What you always wanted to know about smoking-associated oxidative stress, but did not dare to ask
The pathogenesis of numerous diseases related to cigarette smoking is firmly associated in the literature with a development of an oxidative stress. However, the current knowledge on oxidative stress as universal generator of pathologies and the existing methodologies for the assessment of its status do not provide an unambiguous understanding of the mechanisms of the biological effects of cigarette smoke. The main interrelations between (i) cigarette smoking, (ii) developing oxidative stress in the human organism and (iii) the most prominent diseases, whose pathogenesis is thought to be associated with smoking, become evident from the analysis of the statistics of scientific and medical publications and their dynamics over several decades. In this context, our survey encompasses mutagenesis and carcinogenesis, development of cardiovascular and neurodegenerative diseases, digestive diseases, pulmonary diseases including chronic obstructive pulmonary disease, allergic phenomena, alteration of the immune status of smokers and hypoxia. The difficulties in elucidating the influence of cigarette smoking on oxidative stress derive from fundamental problems in assaying oxidative stress status as well as understanding the interplay of pro-oxidative and antioxidant reactants in smoke and in the human organism. These issues make up the subject matter of our current analysis. The latter comprises a retrospective view (since the 1960s) on studying the phenomenon of oxidative stress in the context of cigarette smoking, which constitutes a major challenge for the scientific and methodological strategy for prediction and reduction of the harm in the design of future tobacco products.