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Joshi BC, Juyal V, Sah AN, Verma P, Mukhija M. Review On Documented Medicinal Plants Used For The Treatment Of Cancer. CURRENT TRADITIONAL MEDICINE 2021. [DOI: 10.2174/2215083807666211011125110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background:
Cancer is a frightful disease and it is the second leading cause of death worldwide. Naturally derived compounds are gaining interest of research workers as they have less toxic side effects as compared to currently used treatments such as chemotherapy. Plants are the pool of chemical compounds which provides a promising future for research on cancer.
Objective:
This review paper provides updated information gathered on medicinal plants and isolated phytoconstituents used as anticancer agents and summarises the plant extracts and their isolated chemical constituents exhibiting anticancer potential on clinical trials.
Methods:
An extensive bibliographic investigation was carried out by analysing worldwide established scientific databases like SCOPUS, PUBMED, SCIELO, ScienceDirect, Springerlink, Web of Science, Wiley, SciFinder and Google Scholar etc. In next few decades, herbal medicine may become a new epoch of medical system.
Results:
Many researches are going on medicinal plants for the treatment of cancer but it is a time to increase further experimental studies on plant extracts and their chemical constituents to find out their mechanism of action at molecular level.
Conclusion:
The article may help many researchers to start off further experimentation that might lead to the drugs for the cancer treatment.
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Affiliation(s)
- Bhuwan Chandra Joshi
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University, Bhimtal Campus, Nainital-263136, India
| | - Vijay Juyal
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University, Bhimtal Campus, Nainital-263136, India
| | - Archana N. Sah
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University, Bhimtal Campus, Nainital-263136, India
| | - Piyush Verma
- Department of Pharmacology, School of Pharmaceutical science and Technology, Sardar Bhagwan Singh University, Dehradun-248001, India
| | - Minky Mukhija
- Department of Pharmaceutical Sciences, Ch. Devi Lal College of Pharmacy, Buria Road, Bhagwangarh, Jagadhri-135003, India
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Cui HX, Luo Y, Mao YY, Yuan K, Jin SH, Zhu XT, Zhong BW. Purified anthocyanins from Zea mays L. cob ameliorates chronic liver injury in mice via modulating of oxidative stress and apoptosis. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2021; 101:4672-4680. [PMID: 33491773 DOI: 10.1002/jsfa.11112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/16/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Purple corn (Zea mays L.) is one of the main economic crops in China and has been used in the treatment of cystitis, urinary infections and obesity. However, purple corncobs, the by-product remaining after processing and having an intense purple-black color, are normally disposed of as waste or used as animal feed. Therefore, to further expand the medicinal value of purple corncob, its content was analyzed and, after purification, the effect and mechanism of purified purple corncob anthocyanins (PPCCA) on CCl4 -induced chronic liver injury in mice were investigated. RESULTS It was observed that the total anthocyanin content (TAC) from PPCCA (317.51 ± 9.30 mg cyanidin 3-O-glucoside (C-3-G) g-1 dry weight) was significantly higher than that from the purified purple corn seed anthocyanin (266.73 ± 3.67 mg C-3-G g-1 dry weight), of which C-3-G accounted for 90.6% and 90.4% of the TAC, respectively. Furthermore, compared with the CCl4 group, PPCCA treatment significantly reduced liver index, serum total bilirubin, alanine transaminase, aspartate transaminase and liver malondialdehyde levels, but increased liver superoxide dismutase activity. The pathological changes were also improved, such as more regular arrangement of hepatocytes, less swelling, and fewer vacuoles and apoptotic cells. Additionally, mechanistic studies showed that PPCCA downregulated the expression of Caspase-3, Bax and cytochrome P450 2E1 proteins in the liver and upregulated the expression of Bcl-2. CONCLUSION These results demonstrated that PPCCA could ameliorate CCl4 -induced chronic liver injury by regulating oxidative stress and hepatocyte apoptosis pathways. © 2021 Society of Chemical Industry.
