Signaling pathways and gene-gene network interaction in the pathogenesis of Oral submucous fibrosis: a precancerous condition

A prominent count of world’s population is affected from the oral malignancies and the number is increasing at an alarming rate (90.3 million cases being recorded annually), due to lack of effective control of the malady. These malignancies are almost always preceded by inflammatory oral lesions such as Leukoplakia (LPK), Erythroplakia (EP), Oral lichen planus (OLP) and Oral submucous Fibrosis (OSF) with malignant transformation rates of 15%,14.3%-50%, 0.4%-5.6% and 3%-19% respectively (Mithani et al. 2007). The WHO monograph on Head and Neck Tumors (2005) used the term “Epithelial precursor lesions” for such pre-malignant lesions. In May 2005, the term “Potentially Malignant disorders” was recommended by workshop coordinated by the WHO Collaborating center for Oral Cancer and Precancer in UK as it conveys that not all disorders described under this term may transform into cancer (Warnakulasuriya et al. 2007). The current study comprises the analysis of genetic alteration involved in OSF which is a major concern especially in south Asian countries. Worldwide estimates of OSF in 1996 indicated 2.5 million people being affected; whereas according to 2002 statistics, 5 million cases were reported from Indian subcontinent alone (Rajalalitha et al. 2005). Though current statistics are not available, but the discrete case studies reporting the prevalence of OSF among younger population makes OSF a major health concern among the south Asian countries. This is supported by the widespread use of areca nut and tobacco, which has been implicated as principal etiological factors of OSF, in these countries