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Long-Lasting Effects of Tobacco Smoking on Pulmonary Drug-metabolizing Enzymes: A Case-Control Study on Lung Cancer Patients¹

C.N.R. Institute of Clinical Physiology, Second Medical Clinic [S. P., L. C., L. G., M. R., C. G.], and Section of Thoracic Surgery [G. M., C. A. A.], University of Pisa, Pisa, Italy, and International Agency for Research on Cancer, Lyon, France [A-M. C., M. A., E. H., A. A., R. S., H. B.]

Lung tissue specimens were taken during surgery from iddle-aged men with either lung cancer (LC, n = 54) or a nonneoplastic lung disease (n = 20). Aryl hydrocarbon hydroxylase (AHH), 7-ethoxycoumarin O-deethylase (ECDE), epoxide hydrolase (EH), glutathione S-transferase (GST), and UDP-glucuronosyltransferase (UDPGT) activities and glutathione and malondialdehyde contents were determined in 12,000 x g supernatant fractions from nontumorous parenchymal tissues.

Interindividual differences in enzyme activities ranged from 11- to 440-fold, and glutathione content varied by 17-fold; the values showed unimodal distributions. AHH, ECDE, EH, and UDPGT activities were significantly and positively correlated to each other; a significant negative correlation was found between GST and the other enzymes. A relationship between enzyme activity and number of cigarettes smoked (pack-years) was found only for GST. Ignoring detailed smoking histories in the 6-month period preceding surgery, no difference was found in enzyme activities or glutathione content between LC and nonneoplastic lung disease patients or between smokers and nonsmokers. However, when the number of days since stopping smoking was considered, in smokers a significant increase was found for AHH, EH, and UDPGT activities and a significant decrease was found for GST activity, as compared to nonsmokers. LC patients who had smoked until the day before surgery had higher activities of AHH, ECDE, EH, and UDPGT than nonsmokers, while GST activity was reduced by one-third. The activities of these enzymes returned to the basal level found in nonsmokers within 59 (AHH), 108 (EH), 67 (UDPGT), and 40 (GST) days. LC patients who were recent smokers (within 30 days prior to surgery) had significantly induced AHH and ECDE activities when compared with smoking nonneoplastic lung disease patients. These results show that pulmonary drug metabolism can be altered by tobacco smoking and that these effects can last 40 to 108 days after cessation of smoking. These new findings should be considered in studies on the role of carcinogen-metabolizing enzymes in determining susceptibility to lung cancer.

¹ This work was supported by the C.N.R. of Italy Special Oncology Project, Contract 8600438.44.

² To whom requests for reprints should be addressed, at the International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon Cedex 08, France.

Received 12/16/87. Revised 5/ 4/88. Accepted 5/17/88.

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