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Affiliation(s)
- Hong-Xin Cui
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Disease by Henan & Education Ministry of PR China, Zhengzhou, China
| | - Yang Luo
- Jiyang College of Zhejiang Agriculture and Forestry University, Zhu'ji, China
| | - Yue-Yue Mao
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China
| | - Ke Yuan
- Jiyang College of Zhejiang Agriculture and Forestry University, Zhu'ji, China
| | - Song-Heng Jin
- Jiyang College of Zhejiang Agriculture and Forestry University, Zhu'ji, China
| | - Xiang-Tao Zhu
- Jiyang College of Zhejiang Agriculture and Forestry University, Zhu'ji, China
| | - Bing-Wei Zhong
- Jiyang College of Zhejiang Agriculture and Forestry University, Zhu'ji, China
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Menegazzi M, Masiello P, Novelli M. Anti-Tumor Activity of Hypericum perforatum L. and Hyperforin through Modulation of Inflammatory Signaling, ROS Generation and Proton Dynamics. Antioxidants (Basel) 2020; 10:antiox10010018. [PMID: 33379141 PMCID: PMC7824709 DOI: 10.3390/antiox10010018] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022] Open
Abstract
In this paper we review the mechanisms of the antitumor effects of Hypericum perforatum L. (St. John's wort, SJW) and its main active component hyperforin (HPF). SJW extract is commonly employed as antidepressant due to its ability to inhibit monoamine neurotransmitters re-uptake. Moreover, further biological properties make this vegetal extract very suitable for both prevention and treatment of several diseases, including cancer. Regular use of SJW reduces colorectal cancer risk in humans and prevents genotoxic effects of carcinogens in animal models. In established cancer, SJW and HPF can still exert therapeutic effects by their ability to downregulate inflammatory mediators and inhibit pro-survival kinases, angiogenic factors and extracellular matrix proteases, thereby counteracting tumor growth and spread. Remarkably, the mechanisms of action of SJW and HPF include their ability to decrease ROS production and restore pH imbalance in tumor cells. The SJW component HPF, due to its high lipophilicity and mild acidity, accumulates in membranes and acts as a protonophore that hinders inner mitochondrial membrane hyperpolarization, inhibiting mitochondrial ROS generation and consequently tumor cell proliferation. At the plasma membrane level, HPF prevents cytosol alkalization and extracellular acidification by allowing protons to re-enter the cells. These effects can revert or at least attenuate cancer cell phenotype, contributing to hamper proliferation, neo-angiogenesis and metastatic dissemination. Furthermore, several studies report that in tumor cells SJW and HPF, mainly at high concentrations, induce the mitochondrial apoptosis pathway, likely by collapsing the mitochondrial membrane potential. Based on these mechanisms, we highlight the SJW/HPF remarkable potentiality in cancer prevention and treatment.
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Affiliation(s)
- Marta Menegazzi
- Department of Neuroscience, Biomedicine and Movement Sciences, Biochemistry Section, School of Medicine, University of Verona, Strada Le Grazie 8, I-37134 Verona, Italy
- Correspondence: ; Tel.: +39-045-802-7168
| | - Pellegrino Masiello
- Department of Translational Research and New Technologies in Medicine and Surgery, School of Medicine, University of Pisa, Via Roma 55, I-56126 Pisa, Italy; (P.M.); (M.N.)
| | - Michela Novelli
- Department of Translational Research and New Technologies in Medicine and Surgery, School of Medicine, University of Pisa, Via Roma 55, I-56126 Pisa, Italy; (P.M.); (M.N.)
