THE BIDIRECTIONAL RELATIONSHIP BETWEEN ORAL CANCER AND SARS-COV-2: A PATHOGENIC AND PHARMACOLOGICAL REVIEW
*Dr. Esha Singh
ABSTRACT
The chances of influenza-related hospitalization or mortality are significantly higher in oral cancer survivors than in people with no cancer. ACE2 is the binding receptor for SARS-CoV-2 which is activated by furin. Host cell surface priming is done primarily by type II transmembrane serine protease TMPRSS2 and to some extent by endosomal cysteine proteases Cathepsin B (Cat B) and Cat L. Stratum granulosum of oral epithelium expresses both ACE2 and TMPRSS2 indicating that SARS-CoV-2 can infect human oral keratinized stratified squamous epithelium by micro laceration. ACE2 overexpression plays a significant role in the progression of oral cancer. Furin promotes epithelial-mesenchymal interaction (EMT) leading to more aggressive neoplasia. Cathepsin B and L are potent biomarkers for oral cancer prognosis. CD147 has been identified as another attachment site for the SARS-CoV-2 virus and is also implicated in tumor cell invasion. Immunosuppression is bidirectionally correlated with COVID-19 infectivity and predisposition to malignancy. Interventional management for oral cancer patients should be done reinforcing standard biosecurity measures. Cross-reactivity of these drugs with anti-COVID agents should be considered when treating OSCC patients coinfected with SARS-CoV-2.
Keywords: Oral cancer, SARS-CoV-2, ACE2, TMPRSS2, Furin, oral cancer chemotherapy.
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