Oral submucous fibrosis: an etiological dilemma.

OBJECTIVE: Oral Submucous Fibrosis (OSF), is a well-recognized, oral potentially malignant disorder predominantly affecting the South- Asian countries. OSF causes unique generalized fibrosis of the submucosal oral soft tissues, resulting in marked rigidity of the oral mucosa leading to progressive inability to open the mouth, rigidity of lips and difficulty in protruding the tongue. In this review we have discussed the multifactorial etiology of this potentially malignant disorder, including Chillies, Nutritional Deficiencies, Inducible nitric oxide synthsis (iNOS), genetic and immunological predisposition; and most importantly the role of areca nut and the effect of copper content in it.

Mouthwatering but erosive? A preliminary assessment of the acidity of a basic sauce used in many Indian dishes.

UNLABELLED: The aim of this study was to assess whether some types of Indian cuisine may contain erosive components. Indian dishes were prepared by a previously published method and their pH measured using a pH probe. The results indicated: (i) that some components of Indian cooking, such as tomatoes and red chilli powder, had the potential to erode enamel; (ii) that the pH of some foods was reduced with increasing temperature; and (iii) that all the basic masalas made and tested had a pH of less than 4.5. Within the limitations of the study, it may be concluded that the basic sauce/masala used in north Indian dishes may have erosive potential. CLINICAL RELEVANCE: This information could be considered useful when advising patients who eat Indian curries about causes of acid erosion of their teeth.

Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India.

An etiological and epidemiological study of oral submucous fibrosis (OSMF) has been done in Patna, Bihar. Total 157 cases of OSMF and 135 control subjects were selected for study in the period of 2002-2004. It was observed that Male:Female ratio was 2.7:1. The youngest case of OSMF was 11 year old and the oldest one was 54 years of age. Maximum number of cases were belonging to 21-40 years of age and they were belonging to low or middle socioeconomic class. Most of the OSMF cases used heavy spices and chillies, where as control mild spices and chillies. Gutkha was the most commonly used by the OSMF cases only 3 per cent did not use any gutkha or other areca nut product where as 80 per cent control did not have any chewing habit. The OSMF cases used gutkha and other products 2-10 pouches per day and kept in the mouth for 2-10 minutes and they were using since 2-4 years. Most of the OSMF cases kept gutkha in the buccal vestibule or they chewed and swallowed it, only a small number of patients chewed and spitted it out. It was also observed that OSMF developed on one side of the buccal vestibule where they kept the chew and other side was normal.

Incisor toothwear caused by a dietary habit involving chillies-a case report.

Toothwear cases can vary dramatically in their presentation, with some displaying quite peculiar patterns. This case report outlines a patient's unusual eating habit that had led to a localized pattern of toothwear affecting his maxillary and mandibular central incisors. The patient had a habit of eating fresh chillies between his incisors after most evening meals; this was followed by immediate toothbrushing, which he had done for many years. This case illustrates that, not only is diet analysis important in identifying aetiological factors in toothwear cases, but also dietary habits.

Detection and recognition thresholds to the 4 basic tastes in Mexican patients with primary Sjögren's syndrome.

BACKGROUND: Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterized by inflammatory lymphocytic infiltration of the salivary glands, leading to dryness of the mouth (xerostomia). It has been postulated that xerostomia is the preceding stage for the development of alterations in taste acuity (dysgeusia) in this type of patients. OBJECTIVES: To determine detection and recognition thresholds to the 4 basic tastes (sweet, salty, sour and bitter) in pSS patients and compare them to a control group. To determine if the long-term consumption of chile peppers and spicy Mexican diets had an effect on the taste perception and acuity of the pSS patients. SETTING: This study was done in the Department of Food Science and Technology of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a third-level hospital in Mexico City. SUBJECTS: The patient group consisted of 21 Mexican females (mean +/- s.d., age: 53.1 +/- 9.8 y) diagnosed with pSS (time of duration of the disease, 8.6 +/- 6.6 y, median 7 y, range 1-25 y) who were recruited at the outpatient service of the Department of Immunology and Rheumatology of the INCMNSZ. The control group consisted of 20 healthy nonsmokers age-matched Mexican women (50.3 +/- 11.9 y) most of them personnel of the INCMNSZ, and some friends and nonblood relatives to the patients (sisters-in-law) who volunteered to participate in the study. INTERVENTIONS: Detection and recognition thresholds were determined by the method of least noticeable differences on three occasions during three nonconsecutive days. Saliva production was determined by Saxon's test on two separate occasions. RESULTS: Although saliva production was severely reduced in pSS patients (1.35 +/- 0.55 ml/2 min, P<0.001) compared to controls (6.26 +/- 2.41 ml/2 min), all subjects recognized the 4 basic tastes when these were tested at suprathreshold concentrations. The detection thresholds for the sweet, sour and bitter tastes were higher in pSS patients, as well as the recognition thresholds for the salty, sour and bitter tastes. A relationship between time of evolution of the disease and saliva production with individual thresholds could not be established. CONCLUSIONS: pSS patients exhibited different degrees of dysgeusia depending on the taste being studied, that is, they were mildly dysgeusic for the sweet and salty tastes and clearly dysgeusic for the sour and bitter tastes. Although both pSS patients and controls had consumed 'typical Mexican diets' their entire lives, our results showed that the consumption of chile peppers and spicy foods did not have any effect on the taste perception and acuity of the pSS patients.

Plasma cell gingivitis of unusual origin. A case report.

