Liaison between micro-organisms and oral cancer

Chemopreventive and Biological Strategies in the Management of Oral Potentially Malignant and Malignant Disorders

Oral potentially malignant disorders (OPMD) and oral squamous cell carcinoma (OSCC) represent a significant global health burden due to their potential for malignant transformation and the challenges associated with their diagnosis and treatment. Chemoprevention, an innovative approach aimed at halting or reversing the neoplastic process before full malignancy, has emerged as a promising avenue for mitigating the impact of OPMD and OSCC. The pivotal role of chemopreventive strategies is underscored by the need for effective interventions that go beyond traditional therapies. In this regard, chemopreventive agents offer a unique opportunity to intercept disease progression by targeting the molecular pathways implicated in carcinogenesis. Natural compounds, such as curcumin, green tea polyphenols, and resveratrol, exhibit anti-inflammatory, antioxidant, and anti-cancer properties that could make them potential candidates for curtailing the transformation of OPMD to OSCC. Moreover, targeted therapies directed at specific molecular alterations hold promise in disrupting the signaling cascades driving OSCC growth. Immunomodulatory agents, like immune checkpoint inhibitors, are gaining attention for their potential to harness the body's immune response against early malignancies, thus impeding OSCC advancement. Additionally, nutritional interventions and topical formulations of chemopreventive agents offer localized strategies for preventing carcinogenesis in the oral cavity. The challenge lies in optimizing these strategies for efficacy, safety, and patient compliance. This review presents an up to date on the dynamic interplay between molecular insights, clinical interventions, and the broader goal of reducing the burden of oral malignancies. As research progresses, the synergy between early diagnosis, non-invasive biomarker identification, and chemopreventive therapy is poised to reshape the landscape of OPMD and OSCC management, offering a glimpse of a future where these diseases are no longer insurmountable challenges but rather preventable and manageable conditions.

Bioactive phytocompounds for oral cancer prevention and treatment: A comprehensive and critical evaluation

The high incidence of oral cancer combined with excessive treatment cost underscores the need for novel oral cancer preventive and therapeutic options. The value of natural agents, including plant secondary metabolites (phytochemicals), in preventing carcinogenesis and representing expansive source of anticancer drugs have been established. While fragmentary research data are available on antioral cancer effects of phytochemicals, a comprehensive and critical evaluation of the potential of these agents for the prevention and intervention of human oral malignancies has not been conducted according to our knowledge. This study presents a complete and critical analysis of current preclinical and clinical results on the prevention and treatment of oral cancer using phytochemicals. Our in-depth analysis highlights anticancer effects of various phytochemicals, such as phenolics, terpenoids, alkaloids, and sulfur-containing compounds, against numerous oral cancer cells and/or in vivo oral cancer models by antiproliferative, proapoptotic, cell cycle-regulatory, antiinvasive, antiangiogenic, and antimetastatic effects. Bioactive phytochemicals exert their antineoplastic effects by modulating various signaling pathways, specifically involving the epidermal growth factor receptor, cytokine receptors, toll-like receptors, and tumor necrosis factor receptor and consequently alter the expression of downstream genes and proteins. Interestingly, phytochemicals demonstrate encouraging effects in clinical trials, such as reduction of oral lesion size, cell growth, pain score, and development of new lesions. While most phytochemicals displayed minimal toxicity, concerns with bioavailability may limit their clinical application. Future directions for research include more in-depth mechanistic in vivo studies, administration of phytochemicals using novel formulations, investigation of phytocompounds as adjuvants to conventional treatment, and randomized clinical trials.

Oral Microbiota as a Diagnostic Biomarker of Digestive Cancer: A Systematic Review

AIM

This article aimed to review the association of oral microbiota with digestive cancer (DC).

BACKGROUND

Oral microbiota is one of the most complex ecosystems in our body. The mouth, from which the digestive system starts, may be a source of an abundant taxonomic group of microbiotas that travel to the digestive system followed by growth, reproduction, and settlement, forming a complex microecological environment causing systemic and gastrointestinal (GI) disease.

