Betel Nut Consumption Research Articles

Oral mucosal disorder-A demographic study.

Introduction:Oral mucosal disorder (OMD) has the potential disorder than any other oral disorder. It is found in the all over would. In our country India, is also more prone area of oral mucosal disorder. People more affected in male, low educated, low socioeconomic. Areca nut consumption is more so oral mucosal disorder is more reported, this survey was undertaken in darbhanga and is surrounding to determine the demographic data of oral mucosal disorder and to identify their association with various factors.Materials and Methods:A total of 5620 patients of Oral mucosal disorder attending the dental outpatient clinic of the Department of Oral Medicine and Radiology in dental college and department of dentistry in darbhanga medical college over a period of 36 months were selected for the study. A detailed case history and clinical examination was done in visible light. Study was done on the basis of age group, gender, socioeconomic habit duration, frequency of habit, and type of habit.Statistical Analysis Used:Simple t-test analysis was performed.Results:Of the 5620 cases of OMD studied, 75.01% cases were male. 49.09% were low socioeconomic people, 36.12% graduate educated, 47.29% smokeless habit and frequency of habit more than two time 57.12%. Oral mucosal disorder.Conclusion:Younger populations have relatively a higher percentage of oral mucosal lesions than would older populations. Habits, like smoking and smokeless, which further increase with age, can also increase the incidence of oral mucosal disorder Prevalence of habits was more in males than females.

Comparative Study of Oral Submucosal Fibrosis Management With Two Drug Combination (triamcinolone and Hyaluronidase) V/s Three Drug Combination (triamcinolone, Hyaluronidase and Placental Extract)

BACKGROUND: Oral submucosal fibrosis (OSMF) is a precancerous condition of the oral mucosa. It is exclusively occurring among Indians and South Asiatic people. It occurs due to areca nut consumption which leads to inflammation of oral and pharyngeal mucosa and impaired collagen metabolism. These leads to burning sensation in oral cavity, fibrosis of mucosal lining and trismus in OSMF. Aim: Aim of the study is to know the effect of triamcinolone, hyaluronidase and placental extract in different combination in OSMF grade II and III patients. Material& Method: A prospective study of 50 patients was done where they were divided in two groups. First group was treated with combination triamcinolone & hyaluronidase and second group was treated with triamcinolone, hyaluronidase and placental extract. Effectiveness of treatment was measured by visual analogue scale in pre and post treatment period. Mean score value for each symptoms was compared in two groups. Result: At the end of study, burning sensation showed maximum improvement where mean score for first group was 0.92±0.15 and 0.84±0.16 in second group. For mouth opening, mean score of 3.68±0.26 was seen in first group and mean score of 3.24±0.21 was seen in second group. Both of these results show that second group can give better result compare to first group. Overall improvement was better in second group on comparing mean value score. Thus, OSMF patients show significant improvement (<0.05) by medical treatment. in. Conclusion: Maximal improvement seen in the burning sensation followed by other symptoms like colour of oral mucosa, fibrotic band and mouth opening in decreasing order in both the groups. Results were better with three drug combination group. Thus, corticosteroids, hyaluronidase and placental extract shows good improvement in OSMF patients in the form of relief of symptoms.

KONSUMSI SIRIH PINANG DAN PATOLOGI GIGI PADA MASYARAKAT PRASEJARAH LEWOLEBA DAN LIANG BUA, DI NUSA TENGGARA TIMUR, INDONESIA

This paper focus on chewing betel quid habit that dominantly happen in the Asia to Pacific region. Betel quid leaves traces of reddish-brown colour on the teeth. It was identified that dental stain was very common on teeth of prehistoric skeletal remains, for example in Thailand and Vietnam. Several studies have shown that chewing betel nut can cause diseases in the teeth and oral cavity. The purpose of this study is to describe the relationship between betel nut chewing and the emergence of tooth pathology in teeth from the prehistoric population from Lewoleba and Liang Bua. Ten individuals were observed using the macroscopic method. The results showed that consumption of betel nut (based on dental stains) was followed by attrition, periodontitis and even antemortem tooth loss.

