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Gregg B, Elghazi L, Alejandro EU, Smith MR, Blandino-Rosano M, El-Gabri D, Cras-Méneur C, Bernal-Mizrachi E. Exposure of mouse embryonic pancreas to metformin enhances the number of pancreatic progenitors. Diabetologia 2014; 57:2566-75. [PMID: 25249235 PMCID: PMC4417192 DOI: 10.1007/s00125-014-3379-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 08/28/2014] [Indexed: 01/23/2023]
Abstract
AIMS/HYPOTHESIS Developing beta cells are vulnerable to nutrient environmental signals. Early developmental processes that alter the number of pancreatic progenitors can determine the number of beta cells present at birth. Metformin, the most widely used oral agent for treating diabetes, alters intracellular energy status in part by increasing AMP-activated protein kinase (AMPK) signalling. This study examined the effect of metformin on developing pancreas and beta cells. METHODS Pancreatic rudiments from CD-1 mice at embryonic day 13.0 (E13.0) were cultured with metformin, 5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside (AICAR, an AMPK activator) or vehicle control in vitro. In another set of studies, pregnant C57BL/6 mice were treated with metformin throughout gestation. Embryonic (E14.0) and neonatal pancreases were then analysed for their morphometry. RESULTS In vitro metformin treatment led to an increase in the proliferation and number of pancreatic duodenal homeobox 1-positive (PDX1(+)) progenitors. These results were reproduced by in vitro culture of embryonic pancreas rudiments with AICAR, suggesting that AMPK activation was involved. Similarly, metformin administration to pregnant dams induced an increase in both PDX1(+) and neurogenin 3-positive progenitors in the embryonic pancreas at E14.0 and these changes resulted in an increased beta cell fraction in neonates. CONCLUSIONS/INTERPRETATION These results indicate that exposure to metformin during gestation modulates the early steps of beta cell development (prior to E14.0) towards an increase in the number of pancreatic and endocrine progenitors. These changes ultimately result in a higher beta cell fraction at birth. These findings are of clinical importance given that metformin is currently used for the treatment of gestational diabetes.
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Affiliation(s)
- Brigid Gregg
- Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Michigan, Ann Arbor, Michigan, USA
| | - Lynda Elghazi
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Emilyn U. Alejandro
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Michelle R. Smith
- Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Michigan, Ann Arbor, Michigan, USA
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Manuel Blandino-Rosano
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Deena El-Gabri
- Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Michigan, Ann Arbor, Michigan, USA
| | - Corentin Cras-Méneur
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Ernesto Bernal-Mizrachi
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, Michigan, USA
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan
- Corresponding author: Dr. Ernesto Bernal-Mizrachi VA Ann Arbor Healthcare System, Ann Arbor, Michigan., Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan 48109-0678, USA., Phone: +1 (734) 615-0262, Fax: +1 (734) 936-6684,
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Vargas T, Moreno-Rubio J, Herranz J, Cejas P, Molina S, González-Vallinas M, Ramos R, Burgos E, Aguayo C, Custodio AB, Reglero G, Feliu J, Ramírez de Molina A. Genes associated with metabolic syndrome predict disease-free survival in stage II colorectal cancer patients. A novel link between metabolic dysregulation and colorectal cancer. Mol Oncol 2014; 8:1469-81. [PMID: 25001263 PMCID: PMC5528602 DOI: 10.1016/j.molonc.2014.05.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/08/2014] [Accepted: 05/27/2014] [Indexed: 01/30/2023] Open
Abstract
Studies have recently suggested that metabolic syndrome and its components increase the risk of colorectal cancer. Both diseases are increasing in most countries, and the genetic association between them has not been fully elucidated. The objective of this study was to assess the association between genetic risk factors of metabolic syndrome or related conditions (obesity, hyperlipidaemia, diabetes mellitus type 2) and clinical outcome in stage II colorectal cancer patients. Expression levels of several genes related to metabolic syndrome and associated alterations were analysed by real-time qPCR in two equivalent but independent sets of stage II colorectal cancer patients. Using logistic regression models and cross-validation analysis with all tumour samples, we developed a metabolic syndrome-related gene expression profile to predict clinical outcome in stage II colorectal cancer patients. The results showed that a gene expression profile constituted by genes previously related to metabolic syndrome was significantly associated with clinical outcome of stage II colorectal cancer patients. This metabolic profile was able to identify patients with a low risk and high risk of relapse. Its predictive value was validated using an independent set of stage II colorectal cancer patients. The identification of a set of genes related to metabolic syndrome that predict survival in intermediate-stage colorectal cancer patients allows delineation of a high-risk group that may benefit from adjuvant therapy and avoid the toxic and unnecessary chemotherapy in patients classified as low risk. Our results also confirm the linkage between metabolic disorder and colorectal cancer and suggest the potential for cancer prevention and/or treatment by targeting these genes.
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Affiliation(s)
| | - Juan Moreno-Rubio
- Translational Oncology Laboratory, La Paz University Hospital (IdiPAZ), Madrid, Spain; Medical Oncology, Infanta Sofía University Hospital, Madrid, Spain
| | | | - Paloma Cejas
- Translational Oncology Laboratory, La Paz University Hospital (IdiPAZ), Madrid, Spain
| | | | | | - Ricardo Ramos
- Genomic Service, Scientific Park of Madrid, Madrid, Spain
| | - Emilio Burgos
- Pathology Department, La Paz University Hospital (IdiPAZ), Madrid, Spain
| | - Cristina Aguayo
- Medical Oncology, La Paz University Hospital (IdiPAZ), Madrid, Spain
| | - Ana B Custodio
- Medical Oncology, La Paz University Hospital (IdiPAZ), Madrid, Spain
| | - Guillermo Reglero
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain; Food Research Institute (CIAL) CEI UAM+CSIC, Madrid, Spain
| | - Jaime Feliu
- Medical Oncology, La Paz University Hospital (IdiPAZ), Madrid, Spain
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203
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Dai S, Tang Z, Cao J, Zhou W, Li H, Sampson S, Dai C. Suppression of the HSF1-mediated proteotoxic stress response by the metabolic stress sensor AMPK. EMBO J 2014; 34:275-93. [PMID: 25425574 PMCID: PMC4339117 DOI: 10.15252/embj.201489062] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Numerous extrinsic and intrinsic insults trigger the HSF1-mediated proteotoxic stress response (PSR), an ancient transcriptional program that is essential to proteostasis and survival under such conditions. In contrast to its well-recognized mobilization by proteotoxic stress, little is known about how this powerful adaptive mechanism reacts to other stresses. Surprisingly, we discovered that metabolic stress suppresses the PSR. This suppression is largely mediated through the central metabolic sensor AMPK, which physically interacts with and phosphorylates HSF1 at Ser121. Through AMPK activation, metabolic stress represses HSF1, rendering cells vulnerable to proteotoxic stress. Conversely, proteotoxic stress inactivates AMPK and thereby interferes with the metabolic stress response. Importantly, metformin, a metabolic stressor and popular anti-diabetic drug, inactivates HSF1 and provokes proteotoxic stress within tumor cells, thereby impeding tumor growth. Thus, these findings uncover a novel interplay between the metabolic stress sensor AMPK and the proteotoxic stress sensor HSF1 that profoundly impacts stress resistance, proteostasis, and malignant growth.
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Affiliation(s)
- Siyuan Dai
- The Jackson Laboratory, Bar Harbor, ME, USA
| | - Zijian Tang
- The Jackson Laboratory, Bar Harbor, ME, USA Graduate Programs, Department of Molecular & Biomedical Sciences, The University of Maine, Orono, ME, USA
| | - Junyue Cao
- The Jackson Laboratory, Bar Harbor, ME, USA
| | - Wei Zhou
- The Jackson Laboratory, Bar Harbor, ME, USA
| | - Huawen Li
- The Jackson Laboratory, Bar Harbor, ME, USA
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Arshad OA, Venkatasubramani PS, Datta A, Venkatraj J. Using Boolean Logic Modeling of Gene Regulatory Networks to Exploit the Links Between Cancer and Metabolism for Therapeutic Purposes. IEEE J Biomed Health Inform 2014; 20:399-407. [PMID: 25389247 DOI: 10.1109/jbhi.2014.2368391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The uncontrolled cell proliferation that is characteristically associated with cancer is usually accompanied by alterations in the genome and cell metabolism. Indeed, the phenomenon of cancer cells metabolizing glucose using a less efficient anaerobic process even in the presence of normal oxygen levels, termed the Warburg effect, is currently considered to be one of the hallmarks of cancer. Diabetes, much like cancer, is defined by significant metabolic changes. Recent epidemiological studies have shown that diabetes patients treated with the antidiabetic drug Metformin have significantly lowered risk of cancer as compared to patients treated with other antidiabetic drugs. We utilize a Boolean logic model of the pathways commonly mutated in cancer to not only investigate the efficacy of Metformin for cancer therapeutic purposes but also demonstrate how Metformin in concert with other cancer drugs could provide better and less toxic clinical outcomes as compared to using cancer drugs alone.
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205
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Coencapsulation of epirubicin and metformin in PEGylated liposomes inhibits the recurrence of murine sarcoma S180 existing CD133+ cancer stem-like cells. Eur J Pharm Biopharm 2014; 88:737-45. [DOI: 10.1016/j.ejpb.2014.10.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/08/2014] [Accepted: 10/13/2014] [Indexed: 01/01/2023]
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206
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Atangwho IJ, Yin KB, Umar MI, Ahmad M, Asmawi MZ. Vernonia amygdalina simultaneously suppresses gluconeogenesis and potentiates glucose oxidation via the pentose phosphate pathway in streptozotocin-induced diabetic rats. Altern Ther Health Med 2014; 14:426. [PMID: 25358757 PMCID: PMC4295350 DOI: 10.1186/1472-6882-14-426] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 10/07/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND This study evaluated the impact of Vernonia amygdalina (VA) on the transcription of key enzymes involved in cellular modulation of glucose in streptozotocin-induced diabetic rats in a bid to understand the possible anti-diabetic mechanism of VA. METHODS The chloroform fraction of VA (200 mg/kg and 400 mg/kg body weight) was administered to SDRs for 7 and 14 days. Thereafter, the expression (transcription) of key carbohydrate regulatory genes was evaluated in selected tissues - adipose, muscle and liver. Also, the body weight and blood glucose changes were monitored. RESULTS A 14-day administration of 200 mg and 400 mg of the extract and metformin (500 mg/kg) showed a striking decrease (P <0.05) in the expression of the gluconeogenic enzymes - fructose 1,6-bisphosphatase, phosphoenol pyruvate carboxykinase and glucose 6-phosphatase in the liver and muscle compared to the diabetic control. These genes were highly expressed in tissues of untreated diabetic rats (P <0.05) indicating severe gluconeogenesis. Furthermore, the extract as well as metformin significantly increased glucose oxidation via the pentose phosphate pathway (PPP) i.e. increased expression of the glucose 6-phosphate dehydrogenase (G6PDH) gene (P <0.05) in the liver. Conversely, the expression of the G6PDH in the muscle and adipose tissues significantly decreased (P <0.05), suggesting enhanced utilization of NADPH and ribose in the clearance of reactive oxygen species and for expression of other relevant genes respectively. Also, transcription of the cell proliferation regulatory enzyme, phosphatidylinositol 3-kinase increased in the liver, but decreased in the muscle and adipose tissues (P <0.05) upon treatment with the extract or metformin, implying that the liver responded to the VA and metformin treatments more than other organs. The extract administration also caused a decrease in the expression of key enzymes of glycolysis namely hexokinase and phosphofructokinase, suggestive of a glucose sparing for ribose and NADPH production in PPP. CONCLUSION Overall, data obtained in this study suggest that VA exerts little or no effect on glycolysis; rather, it may achieve its anti-diabetic action by a simultaneous suppression of gluconeogenesis and potentiation of glucose oxidation via PPP pathway, almost exclusively in the liver.
