Title

A review on angio-fibrotic pathways driving cancer potential in oral submucous fibrosis

Authors

Sneha Masne Deshpande^1,*, Sonali Khatri², Pawan Rebello³, Prachi Gholap⁴, Anupa Roshan Shetty⁵, Sheetal Choudhari⁶ & Pankaj Shrikant Deshpande⁷

Affiliation

¹Department of Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Belapur, Navi Mumbai, Maharashtra, India; ²Department of Oral Pathology and Microbiology, Genesis Institute of Dental Sciences and Research, Firozpur, Punjab, India; ³Department of Oral & Maxillofacial Pathology & Oral Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India; ⁴Department of Prosthodontics & Crown and Bridge, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Belapur, Navi Mumbai, Maharashtra, India; ⁵Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, Maharashtra, India; ⁶Department of Oral Pathology and Microbiology, YMT Dental College and Hospital, Kharghar, Navi Mumbai 400089, India; ⁷Department of Civil Engineering, Sidus Buildcon India Private Limited, Navi Mumbai, Maharashtra, India; *Corresponding author

Email

Sneha Masne Deshpande - E-mail: sneha.masne@bharatividyapeeth.edu; Phone: +91 8879870686
Sonali Khatri - E-mail: sonaliviolet@yahoo.com; Phone: +91 9530570720
Pawan Rebello - E-mail: pawanrebello@gmail.com; Phone: +91 9415084133
Prachi Gholap - E-mail: elitedental0505@gmail.com; Phone: +91 8082110022
Anupa Roshan Shetty - E-mail: anupa.shetty@bharatividyapeeth.edu; Phone: +91 9819852997
Sheetal Choudhari - E-mail: kordesheetal@yahoo.co.in; Phone: +91 9819331220
Pankaj Shrikant Deshpande - E-mail: deshpandepankaj08@gmail.com; Phone: +91 9049666783
 

Article Type

Review

Date

Received February 1, 2026; Revised February 28, 2026; Accepted February 28, 2026, Published February 28, 2026

Abstract

Oral Submucous Fibrosis (OSF) is a chronic, progressive, potentially malignant disorder associated with areca-nut exposure, characterized by persistent inflammation, extracellular matrix accumulation, and fibrotic restriction of oral function. This review highlights how fibrosis-driven vascular compromise and sustained hypoxia generate a tumor-promoting microenvironment that underlies malignant transformation. Dysregulated fibroblast activation, abnormal matrix remodeling, impaired angiogenesis, and chronic inflammatory signaling collectively promote stromal stiffness, oxidative stress, epithelial instability, and EMT-like changes. These interconnected angio-fibrotic and hypoxic mechanisms facilitate progression from fibrosis to epithelial dysplasia and ultimately oral squamous cell carcinoma. Understanding this pathogenic network provides a framework for early risk stratification and supports development of targeted anti-fibrotic and anti-angiogenic therapeutic strategies in OSF.

Keywords

Oral submucous fibrosis; areca nut; angiogenesis; fibrosis; VEGF; HIF-1α; oral squamous cell carcinoma (OSCC)

Citation

Deshpande et al. Bioinformation 22(2): 610-614 (2026)

Edited by

P Kangueane

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.