Decreased Levels of Soluble CD44 in a High-Risk Population following a Smoking Cessation Program.

Drew Smith ,Huaping Liu,Abdurrahman Al-Awady,Noël C Barengo,Claudia Gordon,Jerri Halgowich,Monica Webb Hooper,Isabella Buitron,Isildinha M Reis,Shahm Raslan,Monica A Perez ,Elizabeth Franzmann

doi:10.3390/ijerph182413174

Abstract

Tobacco is a risk factor of head and neck cancer (HNC) and smoking cessation alone may reduce HNC risk by 70%. Soluble CD44 (solCD44), a cell surface receptor linked to cell proliferation and migration, and total protein (TP) levels can detect early HNC. This study aims to determine whether salivary solCD44 and TP levels in oral rinses change following a smoking cessation program. 150 smokers provided oral rinse samples at baseline and at a 12-month follow-up after participation in a smoking cessation program. Assays to measure levels of solCD44, TP, and cotinine, a metabolite used as a biomarker of tobacco exposure, were completed. A paired-samples t-test was used to determine whether there was a statistically significant (p < 0.05) mean difference in biomarker levels before and after the program. Baseline and at 12-month follow-up data were available for 88 subjects, 21 of whom quit smoking entirely. Mean levels of solCD44 significantly decreased by 0.412 ng/mL from baseline to the 12-month follow-up, p = 0.010. There was no significant difference in mean TP levels, p = 0.975. Mean cotinine levels decreased significantly by 74.7 ng/mL, p = 0.035. This is the first work demonstrating an association between smoking cessation and decreased solCD44 levels in oral rinses. Decreased expression of the tumorigenic CD44 may be one mechanism by which smoking cessation lowers cancer risk.

Highlights

We have demonstrated that higher levels of Soluble CD44 (solCD44) and total protein are inversely correlated with progression free survival and overall survival among oral and oropharyngeal cancer patients [18]
Inclusion criteria were a status of currently smoking cigarettes daily, willingness to enroll in a smoking cessation program and provide oral rinse samples at a 12-month follow-up visit, and age greater than 21, preference was given to smokers over age 40
Eighty-eight participants who remained in the study for the full twelve months and provided scheduled oral rinses were included for the statistical analysis

Summary

Introduction

Head and neck cancers (HNC) are among the most common malignancies worldwide, surpassing 900,000 cases and 400,000 deaths per year [1]. These cancers affect the squamous cells that line the mucosal surfaces of the head and neck; regions such as the oral cavity, nasal cavity, oropharynx, and larynx are most susceptible to carcinoma [2]. Tobacco and alcohol consumption have long been recognized as significant risk factors [1,3]. Individuals who use both tobacco and alcohol are at greater risk of developing

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