Review of biomarkers to assess the effects of switching from cigarettes to modified risk tobacco products

Context: One approach to reducing the harm caused by cigarette smoking, at both individual and population level, is to develop, assess and commercialize modified risk alternatives that adult smokers can switch to. Studies to demonstrate the exposure and risk reduction potential of such products generally involve the measuring of biomarkers, of both exposure and effect, sampled in various biological matrices.

Objective: In this review, we detail the pros and cons for using several biomarkers as indicators of effects of changing from conventional cigarettes to modified risk products.

Materials and methods: English language publications between 2008 and 2017 were retrieved from PubMed using the same search criteria for each of the 25 assessed biomarkers. Nine exclusion criteria were applied to exclude non-relevant publications.

Results: A total of 8876 articles were retrieved (of which 7476 were excluded according to the exclusion criteria). The literature indicates that not all assessed biomarkers return to baseline levels following smoking cessation during the study periods but that nine had potential for use in medium to long-term studies.

Discussion and conclusion: In clinical studies, it is important to choose biomarkers that show the biological effect of cessation within the duration of the study.     

Urinary excretion of the acrylonitrile metabolite 2-cyanoethylmercapturic acid is correlated with a variety of biomarkers of tobacco smoke exposure and consumption

Acrylonitrile is an IARC class 2B carcinogen present in cigarette smoke. Urinary 2-cyanoethylmercapturic acid (CEMA) is an acrylonitrile metabolite and a potential biomarker for acrylonitrile exposure. The objective of this work was to study the dose response of CEMA in urine of non-smokers and smokers of different ISO tar yield cigarettes. We observed that smokers excreted >100-fold higher amounts of urinary CEMA than non-smokers. The CEMA levels in smokers were significantly correlated with ISO tar yield, daily cigarette consumption, and urinary biomarkers of smoke exposure. In conclusion, urinary CEMA is a suitable biomarker for assessing smoking-related exposure to acrylonitrile.     

The effects of percutaneous transluminal coronary intervention on biomarkers of oxidative stress in the erythrocytes of elderly male patients

Objectives: Oxidative stress plays a key role in the pathogenesis of coronary artery disease. The aim of this study was to compare the effects of percutaneous transluminal coronary angioplasty (PTCA) and elective coronary angiography (EC) on erythrocytic antioxidant defense in elderly male patients.

Methods: Twenty-three stable angina pectoris (SAP) patients undergoing PTCA and 18 patients with ischemic symptoms scheduled to undergo diagnostic EC were included in the study. The concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) and the activities of Zn,Cu-superoxide dismutase (SOD-1), catalase (CAT), and cytosolic glutathione peroxidase (GSH-Px) were examined in the erythrocytes before, immediately after and 2 weeks following PTCA or EC.

Results: The MDA concentrations were significantly higher and SOD-1, CAT, and GSH-Px activities were significantly lower in the PTCA group than in the EC group at baseline. Two weeks after treatment, the activities of the enzymes significantly increased in both groups, whereas the MDA concentrations decreased only in the PTCA patients.

Conclusions: The results confirm that an advanced state of atherosclerosis is related to greater levels of oxidative stress. The study indicates that both procedures may induce antioxidant defenses; however, PTCA exclusively induces a long-term reduction in lipid peroxidation.     

High-resolution mass spectrometry proteomics for the identification of candidate plasma protein biomarkers for chronic obstructive pulmonary disease

Although cigarette smoking is recognized as the most important cause of chronic obstructive pulmonary disease (COPD), the pathophysiological mechanisms underlying the lung function decline are not well understood. Using off-line strong cation exchange fractionation with RP-LC-ESI-MS/MS and robust database searching, 1758 tryptic peptides were identified in plasma samples from cigarette smokers. Using two statistical approaches, 30 peptides were identified to be associated with the annualized rate of lung function decline over 5 years among smokers with COPD characterized as having rapid (n?=?18) or slow (n?=?18) decline and 18 smokers without COPD. The identified peptides belong to proteins that are involved in the complement or coagulation systems or have antiprotease or metabolic functions. This research demonstrates the utility of proteomic profiling to improve the understanding of molecular mechanisms involved in cigarette smoking-related COPD by identifying plasma proteins that correlate with decline in lung function.     