REVIEW RESULTS

A total of 14 articles were chosen for review. Most studies were case-control. Both positive and negative associations were seen between oral microbiome and DC.

CONCLUSION

Digestive cancer may be associated with distinctive oral microbial character.

CLINICAL SIGNIFICANCE

The present systematic review enlightens the risk of digestive carcinoma with oral microbiota that may act as a biomarker for early diagnosis of DC in a more comfortable, acceptable, and noninvasive way. How to cite this article: Ikbal SKA, Yadav SK, Mehrotra R, et al. Oral Microbiota as a Diagnostic Biomarker of Digestive Cancer: A Systematic Review. J Contemp Dent Pract 2023;24(11):902-911.

Advances in the oral microbiota and rapid detection of oral infectious diseases

Several studies have shown that the dysregulation of the oral microbiota plays a crucial role in human health conditions, such as dental caries, periodontal disease, oral cancer, other oral infectious diseases, cardiovascular diseases, diabetes, bacteremia, and low birth weight. The use of traditional detection methods in conjunction with rapidly advancing molecular techniques in the diagnosis of harmful oral microorganisms has expanded our understanding of the diversity, location, and function of the microbiota associated with health and disease. This review aimed to highlight the latest knowledge in this field, including microbial colonization; the most modern detection methods; and interactions in disease progression. The next decade may achieve the rapid diagnosis and precise treatment of harmful oral microorganisms.

Oral Microflora in the Background of Oral Cancer: A Review

Oral cancer exhibits a multifactorial etiology. Microorganisms residing within the oral cavity as normal commensals have long been studied in terms of their role in the process of carcinogenesis. Other factors such as tobacco and alcohol consumption have also been implicated in carcinogenesis as the primary risk factors. Poor oral hygiene, dietary abnormalities, and betel nut chewing can also act as contributory factors in the process of carcinogenesis. Multiple research works have been carried out in the past to shed some light on the role of exogenous bacterial species in the development of cancers. Studies conducted were to assess changes in the oral microflora in patients suffering from oral carcinoma and to evaluate and compare pre-operative and post-operative changes in oral microbiota. For this review, multiple articles were studied and evaluated. Appropriate conclusions were drawn and are presented in the review. A definitive link between cancer and microflora is yet to be established. In the present article, a review of the studies done on the contribution of microbial flora present within the oral cavity and their role in oral cancer is done and its nature and extent are evaluated. A variety of microbiological agents can contribute to the progression of carcinogenesis in the presence of definitive risk factors such as alcoholism and smoking.

Nrf2 in the Field of Dentistry with Special Attention to NLRP3

The aim of this review article was to summarize the functional implications of the nuclear factor E2-related factor or nuclear factor (erythroid-derived 2)-like 2 (Nrf2), with special attention to the NACHT (nucleotide-binding oligomerization), LRR (leucine-rich repeat), and PYD (pyrin domain) domains-containing protein 3 (NLRP3) inflammasome in the field of dentistry. NLRP3 plays a crucial role in the progression of inflammatory and adaptive immune responses throughout the body. It is already known that this inflammasome is a key regulator of several systemic diseases. The initiation and activation of NLRP3 starts with the oral microbiome and its association with the pathogenesis and progression of several oral diseases, including periodontitis, periapical periodontitis, and oral squamous cell carcinoma (OSCC). The possible role of the inflammasome in oral disease conditions may involve the aberrant regulation of various response mechanisms, not only in the mouth but in the whole body. Understanding the cellular and molecular biology of the NLRP3 inflammasome and its relationship to Nrf2 is necessary for the rationale when suggesting it as a potential therapeutic target for treatment and prevention of oral inflammatory and immunological disorders. In this review, we highlighted the current knowledge about NLRP3, its likely role in the pathogenesis of various inflammatory oral processes, and its crosstalk with Nrf2, which might offer future possibilities for disease prevention and targeted therapy in the field of dentistry and oral health.