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Lee Y, Park SH, Lee JH, Ryu HW, Jang HJ, Kim WJ, Hwang E, Kim SJ, Jun HS, Ha UH. The Anti-Tumor Effects of Oenothera odorata Extract Are Mediated by Inhibition of Glycolysis and Cellular Respiration in Cancer Cells. Nutr Cancer 2020; 73:2078-2088. [PMID: 32964733 DOI: 10.1080/01635581.2020.1824000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cancer is caused by uncontrolled cell division and is a leading cause of mortality worldwide. Oenothera odorata (O. odorata) extract is used in herbal medicine to inhibit inflammation, but its potential anti-tumor properties have not been fully evaluated. Here, we demonstrated that O. odorata extract inhibits the proliferation of lung adenocarcinoma and melanoma cell lines In Vitro, and also inhibits the growth of melanoma cells In Vivo. After partitioning the extract with n-hexane, chloroform, ethyl acetate, and n-butanol, it was found that the butanol-soluble (OOB) and water-soluble (OOW) fractions of O. odorata extract are effective at inhibiting tumor cell growth In Vivo although OOW is more effective than OOB. Interestingly, these fractions did not inhibit the growth of non-cancerous cells. The anti-proliferative effects of the OOW fraction were found to be mediated by inhibition of glycolysis and cellular respiration. UPLC of both fractions showed two major common peaks, which were predicted to be hydrolyzable tannin-related compounds. Taken together, these data suggest that O. odorata extract has anti-tumor properties, and the molecular mechanism involves metabolic alterations and inhibition of cell proliferation. O. odorata extract therefore holds promise as a novel natural product for the treatment of cancer.
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Affiliation(s)
- Yeji Lee
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Sang Hyuk Park
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Jung-Hoon Lee
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Hyung Won Ryu
- Natural Medicine Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheong-ju, Republic of Korea
| | - Hyun-Jae Jang
- Natural Medicine Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheong-ju, Republic of Korea
| | - Won Jun Kim
- Natural Medicine Research Center, Korea Research Institute of Bioscience & Biotechnology, Cheong-ju, Republic of Korea
| | - Eunmi Hwang
- Division of Cosmetic and Biotechnology, Hoseo University, Asan, Republic of Korea
| | - Sung-Jo Kim
- Division of Cosmetic and Biotechnology, Hoseo University, Asan, Republic of Korea
| | - Hyun Sik Jun
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Un-Hwan Ha
- Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea
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Kim DY, Won KJ, Hwang DI, Kim HB, Li Y, Lee HM. Migration- and Proliferation-Promoting Activities in Human Keratinocytes of Zea mays Flower Absolute and Its Chemical Composition. Chem Biodivers 2020; 17:e2000227. [PMID: 32383528 DOI: 10.1002/cbdv.202000227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022]
Abstract
Zea mays L. (ZM) has cytotoxic and anti-inflammatory activities, but its biological activities such as skin regeneration and wound healing in human skin have not been reported. In the present study, we tested the effects of ZM flower (ZMF) absolute on proliferation and migration of human keratinocytes (HaCaTs) and identified its components by using gas chromatography/mass spectrometry (GC/MS) analysis. GC/MS analysis revealed that the ZMF absolute contained 13 constituents, and it increased HaCaT proliferation and migration. The ZMF absolute enhanced the phosphorylation levels of serine/threonine-specific protein kinase (Akt), p38 mitogen-activated protein kinase (MAPK), and extracellular signal-regulated kinase1/2 in HaCaTs. In addition, the absolute induced an increase in sprout outgrowth of HaCaTs. The present study reports for the first time that ZMF absolute may promote skin wound healing and/or skin regeneration by stimulating proliferative and migratory activities in dermal keratinocytes through the Akt/MAPK pathway. Therefore, ZMF absolute may be a promising natural material for the use in skin regeneration and/or wound healing applications.