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207
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Li T, Wang G. Computer-aided targeting of the PI3K/Akt/mTOR pathway: toxicity reduction and therapeutic opportunities. Int J Mol Sci 2014; 15:18856-91. [PMID: 25334061 PMCID: PMC4227251 DOI: 10.3390/ijms151018856] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 09/21/2014] [Accepted: 10/08/2014] [Indexed: 12/14/2022] Open
Abstract
The PI3K/Akt/mTOR pathway plays an essential role in a wide range of biological functions, including metabolism, macromolecular synthesis, cell growth, proliferation and survival. Its versatility, however, makes it a conspicuous target of many pathogens; and the consequential deregulations of this pathway often lead to complications, such as tumorigenesis, type 2 diabetes and cardiovascular diseases. Molecular targeted therapy, aimed at modulating the deregulated pathway, holds great promise for controlling these diseases, though side effects may be inevitable, given the ubiquity of the pathway in cell functions. Here, we review a variety of factors found to modulate the PI3K/Akt/mTOR pathway, including gene mutations, certain metabolites, inflammatory factors, chemical toxicants, drugs found to rectify the pathway, as well as viruses that hijack the pathway for their own synthetic purposes. Furthermore, this evidence of PI3K/Akt/mTOR pathway alteration and related pathogenesis has inspired the exploration of computer-aided targeting of this pathway to optimize therapeutic strategies. Herein, we discuss several possible options, using computer-aided targeting, to reduce the toxicity of molecularly-targeted therapy, including mathematical modeling, to reveal system-level control mechanisms and to confer a low-dosage combination therapy, the potential of PP2A as a therapeutic target, the formulation of parameters to identify patients who would most benefit from specific targeted therapies and molecular dynamics simulations and docking studies to discover drugs that are isoform specific or mutation selective so as to avoid undesired broad inhibitions. We hope this review will stimulate novel ideas for pharmaceutical discovery and deepen our understanding of curability and toxicity by targeting the PI3K/Akt/mTOR pathway.
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Affiliation(s)
- Tan Li
- Department of Biology, South University of Science and Technology of China, 1088 Xueyuan Rd., Shenzhen 518055, China.
| | - Guanyu Wang
- Department of Biology, South University of Science and Technology of China, 1088 Xueyuan Rd., Shenzhen 518055, China.
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208
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Marini C, Salani B, Massollo M, Amaro A, Esposito AI, Orengo AM, Capitanio S, Emionite L, Riondato M, Bottoni G, Massara C, Boccardo S, Fabbi M, Campi C, Ravera S, Angelini G, Morbelli S, Cilli M, Cordera R, Truini M, Maggi D, Pfeffer U, Sambuceti G. Direct inhibition of hexokinase activity by metformin at least partially impairs glucose metabolism and tumor growth in experimental breast cancer. Cell Cycle 2014; 12:3490-9. [PMID: 24240433 PMCID: PMC3906335 DOI: 10.4161/cc.26461] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Emerging evidence suggests that metformin, a widely used anti-diabetic drug, may be useful in the prevention and treatment of different cancers. In the present study, we demonstrate that metformin directly inhibits the enzymatic function of hexokinase (HK) I and II in a cell line of triple-negative breast cancer (MDA-MB-231). The inhibition is selective for these isoforms, as documented by experiments with purified HK I and II as well as with cell lysates. Measurements of 18F-fluoro-deoxyglycose uptake document that it is dose- and time-dependent and powerful enough to virtually abolish glucose consumption despite unchanged availability of membrane glucose transporters. The profound energetic imbalance activates phosphorylation and is subsequently followed by cell death. More importantly, the “in vivo” relevance of this effect is confirmed by studies of orthotopic xenografts of MDA-MB-231 cells in athymic (nu/nu) mice. Administration of high drug doses after tumor development caused an evident tumor necrosis in a time as short as 48 h. On the other hand, 1 mo metformin treatment markedly reduced cancer glucose consumption and growth. Taken together, our results strongly suggest that HK inhibition contributes to metformin therapeutic and preventive potential in breast cancer.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Bioimages and Molecular Physiology; Milan, Section of Genoa, Genoa, Italy
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209
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Bosetti C, Rosato V, Li D, Silverman D, Petersen GM, Bracci PM, Neale RE, Muscat J, Anderson K, Gallinger S, Olson SH, Miller AB, Bas Bueno-de-Mesquita H, Scelo G, Janout V, Holcatova I, Lagiou P, Serraino D, Lucenteforte E, Fabianova E, Baghurst PA, Zatonski W, Foretova L, Fontham E, Bamlet WR, Holly EA, Negri E, Hassan M, Prizment A, Cotterchio M, Cleary S, Kurtz RC, Maisonneuve P, Trichopoulos D, Polesel J, Duell EJ, Boffetta P, La Vecchia C, Ghadirian P. Diabetes, antidiabetic medications, and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium. Ann Oncol 2014; 25:2065-2072. [PMID: 25057164 PMCID: PMC4176453 DOI: 10.1093/annonc/mdu276] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus has been associated with an excess risk of pancreatic cancer, but the magnitude of the risk and the time-risk relationship are unclear, and there is limited information on the role of antidiabetic medications. PATIENTS AND METHODS We analyzed individual-level data from 15 case-control studies within the Pancreatic Cancer Case-Control Consortium, including 8305 cases and 13 987 controls. Pooled odds ratios (ORs) were estimated from multiple logistic regression models, adjusted for relevant covariates. RESULTS Overall, 1155 (15%) cases and 1087 (8%) controls reported a diagnosis of diabetes 2 or more years before cancer diagnosis (or interview, for controls), corresponding to an OR of 1.90 (95% confidence interval, CI, 1.72-2.09). Consistent risk estimates were observed across strata of selected covariates, including body mass index and tobacco smoking. Pancreatic cancer risk decreased with duration of diabetes, but a significant excess risk was still evident 20 or more years after diabetes diagnosis (OR 1.30, 95% CI 1.03-1.63). Among diabetics, long duration of oral antidiabetic use was associated with a decreased pancreatic cancer risk (OR 0.31, 95% CI 0.14-0.69, for ≥15 years). Conversely, insulin use was associated with a pancreatic cancer risk in the short term (OR 5.60, 95% CI 3.75-8.35, for <5 years), but not for longer duration of use (OR 0.95, 95% CI 0.53-1.70, for ≥15 years). CONCLUSION This study provides the most definitive quantification to date of an excess risk of pancreatic cancer among diabetics. It also shows that a 30% excess risk persists for more than two decades after diabetes diagnosis, thus supporting a causal role of diabetes in pancreatic cancer. Oral antidiabetics may decrease the risk of pancreatic cancer, whereas insulin showed an inconsistent duration-risk relationship.
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Affiliation(s)
- C Bosetti
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
| | - V Rosato
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - D Li
- M.D. Anderson Cancer Center, University of Texas, Houston
| | - D Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda
| | - G M Petersen
- Department of Health Sciences Research, Medicine and Medical Genetics, Mayo Clinic, Rochester
| | - P M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - R E Neale
- Queensland Institute of Medical Research, Brisbane, Australia
| | - J Muscat
- Department of Public Health Sciences, Penn State University, Penn State
| | - K Anderson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA
| | - S Gallinger
- University Health Network, Department of Surgery, University of Toronto, Toronto, Canada
| | - S H Olson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A B Miller
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - H Bas Bueno-de-Mesquita
- National Institute for Public Health and the Environment (RIVM), Bilthoven; Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - G Scelo
- International Agency for Research on Cancer (IARC), Lyon, France
| | - V Janout
- Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc
| | - I Holcatova
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - P Lagiou
- Department of Epidemiology, Harvard School of Public Health, Boston, USA; Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - D Serraino
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, IRCCS, Aviano
| | - E Lucenteforte
- Department of Preclinical and Clinical Pharmacology Mario Aiazzi Mancini, Università degli Studi di Firenze, Florence, Italy
| | - E Fabianova
- Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | - P A Baghurst
- Public Health, Women's and Children's Hospital, Adelaide, SA, Australia
| | - W Zatonski
- Cancer Center and Institute of Oncology, Warsaw, Poland
| | - L Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Institute and MF MU, Brno, Czech Republic
| | - E Fontham
- Louisiana State University School of Public Health, New Orleans, USA
| | - W R Bamlet
- Department of Health Sciences Research, Medicine and Medical Genetics, Mayo Clinic, Rochester
| | - E A Holly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - E Negri
- Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy
| | - M Hassan
- M.D. Anderson Cancer Center, University of Texas, Houston
| | - A Prizment
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA
| | - M Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Cancer Care Ontario, Toronto, Canada
| | - S Cleary
- University Health Network, Department of Surgery, University of Toronto, Toronto, Canada
| | - R C Kurtz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - P Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - D Trichopoulos
- Department of Epidemiology, Harvard School of Public Health, Boston, USA
| | - J Polesel
- Unit of Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, IRCCS, Aviano
| | - E J Duell
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Boffetta
- The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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210
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Jia G, Aroor AR, Martinez-Lemus LA, Sowers JR. Overnutrition, mTOR signaling, and cardiovascular diseases. Am J Physiol Regul Integr Comp Physiol 2014; 307:R1198-206. [PMID: 25253086 DOI: 10.1152/ajpregu.00262.2014] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of obesity and associated medical disorders has increased dramatically in the United States and throughout much of the world in the past decade. Obesity, induced by excess intake of carbohydrates and fats, is a major cause of Type 2 diabetes, hypertension, and the cardiorenal metabolic syndrome. There is emerging evidence that excessive nutrient intake promotes signaling through the mammalian target of rapamycin (mTOR), which, in turn, may lead to alterations of cellular metabolic signaling leading to insulin resistance and obesity-related diseases, such as diabetes, cardiovascular and kidney disease, as well as cancer. While the pivotal role of mTOR signaling in regulating metabolic stress, autophagy, and adaptive immune responses has received increasing attention, there remain many gaps in our knowledge regarding this important nutrient sensor. For example, the precise cellular signaling mechanisms linking excessive nutrient intake and enhanced mTOR signaling with increased cardiovascular and kidney disease, as well as cancer, are not well understood. In this review, we focus on the effects that the interaction between excess intake of nutrients and enhanced mTOR signaling have on the promotion of obesity-associated diseases and potential therapeutic strategies involving targeting mTOR signaling.
