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At least 19 recordsLinked to original sources

PubMed1996

Oral stent as treatment adjunct for oral submucous fibrosis.

Oral submucous fibrosis is a chronic inflammatory disease that results in progressive juxtaepithelial fibrosis of the oral soft tissues that can cause increasing difficulty in chewing, swallowing, speaking, and mouth opening. Many treatment regimens for oral submucous fibrosis have been proposed to alleviate the signs and symptoms of the disorder. In severe cases, surgical intervention is the only treatment modality, but relapse is a major problem. This article describes the use of an oral stent as an adjunct to surgery to prevent relapse.

Deglutition↗

PubMed1989

[Collagen content and types in oral submucous fibrosis].

Oral submucous fibrosis is a chronic disease of the oral cavity. The basic histological change which occurs is a fibroelastic transformation of the connective tissue in the laminal propria layer associated with epithelial atrophy. The etiology of the disease is uncertain, but there is a close association suggested both geographically and epidemiologically with the habitual chewing of betel nuts. The accumulation of collagen fibers increases with the severity of the disease, and the fibroblasts in the normal mucosa and in the fibrotic mucosa increased their proliferation and collagen synthesis. This can be activated by arecoline, an extract from betel nuts, as described in a recent study. In order to obtain some information about the basic characteristics of the collagen in submucous fibrosis and its correlation with the fibrotic changes, the following study was conducted. In this study, collagen was extracted from the tissues of normal mucosa, normal skin and oral submucous fibrosis with pepsin and disodium hydroxyphosphate. The amino acid compositions of collagen, collagen content, types and their ratios were measured and analyzed. The results indicated that the characteristics of collagen in normal mucosa and skin were similar in content (normal mucosa: 111.8 + 31 micrograms/mg; normal skin: 131.4 + 56.4 micrograms/mg), amino acid compositions, types (I, III, V), and ratios of different types (III/I: normal mucosa: 0.119 + 0.03; normal skin: 0.187 + 0.046, V/I: 0.024 + 0.01; 0.0036 + 0.01). Collagen content in the advanced group with oral submucous fibrosis (221.6 + 58.2 micrograms/mg) was higher than that of the normal mucosa group (111.8 + 31 micrograms/mg) and the moderate group with oral submucous fibrosis (107.1 + 37.8 micrograms/mg) by a significant difference. Put no difference occurred between normal mucosa and moderate group with oral submucous fibrosis. The collagen of normal skin, normal mucosa and oral submucous fibrosis (both the advanced & moderate groups) had similar amino acid compositions, except that the presence of hydroxyproline, proline, and glycine were less in oral submucous fibrosis. The conversion factors for determining the total collagen, done by measuring the concentration of hydroxyproline, were 10.15 for oral submucous fibrosis, 9.21 for normal skin, and 8.52 for normal mucosa. Normal skin, normal mucosa, and oral submucous fibrosis have the same collagen types (I, III, V). The ratios of type III to type I collagen and type V to type I were compared between every two groups and the results showed no significant difference.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed2003

Augmented mRNA expression of tissue inhibitor of metalloproteinase-1 in buccal mucosal fibroblasts by arecoline and safrole as a possible pathogenesis for oral submucous fibrosis.

Oral submucous fibrosis (OSF) is an oral precancerous condition, and is associated with betel quid (BQ) chewing habits. It is a disorder of excessive deposition of collagen in the connective tissues that results from disruption in the regulation of the equilibrium between matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs). Elevated TIMP-1 protein has been thought to be associated with oral fibrosis, however whether TIMP-1 expression in OSF is modulated at the transcriptional level is still unknown. The present study used arecoline, arecaidine and safrole, which are thought to be major toxic ingredients in BQ, as candidates to explore the role of TIMP-1 expression in OSF pathogenesis. Fresh tissue biopsies of oral mucosa from 20 OSF males were included in this study, and fibroblasts were cultured from one OSF buccal mucosa and one normal buccal mucosa of the same OSF patient. To quantify the TIMP-1 expression, enzyme-linked immunosorbent assay (ELISA) was used in the present study. The results indicated that OSF fibroblasts produced more TIMP-1 protein (569.2+/-79.5 ng/ml) than normal fibroblasts (303.0+/-59.3 ng/ml) from the same patients, and the mRNA expression of TIMP-1 in OSF fibroblasts was higher (1.76 fold) than normal fibroblasts of the same patients. Arecoline and safrole significantly elevated TIMP-1 protein and mRNA expression. We concluded that increased mRNA expression of TIMP-1 in buccal mucosal fibroblasts by arecoline and safrole is a possible pathogenesis for oral submucous fibrosis.

