The avermectins are known to possess pronounced antitumor activity
Over the past few years, there have been steadily increasing reports that ivermectin may have varying uses as an anti-cancer agent, as it has been shown to exhibit both anti-cancer and anti-cancer stem cell properties
In human ovarian cancer and NF2 tumor cell lines, high-dose ivermectin inactivates protein kinase PAK1 and blocks PAK1-dependent growth
PAK1 is essential for the growth of more than 70% of all human cancers, including breast, prostate, pancreatic, colon, gastric, lung, cervical and thyroid cancers, as well as hepatoma, glioma, melanoma, multiple myeloma and for neurofibromatosis tumors
Ivermectin suppresses breast cancer by activating cytostatic autophagy, disrupting cellular signaling in the process, probably by reducing PAK1 expression
Cancer stem cells are a key factor in cancer cells developing resistance to chemotherapies and these results indicate that a combination of chemotherapy agents plus ivermectin could potentially target and kill cancer stem cells, a paramount goal in overcoming cancer
Triple-negative breast cancers, which lack estrogen, progesterone and HER2 receptors, account for 10–20% of breast cancers and are associated with poor prognosis
Ivermectin addition led to transcriptional modulation of genes associated with epithelial–mesenchymal transition and maintenance of a cancer stem cell phenotype in triple-negative breast cancers cells, resulting in impairment of clonogenic self-renewal in vitro and inhibition of tumor growth and metastasis in vivo
Ivermectin-induced cytostatic autophagy also leads to suppression of tumor growth in breast cancer xenografts, causing researchers to believe there is scope for using ivermectin to inhibit breast cancer cell proliferation and that the drug is a potential treatment for breast cancer
ivermectin synergizes with the chemotherapy agents cytarabine and daunorubicin to induce cell death in leukemia cells
Ivermectin inhibits proliferation and increases apoptosis of various human cancers
Activation of WNT-TCF signaling is implicated in multiple diseases, including cancers of the lungs and intestine,
A new screening system has found that ivermectin inhibits the expression of WNT-TCF targets
It represses the levels of C-terminal β-catenin phosphoforms and of cyclin D1 in an okadaic acid-sensitive manner, indicating its action involves protein phosphatases
In vivo, ivermectin selectively inhibits TCF-dependent, but not TCF-independent, xenograft growth without side effects
ivermectin has an exemplary safety record, it could swiftly become a useful tool as a WNT-TCF pathway response blocker to treat WNT-TCF-dependent diseases, encompassing multiple cancers.117
the mortality rate of EOC has not been significantly changed for several decades
Sequencing revealed that almost all tumors (96%) had mutations in TP53, which serves as a major driver of this cancer
Low-prevalence but statistically significant mutations in nine other genes including NF1, BRCA1, BRCA2, RB1, and CDK12 were also identified, but the majority of genes were mutated at low frequency, making it difficult to distinguish between driver and passenger mutations
KPNB1 inhibition via any of three KPNB1 siRNAs or importazole treatment induced apoptosis in human EOC cell lines (Fig. 3 A–F and Fig. S4), and was accompanied by an increase in the expression levels of the proapoptotic proteins BAX and cleaved caspase-3
Stable overexpression of KPNB1 in SKOV3 and OVCAR3 (Fig. S6) significantly accelerated cell proliferation/survival (Fig. 5 A–C), confirming that KPNB1 functions as an oncogene in EOC
KPNB1 overexpression significantly decreased caspase-3/7 activity (Fig. 5D), in addition to the expression levels of cleaved caspase-3 and BAX proteins (Fig. 5E). KPNB1 overexpression also decreased p21 and p27 protein levels (Fig. 5E), as opposed to their increase by KPNB1 inhibition
KPNB1 functions as an antiapoptotic and proproliferative oncogene in EOC.
