Abstract: Recently, the researches on betel nut are not only focused on oral damage and carcinogenicity, but also extended to the negative effects on other main organs and systems. It has been showed that arecoline, one of the main biological ingredients of betal nut, affects male and female reproductive system and urinary system, and gestation and fetus. In the male reproductive system, arecoline induced oxidative stress by increasing reactive oxygen species (ROS). Also, arecoline interfered with the immune system by upregulating pro-inflammatory factors and inducing high-expression of cyclooxygenase-2 (COX-2), which caused the damage of sperm structure and function. In addition, arecoline stimulated Leydig cells to secrete excessive testosterone in the testis. In the female reproductive system and gestation, arecoline induced oocyte impairment. Long-term chewing betel nut in pregnant women can affect the neonatal birth outcomes such as low birth weight and premature death. Besides, animal models revealed that arecoline had embryo toxicity and some severe effects on embryo development. In the urinary system, arecoline was responsible for the pathogenesis of chronic kidney disease (CKD) and the development and deterioration of bladder cancer. This review is helpful for us to understand the toxic damage of arecoline on both reproductive and urinary systems.

Key words: Arecoline, Urogenital system, Pregnancy, Embryotoxicity