The evidence associating
Fanconi anemia (FA) phenotype to in-vitro and ex-vivo oxidative stress is reviewed. A
cancer-prone
genetic disease, FA is characterized by delayed
bone marrow failure with a progression to
aplastic anemia. It is diagnosed by excess
chromosomal instability induced by two
clastogens, either
diepoxybutane (DEB) or
mitomycin C (MMC). Clinical symptoms vary in a broad range including a life-threatening hematological impairment, and an extended set of developmental abnormalities, growth retardation and skin pigmentation.
Cancer-proneness in FA results in excess incidence of non-lymphoblastic
leukemias, and of some defined solid
tumors. The relationships of oxidative stress with FA phenotype rely on a consistent body of evidence that includes: (1) excess formation of DNA oxidative damage (both in vitro and in vivo); (2) cellular protection by
hypoxia, low molecular-weight
antioxidants,
antioxidant enzymes, and
thioredoxin overexpression; (3) impaired expression and/or activity of
antioxidant enzymes, and (4) the redox-dependent action mechanisms of MMC and DEB. This evidence points to a re-appraisal of FA phenotype, suggesting a causative role for oxidative stress in
disease progression towards
malignancies and/or bone marrow depletion. A well-established literature reporting epidemiological and experimental data provides the nutritional bases for
cancer control. Thus, the present state-of-the-art in the related fields of oxidative stress, nutrition,
cancer-proneness and FA phenotype, altogether implies the need to undertake the most appropriate efforts to counteract oxidative stress in the clinical management of FA patients.