2020; 95:375-393. [PMID: 33097969 DOI: 10.1007/s00204-020-02926-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/05/2020] [Indexed: 01/13/2023]
Abstract
Areca nut (AN) is consumed by more than 600 million of individuals, particularly in some regions of South Asia, East Africa, and tropical Pacific, being classified as carcinogenic to humans. The most popular way of exposure consists of chewing a mixture of AN with betel leaf, slaked lime, and other ingredients that may also contain tobacco named betel quid (BQ). Arecoline is the principal active compound of AN, and, therefore, has been systematically studied over the years in several in vitro and in vivo genotoxicity endpoints. However, much of this information is dispersed, justifying the interest of an updated and comprehensive review article on this topic. In this sense, it is thus pertinent to describe and integrate the genetic toxicology data available as well as to address key toxicokinetics aspects of arecoline. This review also provides information on the effects induced by arecoline metabolites and related compounds, including other major AN alkaloids and nitrosation derivatives. The complexity of the chemicals involved renders this issue a challenge in genetic toxicology. Overall, positive results in several endpoints have been reported, some of them suggesting a key role for arecoline metabolites. Nevertheless, some negative genotoxicity findings for this alkaloid in short-term assays have also been reported in the literature. Finally, this article also collates information on the potential mechanisms of arecoline-induced genotoxicity, and suggests further approaches to tackle this important toxicological issue.
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Wang YC, Huang JL, Lee KW, Lu HH, Lin YJ, Chen LF, Wang CS, Cheng YC, Zeng ZT, Chu PY, Lin CS. Downregulation of the DNA Repair Gene DDB2 by Arecoline Is through p53's DNA-Binding Domain and Is Correlated with Poor Outcome of Head and Neck Cancer Patients with Betel Quid Consumption. Cancers (Basel) 2020; 12:cancers12082053. [PMID: 32722430 PMCID: PMC7465463 DOI: 10.3390/cancers12082053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 12/19/2022] Open
Abstract
Arecoline is the principal alkaloid in the areca nut, a component of betel quids (BQs), which are carcinogenic to humans. Epidemiological studies indicate that BQ-chewing contributes to the occurrence of head and neck cancer (HNC). Previously, we have reported that arecoline (0.3 mM) is able to inhibit DNA repair in a p53-dependent pathway, but the underlying mechanism is unclear. Here we demonstrated that arecoline suppressed the expression of DDB2, which is transcriptionally regulated by p53 and is required for nucleotide excision repair (NER). Ectopic expression of DDB2 restored NER activity in arecoline-treated cells, suggesting that DDB2 downregulation was critical for arecoline-mediated NER inhibition. Mechanistically, arecoline inhibited p53-induced DDB2 promoter activity through the DNA-binding but not the transactivation domain of p53. Both NER and DDB2 promoter activities declined in the chronic arecoline-exposed cells, which were consistent with the downregulated DDB2 mRNA in BQ-associated HNC specimens, but not in those of The Cancer Genome Atlas (TCGA) cohort (no BQ exposure). Lower DDB2 mRNA expression was correlated with a poor outcome in HNC patients. These data uncover one of mechanisms underlying arecoline-mediated carcinogenicity through inhibiting p53-regulated DDB2 expression and DNA repair.
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Affiliation(s)
- Yu-Chu Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
| | - Jau-Ling Huang
- Department of Bioscience Technology, College of Health Science, Chang Jung Christian University, Tainan 711, Taiwan; (J.-L.H.); (Y.-C.C.); (Z.-T.Z.)
| | - Ka-Wo Lee
- Department of Otorhinolaryngology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan;
| | - Hsing-Han Lu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
- Department of Bioscience Technology, College of Health Science, Chang Jung Christian University, Tainan 711, Taiwan; (J.-L.H.); (Y.-C.C.); (Z.-T.Z.)
| | - Yuan-Jen Lin
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
| | - Long-Fong Chen
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
- Department of Pathology and Medical Research, Show Chwan Memorial Hospital, Changhua 500, Taiwan;
| | - Chung-Sheng Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
| | - Yun-Chiao Cheng
- Department of Bioscience Technology, College of Health Science, Chang Jung Christian University, Tainan 711, Taiwan; (J.-L.H.); (Y.-C.C.); (Z.-T.Z.)
