Summary
During the past decade, remarkable progress has been made in our understanding of cancer-causing agents, mechanisms of cancer formation and the behavior of cancer cells. Cancer is characterized primarily by an increase in the number of abnormal cells derived from a given normal tissue, invasion of adjacent tissues by these abnormal cells, and lymphatic or blood-borne spread of malignant cells to regional lymph nodes and to distant sites (metastasis). It has been estimated that about 75–80% of all human cancers are environmentally induced, 30–40% of them by diet. Only a small minority, possibly no more than 2% of all cases, result purely from inherent genetic changes. Several lines of evidence confirm that the fundamental molecular event or events that cause a cell to become malignant occur at the level of the DNA and a variety of studies indicate that the critical molecular event inchemical carcinogenesis is the interaction of the chemical agent with DNA. The demonstration that DNA isolated from tumor cells can transfect normal cells and render them neoplastic provides direct proof that an alteration of the DNA is responsible for cancer. The transforming genes, or oncogenes, have been identified by restriction endonuclease mapping. One of the characteristics of tumor cells generated by transformation with viruses, chemicals, or radiation is their reduced requirement for serum growth factors. A critical significance of electrophilic metabolites of carcinogenes inchemical carcinogenesis has been demonstrated. A number of “proximate” and “ultimate” metabolites, especially those of aromatic amines, were described. The “ultimate” forms of carcinogens actually interact with cellular constituents to cause neoplastic transformation and are the final metabolic products in most pathways. Recent evidence indicates that free radical derivatives of chemical carcinogens may be produced both metabolically and nonenzymatically during their metabolism. Free radicals carry no charge but do possess a single unpaired electron, making the radical extremely reactive. That such forms may be important in the introduction of neoplastic transformation by chemicals comes from two lines of evidence. (1) Various molecules that inhibit the formation of free radicals, many of which are termed antioxidants, can inhibit the carcinogenic action of a variety of chemical carcinogens. (2) There are relatively specific metabolic reactions of certain chemical carcinogens, particularly of polycyclic hydrocarbons, for which it has been shown to proceed through free radical intermediates. In conclusion, free radical processes withdirect effects on DNA can be proposed for a variety of human and animal carcinogens. As already mentioned, part of the indirect evidence supporting a role for free radicals and active species of oxygen in carcinogenesis is the inhibitory effects of antioxidants in a number of encouraging but yet inconclusive, epidemiological studies and ongoing prospective trials of antioxidant treatment in humans (chemoprevention). Cancer chemoprevention research takes leads from epidemiologic and laboratory research and develops them through in vitro and in vivo preclinical research and initial human studies into randomized controlled clinical trials. The most commonly used chemopreventive agents are retinoids,β-carotene, and vitamins. Some of the most exciting developments in the control of cancer over the next decade will very likely result from this chemopreventive approach, with application not only to prevention of the first or primary malignancy, especially in high risk populations, but also to clinical situations traditionally considered to be in the domain of chemotherapeutic strategies, such as adjuvant treatment after definitive therapy of a primary cancer.
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Abbreviations
- DNA:
-
deoxyribonucleic acid
- PAH:
-
polycyclic aromatic hydrocarbons
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Dedicated to Prof. Dr. med. Dr. h.c. Hans Dierck Waller on the occasion of his 65 th birthday
Manuscripts published in this issue were the matter of a Symposium held at the University of Ulm, April 24–27, 1991
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Clemens, M.R. Free radicals in chemical carcinogenesis. Klin Wochenschr 69, 1123–1134 (1991). https://doi.org/10.1007/BF01645172
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DOI: https://doi.org/10.1007/BF01645172