Betel nut chewing during pregnancy, Madang province, Papua New Guinea

Senn, Michèle; Baiwog, Francesca; Winmai, Josephine; Müeller, Ivo; Rogerson, Stephen J.; Senn, Nicolas

doi:10.1016/j.drugalcdep.2009.06.021

Cited by 74 publications

(78 citation statements)

References 39 publications

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“…Epidemiological evidence suggests that female areca nut chewers are likely to continue the chewing habit during pregnancy and breastfeeding (Senn et al, 2009), and children under the influence of Southeast Asian cultures may start areca quid (AQ) chewing before the age of 10 (Farrand et al, 2001;Senn et al, 2009;Shah et al, 2002). Clinical findings have linked AQ chewing and the deregulation of T-cell-mediated immune responses in AQ chewers and oral cancer patients (Changrani & Gany, 2005;Haque et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Impairment of thymocyte function via induction of apoptosis by areca nut extract

Lee

Lin

Liu

et al. 2013

Journal of Immunotoxicology

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Areca quid (AQ) chewing is a popular oral habit, especially in Southeast Asia cultures, in which children may be engaged in the addictive habit early in their lives. Extracts of areca nuts, the main component of AQ, have been shown to affect the functionality of T-cells. However, the potential influence of ANE on the development of T-cells is unknown. This study, therefore, investigated the impact of areca nut extracts (ANE) on thymocytes and the potential mechanisms of action. Mice administered intraperitoneally with ANE at 1, 5, or 25 mg/kg daily for 5 days showed significant dose-dependent reductions in thymocyte viability. A marked decrease in the total number of thymocytes and the proportion of thymic CD4 þ CD8þ cells was observed in the 25 mg ANE/kg-treated mice, whereas the proportion of CD4 and CD8 single positive and CD4À CD8 À cells was significantly increased. Further examination on the functionality of thymocytes showed that ANE suppress IL-2 production both ex vivo and in vitro. These results suggest that ANE may attenuate the development and functionality of thymic T-cells. ANE also directly induced apoptosis in thymic T-cells through activation of casapase-3 and apoptosis inducing factor (AIF). Collectively, the data suggested that the thymus is a sensitive target to ANE. Early exposure to ANE may interfere with the development and functionality of thymic T-cells.

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Section: Discussionmentioning

confidence: 99%

Impairment of thymocyte function via induction of apoptosis by areca nut extract

Lee

Lin

Liu

et al. 2013

Journal of Immunotoxicology

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“…In rural coastal Papua New Guinea (PNG), both P. falciparum and P. vivax infection are endemic [20], and malaria is an important risk factor for LBW [21], together with maternal betel (areca) nut consumption [22], macronutrient undernutrition [23], and tobacco smoking [24]. Here, macronutrient undernutrition and anaemia were observed to be key risk factors for measuring SGA and for poor fetal weight gain [25].…”

Section: Introductionmentioning

confidence: 99%

Effects of Plasmodium falciparum infection on umbilical artery resistance and intrafetal blood flow distribution: a Doppler ultrasound study from Papua New Guinea

Ome-Kaius

Karl

Wangnapi

et al. 2017

Malar J

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BackgroundDoppler velocimetry studies of umbilical artery (UA) and middle cerebral artery (MCA) flow help to determine the presence and severity of fetal growth restriction. Increased UA resistance and reduced MCA pulsatility may indicate increased placental resistance and intrafetal blood flow redistribution. Malaria causes low birth weight and fetal growth restriction, but few studies have assessed its effects on uteroplacental and fetoplacental blood flow.MethodsColour-pulsed Doppler ultrasound was used to assess UA and MCA flow in 396 Papua New Guinean singleton fetuses. Abnormal flow was defined as an UA resistance index above the 90th centile, and/or a MCA pulsatility index and cerebroplacental ratio (ratio of MCA and UA pulsatility index) below the 10th centile of population-specific models fitted to the data. Associations between malaria (peripheral infection prior to and at ultrasound examination, and any gestational infection, i.e., ‘exposure’) and abnormal flow, and between abnormal flow and birth outcomes, were estimated.ResultsOf 78 malaria infection episodes detected before or at the ultrasound visit, 62 (79.5%) were Plasmodium falciparum (34 sub-microscopic infections), and 16 were Plasmodium vivax. Plasmodium falciparum infection before or at Doppler measurement was associated with increased UA resistance (adjusted odds ratio (aOR) 2.3 95% CI 1.0–5.2, P = 0.047). When assessed by ‘exposure’, P. falciparum infection was significantly associated with increased UA resistance (all infections: 2.4, 1.1–4.9, P = 0.024; sub-microscopic infections 2.6, 1.0–6.6, P = 0.051) and a reduced MCA pulsatility index (all infections: 2.6, 1.2–5.3, P = 0.012; sub-microscopic infections: 2.8, 1.1–7.5, P = 0.035). Sub-microscopic P. falciparum infections were additionally associated with a reduced cerebroplacental ratio (3.64, 1.22–10.88, P = 0.021). There were too few P. vivax infections to draw robust conclusions. An increased UA resistance index was associated with histological evidence of placental malaria (5.1, 2.3–10.9, P < 0.001; sensitivity 0.26, specificity 0.93). A low cerebroplacental Doppler ratio was associated with concurrently measuring small-for-gestational-age, and with low birth weight.Discussion/conclusionBoth microscopic and sub-microscopic P. falciparum infections impair fetoplacental and intrafetal flow, at least temporarily. Increased UA resistance has high specificity but low sensitivity for the detection of placental infection. These findings suggest that interventions to protect the fetus should clear and prevent both microscopic and sub-microscopic malarial infections. Trial Registration ClinicalTrials.gov NCT01136850. Registered 06 April 2010Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1689-z) contains supplementary material, which is available to authorized users.

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“…This Asian cooperative study found that an appreciably higher proportion of chewers who consumed limecontaining TF-BQ developed aBQ-D (≥23.3%) than those who consumed lime-free TF-BQ (4.0%). Calcium hydroxide accelerates the extraction of AN-derived alkaloids during mastication, thus improving the psychoactive effects of these alkaloids on AN chewers [23,35]. The existence of slaked lime, arecoline and guvacoline in AN could correspondingly be hydrolyzed into arecaidine and guvacine (two strong inhibitors of GABA uptake), and consequently exert GABAnergic functions [21].…”

Section: Discussionmentioning

confidence: 99%

Betel‐quid dependence domains and syndrome associated with betel‐quid ingredients among chewers: an Asian multi‐country evidence

Lee

Chiang

et al. 2014

Addiction

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Betel nut chewing during pregnancy, Madang province, Papua New Guinea

Cited by 74 publications

References 39 publications

Impairment of thymocyte function via induction of apoptosis by areca nut extract

Impairment of thymocyte function via induction of apoptosis by areca nut extract

Effects of Plasmodium falciparum infection on umbilical artery resistance and intrafetal blood flow distribution: a Doppler ultrasound study from Papua New Guinea

Betel‐quid dependence domains and syndrome associated with betel‐quid ingredients among chewers: an Asian multi‐country evidence

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