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Affiliation(s)
- Guanghong Jia
- Divisions of Endocrinology, Diabetes, Hypertension and Metabolism, Diabetes Cardiovascular Center, University of Missouri School of Medicine, Columbia, Missouri; Harry S. Truman Memorial Veterans Hospital, University of Missouri School of Medicine, Columbia, Missouri; and
| | - Annayya R Aroor
- Divisions of Endocrinology, Diabetes, Hypertension and Metabolism, Diabetes Cardiovascular Center, University of Missouri School of Medicine, Columbia, Missouri; Harry S. Truman Memorial Veterans Hospital, University of Missouri School of Medicine, Columbia, Missouri; and
| | - Luis A Martinez-Lemus
- Departments of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, Missouri; Harry S. Truman Memorial Veterans Hospital, University of Missouri School of Medicine, Columbia, Missouri; and Dalton Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, Missouri
| | - James R Sowers
- Divisions of Endocrinology, Diabetes, Hypertension and Metabolism, Diabetes Cardiovascular Center, University of Missouri School of Medicine, Columbia, Missouri; Departments of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, Missouri; Harry S. Truman Memorial Veterans Hospital, University of Missouri School of Medicine, Columbia, Missouri; and Dalton Cardiovascular Research Center, University of Missouri School of Medicine, Columbia, Missouri
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211
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Orecchioni S, Reggiani F, Talarico G, Mancuso P, Calleri A, Gregato G, Labanca V, Noonan DM, Dallaglio K, Albini A, Bertolini F. The biguanides metformin and phenformin inhibit angiogenesis, local and metastatic growth of breast cancer by targeting both neoplastic and microenvironment cells. Int J Cancer 2014; 136:E534-44. [DOI: 10.1002/ijc.29193] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/06/2014] [Accepted: 08/27/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Stefania Orecchioni
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Francesca Reggiani
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Giovanna Talarico
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Patrizia Mancuso
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Angelica Calleri
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Giuliana Gregato
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Valentina Labanca
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
| | - Douglas M. Noonan
- Scientific and Technologic Park; IRCCS MultiMedica Italy
- Department of Biotechnology and Life Sciences; University of Insubria; Varese Italy
| | - Katiuscia Dallaglio
- Research and Statistics Department; IRCCS "Tecnologie Avanzate e Modelli Assistenziali in Oncologia" Arcispedale S. Maria Nuova; Reggio Emilia Italy
| | - Adriana Albini
- Research and Statistics Department; IRCCS "Tecnologie Avanzate e Modelli Assistenziali in Oncologia" Arcispedale S. Maria Nuova; Reggio Emilia Italy
| | - Francesco Bertolini
- Laboratory of Hematology-Oncology; European Institute of Oncology; Milan Italy
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Wolfrom CM, Laurent M, Deschatrette J. Can we negotiate with a tumor? PLoS One 2014; 9:e103834. [PMID: 25084359 PMCID: PMC4118912 DOI: 10.1371/journal.pone.0103834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 07/08/2014] [Indexed: 12/18/2022] Open
Abstract
Recent progress in deciphering the molecular portraits of tumors promises an era of more personalized drug choices. However, current protocols still follow standard fixed-time schedules, which is not entirely coherent with the common observation that most tumors do not grow continuously. This unpredictability of the increases in tumor mass is not necessarily an obstacle to therapeutic efficiency, particularly if tumor dynamics could be exploited. We propose a model of tumor mass evolution as the integrated result of the dynamics of two linked complex systems, tumor cell population and tumor microenvironment, and show the practical relevance of this nonlinear approach.
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Affiliation(s)
- Claire M. Wolfrom
- Equipe « Dynamiques cellulaires et modélisation », Inserm Unité 757, Université Paris-Sud, Orsay, France
| | - Michel Laurent
- Equipe « Dynamiques cellulaires et modélisation », Inserm Unité 757, Université Paris-Sud, Orsay, France
| | - Jean Deschatrette
- Equipe « Dynamiques cellulaires et modélisation », Inserm Unité 757, Université Paris-Sud, Orsay, France
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213
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Cheng G, Zielonka J, McAllister D, Tsai S, Dwinell MB, Kalyanaraman B. Profiling and targeting of cellular bioenergetics: inhibition of pancreatic cancer cell proliferation. Br J Cancer 2014; 111:85-93. [PMID: 24867695 PMCID: PMC4090735 DOI: 10.1038/bjc.2014.272] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/21/2014] [Accepted: 04/24/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Targeting both mitochondrial bioenergetics and glycolysis pathway is an effective way to inhibit proliferation of tumour cells, including those that are resistant to conventional chemotherapeutics. METHODS In this study, using the Seahorse 96-well Extracellular Flux Analyzer, we mapped the two intrinsic cellular bioenergetic parameters, oxygen consumption rate and proton production rate in six different pancreatic cancer cell lines and determined their differential sensitivity to mitochondrial and glycolytic inhibitors. RESULTS There exists a very close relationship among intracellular bioenergetic parameters, depletion of ATP and anti-proliferative effects (inhibition of colony-forming ability) in pancreatic cancer cells derived from different genetic backgrounds treated with the glycolytic inhibitor, 2-deoxyglucose (2-DG). The most glycolytic pancreatic cancer cell line was exquisitely sensitive to 2-DG, whereas the least glycolytic pancreatic cancer cell was resistant to 2-DG. However, when combined with metformin, inhibitor of mitochondrial respiration and activator of AMP-activated protein kinase, 2-DG synergistically enhanced ATP depletion and inhibited cell proliferation even in poorly glycolytic, 2-DG-resistant pancreatic cancer cell line. Furthermore, treatment with conventional chemotherapeutic drugs (e.g., gemcitabine and doxorubicin) or COX-2 inhibitor, celecoxib, sensitised the cells to 2-DG treatment. CONCLUSIONS Detailed profiling of cellular bioenergetics can provide new insight into the design of therapeutic strategies for inhibiting pancreatic cancer cell metabolism and proliferation.
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Affiliation(s)
- G Cheng
- Department of Biophysics and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - J Zielonka
- Department of Biophysics and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - D McAllister
- Department of Biophysics and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - S Tsai
- Department of Surgery/Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - M B Dwinell
- Department of Microbiology and Molecular Genetics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - B Kalyanaraman
- Department of Biophysics and Free Radical Research Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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214
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Sebastião I, Candeias E, Santos MS, de Oliveira CR, Moreira PI, Duarte AI. Insulin as a Bridge between Type 2 Diabetes and Alzheimer Disease - How Anti-Diabetics Could be a Solution for Dementia. Front Endocrinol (Lausanne) 2014; 5:110. [PMID: 25071725 PMCID: PMC4086025 DOI: 10.3389/fendo.2014.00110] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 06/24/2014] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes (T2D) and Alzheimer disease (AD) are two major health issues nowadays. T2D is an ever increasing epidemic, affecting millions of elderly people worldwide, with major repercussions in the patients' daily life. This is mostly due to its chronic complications that may affect brain and constitutes a risk factor for AD. T2D principal hallmark is insulin resistance which also occurs in AD, rendering both pathologies more than mere unrelated diseases. This hypothesis has been reinforced in the recent years, with a high number of studies highlighting the existence of several common molecular links. As such, it is not surprising that AD has been considered as the "type 3 diabetes" or a "brain-specific T2D," supporting the idea that a beneficial therapeutic strategy against T2D might be also beneficial against AD. Herewith, we aim to review some of the recent developments on the common features between T2D and AD, namely on insulin signaling and its participation in the regulation of amyloid β (Aβ) plaque and neurofibrillary tangle formation (the two major neuropathological hallmarks of AD). We also critically analyze the promising field that some anti-T2D drugs may protect against dementia and AD, with a special emphasis on the novel incretin/glucagon-like peptide-1 receptor agonists.
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Affiliation(s)
- Inês Sebastião
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Emanuel Candeias
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Maria S. Santos
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Coimbra, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
| | - Catarina R. de Oliveira
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Institute of Biochemistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Paula I. Moreira
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Institute of Physiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana I. Duarte
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
- Institute for Interdisciplinary Research (IIIUC), University of Coimbra, Coimbra, Portugal
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215
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Dhillon SS, Groman A, Meagher A, Demmy T, Warren GW, Yendamuri S. Metformin and Not Diabetes Influences the Survival of Resected Early Stage NSCLC Patients. ACTA ACUST UNITED AC 2014; 6:217-222. [PMID: 26457130 DOI: 10.4172/1948-5956.1000275] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Published data suggest that diabetes influences survival of patients with lung cancer. The anti-cancer effect of metformin confounds this association. We sought to study the association of diabetes and metformin with survival in patients undergoing resection of stage I non-small cell lung cancer (NSCLC). METHODS Pathologic stage I NSCLC patients undergoing anatomic resection from 2002 to 2011 were studied. A diagnosis of diabetes and diabetic medication use were identified through records. Univariate and multivariate analyses examined the association of diabetes and metformin usage with overall survival (OS). RESULTS 409 eligible patients were included in the analysis - excluding patients with neoadjuvant therapy, more than one lung cancer, or resection less than lobectomy. 71 (17.4%) patients were diabetics and 41 (10.0%) used metformin. With a median follow up of 44 months, univariate analysis demonstrates that diabetes had no effect on OS (P=0.75); however, metformin use was associated with improved OS (median survival not reached vs. 60 months; P=0.02). Metformin use remained an important predictor of good survival in multivariate analysis (HR=3.08; P<0.01) after adjusting for age, gender, pathologic stage, histology and smoking status. CONCLUSION Metformin use rather than diabetes is associated with improved long-term survival in Stage I NSCLC patients.