Association of oral pre-malignant lesions with the consumption of tobacco

Background: Tobacco consumption in the form of chewing and smoking is one of the biggest addictions. It causes various oral pre-malignant lesions which mainly include oral sub-mucous fibrosis (OSMF) caused by betel nut consumption and tobacco quid lesion, leukoplakia, erythroplakia and smoker's palate caused by chewing and smoking tobacco.Methods: The data about the past and present consumption of tobacco was collected from 909 individuals. Based on the tobacco habits, the oral cavity findings were assessed and the statistical analysis was carried out to find the significance of associations observed between tobacco consumption and lesions.Results: Out of 909 subjects, 537 were consuming tobacco, out of which 284 were chewers, 65 were smokers and 76 were consuming in both forms. Out of the 284 tobacco chewers, 43% had oral lesions (19.4% had OSMF and 21.5% had tobacco quid) as compared to just 1% of workers having oral lesions (OSMF) amongst those who had no addiction. There was a high prevalence of lesion in tobacco chewers (p&lt;0.005). Out of total smokers, 15.8% had smoker's palate whereas no lesion was seen in the non-addicted workers. The odds of developing oral pre-malignant lesion are 43.62 times higher in exposed individuals.Conclusions: The tobacco consumption in any form is hazardous. Betel nut exposure causes more harmful effect which goes unnoticed. Awareness should be created about various lesions caused by tobacco as well as betel nut and special steps should be taken for early diagnosis and its treatment.

The profound oral cavity cancer burden in the United States Commonwealth of the Northern Mariana Islands: A global health opportunity.

Betel nut consumption contributes to higher rates of oral cavity cancer throughout Micronesia. The purpose of this study is to review local surveys and cancer data to further characterize these issues in the Northern Mariana Islands (CNMI). Two commonwealth-wide health inquiries were reviewed: The Non-Communicable Diseases Survey (NCDS), 2016 and The Youth Risk Behavior Survey (YRBS), 2013. Data pertaining to betel nut, tobacco and alcohol use was extracted. Relevant cancer data from the Commonwealth Healthcare Corporation (CHC) of Saipan and the Surveillance, Epidemiology, and End Results (SEER) databases was assessed. Betel nut chewing was reported by 43% of Asian Pacific Islander (API) adults, with 88% adding tobacco to the chew. Adults aged 20-30 had significantly higher rates of chewing relative to older groups (p < .0001). Tobacco smoking and alcohol use were reported by 25% and 23% of adults, respectively. Betel nut chewing was reported by 33% of high school students. From 2007 to 2016, oral cavity cancers contributed to 9% of all cancer diagnoses and 13% of cancer-related mortalities. SEER data supported oral cavity cancer diagnoses at younger ages in APIs. These results demonstrate concerning trends regarding alcohol, tobacco and betel nut use in the CNMI. Betel nut use is prevalent among APIs of nearly all ages, with the majority adding tobacco to their chew. The available data suggests a drastic oral cavity cancer burden in the CNMI. Efforts should be made to evaluate for effective means of primary and secondary prevention in API regions.

