Alcohol and Head and Neck Cancer: Updates on the Role of Oxidative Stress, Genetic, Epigenetics, Oral Microbiota, Antioxidants, and Alkylating Agents
Giampiero Ferraguti,
Sergio Terracina,
Carla Petrella,
Antonio Greco,
Antonio Minni,
Marco Lucarelli,
Enzo Agostinelli,
Massimo Ralli,
Marco de Vincentiis,
Giammarco Raponi,
Antonella Polimeni,
Mauro Ceccanti,
Brunella Caronti,
Maria Grazia Di Certo,
Christian Barbato,
Alessandro Mattia,
Luigi Tarani,
Marco Fiore
Affiliations
Giampiero Ferraguti
Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
Sergio Terracina
Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
Carla Petrella
Institute of Biochemistry and Cell Biology, IBBC—CNR, 000185 Rome, Italy
Antonio Greco
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
Antonio Minni
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
Marco Lucarelli
Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
Enzo Agostinelli
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
Massimo Ralli
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
Marco de Vincentiis
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy
Giammarco Raponi
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Antonella Polimeni
Department of Odontostomatological and Maxillofacial Sciences, Sapienza University of Rome, 00185 Rome, Italy
Mauro Ceccanti
SITAC, Società Italiana per il Trattamento dell’Alcolismo, 00184 Rome, Italy
Brunella Caronti
Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
Maria Grazia Di Certo
Institute of Biochemistry and Cell Biology, IBBC—CNR, 000185 Rome, Italy
Christian Barbato
Institute of Biochemistry and Cell Biology, IBBC—CNR, 000185 Rome, Italy
Alessandro Mattia
Ministero dell’Interno, Dipartimento della Pubblica Sicurezza, Direzione Centrale di Sanità, Centro di Ricerche e Laboratorio di Tossicologia Forense, 00185 Rome, Italy
Luigi Tarani
Department of Pediatrics, Sapienza University Hospital of Rome, 00185 Rome, Italy
Marco Fiore
Institute of Biochemistry and Cell Biology, IBBC—CNR, 000185 Rome, Italy
Head and neck cancer (HNC) concerns more than 890,000 patients worldwide annually and is associated with the advanced stage at presentation and heavy outcomes. Alcohol drinking, together with tobacco smoking, and human papillomavirus infection are the main recognized risk factors. The tumorigenesis of HNC represents an intricate sequential process that implicates a gradual acquisition of genetic and epigenetics alterations targeting crucial pathways regulating cell growth, motility, and stromal interactions. Tumor microenvironment and growth factors also play a major role in HNC. Alcohol toxicity is caused both directly by ethanol and indirectly by its metabolic products, with the involvement of the oral microbiota and oxidative stress; alcohol might enhance the exposure of epithelial cells to carcinogens, causing epigenetic modifications, DNA damage, and inaccurate DNA repair with the formation of DNA adducts. Long-term markers of alcohol consumption, especially those detected in the hair, may provide crucial information on the real alcohol drinking of HNC patients. Strategies for prevention could include food supplements as polyphenols, and alkylating drugs as therapy that play a key role in HNC management. Indeed, polyphenols throughout their antioxidant and anti-inflammatory actions may counteract or limit the toxic effect of alcohol whereas alkylating agents inhibiting cancer cells’ growth could reduce the carcinogenic damage induced by alcohol. Despite the established association between alcohol and HNC, a concerning pattern of alcohol consumption in survivors of HNC has been shown. It is of primary importance to increase the awareness of cancer risks associated with alcohol consumption, both in oncologic patients and the general population, to provide advice for reducing HNC prevalence and complications.
