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Background: Oral submucous fibrosis (OSF) is insidious in onset and is characterized by inflammation and progressive fibrosis of the lamina propria. Previously, consumption of chillies and arecanut were thought to be the etiology of OSF. Various autoantibodies and specific human leucocyte antigens (HLA) in some patients have indicated an autoimmune role as well as a genetic predisposition for the disease. Studies have also found increased presence of Langerhans cells in OSF patients; this suspects the antigenic behaviour of arecanut on mucosa.
Study Design: Biopsies were taken from the 70 subjects (20 patients with OSF, 20 patients who were arecanut/gutkha chewers with no oral lesions and 30 controls) and sections were subjected to immunohistochemical staining with CD1a.
Results: Immunostaining exhibited brown reaction product deposited in the nucleus and cytoplasm of dendritic cells. There was significant difference in number of Langerhans cells when compared between control, arecanut chewers without any visible lesions and OSMF patients, however the number of Langerhans cells are similar in arecanut chewers and OSMF patients
Conclusion: Arecanut seems to exhibit an antigenic behaviour on the oral mucosa however, not all individuals who chew arecanut or gutkha present with OSF. This is probably due to the fact that these may not be the only cause for causation of OSF. Other factors such as nutrition, immunity, genetics may add on to the etiology of OSF.

CD1a, langerhans cells, OSF