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Affiliation(s)
- Samjot Singh Dhillon
- Department of Medicine-Thoracic Oncology/Pulmonary Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Adrienne Groman
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Alison Meagher
- Department of Pharmacy, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Todd Demmy
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Graham W Warren
- Department of Radiation Oncology and Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, SC, USA
| | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
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216
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Cerezo M, Tomic T, Ballotti R, Rocchi S. Is it time to test biguanide metformin in the treatment of melanoma? Pigment Cell Melanoma Res 2014; 28:8-20. [PMID: 24862830 DOI: 10.1111/pcmr.12267] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/12/2014] [Indexed: 01/04/2023]
Abstract
Metformin is the most widely used antidiabetic drug that belongs to the biguanide class. It is very well tolerated and has the major clinical advantage of not inducing hypoglycemia. Metformin decreases hepatic glucose production via a mechanism requiring liver kinase B1, which controls the metabolic checkpoint, AMP-activated protein kinase-mammalian target of rapamycin and neoglucogenic genes. The effects of metformin on this pathway results in reduced protein synthesis and cell proliferation. These observations have given the impetus for many investigations on the role of metformin in the regulation of tumor cell proliferation, cell-cycle regulation, apoptosis, and autophagy. Encouraging results from these studies have shown that metformin could potentially be used as an efficient anticancer drug in various neoplasms such as prostate, breast, lung, pancreas cancers, and melanoma. These findings are strengthened by retrospective epidemiological studies that have found a decrease in cancer risk in diabetic patients treated with metformin. In this review, we have focused our discussion on recent molecular mechanisms of metformin that have been described in various solid tumors in general and in melanoma in particular.
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Affiliation(s)
- Michael Cerezo
- INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire (C3M), Equipe Biologie et Pathologie des Cellules Mélanocytaire: de la Pigmentation Cutanée au Mélanome, Nice, France; Université de Nice Sophia Antipolis, UFR de Médecine, Nice, France
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217
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Nenu I, Popescu T, Aldea MD, Craciun L, Olteanu D, Tatomir C, Bolfa P, Ion RM, Muresan A, Filip AG. Metformin associated with photodynamic therapy--a novel oncological direction. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2014; 138:80-91. [PMID: 24911275 DOI: 10.1016/j.jphotobiol.2014.04.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/15/2014] [Accepted: 04/28/2014] [Indexed: 12/31/2022]
Abstract
The aim of our study was to assess the effect of the combined treatment of Metformin (Metf) and 5, 10, 15, 20-tetra-sulfophenyl-porphyrin (TSPP)-mediated photodynamic therapy (PDT) on an in vivo tumour model. Wistar male rats were divided in 6 groups: group 1, treated with TSPP; groups 2 and 4 treated with TSPP and Metf, respectively, and irradiated 24h thereafter; group 3 was treated with Metf and the last two groups received the combined treatment, Metf administered prior (group 5) or after (group 6) irradiation. 72 h from the start of the treatment, tumour tissue was sampled for the investigation of oxidative and nitrosative stress. The apoptotic rate, inducible nitric oxide synthase (iNOS) and cyclooxygenase (COX)-2 expressions and matrix metalloproteinases activities were also quantified. Malondialdehyde and glutathione levels were significantly elevated in the groups treated with combined therapy (p<0.05). Metf associated with TSPP-PDT reduced iNOS and COX-2 expressions and enhanced nitrotyrosine levels in both therapeutic regimens. Peroxynitrate formation and its cytotoxic effect on tumour cells were related to an elevated index of apoptosis and necrosis. Moreover, MMP-2 activity reached a minimum in the groups which received combined therapy. Our results confirmed that the association of Metf with PDT might prove a new and promising oncological approach.
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Affiliation(s)
- Iuliana Nenu
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Tiberiu Popescu
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Mihaela D Aldea
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Lucian Craciun
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Diana Olteanu
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Corina Tatomir
- Departments of Radiobiology and Tumor Biology, Oncology Institute "Prof. I. Chiricuta", 34-36 Republicii Street, 400015 Cluj-Napoca, Romania
| | - Pompei Bolfa
- Department of Pathology, Cluj-Napoca, University of Agricultural Sciences and Veterinary Medicine, 3-5 Calea Manastur, 400372 Cluj-Napoca, Romania; Department of Biomedical Sciences, Ross University School of Veterinary Medicine Basseterre, PO Box 334, Saint Kitts and Nevis
| | - Rodica M Ion
- National Research & Development Institute for Chemistry and Petrochemistry ICECHIM 202 Splaiul Independentei, 060021 Bucharest, Romania
| | - Adriana Muresan
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Adriana G Filip
- Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 1 Clinicilor Street, 400006 Cluj-Napoca, Romania.
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Zhang T, Zhang L, Zhang T, Fan J, Wu K, Guan Z, Wang X, Li L, Hsieh JT, He D, Guo P. Metformin sensitizes prostate cancer cells to radiation through EGFR/p-DNA-PKCS in vitro and in vivo. Radiat Res 2014; 181:641-9. [PMID: 24844651 DOI: 10.1667/rr13561.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although neo-adjuvant radiotherapy is generally successful in treatment of advanced prostate cancer, radioresistance is still a major therapeutic problem in many patients. In the current study, we investigated the effects of metformin (1,1-dimethylbiguanide hydrochloride), a widely used antidiabetic drug, on tumor cell radiosensitivity in prostate cancer. Through clonogenic survival assays, we found that metformin treatment enhanced radiosensitivity of prostate cancer cells with a dose enhancement factor. Moreover, irradiation of subcutaneous C4-2 tumors in mice treated with metformin resulted in an increase in radiation-induced tumor growth delay (17.3 days to 29.5 days, P < 0.01), which indicates that the tumor radiosensitivity increased by metformin in vivo. We also measured the sublethal damage repair and analyzed double-strand breaks (DSBs) in X-irradiated cells. γ-H2AX, as an indicator of DSBs, had significantly more foci per cell in the group treated with metformin and radiation compared to groups treated with metformin or irradiation, respectively. Moreover, mice with subcutaneous tumor implants lived longer after a combined treatment of metformin and radiation. In addition, the reduced phosphorylation of DNA-PKcs caused by EGFR/PI3K/Akt down-regulation is essential for metformin to induce radiosensitivity in prostate cancer cells. Our results indicate that metformin enhances prostate cancer cell radiosensitivity in vitro and in vivo. Exposure to metformin before radiation therapy could be a beneficial option for the treatment of prostate cancer.
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Affiliation(s)
- Tingting Zhang
- a Department of Urology, The Second Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Lheureux S, Wilson M, Mackay HJ. Recent and current Phase II clinical trials in endometrial cancer: review of the state of art. Expert Opin Investig Drugs 2014; 23:773-92. [DOI: 10.1517/13543784.2014.907272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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220
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McCarty MF. AMPK activation--protean potential for boosting healthspan. AGE (DORDRECHT, NETHERLANDS) 2014; 36:641-663. [PMID: 24248330 PMCID: PMC4039279 DOI: 10.1007/s11357-013-9595-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/22/2013] [Indexed: 06/01/2023]
Abstract
AMP-activated kinase (AMPK) is activated when the cellular (AMP+ADP)/ATP ratio rises; it therefore serves as a detector of cellular "fuel deficiency." AMPK activation is suspected to mediate some of the health-protective effects of long-term calorie restriction. Several drugs and nutraceuticals which slightly and safely impede the efficiency of mitochondrial ATP generation-most notably metformin and berberine-can be employed as clinical AMPK activators and, hence, may have potential as calorie restriction mimetics for extending healthspan. Indeed, current evidence indicates that AMPK activators may reduce risk for atherosclerosis, heart attack, and stroke; help to prevent ventricular hypertrophy and manage congestive failure; ameliorate metabolic syndrome, reduce risk for type 2 diabetes, and aid glycemic control in diabetics; reduce risk for weight gain; decrease risk for a number of common cancers while improving prognosis in cancer therapy; decrease risk for dementia and possibly other neurodegenerative disorders; help to preserve the proper structure of bone and cartilage; and possibly aid in the prevention and control of autoimmunity. While metformin and berberine appear to have the greatest utility as clinical AMPK activators-as reflected by their efficacy in diabetes management-regular ingestion of vinegar, as well as moderate alcohol consumption, may also achieve a modest degree of health-protective AMPK activation. The activation of AMPK achievable with any of these measures may be potentiated by clinical doses of the drug salicylate, which can bind to AMPK and activate it allosterically.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity, 7831 Rush Rose Dr., Apt. 316, Carlsbad, CA, 92009, USA,
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221
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Izzotti A, Balansky R, D'Agostini F, Longobardi M, Cartiglia C, Micale RT, La Maestra S, Camoirano A, Ganchev G, Iltcheva M, Steele VE, De Flora S. Modulation by metformin of molecular and histopathological alterations in the lung of cigarette smoke-exposed mice. Cancer Med 2014; 3:719-30. [PMID: 24683044 PMCID: PMC4101764 DOI: 10.1002/cam4.234] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 12/22/2022] Open
Abstract
The anti-diabetic drug metformin is endowed with anti-cancer properties. Epidemiological and experimental studies, however, did not provide univocal results regarding its role in pulmonary carcinogenesis. We used Swiss H mice of both genders in order to detect early molecular alterations and tumors induced by mainstream cigarette smoke. Based on a subchronic toxicity study, oral metformin was used at a dose of 800 mg/kg diet, which is 3.2 times higher than the therapeutic dose in humans. Exposure of mice to smoke for 4 months, starting at birth, induced a systemic clastogenic damage, formation of DNA adducts, oxidative DNA damage, and extensive downregulation of microRNAs in lung after 10 weeks. Preneoplastic lesions were detectable after 7.5 months in both lung and urinary tract along with lung tumors, both benign and malignant. Modulation by metformin of 42 of 1281 pulmonary microRNAs in smoke-free mice highlighted a variety of mechanisms, including modulation of AMPK, stress response, inflammation, NFκB, Tlr9, Tgf, p53, cell cycle, apoptosis, antioxidant pathways, Ras, Myc, Dicer, angiogenesis, stem cell recruitment, and angiogenesis. In smoke-exposed mice, metformin considerably decreased DNA adduct levels and oxidative DNA damage, and normalized the expression of several microRNAs. It did not prevent smoke-induced lung tumors but inhibited preneoplastic lesions in both lung and kidney. In conclusion, metformin was able to protect the mouse lung from smoke-induced DNA and microRNA alterations and to inhibit preneoplastic lesions in lung and kidney but failed to prevent lung adenomas and malignant tumors induced by this complex mixture.
