Molecular and cellular cues of diet-associated oral carcinogenesis-with an emphasis on areca-nut-induced oral cancer development

XPO1 serves as a prognostic marker involving AKT/MAPK/TGFBR1 pathway in OSCC

BACKGROUND

Exportin 1 (XPO1) is a nuclear export protein that facilitates the transportation of various substances. XPO1 promotes tumor development as a poor prognostic factor in a variety of tumors and is a therapeutic target for screening inhibitors. However, the role of XPO1 in oral squamous cell carcinoma (OSCC) has yet to be determined.

METHODS

The expression patterns of XPO1 mRNA in OSCC were investigated using bioinformatics tools, and the expression levels of XPO1 protein in OSCC specimens were confirmed by immunohistochemical assays. Survival analysis was conducted to evaluate the impact of XPO1 on prognosis. GO and KEGG enrichment analyses were utilized to uncover the signaling pathways mediated by XPO1. Additionally, we examined the association between XPO1 and AKT/MAPK/TGFBR1 and immune infiltration.

RESULTS

XPO1 mRNA and protein expression levels were significantly enhanced in OSCC and associated with OSCC severity. Enhanced XPO1 expression was indicative of poor survival. Functional analysis showed that XPO1 mediated pathways associated with cell cycle and DNA replication and reduced immune infiltration in OSCC. Additionally, XPO1 mRNA and protein expression levels had significant positive relationships with AKT/MAPK/TGFBR1.

CONCLUSIONS

XPO1, as a marker of poor prognosis in OSCC, can promote OSCC through AKT/MAPK/TGFBR1.

A dicoumarol-graphene oxide quantum dot polymer inhibits porcine reproductive and respiratory syndrome virus through the JAK-STAT signaling pathway

Introduction

Porcine reproductive and respiratory syndrome virus (PRRSV) causes substantial economic losses in the global swine industry. The current vaccine options offer limited protection against PRRSV transmission, and there are no effective commercial antivirals available. Therefore, there is an urgent need to develop new antiviral strategies that slow global PRRSV transmission.

Methods

In this study, we synthesized a dicoumarol-graphene oxide quantum dot (DIC-GQD) polymer with excellent biocompatibility. This polymer was synthesized via an electrostatic adsorption method using the natural drug DIC and GQDs as raw materials.

Results

Our findings demonstrated that DIC exhibits high anti-PRRSV activity by inhibiting the PRRSV replication stage. The transcriptome sequencing analysis revealed that DIC treatment stimulates genes associated with the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signalling pathway. In porcine alveolar macrophages (PAMs), DIC-GQDs induce TYK2, JAK1, STAT1, and STAT2 phosphorylation, leading to the upregulation of JAK1, STAT1, STAT2, interferon-β (IFN-β) and interferon-stimulated genes (ISGs). Animal challenge experiments further confirmed that DIC-GQDs effectively alleviated clinical symptoms and pathological reactions in the lungs, spleen, and lymph nodes of PRRSV-infected pigs.

Discussion

These findings suggest that DIC-GQDs significantly inhibits PRRSV proliferation by activating the JAK/STAT signalling pathway. Therefore, DIC-GQDs hold promise as an alternative treatment for PRRSV infection.

Edible Quality Analysis of Different Areca Nuts: Compositions, Texture Characteristics and Flavor Release Behaviors

The areca nut is one of the most important cash crops in the tropics and has substantial economic value. However, the research information about the edible quality of different areca nuts is still insufficient. This study compared the composition, texture characteristics and flavor release behaviors of four different areca nuts (AN1, AN2, AN3 and AN4) and two commercially dried areca nuts (CAN1 and CAN2). Results showed that AN1 had higher soluble fiber and lower lignin, which was the basis of its lower hardness. Meanwhile, the total soluble solid (TSS) of AN1 was the highest, which indicated that AN1 had a moister and more succulent mouthfeel. After the drying process, the lignification degree of AN1 was the lowest. Through textural analyses, the hardness of AN1 was relatively low compared to the other dried areca nuts. AN1, CAN1 and CAN2 had higher alkaline pectin content and viscosity, and better flavor retention, which indicated better edible quality. The present study revealed the differences of various areca nuts and provided vital information to further advance the study of areca nuts.

