Interplay of epigenetics and epistasis drives oral submucous fibrosis

Persistent injury to oral mucosa due to habitual quid chewing, resulting in the upregulation of inflammatory cytokines and consequential myofibroblastic persistence, emphasizes the role of epigenetic aberration in the pathogenesis of oral submucous fibrosis (OSF). However, there is a dearth of research on the role epistasis plays in the pathophysiology of OSF. Among the important epistatic interactions in the pathophysiology of OSF are those between Phosphatase and Tensin Homologue (PTEN) and Insulin-Like Growth Factor 1, Transforming Growth Factor-β (TGF-β), Cyclooxygenases, and lipoxygenases (LOX). Additionally, PTEN and Nuclear Factor Kappa B (NF-κB) have an epistatic relationship that is particularly mediated by the p65 subunit of NF-κB. Given the importance of epigenetic modification in the pathogenesis of OSF, the potential use of DNA methyltransferase and Histone deacetylase inhibitors as a therapeutic option holds promise. Another in vivo epigenetic therapeutic option for treating OSF is using stimulatory microRNAs against antifibrotic genes and inhibitory microRNAs against profibrotic genes. This review aims to connect numerous epigenetic and epistatic components to the mechanism of OSF. A better understanding of the disease process may provide OSF management with newer therapeutic options

HOXA9 transcription factor is a double-edged sword: from development to cancer progression

The HOXA9 transcription factor serves as a molecular orchestrator in cancer stemness, epithelial-mesenchymal transition (EMT), metastasis, and generation of the tumor microenvironment in hematological and solid malignancies. However, the multiple modes of regulation, multifaceted functions, and context-dependent interactions responsible for the dual role of HOXA9 as an oncogene or tumor suppressor in cancer remain obscure. Hence, unravelling its molecular complexities, binding partners, and interacting signaling molecules enables us to comprehend HOXA9-mediated transcriptional programs and molecular crosstalk. However, it is imperative to understand its central role in fundamental biological processes such as embryogenesis, foetus implantation, hematopoiesis, endothelial cell proliferation, and tissue homeostasis before designing targeted therapies. Indeed, it presents an enormous challenge for clinicians to selectively target its oncogenic functions or restore tumor-suppressive role without altering normal cellular functions. In addition to its implications in cancer, the present review also focuses on the clinical applications of HOXA9 in recurrence and drug resistance, which may provide a broader understanding beyond oncology, open new avenues for clinicians for accurate diagnoses, and develop personalized treatment strategies. Furthermore, we have also discussed the existing therapeutic options and accompanying challenges in HOXA9-targeted therapies in different cancer types

Knowledge and awareness of dental students regarding human papillomavirus and oral cancer in Saudi Arabia

Objective: This study aimed to evaluate the knowledge and awareness of dental students and interns in Saudi Arabia regarding human papillomavirus and oral cancer using a cross-sectional web-based survey. Materials and methods: A cross-sectional survey was undertaken to assess the knowledge of dental students and dental interns regarding oral cancer and awareness of human papillomavirus (HPV) in public and private dental schools in Saudi Arabia. The survey included 18 questions grouped into three sections. The responses were analyzed for variations between dental students and interns, among males and females, and those attending private or public colleges. The Chai-square test assessed the correlation between participants’ demographic data and their knowledge/awareness of oral cancer and HPV. Results: A total of 451 dental students and dental interns responded. The results show that dental students at private and public dental schools in Saudi Arabia are generally knowledgeable regarding knowledge of oral cancer and awareness of human papillomavirus. The dental interns exhibited significantly superior knowledge compared to the undergraduate dental students (p<0.05), particularly in the areas of identifying the most common location of oral cancer and recognizing the signs and symptoms of oral cancer (76.5% versus 65.1% correct answers). The dental interns showed a significant difference and better awareness (p<0.05) than dental students regarding HPV having a relationship with AIDS and HPV causing common warts. Conclusion: Dental students and interns in this study presented a good but less than optimal knowledge and awareness regarding HPV and its prevention. Improving education courses and training for dental students in Saudi Arabia is crucial for improving their knowledge and awareness regarding oral cancer and HPV infection