Biomarkers of oxidative stress for in vivo assessment of toxicological effects of iron oxide nanoparticles

Iron oxide nanoparticles (Fe₂O₃-IONPs) have revolutionized the industry by significant economic and scientific impacts. Enormous increase in the usage of IONPs has raised concerns about their unseen adverse effects. In the current study, we investigated the effects of IONPs and its bulk on oxidative stress biomarkers, histopathology and biodistribution in rats after 28 days repeated oral treatment at 30, 300 and 1000 mg/kg body weight (b.w.). IONPs size in dry, wet forms and crystallinity was determined using TEM, DLS and XRD. The investigation of oxidative stress biomarkers demonstrated significant increase in lipid peroxidation and decrease in reduced glutathione content in the liver, kidney and the brain of the treated groups in a dose dependant manner. Further, antioxidant enzymes catalase, glutathione S transferase, glutathione peroxidase and glutathione reductase activities were significantly elevated along with significant decrease in superoxide dismutase activity in treated rat organs. ICP-OES analysis revealed dose and size dependant accumulation of IONPs in the liver followed by kidney and the brain than bulk. Moreover, accumulation of IONPs at high dose brought pathological changes only in liver. A large fraction of IONPs was eliminated in urine. Bulk material was substantially excreted in faeces than IONPs suggesting increased absorption of IONPs. In conclusion accumulated IONPs and bulk in organs trigger free radical generation, leading to the induction of oxidative stress condition in rats. The results obtained highlight the importance of toxicity assessments in evaluating the efficiency of IONPs for the safe implementation for diversified applications.     

Biochemical indicators of salt stress in Plantago maritima: Implications for environmental stress assessment

Our study is focused on native spontaneous species of saline ecosystems Plantago maritima. Plants were cultivated at several salt concentrations (0, 50, 100, 200, 300, 400 and 500 mM NaCl) in a glass greenhouse under semi-controlled conditions. Growth parameters, water parameters and ionic status were determined and they were used as criteria to assess the response of P. maritima under a salinity gradient. Catalase, guaiacaol and ascobate peroxidase activities, total protein and proline were also determined. Our results show that P. maritima is a facultative halophyte capable of expressing its maximum growth potential at relatively low concentrations of salt (less than 3 g l⁻¹ NaCl). At high doses of salt (concentrations > 200 mM), the decrease in the growth of P. maritima is associated to a decrease in the uptake of K⁺. There is a disruption of the water intake of their organs and therefore results an invasion of the cytoplasm by Na⁺ toxic ion. However, stressed plants use K⁺ more sparingly. They invest especially in the production of biomass expressed by the dry weight of the shoots, and they use Na⁺ and proline for osmotic adjustment. The halophyte studied is able to accumulate high levels of proline in response to increasing salt concentration. The accumulation of the amino compound, mainly in roots, is interpreted as an indicator of salt tolerance. Additionally, a significant correlation between the tolerance of the plants to salinity and the activity of several antioxidant enzymes has been observed. Hence, we suggest the possibility of using these activities as a biochemical indicator for salt tolerance in P. maritima. Our study points out two types of biomarkers of salt exposure: enzymatic biomarkers in the leaves and proline content in the roots. Both did show very good correlation with salt exposure, and thus may be considered good biomarkers of exposure with a very good dose–response relationship.     

