URINARNI METABOLITI KAO INDIKATORI IZLOŽENOSTI LJUDI HEMIJSKIM KARCINOGENIMA
Sažetak
Izloženost stanovništva hemijskim karcinogenima iz životne sredine prestavlja sve veći javnozdravstveni problem. Kancerogene hemikalije mogu se klasifikovati u dve grupe: genotoksične i ne-genotoksične. Genotoksična hemikalija ima potencijal da indukuje nastanak karcinoma, bilo u direktnoj interakciji sa DNK ili sa ćelijskim strukturama odgovornim za očuvanje integriteta genoma. Negenotoksična hemikalija ima potencijal da indukuje rak na indirektan način ulazeći u procese etiopatogeneze karcinoma. Dosadašnja istraživanja ukazuju da se neorganska jedinjenja arsena mogu dovesti u vezu sa nizom malignih bolesti (rakom pluća, mokraćne bešike, kože, bubrega, jetre i prostate). Neorganski arsen pretežno se nalazi u mesu, mlečnim proizvodima i žitaricama, a organski arsen (arsenobetain) u morskim plodovima, voću i povrću. Metaboliti benzena dovode se u vezu sa različitim vrstama leukemija i limfomima, benzidin sa rakom mokraćne bešike, nikl sa rakom pluća, a jedinjenja hroma sa rakom pluća, rakom nosa i nazalnih sinusa. Najveća profesionalna izloženost benzenu je u industriji (kože, elektronskih uređaja, obuće, sportske opreme), a sa benzidinom osobe mogu doći u kontakt preko robe široke potrošnje (proizvodi od kože, odeća i igračke). Najviše koncentracije nikla izmerene su u pasulju, orasima i žitaricama. Kadmijum i kadmijumova jedinjenja uzrokuju rak pluća, a utiču i na pojavu raka bubrega i prostate. Rizik od hepatocelularnog karcinoma značajno je povišen kod ispitanika sa visokim koncentracijama urinarnih metabolita aflatoksina (adukti aflatoksin-N7-gvanina). Izomeri lindana nalaze se u mlečnim proizvodima, mesu, ribi, živini, baštenskom voću, uljima i mastima, lisnatom i korenastom povrću i šećeru, a kod ljudi uzrokuju ne-Hodgkinov limfom. Postoji pozitivna veza između konzumiranja biljke Aristolochia i pojave urotelnih karcinoma. Ne postoje skrininzi za identifikaciju osoba koje su u velikom riziku da dobiju maligno oboljenje u narednih 10 ili 20 godina. U prevenciji nastanka malignih bolesti neophodno je staviti akcenat na pronalaženje adekvatnih metoda za određivanje koncentracija urinarnih metabolita za hemijske karcinogene i definisati njihove rizične vrednosti.
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