Estimation and correlative study of salivary nitrate and nitrite in tobacco related oral squamous carcinoma and submucous fibrosis

Development of an AI-derived, non-invasive, label-free 3D-printed microfluidic SERS biosensor platform utilizing Cu@Ag/carbon nanofibers for the detection of salivary biomarkers in mass screening of oral cancer

Developing a non-invasive and reliable tool for the highly sensitive detection of oral cancer is essential for its mass screening and early diagnosis, and improving treatment efficacy. Herein, we utilized a label-free surface enhanced Raman spectroscopy (SERS)-based biosensor composed of Cu@Ag core-shell nanoparticle anchored carbon nanofibers (Cu@Ag/CNFs) for highly sensitive salivary biomarker detection in oral cancer mass screening. This SERS substrate provided a Raman signal enhancement of up to 107 and a detection limit as low as 10-12 M for rhodamine 6G molecules. Finite-difference time-domain (FDTD) simulation studies on Cu@Ag/CNFs indicated an E-field intensity enhancement factor (|E|2/|E0|2) of 250 at the plasmonic hotspot induced between two adjacent Cu@Ag nanoparticles. The interaction of this strong E-field along with the chemical enhancement effects was responsible for such huge enhancement in the Raman signals. To realize the real capability of the developed biosensor in practical scenarios, it was further utilized for the detection of oral cancer biomarkers such as nitrate, nitrite, thiocyanate, proteins, and amino acids with a micro-molar concentration in saliva samples. The integration of SERS substrates with a 3D-printed 12-channel microfluidic platform significantly enhanced the reproducibility and statistical robustness of the analytical process. Moreover, AI-driven techniques were employed to improve the diagnostic accuracy in differentiating the salivary profiles of oral cancer patients (n1 = 56) from those of healthy controls (n2 = 60). Principal component analysis (PCA) was utilized for dimensionality reduction, followed by classification using a random forest (RF) algorithm, yielding a robust classification accuracy of 87.5%, with a specificity of 92% and sensitivity of 88%. These experimental and theoretical findings emphasize the real-world functionality of the present non-invasive diagnostic tool in paving the way for more accurate and early-stage detection of oral cancer in clinical settings.

Ag nanoisland functionalized hollow carbon nanofibers as a non-invasive, label-free SERS salivary biosensor platform for salivary nitrite detection for pre-diagnosis of oral cancer

A highly selective, label-free, surface-enhanced Raman spectroscopy (SERS) based sensor platform employing hollow carbon nanofibers functionalized with silver nanoparticles (Ag@HCNFs) has been developed to monitor anomalous concentrations of potential biomarkers, such as salivary nitrite facilitating pre-diagnosis of oral cancer. Co-axial electrospinning was used for the fabrication of the nanofibrous Ag@HCNFs followed by thermal treatment of PAN/PVP core-shell nanofibers and chemical reduction of silver nanoislands. The developed plasmonic Ag@HCNFs was structurally and morphologically characterized using X-Ray diffraction, Raman spectroscopy, scanning electron microscopy, and transmission electron microscopy, which clearly demonstrated the successful anchoring of silver nanoparticles on hollow carbon nanofibers. The properties of Ag@HCNFs showed significant SERS enhancement of the order of 107 with a detection limit of 10-11 M with R6G, demonstrating its efficacy to investigate real-time salivary samples, particularly towards the detection of salivary nitrite within the clinically relevant range (50 μM-300 μM) towards the pre-diagnosis of oral cancer. The proposed SERS-based salivary platform has the potential to be used as a low-cost, non-invasive pre-diagnostic tool for early diagnosis and mass screening of oral cancer.

Betel Quid Health Risks of Insulin Resistance Diseases in Poor Young South Asian Native and Immigrant Populations

Betel quid, traditionally prepared with areca nut, betel leaf, and slaked lime, has been consumed for thousands of years, mainly in the form of chewing. Originally used for cultural, medicinal, and ceremonial purposes mainly in South Asian countries, its use has recently spread across the globe due to its psychoactive, euphoric, and aphrodisiac properties. Now it is widely used as a social lubricant and source of financial profit. Unfortunately, the profit motive has led to high rates of habitual consumption with eventual conversion to addiction among young girls and boys. Moreover, the worrisome practice of including tobacco in quid preparations has grown, particularly among pregnant women. Major health concerns include increased rates of malignancy, oral pathology, and cardiovascular, hepatic, fertility, metabolic, and neuropsychiatric disorders. Metabolic disorders and insulin resistance disease states such as type 2 diabetes, obesity, and metabolic syndrome contribute to cognitive decline and neurodegeneration. Mechanistically, the constituents of areca nut/betel quid are metabolized to N-nitroso compounds, i.e., nitrosamines, which are carcinogenic at high doses and cause insulin resistance following chronic low-level exposures. From an epidemiological perspective, the rising tide of insulin resistance diseases including obesity, diabetes, and dementias that now disproportionately burden poor countries has been propagated by rapid commercialization and enhanced access to betel quid. Public health measures are needed to impose socially and ethically responsible barriers to yet another cause of global health disparity.

3D Microfluidic Devices in a Single Piece of Paper for the Simultaneous Determination of Nitrite and Thiocyanate

The concentrations of nitrite and thiocyanate in saliva can be used as the biomarkers of the progression of periodontitis disease and environmental tobacco smoke exposure, respectively. Therefore, it is particularly necessary to detect these two indicators in saliva. Herein, the three-dimensional single-layered paper-based microfluidic analytical devices (3D sl-μPADs) were, for the first time, fabricated by the spraying technique for the colorimetric detection of nitrite and thiocyanate at the same time. The conditions for 3D sl-μPADs fabrication were optimized in order to well control the penetration depth of the lacquer in a paper substrate. Then, the developed 3D sl-μPADs were utilized to simultaneously detect nitrite and thiocyanate and the limits of detection are 0.0096 and 0.074 mM, respectively. What is more, the μPADs exhibited good specificity, good repeatability, and acceptable recoveries in artificial saliva. Therefore, the developed 3D sl-μPADs show a great potential to determine nitrite and thiocyanate for the assessment of the human health.

