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Rosser CJ. Assessing the Causal Relationship between Waterpipe Smoking and Bladder Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:461-462. [PMID: 38566557 DOI: 10.1158/1055-9965.epi-24-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 04/04/2024] Open
Abstract
Rates of waterpipe use increase with very little data reporting any potential health consequences. The current study, a large case-control study, of 4,194 patients from Iran denotes an elevated risk of bladder cancer in exclusive waterpipe smokers compared with non-users. Additional studies are needed to further understand the risk waterpipe smoking has on bladder cancer. See related article by Hadji et al., p. 509.
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Affiliation(s)
- Charles J Rosser
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California
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Zaarour RF, Sharda M, Azakir B, Hassan Venkatesh G, Abou Khouzam R, Rifath A, Nizami ZN, Abdullah F, Mohammad F, Karaali H, Nawafleh H, Elsayed Y, Chouaib S. Genomic Analysis of Waterpipe Smoke-Induced Lung Tumor Autophagy and Plasticity. Int J Mol Sci 2022; 23:ijms23126848. [PMID: 35743294 PMCID: PMC9225041 DOI: 10.3390/ijms23126848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 02/07/2023] Open
Abstract
The role of autophagy in lung cancer cells exposed to waterpipe smoke (WPS) is not known. Because of the important role of autophagy in tumor resistance and progression, we investigated its relationship with WP smoking. We first showed that WPS activated autophagy, as reflected by LC3 processing, in lung cancer cell lines. The autophagy response in smokers with lung adenocarcinoma, as compared to non-smokers with lung adenocarcinoma, was investigated further using the TCGA lung adenocarcinoma bulk RNA-seq dataset with the available patient metadata on smoking status. The results, based on a machine learning classification model using Random Forest, indicate that smokers have an increase in autophagy-activating genes. Comparative analysis of lung adenocarcinoma molecular signatures in affected patients with a long-term active exposure to smoke compared to non-smoker patients indicates a higher tumor mutational burden, a higher CD8+ T-cell level and a lower dysfunction level in smokers. While the expression of the checkpoint genes tested-PD-1, PD-L1, PD-L2 and CTLA-4-remains unchanged between smokers and non-smokers, B7-1, B7-2, IDO1 and CD200R1 were found to be higher in non-smokers than smokers. Because multiple factors in the tumor microenvironment dictate the success of immunotherapy, in addition to the expression of immune checkpoint genes, our analysis explains why patients who are smokers with lung adenocarcinoma respond better to immunotherapy, even though there are no relative differences in immune checkpoint genes in the two groups. Therefore, targeting autophagy in lung adenocarcinoma patients, in combination with checkpoint inhibitor-targeted therapies or chemotherapy, should be considered in smoker patients with lung adenocarcinoma.
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Affiliation(s)
- Rania Faouzi Zaarour
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Mohak Sharda
- National Center for Biological Sciences, Tata Institute of Fundamental Research, Bangalore 560065, India;
- School of Life Science, The University of Trans-Disciplinary Health Sciences & Technology (TDU), Bangalore 560064, India
| | - Bilal Azakir
- Molecular and Translational Medicine Laboratory, Faculty of Medicine, Beirut Arab University, Beirut 11072809, Lebanon; (B.A.); (H.K.)
| | - Goutham Hassan Venkatesh
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Raefa Abou Khouzam
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Ayesha Rifath
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Zohra Nausheen Nizami
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Fatima Abdullah
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Fatin Mohammad
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Hajar Karaali
- Molecular and Translational Medicine Laboratory, Faculty of Medicine, Beirut Arab University, Beirut 11072809, Lebanon; (B.A.); (H.K.)
| | - Husam Nawafleh
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
| | - Yehya Elsayed
- Department of Biology, Chemistry and Environmental Sciences (BCE), American University of Sharjah, Sharjah 26666, United Arab Emirates;
| | - Salem Chouaib
- Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman 4184, United Arab Emirates; (R.F.Z.); (G.H.V.); (R.A.K.); (A.R.); (Z.N.N.); (F.A.); (F.M.); (H.N.)
- Inserm Umr 1186, Integrative Tumor Immunology and Immunotherapy, Gustave Roussy, Faculty of Medicine, University Paris-Saclay, 94805 Villejuif, France
- Correspondence:
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