Cytological Changes in Normal Oral Mucosa of Individuals with Tobacco Habits: A Cytomorphometric Study

Palakurthy, Pavan; Kulkarni, Pavan G; Nandan, Rateesh Kumar; Rao, T Madhusudan; Reddy, Dorankula Shyam Prasad; Muddana, Keerthi

doi:10.5005/jp-journals-10024-2114

Cited by 12 publications

(7 citation statements)

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“…These findings are in accordance with our current study, which indicated an initial increase in nuclear diameter and cellular diameter in the adolescent age group followed by a gradual reduction in the size in the geriatric age groups, which could be attributed to the alterations in the hormonal levels during different phases of a woman's menstrual cycle and high peaks of testosterone inducing increased vasculogenesis in adolescent males [7].…”

Section: Discussionsupporting

confidence: 93%

Comparative Analysis of Cytomorphology in Adolescent and Geriatric Patients: A Cross-Sectional Study

Kannan,

Ramani

2023

Cureus

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BackgroundExfoliation of the surface cells of the normal epithelium occurs as a result of physiological turnover. Epithelial cells are constantly renewed, and they are exfoliated or shed as they migrate from the basal layer to the uppermost layer of the epithelium. Oral exfoliative cytology involves the collection and microscopic evaluation of these shed cells or scraped epithelial cells, quantitatively and qualitatively. The objective of the present study was to analyze and compare the cytomorphometric features like cellular area, nuclear area, and nuclear-cytoplasmic ratio from buccal mucosal smears of adolescent and geriatric patients. This study highlights the changes in cell morphology in different age groups (adolescent and pediatric), which could be attributed to hormonal, habitual, and aging factors. Material and methodsBuccal smear sample was collected from a total of 60 individuals belonging to the age groups of 11-19 years and above 60 years. The smears were stained with H&E and PAP (Papanicolaou) stain. Photomicrographs were taken in 40x, and measurements were calculated using ImageJ software (

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Section: Discussionsupporting

confidence: 93%

Comparative Analysis of Cytomorphology in Adolescent and Geriatric Patients: A Cross-Sectional Study

Kannan,

Ramani

2023

Cureus

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“…With the prevalence of both ONP and Snus usage and the emerging popularity of flavored ONPs in the U.S., there is a crucial need to better understand the oral and pulmonary health effects of smoke-free nicotine-pouch-based products. Studies have shown that regular use of pouches/smokeless tobacco products induces cytological changes in the oral mucosa [34][35][36], e.g., oral submucosal fibrosis is associated with pulmonary complications in smokeless product users [37]. Additionally, studies have shown regular pouches/smokeless tobacco usage can induce oxidative stress, inflammation, and apoptosis in oral keratinocytes [38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Flavor Classification/Categorization and Differential Toxicity of Oral Nicotine Pouches (ONPs) in Oral Gingival Epithelial Cells and Bronchial Epithelial Cells

Shaikh

Tung

Pang

et al. 2022

Toxics

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Oral nicotine pouches (ONPs) are a modern form of smokeless tobacco products sold by several brands in the U.S., which comprise a significant portion of non-combustible nicotine-containing product (NCNP) sales to date. ONPs are available in various flavors and may contain either tobacco-derived nicotine (TDN) or tobacco-free nicotine (TFN). The growth in popularity of these products has raised concerns that flavored ONPs may cause adverse oral health effects and promote systemic toxic effects due to nicotine and other ONP by-products being absorbed into the circulatory system through oral mucosa. We hypothesized that flavored ONPs are unsafe and likely to cause oral and pulmonary inflammation in oral and respiratory epithelial cells. Before analyzing the effects of ONPs, we first classified ONPs sold in the U.S. based on their flavor and the flavor category to which they belonged using a wheel diagram. Human gingival epithelial cells (HGEP) were treated with flavored ONP extracts of tobacco (original, smooth), menthol (wintergreen and cool cider), and fruit flavor (americana and citrus), each from the TDN and TFN groups. The levels of ONP-induced inflammatory cytokine release (TNF-α, IL-6, and IL-8) by ELISA, cellular reactive oxygen species (ROS) production by CellRox Green, and cytotoxicity by lactate dehydrogenase (LDH) release assay in HGEP cells were assessed. Flavored ONP extracts elicited differential toxicities in a dose- and extract-dependent manner in HGEP cells 24 h post-treatment. Both fruit TDN and TFN extracts resulted in the greatest cytotoxicity. Tobacco- and fruit-flavored, but not menthol-flavored, ONPs resulted in increased ROS production 4 h post-treatment. Flavored ONPs led to differential cytokine release (TNF-α, IL-6, and IL-8) which varied by flavor (menthol, tobacco, or fruit) and nicotine (TDN vs. TFN) 24 h post-treatment. Menthol-flavored ONPs led to the most significant TNF-α release; fruit TFN resulted in the most significant IL-6 release; and fruit TDN and tobacco TFN led to the highest release of IL-8. Subsequently, human bronchial epithelial cells (16-HBE and BEAS-2B) were also treated with flavored ONP extracts, and similar assays were evaluated. Here, the lowest concentration treatments displayed increased cytotoxicity. The most striking response was observed among cells treated with spearmint and tobacco flavored ONPs. Our data suggest that flavored ONPs are unsafe and likely to cause systemic and local toxicological responses during chronic usage.