Plasma cell gingivitis is a rare benign condition of the gingiva. It is marked by a dense infiltrate of normal plasma cells separated into aggregates by strands of collagen. It is a hypersensitivity reaction to some antigen, often flavorings or spices. The importance of this lesion is that it may cause severe gingival inflammation, discomfort, and bleeding and may mimic more serious conditions. Plaque control and conventional periodontal therapy alone will not cure this disease. The etiologic agent must be identified and the substance eliminated from use. This report outlines a case of plasma cell gingivitis which may have been brought on by the use of red peppers in cooking.

Foreign body sarcoma: effects of foreign DNA, beta-carotene and paprika applied to the implant surface.

Sarcoma arises extremely rarely on foreign bodies in man, but is aggressive and often lethal. A coating for implants which would further reduce the risk in man is desirable. The incidence in mice is much greater, and responds to chemical treatment of the implant surface. Coating with histones increases tumour yield. Accordingly, related substances, foreign DNA, DNase and a mixture of the two, were tested for anticancer activity by application to 25 mm nitrocellulose filters in groups of 30-45 BALB/c mice, in comparison with untreated filters. Other substances reported to influence neoplasia, paprika, beta-carotene, rhodamine and tuftsin; and substances expected to be neutral, oxyprenolol, liquid paraffin, iodine, and adenosine diphosphate were similarly tested against concurrent untreated controls for comparison. Bovine DNA (p = 0.01) and DNA/DNase mixture (p = 0.04) and DNase fomented tumour growth by 55, 45 and 59% respectively. Paprika and beta-carotene did so by 70% (p = 0.05). The other substances were inert. None were candidates for an anti-sarcoma coating.

Oral epithelial atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, peppers and hot meals, using the AgNOR and Papanicolaou staining techniques.

To evaluate cytological atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, hot meals, and peppers using the AgNOR and Papanicolaou methods. A total of 180 individuals were evaluated, of which 60 were smokers, 34 were alcohol users, 52 were habitual peppers and hot meal (exposed) consumers, 24 were non-exposed, and 10 were patients with Oral Squamous Cell Carcinoma (OSCC), as an internal control. Cytological materials were obtained by brushing of buccal mucosa, on the border of the tongue and on the floor of the mouth, and participants underwent the Papanicolaou test for cytological changes and AgNOR staining for evaluation of the mean number of AgNOR dots per nucleus. SPSS program was used to perform the Pearson chi-square test. The 95% confidence level, Odds Ratio (OR), and the 95% Confidence Intervals (CI) were used. The features of cytological atypia were verified among 10 individuals, including 5 smokers, 2 alcohol users, 2 hot meals and peppers consumers, and one non-exposed. For atypia among tobacco smokers, the adjusted Odds Ratio (OR) and the 95% CI were found to be 2 (0.246-16.24). Increased keratinization was detected among 27 (45%) of the smokers (P < 0.0001), 17 (32.7%) of the pepper and hot meals consumers (P < 0.005), 4 (11.8%) of the alcohol consumers, and among 2 (3.7%) of the non-exposed group. Statistical analyses revealed a greater mean number of AgNORs per nucleus in smokers (3.68) followed by (2.82) alcohol consumers, compared to the habitual peppers and hot meal consumers (2.28) and the non-exposed group (2.00). What's more, 80% of the smears with cytological atypia were identified with 6 +/- 2 AgNOR mean count. The increase of the variables suggests that the evaluation of epithelial atypical changes in individuals exposed to smoking and alcohol carcinogens may be a useful screening tool. While hot meals and peppers did not seem to be a risk for oral mucosal proliferation, they increased the potency of keratinization and infection.

The aetiology of experimental fibrosing alveobronchiolitis induced in rats by paprika dust.

The effect of a single intratracheal dose of respirable paprika (Hungarian) dust, paprika dust extract, and cellulose dust on the lungs of rats was examined sequentially one and three months after a treatment. Treatment with respirable paprika and cellulose dusts resulted in alveobronchiolitis at the end of the first month and fibrotic changes at the end of the third month. As the extract of paprika dust caused no histopathological alterations, it is assumed that the high cellulose content of paprika was responsible for the histological reactions.

Characterization of cross-reactive bell pepper allergens involved in the latex-fruit syndrome.

BACKGROUND: Between 30% and 50% of individuals who are allergic to latex products are also allergic to specific plant foods, a fact that is well documented as the latex-fruit syndrome. Simultaneous sensitization to latex and bell pepper has been previously reported. Although bell pepper fruits are frequently consumed raw, cooked or as a spice, little is known about the cross-reactive allergens. OBJECTIVE: In this study we wished to identify bell pepper allergens involved in the latex-fruit syndrome. METHODS: Sera of four patients who displayed clinical symptoms to latex and bell pepper were used in immunoblot studies on protein extracts of three different cultivars of fresh bell pepper and fresh Hevea latex. Cross-reactive allergens were identified by inhibition experiments using recombinant Hev b 8 (latex profilin), and natural Hev b 2 (latex beta-1,3-glucanase) in addition to the protein extracts. A novel cross-reactive IgE-reactive 30 kDa protein was subjected to sequence analysis. RESULTS: Three patients displayed IgE to profilins from bell pepper fruits and latex. Two patients possessed IgE to Hev b 2, a latex beta-1,3-glucanase, and a homologous protein in bell pepper. One patient possessed IgE reactive with a protein of 30 kDa identified by N-terminal sequencing as an l-ascorbate peroxidase and another patient to a protein of 38 kDa. Additionally, IgE binding proteins in two higher molecular weight ranges showed cross-reactive capacities. CONCLUSION: Our findings show on the molecular level that bell pepper is part of the latex-fruit syndrome. For the first time we have identified the major latex allergen Hev b 2, a beta-1,3-glucanase, and the bell pepper l-ascorbate peroxidase as cross-reactive allergens. We were also able to show that profilins are responsible for some of the IgE cross-reactivity.