Liver diseases

Chronic liver diseases are commonly characterized by continuous inflammation and oxidative stress in the hepatic parenchyma.

CS may impact incidence, severity and clinical course of chronic liver diseases 1.

Indeed, in adult smokers with chronic liver diseases such as primary biliary cirrhosis and chronic hepatitis C, an increased severity of hepatic fibrosis has been well established 2-4. Moreover, CS was identified as an independent risk factor for the onset of non-alcoholic fatty liver disease (NAFLD) 5 and was associated with advanced liver fibrosis in a large multi-center cohort of NAFLD patients 6.

CS can induce hepatotoxicity through different mechanisms. The vast quantities of carbon- and oxygen-centered free radicals contained in CS directly initiated and propagated the process of lipid peroxidation in hepatic and extra-hepatic tissues 7,8. Alternatively, via an indirect mechanism, CS induced abnormally high hemoglobin levels in the blood 9, subsequently resulting in hepatic iron overload and, finally, causing increased ROS generation in the liver 10.

Moreover, as the liver is the major site of synthesis and absorption of plasma lipids and lipoproteins, it has been suggested that CS-related liver dysfunction may contribute to the atherogenic plasma lipid profiles observed in cigarette smokers 11-14.


  1. Whitehead, T. P. et al. The effects of cigarette smoking and alcohol consumption on serum liver enzyme activities: a dose-related study in men. Annals of clinical biochemistry 33 ( Pt 6), 530-535 (1996)
  2. Zein, C. O. et al. Smoking and increased severity of hepatic fibrosis in primary biliary cirrhosis: A cross validated retrospective assessment. Hepatology 44, 1564-1571 (2006)
  3. Tsochatzis, E. et al. Smoking is associated with steatosis and severe fibrosis in chronic hepatitis C but not B. Scandinavian journal of gastroenterology 44, 752-759 (2009)
  4. Pessione, F. et al. Cigarette smoking and hepatic lesions in patients with chronic hepatitis C. Hepatology 34, 121-125 (2001)
  5. Hamabe, A. et al. Impact of cigarette smoking on onset of nonalcoholic fatty liver disease over a 10-year period. Journal of gastroenterology 46, 769-778 (2011)
  6. Zein, C. O. et al. Smoking and severity of hepatic fibrosis in nonalcoholic fatty liver disease. Journal of hepatology 54, 753-759 (2011)
  7. Helen, A. et al. Vitamin C supplementation on hepatic oxidative stress induced by cigarette smoke. Journal of applied toxicology: JAT 17, 289-295 (1997)
  8. Church, D. F. et al. Free-radical chemistry of cigarette smoke and its toxicological implications. Environmental health perspectives 64, 111-126 (1985)
  9. Young, C. J. et al. Smoke inhalation: diagnosis and treatment. Journal of clinical anesthesia 1, 377-386 (1989)
  10. Thomas, C. et al. Hydroxyl radical is produced via the Fenton reaction in submitochondrial particles under oxidative stress: implications for diseases associated with iron accumulation. Redox report : communications in free radical research 14, 102-108 (2009)
  11. de León HD et al. Modulation of the Hepatic Lipidome and Transcriptome of Apoe-/- Mice in Response to Smoking Cessation. Journal of Liver 2, 132 (2013)
  12. U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health (2010)
  13. Gepner, A. D. et al. Effects of smoking and smoking cessation on lipids and lipoproteins: outcomes from a randomized clinical trial. American heart journal 161, 145-151 (2011)
  14. Boue, S. et al. Modulation of atherogenic lipidome by cigarette smoke in apolipoprotein E-deficient mice. Atherosclerosis 225, 328-334 (2012)

Liver diseases Results

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