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高血压与肺癌的合并症:遗传与环境的相互作用

Comorbidity of hypertension and lung cancer: interplay of genetics and environment.

作者信息

Zeng Jingtong, Shi Difang, He Daqian, Dong Wenxun, Yang Zhenghong, Chen Ying

机构信息

Department of Thoracic Surgery I, Yunnan Cancer Center, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Peking University Cancer Hospital Yunnan, No 519 Kunzhou Road, Kunming, 650118, China.

出版信息

Discov Oncol. 2025 Aug 13;16(1):1548. doi: 10.1007/s12672-025-03323-3.

Abstract

Hypertension and lung cancer are two of the most prevalent chronic diseases worldwide, each contributing significantly to public health burdens. While both diseases have been extensively studied individually, their comorbidity remains an underexplored area of research. Recent studies suggest that genetic susceptibility plays a crucial role in the coexistence of these conditions, with overlapping genetic variants influencing both vascular homeostasis and tumorigenesis. The relationship between hypertension and lung cancer is complex, with shared risk factors and common pathogenic mechanisms, including inflammation, oxidative stress, and metabolic dysregulation. Environmental exposures-such as air pollution, tobacco smoke, and heavy metals-can trigger these genetic and epigenetic alterations, thereby increasing susceptibility to both conditions. Beyond genetic predisposition, epigenetic modifications significantly contribute to disease pathogenesis, including DNA methylation, histone modifications, and microRNA (miRNA) regulation. In hypertension, aberrant DNA methylation affects genes involved in vascular remodeling, such as At1b and Scnn1a, influencing blood pressure regulation. Similarly, in lung cancer, tumor suppressor genes such as p16, RASSF1A, and KCNK3 undergo methylation-induced silencing, promoting tumor progression. Histone modifications, particularly histone deacetylase (HDAC) activity, play a key role in both diseases, with HDAC inhibitors like valproic acid showing therapeutic potential in lowering blood pressure and inhibiting lung cancer cell proliferation. Understanding the shared genetic and epigenetic mechanisms between hypertension and lung cancer offers new opportunities for risk prediction, early intervention, and targeted therapies. Future research should focus on integrating genetic screening with environmental risk assessment to develop precision medicine strategies for individuals at high risk of both conditions.

摘要

高血压和肺癌是全球最常见的两种慢性疾病,它们各自对公共卫生负担都有重大影响。虽然这两种疾病已分别得到广泛研究,但它们的合并症仍是一个未被充分探索的研究领域。最近的研究表明,遗传易感性在这些病症的共存中起着关键作用,重叠的基因变异影响血管稳态和肿瘤发生。高血压和肺癌之间的关系很复杂,存在共同的风险因素和共同的致病机制,包括炎症、氧化应激和代谢失调。环境暴露,如空气污染、烟草烟雾和重金属,可引发这些基因和表观遗传改变,从而增加对这两种病症的易感性。除了遗传易感性外,表观遗传修饰对疾病发病机制也有显著贡献,包括DNA甲基化、组蛋白修饰和微小RNA(miRNA)调控。在高血压中,异常的DNA甲基化会影响参与血管重塑的基因,如At1b和Scnn1a,从而影响血压调节。同样,在肺癌中,肿瘤抑制基因如p16、RASSF1A和KCNK3会发生甲基化诱导的沉默,促进肿瘤进展。组蛋白修饰,特别是组蛋白去乙酰化酶(HDAC)活性,在这两种疾病中都起着关键作用,像丙戊酸这样的HDAC抑制剂在降低血压和抑制肺癌细胞增殖方面显示出治疗潜力。了解高血压和肺癌之间共同的遗传和表观遗传机制为风险预测、早期干预和靶向治疗提供了新的机会。未来的研究应专注于将基因筛查与环境风险评估相结合,为同时患有这两种疾病高风险的个体制定精准医学策略。

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