Inhibition of the growth of a murine and various human tumor cell lines in culture and in mice by mixture of certain substances of the circulatory system

Active mixture of serum-circulating small molecules selectively inhibits proliferation and triggers apoptosis in cancer cells via induction of ER stress

Genetic and epigenetic regulation as well as immune surveillance are known defense mechanisms to protect organisms from developing cancer. Based on experimental evidence, we proposed that small metabolically active molecules accumulating in cancer cells may play a role in an alternative antitumor surveillance system. Previously, we reported that treatment with a mixture of experimentally selected small molecules, usually found in the serum (defined 'active mixture', AM), selectively induces apoptosis in cancer cells and significantly inhibits tumor formation in vivo. In this study, we show that the AM elicits gene expression changes characteristic of endoplasmic reticulum (ER) stress in HeLa, MCF-7, PC-3 and Caco-2 cancer cells, but not in primary human renal epithelial cells. The activation of the ER stress pathway was confirmed by the upregulation of ATF3, ATF4, CHAC1, DDIT3 and GDF15 proteins. Mechanistically, our investigation revealed that eIF2α, PERK and IRE1α are phosphorylated upon treatment with the AM, linking the induction of ER stress to the antiproliferative and proapoptotic effects of the AM previously demonstrated. Inhibition of ER stress in combination with BBC3 and PMAIP1 knockdown completely abrogated the effect of the AM. Moreover, we also demonstrated that the AM induces mIR-3189-3p, which in turn enhances the expression of ATF3 and DDIT3, thus representing a possible new feedback mechanism in the regulation of ATF3 and DDIT3 during ER stress. Our results highlight small molecules as attractive anticancer agents and warrant further evaluation of the AM in cancer therapy, either alone or in combination with other ER stress inducing agents.

Identification of Further Components of an Anticancer Defense System Composed of Small Molecules Present in the Serum

BACKGROUND

Earlier we assumed that small molecules selectively accumulated in cancer cells might have a role in a defense system capable of killing cancer cells. We reported earlier that an experimentally selected mixture of substances present in the serum ("active mixture," AM) shows a selective toxic effect in vitro and in vivo on various cancer cells. In this study we investigated additional compounds found in the serum to further expand our knowledge of this defense system.

MATERIALS AND METHODS

The cell proliferation was detected by WST-1 assay. The mRNA level of the examined genes was measured by quantitative real-time polymerase chain reaction.

RESULTS

We identified 34 additional compounds (l-amino acid metabolites, phenolic acids, d-amino acids, keto acids, etc.), which when applied in a per se nontoxic concentration are able to enhance the effect of AM. The combination of the mixture of these newly identified substances (new mixture, NM) with AM produced a significantly higher cancer cell growth inhibitory effect than NM or AM applied alone on HeLa, MCF-7, PC-3, Caco-2, HepG2, and 4T1 cancer cell lines, and more efficiently induced the expression of certain proapoptotic genes in HeLa cells. Any given combinations of the individual compounds of AM and NM always produced an increased effect compared with AM alone.

CONCLUSIONS

The newly identified compounds significantly enhance the anticancer effect of AM. The components of AM and NM together may form part of a defense system capable of killing cancer cells and are worthy of further investigation.

Safety, tolerability, and effect on quality of life of a mixture of amino acids and other small molecules in cancer patients

We performed two clinical studies to evaluate the safety, tolerability, and effect on quality of life of a product containing a mixture of amino acids, vitamins, and other small molecules. In the first one period, open-label, multiple-dose study, the safety and tolerability of a 1-week administration was evaluated in 24 healthy volunteers. In the second one period, open-label, multiple-dose, single-arm study, we investigated the safety, tolerability, and effect on quality of life of a 4-week administration in 50 cancer patients. The safety assessment included the monitoring of adverse events, changes in physical status, and clinical laboratory tests. Changes in quality of life were measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 version 3.0 (EORTC QLQ-C30). We have found that administration of the investigated product is safe and well tolerated in healthy individuals and in cancer patients. Administration of the product to cancer patients significantly improved their quality of life (EORTC QLQ-C30 global health status score: baseline: 24.17 ± 9.2; end of treatment: 47.08 ± 14.56, p<0.001). To evaluate the anticancer activity of the investigated product in humans, a randomized, blinded, combination clinical trial should be conducted.