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Affiliation(s)
- Alberto Izzotti
- Department of Health Sciences, University of Genoa, Genoa, Italy
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222
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Cardwell CR, Kunzmann AT, Cantwell MM, Hughes C, Baron JA, Powe DG, Murray LJ. Low-dose aspirin use after diagnosis of colorectal cancer does not increase survival: a case-control analysis of a population-based cohort. Gastroenterology 2014; 146:700-708.e2. [PMID: 24239563 DOI: 10.1053/j.gastro.2013.11.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/06/2013] [Accepted: 11/09/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Individuals who began taking low-dose aspirin before they were diagnosed with colorectal cancer were reported to have longer survival times than patients who did not take this drug. We investigated survival times of patients who begin taking low-dose aspirin after a diagnosis of colorectal cancer in a large population-based cohort study. METHODS We performed a nested case-control analysis using a cohort of 4794 patients diagnosed with colorectal cancer from 1998 through 2007, identified from the UK Clinical Practice Research Datalink and confirmed by cancer registries. There were 1559 colorectal cancer-specific deaths, recorded by the Office of National Statistics; these were each matched with up to 5 risk-set controls. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI), based on practitioner-recorded aspirin usage. RESULTS Overall, low-dose aspirin use after a diagnosis of colorectal cancer was not associated with colorectal cancer-specific mortality (adjusted OR = 1.06; 95% CI: 0.92-1.24) or all-cause mortality (adjusted OR = 1.06; 95% CI: 0.94-1.19). A dose-response association was not apparent; for example, low-dose aspirin use for more than 1 year after diagnosis was not associated with colorectal cancer-specific mortality (adjusted OR = 0.98; 95% CI: 0.82-1.19). There was also no association between low-dose aspirin usage and colon cancer-specific mortality (adjusted OR = 1.02; 95% CI: 0.83-1.25) or rectal cancer-specific mortality (adjusted OR = 1.10; 95% CI: 0.88-1.38). CONCLUSIONS In a large population-based cohort, low-dose aspirin usage after diagnosis of colorectal cancer did not increase survival time.
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Affiliation(s)
- Chris R Cardwell
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
| | - Andrew T Kunzmann
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland; Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Marie M Cantwell
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland; Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Carmel Hughes
- School of Pharmacy, Queen's University Belfast, Northern Ireland
| | - John A Baron
- Department of Medicine, University of North Carolina School of Medicine Chapel Hill, North Carolina
| | - Des G Powe
- Department of Cellular Pathology, Queen's Medical Centre, Nottingham University Hospitals, NHS Trust, UK; The John van Geest Cancer Research Centre, Nottingham Trent University, Nottingham, UK
| | - Liam J Murray
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland; Centre of Excellence for Public Health (NI), Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
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Lettieri Barbato D, Vegliante R, Desideri E, Ciriolo MR. Managing lipid metabolism in proliferating cells: new perspective for metformin usage in cancer therapy. Biochim Biophys Acta Rev Cancer 2014; 1845:317-24. [PMID: 24569230 DOI: 10.1016/j.bbcan.2014.02.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/18/2014] [Indexed: 01/01/2023]
Abstract
Cancer cells metabolically adapt to undergo cellular proliferation. Lipids, besides their well-known role as energy storage, represent the major building blocks for the synthesis of neo-generated membranes. There is increasing evidence that cancer cells show specific alterations in different aspects of lipid metabolism. The changes of expression and activity of lipid metabolising enzymes are directly regulated by the activity of oncogenic signals. The dependence of tumour cells on the deregulated lipid metabolism suggests that proteins involved in this process could be excellent chemotherapeutic targets for cancer treatment. Due to its rare side effects in non-cancerous cells, metformin has been recently revaluated as a potential anti-tumourigenic drug, which negatively affects lipid biosynthetic pathways. In this review we summarised the emerging molecular events linking the anti-proliferative effect of metformin with lipid metabolism in cancer cells.
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Affiliation(s)
- Daniele Lettieri Barbato
- Dept. of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Rolando Vegliante
- Dept. of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Enrico Desideri
- Dept. of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Maria Rosa Ciriolo
- Dept. of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; IRCCS San Raffaele, Biochemistry of Ageing, Via di Val Cannuta, 00166 Rome, Italy.
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Yue W, Yang CS, DiPaola RS, Tan XL. Repurposing of metformin and aspirin by targeting AMPK-mTOR and inflammation for pancreatic cancer prevention and treatment. Cancer Prev Res (Phila) 2014; 7:388-97. [PMID: 24520038 DOI: 10.1158/1940-6207.capr-13-0337] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Pancreatic cancer, as the fourth leading cause of cancer-related deaths, carries a poor prognosis with a median survival of 6 months and a dismal 5-year survival rate of 3% to 5%. These statistics highlight an urgent need for novel chemopreventive and therapeutic strategies for this malignancy. Metformin and aspirin have been explored as two emerging cancer chemoprevention agents for different types of cancers, including pancreatic cancer. Here, we review the effects of both metformin and aspirin on pancreatic tumorigenesis and their potential actions in pancreatic cancer. Special attention is paid to their effects on the important signaling pathways of pancreatic cancer development as well as possible mechanisms for synergy between these two agents. For metformin, the most important mechanism may involve the inhibition of mTOR signaling via AMP-activated protein kinase (AMPK)-dependent and -independent pathways. For aspirin, the major mechanism is the anti-inflammatory action through the inhibition of COX-1/COX-2 and modulation of the NFκB or STAT3 pathway. In addition, aspirin may activate AMPK, and both agents may affect Notch, Wnt/β-catenin, and other signaling pathways. The combination of metformin and aspirin will provide additive and possibly synergistic effects for the prevention and treatment of pancreatic cancer.
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Affiliation(s)
- Wen Yue
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, 195 Little Albany Street, R5566, New Brunswick, NJ 08901.
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Metformin: a potential therapeutic agent for recurrent colon cancer. PLoS One 2014; 9:e84369. [PMID: 24465408 PMCID: PMC3896365 DOI: 10.1371/journal.pone.0084369] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 11/22/2013] [Indexed: 01/15/2023] Open
Abstract
Accumulating evidence suggests that metformin, a biguanide class of anti-diabetic drugs, possesses anti-cancer properties. However, most of the studies to evaluate therapeutic efficacy of metformin have been on primary cancer. No information is available whether metformin could be effectively used for recurrent cancer, specifically colorectal cancer (CRC) that affects up to 50% of patients treated by conventional chemotherapies. Although the reasons for recurrence are not fully understood, it is thought to be due to re-emergence of chemotherapy-resistant cancer stem/stem-like cells (CSCs/CSLCs). Therefore, development of non-toxic treatment strategies targeting CSCs would be of significant therapeutic benefit. In the current investigation, we have examined the effectiveness of metformin, in combination with 5-fluorouracil and oxaliplatin (FuOx), the mainstay of colon cancer therapeutics, on survival of chemo-resistant colon cancer cells that are highly enriched in CSCs/CSLCs. Our data show that metformin acts synergistically with FuOx to (a) induce cell death in chemo resistant (CR) HT-29 and HCT-116 colon cancer cells, (b) inhibit colonospheres formation and (c) enhance colonospheres disintegration. In vitro cell culture studies have further demonstrated that the combinatorial treatment inhibits migration of CR colon cancer cells. These changes were associated with increased miRNA 145 and reduction in miRNA 21. Wnt/β-catenin signaling pathway was also down-regulated indicating its pivotal role in regulating the growth of CR colon cancer cells. Data from SCID mice xenograft model of CR HCT-116 and CR HT-29 cells show that the combination of metformin and FuOX is highly effective in inhibiting the growth of colon tumors as evidenced by ∼ 50% inhibition in growth following 5 weeks of combination treatment, when compared with the vehicle treated controls. Our current data suggest that metformin together with conventional chemotherapy could be an effective treatment regimen for recurring colorectal cancer (CRC).
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226
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Bordeleau L, Yakubovich N, Dagenais GR, Rosenstock J, Probstfield J, Chang Yu P, Ryden LE, Pirags V, Spinas GA, Birkeland KI, Ratner RE, Marin-Neto JA, Keltai M, Riddle MC, Bosch J, Yusuf S, Gerstein HC. The association of basal insulin glargine and/or n-3 fatty acids with incident cancers in patients with dysglycemia. Diabetes Care 2014; 37:1360-6. [PMID: 24574355 DOI: 10.2337/dc13-1468] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiologic studies linking insulin glargine and glucose-lowering therapies to cancers and n-3 fatty acids to cancer prevention have not been confirmed. We aimed to assess the effect of insulin glargine and n-3 fatty acids on incident cancers within the context of the ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial. RESEARCH DESIGN AND METHODS The ORIGIN trial is an international, long-term, randomized two-by-two factorial study comparing insulin glargine with standard care and n-3 fatty acids with placebo (double blind) in people with dysglycemia at high risk for cardiovascular events. The primary outcome measure (cancer substudy) was the occurrence of any new or recurrent adjudicated cancer. Cancer mortality and cancer subtypes were also analyzed. RESULTS Among 12,537 people (mean age 63.5 years, SD 7.8; 4,388 females), 953 developed a cancer event during the median follow-up of 6.2 years. In the glargine and standard care groups, the incidence of cancers was 1.32 and 1.32 per 100 person-years, respectively (P = 0.97), and in the n-3 fatty acid and placebo groups, it was 1.28 and 1.36 per 100 person-years, respectively (P = 0.39). No difference in the effect of either intervention was noted within predefined subgroups (P for all interactions ≥0.17). Cancer-related mortality and cancer-specific outcomes also did not differ between groups. Postrandomization HbA1c levels, glucose-lowering therapies (including metformin), and BMI did not affect cancer outcomes. CONCLUSIONS Insulin glargine and n-3 fatty acids have a neutral association with overall and cancer-specific outcomes, including cancer-specific mortality. Exposure to glucose-lowering therapies, including metformin, and HbA1c level during the study did not alter cancer risk.
