Pharmacological properties of Salvia officinalis in the management of oral squamous cell carcinoma

Abstract

Oral cancer represents a major public health challenge in India accounting for significant mortality globally. It is among the most common cancers in the south-east asia, due to prevalent tobacco use and betel-quid chewing. Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity, accounting for most of oral cancers. Salvia officinalis L. (common sage) has long been valued in traditional healing systems for its pharmacological potential. The bioactivity of Salvia officinalis is due to its diverse profile of phytochemicals, such as rosmarinic acid, carnosic acid, carnosol, terpenoids and flavonoids. Preliminary findings suggest that Sage extracts act through inhibition of proinflammatory NF-?B signaling pathways and regulation of MAPK/ERK signaling cascades involved in tumor progression. These are also involved in scavenging of reactive oxygen species (ROS) to protect cells from oxidative cellular damage leading to apoptosis by modulating mitochondrial associated pathways. Sage extracts report significantly reduced viability of human carcinoma cells, altering the expression of genes regulating cell cycle control, DNA repair, and p53 signaling, suggesting activation of tumor-suppressive pathways. One of the major bioactive compounds in sage, rosmarinic acid, has been shown to suppress proliferation of oral cancer cells, by inducing G2/M cell-cycle arrest, trigger endoplasmic reticulum stress, and promote apoptosis, while also reducing their migratory capacity. Present investigations further indicate that sage preparations may offer therapeutic benefits in managing inflammatory and other metabolic disorders related to OSCC and are generally safe for human use. Overall, these findings highlight Salvia officinalis as a scientifically relevant medicinal resource rich in bioactive phytochemicals for management of OSCC. Further research, particularly mechanistic investigations and in vivo validation, is required to establish its clinical efficacy and safety.