Pathogenesis of oral submucous fibrosis

Abstract

Data from recent epidemiological studies provide overwhelming evidence that areca nut is the main etiological factor for oral submucous fibrosis (OSF). It is logical to hypothesize that the increased collagen synthesis or reduced collagen degradation is the possible mechanism in the development of the disease. There are numerous biological pathways involved in the above processes and it is likely that the normal regulatory mechanisms are either down regulated or up regulated at different stages of the disease. The copper content of areca nut is high and the possible role of copper as a mediator of fibrosis is supported by the demonstration of the up regulation of lysyl oxidase in OSMF biopsies. The aim of this article is to emphasize that the incorporation of copper into the areca nut is through the Bordeaux mixture, which is sprayed as a fungicide on areca plantations in regions with scheduled monsoons and of which copper sulfate is an important constituent.

Oral submucous fibrosis: a historical perspective and a review on etiology and pathogenesis

“…66 Copper dependant enzyme lysyl oxidase is critical for collagen cross linking and organization of ECM. 67 Salivary copper is found to be higher in arecanut chewers.…”

Oral Submucous Fibrosis; Oral Health Impact Profile of Patients and Its Correlation With Its Clinical Grading

“…4 The rigidity of lip, tongue and palate occurs, which in turn causes limitation of tongue movement and mouth opening. 5 The hallmark of OSMF is pathological fibrosis of submucous tissue which affects most of the oral cavity, oro-pharynx and upper 1/3 of esophagus.…”

Clinico-Pathological Evaluation and Correlation of Stages of Oral Submucous Fibrosis with Different Habits

“…It is logical to hypothesize that the increased collagen synthesis or reduced collagen degradation is the possible mechanism in the development of the disease [10][11][12][13]. Areca nut (usually incorporated in betel quid) is the fourth most common psychoactive substance in the world (after caffeine, alcohol and nicotine), its use extending to several hundred million people.…”