Oral microbiome associated with lymph node metastasis in oral squamous cell carcinoma

Oral microbiota can alter cancer susceptibility and progression by modulating metabolism and inflammation. We assessed the association between the oral microbiome and lymph node (LN) metastasis in oral squamous cell carcinoma (OSCC). We collected a total of 54 saliva samples from patients with OSCC before surgery. LN metastasis was assessed based on postoperative pathological examination. We used QIIME2, linear discriminant analysis effect size (LEfSe), and PICRUSt2 methods to analyze microbial dysbiosis. A random forest classifier was used to assess whether the oral microbiome could predict LN metastasis. Among the 54 OSCC samples, 20 had LN metastasis, and 34 had no evidence of metastasis. There was a significant difference in β-diversity between the metastasis and no metastasis groups. Through LEfSe analysis, the metastasis group was enriched in the genera Prevotella, Stomatobaculum, Bifidobacterium, Peptostreptococcaceae, Shuttleworthia and Finegoldia. Pathways related to signal peptidase II were predominant in the no metastasis group. The RF model showed a modestly high accuracy for predicting metastasis. Differences in microbial community composition and functions were observed in the oral microbiome of patients with OSCC with and without LN metastasis. However, the finding that specific taxa may be associated with LN metastasis should be verified in a further prospective study.

Effect of Chemo-radiotherapy on Salivary Flora of Oral Cancer Patients

Management of cancers of oral cancers has remained a major challenge in India and globally. Radiotherapy and chemotherapy are mostly employed for treatment which inflicts changes in oral mucosa and makes it vulnerable for bacterial colonization and eventual infections. This study aims at evaluating the changes in oropharyngeal flora (bacteria and yeast) in oral cancer patients treated by a combination of chemo-radiotherapy with the control groups comprising of non-cancerous patients living in the same environment. This prospective evaluation included Seventy-seven patients with oral squamous cell carcinomas in the study group. Whereas the control group comprised of twenty-five non-cancerous patients. Saliva samples were collected from patients with oral carcinomas and those of the control group for bacteriological examination, and were transported within 2 hours to the laboratory and immediately inoculated and incubated. The oral microflora samples collected were evaluated for the presence of bacteria in saliva in both study and control group of patients. We evaluated the change in salivary oral flora during chemo-radiotherapy treatment. A statistically significant increase in growth of normal as well as abnormal oral flora was observed post-radiation. Escherichia coli showed a significant decrease in post-RT and also near to significant in control. Various changes in salivary oral flora were observed during the course of chemo-radiotherapy in study and controls groups. This shows that there are some sensitive spots in the oral cavity where the occurrence of oral cancer is more.

Looking beyond the smokescreen: can the oral microbiome be a tool or target in the management of tobacco-associated oral cancer?

A wide range of microbes inhabit the oral cavity, and bacterial and fungal communities most often exist as structured communities or biofilms. The use of tobacco alters the structure of the oral microbiome, including that of potentially malignant lesions, and the altered oral microbiome influences key microenvironmental changes such as chronic inflammation, secretion of carcinogenic toxins, cellular and tissue remodelling and suppression of apoptosis. Given this, it is clear that the bacterial and fungal biofilms in potentially malignant states are likely not passive entities, but could play a critical role in shaping potential malignant and carcinogenic conditions. This holds potential towards leveraging the oral microbiome for the management of tobacco-associated potentially malignant lesions and oral cancer. Here, we explore this line of investigation by reviewing the effects of tobacco in shaping the oral microbiome, and analyse the available evidence in the light of the microbiome of oral potentially malignant and cancerous lesions, and the role of dysbiosis in carcinogenesis. Finally, we discuss possible interventions and approaches using which the oral microbiome could be leveraged towards precision-based oral cancer therapeutics.

The effect of allicin on cell proliferation and apoptosis compared to blank control and cis-platinum in oral tongue squamous cell carcinoma

Background

Oral tongue squamous cell carcinoma (OTSCC) has aggressive clinical behavior with poor prognosis. Allicin plays a tumor-suppressive role in various cancers, although the role of allicin in OTSCC is unknown. We aimed to investigate the effect of allicin on cell proliferation and apoptosis compared to blank control and cis-platinum in OTSCC.

