Lung carcinogenesis: Pivotal role of metals in tobacco smoke

Although significant progress has been made in unraveling the molecular mechanisms responsible for tobacco smoke toxicity and carcinogenicity, only limited information is available concerning the mechanisms by which tar particles and the gaseous phase constituents of tobacco smoke participate and contribute to carcinogenic processes in lung cancer. The present review critically evaluates how metals contained in the tar particles and the gaseous phase of tobacco smoke play a leading role in the carcinogenic process, taking into consideration the physiology and pathophysiology of the bronchial epithelium. Overwhelmingly, the published data indicate that the bronchopulmonary epithelial cells may represent the first and most critical line of defense against cigarette smoke.