Letter to the Editor: “Carcinogenesis of Male Oral Submucous Fibrosis Alters Salivary Microbiomes”

Abstract

A recently published paper by Chen et al. (2021) provided new insights into salivary microbiome and microbial metabolite alterations during the malignant transformation of oral submucous fibrosis (OSF). These findings gave new direction to the understanding of carcinogenesis mechanism of oral squamous cell carcinoma in the background of OSF (OSCC-OSF).By virtue of dynamic composition, saliva plays an important role in maintaining homeostasis in the oral mucosa along with oral microbial integrity. Alteration in quality (antibiotic drugs) and quantity (xerostomia) is known to cause change in composition of oral microbiome and subsequently the microbial metabolites (Pedersen et al. 2018). In this regard, dysbiosis in the salivary microbiome was reported in xerostomia and primary Sjögren's syndrome patients compared to healthy controls (Rusthen et al. 2019). Decreased salivary secretion is 1 of the symptoms of the OSF, which is mainly attributed to the involvement of minor salivary glands by the fibrosis present in the connective tissue stroma (Sarode et al. 2020). Thus, salivary microbiome alteration observed by the author could be attributed to the xerostomia seen in OSF patients. Therapeutically restoring the saliva quality and quantity could help in aborting the relevant carcinogenesis events. We believe that salivary flow rate analysis of OSF patients and inclusion of healthy controls in the study could be able to bring out some interesting conclusions. Apart from this, iron deficiency anemia and immune status are also associated with OSF, which can modulate the salivary microbiome and therefore need due consideration in these kinds of studies.