Impact of red-lime and white-lime betel quid on oral cell lines: Cytotoxicity and effects on fibronectin and type I collagen expression

Background/purpose: Chewing betel quid is linked to an increased risk of oral cancer. This study investigates the effects of red-lime and white-lime betel quid extracts on oral cell lines, focusing on cytotoxicity and their influence on fibronectin and Type I collagen expression, which were crucial for oral tissue integrity and cancer development. Materials and methods: Four oral cell lines, human gingival fibroblasts, tongue squamous cell carcinoma cells, human periodontal ligament fibroblasts, and human fetal osteoblasts, were treated with red-lime and white-lime betel quid extracts. Cytotoxicity assays and Western blotting were used to assess cell viability and protein expression. Results: Both red-lime and white-lime betel quid extracts exhibited dose-dependent effects on all tested cell lines, with variations in sensitivity observed among cell types. Notably, red-lime betel quid exerted stronger cytotoxic effects on human gingival fibroblasts and human fetal osteoblasts. Red-lime betel quid increased fibronectin and Type I collagen in periodontal ligament fibroblasts but reduced both proteins in fetal osteoblasts. White-lime betel quid extract generally elevated fibronectin and decreased Type I collagen across cell lines. Conclusion: This study reveals a nuanced, concentration-dependent impact of betel quid extracts on oral cells, with significant variability in cytotoxicity and changes in fibronectin and Type I collagen expression. These findings suggest that abrupt cessation of betel quid chewing can lead to dental issues such as mobile teeth. Red-lime betel quid uniquely affects periodontal ligament fibroblasts by increasing both fibronectin and Type I collagen.