Ecological risk assessment of transgenic plant releases: an Austrian perspective

Some prerequisites for ecological risk assessment of transgenic plant releases are examined, with the aim of identifying research needs in Austria. Austria harbours high habitat diversity, extending from the Alps to the Pannonian continental lowlands. The Pannonian flora includes potential cross-breeding partners of several crops, which do not occur in western Europe. The border zones of major biogeographical regions contain high biodiversity, both in terms of species and habitat diversity; whether the genetic variability of widespread plant species is also increased in these areas requires further investigation. Especially in Alpine regions, transgenic grasses might eventually cause profound changes in community structure. Ecological risk assessment of transgenic crop releases should not only consider adverse effects on non-target species and ecosystems, but also their likely impact on the agroecosystems.     

Biomarkers of oxidative stress in Biomphalaria alexandrina snails for assessing the effects of certain inorganic fertilisers

Freshwater snails are often used to monitor aquatic pollution. The present study aims to use Biomphalaria alexandrina snails as bio-indicators for three types of NPK fertilisers (high nitrogen, high phosphorus and balanced). Data showed that high phosphorus and high nitrogen fertilisers have a negative impact on the growth rate of juvenile snails. Such observations were supported by determining antioxidant parameters in the digestive gland. Results indicated a significant increase in the catalase activity of snails that were exposed to ½ LC₅₀ concentrations of balanced and high phosphorus fertilisers. Meanwhile, the glutathione S-transferase, glutathione peroxidase and reduced glutathione parameters showed varying results representing an increase or decrease in the activities of all treated groups after both the first and second weeks, according to the type of fertiliser the snails were exposed to.     

Gender difference in oxidative stress: a new look at the mechanisms for cardiovascular diseases

Gender differences are present in many diseases and are especially prevalent in cardiovascular disease. Males tend to suffer from myocardial infarctions earlier than females, and a woman's risk of cardiovascular disease increases after menopause, suggesting a cardio‐protective role of estrogen. However, hormone replacement therapy did not decrease the risk of cardiovascular disease in post‐menopausal women; thus, other mechanisms may be involved besides estrogen. Oxidative stress plays an important role in the development of cardiovascular diseases such as coronary artery disease. Gender is also associated with differences in oxidative stress. Under physiological conditions, females appear to be less susceptible to oxidative stress. This may be due to the antioxidant properties of estrogen, gender differences in NADPH‐oxidase activity or other mechanism(s) yet to be defined. This review strives to discuss gender differences in general terms followed by a more detailed examination of gender differences with oxidative stress and various associated diseases and the possible mechanisms underlying these differences.     

Involuntary smoking and the risk of head and neck cancer in an East Asian population

BackgroundAlthough tobacco involuntary smoking is an established risk factor for lung cancer, the association with head and neck cancer (HNC) is not established. We aimed to investigate this potential association in an East Asian population.MethodsWe conducted a multicenter case-control study in East Asia including eight centers. We restricted our analysis to never tobacco smokers (303 cases and 459 controls) and to never tobacco smokers/never alcohol drinkers (243 cases and 403 controls).ResultsAmong never tobacco smokers, involuntary smoking was associated with a 1.47-fold increase in risk of HNC (95%CI = 1.02, 2.13) and a 1.8-fold increase in the risk of oral cavity cancer (95%CI = 1.14, 2.92). Among never tobacco smokers who were also never alcohol drinkers, increased risks were detected for more than 3 h per day of involuntary smoking exposure and for 15 or more years of exposure. A dose-response relation was suggested for frequency of exposure (p for trend = 0.014) and for years of exposure (p for trend = 0.010) for oral cavity cancer. We did not detect strong increases in the risk of the other HNC subsites.ConclusionsOur study supports the association between involuntary smoking and the risk of HNC. The association may be stronger for oral cavity cancer than for other HNC subsites.     

