Abstract
Cancer is the second leading cause of death and is becoming the leading one in old age. Vegetable and fruit consumption is inversely associated with cancer incidence and mortality. Currently, interest in a number of fruits high in polyphenols has been raised due to their reported chemopreventive and/or chemotherapeutic potential. Pomegranate has been shown to exert anticancer activity, which is generally attributed to its high content of polyphenols. This review provides a comprehensive analysis of known targets and mechanisms along with a critical evaluation of pomegranate polyphenols as future anticancer agents. Pomegranate evokes antiproliferative, anti-invasive, and antimetastatic effects, induces apoptosis through the modulation of Bcl-2 proteins, upregulates p21 and p27, and downregulates cyclin-cdk network. Furthermore, pomegranate blocks the activation of inflammatory pathways including, but not limited to, the NF-κB pathway. The strongest evidence for its anticancer activity comes from studies on prostate cancer. Accordingly, some exploratory clinical studies investigating pomegranate found a trend of efficacy in increasing prostate-specific antigen doubling time in patients with prostate cancer. However, the genotoxicity reported for pomegranate raised certain concerns over its safety and an accurate assessment of the risk/benefit should be performed before suggesting the use of pomegranate or its polyphenols for cancer-related therapeutic purposes.
Highlights
Cancer is the second leading cause of death and is becoming the leading one in old age
Pomegranate (Punica granatum L.) has been shown to exert anticancer activity, which is generally attributed to its high content of polyphenols including ellagitannins, ellagic acid, and other flavonoids [3]
It was found that punicalagin-derived ellagic acid is transformed into dimethylellagic acid glucuronide in plasma and urine on the day of administration of pomegranate juice
Summary
Cancer is the second leading cause of death and is becoming the leading one in old age. The process of cancer development is a consequence of genetic and epigenetic alterations that lead to disruption of basic biological functions, such as cell division, differentiation, angiogenesis, and migration, and transform normal epithelium to preneoplastic lesions and to invasive carcinoma. The presence of precursor lesions that represent intermediate stages between normal and malignant cells, the slow growth, likely for decades, before symptoms arise and diagnosis is established, a long latency period, and the age-dependent incidence of most cancers indicate that the carcinogenic process occurs during a protracted interval, providing the opportunity to block or delay the process, thereby preventing the development of invasive cancer. The aim of the present review is to critically discuss the cumulative evidence suggesting that pomegranate consumption possesses multiple biological actions and may be helpful in the prevention and therapy of cancer and to provide insight into its anticancer mechanisms
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