Collagen cross-linking in oral cancer

Carcinogenesis is widely recognized to be caused by qualitative and quantitative genetic changes. These changes include abnormalities in gene structure itself and/or in transcriptional mechanisms involved in gene expression in cancer cells and cancer-associated cells. Emerging evidence has also revealed that the nature of the extracellular matrix (ECM) in the tumor microenvironment actively regulates cancer cell growth, migration, and metastasis. The most abundant protein in the ECM surrounding cancer cells is fibrillar type I collagen that accumulates and stiffens through formation of specific types of covalent intermolecular cross-links. Alterations in the physicochemical nature of ECM proteins like fibrillar type I collagen can affect cancer cell behavior. This review provides an overview of collagen cross-linking and its roles in oral cancer as well as possible clinical applications.