Toxico-Epigenomic Mechanisms of Smoking Exposure in Lung Cancer Development

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Hana Sarvella Setyawan
PT Dion Farma Abadi

Lung cancer remains one of the leading causes of cancer-related mortality worldwide, with cigarette smoking recognized as the primary environmental risk factor contributing to its development. Tobacco smoke contains various carcinogenic compounds that induce oxidative stress and epigenetic alterations, including DNA methylation and histone modifications, which regulate gene expression without altering the DNA sequence. This review aimed to examine the toxico-epigenomic mechanisms underlying smoking-induced lung carcinogenesis, particularly the roles of nicotine-derived nitrosamine ketone (NNK), carbon monoxide, DNA methyltransferases (DNMTs), and chromatin modifications. This study employed a narrative literature review approach by analyzing relevant peer-reviewed scientific publications focusing on tobacco toxicology, epigenetic regulation, and lung cancer mechanisms. The findings indicated that NNK contributes to lung carcinogenesis through DNMT1 stabilization, promoter hypermethylation, and the silencing of tumor suppressor genes, while carbon monoxide promotes hypoxia and reactive oxygen species generation, further enhancing epigenetic dysregulation. These mechanisms influence critical biological processes, including cell proliferation, apoptosis, DNA repair, and tumor progression. Understanding smoking-related epigenetic alterations provides important insights for developing early diagnostic biomarkers and targeted therapeutic strategies, including DNMT inhibitors such as 5-azacitidine, 5-aza-2'-deoxycytidine, and zebularine. This review highlights the importance of integrating toxico-epigenomic approaches to improve understanding and management of smoking-related lung cancer.


Keywords: toxico-epigenomics, DNA methylation, lung cancer
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