Adult↗

PubMed2005

Morphological changes in oral mucosae and their connective tissue cores regarding oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a chronic disease of the oral cavity characterized by an inflammatory reaction followed by severe fibro-elastic changes. The aim of the present study was to investigate the three-dimensional morphological changes in the connective tissue cores (CTCs) of the oral mucosa in OSF. The sample consisted of buccal mucosal biopsies from ten human subjects ranging in age from 40-45 years; five of them were clinically diagnosed as having moderate to severe OSF, and the remaining five served as unaffected controls. Half of each biopsy was formalin-fixed and paraffin-embedded for light microscopy, while the other half was fixed in a Karnovsky's solution, treated with HCl to exfoliate the epithelium, and processed for examination under a scanning electron microscope (SEM). Oral submucous fibrosis biopsies exhibited heavily packed aldehyde fuchsin-positive fibers (i.e. elastic fibers) in the submucosa under the light microscope. Broad bundles of collagen fibers were seen in a concentrated manner in the deeper layers. Scanning electron microscopy of the buccal mucosa in OSF showed the finger-shaped CTCs to be attenuated beneath the epithelium at the initial stages of the disease. Patchy degenerative areas lacking the CTCs were observed in advanced cases. These degenerative areas increased gradually with the progression of the disease. Highly fibrosed cases showed severe degeneration of the CTCs, resulting in a smoothening of the connective tissue surface in the buccal mucosa.

Adult↗

PubMed1987

Estimation of complement C3 in oral submucous fibrosis.

Oral submucous fibrosis is a chronic disease of obscure aetiology. Considering the significant immunological findings in oral submucous fibrosis, the serum C3 levels were estimated by RID method and were found to be unaltered.

Adult↗

PubMed2000

Histological changes to palatal and paratubal muscles in oral submucous fibrosis.

Oral submucous fibrosis (OSMF) is prevalent in the Indian subcontinent. In a large number of patients conductive deafness due to eustachian tube dysfunction has been found. The present study was, therefore, planned to assess the histopathological changes in palatal and paratubal muscles in oral submucous fibrosis. Incisional biopsy from the soft palate was taken in clinically proven cases of OSMF. In most of the cases, signs of chronic inflammation and fibrosis were seen in the submucosa. Dysplasia was noticed in seven (13.2 per cent) patients. Degenerative changes in palatal/paratubal muscles were found in the form of loss of cross striations in seven (13.2 per cent), oedematous muscle fibres in five (9.4 per cent) and atrophy in five (9.4 per cent) cases. It was concluded that there was definite involvement of palatal and paratubal muscles in OSMF. This could explain the eustachian tube dysfunction in these patients.

Ear Diseases↗

PubMed1999

Deficiency in collagen and fibronectin phagocytosis by human buccal mucosa fibroblasts in vitro as a possible mechanism for oral submucous fibrosis.