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Affiliation(s)
- Do Yoon Kim
- College of Chemistry and Chemical Engineering, Hunan Institute of Science and Technology, Yueyang, 414006, P. R. China.,Division of Cosmetic and Biotechnology, College of Life and Health Sciences, Hoseo University, Asan, 31499, South Korea
| | - Kyung Jong Won
- Department of Physiology and Medical Science, School of Medicine, Konkuk University, Chungju, 27478, South Korea
| | - Dae Il Hwang
- Division of Cosmetic and Biotechnology, College of Life and Health Sciences, Hoseo University, Asan, 31499, South Korea.,Institute of Jinan Red Ginseng, Jinan, 55442, South Korea
| | - Ha Bin Kim
- Division of Cosmetic and Biotechnology, College of Life and Health Sciences, Hoseo University, Asan, 31499, South Korea.,National Institute of Forest Science, Seoul, 02455, South Korea
| | - Yali Li
- Division of Cosmetic and Biotechnology, College of Life and Health Sciences, Hoseo University, Asan, 31499, South Korea
| | - Hwan Myung Lee
- Division of Cosmetic and Biotechnology, College of Life and Health Sciences, Hoseo University, Asan, 31499, South Korea
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Oddone N, Boury F, Garcion E, Grabrucker AM, Martinez MC, Da Ros F, Janaszewska A, Forni F, Vandelli MA, Tosi G, Ruozi B, Duskey JT. Synthesis, Characterization, and In Vitro Studies of an Reactive Oxygen Species (ROS)-Responsive Methoxy Polyethylene Glycol-Thioketal-Melphalan Prodrug for Glioblastoma Treatment. Front Pharmacol 2020; 11:574. [PMID: 32425795 PMCID: PMC7212708 DOI: 10.3389/fphar.2020.00574] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/15/2020] [Indexed: 12/11/2022] Open
Abstract
Glioblastoma (GBM) is the most frequent and aggressive primary tumor of the brain and averages a life expectancy in diagnosed patients of only 15 months. Hence, more effective therapies against this malignancy are urgently needed. Several diseases, including cancer, are featured by high levels of reactive oxygen species (ROS), which are possible GBM hallmarks to target or benefit from. Therefore, the covalent linkage of drugs to ROS-responsive molecules can be exploited aiming for a selective drug release within relevant pathological environments. In this work, we designed a new ROS-responsive prodrug by using Melphalan (MPH) covalently coupled with methoxy polyethylene glycol (mPEG) through a ROS-cleavable group thioketal (TK), demonstrating the capacity to self-assembly into nanosized micelles. Full chemical-physical characterization was conducted on the polymeric-prodrug and proper controls, along with in vitro cytotoxicity assayed on different GBM cell lines and “healthy” astrocyte cells confirming the absence of any cytotoxicity of the prodrug on healthy cells (i.e. astrocytes). These results were compared with the non-ROS responsive counterpart, underlining the anti-tumoral activity of ROS-responsive compared to the non-ROS-responsive prodrug on GBM cells expressing high levels of ROS. On the other hand, the combination treatment with this ROS-responsive prodrug and X-ray irradiation on human GBM cells resulted in an increase of the antitumoral effect, and this might be connected to radiotherapy. Hence, these results represent a starting point for a rationale design of innovative and tailored ROS-responsive prodrugs to be used in GBM therapy and in combination with radiotherapy.
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Affiliation(s)
- Natalia Oddone
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Frank Boury
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Emmanuel Garcion
- CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - Andreas M Grabrucker
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.,Bernal Institute, University of Limerick, Limerick, Ireland.,Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | | | - Federica Da Ros
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Janaszewska
- Department of General Biophysics, Faculty of Biology and Environmental Protection, Lodz, Poland
| | - Flavio Forni
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Angela Vandelli
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Tosi
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Barbara Ruozi
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jason T Duskey
- Nanotech Lab TeFarTI Group, Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Umberto Veronesi Foundation, Milano, Italy
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Corn Silk ( Zea mays L.) Induced Apoptosis in Human Breast Cancer (MCF-7) Cells via the ROS-Mediated Mitochondrial Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9789241. [PMID: 31781357 PMCID: PMC6855084 DOI: 10.1155/2019/9789241] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 06/27/2019] [Indexed: 01/05/2023]
Abstract
Cancer has been recognized as one of the life-threating diseases. Breast cancer is a leading cause of mortality among women. In spite of current developments in the therapy and diagnosis of cancer, the survival rate is still less. Recently, plant-derived natural products gain attention as anticancer agents due to the nontoxic nature. Therefore, the aim of present study was to investigate the anticancer capacity of corn silk extract (CSE) on human breast cancer (MCF-7) and normal human mesenchymal (hMSC-TERT4) cells. Following 24 h treatment to corn silk extract, the cytotoxicity was assessed by MTT, NRU, and morphological assays. The oxidative stress markers (GSH and LPO), ROS production, MMP change, and expression of apoptotic marker genes (p53, Bax, Bcl-2, caspase-3, and caspase-9) were also studied in MCF-7 cells treated at 250 to 1000 μg/ml of CSE for 24 h. Our results showed that CSE decreased the cell viability and increased the apoptosis in a dose-dependent manner. The level of LPO and ROS production was found significantly higher; however, GSH and MMP level was observed lower in CSE-treated MCF-7 cells. The real-time PCR data showed a significant upregulation in p53, Bax, caspase-3, and caspase-9 and downregulation in the mRNA expression of Bcl-2 genes in MCF-7 cells exposed to CSE. Collectively, the data from this study stated that corn silk extract induced apoptosis via the ROS-mediated mitochondrial pathway in MCF-7 cells.