| | - Zih-Ting Zeng
- Department of Bioscience Technology, College of Health Science, Chang Jung Christian University, Tainan 711, Taiwan; (J.-L.H.); (Y.-C.C.); (Z.-T.Z.)
| | - Pei-Yi Chu
- Department of Pathology and Medical Research, Show Chwan Memorial Hospital, Changhua 500, Taiwan;
| | - Chang-Shen Lin
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-C.W.); (H.-H.L.); (Y.-J.L.); (L.-F.C.); (C.-S.W.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung 804, Taiwan
- Correspondence: or
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Fazil M, Nikhat S. Topical medicines for wound healing: A systematic review of Unani literature with recent advances. JOURNAL OF ETHNOPHARMACOLOGY 2020; 257:112878. [PMID: 32325180 DOI: 10.1016/j.jep.2020.112878] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 03/26/2020] [Accepted: 04/11/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Wound healing is an important area of research in contemporary medicine. Unani is a traditional medicine system based on hundreds of years of observations and experiences. Wounds are described under the headings qarha (arabic) and jarāhat (persian) in classical Unani texts. Several drugs of herbal, mineral and animal origin are described in Unani texts as having wound healing properties. Many of these drugs have been screened on various scientific parameters but the potential of most drugs remains unexplored. METHODOLOGY The study was aimed at summarizing the topical wound healing drugs mentioned in classical Unani books. The topical wound healing drugs were first identified in classical texts. Then 20 drugs were selected for detailed review on the basis of clinical relevance and wide availability. OBSERVATIONS AND RESULTS Seventy drugs were identified in Unani texts after removal of duplicacy. Most of the drugs (85.71%) were of herbal origin, while 10% were of mineral origin and the rest 4.28% were of animal origin. Most of the herbal drugs belonged to the Fabaceae (10%) and Rosaceae (8.33%) families. Biologically active compounds such as phenols, sterols, hydrocarbons, anthocyanidins, flavonoids and tannins have been identified in almost all drugs which support classical literature. CONCLUSION Unani system of medicine has a rich legacy of effective wound healing drugs, which is reinforced by modern researches. Most drugs exert their action on multiple phases of wound healing. In addition, most drugs have no reported adverse effects in laboratory and clinical studies. Hence, Unani medicine may offer the much-needed affordable and effective wound care in a wide range of clinical settings.
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Affiliation(s)
- Mohammad Fazil
- HAK Institute of Literary and Historical Research in Unani Medicine, CCRUM, Jamia Millia Islamia Campus, New Delhi, India.
| | - Sadia Nikhat
- Dept. of Ilaj Bit Tadbeer, School of Unani Medical Education and Research, Jamia Hamdard, New Delhi, India.
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Yang CY, Liu CR, Chang IYF, OuYang CN, Hsieh CH, Huang YL, Wang CI, Jan FW, Wang WL, Tsai TL, Liu H, Tseng CP, Chang YS, Wu CC, Chang KP. Cotargeting CHK1 and PI3K Synergistically Suppresses Tumor Growth of Oral Cavity Squamous Cell Carcinoma in Patient-Derived Xenografts. Cancers (Basel) 2020; 12:cancers12071726. [PMID: 32610557 PMCID: PMC7408003 DOI: 10.3390/cancers12071726] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023] Open
Abstract
Oral cavity squamous cell carcinomas (OSCCs) are aggressive tumors, and their recurrence leads to poor prognosis and reduced survival rates. This study aimed to identify therapeutic targets and to evaluate the efficacy of targeted inhibitors in OSCC patient-derived xenograft (PDX) models. Herein, we reported that OSCC PDXs recapitulated the genomic signatures of their paired primary tumors and the expression of CHEK1, PIK3CA, and PIK3CD was significantly upregulated in OSCC. The antitumor efficacy of CHK1 inhibitors (PF477736, AZD7762, LY2606368) and PI3K inhibitors (BYL719, GDC0941, GSK1059615) was investigated in OSCC cell lines and PDX models. Targeting either CHK1 or PI3K effectively inhibited cell proliferation and colony formation by inducing cell cycle arrest and apoptosis in in vitro cell-based assays. Cisplatin-based chemotherapy combined with CHK1 inhibitor treatment synergistically inhibited cell proliferation by suppressing CHK1 phosphorylation and inducing PARP cleavage. Furthermore, compared with monotherapy, cotreatment with CHK1 and PI3K inhibitors exerted synergistic anticancer effects by suppressing CHK1, AKT, and 4E-BP1 phosphorylation. In summary, our study identified CHK1 and PI3K as promising targets, especially in a dual treatment strategy combining a CHK1 inhibitor with cisplatin or a PI3K inhibitor as a novel therapeutic approach for OSCC patients with aberrant cell cycle regulation and PI3K signaling activation.
