Nicotine and angiogenesis: a new paradigm for tobacco-related diseases

Ann Med. 2004;36(1):33-40. doi: 10.1080/07853890310017576.


The pathophysiology of tobacco-related diseases is complex and multifactorial. Among the approximately 4,000 compounds in tobacco smoke are carcinogens such as nitrosamines, irritants such as a variety of phenolic compounds, volatiles such as carbon monoxide, and of course nicotine. Nicotine itself has quite complex actions, mediated in part by nicotinic cholinergic receptors that may have extraneuronal, as well as neuronal distribution. This review discusses the mechanisms by which nicotine contributes to tobacco-related disease, with a focus on the surprising new finding that nicotine is a potent angiogenic agent. Nicotine hijacks an endogenous nicotinic cholinergic pathway present in endothelial cells that is involved in physiological, as well as pathological angiogenesis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Animals
  • Arteriosclerosis / chemically induced
  • Carcinogens / adverse effects
  • Hexamethonium Compounds / adverse effects
  • Humans
  • Lung Neoplasms / chemically induced
  • Neovascularization, Pathologic / chemically induced*
  • Nicotine / adverse effects*
  • Receptors, Nicotinic / drug effects
  • Receptors, Nicotinic / metabolism
  • Smoking / adverse effects*
  • Tobacco


  • Carcinogens
  • Hexamethonium Compounds
  • Receptors, Nicotinic
  • Nicotine