Abstract

Betel quid (BQ) chewing is an etiologic factor of oral submucous fibrosis (OSF) and oral cancer. There are 600 million BQ chewers worldwide. The mechanisms for the toxic and inflammatory responses of BQ are unclear. In this study, both areca nut (AN) extract (ANE) and arecoline stimulated epidermal growth factor (EGF) and interleukin-1α (IL-1α) production of gingival keratinocytes (GKs), whereas only ANE can stimulate a disintegrin and metalloproteinase 17 (ADAM17), prostaglandin E2 (PGE2) and 8-isoprostane production. ANE-induced EGF production was inhibited by catalase. Addition of anti-EGF neutralizing antibody attenuated ANE-induced cyclooxygenase-2 (COX-2), mature ADAM9 expression and PGE2 and 8-isoprostane production. ANE-induced IL-1α production was inhibited by catalase, anti-EGF antibody, PD153035 (EGF receptor antagonist) and U0126 (MEK inhibitor) but not by α-naphthoflavone (cytochrome p450-1A1 inhibitor). ANE-induced ADAM17 production was inhibited by pp2 (Src inhibitor), U0126, α-naphthoflavone and aspirin. AG490 (JAK inhibitor) prevented ANE-stimulated ADAM17, IL-1α, PGE2 production, COX-2 expression, ADAM9 maturation, and the ANE-induced decline in keratin 5 and 14, but showed little effect on cdc2 expression and EGF production. Moreover, ANE-induced 8-isoprostane production by GKs was inhibited by catalase, anti-EGF antibody, AG490, pp2, U0126, α-naphthoflavone, Zinc protoporphyrin (ZnPP) and aspirin. These results indicate that AN components may involve in BQ-induced oral cancer by induction of reactive oxygen species, EGF/EGFR, IL-1α, ADAMs, JAK, Src, MEK/ERK, CYP1A1, and COX signaling pathways, and the aberration of cell cycle and differentiation. Various blockers against ROS, EGF, IL-1α, ADAM, JAK, Src, MEK, CYP1A1, and COX can be used for prevention or treatment of BQ chewing-related diseases.

Highlights

  • Chewing betel quid (BQ) is popular in Taiwan, India and many Southeast Asian countries [1,2,3]

  • Previous studies have observed the stimulation of many signal transduction pathways, such as PI3K/Akt, nuclear factor-κB (NF-κB), mitogen-activated protein kinase kinase (MEK)/ ERK, p38, jun N-terminal kinase (JNK), TGF-β/Smad and glycogen synthase kinase-3β (GSK-3β) pathways, by areca nut (AN) components in epithelial cells [19,20,21]

  • To further elucidate the upstream signaling and downstream effective molecules, we found that AN components induce epidermal growth factor (EGF), IL-1α and a disintegrin and metalloproteinase 17 (ADAM17) secretion by gingival keratinocytes (GKs)

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Summary

Introduction

Chewing betel quid (BQ) is popular in Taiwan, India and many Southeast Asian countries [1,2,3]. This habit increases the risk of oral leukoplakia, oral submucous fibrosis (OSF) and oral cancer. The induction of reactive oxygen species (ROS), damage to cellular targets (DNA, protein, lipid) after metabolic activation of BQ components by phase 1 enzymes (e.g., cytochrome P450s) [5], the cytotoxic effects of BQ constituents, keratinocyte inflammation and oncogene activation are suggested to be the contributing factors. The roles of ROS production by BQ components and the related upstream/downstream signaling in mediating cytotoxicity, aberrant differentiation and prostanoid production/tissue inflammation are crucial in BQ carcinogenesis

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