Oral submucous fibrosis (OSF), a chronic oral mucosal condition commonly found in south Asians, is a disorder characterized by a quantitative as well as a qualitative alteration of collagen deposition within the subepithelial layer of the oral mucosa. Since degradation of collagen by fibroblast phagocytosis is an important pathway for physiological remodelling of soft connective tissues, we have investigated phagocytosis of collagen- and fibronectin-coated latex beads by fibroblast cultures with an in vitro model system. Coated fluorescent latex beads were incubated with human oral mucosa fibroblasts and the fluorescence associated with internalized beads was measured by flow cytometry. Cells from normal tissues that had been incubated with beads for 16 h contained a mean of 75% collagen phagocytic cells and 70% fibronectin phagocytic cells; however, about 15% and 10% of phagocytic cells individually contained more than twice the mean number of beads per cell. In contrast, cells from OSF tissues exhibited a 40% reduction of the proportions of collagen phagocytic cells (mean=35%) and a 48% decrease of the proportions of fibronectin phagocytic cells (mean=22%), none of the cells having a high number of beads as compared to normal fibroblasts. OSF lesions appear to contain fibroblasts with marked deficiencies in collagen and fibronectin phagocytosis. To investigate if inhibition of phagocytosis could be demonstrated in vitro, normal fibroblast cultures were incubated with areca nut alkaloids (arecoline, arecaidine). The cultures had a dose-dependent reduction in the proportions of phagocytic cells. On the other hand, corticosteroid used in the treatment of OSF exhibited a dose-dependent enhancement in the proportion of phagocytic cells. Therefore, our hypothesis for OSF, although oversimplified, is that betel nut alkaloids (arecoline, arecaidine) inhibit fibroblast phagocytosis and this provides a mechanism for the development of OSF. The benefit of a local intralesional injection of corticosteroid is also possibly, at least in part, through an enhancement of fibroblast collagen phagocytosis.

Administration, Topical↗

PubMed1996

Zinc and iron as bioindicators of precancerous nature of oral submucous fibrosis.

Oral Submucous Fibrosis (OSF) is a precancerous condition of oral cavity and oropharynx. Its etiopathogenesis is still obscure. Epithelial dysplasia is considered an important indicator of it. In the present study, the authors try to ascertain bioinorganic parameters as alternate indicators of malignant potential of OSF along with other clinicopathological attributes. They also try to identify causative factors. Thirty-six OSF patients, showing different degrees of epithelial dysplasia, and 12 normal individuals are studied with special reference to trace metal contents (Zn and Fe) in oral tissues. Statistical analyses of data indicate that trace metal contents can be regarded as an alternate indicator of the precancerous nature of OSF. Some clinicopathological attributes that are easier and cheaper to measure may also indicate OSF.

Adult↗

PubMed2002

Altered elemental profile as indicator of homeostatic imbalance in pathogenesis of oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a potential precancerous condition of the oral cavity and oropharynx. The etiopathogenesis of this complex precancerous condition is still obscure. In addition to deleterious oral habits, malnutrition, and possible genetic predisposition, altered bioelemental status is also likely to play an important role in its pathogenesis. The present study analyzed 68 elements by inductively coupled plasma-mass spectroscopy in oral mucosa of normal and OSF individuals and some interesting alterations in elemental profile in the diseased tissue have been noted, indicating a homeostatic imbalance. These bioelemental alterations leading to homeostatic imbalance might be considered as an important biological event in the pathogenesis of OSF.

Homeostasis↗

PubMed2002

Interaction of collagen-related genes and susceptibility to betel quid-induced oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a precancerous condition of the oral cavity. It is a collagen-related disorder induced by betel quid chewing, a habit that is common in Taiwan. However, the cumulative exposure to betel quids varies in OSF patients. It seems that there is individual susceptibility to betel quid-induced OSF. This study compared the association of OSF and polymorphisms of six collagen-related genes, collagen 1A1 and 1A2 (COL1A1 and COL1A2), collagenase-1 (COLase), transforming growth factor beta1 (TGF-beta1), lysyl oxidase (LYOXase), and cystatin C (CST3), between patients with low and high exposure to betel quids. A total of 166 patients with OSF from a medical center and 284 betel quid chewers who were free of OSF and oral cancer, from the same hospital and five townships, were recruited. PCR-based restriction fragment length polymorphism assays were used to determine the genotypes of the six collagen-related genes situated on different chromosomes. We found that the genotypes associated with the highest OSF risk for collagen 1A1, collagen 1A2, collagenase-1, transforming growth factor beta1, lysyl oxidase, and cystatin C were CC, AA, TT, CC, AA, and AA, respectively, for the low-exposure group, and TT, BB, AA, CC, GG, and AA, respectively, for the high-exposure group. A trend was noted for an increased risk of OSF with increasing number of high-risk alleles for those with both high and low exposures for betel quid. The cell selection mechanism of oral fibroblasts is proposed to explain the effect of the modification of cumulative betel quid exposure on the risk profiles of collagen-related genes. These results imply that susceptibility to OSF could involve multigenic mechanisms modified by the betel quid-exposure dose.