Head and Neck Squamous Cell Carcinoma in Young Adults: A Hospital‑Based Study

Abstract Background: Head and neck cancers (HNCs) account for 30% of all cancers in India. In north eastern India, tobacco-related cancers are very common because of the widespread use of tobacco. The paucity of any study from this region in young head and neck patients has prompted us to take up this study. Methodology: A retrospective study was conducted at Dr. B Borooah Cancer Institute, Guwahati during January 2015–December 2015. Data regarding tumor site, age, sex, education, habit of tobacco (smokeless and smoke), and betel nut consumption were analyzed using IBM SPSS version 19. P &lt; 0.05 was considered as statistically significant. Results: About 75.1% patients were males. Among patients ≤39 years, 83.7% were tobacco chewers, 50.5% were smokers, and 83.7% betel nut chewers, and among &gt;39 years, these proportions were 83.7%, 56.2%, and 78.7%, respectively. The most common site among ≤39 years and &gt;39 were mouth (40.8%) and hypopharynx (36.8%). Among tobacco and betel nut chewers and smokers, the most common sites were mouth (40.3%, 42.5%) and hypopharynx (41.5%). The site of head and neck squamous cell carcinoma was highly associated with chewing and smoking habit (P &lt; 0.05). Among illiterate patients, proportions of tobacco and betel nut chewers and smokers were 65.3%, 61.6%, and 67.9%, respectively. Conclusion: A positive association between tobacco use, male gender, and low education levels were found. The younger generation should be made aware about the adverse health consequences of tobacco use to reduce the preventable risk factors of HNC.

The Prevalence and Risk Factors for Potential Oral Malignant Disorders in a Middle Aged North Indian Population

INTRODUCTION: The menace of oral cancer has become a public health concern and its prevalence is increasing with every passing day, making it the sixth most common cancer across the globe.&#x0D; OBJECTIVE: To evaluate the prevalence and risk factors for potential oral malignant disorders in a middle aged north Indian population.&#x0D; MATERIALS AND METHODS: This Cross-sectional study was carried out on 1260 individuals in Delhi and NCR. A questionnaire was created to record information about socio demographic traits, oral hygiene routines, threat associated to oral probable malignant disorders .The Oral Mucosal lesions were examined by professionals. Results. The Overall Prevalence of Potential oral malignant disorders was found to be with oral submucous fibrosis (6.09%) found in a greater extent and erythroplakia (0.15%)found to be lesser.&#x0D; RESULTS: It was documented that 11.48% of the Northern Indian Population which suffered from oral malignant lesions, with the prevalence rates of leukoplakia in 3.01%, Lichen Planus in 1.42% and lowest being erythroplakia in 0.15% of the subjects. The prevalence of oral malignant lesions among males was found to be higher(12.8%) as compared to females p value &lt;0.0001. No significant difference was found between categories of socio-economic status, tooth brushing methods ,brushing frequency with prevalence of oral malignant disorders&#x0D; CONCLUSION: The Study augments an interrelation between tobacco and areca nut consumption with oral probable malignant disorders. An interrelation of oral probable malignant disorders with diabetes and BMI was confirmed by this study.

Testing for Betel Nut Alkaloids in Hair of Papuans Abusers using UPLC-MS/MS and UPLC-Q-Tof-MS.

Betel nut is the fruit of Areca palm, growing in Papua New Guinea. Mixed with limestone and stick mustard, arecoline and guvacoline, which are present in betel nut, are hydrolyzed into arecaidine and guvacine, respectively. As part of the study on dietary habits of Papuans residents, our laboratory was asked to analyze the four alkaloids in hair to document long-term exposure. Hair samples were collected from 19 adult subjects (males=11; females=8), by some of the authors, and were sent to the laboratory for analysis. The four alkaloids have very similar chemical structures. In order to accurately identify the drugs, two methods were developed. First, the compounds were identified using an ultra-high-performance liquid chromatography system coupled to time-of-flight mass spectrometry. Then, they were quantified by an ultra-high-performance liquid chromatography system coupled to tandem mass spectrometry. After decontamination with dichloromethane, hair samples were cut into very small segments and 20mg were incubated in methanol for 2h 30min in an ultrasound bath. After cooling, the methanol was evaporated to dryness in presence of 20-μL octanol to prevent volatilization. Nicotine-d4 was used as an internal standard. Linearity was observed for concentrations ranging from the limit of quantification to 20ng/mg for arecoline, arecaidine, guvacine and guvacoline. Measured concentrations were in the range 60pg/mg to 18ng/mg for arecoline (n=19), 14pg/mg to 2.5ng/mg for guvacoline (n=11), 63pg/mg to 3.8ng/mg for arecaidine (n=11) and 100pg/mg to 3.2ng/mg for guvacine (n=6). There was no correlation between concentrations of arecoline and arecaidine (ratio from 0.01 to 0.18) and guvacoline and guvacine (ratio from 0.06 to 3.50). However, the identification of these substances in hair is a good marker of consumption of betel nut and allows us to document a local practice that remains difficult to evaluate just by questioning.