Genetic and epigenetic instability induced by betel quid associated chemicals

Over the years, betel quid chewing and tobacco use have attracted considerable interest as they are implicated as the most likely causative risk factors of oral and esophageal cancers. Although areca nut use and betel quid chewing may lead to apoptosis, chronic exposure to areca nut and slaked lime may promote pre-malignant and malignant transformation of oral cells. The putative mutagenic and carcinogenic mechanisms may involve endogenous nitrosation of areca and tobacco alkaloids as well as the presence of direct alkylating agents in betel quid and smokeless tobacco. Metabolic activation of carcinogenic N-nitrosamines by phase-I enzymes is required not only to elicit the genotoxicity via the reactive intermediates but also to potentiate the mutagenicity with the sporadic alkylations of nucleotide bases, resulting in the formation of diverse DNA adducts. Persistent DNA adducts provides the impetus for genetic and epigenetic lesions. The genetic and epigenetic factors cumulatively influence the development and progression of disorders such as cancer. Accumulation of numerous genetic and epigenetic aberrations due to long-term betel quid (with or without tobacco) chewing and tobacco use culminates into the development of head and neck cancers. We review recent evidence that supports putative mechanisms for mutagenicity and carcinogenicity of betel quid chewing along with tobacco (smoking and smokeless) use. The detailed molecular mechanisms of the extent of accumulation and patterns of genetic alterations, indicative of the prior exposure to carcinogens and alkylating agents because of BQ chewing and tobacco use, have not yet been elucidated.

High frequencies of vitamin B12 and folic acid deficiencies and hyperhomocysteinemia in Taiwanese male patients with oral submucous fibrosis

Background

/purpose: Oral submucous fibrosis (OSF) is a betel quid chewing-caused oral mucosal disease with progressive collagen deposition. This study evaluated whether Taiwanese male OSF patients had high frequencies of vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity.

Materials and methods

The blood hemoglobin (Hb), serum iron, vitamin B12, folic acid, homocysteine, and GPCA concentrations in 62 male OSF patients were measured and compared with the corresponding data in 124 age-matched male healthy control subjects.

Results

We found that 5 (8.1%), 12 (19.4%), 32 (51.6%), 31 (50.0%), 22 (35.5%), and 6 (9.7%) of the 62 male OSF patients had Hb (<13 g/dL), iron (≤70 μg/dL), vitamin B12 (≤450 pg/mL), and folic acid (≤6 ng/mL) deficiencies, hyperhomocysteinemia (>12 μM), and serum GPCA positivity, respectively. Furthermore, OSF patients had significantly higher frequencies of Hb (P = 0.006), vitamin B12 (P < 0.001), and folic acid (P < 0.001) deficiencies, hyperhomocysteinemia (P < 0.001), and serum GPCA positivity (P = 0.030) than 124 healthy control subjects. Of the 22 OSF patients with hyperhomocysteinemia, 4 had vitamin B12 deficiency only, 7 had folic acid deficiency only, and 11 had both vitamin B12 and folic acid deficiencies.

Conclusion

We conclude that Taiwanese male OSF patients have high frequencies of vitamin B12 and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity. The hyperhomocysteinemia in our OSF patients is predominantly due to deficiencies of either vitamin B12 or folic acid or both.

Higher frequencies of anemia, vitamin B12 deficiency, and gastric parietal cell antibody positivity in folic acid-deficient Taiwanese male oral submucous fibrosis patients

Background/purpose

Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with folic acid (FA) deficiency (the serum FA level ≤6 ng/mL, so-called FA-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and vitamin B12 deficiencies, and serum gastric parietal cell antibody (GPCA) positivity.

Materials and methods

The blood Hb and serum iron, vitamin B12, FA, and GPCA concentrations in 59 Taiwanese male FA-deficient OSF patients were measured and compared with the corresponding data in 118 age-matched healthy male control subjects.

Results

We found that 3 (5.1%), 35 (59.3%), and 7 (11.9%) of the 59 FA-deficient OSF patients had blood Hb (<13 g/dL) and serum vitamin B12 (≤450 pg/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 59 FA-deficient OSF patients had significantly higher frequencies of serum vitamin B12 deficiency and serum GPCA positivity than 118 healthy control subjects (all P-values <0.05). Of the 3 anemic FA-deficient OSF patients, one had macrocytic anemia and the other two had thalassemia trait-induced anemia.

