Anticancer effects of Chinese red yeast rice versus monacolin K alone on colon cancer cells

A Review and Update of Red Yeast Rice

Dyslipidemia is a growing concern causing significant morbidity and mortality. High cholesterol levels increase the risk of individuals developing heart disease, stroke, and other disease states. Dietary modification is the initial approach for treatment, but many patients require statins (3-hydroxy-3-methylglutaryl co-enzyme A reductase inhibitors) to reduce cardiovascular risk. Unfortunately, a number of patients cannot tolerate statins, leading to practitioners searching for alternative regimens. One alternative that has been extensively studied is red yeast rice ( Monascus purpureus), a dietary supplement. In patients with dyslipidemia, red yeast rice was efficacious and safe for short-term use (<16 weeks). Red yeast rice has also been studied head to head with statins and was shown to be noninferior in reducing cholesterol levels and cardiovascular risk. Because of the positive clinical effects seen in dyslipidemia, researchers have begun to study its use in other disease states.

Statin Clinical Trial (REALITY) for prostate cancer: an over 15-year wait is finally over thanks to a dietary supplement

Support for a prescription statin clinical trial for the prevention or treatment of prostate cancer has been lacking, although recent data have provoked interest in such a study. The authors have initiated a pilot trial of red yeast rice (RYR) extract and prostate cancer. RYR significantly reduces low-density lipoprotein and is an option for statin-intolerant patients. RYR appears to be an adequate proxy for some statins as long as quality control is monitored. The REALITY (REduction in Active surveillance Lipid Indices Through Yeast of red rice) trial will be conducted in Toronto, Canada.

Anti-cancer characteristics of mevinolin against three different solid tumor cell lines was not solely p53-dependent

Mevinolin (MVN) has been used clinically for the treatment of hypercholesterolemia with very good tolerance by patients. Based on epidemiological evidences, MVN was suggested strongly for the treatment of neoplasia. Early experimental trials suggested the mixed apoptotic/necrotic cell death pathway was activated in response to MVN exposure. Herein, the cytotoxic profile of MVN was evaluated, compared to the robust and frequently used anti-cancer drug doxorubicin (DOX), against breast (MCF-7), cervical (HeLa) and liver (HepG(2)) transformed cell lines. MVN was showed comparable results in cytotoxic profile with DOX in all tested solid tumor cell lines. In addition, the MVN-induced cytotoxicity was inferred to be multi-factorial and not solely dependent on p53 expression. It was concluded that molecular and genetic assessment of MVN-induced cell death would be useful for developing cancer therapeutic treatments.

Red Mold Rice Mitigates Oral Carcinogenesis in 7,12-Dimethyl-1,2-Benz[a]anthracene-Induced Oral Carcinogenesis in Hamster

The prevalence of oral tumor has exponentially increased in recent years; however, the effective therapies or prevention strategies are not sufficient. Red mold rice is a traditional Chinese food, and several reports have demonstrated that red mold rice had an anti-tumor effect. However, the possible anti-tumor mechanisms of the red mold rice are unclear. In this study, we examined the anti-tumor effect of red mold rice on 7,12-dimethyl-1,2-benz[a]anthracene (DMBA)-induced oral tumor in hamster. The ethanol extract of red mold rice (RMRE) treatment significantly decreases the levels of DMBA-induced reactive oxygen species, nitro oxide and prostaglandin E₂ than those of the lovastatin-treated group (P < .001). Moreover, RMRE decreases the formation of oral tumor induced by DMBA. Monacolin K, monascin, ankaflavin or other red mold rice metabolites had been reported to decrease inflammation and oxidative stress and exerted anti-tumor effects. Therefore, we evaluated the anti-inflammation and anti-oxidative stress effects of monacolin K, monascin, ankaflavin and citrinin in lipopolysaccharide-treated RAW264.7 cells. We found that RMRE reduced the LPS-induced nitrite levels in RAW264.7 cells better than monacolin K, monascin, ankaflavin or citrinin (P < .05).

