Abstract
Objective: Triptolide (TL), a natural product isolated from Tripterygium wilfordii Hook F (TwHF), shows potent anticancer effects in vitro and in vivo. We aimed to summary the biochemical mechanisms through which TL has been shown to induce apoptosis, autophagy and inhibit angiogenesis in pancreatic cancer (PC).Methods: We undertook a systematic review of preclinical evidence. We searched electronic databases. The potential mechanisms and the underlying signaling pathways have been accumulated as well.Results: We screened 116 abstracts for eligibility and included 17 preclinical studies in the analysis. Details of the animals and cell lines were provided in 16 studies (94.1%). Six studies (75.0%) randomly assigned animals to treatment or control groups and only 1 study (12.5%) reported on blinding. The majority of the TL's research field has focused on its pro-apoptotic effects through downregulation of inhibitory pathways and upregulation of apoptotic pathways. The studies have shown that TL is effective both in vitro and in vivo against PC cells.Conclusion: This study provides a systematic summary of TL's anti-pancreatic cancer profile and the underlying mechanisms of with special emphasis on the apoptosis, autophagy, angiogenesis and related molecular pathways. Improved study quality in terms of treatment allocation methods reporting, randomization and blinding will accelerate needed progress toward trials.
Highlights
Pancreatic cancer (PC) is a highly lethal malignancy with few effective treatments (Manuel, 2010)
Like any chemotherapy, chemoresistance is the major impediment for treating PC (Rivera et al, 2009)
Eight studies (47.1%) with had both in vitro and in vivo assessments (Table 1) provided explicit information in the methods section concerning the number of animals allocated to each treatment group, and they accounted for all animals in their results
Summary
Pancreatic cancer (PC) is a highly lethal malignancy with few effective treatments (Manuel, 2010). 10–20% of patients receive a diagnosis at a stage that is amenable to surgical resection and possible cure (Michalski et al, 2007). Gemcitabine, which works as a nucleoside analog for deoxycytidine triphosphate, is used as a first line treatment for PC (Di et al, 2010). Like any chemotherapy, chemoresistance is the major impediment for treating PC (Rivera et al, 2009). Many potential treatments are being tested in the preclinical stage. A natural product called triptolide (TL), has shown promise as an anticancer
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