Copper content in Areca nut as an emerging etiology for liver disease – A Comprehensive Review

Abstract

Areca nut (AN) is the fourth most widely used addictive substance and chewed regularly by at least 10% of the world population. AN cause many harmful effects on the human body in general as well as in the oral cavity. Amongst this one of the vital organs being damaged due to AN consumption is liver for which a number of mechanisms are reported to be responsible. Frequently alkaloids in AN are considered as the main culprit. But, other components like copper (Cu) content in AN is also believed to play a role in the pathogenesis of liver fibrosis. It is stated that an adult Indian chewing AN daily consumes over 5 mg of Cu per day, of which the substantial amount is absorbed. However, the recommended intake per day is 0.9 mg. Excess Cu acts by upregulating lysyl oxidase activity, which enhances collagen synthesis and inhibits collagen degradation leading to fibrosis of tissues. Another reason for liver toxicity could be reactive oxygen species generated by Cu content in AN. Thus, it may be stated that Cu in AN can be one of the risk factors inducing liver damage. The present review highlights the role of Cu content of AN in the development of liver fibrosis.