Conclusion

We conclude that Taiwanese male FA-deficient OSF patients have high frequencies of serum vitamin B12 deficiency and GPCA positivity than healthy control subjects. The vitamin B12 and FA deficiencies in FA-deficient OSF patients are more likely due to OSF symptoms and signs-caused insufficient intake, difficulty in chewing and swallowing, and malabsorption of food fragment-bound vitamin B12 and FA rather than the GPCA positivity in these OSF patients.

Higher frequencies of anemia, hematinic deficiencies, and gastric parietal cell antibody positivity in vitamin B12-deficient Taiwanese male oral submucous fibrosis patients

Abstract Background/purpose

Oral submucous fibrosis (OSF) is a progressive fibrotic oral mucosal disease associated with betel quid chewing. This study evaluated whether Taiwanese male OSF patients with vitamin B12 deficiency (the serum vitamin B12 level ≤ 450 pg/mL, B12-deficient OSF patients) had high frequencies of blood hemoglobin (Hb) and serum iron and folic acid deficiencies, and serum gastric parietal cell antibody (GPCA) positivity.

Materials and methods

The blood Hb and serum iron, vitamin B12, folic acid, and GPCA concentrations in 66 Taiwanese male B12-deficient OSF patients were measured and compared with the corresponding data in 132 age-matched healthy male control subjects.

Results

We found that 6 (9.1%), 19 (28.8%), 35 (53.0%), and 9 (13.6%) of the 66 B12-deficient OSF patients had blood Hb (<13 g/dL) and serum iron (≤70 μg/dL), and folic acid (≤6 ng/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, 66 OSF patients had significantly higher frequencies of blood Hb and serum iron and folic acid deficiencies, and serum GPCA positivity than 132 healthy control subjects (all P-values < 0.05). Of the 6 anemic B12-deficient OSF patients, one had macrocytic anemia, two normocytic anemia, and three thalassemia trait-induced anemia.

Conclusion

Taiwanese male B12-deficient OSF patients have high frequencies of blood Hb, serum iron and folic acid deficiencies, and serum GPCA positivity. The anemia and hematinic deficiencies in B12-deficient OSF patients are likely due to OSF symptoms and signs-caused insufficient intake, poor chewing, and malabsorption of hematinic elements from ingested food stuffs rather than the GPCA positivity.

Non-steroidal anti-inflammatory drugs and biomarkers: A new paradigm in colorectal cancer

Colorectal cancer is a sporadic, hereditary, or familial based disease in its origin, caused due to diverse set of mutations in large intestinal epithelial cells. Colorectal cancer (CRC) is a common and deadly disease that accounts for the 4^th worldwide highly variable malignancy. For the early detection of CRC, the most common predictive biomarker found endogenously are KRAS and ctDNA/cfDNA along with SEPT9 methylated DNA. Early detection and screening for CRC are necessary and multiple methods can be employed to screen and perform early diagnosis of CRC. Colonoscopy, an invasive method is most prevalent for diagnosing CRC or confirming the positive result as compared to other screening methods whereas several non-invasive techniques such as molecular analysis of breath, urine, blood, and stool can also be performed for early detection. Interestingly, widely used medicines known as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation have reported chemopreventive impact on gastrointestinal malignancies, especially CRC in several epidemiological and preclinical types of research. NSAID acts by inhibiting two cyclooxygenase enzymes, thereby preventing the synthesis of prostaglandins (PGs) and causing NSAID-induced apoptosis and growth inhibition in CRC cells. This review paper majorly focuses on the diversity of natural and synthetic biomarkers and various techniques for the early detection of CRC. An approach toward current advancement in CRC detection techniques and the role of NSAIDs in CRC chemoprevention has been explored systematically. Several prominent governing mechanisms of the anti-cancer effects of NSAIDs and their synergistic effect with statins for an effective chemopreventive measure have also been discussed in this review paper.

Significantly higher frequencies of macrocytosis, anemia, serum vitamin B12 and folic acid deficiencies, and hyperhomocysteinemia in male than in female atrophic glossitis patients

Background/purpose

Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 150 male and 914 female AG patients.

Materials and methods

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 150 male and 914 female AG patients were measured and compared with the corresponding levels in 75 male and 457 female healthy control subjects (HCSs), respectively.

Results

We found that 150 male AG patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels, and significantly higher mean serum homocysteine levels than 75 male HCSs. Moreover, 914 female AG patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 457 female HCSs. In addition, 150 male AG patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiency and hyperhomocysteinemia than 914 female AG patients.

