Contemporary perceptions about mechanisms of harmful impacts exerted by N-nitrosamines on human health and specific markers of pathological effects initiated by them (analytical review)

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Abstract

Nitrosamines have toxic properties with a wide range of biological effects including mutagenic, carcinogenic, embryotoxic, teratogenic ones as well as effects on specific target organs or systems. Technogenic transformations result in greater emissions of nitrogen-containing chemicals into ambient air. This leads to their subsequent accumulation in the environment and human body and initialization of nitrosation involving occurrence of highly toxic N-nitrosamines (NA). Levels of nitrites/nitrates and NA in foods and drinking water, which are higher than established safety standards, and elevated endogenous NA formation induce various pathological processes in the human body including oncological ones. Identification of the most promising trends in preventive sanitary-hygienic activities and medical and preventive technologies requires generalization of accumulated sanitary-hygienic, epidemiological, and clinical and laboratory data.

The aim of this study was to generalize contemporary perceptions about mechanisms of harmful impacts exerted by NA on human health and the most effective methods for identifying pathological processes initiated by them. Literature analysis relied on reviewing databases belonging to electronic scientific libraries including CyberLeninka and eLIBRARY.RU, the United States National Library of Medicine, Central Scientific Medical Library, Rukont National Digital Resource over the last 15 years. The review covers data on NA sources and ways of entering the human body; the most effective techniques for their identification; safe NA levels in food products and medications; mechanisms of harmful impacts and initiated pathological processes; as well as markers of exposure and effect. The most effective techniques for NA identification include HPLC and GC with MS — MS. Markers of NA occurrence in environmental objects include NDMA, NMEA, NDEA, NPR, NDPA, NPIP, NDBA; markers of exposure, NDMA, NDEA, NNK and NNN in biological media; markers of the effect include indicators of oxidative stress, levels of pro-inflammatory and anti-inflammatory cytokines, stress-hormones, lipid profile indicators, indicators of immune suppression and apoptotic activity, IgG specific to NA and tumor markers for CEA and CA 19-9.

Contribuition:
Ustinova O.Yu. — concept and design of the study, collection of material, writing and editing the text;
Leshkova I.V. — collecting material, writing and editing text;
Vlasova E.M. — collecting material, writing, and editing text;
Vorobyova A.A. — collecting material, writing, and editing text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: February 16, 2024 / Accepted: April 9, 2024 / Published: June 17, 2024

 

About the authors

Olga Yu. Ustinova

Federal Scientific Center for Medical and Preventive Health Risk Management Technologies of the Federal Service for Surveillance over Consumer Rights Protection and Human Wellbeing; Perm State Scientific Research University,

Author for correspondence.
Email: ustinova@fcrisk.ru
ORCID iD: 0000-0002-9916-5491

MD, PhD, DSci., Professor, Deputy Director for Healthcare Services at the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation; Professor at the Microbiology and Immunology Department of the Biology Faculty, Perm State Scientific Research University, Perm, 614068, Russian Federation

e-mail: ustinova@fcrisk.ru

Russian Federation

Irina V. Leshkova

Federal Scientific Center for Medical and Preventive Health Risk Management Technologies of the Federal Service for Surveillance over Consumer Rights Protection and Human Wellbeing

Email: noemail@neicon.ru
ORCID iD: 0000-0002-6161-8897

Physician at the sanatorium of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation

Russian Federation

Elena M. Vlasova

Federal Scientific Center for Medical and Preventive Health Risk Management Technologies of the Federal Service for Surveillance over Consumer Rights Protection and Human Wellbeing

Email: vlasovaem@fcrisk.ru
ORCID iD: 0000-0003-3344-3361

MD, PhD, Head of the Occupational Pathology Center (occupational pathologist) of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation

e-mail: vlasovaem@fcrisk.ru

Russian Federation

Alena A. Vorobyeva

Federal Scientific Center for Medical and Preventive Health Risk Management Technologies of the Federal Service for Surveillance over Consumer Rights Protection and Human Wellbeing

Email: epletina-alena@rambler.ru
ORCID iD: 0000-0002-8747-8773

MD, PhD, Head of the sanatorium of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Perm, 614045, Russian Federation

e-mail: epletina-alena@rambler.ru

Russian Federation

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 37884 от 02.10.2009.