Toxoplasmosis: stages of the protozoan life cycle and risk assessment in humans and animals for an enhanced awareness and an improved socio-economic status

Toxoplasma gondii is a protozoan parasite distributed globally. It causes toxoplasmosis, which is prevalent in animals, birds, and soil. T. gondii infection leads to severe pathological impacts in immunodeficient patients and congenital cases. This review indicated that high prevalence groups had close contact with cats, dogs, consumed uncooked raw fruits, meat, or vegetables and the socio-economic level noted to be one of the crucial factors that influence toxoplasmosis. Toxoplasmosis infection is high in low-income countries and low in developed European countries. Immunosuppressed groups and pregnant women were the highly vulnerable groups. The epidemiology of the parasite enumerated various routes of infections; but consumption of T. gondii contaminated food was the major route of disease transmission. However, the role of meat and meat-producing animals on disease transmission remained unclear. Unfiltered water acts as the primary reservoir of toxoplasmosis transmission. The diagnostic methods for determining T. gondii infection are not the gold standard, and different approaches have been prescribed to analyze the infected populations based on the organs affected. Although toxoplasmosis was reported before 70 years, no appropriate solution noted to be recommended to treat this disease. Based on the present analyses, it concluded that the eradication of toxoplasmosis would be challenging from the world until people''s socio-economic level is improved. The main aim of the present study was to analyze and update the disease transmission, epidemiology, and possible clinical interventions of toxoplasmosis.     

Exogenous markers for the characterization of human diseases associated with oxidative stress

Many human conditions, including neurological diseases, atherosclerosis, cancer, diabetic complications and aging, are thought to be associated with oxidative stress (OS). The development of reliable and informative markers for the characterization of OS in humans is thus highly important. Various endogenous markers are known, but their accumulation with increasing OS and with time is not certain, and most of them do not provide information on the type or source of the stress, or on the kinetics of their formation. The aim of the present overview is to present exogenous markers, designed and synthesized by our group, which are sensitive to OS and can identify its presence, the type of reactive oxygen and nitrogen species involved ex vivo, and potential damage incurred by bio-macromolecules, in real time. A microdialysis technique is used in animals for evaluation of OS in vivo. The designed probes are composed of several endogenous subunits, attached together covalently to form molecules that do not exist as such in humans. The subunits include an amino acid (tyrosine), an unsaturated fatty acid (linoleic acid), a nucleic acid (2′-deoxyribose guanosine) and cholesterol, representing the major macromolecules of the body, i.e. proteins, lipids, DNA and sterols, respectively. Incubation of these markers in a biological sample ex vivo, such as blood/serum, urine, saliva, cells or tissues under OS, alters their subunits, which are then analyzed and identified by LC/MS. This review demonstrates the potential of these markers to identify OS in samples taken from humans and animals suffering from, for example, atherosclerosis, hypertension, or Alzheimer's or Parkinson's disease.     

Dietary polyunsaturated fatty acids and heme iron induce oxidative stress biomarkers and a cancer promoting environment in the colon of rats

The end products of polyunsaturated fatty acid (PUFA) peroxidation, such as malondialdehyde (MDA), 4-hydroxynonenal (HNE), and isoprostanes (8-iso-PGF_2α), are widely used as systemic lipid oxidation/oxidative stress biomarkers. However, some of these compounds have also a dietary origin. Thus, replacing dietary saturated fat by PUFAs would improve health but could also increase the formation of such compounds, especially in the case of a pro-oxidant/antioxidant imbalanced diet. Hence, the possible impact of dietary fatty acids and pro-oxidant compounds was studied in rats given diets allowing comparison of the effects of heme iron vs. ferric citrate and of ω-6- vs. ω-3-rich oil on the level of lipid peroxidation/oxidative stress biomarkers. Rats given a heme iron-rich diet without PUFA were used as controls. The results obtained have shown that MDA and the major urinary metabolite of HNE (the mercapturic acid of dihydroxynonane, DHN-MA) were highly dependent on the dietary factors tested, while 8-iso-PGF_2α was modestly but significantly affected. Intestinal inflammation and tissue fatty acid composition were checked in parallel and could only explain the differences we observed to a limited extent. Thus, the differences in biomarkers were attributed to the formation of lipid oxidation compounds in food or during digestion, their intestinal absorption, and their excretion into urine. Moreover, fecal extracts from the rats fed the heme iron or fish oil diets were highly toxic for immortalized mouse colon cells. Such toxicity can eventually lead to promotion of colorectal carcinogenesis, supporting the epidemiological findings between red meat intake and colorectal cancer risk.Therefore, the analysis of these biomarkers of lipid peroxidation/oxidative stress in urine should be used with caution when dietary factors are not well controlled, while control of their possible dietary intake is needed also because of their pro-inflammatory, toxic, and even cocarcinogenic effects.     