ANTIOXIDANT RICH TROPICAL HERBS TO COMBAT ARECA-NUT INDUCED OPMDS

Objectives Areca-Nut (AN) induced Oral Premalignant Diseases (OPMDs) are a health burden in Asian countries which causes higher morbidity and mortality. Oral Submucous Fibrosis (OSMF) and Oral Leukoplakia (OL) are the most vulnerable AN induced OPMDs which have a considerable malignant transformation rate. The underline mechanism of the carcinogenesis in OPMDs is still obscure. It was found that the oxidative stress caused by the AN can induce the carcinogenesis in OPMDs. Based on our previous research, it was found that some of these OPMDs have DNA damage caused by oxidative stress. Tropical countries are rich of herbs with antioxidants. Our attempt was to test few herbs as a remedy to reverse the potential carcinogenesis in AN induced OPMDs by reducing the oxidative stress caused by the AN. Findings Expression of Phospho histone H2AX, DNA double-strand breaks (DNA DSBs) marker was tested immuno-histochemically in OPMDs with the history of AN consumption and compared with normal oral mucosa (NOM) and oral squamous cell carcinoma (OSCC). Phospho histone H2AX was significantly increased in OL and OSMF compared to the NOM (p Conclusions This study is evident that blocking ROS generation by herbal extracts as a promising approach to reverse DNA DSBs caused by AN. Especially, to prevent malignant transformation in OPMDs

INCIDENCE RATES OF ORAL AND OROPHARYNGEAL CANCER IN SOUTH AFRICA 1988-2013

In South Africa, the four different population groups (White, Black, Coloured/Mixed Race and Asian) have very different incidence rates of oral cancers. The possible impact of HR-HPV infection on the incidence of oropharyngeal cancer in this country has not been assessed. Objectives To describe and compare the trends in age standardised incidence rates (ASIR) of oral and oropharyngeal cancer in South Africa from 1988 to 2013. Methods The ASIRs of these cancers were calculated from the incidence rates published by the National Cancer Registry (SA-NCR), a pathology-based registry. Findings The average ASIR (/100,000/year) of oral cavity cancer for all males was 5.9 and for all females 1.74; the highest affected were the males of mixed race (8.47) and white males (6.19) and the Asian females (4.61). The latter population group is known for a high consumption of Areca nut. The average ASIR of pharyngeal cancer for all males was 2.61 and for all females 0.71; The highest incidence of pharyngeal cancer was noted in the males of mixed race (3.86) and white males (2.73). As South Africa is not known for a high incidence of nasopharyngeal cancer, these rates would more or less apply to oropharyngeal cancers. The trends of oral cavity and oropharyngeal cancer ASIRs over the period 1988-2013 show a slight downward trend except for white and mixed-race females. The incidence trends in pharyngeal cancer also show a decline over that period. Conclusion The intensification of the anti-tobacco legislation and campaigns in South Africa might have contributed to the slightly declining incidences of oral and pharyngeal cancer. Contrary to data reported in the United States and Europe, there is no indication of a rise in HR-HPV driven oropharyngeal cancers over the period 1998-2013 which could indicate that South Africa is lagging behind in the HR-HPV related carcinoma epidemic.