Patients with higher expression levels of KPNB1 showed earlier recurrence and worse prognosis than those with lower expression levels of KPNB1
KPNB1 acts as an oncogene in human EOC and represents a promising therapeutic target.
ivermectin treatment suppressed cell proliferation/viability in a dose-dependent manner (Fig. 7A), indicating that it exerts an antitumor effect on EOC
ivermectin also induced apoptosis
ivermectin increased the expression levels of BAX, and cleaved PARP, as well as p21 and p27
KPNB1 inhibition is responsible for the antitumor effect of ivermectin
we found that ivermectin synergistically reduced cell proliferation/viability in combination with paclitaxel in human EOC cells
Single treatment of ivermectin or paclitaxel reduced tumor growth in nude mice, but, notably, combination treatment of ivermectin and paclitaxel almost completely suppressed tumor growth
ERBB2, is amplified and overexpressed in many cancers, including breast (31), ovary (31), colon (32), bladder (33), non-small-cell lung (34), and gastric cancer (35), and is a poor prognostic factor in certain cancer types
KPNB1 was the second-highest-ranked gene identified in our screen
Increased KPNB1 protein levels have been reported in several cancers, including cervical cancer (42), hepatocellular carcinoma (43), and glioma (44), suggesting KPNB1’s oncogenic potential in these tumor types
our findings suggest that KPNB1 might serve as a master regulator of cell cycle by regulating several cell cycle-related proteins, including p21, p27, and APC/C family members
higher and/or more-frequent doses of ivermectin than currently approved for humans are well tolerated in humans
none of the mice in this study treated with the effective dosage of ivermectin for in vivo anticancer therapy showed severe adverse event
we found that the combination of ivermectin and paclitaxel produces a stronger antitumor effect on EOC cell lines than either drug alone
Ivermectin found to be pro-apoptotic for the epithelial ovarian cancer oncogene, KPNB1 in in Vivo study. This effective anti-parasitic drug inhibits the KPNB1 oncogene.
The switch may also involve down-regulation of endogenous inhibitors of angiogenesis such as endostatin, angiostatin or thrombospondin (reviewed in [5]) and has thus been regarded as the result of tipping the net balance between positive and negative regulators
There is a complex interrelationship between tumor hypoxia and tumor angiogenesis
Environmental stress as a result of low oxygen and proper nutrient deprivation, such as glucose deprivation, are capable of inducing VEGF mRNA stabilization resulting in increased levels of the secreted ligand and angiogenic growth
HIFalpha subunits accumulate in the cytoplasm where they bind HIFbeta to form a heterodimer that subsequently translocates to the nucleus to activate transcription of target genes, including genes important for various processes such as metabolism (glucose transporter (GLUT)-1, hexokinase (HK)-1), cell growth (cyclin (CCN)-D1 [23]) and also angiogenesis, such as erythropoietin, VEGF and PDGF [24] (summarized in Fig. 1)
When oxygen levels are low (hypoxia; red arrow) PHDs cannot hydroxylate HIFalphas thereby allowing them to escape pVHL-mediated degradation. HIFalpha subunits accumulate and bind to their heterodimeric partner, HIFbeta, translocate into the nucleus and activate a cascade of hypoxic signaling first by the transcription of various target genes including microRNAs that are important for tumor promoting pathways
c-Src is also capable of activating HIFs by indirectly inhibiting PHD activity via the NADPH oxidase/Rac pathway.
mTOR can also promote stabilization and HIF transcriptional activity
hypoxia inducible factors (HIFs), heterodimeric transcription factors composed from alpha and beta subunits, which can be rapidly stabilized to fluidly adapt to and overcome the effects of a hypoxic environment
Curcumin inhibits the expression of epidermal growth factor receptor (EGFR), VEGFR-1, VEGFR-2 and VEGFR-3, and the kinase activity of Src and FAK, which are responsible for the induction of angiogenic genes as well as endothelial cell polarity and migration
Curcumin also reduces the MMP-2 and MMP-9 expression, along with the suppression of growth and invasion potential of tumor cells in culture and xenograft experiments
The expression of angiogenic biomarkers COX-2 and serum levels of VEGF were significantly reduced in the curcumin-treated group
Resveratrol inhibits capillary endothelial cell growth and new blood vessel growth in animals
[155] and impeding angiogenesis by suppressing VEGF expression through down-regulation of HIF-1alpha
resveratrol was reported to inhibit cell proliferation of human ovarian cancer cells and human osteosarcoma cells by attenuating HIF-1alpha
prevents cytokine-induced vascular leakage and tumor metastasis
The underlying molecular mechanisms include: blocking VEGF- and FGF-receptor-mediated MAPK activation, inhibiting Akt- and MAPK-driven HIF-1alpha basal expression and its induction by IGF-1, stimulating the proteasomal degradation of HIF-1alpha, inhibiting phosphatidyl inositol (PI)-3K/Akt and Ras/mitogen/extracellular signal-regulated kinase (MEK)/ERK pathways, and activation of forkhead box (FOX)O transcription factors
Resveratrol inhibits ER-alpha in human breast cancer cells providing potential mechanism to inhibit pro growth/pro inflammatory signaling favoring breast cancer. So maybe, a glass of red wine keeps the breast cancer doctor away??