Anti-tumor and anti-inflammatory properties of ankaflavin and monaphilone A from monascus purpureus NTU 568

An azaphilonidal derivative monaphilone A (MA) was recently isolated from the fermented products of Monascus purpureus NTU 568 by our laboratory. We report here the exploration of apoptosis-related and anti-inflammatory properties of MA and ankaflavin (AK) by some experiments about inducing death of human laryngeal carcinoma cell line HEp-2 and reducing inflammatory responses on murine macrophage RAW 264.7 cells. We employed a ssDNA enzyme-linked immunosorbent assay (ELISA) kit to investigate the nuclear changes of early apoptosis induced by AK and MA on HEp-2 cells and used a western blot and an enzyme activity assay to demonstrate the activation of caspase-3, caspase-8, and caspase-9 by MA and AK. Our studies revealed that AK and MA may decrease lipopolysaccharide (LPS)-induced inflammatory responses, including nitrite productions and expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) in RAW 264.7 cells. All evidence support that azaphilonidal derivatives from M. purpureus NTU 568, such as AK and MA, are suitable for the development of chemotherapy or chemopreventive agents.

Chinese red yeast rice inhibition of prostate tumor growth in SCID mice

Prostate cancer is a slowly developing but very common cancer in males that may be amenable to preventive strategies that are not toxic. Chinese red yeast rice (RYR), a food herb made by fermenting Monascus purpureus Went yeast on white rice, contains a mixture of eight different monacolins that inhibit cholesterogenesis in addition to red pigments with antioxidant properties. Monacolin K is identical to lovastatin (LV), but LV unlike RYR can be used in individuals intolerant to statins due to muscle pain. Both LV and RYR inhibit de novo cholesterogenesis, which is critical to the growth of tumor cells. Long-term use of statin drugs has been associated with a reduced risk of prostate cancer. We have previously shown that RYR inhibited androgen-dependent and androgen receptor-overexpressing androgen-independent prostate cancer cell proliferation in vitro. This study was designed to determine whether RYR and LV inhibit prostate tumor growth in SCID mice. RYR significantly reduced tumor volumes of androgen-dependent and androgen-independent prostate xenograft tumors compared with animals receiving vehicle alone (P < 0.05). Inhibition by RYR was greater than that observed with LV at the dose found in RYR, showing that other compounds in RYR contributed to the antiproliferative effect. There was a significant correlation of tumor volume to serum cholesterol (P < 0.001). RYR decreased gene expression of androgen synthesizing enzymes (HSD3B2, AKR1C3, and SRD5A1) in both type of tumors (P < 0.05). Clinical studies of RYR for prostate cancer prevention in the increasing population of men undergoing active surveillance should be considered.

Orally administrated cinnamon extract reduces β-amyloid oligomerization and corrects cognitive impairment in Alzheimer's disease animal models

An increasing body of evidence indicates that accumulation of soluble oligomeric assemblies of β-amyloid polypeptide (Aβ) play a key role in Alzheimer's disease (AD) pathology. Specifically, 56 kDa oligomeric species were shown to be correlated with impaired cognitive function in AD model mice. Several reports have documented the inhibition of Aβ plaque formation by compounds from natural sources. Yet, evidence for the ability of common edible elements to modulate Aβ oligomerization remains an unmet challenge. Here we identify a natural substance, based on cinnamon extract (CEppt), which markedly inhibits the formation of toxic Aβ oligomers and prevents the toxicity of Aβ on neuronal PC12 cells. When administered to an AD fly model, CEppt rectified their reduced longevity, fully recovered their locomotion defects and totally abolished tetrameric species of Aβ in their brain. Furthermore, oral administration of CEppt to an aggressive AD transgenic mice model led to marked decrease in 56 kDa Aβ oligomers, reduction of plaques and improvement in cognitive behavior. Our results present a novel prophylactic approach for inhibition of toxic oligomeric Aβ species formation in AD through the utilization of a compound that is currently in use in human diet.

Accelerated solvent extraction of monacolin K from red yeast rice and purification by high-speed counter-current chromatography

Monacolin K from red yeast rice was extracted by accelerated solvent extraction (ASE). The effects of various extraction parameters including extraction temperature, static extraction time and cycle index on yield were investigated using a DIONEX ASE 300 system to select the optimal conditions by an orthogonal test design L(9) (3)(3). The optimum extraction conditions were determined as follows: extraction temperature 120°C, static extraction time 7min, and cycle index 3. Under the optimal conditions, the yield of ASE extract and monacolin K was 5.35% and 9.26mg/g of dry red yeast rice, respectively. A separation and purification method of monacolin K was then established using high-speed counter-current chromatography (HSCCC) with a two-phase solvent system composed of n-hexane-ethyl acetate-methanol-water (8:2:5:5, v/v/v/v). From 300mg of crude extract, 51.2mg of monacolin K was obtained with the purity of 98.7%. The chemical structure of isolated compound was identified by UV, ESI-MS and (1)H NMR.