Adult↗

PubMed2001

Interferon gamma (IFN-gamma) may reverse oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a chronic disease of the oral cavity and oropharyngx characterised by fibrosis in the submucosa leading to progressive limitation of the mouth opening. Interferon gamma (IFN-gamma) is a known anti-fibrotic cytokine. In this study we have investigated: a) the effect of IFN-gamma on collagen synthesis by arecoline-stimulated OSF fibroblasts in vitro (n=5), b) the effect of intra-lesional IFN-gamma on the fibrosis of OSF patients (n=29) and c) the immunohistochemical analysis of pre- and post-treatment inflammatory cell infiltrates and cytokine levels in the lesional tissue (n=29). The results show that the increased collagen synthesis in vitro in response to arecoline was inhibited in the presence of IFN-gamma (0.01-10.0 U/ ml) in a dose-related way. In an open uncontrolled study intra-lesional IFN-gamma treatment showed improvement in the patients mouth opening from an inter-incisal distance before treatment of 21 +/- 7 mm, to 30 +/- 7 mm immediately after treatment and 30 +/- 8 mm 6-months later, giving a net gain of 8 +/- 4 mm (42%) (range 4-15 mm). Patients also reported reduced burning dysaesthesia and increased suppleness of the buccal mucosa. The post-treatment immunohistochemistry showed a decreased amount of inflammatory cell infiltrate and an altered level of cytokines compared with the pre-treatment lesional tissue. The effect of IFN-gamma on collagen synthesis appears to be a key to the treatment of these patients, and intra-lesional injections of the cytokine may have a significant therapeutic effect on OSF.

Areca↗

PubMed1997

An immunohistochemical study of oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a chronic disease of the oral cavity characterized by inflammation and progressive mucosal fibrosis. These reactions may be the result of either direct stimulation from exogenous antigens like areca alkaloids or by changes in tissue antigenicity that may lead to an autoimmune response. This study investigated the presence and distribution of inflammatory cells and MHC class II antigen expression by epithelial and immunocompetent cells using a three-stage immunoperoxidase method on frozen sections. Thirty OSF tissue specimens and ten normal buccal mucosae were studied and compared. All tissues were investigated using antibodies to T cells (CD3), T helper/inducer cells (CD4), T suppressor/ cytotoxic cells (CD8), B cells (CD20), naive T cells and monocytes (CD45RA), macrophages, Langerhans' cells (CD68) and HLA-DR-positive cells (HLA-DR alpha). The predominant cell populations detected in normal tissues were CD3, CD4 and HLA-DR-positive cells. The distribution of CD4-positive cells was similar to that of CD3-positive cells, which were scattered, often uniformly distributed, both in the epithelium and connective tissue. CD8-positive cells were occasionally seen in the normal epithelium and lamina propria. Few scattered B cells (CD20) and macrophages (CD68) were observed in normal mucosa. Naive T cells (CD45RA) were seen in all normal tissues focally concentrated around the connective tissue papillae, with a similar distribution to that of CD3-positive cells. All normal sections showed HLA-DR-positive cells scattered both in the epithelium and in the lamina propria. Epithelial cells did not show any positive reaction to this antibody and many intraepithelial positive cells showed a dendritic morphology. The cell population detected in OSF showed higher numbers of CD3 and HLA-DR-positive cells compared with those of the normal tissues. The pattern of staining for CD4-positive cells in OSF tissues was similar to that of CD3-positive cells both in the epithelium and connective tissue and was higher than that in normal tissues. A few scattered CD8-positive cells and only occasional CD20- and CD68-positive cells were seen in OSF sections. Few CD45RA-positive cells were found in the epithelium and lamina propria of OSF sections. However, OSF specimens showed high numbers of HLA-DR-positive cells in the basal layer of the epithelium, juxtaepithelium and in the lamina propria in a similar distribution to that of CD3 cells compared with the normal tissues. Most HLA-DR-positive cells in the epithelium showed dendrites directed vertically towards the surface. The increased evidence of CD4 and HLA-DR-positive cells in OSF tissues suggests that most lymphocytes were activated and shows an increased presence of Langerhans' cells. The presence of these immunocompetent cells and high ratio of CD4 to CD8 in OSF tissues suggest an ongoing cellular immune response leading to a possible imbalance of immunoregulation and alteration in local tissue architecture.

