Preclinical methodologies for studying smokeless tobacco-induced oral carcinogens: A perspective

Abstract

Understanding the carcinogenesis mechanism of different carcinogenic agents is paramount for implementing preventive and therapeutic strategies for cancer. Hence, an appropriate simulation of the clinical situation in preclinical studies should be the prime mandate for reaching the validated and pragmatic conclusion. In Asian and Southeast Asian countries, one of the most common etiological agents for oral squamous cell carcinoma (OSCC) is the consumption of betel quid (BQ) with and without tobacco. BQ is marketed in the form of a mixture of various ingredients. It is quite conceivable that when BQ is placed or chewed in the oral cavity, all the carcinogenic components released from different agents get mixed and forms an amalgamation of carcinogens. To further add to the complexity, oral microbial flora also becomes part and parcel of this amalgamation. We envisage the interactions of various carcinogens with each other and the salivary components and microbial flora. However, this clinical scenario is not exactly simulated in various in-vitro experimental studies published in the literature. To better understand the oral carcinogenesis mechanism, it becomes imperative to consider the aforementioned fact in mind while studying carcinogens for oral cancer. In the present commentary, we have made an effort to discuss the amalgamation of the carcinogens in the oral cavity and propose the possible preclinical model to study carcinogens associated with OSCC.

Keywords

• Carcinogenesis
• Betel quid
• Areca nut
• Oral cancer