Cytotoxicity of Monascus pigments and their derivatives to human cancer cells

Six pigments were separated from Monascus product, and some derivatives were chemically synthesized. The cytotoxicity of different Monascus pigments to various human cancer cells (SH-SY5Y, HepG2, HT-29, BGC-823, AGS, and MKN45) was evaluated. Rubropunctatin showed the greatest anticancer effect within the tested compounds. The inhibition effect of rubropunctatin was higher than that of taxol on the growth of the human gastric cancer cell SH-SY5Y (P<0.05), BGC-823 (P<0.01), AGS (P<0.01), and MKN45 (P<0.05). On the other hand, its cytotoxicity to the normal human gastric epithelial cell GES-1 was less than that of taxol (P<0.01). The experimental data demonstrated that rubropunctatin was a valuable compound with high anticancer activity, which could offer better therapeutic benefits than taxol. Cell apoptosis stages were assayed by annexin V-EGFP/PI staining experiments using flow cytometry. The data showed that 87.63% of tested BGC-823 cells entered the early phase of apoptosis when treated with 5 microM rubropunctatin for 24 h. A drug concentration-dependent cell apoptosis was observed. The analysis of the relationship between pharmaceutical activity and the chemical structure of the tested compounds led to the conclusion that 6-internal ether, 4-carbonyl, and conjugated double bonds in the tricyclic structure of rubropunctatin were necessary to the anticancer effect, whereas the difference of C2H4 in the side chain showed little influence. Rubropunctatin could be supplied as a precursor compound in the development of a new natural anticancer reagent.

Genomic and in vivo evidence of synergy of a herbal extract compared to its most active ingredient: Rabdosia rubescens vs. oridonin

Rabdosia rubescens is a herbal root extract of traditional Chinese medicine (TCM) used to treat inflammatory diseases and oral cancers. A key principle of TCM is that multiple ingredients in a plant extract are more effective and less toxic than a single purified active ingredient or a purified drug derived from a plant product. Rabdosia rubescens extract (RRE) contains terpenoids and flavonoids, but the most active ingredient within the extract attributed to the inhibition of cancer is the kaurene diterpene, oridonin. In order to research synergy with a complete plant extract, the effects of RRE on the inhibition of prostate cancer cell proliferation were compared to the effects of pure oridonin alone in vitro. Three groups of 8 SCID mice bearing human prostate cancer xenografts (LAPC-4) were administered either RRE containing 0.02 mg/g oridonin, pure oridonin at a dose of 0.02 mg/g, or pure oridonin at a dose of 0.1 mg/g, by gavage for 5 days/week for 4 weeks. RRE and pure oridonin at 0.1 mg/g inhibited tumor growth to a similar extent, while oridonin at a dose of 0.02 mg/g did not. Therefore, in comparison to RRE, five times more pure oridonin was required to obtain equivalent prostate xenograft growth inhibition. Since the nuclear factor-κB signaling pathway and inflammation are implicated in prostate carcinogenesis, gene microarray analysis was conducted and demonstrated activation of genes by RRE that was not evident with oridonin treatment alone. This study demonstrated that genomic methods and xenograft studies are capable of demonstrating the benefits of the synergy of whole plant extracts rather than active ingredients isolated and purified as drugs.

Anti-cancer effect of rubropunctatin against human gastric carcinoma cells BGC-823

The Monascus pigment, rubropunctatin, was extracted and purified from red mold rice (RMR) and its cytotoxic activities against human gastric adenocarcinoma BGC-823 cells were studied both in vitro and in vivo. Rubropunctatin inhibited the proliferation of BGC-823 cells with an inhibitory concentration (IC₅₀) of 12.57 μM, while it exhibited no significant toxicity to normal gastric epithelial cell GES-1 at the same concentration. Treatment of BGC-823 cells with rubropunctatin resulted in a dose- and time-dependent apoptosis, as validated by the increase in the percentage of cells in sub-G1 phase and phosphotidylserine externalization. The in vivo experimental data demonstrated that rubropunctatin could offer similar therapeutic benefits in comparison with the same dose of taxol. After five times of intravenous injection, tumor weight in BGC-823-bearing nude mice reduced 23.5% at the dose of 8 mg/kg and 37.7% at the dose of 32 mg/kg, respectively. The expressions of 30 genes related to induction of apoptosis were found up-regulated significantly. The two most expressed genes were tumor necrosis factor (TNF) and DNA-damage inducible transcript 3. TNF was considered as a major mediator of apoptosis induced by rubropunctatin. This is the first report describing the anti-proliferative effect of rubropunctatin and its apoptosis mechanism on BGC-823 cells. Rubropunctatin has potential to be developed as a new natural anti-cancer agent.