Effects of vitamin B6 metabolism on oncogenesis, tumor progression and therapeutic responses

Pyridoxal-5'-phosphate (PLP), the bioactive form of vitamin B6, reportedly functions as a prosthetic group for >4% of classified enzymatic activities of the cell. It is therefore not surprising that alterations of vitamin B6 metabolism have been associated with multiple human diseases. As a striking example, mutations in the gene coding for antiquitin, an evolutionary old aldehyde dehydrogenase, result in pyridoxine-dependent seizures, owing to the accumulation of a metabolic intermediate that inactivates PLP. In addition, PLP is required for the catabolism of homocysteine by transsulfuration. Hence, reduced circulating levels of B6 vitamers (including PLP as well as its major precursor pyridoxine) are frequently paralleled by hyperhomocysteinemia, a condition that has been associated with an increased risk for multiple cardiovascular diseases. During the past 30 years, an intense wave of clinical investigation has attempted to dissect the putative links between vitamin B6 and cancer. Thus, high circulating levels of vitamin B6, as such or as they reflected reduced amounts of circulating homocysteine, have been associated with improved disease outcome in patients bearing a wide range of hematological and solid neoplasms. More recently, the proficiency of vitamin B6 metabolism has been shown to modulate the adaptive response of tumor cells to a plethora of physical and chemical stress conditions. Moreover, elevated levels of pyridoxal kinase (PDXK), the enzyme that converts pyridoxine and other vitamin B6 precursors into PLP, have been shown to constitute a good, therapy-independent prognostic marker in patients affected by non-small cell lung carcinoma (NSCLC). Here, we will discuss the clinical relevance of vitamin B6 metabolism as a prognostic factor in cancer patients.

A mixture of amino acids and other small molecules present in the serum suppresses the growth of murine and human tumors in vivo

Previously we have hypothesized that the small molecules which are selectively accumulated in cancer cells might participate in a non-immunological antitumor surveillance mechanism. We demonstrated earlier that a mixture of experimentally selected substances (“active mixture”, AM: l-arginine, l-histidine, l-methionine, l-phenylalanine, l-tyrosine, l-tryptophan, l-ascorbate, d-biotin, pyridoxine, riboflavin, adenine, l(-)malate) possesses a selective toxic effect in vitro on a variety of tumor cell lines, and we have shown that the AM selectively induces apoptosis of cancer cells in vitro. To explore the in vivo significance of our earlier findings we examined the antitumor effect of AM in Colon 26 murine colorectal adenocarcinoma, B16 murine melanoma, MXT murine mammary carcinoma, S180 murine sarcoma, P388 murine lymphoid leukemia, HL-60 human promyeloid leukemia, PC-3 human prostate carcinoma, and HT-29 human colon carcinoma tumor models. Treatment of tumor bearing mice with AM inhibited the growth of the tumors investigated, with an inhibitory effect ranging from 40 to 69%. The AM had a comparable antitumor effect with 5-fluorouracil and cisplatin in the Colon-26 tumor model, and combined treatment with AM and 5-fluorouracil or cisplatin resulted in an enhanced tumor growth inhibitory effect. The AM induced apoptosis through the mitochondrial pathway and induced G1 arrest in PC-3 cells and increased the number of apoptotic cells in PC-3 xenografts. These findings suggest that the AM might offer an interesting perspective in the treatment of cancer and in combination with other treatments may offer hope for a more effective cancer therapy.

