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Additionally, nitrosamines derived from betel quid and tobacco mediating oxidation of thiol group of antioxidants such as glutathione-S-transferase, superoxide dismutase (SOD), glutathione reductase, glutathione peroxidase (GPx), and catalase (CAT) were reported (Shiu and Chen, 2004) to induce changes in oral microbiome communities contributing to oral carcinogenesis (Lee et al., 2017