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Oddone N, Pederzoli F, Duskey JT, De Benedictis CA, Grabrucker AM, Forni F, Angela Vandelli M, Ruozi B, Tosi G. ROS-responsive “smart” polymeric conjugate: Synthesis, characterization and proof-of-concept study. Int J Pharm 2019; 570:118655. [DOI: 10.1016/j.ijpharm.2019.118655] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 02/08/2023]
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Hwang E, Kim GW, Song KD, Lee HK, Kim SJ. The enhancing effect of Acanthopanax sessiliflorus fruit extract on the antibacterial activity of porcine alveolar 3D4/31 macrophages via NF-κB1 and lipid metabolism regulation. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2019; 32:1776-1788. [PMID: 31010992 PMCID: PMC6817778 DOI: 10.5713/ajas.18.0874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/21/2019] [Indexed: 12/15/2022]
Abstract
Objective The demands for measures to improve disease resistance and productivity of livestock are increasing, as most countries prohibit the addition of antibiotics to feed. This study therefore aimed to uncover functional feed additives to help enhance livestock immunity and disease resistance, using Acanthopanax sessiliflorus fruit extract (ASF). Methods ASF was extracted with 70% EtOH, and total polyphenolic and catechin contents were measured by the Folin-Ciocalteu and vanillin assay, respectively. The 3D4/31 porcine macrophage cells (MΦ) were activated by phorbol 12-myristate 13-acetate (PMA), and cell survival and growth rate were measured with or without ASF treatment. Flow-cytometric analysis determined the lysosomal activity, reactive oxygen species levels (ROS), and cell cycle distribution. Nuclear factor kappa B (NF-κB) and superoxide dismutase (SOD) protein expression levels were quantified by western blotting and densitometry analysis. Quantitative polymerase chain reaction was applied to measure the lipid metabolism-related genes expression level. Lastly, the antibacterial activity of 3D4/31 MΦ cells was evaluated by the colony forming unit assay. Results ASF upregulated the cell viability and growth rate of 3D4/31 MΦ, with or without PMA activation. Moreover, lysosomal activity and intracellular ROS levels were increased after ASF exposure. In addition, the antioxidant enzyme SOD2 expression levels were proportionately increased with ROS levels. Both ASF and PMA treatment resulted in upregulation of NF-κB protein, tumor necrosis factor (TNF)α mRNA expression levels, lipid synthesis, and fatty acid oxidation metabolism. Interestingly, co-treatment of ASF with PMA resulted in recovery of NF-κB, TNFα, and lipid metabolism levels. Finally, ASF pretreatment enhanced the in vitro bactericidal activity of 3D4/31 MΦ against Escherichia coli. Conclusion This study provides a novel insight into the regulation of NF-κB activity and lipid metabolism in MΦ, and we anticipate that ASF has the potential to be effective as a feed additive to enhance livestock immunity.
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Affiliation(s)
- Eunmi Hwang
- Division of Cosmetics and Biotechnology, College of Life and Health Sciences, Hoseo University, Baebang, Asan 31499, Korea
| | - Gye Won Kim
- Brewing Research Center, Academic Industry Cooperation, Hankyong National University, Anseong 17579, Korea
| | - Ki Duk Song
- Department of Animal Biotechnology, Chonbuk National University, Jeonju 54896, Korea
| | - Hak-Kyo Lee
- Department of Animal Biotechnology, Chonbuk National University, Jeonju 54896, Korea
| | - Sung-Jo Kim
- Division of Cosmetics and Biotechnology, College of Life and Health Sciences, Hoseo University, Baebang, Asan 31499, Korea
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