Methods

Tca-8113 and SCC-25 cells were treated with non-stimulated control, 12.5 µg/mL allicin, 25 µg/mL allicin, 50 µg/mL allicin, and 40 µg/mL cis-platinum, which were divided into blank control, allicin 12.5 µg/mL, allicin 25 µg/mL, allicin 50 µg/mL, and cis-platinum 40 µg/mL groups, respectively. Cell proliferation was determined by the Cell Counting Kit-8 assay. Cell apoptosis was detected by annexin V/propidium iodide and Western blot assays.

Results

In Tca-8113 and SCC-25 cells, cell proliferation was inhibited by 40 μg/mL cis-platinum, 12.5 μg/mL allicin, 25 μg/mL allicin, and 50 μg/mL allicin. Cell apoptosis was promoted by 40 μg/mL cis-platinum, 12.5 μg/mL allicin, 25 μg/mL allicin, and 50 μg/mL allicin, while compared to 40 μg/mL cis-platinum, it was increased by 50 μg/mL allicin. Western blot assay revealed that expression of pro-apoptosis protein Bax and C-Caspase 3 increased, but apoptosis-inhibitory protein Bcl-2 expression decreased with 40 μg/mL cis-platinum, 12.5 μg/mL allicin, 25 μg/mL allicin, and 50 μg/mL allicin, while compared to 40 μg/mL cis-platinum, Bax and C-Caspase 3 expression was increased by 50 μg/mL allicin.

Conclusion

Allicin was shown to have good efficacy in repressing cell proliferation as well as facilitating cell apoptosis in OTSCC.

Oral microbiome and oral cancer - The probable nexus

Oral squamous cell carcinoma is one of the most common malignancies and is the leading cause of morbidity and mortality. The known risk factors for oral cancer are tobacco, alcohol consumption and betel quid chewing. Nutritional deficiencies and certain microorganisms are also associated with oral cancer. Oral cavity is a host to numerous microorganisms, majority of which are bacterial communities along with fungi and viruses. A possibility of the dysregulation of the oral microbiome cannot be ignored. Oral microbiome is defined as the collective genome of microorganisms that reside in the oral cavity. With the development of culture-independent techniques, the detection and identification of the bacteria which cannot be cultured has become possible. Revolution in technology has led to increased research in this area in an attempt to find the role of microbiome in health and disease. Before identifying the exact role the microbiome plays in the development of oral cancer, it is essential to profile the microbiome in healthy individuals and patients with oral cancer. It is essential to note that oral cancer may sometimes occur without any habit too!! This article is an attempt to review the role of oral microbiome in oral cancer with a focus on the bacteriome, its related studies and in brief about the omics technologies in understanding the microbiome.

The Potential of Phytochemicals in Oral Cancer Prevention and Therapy: A Review of the Evidence

The etiological factors of oral cancer are complex including drinking alcohol, smoking tobacco, betel quid chewing, human papillomavirus infection, and nutritional deficiencies. Understanding the molecular mechanism of oral cancer is vital. The traditional treatment for patients with oral squamous cell carcinoma (e.g., surgery, radiotherapy, and chemotherapy) and targeted molecular therapy still have numerous shortcomings. In recent years, the use of phytochemical factors to prevent or treat cancer has received increasing attention. These phytochemicals have little or no toxicity against healthy tissues and are thus ideal chemopreventive agents. However, phytochemicals usually have low water solubility, low bioavailability, and insufficient targeting which limit therapeutic use. Numerous studies have investigated the development of phytochemical delivery systems to address these problems. The present article provides an overview of oral cancer including the etiological factors, diagnosis, and traditional therapy. Furthermore, the classification, dietary sources, anticancer bioactivity, delivery system improvements, and molecular mechanisms against oral cancer of phytochemicals are also discussed in this review.