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Shafiee MN, Khan G, Ariffin R, Abu J, Chapman C, Deen S, Nunns D, Barrett DA, Seedhouse C, Atiomo W. Preventing endometrial cancer risk in polycystic ovarian syndrome (PCOS) women: Could metformin help? Gynecol Oncol 2014; 132:248-53. [DOI: 10.1016/j.ygyno.2013.10.028] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/11/2013] [Accepted: 10/22/2013] [Indexed: 12/13/2022]
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228
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La Vecchia C, Bosetti C. Metformin: are potential benefits on cancer risk extended to cancer survival? Oncologist 2013; 18:1245-7. [PMID: 24258614 DOI: 10.1634/theoncologist.2013-0381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Carlo La Vecchia
- Department of Epidemiology, IRCCS-lstituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
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229
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Zannella VE, Dal Pra A, Muaddi H, McKee TD, Stapleton S, Sykes J, Glicksman R, Chaib S, Zamiara P, Milosevic M, Wouters BG, Bristow RG, Koritzinsky M. Reprogramming metabolism with metformin improves tumor oxygenation and radiotherapy response. Clin Cancer Res 2013; 19:6741-50. [PMID: 24141625 DOI: 10.1158/1078-0432.ccr-13-1787] [Citation(s) in RCA: 238] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Tumor hypoxia is a negative prognostic factor in multiple cancers, due in part to its role in causing resistance to radiotherapy. Hypoxia arises in tumor regions distal to blood vessels as oxygen is consumed by more proximal tumor cells. Reducing the rate of oxygen consumption is therefore a potential strategy to reduce tumor hypoxia. We hypothesized that the anti-diabetic drug metformin, which reduces oxygen consumption through inhibition of mitochondrial complex I, would improve radiation response by increasing tumor oxygenation. EXPERIMENTAL DESIGN Tumor hypoxia was measured in xenografts before and after metformin treatment using 2-nitroimidazole hypoxia markers quantified by immunohistochemistry (IHC), flow cytometry, and positron emission tomography (PET) imaging. Radiation response was determined by tumor growth delay and clonogenic survival in xenografts with and without administration of metformin. The impact of metformin use on outcome was assessed in 504 patients with localized prostate cancer treated with curative-intent, image-guided radiotherapy (IGRT) from 1996 to 2012. Three-year biochemical relapse-free rates were assessed using the Kaplan-Meier method. RESULTS Metformin treatment significantly improved tumor oxygenation in two xenograft models as measured by IHC, flow cytometry, and PET imaging. Metformin also led to improved radiotherapy responses when mice were administered metformin immediately before irradiation. Clinically, metformin use was associated with an independent and significant decrease in early biochemical relapse rates (P = 0.0106). CONCLUSION Our data demonstrate that metformin can improve tumor oxygenation and response to radiotherapy. Our study suggests that metformin may represent an effective and inexpensive means to improve radiotherapy outcome with an optimal therapeutic ratio.
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Affiliation(s)
- Vanessa E Zannella
- Authors' Affiliations: Princess Margaret Cancer Centre and Radiation Medicine Program, University Health Network; Institute of Medical Science, Department of Radiation Oncology, Faculty of Medicine, Department of Medical Biophysics, University of Toronto; Selective Therapies Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada; and Department of Radiation Oncology (Maastro Lab), GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
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Cabreiro F, Gems D. Worms need microbes too: microbiota, health and aging in Caenorhabditis elegans. EMBO Mol Med 2013; 5:1300-10. [PMID: 23913848 PMCID: PMC3799487 DOI: 10.1002/emmm.201100972] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/07/2013] [Accepted: 06/12/2013] [Indexed: 12/24/2022] Open
Abstract
Many animal species live in close association with commensal and symbiotic microbes (microbiota). Recent studies have revealed that the status of gastrointestinal tract microbiota can influence nutrition-related syndromes such as obesity and type-2 diabetes, and perhaps aging. These morbidities have a profound impact in terms of individual suffering, and are an increasing economic burden to modern societies. Several theories have been proposed for the influence of microbiota on host metabolism, but these largely remain to be proven. In this article we discuss how microbiota may be manipulated (via pharmacology, diet, or gene manipulation) in order to alter metabolism, immunity, health and aging in the host. The nematode Caenorhabditis elegans in combination with one microbial species is an excellent, defined model system to investigate the mechanisms of host–microbiota interactions, particularly given the combined power of worm and microbial genetics. We also discuss the multifaceted nature of the worm–microbe relationship, which likely encompasses predation, commensalism, pathogenicity and necromeny.
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Affiliation(s)
- Filipe Cabreiro
- Institute of Healthy Ageing, and Research Department of Genetics, Evolution and Environment, University College London, London, UK.
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231
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Muaddi H, Chowdhury S, Vellanki R, Zamiara P, Koritzinsky M. Contributions of AMPK and p53 dependent signaling to radiation response in the presence of metformin. Radiother Oncol 2013; 108:446-50. [PMID: 23891087 DOI: 10.1016/j.radonc.2013.06.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 06/08/2013] [Accepted: 06/11/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Metformin is commonly prescribed to treat type 2 diabetes, and has additional potential as a cancer prophylactic and therapeutic. Metformin activates AMPK that in turn can launch a p53-dependent metabolic checkpoint. Possible interactions between metformin and radiation are poorly understood. Since radiation-induced signaling also involves AMPK and p53, we investigated their importance in mediating responses to metformin and radiation. MATERIALS AND METHODS A549 cells, HCT116 cells wildtype or knockout for p53 or MEFs wildtype or double knockout for AMPKα1 and α2 were irradiated in the presence or absence of metformin. The impact of metformin on oxygen consumption and proliferation rates was determined, as well as clonogenic radiation survival. RESULTS Metformin resulted in moderate radiation protection in all cell lines, irrespective of AMPK and p53. Loss of AMPK sensitized cells to the anti-proliferative effects of metformin, while loss of p53 promoted both the growth inhibitory and toxic effects of metformin. Consequently, overall cell death after radiation was similar with and without metformin irrespective of AMPK or p53 genotype. CONCLUSIONS The anti-proliferative activity of metformin may confer benefit in combination with radiotherapy, and this benefit is intensified upon loss of AMPK or p53 signaling.
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Affiliation(s)
- Hala Muaddi
- Ontario Cancer Institute and Campbell Family Institute for Cancer Research, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada; Faculty of Medicine, University of Toronto, Canada
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232
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Zhang Q, Celestino J, Schmandt R, McCampbell AS, Urbauer DL, Meyer LA, Burzawa JK, Huang M, Yates MS, Iglesias D, Broaddus RR, Lu KH. Chemopreventive effects of metformin on obesity-associated endometrial proliferation. Am J Obstet Gynecol 2013; 209:24.e1-24.e12. [PMID: 23500454 DOI: 10.1016/j.ajog.2013.03.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 01/30/2013] [Accepted: 03/07/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Obesity is a significant contributing factor to endometrial cancer risk. We previously demonstrated that estrogen-induced endometrial proliferation is enhanced in the context of hyperinsulinemia and insulin resistance. In this study, we investigate whether pharmacologic agents that modulate insulin sensitivity or normalize insulin levels will diminish the proliferative response to estrogen. STUDY DESIGN Zucker fa/fa obese rats and lean controls were used as models of hyperinsulinemia and insulin resistance. Insulin levels were depleted in ovariectomized rats following treatment with streptozotocin, or modulated by metformin treatment. The number of BrdU-incorporated cells, estrogen-dependent proliferative and antiproliferative gene expression, and activation of mTOR and ERK1/2 MAPK signaling were studied. A rat normal endometrial cell line RENE1 was used to evaluate the direct effects of metformin on endometrial cell proliferation and gene expression in vitro. RESULTS Streptozotocin lowered circulating insulin levels in obese rats and decreased the number of BrdU-labeled endometrial cells even in the presence of exogenous estrogen. Treatment with the insulin-sensitizing drug metformin attenuated estrogen-dependent proliferative expression of c-myc and c-fos in the obese rat endometrium compared to untreated controls and was accompanied by inhibition of phosphorylation of the insulin and IGF1 receptors (IRβ/IGF1R) and ERK1/2. In vitro studies indicated metformin inhibited RENE1 proliferation in a dose-dependent manner. CONCLUSION These findings suggest that drugs that modulate insulin sensitivity, such as metformin, hinder estrogen-mediated endometrial proliferation. Therefore, these drugs may be clinically useful for the prevention of endometrial cancer in obese women.
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233
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Habib A, Karmali V, Polavarapu R, Akahori H, Pachura K, Finn AV. Metformin impairs endothelialization after placement of newer generation drug eluting stents. Atherosclerosis 2013; 229:385-7. [PMID: 23880192 DOI: 10.1016/j.atherosclerosis.2013.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 05/30/2013] [Accepted: 06/06/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Metformin impairs endothelialization of drug eluting stents (DES) due to convergent signaling at the mammalian target of rapamycin (mTOR) pathway. We assessed whether metformin will continue to adversely affect stent endothelialization despite design improvements in newer generation DES. METHODS Rabbit iliac artery stenting with newer generation DES was performed followed by 14 days of either normal chow diet or one with metformin (100 mg/kg/day) added. Scanning electron microscopy was used to assess stent endothelialization after sacrifice. RESULTS In the metformin-treated group there was significantly less endothelialization compared to the placebo-treated group. Paclitaxel-eluting stents in placebo-treated group had the greatest degree of endothelialization with significantly less in its metformin-treated counterpart and all-limus eluting stent groups. CONCLUSIONS Metformin inhibited stent endothelialization in newer generation DES despite improvements in stent design. By impairing stent endothelialization, metformin may increase the risk for thrombotic complications after newer generation DES placement.
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Affiliation(s)
- Anwer Habib
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA
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234
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Spillane S, Bennett K, Sharp L, Barron TI. A cohort study of metformin exposure and survival in patients with stage I-III colorectal cancer. Cancer Epidemiol Biomarkers Prev 2013; 22:1364-73. [PMID: 23753040 DOI: 10.1158/1055-9965.epi-13-0347] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Preclinical evidence suggests a beneficial effect of metformin in colorectal cancer. This study aimed to investigate associations between metformin exposure and colorectal cancer-specific survival using population-level data. METHODS Adult patients with stage I-III colorectal cancer diagnosed from 2001 to 2006 were identified from the National Cancer Registry Ireland. Use of metformin and other antidiabetic medications was determined from a linked national prescription claims database. Multivariate Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for associations between prediagnostic metformin exposure (versus nonmetformin antidiabetic drugs) and colorectal cancer-specific mortality. Models were stratified by antidiabetic drug coprescription and intensity of metformin exposure. RESULTS The cohort included 207 diabetics who received metformin, 108 diabetics not exposed to metformin, and 3,501 nondiabetic patients. In multivariate analyses, a nonsignificant reduction in colorectal cancer-specific mortality was observed for metformin-exposed patients relative to other treated diabetics (HR, 0.61; 95% CI, 0.37-1.01). In stratified analyses, no significant association was observed for patients receiving low-intensity metformin or metformin in combination with other antidiabetic drugs. High-intensity exclusive metformin use was associated with a significant reduction in colorectal cancer-specific mortality (HR, 0.44; 95% CI, 0.20-0.95). CONCLUSIONS Significant associations between metformin exposure and colorectal cancer-specific mortality were observed only for high-intensity exclusive metformin use in the diabetic cohort. IMPACT This study provides moderate evidence of an association between metformin exposure and improved colorectal cancer survival in a diabetic population. Additional studies in larger cohorts, with detailed information on diabetes severity, are required to confirm these results.