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Affiliation(s)
- Chia-Yu Yang
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-Y.Y.); (C.-R.L.); (F.-W.J.); (W.-L.W.); (T.-L.T.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (H.L.); (Y.-S.C.)
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
| | - Chiao-Rou Liu
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-Y.Y.); (C.-R.L.); (F.-W.J.); (W.-L.W.); (T.-L.T.)
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Ian Yi-Feng Chang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
| | - Chun-Nan OuYang
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
| | - Chia-Hsun Hsieh
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yen-Lin Huang
- Department of Pathology, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
| | - Chun-I Wang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
| | - Fei-Wen Jan
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-Y.Y.); (C.-R.L.); (F.-W.J.); (W.-L.W.); (T.-L.T.)
| | - Wan-Ling Wang
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-Y.Y.); (C.-R.L.); (F.-W.J.); (W.-L.W.); (T.-L.T.)
| | - Ting-Lin Tsai
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (C.-Y.Y.); (C.-R.L.); (F.-W.J.); (W.-L.W.); (T.-L.T.)
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (H.L.); (Y.-S.C.)
| | - Hsuan Liu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (H.L.); (Y.-S.C.)
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
- Department of Cell and Molecular Biology, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Ching-Ping Tseng
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan
| | - Yu-Sun Chang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (H.L.); (Y.-S.C.)
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
| | - Chih-Ching Wu
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Correspondence: (C.-C.W.); or (K.-P.C.)
| | - Kai-Ping Chang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan; (I.Y.-F.C.); (C.-N.O.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-C.W.); or (K.-P.C.)
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Glutathione S-transferasesP1 AA (105Ile) allele increases oral cancer risk, interacts strongly with c-Jun Kinase and weakly detoxifies areca-nut metabolites. Sci Rep 2020; 10:6032. [PMID: 32265484 PMCID: PMC7138809 DOI: 10.1038/s41598-020-63034-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 03/19/2020] [Indexed: 11/21/2022] Open
Abstract
The Glutathione S-transferases (GSTs) protects cellular DNA against oxidative damage. The role of GSTP1 polymorphism (A313G; Ile105Val) as a susceptibility factor in oral cancer was evaluated in a hospital-based case-control study in North-East India, because the habit of chewing raw areca-nut (RAN) with/without tobacco is common in this region. Genetic polymorphism was investigated by genotyping 445 cases and 444 controls. Individuals with the GSTP1 AA-genotype showed association with the oral cancer (OR = 3.1, 95% CI = 2.4–4.2, p = 0.0002). Even after adjusting for age, sex and habit the AA-genotype is found to be significantly associated with oral cancer (OR = 2.4, 95% CI = 1.7–3.2, p = 0.0001). A protein-protein docking analysis demonstrated that in the GG-genotype the binding geometry between c-Jun Kinase and GSTP1 was disrupted. It was validated by immunohistochemistry in human samples, showing lower c-Jun-phosphorylation and down-regulation of pro-apoptotic genes in normal oral epithelial cells with the AA-genotype. In silico docking revealed that AA-genotype weakly detoxifies the RAN/tobacco metabolites. In addition, experiments revealed a higher level of 8-Oxo-2′-deoxyguanosine induction in tumor samples with the AA-genotype. Thus, habit of using RAN/tobacco and GSTP1 AA-genotype together play a significant role in predisposition to oral cancer risk by showing higher DNA-lesions and lower c-Jun phosphorylation that may inhibit apoptosis.
