School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada.
J Appl Toxicol. 2024 Jan;44(1):17-27. doi: 10.1002/jat.4504. Epub 2023 Jun 18.
Alcohol consumption is associated with an increased risk of breast cancer, even at low alcohol intake levels, but public awareness of the breast cancer risk associated with alcohol intake is low. Furthermore, the causative mechanisms underlying alcohol's association with breast cancer are unknown. The present theoretical paper uses a modified grounded theory method to review the research literature and propose that alcohol's association with breast cancer is mediated by phosphate toxicity, the accumulation of excess inorganic phosphate in body tissue. Serum levels of inorganic phosphate are regulated through a network of hormones released from the bone, kidneys, parathyroid glands, and intestines. Alcohol burdens renal function, which may disturb the regulation of inorganic phosphate, impair phosphate excretion, and increase phosphate toxicity. In addition to causing cellular dehydration, alcohol is an etiologic factor in nontraumatic rhabdomyolysis, which ruptures cell membranes and releases inorganic phosphate into the serum, leading to hyperphosphatemia. Phosphate toxicity is also associated with tumorigenesis, as high levels of inorganic phosphate within the tumor microenvironment activate cell signaling pathways and promote cancer cell growth. Furthermore, phosphate toxicity potentially links cancer and kidney disease in onco-nephrology. Insights into the mediating role of phosphate toxicity may lead to future research and interventions that raise public health awareness of breast cancer risk and alcohol consumption.
饮酒会增加患乳腺癌的风险,即使饮酒量低也是如此,但公众对饮酒与乳腺癌风险相关的认识较低。此外,酒精与乳腺癌相关的因果机制尚不清楚。本理论论文使用改良的扎根理论方法审查研究文献,提出酒精与乳腺癌的关联是通过磷酸盐毒性介导的,即体内组织中过量无机磷酸盐的积累。血清无机磷酸盐水平通过骨骼、肾脏、甲状旁腺和肠道释放的激素网络进行调节。酒精会加重肾脏功能负担,可能会干扰无机磷酸盐的调节,损害磷酸盐排泄,并增加磷酸盐毒性。除了导致细胞脱水外,酒精还是非创伤性横纹肌溶解症的病因,横纹肌溶解症会破坏细胞膜并将无机磷酸盐释放到血清中,导致高磷酸盐血症。磷酸盐毒性也与肿瘤发生有关,因为肿瘤微环境中高浓度的无机磷酸盐会激活细胞信号通路并促进癌细胞生长。此外,磷酸盐毒性可能在肿瘤肾脏病学中将癌症和肾脏疾病联系起来。深入了解磷酸盐毒性的介导作用可能会为未来的研究和干预措施提供依据,以提高公众对乳腺癌风险和饮酒相关风险的认识。