title: Saliva--a pivotal player in the pathogenesis of oropharyngeal cancer.
abstract: Oropharyngeal (OP) cancer, which is usually squamous cell carcinoma, is the most common head and neck malignancy and accounts for 2-4% of all new cancers. It is primarily induced by exposure to tobacco. The paradigm of cigarette smoke (CS)-induced OP cancer's pathogenesis is based on the assumption that a constant direct attack of various CS carcinogens causes widespread accumulating cellular and DNA aberrations in the OP mucosal cells, in turn eventually resulting in malignant transformation. However, there is never a direct contact between CS and the OP mucosa. Saliva, bathing the mucosa from the oral cavity to the larynx, always intervenes, and CS must first interact with saliva before it reaches the mucosa. The current study investigated the role of saliva in the pathogenesis of OP cancer. A synergistic effect of CS and saliva on oral cancer cells was demonstrated. This synergism is based on the reaction between redox active metals in saliva and low reactive free radicals in CS, which results in the production of highly active hydroxyl free radicals. Thus, when exposed to CS, salivary behavior is reversed and the saliva loses its antioxidant capacity and becomes a potent pro-oxidant milieu. The devastating role of CS-borne aldehydes was demonstrated as well. Based on these results and on our recent reports demonstrating that CS destroys various salivary components, including protective ones such as peroxidase, the most important salivary antioxidant enzyme, a comprehensive view of the pivotal role of saliva in the pathogenesis of CS-induced OP cancer is suggested.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Oral Biochemistry Laboratory and Salivary Clinic, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Reznick
authors.forename: O
authors.initials: O
authors.lastname: Hershkovich
authors.forename: R M
authors.initials: RM
authors.lastname: Nagler
mesh_terms: D000328:Adult; D000447:Aldehydes / Q000009:adverse effects; D000975:Antioxidants; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000503:physiopathology*; D002470:Cell Survival; D004249:DNA Damage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000209:etiology / Q000503:physiopathology*; D009195:Peroxidase / Q000378:metabolism / Q000494:pharmacology; D012463:Saliva / Q000737:chemistry*; D012907:Smoking / Q000009:adverse effects*; D014407:Tumor Cells, Cultured
chemical_list: D000447:Aldehydes; D000975:Antioxidants; D009195:Peroxidase