Conclusion

The male AG patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than the female AG patients.

Significantly lower mean serum vitamin B12 and folic acid levels and a significantly higher frequency of serum iron deficiency in younger than in older atrophic glossitis patients

Background/purpose

: Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients.

Materials and methods

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively.

Results

We found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients.

Conclusion

The younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients.

Are There Betel Quid Mixtures Less Harmful than Others? A Scoping Review of the Association between Different Betel Quid Ingredients and the Risk of Oral Submucous Fibrosis

Oral submucous fibrosis (OSF) is a potentially malignant condition of the oral cavity characterized by progressive fibrosis of the submucosal tissues. OSF is typically associated with the use of betel quid (BQ), a chewing package made of natural products (e.g., areca nut, betel leaves), with or without smokeless tobacco. BQ ingredients contain pro-carcinogenic bioactive compounds, but also potentially protective biomolecules, and we have shown recently that the chemical properties of different BQ recipes vary, which may explain the unequal prevalence of OSF and oral cancer in BQ users in different geographical regions. Hence, this scoping review was aimed at evaluating the existing literature regarding different BQ compounds and their association with OSF. The repository of the National Library of Medicine (MEDLINE/PubMed), medRxiv databases, Google scholar, Baidu scholar, CNKI, and EBSCO were used to search for publications that investigated the association between BQ chewing and OSF up to November 2021. The search terminology was constructed using the keywords "betel quid" and "oral submucous fibrosis", and their associated terms, with the use of Boolean operators. The search was conducted under Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, together with clear inclusion and exclusion criteria. The review showed that the risk of developing OSF varied between different BQ recipes, and that chewing BQ mixtures containing betel inflorescence (BI) significantly increased the risk of OSF, as did the addition of tobacco. Conversely, the use of betel leaf in the mixture was likely to be protective, which may be due to the presence of polyphenols. Although further research is needed to determine the effect of individual BQ ingredients in the development of OSF, our pilot results provide the scope and rationale for informing future chemopreventive strategies for OSF and oral cancer in BQ chewers.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in younger and older burning mouth syndrome patients

Abstract Background/purpose

Our previous study found that 19.8%, 16.2%, 4.8%, 2.3%, and 19.2% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 272 younger (≤50 years old) and 612 older (>50 years old) BMS patients.

Materials and methods

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 272 younger and 612 older BMS patients were measured and compared with the corresponding levels in 136 younger (≤50 years old) and 306 older (>50 years old) healthy control subjects (HCSs), respectively.

Results

We found that 272 younger BMS patients had significantly lower mean blood Hb and serum iron, vitamin B12, and folic acid levels than 136 younger HCSs. Moreover, 612 older BMS patients had significantly lower mean blood Hb, and serum iron and vitamin B12 levels and significantly higher mean serum homocysteine level than 306 older HCSs. In addition, 272 younger BMS patients had higher mean blood Hb level (marginal significance, P = 0.056), significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of iron and folic acid deficiencies than 612 older BMS patients.

Conclusion

The younger BMS patients do have higher mean blood Hb level, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of serum iron and folic acid deficiencies than the older BMS patients.

Anemia, hematinic deficiencies, and hyperhomocysteinemia in male and female burning mouth syndrome patients

Background/purpose

Our previous study found that 19.8%, 16.2%, 4.8%, 2.3%, 19.2%, and 12.3% of 884 burning mouth syndrome (BMS) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 212 male and 672 female BMS patients.

Materials and methods

The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 212 male and 672 female BMS patients were measured and compared with the corresponding levels in 106 male and 336 female healthy control subjects, respectively.

Results

We found that 212 male BMS patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels and significantly higher mean serum homocysteine levels than 106 male healthy control subjects. Moreover, 672 female BMS patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 336 female healthy control subjects. In addition, 212 male BMS patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than 672 female BMS patients.

Conclusion

The male BMS patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of folic acid deficiency and hyperhomocysteinemis than the female BMS patients.

Higher serum homocysteine level and frequency of hyperhomocysteinemia in carcinoembryonic antigen-positive or squamous cell carcinoma-antigen-positive oral leukoplakia patients

BACKGROUND/PURPOSE

Our previous study found significantly lower serum hematinic levels and higher serum homocysteine level as well as higher frequencies of serum hematinic deficiencies and hyperhomocysteinemia in oral leukoplakia (OL) patients than in healthy control subjects. This study evaluated whether carcinoembryonic antigen (CEA)-positive or squamous cell carcinoma-antigen (SCC-Ag)-positive OL patients had significantly lower serum hematinic levels and higher serum homocysteine level as well as significantly higher frequencies of hematinic deficiencies and hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients or healthy control subjects.

