Arecoline in buccal cells reflects Areca nut dose

Area of Science:

• Toxicology
• Biomarkers
• Public Health

Background:

• Areca nut (AN) use is a global health concern due to its carcinogenic properties.
• Effective AN cessation strategies are hindered by a lack of reliable biomarkers for AN dose.
• Arecoline, a major alkaloid in AN, is a potential candidate for a cessation biomarker.

Purpose of the Study:

• To establish arecoline levels in buccal cells (BCs) as a reliable biomarker for quantifying areca nut (AN) dose.
• To investigate the correlation between self-reported AN dose (average AN load, AANL) and BC arecoline concentrations.
• To explore potential differences in this association based on AN consumption patterns (Class 1 vs. Class 2 chewers, with or without lime).

Main Methods:

• Recruited 103 areca nut chewers, collecting self-reported AN consumption data (AANL).
• Measured arecoline concentrations in buccal cells (BCs) using liquid chromatography-mass spectrometry.
• Employed regression analysis to correlate transformed AANL with transformed BC arecoline levels, analyzing subgroups.

Main Results:

• A significant positive correlation was found between AANL and BC arecoline levels across all participants (r=0.40, p<0.01).
• The association was strongest in Class 1 chewers (r=0.51, p<0.01) and those who consumed AN with lime.
• BC arecoline demonstrated reliability as a biomarker for AN dose, with similar associations regardless of lime inclusion but differences between chewing classes.

Conclusions:

• Buccal cell arecoline serves as a dependable biomarker for estimating areca nut (AN) dose.
• This biomarker can be instrumental in evaluating the effectiveness of AN cessation interventions.
• The findings support the use of BC arecoline measurements in population-based studies assessing AN chewing behaviors.