Testing for betel nut alkaloids in hair using UHPLC-MS/MS and UHPLC-Q-ToF-MS

Simultaneous identification and quantification of 4 betel nut alkaloids (arecoline, arecaidine, guvacoline and guvacine), in the hair of papuans abusers. Betel nut or areca nut, also known as “buai” in Papua New Guinea is the fruit of Areca catechu palm. This nut is highly consumed by the local population and represents a large part of the internal commercial activity of the island. The betel nut is mixed with lime powder made of shell or coral and stick mustard, which is a kind of bean also called “daka”. This mixture, of a typical red color, is chewed all along the day and finally spat in the street by the residents. Two major compounds are presents in betel nut: arecoline and guvacoline. In presence of lime (alkaline conditions), these alkaloids are hydrolyzed into arecaidine and guvacine respectively. These 4 substances have stimulating, anorectic and mildly euphoric effects. Some side effects are associated with this addiction, and the use of betel nut is the principal cause of mouth and esophagus cancer in Papua New Guinea. As part of the study on dietary habits, phenotypic and genetic diversity of papuans residents, our laboratory was asked to analyze the active substances in hair to document exposure. Hair samples were collected from 19 adult subjects (males = 11; females = 8) by some of the authors and sent to the laboratory for analysis. The 4 alkaloids of betel nut have very similar chemical structures. In order to identify accurately the drugs, two methods were developed. First, the compounds were identified using an ultra-high-performance liquid chromatography system coupled to time-of-flight mass spectrometry (Waters XEVO ® G2-XS qTof). Then, they were quantified by an ultra-high-performance liquid chromatography system coupled to tandem mass spectrometry (Waters XEVO ® TQD). Hair samples were twice decontaminated with dichloromethane and cut into very small segments using scissors. Given the curvy nature of all the specimens, there was no attempt to do segmentation. Then, 20 mg were incubated in methanol during 2 h 30 in an ultrasound bath. After cooling, the methanol was evaporated to dryness in presence of 20 μL octanol to prevent volatilization. Linearity was observed for concentration ranging from LOQ to 20 ng/mg with a correlation coefficient R 2 of 0.9994, 0.9999, 0.9999 and 0.9981 for arecoline, arecaidine, guvacine and guvacoline respectively. Measured concentrations were in the range: 60 pg/mg to 18 ng/mg for arecoline ( n = 19), 14 pg/mg to 2.5 ng/mg for guvacoline ( n = 11), 63 pg/mg to 3.8 ng/mg for arecaidine ( n = 11) and 100 pg/mg to 3.2 ng/mg for guvacine ( n = 6). There was no correlation between concentrations of arecoline and arecaidine (ratio arecaidine/arecoline from 0.01 to 0.18) and guvacoline and guvacine (ratio guvacine/guvacoline from 0.06 to 3.50). However, the identification of these substances in hair is a good marker of consumption of betel nut, and allows to document a local practice which remains difficult to evaluate just by questioning.

Risks of substance uses, alcohol flush response, Helicobacter pylori infection and upper digestive tract diseases-An endoscopy cross-sectional study.

This study examines the effects of environmental hazards, including tobacco, alcohol/alcohol flush response, areca nut, and Helicobacter pylori (H pylori) infection on upper digestive diseases. This is a multi-hospital-based endoscopy-survey cross-sectional study. Subjects were received upper endoscopies in outpatient clinics at four hospitals in Taiwan between 2008 and 2013. Biopsy-based methods or urea breath test were used confirm the status of H pylori infection. In total, 8135 subjects were analyzed. Higher cumulative amounts of alcohol consumption were at higher risk of Barrett's esophagus and esophageal squamous cell carcinoma (ESCC), higher cumulative amounts of tobacco consumption were at higher risk of peptic ulcer, and higher cumulative amounts of areca nut consumption were at higher risk of duodenitis. Alcohol flush response was significant risk for reflux esophagitis and Barrett's esophagus (adjusted odds ratio [aOR] = 1.18 and 1.32, 95% confidence interval [CI] = 1.07-1.31 and 1.06-1.65, respectively). H pylori infection was inversely associated with ESCC risk (aOR = 0.20, 95% CI = 0.10-0.40). In addition, H pylori infection was consistently and significantly risk factors for gastrointestinal diseases, including peptic ulcer, gastric adenocarcinoma, and duodenitis (aOR = 5.51, 1.84, and 2.10, 95% CI = 4.85-6.26, 1.03-3.26, and 1.71-2.56, respectively). Besides the cumulative risk of alcohol, tobacco, and areca nut for Barrett's esophagus, ESCC, and peptic ulcer, respectively, presence of facial flushing was the significant risk for reflux esophagitis and Barrett's esophagus. H pylori infection was positively associated with peptic ulcer, gastric adenocarcinoma, and duodenitis, but inversely associated with ESCC.

