Abstract

Previous in vitro and in vivo studies have reported that 1'-S-1'-acetoxychavicol acetate (ACA) isolated from rhizomes of the Malaysian ethno-medicinal plant Alpinia conchigera Griff (Zingiberaceae) induces apoptosis-mediated cell death in tumour cells via dysregulation of the NF-κB pathway. However there were some clinical development drawbacks such as poor in vivo solubility, depreciation of biological activity upon exposure to an aqueous environment and non-specific targeting of tumour cells. In the present study, all the problems above were addressed using the novel drug complex formulation involving recombinant human alpha fetoprotein (rhAFP) and ACA. To study the synergistic effect of both agents on human cancer xenografts, athymic nude (Nu/Nu) mice were used and treated with various combination regimes intraperitoneally. Serum levels of tumour markers for carcinoembryonic antigen (CEA) and prostate specific antigen (PSA) were assessed using sandwich ELISA. IHC and Western blotting were also conducted on in vivo tumour biopsies to investigate the involvement of NF-κB regulated genes and inflammatory biomarkers. Quantification and correlation between drug efficacies and AFP-receptors were done using IF-IC and Pearson's correlation analysis. Mice exposed to combined treatments displayed higher reductions in tumour volume compared to stand alone agents, consistent with in vitro cytotoxicity assays. Milder signs of systemic toxicity, such as loss in body weight and inflammation of vital organs were also demonstrated compared to stand alone treatments. Tumour marker levels were consistent within all rhAFP/ACA treatment groups where levels of CEA and PSA were initially elevated upon commencement of treatment, and consecutively reduced corresponding to a decrease in tumour bulk volume. Both IHC and Western blotting results indicated that the combined action of rhAFP/ACA was not only able to down-regulate NF-κB activation, but also reduce the expression of NF-κB regulated genes and inflammatory biomarkers. The efficacy of rhAFP/ACA complex was also found to be weakly negatively correlated to the level of surface AFP-receptors between tumour types. This drug complex formulation shows great therapeutic potential against AFP-receptor positive tumours, and serves as a basis to overcome insoluble and non-specific anti-neoplastic molecules.

Highlights

  • Cancer is amongst one of the most challenging health problems in the world today

  • Tumour marker levels were consistent within all recombinant human alpha fetoprotein (rhAFP)/ACA treatment groups where levels of carcinoembryonic antigen (CEA) and prostate specific antigen (PSA) were initially elevated upon commencement of treatment, and consecutively reduced corresponding to a decrease in tumour bulk volume

  • Previous research have shown that Alpha fetoprotein (AFP) can bind metals and small hydrophobic molecules while inducing significant stabilization of the tertiary structure of the protein with respect to thermal melting [12]

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Summary

Introduction

Cancer is amongst one of the most challenging health problems in the world today. Even with advances in medical science disciplines such as surgery, immunotherapy, chemotherapy, hormonal therapy, and radiotherapy, there is still no significant progress in its treatment. The conventional radiotherapy and chemotherapy with synthetic drugs used in treating cancer are expensive, and induce severe side effects including immunosuppression, organ failure and susceptibility toward infectious diseases which may cause the death of patients upon treatment [1]. Strategies involving combined therapies or agents with distinct molecular mechanisms are considered more promising for higher efficacy and better survival. The rationale for combination therapy is to use drugs that work by different mechanisms of action to decrease the likelihood of resistant cancer cell development. There is an increase in the number of preclinical and clinical studies involving novel combinations of anti-cancer drug therapies and chemopotentiating agents to improve cancer treatment outcome [2]

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