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Al-Tayar BA, Ahmad A, Yusoff ME, Abdullah SF, Mohamad NK, Md Hashim SN, Kishida S, Kishida M, Nakamura N, Kibe T, Harun MH. Cytotoxic Effects of Betel Quid and Areca Nut Aqueous Extracts on Mouse Fibroblast, Human Mouth-Ordinary-Epithelium 1 and Human Oral Squamous Cell Carcinoma Cell Lines. Asian Pac J Cancer Prev 2020; 21:1005-1009. [PMID: 32334462 PMCID: PMC7445995 DOI: 10.31557/apjcp.2020.21.4.1005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Betel quid chewing is more common among the older generation in rural areas of Malaysia. Oral cancer in Asia has been associated with the habit of chewing betel quid and areca nut. Objective: This study aims to investigate the cytotoxic effects of betel quid and areca nut extracts on the fibroblast (L929), mouth-ordinary-epithelium 1 (MOE1) and oral squamous cell carcinoma (HSC-2) cell lines. Methods: L929, MOE1 and HSC-2 cells were treated with 0.1, 0.2 and 0.4 g/ml of betel quid and areca nut extracts for 24, 48 and 72 h. MTT assay was performed to assess the cell viability. Results: Both extracts, regardless of concentration, significantly reduced the cell viability of L929 compared with the control (P<0.05). Cell viability of MOE1 was significantly enhanced by all betel quid concentrations compared with the control (P<0.05). By contrast, 0.4 g/ml of areca nut extract significantly reduced the cell viability of MOE1 at 48 and 72 h of incubation. Cell viability of HSC-2 was significantly lowered by all areca nut extracts, but 0.4 g/ml of betel quid significantly increased the cell viability of HSC-2 (P<0.05). Conclusion: Areca nut extract is cytotoxic to L929 and HSC-2, whereas the lower concentrations of areca nut extract significantly increased the cell viability of MOE1 compared to the higher concentration and control group. Although betel quid extract is cytotoxic to L929, the same effect is not observed in MOE1 and HSC-2 cell lines. Further investigations are needed to clarify the mechanism of action.
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Affiliation(s)
- Badr Abdullah Al-Tayar
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Azlina Ahmad
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Mohamad Ezany Yusoff
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Siti Fadilah Abdullah
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Noor Khairiena Mohamad
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Siti Nurnasihah Md Hashim
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Shosei Kishida
- Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Japan
| | - Michiko Kishida
- Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Japan
| | - Norifumi Nakamura
- Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Japan
| | - Toshiro Kibe
- Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Japan
| | - Masitah Hayati Harun
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
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Discoidin Domain Receptor-1 (DDR1) is Involved in Angiolymphatic Invasion in Oral Cancer. Cancers (Basel) 2020; 12:cancers12040841. [PMID: 32244515 PMCID: PMC7226486 DOI: 10.3390/cancers12040841] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022] Open
Abstract
The discoidin domain receptor-1 (DDR1) is a non-integrin collagen receptor recently implicated in the collective cell migration of other cancer types. Previously, we identified an elevated expression of DDR1 in oral squamous cell carcinoma (OSCC) cells. Through the data mining of a microarray dataset composed of matched tumor-normal tissues from forty OSCC patients, we distilled overexpressed genes statistically associated with angiolymphatic invasion, including DDR1, COL4A5, COL4A6 and PDPN. Dual immunohistochemical staining further confirmed the spatial locations of DDR1 and PDPN in OSCC tissues indicative of collective cancer cell invasion. An elevated DDR1 expression at both the transcription and protein level was observed by treating keratinocytes with collagen of fibrillar or basement membrane types. In addition, inhibition of DDR1 kinase activity in OSCC TW2.6 cells disrupted cell cohesiveness in a 2D culture, reduced spheroid invasion in a collagen gel matrix, and suppressed angiolymphatic invasion in xenograft tissues. Taken together, these results suggest that collagen deposition in the affected tissues followed by DDR1 overexpression could be central to OSCC tumor growth and angiolymphatic invasion. Thus, DDR1 inhibitors are potential therapeutic compounds in restraining oral cancer, which has not been previously explored.
