title: The pathobiological impact of cigarette smoke on pancreatic cancer development (review).
abstract: Despite extensive efforts, pancreatic cancer remains incurable. Most risk             factors, such as genetic disposition, metabolic diseases or chronic pancreatitis             cannot be influenced. By contrast, cigarette smoking, an important risk factor             for pancreatic cancer, can be controlled. Despite the epidemiological evidence             of the detrimental effects of cigarette smoking with regard to pancreatic cancer             development and its unique property of being influenceable, our understanding             of cigarette smoke-induced pancreatic carcinogenesis is limited. Current data             on cigarette smoke-induced pancreatic carcinogenesis indicate multifactorial events             that are triggered by nicotine, which is the major pharmacologically active constituent             of tobacco smoke. In addition to nicotine, a vast number of carcinogens have the             potential to reach the pancreatic gland, where they are metabolized, in some instances             to even more toxic compounds. These metabolic events are not restricted to pancreatic             ductal cells. Several studies show that acinar cells are also greatly affected.             Furthermore, pancreatic cancer progenitor cells do not only derive from the ductal             epithelial lineage, but also from acinar cells. This sheds new light on cigarette             smoke-induced acinar cell damage. On this background, our objective is to outline             a multifactorial model of tobacco smoke-induced pancreatic carcinogenesis.
authors.affiliation: Department of General- and Visceral Surgery, Universitätsklinik Freiburg, Freiburg, Germany. uwe.wittel@uniklinik-freiburg.de
authors.forename: Uwe A
authors.initials: UA
authors.lastname: Wittel
authors.forename: Navneet
authors.initials: N
authors.lastname: Momi
authors.forename: Gabriel
authors.initials: G
authors.lastname: Seifert
authors.forename: Thorsten
authors.initials: T
authors.lastname: Wiech
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Batra
mesh_terms: D061354:Acinar Cells / Q000187:drug effects / Q000473:pathology; D000818:Animals; D002273:Carcinogens / Q000494:pharmacology; D021441:Carcinoma, Pancreatic Ductal / Q000209:etiology* / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D006801:Humans; D009538:Nicotine / Q000494:pharmacology; D010179:Pancreas / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000209:etiology* / Q000473:pathology; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*; D014026:Nicotiana
chemical_list: D002273:Carcinogens; D012906:Smoke; D009538:Nicotine