Abstract

Betel nut consumption has significant implications for the public health globally, as the wide-spread habit of Areca chewing throughout Asia and the Pacific is associated with a high prevalence of oral carcinoma and other diseases. Despite a clear causal association of betel nut chewing and oral mucosal diseases, the biological mechanisms that link Areca nut-contained molecules, inflammation and cancer remain underexplored. In this study we show that the whole Areca nut extract (ANE) is capable of mobilizing Ca2+ in various immune cell lines. Interestingly, none of the four major alkaloids or a range of other known constituents of Areca nut were able to induce such Ca2+ signals, suggesting that the active components might represent novel or so far unappreciated chemical structures. The separation of ANE into aqueous and organic fractions has further revealed that the calcium-mobilizing molecules are exclusively present in the aqueous extract. In addition, we found that these calcium signals are associated with the activation of several immune cell lines as shown by the release of pro-inflammatory cytokines and increased cell proliferation. These results indicate that calcium-mobilizing molecules present in the aqueous fraction of the Areca nut may critically contribute to the inflammatory disorders affecting betel nut chewers.

Highlights

  • Betel or Areca nuts are used around the world by approximately 600 million people and are ranked fourth in worldwide use among psychoactive substances

  • Several studies have analyzed the chemical composition of Areca nut extract (ANE) and some alkaloids have been identified as candidates for the deleterious health effects on betel nut chewers, little is known about their effects on Ca2+ signaling and the early causative events of inflammation

  • Our results demonstrate that ANE can induce calcium signals in at least 3 immune cell lines and human primary immune cells (PBMCs), inducing the production of pro-inflammatory cytokines

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Summary

Introduction

Betel or Areca nuts are used around the world by approximately 600 million people and are ranked fourth in worldwide use among psychoactive substances. Additional studies have shown betel nut use causes cardiovascular disease[6], aggravates asthma[7], and can affect reproductive health[8,9]. Areca nut chewing promotes the release of various mediators from host cells that contribute to a chronic inflammatory microenvironment in the oral cavity and further supports the development of oral lesions and tissue damage. It is widely acknowledged and appreciated that chronic inflammation plays an important role in carcinogenesis, but the biological mechanisms that link Areca nut-contained molecules, immune cell activation, cytokine production, inflammation, and cancer remain underexplored and are the focus of the present study. The measurements were performed using RBL-2H3 rat mast cells (A), Jurkat human T cells (B), U937 human monocytes (C), HL-60 human neutrophils (D) and human primary Peripheral Blood Mononuclear Cells (PBMCs) from two different sources; PBMCs-1 from Lonza (E) and PBMCs-2 from Stemcell Technologies (F)

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