Experimental evidence for killing the resistant cells and raising the efficacy and decreasing the toxicity of cytostatics and irradiation by mixtures of the agents of the passive antitumor defense system in the case of various tumor and normal cell lines in vitro

Despite the substantial decline of the immune system in AIDS, only a few kinds of tumors increase in incidence. This shows that the immune system has no absolute role in the prevention of tumors. Therefore, the fact that tumors do not develop in the majority of the population during their lifetime indicates the existence of other defense system(s). According to our hypothesis, the defense is made by certain substances of the circulatory system. Earlier, on the basis of this hypothesis, we experimentally selected 16 substances of the circulatory system and demonstrated that the mixture of them (called active mixture) had a cytotoxic effect (inducing apoptosis) in vitro and in vivo on different tumor cell lines, but not on normal cells and animals. In this paper, we provide evidence that different cytostatic drugs or irradiation in combination with the active mixture killed significantly more cancer cells, compared with either treatments alone. The active mixture decreased, to a certain extent, the toxicity of cytostatics and irradiation on normal cells, but the most important result was that the active mixture destroyed the multidrug-resistant cells. Our results provide the possibility to improve the efficacy and reduce the side-effects of chemotherapy and radiation therapy and to prevent the relapse by killing the resistant cells.

Experimental evidence for the existence of the passive antitumor defense system formed by the synergistic action of certain small substances of the circulatory system

In AIDS, only a few types of tumors (mainly Kaposi's sarcoma and non-Hodgkin's lymphoma) increase in incidence despite global abnormalities in the immune system. In addition, the reason for the higher incidence of these tumors is not immunosuppression but other agents. This shows that the immune system has no absolute role in the prevention of tumors. Consequently, the fact that tumors do not develop in the majority of the population during their lifetime, indicates the existence of other defense system(s). We demonstrated previously that a mixture of 16 substances (selected experimentally out of 89 compounds of the circulatory system using the synergistic tumor cell-killing effect as criteria) had a cytotoxic effect (inducing apoptosis) in vitro and in vivo on tumor cell lines, but not on normal cells in vitro or animals. In our hypothesis these substances (L-tryptophan, L-tyrosine, L-methionine, L(-)malate, L-ascorbate, L-arginine, L-phenylalanine, L-histidine, 2-deoxy-D-ribose, d-biotin, pyridoxine, adenine, riboflavin, D(+)-mannose, orotate, and hippurate) are the active agents of a passive antitumor defense system (PADS). On the basis of the results, a tablet and a cream were developed, and an infusion is in preclinical phase. In this study we demonstrate that the above-mentioned substances can kill tumor cells when the experimental protocols, concentrations, and cell numbers are chosen to be comparable to the physiological conditions that exist in the living system when these substances fight against arising cancer cells. The results of our experiments demonstrate that the PADS really works in the human body.

Natural products for cancer prevention: a global perspective

The control of cancer, the second leading cause of death worldwide, may benefit from the potential that resides in alternative therapies. The primary carcinogens stem from a variety of agricultural, industrial, and dietary factors. Conventional therapies cause serious side effects and, at best, merely extend the patient's lifespan by a few years. There is thus the need to utilise alternative concepts or approaches to the prevention of cancer. This review focuses on the many natural products that have been implicated in cancer prevention and that promote human health without recognisable side effects. These molecules originate from vegetables, fruits, plant extracts, and herbs.

Apoptosis of tumor cells induced by substances of the circulatory system

Despite global abnormalities of the immune system, such as in AIDS, the incidence of only a few kinds of tumor increases, and even in the development of these tumors the degree of immunosuppression seems not to be a critical factor. This means that the known immune system has no significant role in the tumor preventing mechanism. Thus, the fact that tumors do not develop in the majority of the population during their lifetime, indicates the existence of an additional defense mechanism of the immune system. We demonstrated previously that this defense is produced by the synergistic action of certain substances of the circulatory system. Here we report that the substances taking part in the defense induced, but only when they were used together, the apoptosis of tumor cells, but not normal cells, as was detected by different methods. Other substances of the circulatory system did not show similar effects. These results further support the existence of the mentioned defense mechanism called by us the Passive Antitumor Defense System.