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Sharan RN, Chanu TM, Chakrabarty TK, Farsalinos K. Patterns of tobacco and e-cigarette use status in India: a cross-sectional survey of 3000 vapers in eight Indian cities. Harm Reduct J 2020; 17:21. [PMID: 32228623 PMCID: PMC7106589 DOI: 10.1186/s12954-020-00362-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 03/13/2020] [Indexed: 01/04/2023] Open
Abstract
Background Tobacco smoking is one of the biggest and avoidable public health threats in the world, especially in low- and middle-income countries. India represents a highly complex public health environment due to the large number of smokers and complexities arising from tobacco use in different forms, including a variety of smokeless tobacco (SLT) products. Electronic cigarettes, an alternative nicotine delivery system with significantly less harmful emissions than smoke, could be an option for those who are unable to achieve smoking abstinence using other available means. This study, which we believe is the first of this kind in India, was conducted to obtain data on the characteristics and tobacco use profile of e-cigarette users (vapers) in India. Methods An interview-based survey was performed in the 8 largest metropolitan cities in India using a convenience sampling approach involving a total of 3000 subjects. Inclusion criteria were being a current e-cigarette user and aged 18 years or more. Interviewers were asked to continue recruitment until a total sample of 375 was reached in each target city. Results A total of 3000 vapers (81.4% males and 18.6% females, median age 29 years) participated to the study. The majority (80%) were first exposed to nicotine via tobacco smoking, SLT use, or both. Most of the subjects (79%) believed that e-cigarettes were less harmful than smoking. The vast majority of smokers (71.3%) reported smoking cessation (30.0%) or reduction in consumption (41.3%) with the help of e-cigarettes. Similar changes were observed in SLT users. Participants reported minimal side effects and some health benefits after e-cigarette use initiation. Conclusion Indian vapers who participated to this study were predominantly smokers and SLT users before e-cigarette use initiation, with the majority subsequently quitting or reducing tobacco use. Minimal side effects of e-cigarette were experienced, while some health benefits were also reported.
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Affiliation(s)
- Rajeshwar Nath Sharan
- Radiation & Molecular Biology Unit, Department of Biochemistry, North-Eastern Hill University, Shillong, 793022, India.
| | - Tongbram Malemnganbi Chanu
- Radiation & Molecular Biology Unit, Department of Biochemistry, North-Eastern Hill University, Shillong, 793022, India
| | | | - Konstantinos Farsalinos
- Department of Cardiology, Onassis Cardiac Surgery Center, Sygrou 356, 17674, Kallithea, Greece.,Center of Excellence in Trauma and Accidents, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pharmacy, University of Patras, 26500, Rio, Greece
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45
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Salehi B, Konovalov DA, Fru P, Kapewangolo P, Peron G, Ksenija MS, Cardoso SM, Pereira OR, Nigam M, Nicola S, Pignata G, Rapposelli S, Sestito S, Anil Kumar NV, de la Luz Cádiz-Gurrea M, Segura-Carretero A, P Mishra A, Sharifi-Rad M, Cho WC, Taheri Y, Setzer WN, Sharifi-Rad J. Areca catechu-From farm to food and biomedical applications. Phytother Res 2020; 34:2140-2158. [PMID: 32159263 DOI: 10.1002/ptr.6665] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 01/29/2023]
Abstract
The family Arecaceae includes 181 genera and 2,600 species with a high diversity in physical characteristics. Areca plants, commonly palms, which are able to grow in nearly every type of habitat, prefer tropical and subtropical climates. The most studied species Areca catechu L. contains phytochemicals as phenolics and alkaloids with biological properties. The phenolics are mainly distributed in roots followed by fresh unripe fruits, leaves, spikes, and veins, while the contents of alkaloids are in the order of roots, fresh unripe fruits, spikes, leaves, and veins. This species has been reputed to provide health effects on the cardiovascular, respiratory, nervous, metabolic, gastrointestinal, and reproductive systems. However, in many developing countries, quid from this species has been associated with side effects, which include the destruction of the teeth, impairment of oral hygiene, bronchial asthma, or oral cancer. Despite these side effects, which are also mentioned in this work, the present review collects the main results of biological properties of the phytochemicals in A. catechu. This study emphasizes the in vitro and in vivo antioxidant, antimicrobial, anticancer, and clinical effectiveness in humans. In this sense, A. catechu have demonstrated effectiveness in several reports through in vitro and in vivo experiments on disorders such as antimicrobial, antioxidant, or anticancer. Moreover, our findings demonstrate that this species presents clinical effectiveness on neurological disorders. Hence, A. catechu extracts could be used as a bioactive ingredient for functional food, nutraceuticals, or cosmeceuticals. However, further studies, especially extensive and comprehensive clinical trials, are recommended for the use of Areca in the treatment of diseases.