METHODS

The complete blood count, serum iron, vitamin B12, folic acid, and homocysteine levels in 184 OL patients including 85 CEA-positive, 99 CEA-negative, 25 SCC-Ag-positive, and 159 SCC-Ag-negative OL patients and in 184 age- and sex-matched healthy control subjects were measured and compared.

RESULTS

We found that the 85 CEA-positive or 25 SCC-Ag-positive OL patients had a significantly lower mean serum folic acid level and a significantly higher mean serum homocysteine level as well as significantly higher frequencies of serum folic acid deficiency and hyperhomocysteinemia than 184 healthy control subjects. Moreover, the 25 SCC-Ag-positive OL patients had a significantly higher mean serum homocysteine level than the 159 SCC-Ag-negative OL patients. The 85 CEA-positive OL patients had a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than 99 CEA-negative OL patients (marginally significant, P = 0.060).

CONCLUSION

CEA-positive or SCC-Ag-positive OL patients tend to have a higher mean serum homocysteine level and a higher frequency of hyperhomocysteinemia than CEA-negative or SCC-Ag-negative OL patients, respectively.

A pharmacological review of dicoumarol: An old natural anticoagulant agent

Dicoumarol is an oral anticoagulant agent prescribed in clinical for decades. It is a natural hydroxycoumarin discovered from the spoilage of Melilotus officinalis (L.) Pall and is originally discovered as a rodenticide. Due to its structural similarity to that of vitamin K, it significantly inhibits vitamin K epoxide reductase and acts as a vitamin K antagonist. Dicoumarol is mainly used as an anticoagulant to prevent thrombogenesis and to cure vascular thrombosis. Other biological activities besides anticoagulants such as anticancer, antimicrobial, antiviral, etc., have also been documented. The side effects of dicoumarol raise safety concerns for clinical application. In this review, the physicochemical property, the pharmacological activities, the side effects, and the pharmacokinetics of dicoumarol were summarized, aiming to provide a whole picture of the "old" anticoagulant.

Role and Mechanism of LIF in Oral Squamous Cell Carcinoma Progression

Background: Metastasis is a severe problem in patients with oral squamous cell carcinoma (OSCC), which is the fifth most common cancer worldwide. Leukemia inhibitory factor (LIF) has been studied in different cancers, while the role of LIF in OSCC remains unclear. Methods: LIF expression was detected in 100 OSCC samples by immunohistochemistry. Effects of LIF on cell motility were evaluated in OSCC cell lines. High-throughput microarray analysis was also conducted. The correlation between LIF and the downstream effector was analyzed by real-time quantitative reverse transcription PCR. Results: Patients with OSCC who had lymph node metastasis or advanced cancer stages showed high LIF expression. OSCC patients with higher LIF expression, advanced stage, large tumor size, or lymph node metastasis had significantly shorter overall survival. LIF regulated cancer cell motilities through outside-in signaling. The inhibin beta A subunit (INHBA) gene was identified as a crucial downstream effector of LIF-promoted OSCC progression and restored migration and invasion abilities in LIF knockdown transfectants. Conclusion: LIF enhances regional lymphatic spread, thus leading to an advanced cancer stage. Regulation of LIF downstream molecules such as INHBA inhibits the invasion or migration ability of cancer cells. Thus, LIF can be a potential target in preventing cancer metastasis and spread.

Mutational landscape of head and neck squamous cell carcinomas in a South Asian population

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer type globally and contributes significantly to burden of disease in South Asia. In Pakistan, HNSCC is among the most commonly diagnosed cancer in males and females. The increasing regional burden of HNSCC along with a unique set of risk factors merited a deeper investigation of the disease at the genomic level. Whole exome sequencing of HNSCC samples and matched normal genomic DNA analysis (n=7) was performed. Significant somatic single nucleotide variants (SNVs) were identified and pathway analysis performed to determine frequently affected signaling pathways. We identified significant, novel recurrent mutations in ASNS (asparagine synthetase) that may affect substrate binding, and variants in driver genes including TP53, PIK3CA, FGFR2, ARID2, MLL3, MYC and ALK. Using the IntOGen platform, we identified MAP kinase, cell cycle, actin cytoskeleton regulation, PI3K-Akt signaling and other pathways in cancer as affected in the samples. This data is the first of its kind from the Pakistani population. The results of this study can guide a better mechanistic understanding of HNSCC in the population, ultimately contributing new, rational therapeutic targets for the treatment of the disease.

