Molecular Pathogenesis of Oral Submucous Fibrosis: A Critical Appraisal

Abstract

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

Immunohistochemical Analysis of Myofibroblasts Using α- SMA in Oral Submucous Fibrosis Turning into Malignancy- A Case Report and Review

“…The main etiology of the OSF is said to be betel nut either the ripened fruit or the fresh green fruit that is taken by people all around the world. It is the by-product of the areca nut namely alkaloids [1], flavonoids and trace elements [7]. The alkaloids present are arecaidine, acrecoline, guvacin and guvacolins, considered to be most potent cause along with flavonoid component including tannins and catechins, which causes collagen disturbances as well as enhanced myofibroblastic activity [4].…”

“…The pathogenesis of OSF includes genetic predisposition including polymorphism of genes such as cytochrome P450 3A, along with this it also lies in increased collagen production followed by cross-linking of the produced collagen abide by less collagen destruction [7].…”

Efficacy of spirulina in management of oral submucous fibrosis − a systematic review

“…Oral submucous fibrosis (OSF) is a chronic, progressive, potentially malignant condition of the oral cavity that predominantly affects people of South-East Asian origin [1] and is characterized by a juxta-epithelial inflammatory reaction followed by fibroelastic change in the lamina propria and epithelial atrophy which leads to stiffness of the oral mucosa, trismus and inability to eat [2]. This entity has a long history of nomenclature starting from "atrophica idiopathica (tropica) mucosae oris" as given by Schwartz (1952) to the recent categorization as "Oral Potentially Malignant Disorder (OPMD) by Warnakulasuriya et al [3,4].…”

“…Data elucidate that, cases have increased dramatically from an estimated 2.5 million in 1980 to 14 million cases in 2010. [1] The prevalence rate of OSF range from 0.1 to 30%, varying by geographical location [6]. The prevalence of OSMF in India has been estimated to range from 0.2 to 2.3% in males and 1.2-4.6% in females, with a broad age range from 11 to 60 years [7].…”

The study of placentrex and hydrocortisone as an adjunct treatment in oral submucous fibrosis

“…Nutritional deficiencies like iron insufficiency anemia, vitamin B complex deficiency, and malnutrition interfere with the repair if the inflamed oral mucosa leading to insufficient healing and defective scarring. [ 3 4 ] Over the years, a lot of literature has been published discussing the various treatment strategies for OSMF. [ 5 6 ] First and foremost strategy is discontinuing the habit.…”