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Affiliation(s)
- Bahare Salehi
- Student Research Committee, School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Dmitry A Konovalov
- Department of Pharmacognozy and Botany, Pyatigorsk Medical and Pharmaceutical Institute, A branch of Volgograd State Medical University Ministry of Health of the Russian Federation, Pyatigorsk, Russia
| | - Pascaline Fru
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Petrina Kapewangolo
- Department of Chemistry and Biochemistry, University of Namibia, Windhoek, Namibia
| | - Gregorio Peron
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Mileski S Ksenija
- Department of Morphology and Systematic of Plants, Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Susana M Cardoso
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, Aveiro, Portugal
| | - Olivia R Pereira
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Bragança, Portugal
| | - Manisha Nigam
- Department of Biochemistry, H. N. B. Garhwal (A Central) University, Srinagar Garhwal, India
| | - Silvana Nicola
- Department of Agricultural, Forest and Food Sciences, University of Turin, Turin, Italy
| | - Giuseppe Pignata
- Department of Agricultural, Forest and Food Sciences, University of Turin, Turin, Italy
| | - Simona Rapposelli
- Department of Pharmacy, University of Pisa, Pisa, Italy.,Interdepartmental Research Centre for Biology and Pathology of Aging, University of Pisa, Pisa, Italy
| | | | - Nanjangud V Anil Kumar
- Department of Chemistry, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - María de la Luz Cádiz-Gurrea
- Department of Analytical Chemistry, Faculty of Sciences, University of Granada, Granada, Spain.,Research and Development Functional Food Centre (CIDAF), Bioregión Building, Health Science Technological Park, Granada, Spain
| | - Antonio Segura-Carretero
- Department of Analytical Chemistry, Faculty of Sciences, University of Granada, Granada, Spain.,Research and Development Functional Food Centre (CIDAF), Bioregión Building, Health Science Technological Park, Granada, Spain
| | - Abhay P Mishra
- Department of Pharmaceutical Chemistry, H. N. B. Garhwal (A Central) University, Srinagar Garhwal, India
| | - Mehdi Sharifi-Rad
- Department of Medical Parasitology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - William C Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Yasaman Taheri
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Pharmacology and Toxicology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - William N Setzer
- Department of Chemistry, University of Alabama in Huntsville, Huntsville, Alabama, USA.,Aromatic Plant Research Center, Lehi, Utah, USA
| | - Javad Sharifi-Rad
- Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran
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Paulino YC, Wilkens LR, Sotto PP, Franke AA, Kawamoto CT, Chennaux JSN, Mendez AJ, Tenorio LF, Badowski G, Pokhrel P, Herzog TA. Rationale and design of a randomized, controlled, superiority trial on areca nut/betel quid cessation: The Betel Nut Intervention Trial (BENIT). Contemp Clin Trials Commun 2020; 17:100544. [PMID: 32154430 PMCID: PMC7052403 DOI: 10.1016/j.conctc.2020.100544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 01/28/2020] [Accepted: 02/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background Areca nut (AN) is the seed endosperm of the Areca catechu L. palm and a Group 1 carcinogen chewed by 10–20% of the world population. AN is often chewed with Piper betle L. leaf, slaked lime, and tobacco to form a betel quid (BQ). The negative health effects associated with AN/BQ consumption warrant the need for an evidence-based cessation program. However, systematic research on AN/BQ cessation is rare. Methods/design The Betel Nut Intervention Trial (BENIT; trial #NCT02942745) is a randomized controlled trial designed to test the efficacy of an intensive AN/BQ cessation program. The trial is ongoing in Guam and Saipan with adult chewers who include tobacco in their BQ. Enrolled participants are assessed for their primary (chewing status) and secondary (saliva bio-verification) outcome at baseline, 22 days, and 6 months. Participants randomized into the control arm receive an educational booklet while those randomized into the intervention arm receive the educational booklet and a 22-day cessation program modeled after a smoking cessation program and led by trained facilitators. Information on chewing behavior (history, reasons for chewing, and AN/BQ composition and dependency) are collected. The intervention effectiveness is assessed using the logistic mixed model to compare cessation status between randomization groups. Discussion AN/BQ chewing affects a large population of people, many of whom live in low and moderate income countries in the Asia-Pacific region. Although the BENIT focuses on chewers in Guam and Saipan, it has the potential for greater regional and global importance.