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“…[ 3 ] Oral cancer may appear as an innocuous and asymptomatic lesion in the beginning stages and in the advanced stage of the tumor, symptomatic changes are seen and the patients report to the clinician in this stage; hence, the early diagnosis of the lesion is the key aspect in reducing the mortality associated with oral cancer. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Genotoxic Effect of Various forms of Tobacco on Oral Buccal Mucosa and Nuclear Changes as a biomarker

Devadoss

Raveendranath

Kathiresan

et al. 2021

Journal of Pharmacy and Bioallied Sciences

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Aim: The present study aims to assess the genotoxic effect of various forms of tobacco users on buccal mucosa and nuclear changes as biomarkers. Materials and Methods: The study involves 150 cases, they were divided into three groups (two study groups and one control group). The buccal cytological smears were taken from three groups: Group I – 50 smokers, Group II – 50 nonsmokers (smokeless tobacco), and Group III – 50 control group. The buccal cells were transferred into a test tube containing Tris-ethylenediaminetetraacetic acid buffer (pH = 7) and was centrifuged (Remi® 1500 revolution/min [rpm]). Cell suspensions were transferred to the slides and fixed. The slides were stained using PAP and Feulgen stain. The MN and other nuclear abnormalities were studied and compared. Results: Nonsmokers (smokeless tobacco) had significantly increased frequency of all nuclear anomalies compared to smokers and healthy controls. Binucleation, karyorrhexis, micronuclei (MN), karyolysis, broken egg nuclei, and prominent nucleoli in nonsmokers (smokeless tobacco) and condensed chromatin in smokers were the most frequent anomalies. Binucleation and karyorrhexis were significantly more frequent in nonsmokers (smokeless tobacco) compared to smokers. The other nuclear abnormalities were not statistically significant in smokers and nonsmokers (smokeless tobacco). Conclusion: Numerous studies have stated that MN and other nuclear anomalies were present in higher frequency in smokers and nonsmokers. In our study, we found binucleation and karyorrhexis were statistically significant in nonsmokers (smokeless tobacco) compared to smokers. The other nuclear anomalies showed insignificant results. In order to further validate the significance of this study, a larger sample size has to be studied. On comparing the staining efficacy of smokers and nonsmokers using PAP and Feulgen stain, both the stains showed positive results. In the present study, DNA-specific Feulgen stain shows better staining of nuclear anomalies compared to DNA nonspecific PAP stain, which was found to be statistically significant.

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Cytological Changes in Normal Oral Mucosa of Individuals with Tobacco Habits: A Cytomorphometric Study

Cited by 12 publications

References 11 publications

Comparative Analysis of Cytomorphology in Adolescent and Geriatric Patients: A Cross-Sectional Study

Comparative Analysis of Cytomorphology in Adolescent and Geriatric Patients: A Cross-Sectional Study

Flavor Classification/Categorization and Differential Toxicity of Oral Nicotine Pouches (ONPs) in Oral Gingival Epithelial Cells and Bronchial Epithelial Cells

Genotoxic Effect of Various forms of Tobacco on Oral Buccal Mucosa and Nuclear Changes as a biomarker

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