Adolescent↗

PubMed1998

Immunolocalization of cytokines and growth factors in oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a chronic fibrotic disease of the oral cavity and oropharynx characterized by fibroelastic change in the mucosa which leads to progressive inability to open the mouth. The inflammatory cells in the lesional tissue consist mainly of T lymphocytes, with a high CD4:CD8 ratio, and major histocompatibility complex (MHC) class II expressing antigen-presenting cells. Cytokines and growth factors produced by inflammatory cells within the lesion may promote fibrosis by inducing proliferation of fibroblasts, upregulating collagen synthesis and downregulating collagenase production. The authors used a three-stage immunoperoxidase technique to investigate the expression of interleukin alpha (IL-1alpha) and beta, IL-6 interferon (IFN)-alpha, beta and gamma, transforming growth factor beta (TGF-beta), platelet-derived growth factor (PDGF) and basic fibroblast growth factor (bFGF) in frozen sections of OSF and compared it with that in normal buccal mucosa. The expression of cytokines and growth factors in normal tissues was consistent with their well known distribution and cell of origin, but the intensity and distribution in OSF were all, with the exception of IFN-alpha and gamma, upregulated with strong expression in both the epithelium and underlying connective tissue. IFN-alpha showed a similar pattern of staining in both normal mucosa and OSF. IFN-gamma showed little or no expression in most lesional tissues, suggesting an innate deficiency or downregulation of this cytokine. The general increase in pro-inflammatory cytokines and growth factors, and reduced production of IFN-gamma, may play an important role in the pathogenesis of OSF.

Adolescent↗

PubMed1992

Collagenase activity in oral submucous fibrosis.

Oral submucous fibrosis (OSF) is characterized by an abnormal accumulation of collagen fiber in oral submucosa. OSF is a collagen disease and is also regarded as a precancerous lesion. In the previous study, we discovered that the collagen content in oral mucosa of OSF is statistically higher than in normal mucosa. This research examined the relationship between the fibrosis and collagenase activity. Collagenase activity was determined by using soluble 14C-glycine-labeled collagen (9813 cpm/200 micrograms/tube) as a substrate in a solution incubated for 30 hours at 35 degrees C. The results showed that the collagenase activity of the OSF was much lower than that of normal oral mucosa (65.23 +/- 19.49 units/g tissue in normal mucosa vs. 29.48 +/- 5.69 units/g tissue in OSF). Furthermore, the cleavage pattern revealed by SDS-Polyacrylamid gel electrophoresis (SDS-PAGE) confirmed that the partially purified OSF collagenase was likely to be typical mammalian collagenase, with a molecular weight of about 68.0 kDa.

Chromatography, Gel↗

PubMed2000

Raised tissue copper levels in oral submucous fibrosis.