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Affiliation(s)
- Yvette C Paulino
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Lynne R Wilkens
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Patrick P Sotto
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Adrian A Franke
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Crissy T Kawamoto
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Jade S N Chennaux
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Ana Joy Mendez
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Lynnette F Tenorio
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Grazyna Badowski
- University of Guam Cancer Research Center, University Dr, House 7, Dean's Circle UOG Station, Mangilao, GU, 96923, USA
| | - Pallav Pokhrel
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Thaddeus A Herzog
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
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Sotto PP, Mendez AJ, Herzog TA, Cruz C, Chennaux JSN, Legdesog C, Paulino YC. Barriers to Quitting Areca Nut Consumption and Joining a Cessation Program as Perceived by Chewer and Nonchewer Populations in Guam. Subst Use Misuse 2020; 55:947-953. [PMID: 31973623 PMCID: PMC7750034 DOI: 10.1080/10826084.2020.1716012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Areca nut (AN) is a carcinogenic substance consumed by roughly 600 million individuals worldwide with increasing popularity in Guam. In response, a cessation program was developed and implemented in Guam and Saipan. However, to improve its delivery, it is necessary to understand the reasons influencing recruitment and participation, such as why a chewer may not want to quit or join a cessation program. Objective: To explore barriers inhibiting chewers from quitting AN chewing and from participating in a cessation program. Methods: Nine individual and group discussions were facilitated with a convenience sample of 17 chewers and nonchewers in Guam in 2017. The mean age of the participants was 36.4 years. Recurring themes relating to reasons for not quitting and not joining a cessation program were extracted. Results: Results produced three general categories-Sociocultural, Behavioral, and Accessible. Each category encompasses different attributes concerning reasons not to quit chewing (e.g. addiction, enabling community, or belief that AN is harmless), and reasons influencing lack of participation in a cessation program (e.g. time, transportation, or relatability). Conclusions: Current findings suggest chewers are unaware of the harmful effects of AN. Also, they may not comprehend the purpose of a cessation program. In addition, the likelihood of chewers participating in a cessation program is influenced by their level of comfort with the program and personnel, and whether a program addresses their time and transportation limitations.
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Affiliation(s)
- Patrick P Sotto
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
| | - Ana J Mendez
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
| | - Thaddeus A Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
| | - Casierra Cruz
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
| | - Jade S N Chennaux
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
| | - Chandra Legdesog
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
| | - Yvette C Paulino
- Cancer Research Center, Research Corporation of the University of Guam, Mangilao, Guam, USA
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Hung CC, Lee CH, Chung CM, Nithiyanantham S, Lane HY, Ko YC. Antidepressant-induced reduction in betel-quid use in patients with depression: A pioneer clinical study. Medicine (Baltimore) 2020; 99:e18672. [PMID: 31895834 PMCID: PMC6946344 DOI: 10.1097/md.0000000000018672] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/17/2019] [Accepted: 12/08/2019] [Indexed: 12/20/2022] Open
Abstract
Betel-quid is commonly used around the world and is listed as a Group I carcinogen. Prior research has suggested a possible association between antidepressants and betel-quid use. We aimed to clarify the effects of antidepressant therapy in betel-quid chewers in the population of patients with depression.We enrolled 204 patients with depressive disorders, collected their demographic information, and administered the Substance Use Severity Rating Scale for alcohol, cigarettes, and betel-quid and the Hamilton Depression Rating Scale. We compared betel-quid and non-betel-quid chewers and examined the effects of antidepressant therapy on betel-quid abstinence after previous exposure to betel-quid.Patients with depression were reported a higher prevalence of 26% betel-quid chewing habits and patients who chewed betel-quid showed more severe depressive symptoms. After antidepressant therapy, the addictiveness of betel-quid was significantly reduced by 4 times.This was a pioneering study showing that antidepressants could be a candidate for betel-quid cessation therapy. Future clinical trials are needed to verify their efficacy in reducing consumption for betel-quid addiction treatment.
