Development of smokeless tobacco-induced oral mucosal lesions

This study examined clinical and inflammatory mediator parameters during the development of snuff-induced mucosal lesions. Nineteen smokeless tobacco (ST) users placed moist snuff at designated new placement sites over either a 2-or 7-day period. By day 2, the predominant clinical alteration was an erythematous reaction, and one-third of the subjects demonstrated white striations in combination with erythema or ulceration. By 7 days, 56% of the subjects displayed white striated lesions. Tissue concentrations (pg/mg) of IL-1β were 4.6±1.6 at new placement sites as compared with 0.7±0.4 at control sites (P < 0.05). PGE₂ and IL-1α concentrations also were significantly higher (P < 0.05) at new placement sites as compared with control sites (9.4±2.2 vs 4.1±0.7 and 6.2±1.3 vs 3.2±0.7, respectively). In view of the recognized role of PGE₂ and IL-1 in immune and inflammatory functions, these mediators may play a role in the pathogenesis of clinical alterations at ST placement sites.