Saw Palmetto inhibits 5alpha reductase activity. This study looked at the inhibition of Saw Palmetto of 5alpha reductase activity in prostate cancer. Saw Palmetto is also known as Serenoa repens.
aromatase inhibition with anastrozole, in this study, resulted in impaired flow mediated dilation. No resultant change in inflammatory markers were seen. Again, my problem with this study is the use of serum for the hormone evaluation. I would bet not enough aromatase inhibition was provided.
cordyceps shown to decrease LPS stimulated macrophage inflammation. Specifically, IL-1Beta, IL-6, TNF-alpha were shown to be inhibited. Also, NF-kappaB inhibition was found with cordyceps
The process of androgen deprivation therapy needs to be re-evaluated. Why? First, the CVD side effects associated with the androgen depletion. Second, the depletion of 3 beta androstanediol that has been shown to bind to ER beta and inhibit growth. As in this study that finds that ER beta activity slows prostate cancer through destabilizing of HIF-1 alpha and by inhibiting VEGF.
Around 50% of ageing, obese men presenting to the diabetes clinic have lowered testosterone levels relative to reference ranges
based on healthy young men
The absence of high-level evidence in this
area is illustrated by the Endocrine Society testosterone therapy in men with androgen deficiency clinical practice guidelines
(Bhasin et al. 2010), which are appropriate for, but not specific to men with metabolic disorders. All 32 recommendations made in these guidelines
are based on either very low or low quality evidence.
A key concept relates to making a distinction between replacement and pharmacological testosterone therapy
The presence of symptoms was more closely linked to increasing age than to testosterone levels
Findings similar to type 2 diabetes were reported for men with the metabolic syndrome, which were associated with reductions
in total testosterone of −2.2 nmol/l (95% CI −2.41 to 1.94) and in free testosterone
low testosterone is more predictive of the metabolic syndrome in lean men
Cross-sectional studies uniformly show that 30–50% of men with
type 2 diabetes have lowered circulating testosterone levels, relative to references based on healthy young men
In a recent cross-sectional study of 240 middle-aged men (mean age 54 years) with either type 2 diabetes, type 1 diabetes
or without diabetes (Ng Tang Fui et al. 2013b), increasing BMI and age were dominant drivers of low total and free testosterone respectively.
both diabetes and the metabolic syndrome are associated with a modest reduction in testosterone, in magnitude comparable
with the effect of 10 years of ageing
In a cross-sectional study of 490 men with type 2 diabetes, there was a strong independent association of low testosterone
with anaemia
In men, low testosterone is a marker of poor health, and may improve our ability to predict risk
probably the most important point made in this article
low testosterone identifies men with an adverse metabolic phenotype
Diabetic men with low testosterone are significantly more likely to be obese or insulin resistant
increased inflammation, evidenced by higher CRP levels
Bioavailable
but not free testosterone was independently predictive of mortality
It remains possible that low testosterone is a consequence of insulin resistance, or simply a biomarker,
co-existing because of in-common risk factors.
