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Sunday June 16, 2002 10:25 PM GMT
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Active oxygen species have long been known to be mutagenic,
hence playing a role in cancer formation.
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Introduction
The development of cancer is composed of
a series of complex processes of cellular and molecular changes. Active oxygen
species and other free radicals have long been known to be mutagenic. There is
also evidence that they act as mediators of the other pheno and genotypic
changes that lead from mutation to neoplasia. Free radical production is
universal in all respiring organisms and is enhanced by many disease processes,
carcinogen exposure and under conditions of stress.
This can be demonstrated both clinically
and epidemiologically in addition to experimental evidence. One form of indirect
evidence of the contribution of free radicals to carcinogenesis is the studies
performed using antioxidants as protecting agents against cancer.
The intake of transition metals may
facilitate the production of active oxygen species. Chronic inflammatory
conditions in which oxidative stress dramatically increases also contributes to
carcinogenesis. Many chemical carcinogens are thought to act through the
production of free radical metabolites or processes.
Multistage carcinogenesis:
The concept of multistage carcinogenesis
was initially developed in rodent skin models in the 1940s (Rous
and Kidd 1941; Mottram 1944). Moreover, epidemiological data suggests that
cancer is a multistage process. Experimental carcinogenesis proceeds through at
least 3 distinct stages:

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1. Initiation:
Initiation
is the process in which a single somatic cell undergoes non-lethal, but
heritable mutation. This initiating mutation may give the initiated cell the
growth advantage needed in the second stage of promotion. In contrast to its
neighbours, the initiated cell can escape the cellular regulatory mechanisms.
2. Promotion:
Is the process in which the initiated
cell is exposed to a tumour promoter which causes these cells to undergo
phenotypical clonal expansion. Tumour promoters could either be external or
internal stimuli. Only initiated cells are stimulated to grow (Cerutti
et al. 1988). The signal to expand clonally could be a result of the direct
effect of the tumour promoter or as an indirect effect of the promoter on the
adjacent cells. However, tumour initiation and promotion together produce
relatively benign growths. It is the third step in which these growths undergo
malignant conversion. This process is generally slow, occurs over a long time,
and is altered greatly by agents that affect growth rates (e.g., hormones,
growth factors, vitamin A and the retinoids, vitamin D, folate, calcium).
3. Malignant conversion:
Like initiation requires genetic
alteration. Here cellular growth is further deregulated thus proceeds
uncontrolled. Progression is probably the most complex of the three stages,
because both acquired genetic and phenotypic occur, and cellular expansion is
rapid. Retinoids affect this stage, as do other inhibitors of growth (e.g.,
polyamine synthesis inhibitors) and antioxidants. As the tumour progresses,
sensitivity to dietary compounds, inhibitors of growth, and enhancers of
differentiation gradually disappears until the tumour becomes progressively more
autonomous and controllable only by more drastic intervention (Guyton
and Kensler, 1993).
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