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Affiliation(s)
- Chung-Chieh Hung
- Graduate Institute of Clinical Medical Science, China Medical University
- Department of Psychiatry, China Medical University Hospital, Taichung
| | - Chien-Hung Lee
- Department of Public Health, Environmental Medicine Research Center, College of Health Sciences, Kaohsiung Medical University, Kaohsiung
| | - Chia-Min Chung
- Graduate Institute of Clinical Medical Science, China Medical University
- Environment-Omics-Disease Research Center, China Medical University Hospital, China Medical University
| | - Srinivasan Nithiyanantham
- Environment-Omics-Disease Research Center, China Medical University Hospital, China Medical University
| | - Hsien-Yuan Lane
- Graduate Institute of Clinical Medical Science, China Medical University
- Department of Psychiatry, China Medical University Hospital, Taichung
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Ying-Chin Ko
- Graduate Institute of Clinical Medical Science, China Medical University
- Environment-Omics-Disease Research Center, China Medical University Hospital, China Medical University
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49
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Papke RL, Bhattacharyya I, Hatsukami DK, Moe I, Glatman S. Betel Nut (areca) and Smokeless Tobacco Use in Myanmar. Subst Use Misuse 2020; 55:1385-1394. [PMID: 31220988 PMCID: PMC7774082 DOI: 10.1080/10826084.2019.1624774] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Betel nut (areca) is the world's fourth most commonly used addictive substance. Arecoline, a muscarinic agonist in areca, is also a partial agonist for the addiction-related high-affinity brain nicotine receptors. In many countries, smokeless tobacco is commonly mixed with areca. Objective: We sought to evaluate the knowledge of self-harm, and addiction associated betel quid use in an unban population. Methods: We conducted a survey study of 200 betel quid users in Yangon, Myanmar, and a survey of betel quid vendors to determine the relative amounts of areca and tobacco in the available quids. Results: The data determined that a large majority of the survey subjects (84%) used tobacco with their areca. Users had a general awareness that betel chewing was "a bad habit" (85%) and 80% were aware of the cancer risks. Understanding areca addiction remains a challenge since, aside from the strong muscarinic activity of arecoline stimulating salivation, overt neurologic effects are difficult for even the users to identify. Fifty eight percent of the respondents indicated that chewing betel quid had effects like drinking coffee, and 55.5% indicated that it had effects like drinking alcohol. Data obtained from the quid vendors indicated that 75% added tobacco in equal amounts to areca. Conclusion: The concomitant use of nicotine and areca indicates that betel quid addiction includes a significant component of nicotine dependence. However, the additional activities of areca, including the muscarinic effects of arecoline, indicate that potential cessation therapies should optimally address other factors as well.
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Affiliation(s)
- Roger L Papke
- Department of Pharmacology and Therapeutics, University of Florida, College of Medicine, Gainesville, Florida, USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, College of Dentistry, Gainesville, Florida, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and the Masonic Cancer Center, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ingyin Moe
- Ko Shwe Ventures Pte. Ltd, Yangon, Myanmar
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50
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Pidugu VK, Pidugu HB, Wu MM, Liu CJ, Lee TC. Emerging Functions of Human IFIT Proteins in Cancer. Front Mol Biosci 2019; 6:148. [PMID: 31921891 PMCID: PMC6930875 DOI: 10.3389/fmolb.2019.00148] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022] Open
Abstract
Interferon-induced protein with tetratricopeptide repeats (IFIT) genes are prominent interferon-stimulated genes (ISGs). The human IFIT gene family consists of four genes named IFIT1, IFIT2, IFIT3, and IFIT5. The expression of IFIT genes is very low in most cell types, whereas their expression is greatly enhanced by interferon treatment, viral infection, and pathogen-associated molecular patterns (PAMPs). The proteins encoded by IFIT genes have multiple tetratricopeptide repeat (TPR) motifs. IFIT proteins do not have any known enzymatic roles. However, they execute a variety of cellular functions by mediating protein-protein interactions and forming multiprotein complexes with cellular and viral proteins through their multiple TPR motifs. The versatile tertiary structure of TPR motifs in IFIT proteins enables them to be involved in distinct biological functions, including host innate immunity, antiviral immune response, virus-induced translation initiation, replication, double-stranded RNA signaling, and PAMP recognition. The current understanding of the IFIT proteins and their role in cellular signaling mechanisms is limited to the antiviral immune response and innate immunity. However, recent studies on IFIT protein functions and their involvement in various molecular signaling mechanisms have implicated them in cancer progression and metastasis. In this article, we focused on critical molecular, biological and oncogenic functions of human IFIT proteins by reviewing their prognostic significance in health and cancer. Research suggests that IFIT proteins could be novel therapeutic targets for cancer therapy.
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Affiliation(s)
| | | | - Meei-Maan Wu
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chung-Ji Liu
- Department of Oral and Maxillofacial Surgery, Mackay Memorial Hospital, Taipei, Taiwan
| | - Te-Chang Lee
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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