Determination of Pyruvate Metabolic Fates Modulates Head and Neck Tumorigenesis

Even with increasing evidence for roles of glycolytic enzymes in controlling cancerous characteristics, the best target of candidate metabolic enzymes for lessening malignancy remains under debate. Pyruvate is a main glycolytic metabolite that could be mainly converted into either lactate by Lactate Dehydrogenase A (LDHA) or acetyl-CoA by Pyruvate Dehydrogenase E1 component α subunit (PDHA1) catalytic complex. In tumor cells, accumulating lactate is produced whereas the conversion of pyruvate into mitochondrial acetyl-CoA is less active compared with their normal counterparts. This reciprocal molecular association makes pyruvate metabolism a potential choice of anti-cancer target. Cellular and molecular changes were herein assayed in Head and Neck Squamous Cell Carcinoma (HNSCC) cells in response to LDHA and PDHA1 loss in vitro, in vivo and in clinic. By using various human cancer databases and clinical samples, LDHA and PDHA1 levels exhibit reversed prognostic roles. In vitro analysis demonstrated that decreased cell growth and motility accompanied by an increased sensitivity to chemotherapeutic agents was found in cells with LDHA loss whereas PDHA1-silencing exhibited opposite phenotypes. At the molecular level, it was found that oncogenic Protein kinase B (PKB/Akt) and Extracellular signal-regulated kinase (ERK) singling pathways contribute to pyruvate metabolism mediated HNSCC cell growth. Furthermore, LDHA/PDHA1 changes in HNSCC cells resulted in a broad metabolic reprogramming while intracellular molecules including polyunsaturated fatty acids and nitrogen metabolism related metabolites underlie the malignant changes. Collectively, our findings reveal the significance of pyruvate metabolic fates in modulating HNSCC tumorigenesis and highlight the impact of metabolic plasticity in HNSCC cells.

Acquisition cancer stemness, mesenchymal transdifferentiation, and chemoresistance properties by chronic exposure of oral epithelial cells to arecoline

Oral squamous cell carcinoma (OSCC), one of the most deadliest malignancies in the world, is caused primarily by areca nut chewing in Southeast Asia. The mechanisms by which areca nut participates in OSCC tumorigenesis are not well understood. In this study, we investigated the effects of low dose long-term arecoline (10 μg/mL, 90-days), a major areca nut alkaloid, on enhancement cancer stemness of human oral epithelial (OE) cells. OE cells with chronic arecoline exposure resulted in increased ALDH1 population, CD44 positivity, stemness-related transcription factors (Oct4, Nanog, and Sox2), epithelial-mesenchymal transdifferentiation (EMT) traits, chemoresistance, migration/invasiveness/anchorage independent growth and in vivo tumor growth as compared to their untreated controls. Mechanistically, ectopic miR-145 over-expression in chronic arecoline-exposed OE (AOE) cells inhibited the cancer stemness and xenografic. In AOE cells, luciferase reporter assays further revealed that miR-145 directly targets the 3′ UTR regions of Oct4 and Sox2 and overexpression of Sox2/Oct4 effectively reversed miR-145-regulated cancer stemness-associated phenomenas. Additionally, clinical results further revealed that Sox2 and Oct4 expression was inversely correlated with miR-145 in the tissues of areca quid chewing-associated OSCC patients. This study hence attempts to provide novel insight into areca nut-induced oral carcinogenesis and new intervention for the treatment of OSCC patients, especially in areca nut users.

Prevalence of Oral Mucosal Lesions among Dental Patients with Mixed Habits in Salem District - A Study

BACKGROUND

The practice of betel nut chewing with or without tobacco is still practiced in south india, salem inspite of its harmful effects.