Knowledge, attitude and practice towards areca nut use among medical student of Nagpur city

Background: Areca nut is consumed by approximately 600 million people worldwide and is the fourth most common psychoactive substance used globally and also gaining popularity among younger populations. There is substantial evidence that areca nut is the sole factor for the causation of premalignant condition like oral submucous fibrosis, aggravating asthma, liver fibrosis, hypertension, etc., and has its deleterious effects on other system of the body as well. As the MBBS curriculum does not include the awareness regarding the detrimental effects of areca nut use, it becomes mandatory for people from health science fraternity including medical students to have knowledge and awareness regarding such harmful agents. Therefore, the study is planned to assess the knowledge, attitude and practice toward areca nut consumption among medical students. Aim: To assess the knowledge, attitude, and practice toward areca nut consumption among medical students of Nagpur city. Methodology: After getting approval from the Institutional Ethics Committee dated 22nd July2019, this cross-sectional study was carried out at VSPM DC and RC in collaboration with NKP SIMS Nagpur. The validated questionnaire was designed which comprised of 23 close-ended questions to asses about knowledge, attitude, and practice toward consumption of areca nut. The questionnaire was prepared on Google form which was then sent via e-mail among 200 medical students including interns and post-graduates willing to participate in the study and their responses were obtained by five-point Likert scale that ranges from strongly agree to strongly disagree. Results: There was a high percentage of unawareness regarding knowledge and attitude parameters and lack of practice of areca nut among medical students. Conclusion: There is need “to update” the knowledge and awareness among medical students regarding hazards of the areca nut use by conducting CME programs in order to provide better life quality to the patients.

Adverse cardiovascular effects of betel nut

Background: Areca nut (Areca Catechu) is considered to be the fourth extremely prevalent addictive psychoactive substance consumed widely by about 10%–20% of the world population. Due to its theological and cultural acceptance, areca nut is chewed in different forms and formulations. It has been observed that people who chew supari (areca nut) exclusively for many years suffer from diabetes mellitus, coronary artery disease (CAD), oral submucous fibrosis, and oral cancer. We, therefore, planned to see its association with various cardiovascular ailments at our center. Materials and Methods: This was a single-center observational study carried out on people chewing areca nut exclusively (no other toxic or addicting substance) attending cardiac outpatient department (OPD) in National Heart Institute and Research Centre, Delhi, India. The subjects data were collected regarding the history of the disease, consumption of areca nut, and socioeconomic status with relevant work up. Results: There were 17 subjects who primarily chewed areca nut; 11 of them had CAD, diabetes, oral submucous fibrosis, and aplastic anemia. Further, one particular case not only suffered oral cancer but also had two episodes of myocardial infarction, but continued to chew areca nut. The second episode of myocardial infarction was fatal. Conclusion: Areca nut chewing is also associated with significant cardiovascular morbidities besides oral cancer. In such preparations, the risk of some other toxic substances together with areca nut cannot be eliminated as no empirical analysis has been carried out to the best of our knowledge and belief. In order to clarify its effect on other vascular diseases, further work with a larger sample size is required.