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Affiliation(s)
- Susan Spillane
- Department of Pharmacology & Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
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235
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Abstract
The mechanisms underlying the biological activity of metformin, a widely prescribed drug to treat type 2 diabetes, remain elusive. In a recent issue of Cell, Cabreiro et al. report that in C. elegans, metformin indirectly impacts lifespan by altering the methionine metabolism of its microbial partner E. coli (Cabreiro et al., 2013).
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Affiliation(s)
- Gilles Storelli
- Institut de Génomique Fonctionnelle de Lyon (IGFL), Ecole Normale Supérieure de Lyon, CNRS UMR 5242, Université Claude Bernard Lyon-1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France
| | - Mélisandre Téfit
- Institut de Génomique Fonctionnelle de Lyon (IGFL), Ecole Normale Supérieure de Lyon, CNRS UMR 5242, Université Claude Bernard Lyon-1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France
| | - François Leulier
- Institut de Génomique Fonctionnelle de Lyon (IGFL), Ecole Normale Supérieure de Lyon, CNRS UMR 5242, Université Claude Bernard Lyon-1, 46 Allée d'Italie, 69364 Lyon Cedex 07, France.
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Cabreiro F, Au C, Leung KY, Vergara-Irigaray N, Cochemé H, Noori T, Weinkove D, Schuster E, Greene N, Gems D. Metformin retards aging in C. elegans by altering microbial folate and methionine metabolism. Cell 2013; 153:228-39. [PMID: 23540700 PMCID: PMC3898468 DOI: 10.1016/j.cell.2013.02.035] [Citation(s) in RCA: 689] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 11/07/2012] [Accepted: 02/11/2013] [Indexed: 12/19/2022]
Abstract
The biguanide drug metformin is widely prescribed to treat type 2 diabetes and metabolic syndrome, but its mode of action remains uncertain. Metformin also increases lifespan in Caenorhabditis elegans cocultured with Escherichia coli. This bacterium exerts complex nutritional and pathogenic effects on its nematode predator/host that impact health and aging. We report that metformin increases lifespan by altering microbial folate and methionine metabolism. Alterations in metformin-induced longevity by mutation of worm methionine synthase (metr-1) and S-adenosylmethionine synthase (sams-1) imply metformin-induced methionine restriction in the host, consistent with action of this drug as a dietary restriction mimetic. Metformin increases or decreases worm lifespan, depending on E. coli strain metformin sensitivity and glucose concentration. In mammals, the intestinal microbiome influences host metabolism, including development of metabolic disease. Thus, metformin-induced alteration of microbial metabolism could contribute to therapeutic efficacy—and also to its side effects, which include folate deficiency and gastrointestinal upset. PaperClip
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Affiliation(s)
- Filipe Cabreiro
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
| | - Catherine Au
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
| | - Kit-Yi Leung
- Neural Development Unit, Institute of Child Health, University College London, London WC1N 1EH, UK
| | | | - Helena M. Cochemé
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
| | - Tahereh Noori
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
| | - David Weinkove
- School of Biological and Biomedical Sciences, Durham University, Durham DH1 3LE, UK
| | - Eugene Schuster
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
| | - Nicholas D.E. Greene
- Neural Development Unit, Institute of Child Health, University College London, London WC1N 1EH, UK
| | - David Gems
- Institute of Healthy Ageing, and G.E.E., University College London, London WC1E 6BT, UK
- Corresponding author
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Conteduca V, Di Lorenzo G, Bozza G, Ardito R, Aieta M. Metabolic syndrome as a peculiar target for management of prostate cancer patients. Clin Genitourin Cancer 2013; 11:211-20. [PMID: 23701880 DOI: 10.1016/j.clgc.2013.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 02/21/2013] [Accepted: 04/02/2013] [Indexed: 12/16/2022]
Abstract
An interesting and reciprocal association between the metabolic syndrome and prostate cancer has been identified. Metabolic alterations, such as hyperinsulinemia, increased levels of insulin growth factor-1, and insulin resistance could be on the basis of development and progression of many tumors, including prostate cancer, and changes in body composition, in turn, can represent some side effects of androgen deprivation therapy and novel drugs, such as mammalian target of rapamycin inhibitors. This review evaluates this interrelation between metabolic syndrome and prostate tumor scanning in many clinical and preclinical epidemiological studies and describes possible pathogenetic biological mechanisms. Finally, this article discusses feasible clinical implications for the management, prevention, diagnosis, prognosis, and treatment of patients affected by metabolic syndrome and prostate cancer, with particular attention to the metformin action.
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Affiliation(s)
- Vincenza Conteduca
- Centro di Riferimento Oncologico della Basilicata IRCCS, Rionero in Vulture, Italy.
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238
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Erices R, Bravo ML, Gonzalez P, Oliva B, Racordon D, Garrido M, Ibañez C, Kato S, Brañes J, Pizarro J, Barriga MI, Barra A, Bravo E, Alonso C, Bustamente E, Cuello MA, Owen GI. Metformin, at concentrations corresponding to the treatment of diabetes, potentiates the cytotoxic effects of carboplatin in cultures of ovarian cancer cells. Reprod Sci 2013; 20:1433-46. [PMID: 23653391 DOI: 10.1177/1933719113488441] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of the type 2 diabetics drug metformin has been correlated with enhanced progression-free survival in ovarian cancer. The literature has speculated that this enhancement is due to the high concentration of metformin directly causing cancer cell death. However, this explanation does not fit with clinical data reporting that the women exposed to constant micromolar concentrations of metformin, as present in the treatment of diabetes, respond better to chemotherapy. Herein, our aim was to examine whether micromolar concentrations of metformin alone could bring about cancer cell death and whether micromolar metformin could increase the cytotoxic effect of commonly used chemotherapies in A2780 and SKOV3 cell lines and primary cultured cancer cells isolated from the peritoneal fluid of patients with advanced ovarian cancer. Our results in cell lines demonstrate that no significant loss of viability or change in cell cycle was observed with micromolar metformin alone; however, we observed cytotoxicity with micromolar metformin in combination with chemotherapy at concentrations where the chemotherapy alone produced no loss in viability. We demonstrate that previous exposure and maintenance of metformin in conjunction with carboplatin produces a synergistic enhancement in cytotoxicity of A2780 and SKOV3 cells (55% and 43%, respectively). Furthermore, in 5 (44%) of the 11 ovarian cancer primary cultures, micromolar metformin improved the cytotoxic response to carboplatin but not paclitaxel or doxorubicin. In conclusion, we present data that support the need for a clinical study to evaluate the adjuvant maintenance or prescription of currently approved doses of metformin during the chemotherapeutic treatment of ovarian cancer.
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Affiliation(s)
- Rafaela Erices
- 1Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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Krentz AJ, Viljoen A, Sinclair A. Insulin resistance: a risk marker for disease and disability in the older person. Diabet Med 2013; 30:535-48. [PMID: 23173973 DOI: 10.1111/dme.12063] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 11/06/2012] [Indexed: 12/24/2022]
Abstract
Clinical metabolic studies have demonstrated that insulin action declines progressively with age in humans. In addition to its close association with Type 2 diabetes, which reduces life expectancy in older people, age-related insulin resistance is implicated in pathogenesis of several highly prevalent disorders for which ageing is a major risk factor. These include atherosclerotic cardiovascular disease, dementia, frailty and cancer. Accordingly, insulin resistance may be viewed as biomarker of age-related ill health and reduced lifespan. The rapidly rising number of older people, coupled with a high prevalence of insulin resistance resulting from obesity and sedentary lifestyles, presents unprecedented public health and societal challenges. Studies of centenarians have shown that preserved whole-body sensitivity to insulin is associated with longevity. The mechanisms through which insulin action is associated with age-related diseases remain unclear. Changes in body composition, i.e. sarcopenia and excess adiposity, may be more potent than age per se. Moreover, the impact of insulin resistance has been difficult to disentangle from the clustering of vascular risk factors that co-segregate with the insulin resistance-hyperinsulinaemia complex. Potentially modifiable mediators of age-related changes in insulin sensitivity include alterations in adipocytokines, impaired skeletal myocyte mitochondrial function and brown fat activity. The hypothesis that improving or maintaining insulin sensitivity preserves health and extends lifespan merits further evaluation. Practical non-pharmacological interventions directed against age-related insulin resistance remain underdeveloped. Novel metabolically active pharmacological agents with theoretical implications for some age-related disorders are entering clinical trials. However, recent adverse experiences with the thiazolidinediones suggest the need for a cautious approach to the use of insulin sensitizing drugs in older people. This could be particularly important in the absence of diabetes where the risk to benefit analysis may be less favourable.
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Affiliation(s)
- A J Krentz
- Institute of Diabetes for Older People, Bedfordshire & Hertfordshire Postgraduate Medical School, University of Bedfordshire, Luton, UK.
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240
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Abstract
The ageing of populations worldwide is leading to an unprecedented increase in cancer cases and fatalities. Understanding the links between cancer and ageing is therefore more important than ever. How the interplay of ageing-associated changes affects cancer initiation and progression is complex, however, and some ageing processes probably foster cancer development whereas others hinder it, possibly in a tissue-specific manner. In the emerging age of cancer, how can our growing understanding of the biology of ageing inform cancer biology?
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Aksoy S, Sendur MAN, Altundag K. Demographic and clinico-pathological characteristics in patients with invasive breast cancer receiving metformin. Med Oncol 2013; 30:590. [PMID: 23636908 DOI: 10.1007/s12032-013-0590-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 04/23/2013] [Indexed: 12/13/2022]
Abstract
There was a contradictory data with metformin use on breast cancer risk, but there is growing evidence that the use of metformin in diabetic patients was associated with lower risks of breast cancer mortality and incidence. The effect of metformin on clinical and pathological properties of breast cancer was not known exactly, and we aimed to investigate the demographic and clinico-pathological characteristics of patients with metformin users at the time of breast cancer diagnosis. Patients with breast cancer diagnosed from 2000 to 2012 in our clinic were retrospectively analyzed. Patient's demographics, including survival data and tumor characteristics were obtained from medical charts. Breast cancer patients who were taking metformin at the time of breast cancer diagnosis were enrolled as metformin users (n = 148), where the patients matched with the same age who were not taking metformin were included as a control group (n = 636). A total of 784 patients were included in this study. Median age of both metformin users and nonusers was 57 (23-87). There were no significant differences in baseline tumor size (P = 0.60), tumor stage (P = 0.76), and node positivity (P = 0.13) between the two groups. Metformin user patients compared to nonusers had significantly lower incidence of histological grade III tumor (P = 0.03). A similar significant trend for lower incidence of triple negative (P = 0.01) and higher incidence ER positivity (P = 0.008) and PR positivity (P = 0.01) was also seen in metformin users. In survival analysis, the estimated median disease-free survival was 118 months in metformin users, whereas 69 months in nonusers (P = 0.09). Median overall survival (OS) could not be obtained due to low events. In patients with metformin users, OS rate was 98.4, 97.1, and 93.8 %, and in nonusers was 99.6, 94.4, and 90.5 %, the first, third, and fifth years, respectively. The use of metformin at the time of breast cancer diagnosis was associated with better clinico-pathological properties and nonsignificantly improved disease-free survival in breast cancer patients.