METHODOLOGY

200 Patients visiting the outpatient department, Oral medicine and radiology from Aug 2015 to Aug 2016.

RESULT AND CONCLUSION

In our study, 3 women were exclusively churut smokers. Thirty-eight percent of the dental patients were beedi smoker, 32% were tobacco chewers, 12% were both betel nut and tobacco chewers, 8% were exclusively betel nut chewers, 1% of the dental population were exclusively churut smokers. Mean age group of the study population is 50.2 (14.4). There are 28 females and 172 males in the study group. Chi-square test revealed a statistically significant difference (P = 0.001) between males and females based on soft-tissue findings and no statistically significant difference (P = 0.572) between males and females based on distribution of hard-tissue findings.

Infectious Agents Associated with Head and Neck Carcinomas

In addition to traditional risk factors such as smoking habits and alcohol consumption, certain microbes also play an important role in the generation of head and neck carcinomas. Infection with high-risk human papillomavirus types is strongly associated with the development of oropharyngeal carcinoma, and Epstein-Barr virus appears to be indispensable for the development of non-keratinizing squamous cell carcinoma of the nasopharynx. Other viruses including torque teno virus and hepatitis C virus may act as co-carcinogens, increasing the risk of malignant transformation. A shift in the composition of the oral microbiome was associated with the development of oral squamous cell carcinoma, although the causal or casual role of oral bacteria remains to be clarified. Conversion of ethanol to acetaldehyde, a mutagenic compound, by members of the oral microflora as well as by fungi including Candida albicans and others is a potential mechanism that may increase oral cancer risk. In addition, distinct Candida spp. also produce NBMA (N-nitrosobenzylmethylamine), a potent carcinogen. Inflammatory processes elicited by microbes may also facilitate tumorigenesis in the head and neck region.

MicroRNA-211 Enhances the Oncogenicity of Carcinogen-Induced Oral Carcinoma by Repressing TCF12 and Increasing Antioxidant Activity

miR-211 expression in human oral squamous cell carcinoma (OSCC) has been implicated in poor patient survival. To investigate the oncogenic roles of miR-211, we generated K14-EGFP-miR-211 transgenic mice tagged with GFP. Induction of oral carcinogenesis in transgenic mice using 4-nitroquinoline 1-oxide (4NQO) resulted in more extensive and severe tongue tumorigenesis compared with control animals. We found that 4NQO and arecoline upregulated miR-211 expression in OSCC cells. In silico and experimental evidence further revealed that miR-211 directly targeted transcription factor 12 (TCF12), which mediated suppressor activities in OSCC cells and was drastically downregulated in tumor tissues. We used GeneChip analysis and bioinformatic algorithms to identify transcriptional targets of TCF12 and confirmed through reporter and ChIP assays that family with sequence similarity 213, member A (FAM213A), a peroxiredoxin-like antioxidative protein, was repressed transcriptionally by TCF12. FAM213A silencing in OSCC cells diminished oncogenic activity, reduced the ALDH1-positive cell population, and increased reactive oxygen species. TCF12 and FAM213A expression was correlated inversely in head and neck carcinoma samples according to The Cancer Genome Atlas. OSCC patients bearing tumors with high FAM213A expression tended to have worse survival. Furthermore, 4NQO treatment downregulated TCF12 and upregulated FAM213A by modulating miR-211 both in vitro and in vivo Overall, our findings develop a mouse model that recapitulates the molecular and histopathologic alterations of human OSCC pathogenesis and highlight a new miRNA-mediated oncogenic mechanism. Cancer Res; 76(16); 4872-86. ©2016 AACR.

Dynamic cellular and molecular modulations of diabetes mediated head and neck carcinogenesis

Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms worldwide. While numerous potent dietary insults were considered as oncogenic players for HNSCC development, the impact of metabolic imbalance was less emphasized during HNSCC carcinogenesis. Previous preclinical and epidemiological investigations showed that DM could possibly be correlated with greater incidence and poorer prognosis in HNSCC patients; however, the outcomes from different groups are contradictive and underlying mechanisms remains elusive. In the present study, the changes of cellular malignancy in response to prolonged glucose incubation in HNSCC cells were examined. The results demonstrated that hyperglycemia enhanced HNSCC cell malignancy over time through suppression of cell differentiation, promotion of cell motility, increased resistance to cisplatin, and up-regulation of the nutrient-sensing Akt/AMPK-mTORC1 pathway. Further analysis showed that a more aggressive tongue neoplastic progression was found under DM conditions compared to non-DM state whereas DM pathology led to a higher percentage of cervical lymph node metastasis and poorer prognosis in HNSCC patients. Taken together, the present study confirms that hyperglycemia and DM could enhance HNSCC malignancy and the outcomes are of great benefit in providing better anti-cancer treatment strategy for DM patients with HNSCC.