Comparative Evaluation of Saliva's Oxidant-Antioxidant Status in Patients with Different Clinicopathological Types of Oral Leukoplakia

Objectives

Despite advancements in the management of oral cancer, the mortality rate associated with it still remains a matter of concern. Early identification and intervention of precursor lesions such as leukoplakia have always been emphasized, as this can drastically improve the scenario. The oxidative stress has been implicated in the pathogenesis of several diseases, including oral cancer. The aim of this study was to evaluate salivary oxidant and antioxidant levels in patients with different clinicopathological stages of oral leukoplakia.

Materials and Methods

An analytical study with case-control study design was conducted. Forty newly diagnosed cases of oral leukoplakia were considered in the case group. The equal number of age- and gender-matched subjects was included in the control study group. Unstimulated whole-saliva supernatant was used to determine the levels of lipid peroxidation, glutathione S-transferase, nitrites, and uric acid using ultraviolet visible spectrophotometer. The statistical comparisons were performed by independent Student's unpaired t test and one-way analysis of variance with post hoc analysis. Correlation analysis was performed among salivary parameters and with baseline variables.

Results

End products of free radical damage and nitrite levels were significantly increased in patients with oral leukoplakia compared to controls. Conversely, levels of glutathione S-transferase and uric acid were significantly decreased in the study group in comparison with healthy subjects. Similar trends were seen along the clinical stages and histopathological grades of leukoplakia.

Conclusion

Elevated levels of reactive species with a concomitant reduction in antioxidants in leukoplakia indicate its potential as an early diagnostic marker.

T-shirt ink for one-step screen-printing of hydrophobic barriers for 2D- and 3D-microfluidic paper-based analytical devices

This work presents the use of polyvinyl chloride (PVC) fabric ink, commonly employed for screening t-shirts, as new and versatile material for printing hydrophobic barrier on paper substrate for microfluidic paper-based analytical devices (μPADs). Low-cost, screen-printing apparatus (e.g., screen mesh, squeegee, and printing table) and materials (e.g. PVC ink and solvent) were employed to print the PVC ink solution onto Whatman filter paper No. 4. This provides a one-step strategy to print flow barriers without the need of further processing except evaporation for 3-5 min in a fume hood to remove the solvent. The production of the single layer μPADs is reasonably high with up to 77 devices per screening with 100% success rate. This method produces very narrow fluidic channel 486 ± 14 μm in width and hydrophobic barrier of 642 ± 25 μm thickness. Reproducibility of the production of fluidic channels and zones is satisfactory with RSDs of 2.9% (for 486-μm channel, n = 10), 3.7% (for 2-mm channel, n = 50) and 1.5% (for 6-mm diameter circular zone, n = 80). A design of a 2D-μPAD produced by this method was employed for the colorimetric dual-measurements of thiocyanate and nitrite in saliva. A 3D-μPADs with multiple layers of ink-screened paper was designed and constructed to demonstrate the method's versatility. These 3D-μPADs were designed for gas-liquid separation with in-situ colorimetric detection of ethanol vapor on the μPADs. The 3D-μPADs were applied for direct quantification of ethanol in beverages and highly colored pharmaceutical products. The printed barrier was resistant up to 8% (v/v) ethanol without liquid creeping out of the barrier.

Repeated exposure to whole cigarette smoke promotes primary human gingival epithelial cell growth and modulates keratin expression

BACKGROUND AND OBJECTIVE

The gingiva is the first oral tissue directly exposed to cigarette smoke (CS). Exposure to CS compromises the structure and function of gingival tissue. Damaging or altering the gingival epithelium leads to a compromised protective barrier of the periodontium, resulting in several diseases. The aim of this study was to assess the effect of repeated exposure to CS on gingival epithelial cell growth and on expression of apoptotic protein and keratin.

MATERIAL AND METHODS

Primary human gingival epithelial cells were seeded on a collagen scaffold for 5 d to allow growth and stratification. The cells were then exposed for 5 min to whole CS for 3, 6 and 9 d. At the end of each exposure period, cell proliferation [using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) (MTT) and 5-bromo-2'-deoxyuridine (BrdU) assays], gene expression [by quantitative reverse transcription polymerase chain reaction (qRT-PCR)] and protein production (by western blot analysis) were investigated.

RESULTS

Higher metabolic activity was found in the CS-exposed cells than in the nonexposed cells, specifically after 3 and 6 d of exposure to CS. At 9 d there was no significant difference between CS-exposed and nonexposed cells. Metabolic activity was supported by the BrdU cell-proliferation analyses, which showed increased cell growth at 3 d compared with the control. However, at 6 and 9 d, cell proliferation in the CS-exposed culture was comparable to that in the nonexposed culture. Interestingly, the Bax/Bcl-2 protein ratios decreased with increased CS exposure, suggesting cell resistance. Moreover, protein analyses showed that CS decreased expression of keratin(K) 5 at 3, 6 and 9 d, and increased expression of K14 at 6 and 9 d. Finally, mRNA analyses showed significant decreases of K1, K6, K10 and K16 in CS-exposed cultures, correlating, at times, with a decrease of protein production.

CONCLUSION

CS was shown to increase epithelial cell proliferation, which may involve cell resistance to apoptosis. This is supported by the modulation of expression of different keratin genes and proteins. Altogether, these data may explain the hyperplasia reported in gingival tissue, as well as periodontal disease, in smokers.