In prospective studies, reviewed in detail elsewhere (Grossmann et al. 2010) the inverse association of low testosterone with metabolic syndrome or diabetes is less consistent for free testosterone
compared with total testosterone
In a study from the Framingham cohort, SHBG but not testosterone was prospectively and independently associated with incident
metabolic syndrome
low SHBG (Ding et al. 2009) but not testosterone (Haring et al. 2013) with an increased risk of future diabetes
In cross-sectional studies of men with (Grossmann et al. 2008) and without (Bonnet et al. 2013) diabetes, SHBG but not testosterone was inversely associated with worse glycaemic control
SHBG may have biological actions
beyond serving as a carrier protein for and regulator of circulating sex steroids
In men with diabetes, free testosterone, if measured by gold standard equilibrium dialysis (Dhindsa et al. 2004), is reduced
expensive, laborious process filled with variables
Low free testosterone remains inversely associated with insulin resistance, independent of SHBG (Grossmann et al. 2008). This suggests that the low testosterone–dysglycaemia association is not solely a consequence of low SHBG.
Experimental evidence reviewed below suggests that visceral adipose tissue is an important intermediate (rather than a
confounder) in the inverse association of testosterone with insulin resistance and metabolic disorders.
testosterone promotes the commitment of
pluripotent stem cells into the myogenic lineage and inhibits their differentiation into adipocytes
testosterone regulates the metabolic functions
of mature adipocytes (Xu et al. 1991, Marin et al. 1995) and myocytes (Pitteloud et al. 2005) in ways that reduce insulin resistance.
Pre-clinical evidence (reviewed in Rao et al. (2013)) suggests that at the cellular level, testosterone may improve glucose metabolism by modulating the expression of the glucose-transported
Glut4 and the insulin receptor, as well as by regulating key enzymes involved in glycolysis.
More recently testosterone has
been shown to protect murine pancreatic β cells against glucotoxicity-induced apoptosis
Interestingly, a reciprocal feedback also appears to exist, given that not only chronic (Cameron et al. 1990, Allan 2013) but also, as shown more recently (Iranmanesh et al. 2012, Caronia et al. 2013), acute hyperglycaemia can lower testosterone levels.
There is
also evidence that testosterone regulates insulin sensitivity directly and acutely
In men with prostate cancer commencing androgen deprivation therapy, both total as well as, although not in all studies (Smith 2004), visceral fat mass increases (Hamilton et al. 2011) within 3 months
More prolonged (>12 months) androgen deprivation therapy has been associated with increased risk of diabetes in several
large observational registry studies
Testosterone has also been shown to reduce the concentration of pro-inflammatory cytokines in some, but not all studies, reviewed
recently in Kelly & Jones (2013). It is not know whether this effect is independent of testosterone-induced changes in body composition.
the observations discussed in this section suggest that it is the decrease in testosterone that causes insulin
resistance and diabetes. One important caveat remains: the strongest evidence that low testosterone is the cause rather than
consequence of insulin resistance comes from men with prostate cancer (Grossmann & Zajac 2011a) or biochemical castration, and from mice lacking the androgen receptor.
Several large prospective studies have shown that weight gain or development of type 2 diabetes is major drivers of the
age-related decline in testosterone levels
there is increasing evidence that healthy ageing by itself is generally not associated with marked reductions in
testosterone
Circulating testosterone, on an average 30%, is lower in obese compared with lean men
increased visceral fat is an important component in the association of low testosterone and insulin resistance
The vast majority of men with metabolic disorders have functional gonadal axis suppression with modest reductions in testosterone
levels
obesity is a dominant
risk factor
men with Klinefelter syndrome have an increased risk of metabolic disorders. Interestingly, greater body fat
mass is already present before puberty
Only 5% of men with type 2 diabetes have elevated LH levels
inhibition of the gonadal axis predominantly takes place in the hypothalamus,
especially with more severe obesity
Metabolic factors, such as leptin, insulin (via deficiency or resistance) and ghrelin
are believed to act at the ventromedial and arcuate nuclei of the hypothalamus to inhibit gonadotropin-releasing hormone (GNRH)
secretion from GNRH neurons situated in the preoptic area
kisspeptin has emerged as one of the
