Abstract

Carcinogenesis is a multistep process triggered by genetic alterations that activate different signal transduction pathways and cause the progressive transformation of a normal cell into a cancer cell. Polyphenols, compounds ubiquitously expressed in plants, have anti-inflammatory, antimicrobial, antiviral, anticancer, and immunomodulatory properties, all of which are beneficial to human health. Due to their ability to modulate the activity of multiple targets involved in carcinogenesis through direct interaction or modulation of gene expression, polyphenols can be employed to inhibit the growth of cancer cells. However, the main problem related to the use of polyphenols as anticancer agents is their poor bioavailability, which might hinder the in vivo effects of the single compound. In fact, polyphenols have a poor absorption and biodistribution, but also a fast metabolism and excretion in the human body. The poor bioavailability of a polyphenol will affect the effective dose delivered to cancer cells. One way to counteract this drawback could be combination treatment with different polyphenols or with polyphenols and other anti-cancer drugs, which can lead to more effective antitumor effects than treatment using only one of the compounds. This report reviews current knowledge on the anticancer effects of combinations of polyphenols or polyphenols and anticancer drugs, with a focus on their ability to modulate multiple signaling transduction pathways involved in cancer.

Highlights

  • Polyphenols, a large group of compounds ubiquitously expressed in plants, are secondary metabolites that play various roles in host defense against pathogens, ultraviolet radiation, and signal transduction [1]

  • Polyphenols, compounds ubiquitously expressed in plants, have beneficial effects on human health, including anti-inflammatory, antimicrobial, antiviral, anticancer, and immunomodulatory activities [3,4,5]

  • Carcinogenesis is a multistep process triggered by genetic alterations that activate multiple signal transduction pathways and cause the progressive transformation of a normal cell into a cancer cell [9]

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Summary

Introduction

Polyphenols, a large group of compounds ubiquitously expressed in plants, are secondary metabolites that play various roles in host defense against pathogens, ultraviolet radiation, and signal transduction [1]. Cross-talk between the signaling pathways mediated by avian erythroblastosis oncogene B (ErbB) receptors, nuclear factor-kappaB (NF-κB), and the Hedgehog (Hh)/glioma-associated (GLI) oncogene cascade (HH/GLI) plays an important role in neoplastic transformation [3]. Because they are able to modulate the signal transduction pathways involved in carcinogenesis, plant derivatives have promising potential for counteracting tumor growth [3,13,14]. This report reviews current knowledge on the anticancer effects of combinations of polyphenols or polyphenols and anticancer drugs, with a focus on their ability to modulate multiple signaling transduction pathways involved in carcinogenesis

Classification of Polyphenols
Flavonoids
Flavonols
Flavones
Flavan-3-Ols
Anthocyanins
Flavanones
Isoflavones
Minor Subclass of Flavonoids
Phenolic Acids
Stilbenes
Lignans
Other Polyphenols
Polyphenols Target Signal Transduction Pathways Involved in Carcinogenesis
Modulation of ErbB Receptors Signaling Pathway by Polyphenols in Cancer Cells
Modulation of the NF-κB Pathway by Polyphenols in Cancer Cells
Other Signal Transduction Pathways Involved in Carcinogenesis
Bioavailability of Polyphenols
Combinations of Polyphenols
Combinations of Polyphenols and Anticancer Drugs
Combinations of Polyphenols in Clinical Trials
Nanotechnology and Polyphenols
Findings
Perspective and Conclusions

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