Oral Submucous Fibrosis: A Review on Etiopathogenesis, Diagnosis, and Therapy

Abstract

Oral submucous fibrosis (OSF) is characterized by abnormal collagen deposition. It is a precancerous disorder and transforms into a malignant tumor in 1.5–15% of all cases. Symptoms include submucous fibrosis, ulceration, xerostomia, a burning sensation, and restricted mouth opening. All of these greatly interfere with patient quality of life. The present review introduces OSF from a molecular perspective and summarizes what is known about its underlying mechanisms, diagnostic biomarkers, and therapeutic interventions. In addition to the aggressive treatment of OSF, its prevention is also important. Future research should, therefore, focus on improving the oral health literacy of the patients susceptible to OSF.

Long non‑coding RNA expression profiles and related regulatory networks in areca nut chewing‑induced tongue squamous cell carcinoma

“…These findings suggest that immune inflammatory responses may play more important carcinogenic roles in patients with oral cancer who chew areca nuts compared with patients who develop OSCC due to other causes. Autoimmune reaction is one of the pathogenic factors of OSF which is the main precancerous lesion of areca nut chewing induced OSCC (14). Long-term stimulation of exogenous antigens, and being repeatedly damaged and repaired places the oral mucosa in a state of chronic inflammation in patients who have chewed areca nuts for a long period of time (14,85).…”

“…Autoimmune reaction is one of the pathogenic factors of OSF which is the main precancerous lesion of areca nut chewing induced OSCC (14). Long-term stimulation of exogenous antigens, and being repeatedly damaged and repaired places the oral mucosa in a state of chronic inflammation in patients who have chewed areca nuts for a long period of time (14,85). Long-term unresolved inflammation triggers cancer progression (86,87), thus, inflammation-mediated carcinogenesis may be one of the pathogenic factors of areca nut chewing induced TSCC.…”

“…The areca nut is classified as a group 1 carcinogen, which can induce oral precancerous lesions and oral cancer (13). Oral submucous fibrosis (OSF) is a precancerous disorder caused by areca nut chewing (14). Areca nut extract can stimulate oral keratinocyte to secrete fibrosis-related cytokines, promote fibroblast proliferation and collagen synthesis, cause oral mucosal fibrosis, and ultimately induce OSF (15).…”

“…Areca nut extract can stimulate oral keratinocyte to secrete fibrosis-related cytokines, promote fibroblast proliferation and collagen synthesis, cause oral mucosal fibrosis, and ultimately induce OSF (15). Previous studies have demonstrated that OSF transforms into a malignant tumor in 1.5-15% of all cases (14,16) and increases the risk of oral cancer by 19.1-fold (17,18). In India, Pakistan and other countries or regions, oral cancer is at the forefront of malignant tumors due to the high prevalence of areca nut chewing, and consequently, the high morbidity of OSF (19,20).…”

Oral Submucous Fibrosis: A Review on Biomarkers, Pathogenic Mechanisms, and Treatments

“…Some underlying molecular differences exist between normal, oral, and potentially malignant disorders and early and late cancer stages. In recent years, biomarkers have been developed through existing biology techniques; cytological features, promoter methylation, polymorphism, mRNAs, microRNA, non-coding RNAs, and protein and trace elements in a solid biopsy, liquid biopsy from serum, and saliva have been used as potential biomarkers for OSF ( Table 3 ) [ 65 ]. The use of cytology, tissue, serum, and saliva samples for analysis has unique advantages.…”