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Affiliation(s)
- Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer, Ankara, Turkey
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242
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Sączewski F, Balewski Ł. Biological activities of guanidine compounds, 2008 - 2012 update. Expert Opin Ther Pat 2013; 23:965-95. [PMID: 23617396 DOI: 10.1517/13543776.2013.788645] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Compounds incorporating guanidine moiety have found many practical applications in diverse areas of chemistry, such as nucleophilic organocatalysis, anion recognition and coordination chemistry. Moreover, guanidine functional group is found in natural products, pharmaceuticals and cosmetic ingredients produced by synthetic methods. Thus, knowledge of their biological activities and therapeutic uses is of utmost importance for researchers involved in drug discovery processes. AREAS COVERED In this review the authors highlight the continued development and therapeutic applications of newly synthesized guanidine-containing compounds including small peptides and peptidomimetics incorporating arginine. The review presents patents and patent applications filed in the years 2008 - 2012 with emphasis placed on new mechanisms of pharmacological action of guanidine derivatives. EXPERT OPINION While guanidines are often thought of as strong organic bases and compounds hydrophilic in nature, over the last 4 years there has been an enormous increase in discovery of new promising lead structures with guanidine core, suitable for development of potential drugs acting at central nervous system, anti-inflammatory agents, anti-diabetic and chemotherapeutic agents as well as cosmetics.
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Affiliation(s)
- Franciszek Sączewski
- Medical University of Gdańsk, Department of Chemical Technology of Drugs, Al. Gen. Hallera 107, 80-416 Gdańsk, Poland.
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243
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Affiliation(s)
- Hyeong Kyu Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
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244
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Visser GHA, de Valk HW. Is the evidence strong enough to change the diagnostic criteria for gestational diabetes now? Am J Obstet Gynecol 2013; 208:260-4. [PMID: 23103371 DOI: 10.1016/j.ajog.2012.10.881] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 10/09/2012] [Accepted: 10/20/2012] [Indexed: 02/06/2023]
Abstract
The International Association of the Diabetes and Pregnancy Study Groups has proposed new thresholds for oral glucose tolerance tests that are based on the large observational Hyperglycemia and Adverse Pregnancy Outcomes study. By using these criteria about 18% of pregnant women will be diagnosed as having gestational diabetes mellitus. The question arises if we are ready for such an enormous increase in gestational diabetes mellitus patients, if outcome would really improve by using these criteria, and if additional studies are necessary before deciding on new diagnostic thresholds. In this clinical opinion, the pros and cons will be discussed.
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Affiliation(s)
- Gerard H A Visser
- Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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245
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Ko JC, Huang YC, Chen HJ, Tseng SC, Chiu HC, Wo TY, Huang YJ, Weng SH, Chiou RYY, Lin YW. Metformin induces cytotoxicity by down-regulating thymidine phosphorylase and excision repair cross-complementation 1 expression in non-small cell lung cancer cells. Basic Clin Pharmacol Toxicol 2013; 113:56-65. [PMID: 23362830 DOI: 10.1111/bcpt.12052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/02/2013] [Indexed: 01/22/2023]
Abstract
Metformin is an antidiabetic drug recently shown to inhibit cancer cell proliferation and growth, although the involved molecular mechanisms have not been elucidated. In many cancer cells, high expression of thymidine phosphorylase (TP) and Excision repair cross-complementation 1 (ERCC1) is associated with poor prognosis. We used A549 and H1975 human non-small cell lung cancer (NSCLC) cell lines to investigate the role of TP and ERCC1 expression in metformin-induced cytotoxicity. Metformin treatment decreased cellular TP and ERCC1 protein and mRNA levels by down-regulating phosphorylated MEK1/2-ERK1/2 protein levels in a dose- and time-dependent manner. The enforced expression of the constitutively active MEK1 (MEK1-CA) vectors significantly restored cellular TP and ERCC1 protein levels and cell viability. Specific inhibition of TP and ERCC1 expression by siRNA enhanced the metformin-induced cytotoxicity and growth inhibition. Arachidin-1, an antioxidant stilbenoid, further decreased TP and ERCC1 expression and augmented metformin's cytotoxic effect, which was abrogated in lung cancer cells transfected with MEK1/2-CA expression vector. In conclusion, metformin induces cytotoxicity by down-regulating TP and ERCC1 expression in NSCLC cells.
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Affiliation(s)
- Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan
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246
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Lamming DW, Ye L, Sabatini DM, Baur JA. Rapalogs and mTOR inhibitors as anti-aging therapeutics. J Clin Invest 2013; 123:980-9. [PMID: 23454761 DOI: 10.1172/jci64099] [Citation(s) in RCA: 372] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Rapamycin, an inhibitor of mechanistic target of rapamycin (mTOR), has the strongest experimental support to date as a potential anti-aging therapeutic in mammals. Unlike many other compounds that have been claimed to influence longevity, rapamycin has been repeatedly tested in long-lived, genetically heterogeneous mice, in which it extends both mean and maximum life spans. However, the mechanism that accounts for these effects is far from clear, and a growing list of side effects make it doubtful that rapamycin would ultimately be beneficial in humans. This Review discusses the prospects for developing newer, safer anti-aging therapies based on analogs of rapamycin (termed rapalogs) or other approaches targeting mTOR signaling.
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Affiliation(s)
- Dudley W Lamming
- Whitehead Institute for Biomedical Research, Department of Biology, Howard Hughes Medical Institute, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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247
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Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain Behav Immun 2013; 30 Suppl:S88-98. [PMID: 22627072 PMCID: PMC3444659 DOI: 10.1016/j.bbi.2012.05.009] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 05/09/2012] [Accepted: 05/11/2012] [Indexed: 02/06/2023] Open
Abstract
A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of interest in the hope of highlighting future paths that could move the field of biobehavioral oncology intervention research forward.
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248
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Zhang H, Gao C, Fang L, Zhao HC, Yao SK. Metformin and reduced risk of hepatocellular carcinoma in diabetic patients: a meta-analysis. Scand J Gastroenterol 2013; 48:78-87. [PMID: 23137049 DOI: 10.3109/00365521.2012.719926] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Recent epidemiological studies suggest that metformin treatment may reduce the risks of cancer and overall cancer mortality among patients with diabetes mellitus (DM). However, data on hepatocellular carcinoma (HCC) are very limited and inconsistent. This meta-analysis was designed to pool data currently available to determine the association between metformin use and HCC among diabetic patients. METHODS The Medline and Embase databases were searched to identify the relevant studies between January 1966 and December 2011. The overall analysis was derived using a random-effects meta-analysis model (DerSimonian and Laird method). Subgroup analysis was performed to explore the source of heterogeneity and validate the results from overall analysis. The Newcastle-Ottawa Quality assessment scales were adopted for quality assessment; Begg's funnel plot and Egger's regression asymmetry test were used to detect the publication bias. RESULTS A total of seven studies were identified, including three cohort studies and four case-control studies. Based on the available data, the overall prevalence of HCC was 3.40% (562/16,549) in DM patients. The overall analysis showed a significantly reduced risk of HCC in metformin users versus nonusers in diabetic patients (relative risk (RR) 0.24, 95% confidence interval (CI) 0.13-0.46, p < 0.001). Fifteen subgroup analyses were performed, and most of them (12/15 = 80%) provided supporting evidence for the results of overall analysis. Begg's (Z = -0.15, p = 0.8819) and Egger's test (t = -0.79, p = 0.468) showed no significant risk of having a publication bias. CONCLUSION Metformin treatment was associated with reduced risk of HCC in diabetic patients. To clarify this relationship, more high-quality studies are required.
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Affiliation(s)
- Hui Zhang
- Department of Gastroenterology, China-Japan Friendship Hospital, Peking University Health Science Center, Beijing, PR China
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249
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Abstract
Metformin, a biguanide is well known treatment for type 2 diabetes mellitus that has diverse mechanism of actions. Various studies have elucidated the role of this drug in different pathologies. The well-known United Kingdom Prospective Diabetic Study (UKPDS) has observed its survival benefits in a large cohort of individuals. Data has been conclusive that metformin also has beneficial role in lipid disorders as it improves the markers of metabolic syndrome. Studies have also shown the beneficial roles in antipsychotic induced weight gain as well as HIV lipodystrophy syndrome. Evidence is accumulating that metformin also improves the fertility in females with Polycystic Ovarian Syndrome (PCOS). It also delays aging and is effective in aging related disorders and is equally effective in inflammation related disorders at least in different rodent studies. Metformin's major effect has been shown in various cancers ranging from solid to hematological malignancies. Researchers are working to reveal more benefits of this magic drug but it remains an unexplored territory for the medical community.
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Affiliation(s)
- Khalid Mahmood
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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250
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Abstract
The prevalence of overweight and obesity in the United States and elsewhere has increased dramatically in recent decades. It has long been known that obese women have an increased risk of developing endometrial cancer, but recent studies suggest this association is strongest for the most common low-grade endometrioid endometrial cancers and weaker for the other histologic subtypes. There are insufficient data to assess whether obesity affects endometrial cancer-specific survival or whether the relation with all-cause mortality is similar to that seen in the general population. Recent data suggest obesity also increases risk of ovarian cancer, although it may not influence risk of the high-grade serous cancers that account for the majority of ovarian cancer deaths, and that it is also associated with poorer outcomes. There is currently insufficient evidence to draw any clear conclusions regarding the relation between obesity and risk of/survival from other gynecologic cancers although there are suggestions that obesity may increase risk of cervical cancer, particularly adenocarcinoma, and perhaps vulvar cancer. Possible mechanisms whereby obesity might influence gynecologic cancer risk and survival include: its strong association with endogenous estrogen levels among postmenopausal women, its effects on glucose metabolism, its effects on the wide range of adipocytokines and inflammatory mediators that are produced by adipose tissue and altered in concentration among obese individuals, and its potential effects on patient management, particularly with regard to chemotherapy dosing.
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Affiliation(s)
- Penelope M Webb
- From the Queensland Institute of Medical Research, Brisbane, Australia
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