Oral microbiota and gastrointestinal cancer

The microbiota inhabiting the oral cavity is a complex ecosystem and responsible for resisting pathogens, maintaining homeostasis, and modulating the immune system. Some components of the oral microbiota contribute to the etiology of some oral diseases. Accumulating evidence suggests that the human oral microbiota is implicated in the development and progression of gastrointestinal cancer. In this review, we described the current understanding of possible roles and mechanisms of oral microbiota in the gastrointestinal cancers studied to date. The perspectives for oral microbiota as the biomarkers for early detection and new therapeutic targets were also discussed.

Oral bacterial flora and oral cancer: The possible link?

Oral cancer exhibits multifactorial etiology with tobacco and alcohol long been implicated as the primary risk factors. In addition, betel nut, dietary factors and poor oral hygiene have also been found to have a role in the etiology of oral cancer. Past research has uncovered a great deal of information regarding the association of exogenous bacteria with cancer. However, our definitive knowledge of the oral commensal bacteria and oral cancer link remains inadequate. In the present article, we hypothesize a causal role for oral bacterial flora in oral cancer although an indirect one. We propose that the normal bacterial flora in conjunction with the already established risk factors such as alcohol consumption may play a role in cancer development. The continued exploration of this topic may aid in better understanding of the pathogenesis of oral cancer thereby helping in appropriate treatment and better prognosis.

Study of virulence factor of Candida species in oral lesions and its association with potentially malignant and malignant lesions

OBJECTIVE

The aim of this study was to explore the association between malignant and premalignant lesions and the virulence factor profile of Candida spp. recovered from different oral lesions.

DESIGN

Candida spp. isolated from malignant lesions (squamous cell carcinoma, OC, n = 25), atypical lichen planus (AL, n = 11), chronic candidiasis (CC, n = 25), and asymptomatic carriers (WI, n = 15, control strains.) Isolates were identified in chromogenic medium, colony morphology and biochemical tests. The lipolytic and proteinase activity was determined on supplemented agar with olive oil and BSA, respectively. The biofilm formation with XTT reduction assay and cellular surface hydrophobicity (CSH) by water-hydrocarbon method were performed.

RESULTS

All isolates recovered from oral lesions produced the four virulence factors studied with significantly higher levels than in WI isolates. Interestingly, lipolytic activity was absent in WI isolates. The proteolytic activity was similar in AL and OC isolates. OC isolates showed significantly higher CSH values than other clinical isolates. Non-albicans species showed higher biofilm formation than C.albicans (P = 0.03.) There were no significant differences in virulence factors among species. A strong positive correlation was found between proteinase and lipase activity (r = 0.90, P < 0.0001), and between hydrophobicity and biofilm (R = 0.81, P < 0.0001.) CONCLUSIONS: Our results indicate that OC Candida isolates exhibited a significant higher attributes of virulence than other lesions fungus isolates, providing evidence about the association between Candida pathogenicity and lesions severity.

Impacts of survivin and caspase-3 on apoptosis and angiogenesis in oral cancer

The present study aimed to investigate the impact of survivin and caspase-3 on apoptosis and angiogenesis in oral cancer. A total of 16 oral leukoplakia cases accompanied by low-moderate epithelial dysplasia, 12 cases of oral leukoplakia accompanied by severe epithelial dysplasia, 17 cases of high-moderate differentiated oral squamous cell carcinoma and 10 cases of normal oral mucosa were selected. Immunohistochemistry was used to detect the expression levels of survivin, caspase-3, and caspase inhibitor factor VIII in lesions from each group. Terminal deoxynucleotidyl transferase 2'-deoxyuridine, 5'-triphosphate nick end labeling was performed to detect the apoptotic index of oral leukoplakia and cancer tissue. Immunohistochemistry revealed increased expression levels of survivin in oral cancer tissues, as compared with the normal mucosa, whereas the expression of Caspase-3 was decreased during malignant transformation. Microvascular density (MVD) was increased from 28.49±11.87 strips/mm² (mean ± standard deviation, normal control group) to 91.98±40.20 strips/mm² (oral cancer group). Therefore, survivin may serve an important role in oral cancer, as its expression was increased in association with a downward trend in caspase-3 expression and apoptotic index, whereas MVD was significantly increased.