槟榔在口腔黏膜下纤维性变发病机制中的作用

Role of Areca-nut on the Pathogenesis of Oral Submucous Fibrosis

口腔黏膜下纤维性变(O ra l Subm ucous F ibrosis,O SF)是一种以炎症和渐进性黏膜改变导致进行性张口困难为特征的口腔黏膜慢性病症.近年来相当多的流行病学研究资料指出槟榔是O SF的主要病源因子,在O SF的发病上,不论是嚼食槟榔的频率还是持续的时间都呈现了剂量依赖性.在嚼食槟榔时粗糙纤维对口腔黏膜产生的强烈机械刺激作用、槟榔中的生物碱与单宁对细胞外基质分子的影响以及槟榔中的铜在纤维化疾病中的作用等方面对槟榔在O SF发病原因与发病机制中的作用加以综述,旨在分析迄今为止国内外学者对槟榔在O SF上所做的研究,以期让基础科研人员、公共卫生工作者以及广大槟榔嗜好者对槟榔在人类O SF中的作用有更深入的了解.

Oral submucous fibrosis （OSF） is a chronic oral mucous membrane disease characterized with progressive limitation of the opening of mouth caused by inflammation and mucous membrane disorder. Data from recent epidemiological studies provide overwhelming evidence that areca nut is the main aetiologieal factor for OSF. A clear dose-dependent relationship was observed for both frequency and duration of chewing areea nut in the development of OSF. Areca chewing may exert a strong mechanical stimulation on the oral mucous membrane as the robust fibre in the nut, the areea-speeified alkaloids and tannin which may have a synergistic role, seem to interfere with the molecular processes of deposition and/or degradation of extracellular matrix molecules such as collagen; the copper content of areca nut is high and may play a role as a mediator in fibrosis. Furthermore, it has been postulated that areea nut may also induce the development of the disease by increased levels of cytokines in the lamina propria. Therefore, this article aims at analyzing the recent developments that may lead to our understanding of the aetiology and pathogenesis of OSF with special reference to areca nut as the maior aetiologieal factor and making it known to the public what a role areea nut may have played in human OSF.