Process-Induced Cell Injury in Laser Direct Writing of Human Colon Cancer Cells

Matrix-assisted pulsed-laser evaporation direct-write has emerged as a promising technique for biological construct fabrication. The posttransfer cell viability in matrix-assisted pulsed-laser evaporation direct-write depends on various operating conditions such as the applied laser fluence. To date, the effects of operating conditions such as laser fluence, direct-writing height, and cell density on the posttransfer cell viability have not been well elucidated. This study investigates the effects of operating conditions on the posttransfer cell viability in laser direct writing of human colon cancer HT-29 cells. It has been observed that (1) the HT-29 cell viability decreases from 95% to 78% as the laser fluence increases from 258 to 1482 mJ/cm(2), and the posttransfer cell proliferation capacity does not vary significantly as the laser fluence changes; (2) the direct-writing height does not have noticeable effect on the posttransfer cell viability under low laser fluences (258 and 869 mJ/cm(2)). However, a larger height (such as 29.3 mm) led to an almost 8% viability improvement compared with that of 16.6 mm under a high laser fluence (1482 mJ/cm(2)); and (3) the posttransfer cell viability is not dependent on the cell density for a range from 1 × 10(6) to 1 × 10(7) cells/mL.

Chinese red yeast rice versus lovastatin effects on prostate cancer cells with and without androgen receptor overexpression

Chinese red yeast rice (RYR), a food herb made by fermenting Monascus purpureus Went yeast on white rice, contains a mixture of eight different monacolins that inhibit cholesterogenesis and also red pigments with antioxidant properties. Monacolin K (MK) is identical to lovastatin (LV). Both LV and RYR contain statins, which could inhibit de novo cholesterogenesis, which is critical to the growth of tumor cells. Dysregulation of the cholesterol biosynthetic pathway has been demonstrated during progression to androgen independence in xenograft models, and it has been proposed that cholesterogenesis and androgen receptor (AR) up-regulation are essential to androgen-independent cell survival. This study was designed to examine the differences between the effects of RYR and LV on androgen-dependent LNCaP cells and androgen-independent cells overexpressing AR (LNCaP-AR). RYR showed more potent inhibition effect on prostate cancer cell growth compared to LV. Both the pigment and monacolin-enriched fractions purified from RYR inhibited proliferation (P < .001) to a lesser extent than intact RYR. While mevalonate, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), restored proliferation in LV-treated cells, it failed to do so in RYR-treated cells. Expression of the HMGCR gene was up-regulated by LV (P < .001) but not RYR in both LNCaP and LNCaP-AR cells. These results suggest that the RYR matrix beyond MK alone may be bioactive in inhibiting androgen-dependent and -independent prostate cancer growth. In vivo studies are needed to further establish the potential advantages of RYR over LV in prostate cancer chemoprevention and in the prevention of the emergence of androgen independence.

Natural products and colon cancer: current status and future prospects

Carcinogenesis is a multistage process consisting of initiation, promotion and progression phases. Thus, the multistage sequence of events has many phases for prevention and intervention. Chemoprevention, a novel approach for controlling cancer, involves the use of specific natural products or synthetic chemical agents to reverse, suppress or prevent premalignancy before the development of invasive cancer. Several natural products, such as, grains, nuts, cereals, spices, fruits, vegetables, beverages, medicinal plants and herbs and their various phytochemical constituents including, phenolics, flavonoids, carotenoids, alkaloids, nitrogen containing as well as organosulfur compounds confer protective effects against wide range of cancers including colon cancer. Since diet has an important role in the etiology of colon cancer, dietary chemoprevention received attention for colon cancer prevention. However, identification of an agent with chemopreventive potential requires in vitro studies, efficacy and toxicity studies in animal models before embarking on human clinical trials. A brief introduction about colon cancer and the role of some recent natural products in colon cancer chemoprevention with respect to multiple molecular mechanisms in various in vitro, in vivo and clinical studies are described in this review.