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Its pathogenic factors are complex and include chewing areca nuts or other spicy food items, nutrition, and genetic and immune factors. Recently, immune factors have become the focus of medical research, with increased attention being paid to the role of immune regulation in diseases, particularly tumors. OSF is accompanied by obvious changes in the immune microenvironment. The aim of this review is to discuss the potential relationship of OSF and areca nuts genetic with the immune system, including lymphocytes, macrophage, Langerhans cell, mast cell, and substances released by activated immune cells, to determine the pathogenesis and treatment of OSF from an immunologic viewpoint.<\/jats:p>","DOI":"10.1002\/jlb.3mr0521-763rr","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T11:03:42Z","timestamp":1623668622000},"page":"469-476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Immunopathogenesis of oral submucous fibrosis by chewing the areca nut"],"prefix":"10.1093","volume":"111","author":[{"given":"Liping","family":"Wang","sequence":"first","affiliation":[{"name":"Xiangya Stomatological Hospital, Central South University , Changsha, Hunan, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangui","family":"Tang","sequence":"additional","affiliation":[{"name":"Xiangya Stomatological Hospital, Central South University , Changsha, Hunan, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/0030-4220(66)90367-7","article-title":"Oral submucous fibrosis","volume":"22","author":"Pindborg","year":"1966","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/jop.12581","article-title":"Oral submucous fibrosis: an update on current theories of pathogenesis","volume":"46","author":"Arakeri","year":"2017","journal-title":"Oral Pathol Med"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.oraloncology.2011.10.011","article-title":"Proposed clinical classification for oral submucous fibrosis","volume":"48","author":"More","year":"2012","journal-title":"Oral Oncol"},{"key":"2023032109095759300_","first-page":"224","article-title":"Oral submucous fibrosis as a precancerous condition","volume":"92","author":"Pindborg","year":"1984","journal-title":"Scand J Dent Res"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S1368-8375(01)00003-3","article-title":"Role of areca nut in betel quid-associated chemical carcinogenesis: current awareness and future perspectives","volume":"37","author":"Jeng","year":"2001","journal-title":"Oral Oncol"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.jobcr.2019.06.016","article-title":"Proposed clinical definition for oral submucous fibrosis","volume":"9","author":"More","year":"2019","journal-title":"J Oral Biol Craniofac Res"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/0030-4220(80)90329-1","article-title":"Incidence and early forms of oral submucous fibrosis","volume":"50","author":"Pindborg","year":"1980","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s10006-010-0225-x","article-title":"Oral submucous fibrosis: a clinicopathologic review of 205 cases in Indians","volume":"15","author":"Angadi","year":"2011","journal-title":"Oral Maxillofac Surg"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10006-010-0219-8","article-title":"Areca nut in pathogenesis of oralsubmucous fibrosis: revisited","volume":"5","author":"Angadi","year":"2011","journal-title":"Oral Maxillofac Surg"},{"key":"2023032109095759300_","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S0901-5027(87)80115-7","article-title":"Oral submucousfibrosis","volume":"16","author":"Morawetz","year":"1987","journal-title":"Int J Oral Maxillofac Surg"},{"key":"2023032109095759300_","first-page":"505","article-title":"Histomorphology of oral submucous fibrosis. 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