most potent secretagogues of GNRH release
hypothesis that obesity-mediated inhibition of kisspeptin signalling contributes to the suppression
of the HPT axis, infusion of a bioactive kisspeptin fragment has been recently shown to robustly increase LH pulsatility,
LH levels and circulating testosterone in hypotestosteronaemic men with type 2 diabetes
A smaller study with a similar experimental design found that acute testosterone withdrawal reduced insulin sensitivity
independent of body weight, whereas oestradiol withdrawal had no effects
suppression of the diabesity-associated HPT axis is functional, and may hence be
reversible
Obesity and dysglycaemia and associated comorbidities such as obstructive sleep apnoea (Hoyos et al. 2012b) are important contributors to the suppression of the HPT axis
weight gain and development
of diabetes accelerate the age-related decline in testosterone
Modifiable risk factors such as obesity and co-morbidities are more strongly associated with a decline in circulating testosterone
levels than age alone
55% of symptomatic androgen deficiency reverted to a normal testosterone or an asymptomatic state after 8-year follow-up,
suggesting that androgen deficiency is not a stable state
Weight loss can reactivate the hypothalamic–pituitary–testicular axis
Leptin treatment resolves hypogonadism in leptin-deficient men
The hypothalamic–pituitary–testicular axis remains responsive to treatment with aromatase inhibitors or selective oestrogen
receptor modulators in obese men
Kisspeptin treatment increases LH secretion, pulse frequency and circulating testosterone levels in hypotestosteronaemic men
with type 2 diabetes
change in BMI was associated with the change in testosterone (Corona et al. 2013a,b).
weight loss can lead to genuine reactivation
of the gonadal axis by reversal of obesity-associated hypothalamic suppression
There is pre-clinical and observational evidence that chronic hyperglycaemia can inhibit the HPT axis
in men who improved their glycaemic control over time, testosterone levels increased. By
contrast, in those men in whom glycaemic control worsened, testosterone decreased
testosterone levels should be measured after successful weight loss to identify men with an insufficient rise
in their testosterone levels. Such men may have HPT axis pathology unrelated to their obesity, which will require appropriate
evaluation and management.
Estradiol inhibits glutamate mediated influx of calcium and thus cell death in cell line. Glutamate, the principle excitatory neurotransmitter, is involved in neurodegeneration through activation of calcium channels. This study of cell line cultures found that Estradiol inhibits this process. I question whether this is applicable to both men and women. Time will tell.
one can conclude that ERβ has an overall antiproliferative effect, thereby inhibiting cancer cell
proliferation and antagonizing ERα function in the breast
HRT with estrogen alone did not increase the risk of breast cancer in the
Women's Health Initiative clinical trials program
colorectal normal or cancer epithelium does not coexpress ERα and ERβ
ERβ expression resulted in the inhibition of proliferation and G1 phase cell-cycle arrest
ERβ
expression strongly inhibited cMyc and tumor growth in a xenograft mouse model
induced ERβ in CRC
cells has an antiproliferative, tumor-suppressive function that is independent of ERα
ERs also have the ability to bind many other compounds with an estrogen-like structure, including phytoestrogens
and xenoestrogens (or endocrine disruptors)
Phytoestrogens are a diverse class of natural compounds with structural similarity to estradiol
Barone et al. recently found that two ERβ-selective
phytoestrogens effectively counteracted CRC tumorigenesis and surprisingly increased ERβ expression in mice with mutations
of the tumor-suppressor gene adenomatous polyposis coli
We can conclude that estrogens are important in protecting against CRC initiation and progression, and that the protective
effect most likely is mediated by ERβ
Inhibition of NO production will result in increased COX and thus vasoconstriction in rate model. Hg has been shown to both inhibit NO synthase and increase COX.
high leptin levels found to inhibit pituitary LH/FSH release. Of note, high leptin levels inhibited leydig cell production of Testosterone following hCG stimulation. This is a rat in vitro study.
Over 50% of the flavonoids significantly inhibited aromatase activity, with greatest activity being demonstrated with apigenin (IC50: 0.9 microg/mL), chrysin (IC50: 1.1 microg/mL), and hesperetin (IC50: 1.0 microg/mL)
These data suggest that curcumin and resveratrol may provide a novel and safe approach to reduce or inhibit
the chronic inflammatory properties of adipose tissue.