Oral submucous fibrosis (OSF) is a well-recognised-potentially malignant condition of the oral cavity associated with areca nut chewing. Areca nut has been shown to have a high copper content compared to other commonly eaten nuts, and chewing areca nut for 5-30 min significantly increases soluble copper in whole mouth fluids. Our aims were to determine if tissue and serum concentrations of copper were raised in patients with OSF as a result of chewing areca nut. A panel of buccal mucosal biopsies from patients with OSF from Nagpur, India, was used to measure the tissue concentrations of copper by mass absorption spectrometry (MAS). By MAS, the mean tissue copper level was 5.5+/-2.9 microg/g in the OSF specimens (n=11) compared with 4+/-1.9 microg/g in the non-areca chewing controls (n=7) (P=0.2). Energy dispersive x-ray microanalysis (EDX) was used to identify the presence and distribution of the metal element. EDX showed distinct peaks corresponding to copper (Kalpha 8.04 keV; Kbeta, 8.91 keV) in the epithelium (21/23) and in the connective tissue (17/23) of the OSF specimens compared to spectra obtained from control oral biopsies from non-areca chewing subjects (n=7). These findings were confirmed by secondary ion mass spectrometry (SIMS) analysis in a small number of samples. Serum copper (17.23+/-1.80 pmol/l), caeruloplasmin (0.32+/-0.04 g/l) levels and urinary copper (0.52+/-0.26 micromol/l) in OSF patients (n=14) were within the laboratory reference ranges. The finding of copper in OSF tissue supports the hypothesis of copper as an initiating factor in OSF, playing a role in stimulating fibrogenesis by the upregulation of lysyl oxidase activity.

Adolescent↗

PubMedDate not supplied

Further on the causation of oral submucous fibrosis.

Oral submucous fibrosis is perhaps a disease of multifactorial aetiology, of which areca nut usage is definitely a causative factor. We disagree with the previous reports in that the action of areca quid on the oral mucosa is not that simplistic and is not dictated solely by the duration of exposure to it or by simple process of passive diffusion. We noted that the role of copper cannot be segregated from that of zinc, the biochemical relatedness of these two elements is well elucidated. The transport of copper in to the oral epithelium may be dictated more by the composition of the quid rather than the time of exposure. Zinc is implicated in the modulation of mucosal metallothionein, thereby interfering with copper absorption. The bioavailability of zinc in its turn depends on elements like calcium and iron present in oral fluid. The usage of slaked lime(calcium hydroxide) as as ingredient of betel quid, thereby causing an interference with zinc bioavailability is a matter of concern. Of practical importance is the processing of raw areca nut and the various proprietary forms (sachets) available in the market, the toxic effects of which varies depending on its contents. Studies on the role of geochemical factors in modulating the chemical composition of the various nut forms, thereby altering its toxic effects will be an interesting pursuit.

Absorption↗

PubMed1981

Oral submucous fibrosis.

Oral submucous fibrosis is defined and its importance with respect to debilitation and precancerous potential evaluated. Current theories of aetiology are discussed and its pathogenesis and clinical presentation described. Management of the disease is discussed and the conclusion is drawn that modern surgical techniques, currently offer the best prognosis.

Connective Tissue↗

PubMedDate not supplied

Immunological studies in oral submucous fibrosis.

Oral submucous fibrosis (OSMF) is a high risk precancerous condition. The possible role of immunological factors in the pathogenesis of this condition was evaluated in 113 cases and 25 controls. The male/female ratio was 1.5/1. The mean age of males was significantly lower than that of females. The mean ESR levels were within normal limits, but for a higher than 20 mm fall per hr. in 40% of the cases. The serum IgA, IgG, and IgM levels were elevated significantly as compared to the controls. Circulating auto-antibodies and tissue-deposited antibodies were also found in 33% and 40% of the cases, respectively. From the analysis of the results, it is difficult to ascribe an auto-immune basis for the causation of OSMF. The female bias and elder age group, the factors generally considered in favour of an immune disorder, was not found in our study. However, raised ESR in 40% and serum globulin levels in 47% of the patients, distinctly higher levels of serum immunoglobulins, and positivity for circulating and tissue deposited antibodies in 33% and 34% of the cases respectively, do indicate an immunological basis. Therefore, further studies are required to ascertain the role of cellular immune mechanism and genetic parameters to explain the etiopathogenesis of this complex clinical entity.

Adolescent↗