Knowledge on Health Effects and Current Practice Toward Arecanut Use Among Secondary School Children Living in Malé City, Maldives

Background: The fourth most commonly used addictive substance in the world is arecanut and is classified as a group 1 carcinogen to human. Over 600 million people are estimated to chew arecanut. It is consumed in some form or other, often with betel quid by 10%–20% of world's population. School goers lack the knowledge and practice toward arecanut use. Many high school children are not well aware about the health hazards of arecanut consumption. Most children start arecanut use at younger age. Arecanut consumption is more prevalent among boys than girls. Arecanut was introduced for majority of the school goers by either their friends or family. Most common form of arecanut used by school goers is sweetened supari. Aim: The current study was conducted to identify the knowledge on health effects, and current practice toward arecanut use among secondary school children living in Malé City, Maldives. Methods: A cross-sectional survey using precoded questionnaire was used. A total of 1350 questionnaire was distributed to the secondary school students studying at selected schools in Malé City and 804 questionnaires were returned. The total target population was 5297. The schools were selected through cluster sampling, while the students were selected via simple random sampling. The calculated sample size consists of 674 students which are equally selected from both genders. Data analyses were executed by using Excel and SPSS 21 software. Descriptive statistics and nonparametric tests were performed. Ethical approval was obtained from Villa College as well from national health research committee at ministry of health. Results: Secondary school children in Malé City have inadequate knowledge on harmful effects of arecanut use. The knowledge varies based on their gender, grade, school, and residence, but does not vary based on their age. The knowledge on harmful effects of arecanut use is more among girls, students at grade 9, students studying at Rehendhi school, and more among those who lives in both Hulhumalé and Vilimalé than those who live in Malé. The students started arecanut use mainly at age between 11-15 years. It was introduced by either friends or family members among large number of school children. Majority of participants used supari as a main form of arecanut, and Rasily supari was the favorite brand of supari among secondary school children. Boys start its use earlier, frequency, duration, and daily consumption is higher among boys than girls. Conclusion: Secondary school children have inadequate knowledge on harmful effects of arecanut use. Supari is the main form of arecanut use and most of the students initiated the habit at a younger age, which is an alarming threat to the society, hence there is an urgent need to start school based preventive programs, community awareness programs, for school children, teachers, parents, and general public at large as stopping the starting of a habit is much easier than quitting of same habit.

AA Homozygous Genotype of GSTP1 I105V Polymorphism in Oral Cancer: In Silico Screening, Molecular Dynamics Simulation and Activity Studies of Wild and Mutant GSTP1

Background: Highest incidence of oral squamous cell carcinoma (OSCC) has been reported in north-eastern India and causal association between cancer and raw areca-nut (RAN) consumption are well evident. Earlier studies revealed that monitoring the occurrence of precocious anaphase and expression of securin in blood lymphocytes can be a good biomarkers for cancer risk in RAN+lime chewers. Glutathione S-transferases (GSTs) are considered an important cellular detoxification system that provide protection against the effects of toxins and determine individual's cancer susceptibility. Aim: Although GST gene family has been extensively studied, its role as susceptibility factor in oral cancer risk in the RAN chewing population in Meghalaya state, India has not been explored. The association of polymorphisms in GSTP1 (Ile105Val) gene with OSCC risk in Meghalaya, India, was evaluated. Earlier both AA reference and the GG/AG mutant genotype of GSTP1 gene showed an association with different types of cancers. Methods: Genetic polymorphism was evaluated by genotyping 129 cases and 156 controls using PCR-RFLP method and validated by Sanger sequencing in a hospital-based case-control study. GSTP1's interaction status with c-Jun Kinase (JNK) was evaluated through protein-protein docking analysis and this was also validated experimentally by immunohistochemistry and qRT-PCR. Results: Individuals with AA allele of GSTP1 showed significant association with the risk of OSCC compared with individuals with AG/GG mutant genotypes in habit-matched “RAN-only” and “RAN+Tobacco” group. The binding geometry between JNK and GSTP1 was disrupted in mutant combinations. It was demonstrated that AA homozygous genotype of oral epithelial cells showed reduced c-Jun-phosphorylation and proapoptotic genes expression than AG/GG genotypes. In silico docking revealed that homodimeric GSTP1 with AA genotype showed weak catalytic activity in detoxification of RAN and tobacco toxins compared with the AG/GG mutant proteins. Interestingly, the quantitation of 8-Oxo-2´-deoxyguanosine in DNA digests by ELISA-kit showed no differences in these genotypes, however the frequency of sister-chromatid exchanges was significantly higher in individuals with GSTP1 AA genotype than GG genotype. Conclusion: Thus in this population, specific traditional habit along with GSTP1 AA genotype play a significant role in predisposition to oral cancer risk by showing higher DNA-lesions, might be caused by some specific RAN/tobacco metabolites, and lower c-Jun phosphorylation which may inhibit apoptosis.

