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A study was carried out to investigate whether smoking had any effecton the Langerhans cells in the oral mucosa, which might throw light onto themechanism of malignant transformation of some keratotic lesions in the oral cavity. Thirty-two cases of keratotic lesions from biopsy specimens ofsmokers and non-smokers were studied. Langerhans cells were identified by immunocytochemical staining for 5100 proteins and their densitiesquantified. Smokers were associated with a significant reduction in the Langerhans cell population compared to non-smokers. The mean valuesof Langel:lans cell density in light smokers and heavy smokers were 28.64/mm2 and 33.421mm2 respectively compared to 66.51/mm2 in nonsmokers.There was a dose-response relation between the number of cigarettes smoked daily and the effect on cell counts. These findings of alocal immunological effect of smoking on oral epithelium may explain the means by which cigarette smoking contributes to the development of oralcancer.

The Oral Mucosa and Langerhans Cells in Smokers: Evidence for Carcinogenesis