Elevation of Twist expression by arecoline contributes to the pathogenesis of oral submucous fibrosis

BACKGROUND/PURPOSE

Oral submucous fibrosis (OSF), a chronic progressive scarring disease, has been considered as a precancerous condition of oral mucosa. In this study, we investigated the functional role of Twist, an epithelial-mesenchymal transition (EMT) transcriptional factor, in myofibroblastic differentiation activity of OSF.

METHODS

Arecoline, a major areca nut alkaloid, was used to explore whether expression of Twist could be changed dose-dependently in human primary buccal mucosal fibroblasts (BMFs). Collagen gel contraction and migration capability in arecoline-stimulated BMFs and primary oral submucous fibrosis-derived fibroblasts (OSFs) with Twist knockdown was presented.

RESULTS

We observed that the treatment of arecoline dose-dependently increased Twist expression transcript and protein levels in BMFs. The myofibroblast activity including collagen gel contraction and migration capability also induced by arecoline, while knockdown of Twist reversed these phenomena. Importantly, inhibition of Twist led to the suppression collagen contraction and wound healing capability of primary cultivated OSFs. Clinically, Twist transcript and protein expression was higher in areca quid chewing-associated OSF tissues than in normal oral mucosa tissues.

CONCLUSION

This evidence suggests that upregulation of Twist might be involved in the pathogenesis of areca quid-associated OSF through dysregulation of myofibroblast activity.

Elevated Lin28B expression is correlated with lymph node metastasis in oral squamous cell carcinomas

BACKGROUND

Lymph node (LN) metastasis is the most common cause of oral squamous cell carcinoma (OSCC)-related death. Searching the detailed molecular mechanisms involved LN metastasis in OSCC is still an open question.

METHODS

Paired tissue samples from tumor (T) and adjacent non-cancerous matched tissues (NCMT) parts, as well as LN metastatic lesions in patient with OSCC tissues were subjected to quantitative real-time PCR analysis for the expression levels of Lin28B. Arecoline, a major areca nut alkaloid, was to explore whether expression of Lin28B could be changed dose dependent in oral epithelial cells. Control and Lin28B-knockdown arecoline-stimulated oral epithelial cells were subjected to migration/invasion/anchorage-independent growth assay.

RESULTS

Compared with NCMT samples from the same OSCC patient, the expression of Lin28B was increased in all of the tumor samples. A similar upregulation of Lin28B was also observed in LN metastatic when compared with local tumors. Arecoline treatment dose dependently induced Lin28B expression in SG and FaDu cells. Lentiviral-mediated silencing Lin28B expression significantly attenuated arecoline-induced oncogenicity including proliferation, migration, invasiveness, and anchorage-independent growth in SG and FaDu cells.

CONCLUSIONS

Lin28B may be a useful biomarker and novel molecular target for LN metastasis OSCC patients' treatment.

ZEB1 as an indicator of tumor recurrence for areca quid chewing-associated oral squamous cell carcinomas

BACKGROUND

Oral squamous cell carcinoma (OSCC) is the sixth most prevalent malignancy worldwide and the third most common cancer in developing nation. Most OSCC patients relapse within months after receiving treatment. Therefore, searching the biomarkers of recurrence is urgently required to improve OSCC patient survival.

METHODS

We set out to explore whether expression of ZEB1 could be triggered in oral epithelial cells (SG and FaDu) by arecoline in vitro. Control and ZEB1-knockdown arecoline-stimulated SG and FaDu were subjected to migration/invasiveness/anchorage-independent growth assay. Primary and recurrent OSCC tissues from areca quid chewers were analyzed using real-time RT-PCR analysis for ZEB1 expression.

RESULTS

Arecoline led to dose-dependent elevation of ZEB1 expression in SG and FaDu cells. Downregulation of ZEB1 by lentiviral infection significantly reversed arecoline-induced oncogenicity including migration ability, cell invasiveness, and anchorage-independent growth in SG and FaDu cells. Clinically, the level of ZEB1 expression was higher in recurrent OSCC tumor samples but lower in primary lesions.

CONCLUSIONS

Targeting ZEB1 might offer a new strategy for the treatment of OSCC patients. ZEB1 can serve as a progression and relapse marker in OSCC patients.