Relationship between thyroid nodules and lifestyle characteristics in Chinese centenarians

Objective To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age. Key words: Ultrasonography; Thyroid nodules; Centenarians; Lifestyle characteristics

Areca nut trade, globalisation and its health impact: perspectives from India and South-east Asia.

Areca nut (AN) is consumed globally by 600 million people, and 10%-20% of the world population uses betel quid, a preparation containing areca nut. India and other South-east Asian countries are the largest consumers of AN in the world. The aim of this article is to review the economic impact and oral health effects of the consumption of AN. It will also discuss the role of dentists and auxiliary healthcare providers for increasing public awareness and the need for a strong public health policy. To address the concerned area, PubMed, Scopus and Google Scholar databases were explored from the year 1965 until 2017. Studies focusing on various aspects of AN only, and articles published in English were included. Anecdotal reports, case reports and unpublished data were excluded. This narrative review suggests India is the world's largest producer of AN along with the largest AN consuming population followed by other South-east Asian countries. AN chewing causes oral submucous fibrosis (OSF) and it is most commonly observed in people of India and South-east Asia. AN use is associated with various social and unsocial aspects. Dentists and dental auxiliaries can increase the knowledge and awareness of a health issue (OSF) among the target audience as well as the detrimental effects of AN chewing. There is a need for more aggressive public health measures and dentists and dental auxiliaries should be employed to bring awareness to the general public regarding AN use.

Thyroid nodules in centenarians: prevalence and relationship to lifestyle characteristics and dietary habits.

BackgroundThyroid nodules (TNs) are common thyroid lesions in older population. Few studies have focused on the prevalence of TNs and their relationship to lifestyle characteristics and dietary habits in centenarians. The current study aimed at determining the prevalence of TNs in Chinese centenarians by using high-resolution ultrasound (US) equipment and at investigating its relationship to lifestyle characteristics and dietary habits.Participants and methodsThe current study was part of the China Hainan Centenarian Cohort Study that was conducted in Hainan, an iodine-sufficient region in People’s Republic of China. A total of 874 permanent residents aged ≥100 years (mean age =102.8±2.8 years) without any missing data were included in the analysis.ResultsAmong the participants, 649 of them were detected at least one TN under the US examinations. The overall prevalence rate of TNs was 74.3%. The prevalence of TNs was higher in participants who were women, had hypertension, had diabetes, and were underweight compared with their counterparts. Multivariate logistic regression analyses showed that being female, hypertensive, and diabetic; betel quid consumption; and red meat consumption were independent risk factors, while being underweight and nut consumption were independent protective factors for TNs.ConclusionOur findings indicate that the presence of TNs was highly prevalent in Chinese centenarians, particularly in women. In addition to gender, having hypertension, having diabetes, and being underweight, the presence of TNs was independently associated with betel quid, red meat, and nut consumption. Further prospective studies are warranted to verify these associations in populations from different age strata, races, cultures, and iodine supplementation.

Areca nut extracts mobilize calcium and release pro-inflammatory cytokines from various immune cells

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.