Experimental schistosomal hepatitis: protective effect of coenzyme-Q10 against the state of oxidative stress

Schistosoma mansoni (S. mansoni) eggs trapped in the host liver elicit a chain of oxidative processes that may be, at least in part, responsible for the pathology and progression of fibrosis associated with schistosomal hepatitis. This study was designed to assess the protective effect of the antioxidant coenzyme-Q10 (Co-Q10) against experimental S. mansoni-induced oxidative stress in the liver, and its potential role as an adjuvant to praziquantel (PZQ) therapy. The oxidative stress and overall liver function were improved under Co-Q10 therapy as evidenced by significant reduction in oxidative stress markers and preservation of antioxidant factors. Liver fibrosis was also reduced with a positive impact on liver function. Moreover, addition of Co-Q10 to PZQ therapy caused: significant reduction of liver egg load, significant improvement of the redox status, and lastly decreased liver fibrosis.     

The effect of silica exposure on the risk of lung cancer: A meta-analysis

Lung cancer is an incurable disease with an increased mortality rate caused by the inhalation of dust-containing crystalline silica particles. Silica exposure is one of the most important occupational hazards in the world. Whether the association between silica exposure and lung cancer is because of the fibrotic process or to the effect of respirable silica itself is unclear. The International Agency for Research on Cancer (IARC) classified silica as a human lung carcinogen. The opinion of lung cancer is a question that has been addressed in this review. Three electronic databases, including MEDLINE, Scopus, and Web of Science, were used to search for relevant literature from 2000 to 2022. To evaluate the relationship between exposure to silica and developing lung cancer, we performed a meta-analysis using the random-effects model. For each study, the overall odds ratio (OR), relative risk (RR) with 95% confidence intervals (CI), and p values were calculated. An extensive database search resulted in the selection of 20 (case‒control and nested case‒control studies were selected) out of 527 studies. Among the 20 selected studies, 7 studies showed a significant association between silica exposure and an increased risk of lung cancer. Further analysis showed that among the selected studies, six studies showed a significant correlation between combined exposure to silica and smoking with an increased risk of lung cancer. The data from the present study showed that smoking habits increased the impact of silica exposure on the initiation of lung carcinogenesis in exposed workers.     

Predictive value of metabolomic biomarkers for cardiovascular disease risk: a systematic review and meta-analysis

Abstract

Background: Metabolomic analysis aids in the identification of novel biomarkers by revealing the metabolic dysregulations underlying cardiovascular disease (CVD) aetiology. The aim of this study was to evaluate which metabolic biomarkers could add value for the prognosis of CVD events using meta-analysis.

Methods: The PRISMA guideline was followed for the systematic review. For the meta-analysis, biomarkers were included if they were tested in multivariate prediction models for fatal CVD outcomes. We grouped the metabolites in biological classes for subgroup analysis. We evaluated the prediction performance of models which reported discrimination and/or reclassification statistics.

Results: For the systematic review, there were 22 studies which met the inclusion/exclusion criteria. For the meta-analysis, there were 41 metabolites grouped into 8 classes from 19 studies (45,420 subjects, 5954 events). A total of 39 of the 41 metabolites were significant with a combined effect size of 1.14 (1.07–1.20). For the predictive performance assessment, there were 21 studies, 54,337 subjects, 6415 events. The average change in c-statistic after adding the biomarkers to a clinical model was 0.0417 (SE 0.008).

Conclusions: This study provides evidence that metabolomic biomarkers, mainly lipid species, have the potential to provide additional prognostic value. Current data are promising, although approaches and results are heterogeneous.