Abstract
Angiogenesis, the process of formation and recruitment of new blood vessels from pre-existing vessels, plays an important role in the development of cancer. Therefore, the use of antiangiogenic agents is one of the most critical strategies for the treatment of cancer. In addition, the complexity of cancer pathogenicity raises the need for multi-targeting agents. Coumarins are multi-targeting natural agents belonging to the class of benzopyrones. Coumarins have several biological and pharmacological effects, including antimicrobial, antioxidant, anti-inflammation, anticoagulant, anxiolytic, analgesic, and anticancer properties. Several reports have shown that the anticancer effect of coumarins and their derivatives are mediated through targeting angiogenesis by modulating the functions of vascular endothelial growth factor as well as vascular endothelial growth factor receptor 2, which are involved in cancer pathogenesis. In the present review, we focus on the antiangiogenic effects of coumarins and related structure-activity relationships with particular emphasis on cancer.
Highlights
Angiogenesis, the growth of blood vessels from the existing vasculature, has been shown to play a critical role in the development of various diseases, including rheumatoid arthritis, diabetic retinopathy, asthma, endometriosis, psoriasis, obesity, and cancer [1,2,3].Inflammation, tissue ischemia, and hypoxia which cause the release of the angiogenesis factors, such as vascular endothelial growth factor (VEGF), cytokines, cell adhesion molecules, and nitric oxide (NO), are among the most important triggers of angiogenesis [4]
Investigating novel drugs to attenuate or prevent angiogenesis-associated complications in cancer is of great importance
The several clinical limitations and side effects related to the administration of current antiangiogenic agents for cancer treatment raise the need to find alternative treatments
Summary
Angiogenesis ( known as neovascularization), the growth of blood vessels from the existing vasculature, has been shown to play a critical role in the development of various diseases, including rheumatoid arthritis, diabetic retinopathy, asthma, endometriosis, psoriasis, obesity, and cancer [1,2,3]. Cancer remains a clinical challenge, despite advancements in its treatment This raises the need to investigate novel multi-target agents to attenuate multiple signaling pathways involved in tumor progression. Growing evidence has introduced coumarins as potential multi-targeting agents with various pharmacological effects and medicinal uses [15] Coumarins, with their 2H-1-benzopyran-2-one structure, are natural compounds that exist in various plant families, including Apiaceae, Asteraceae, Fabaceae, Rutaceae, Moraceae, Oleaceae, and Thymelaeaceae [16]. Due to the antioxidant [17], anti-inflammatory [18], anxiolytic [19], analgesic [20], neuroprotective [21], cardioprotective [22], antidiabetic [23], and anticancer [24] activities of coumarins [25], researchers have studied the synthesis of various coumarin derivatives, in addition to their purification from natural sources [26] Both synthetic and natural coumarins have shown noticeable anticancer effects in vitro and in vivo through various mechanisms [27], including the inhibition of angiogenesis [28,29]. We focus on the cellular signaling pathways of angiogenesis and recent pharmacological antiangiogenic agents, emphasizing natural and synthetic coumarins with antiangiogenic effects as well as their pharmacological mechanisms and structure-activity relationship in cancer
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