Recent advances in natural therapeutic approaches for the treatment of cancer.

Plants and natural compounds have been widely recognized to have potential for the prevention of cancer progression and as complementary or standalone treatments for cancer patients. The major benefits of natural compounds are their reduced toxicity compared to more aggressive and widely utilized cancer treatment approaches. Preclinical studies have led to the discovery of a number of natural anticancer compounds, including preparations of Vitex negundo L., green tea, mandarin peel oil, ursolic acid, curcumin and resveratrol. Although the in vitro data highlights the potential of these natural alternatives, their benefits in clinical cancer treatment remain less conclusive. In this review, we will discuss some of the recent advances in natural anticancer treatment discovery for the four most prominent global cancers, namely, breast, lung, prostate and skin metastases. As the exploration of natural therapeutics continues to expand, these substances have the potential to be utilized as preventative strategies and complimentary therapeutics. In some cases, they may have sufficient anti-tumor and anti-carcinogenic properties to function as standalone cancer treatments.

Overexpression of insulin-like growth factor-I†receptor as a pertinent biomarker for hepatocytes malignant transformation.

AIM: To investigate the dynamic features of insulin-like growth factor-I receptor (IGF-IR) expression in rat hepatocarcinogenesis, and the relationship between IGF-IR and hepatocytes malignant transformation at mRNA or protein level. METHODS: Hepatoma models were made by inducing with 2-fluorenylacetamide (2-FAA) on male Sprague-Dawley rats. Morphological changes of hepatocytes were observed by pathological Hematoxylin and eosin staining, the dynamic expressions of liver and serum IGF-IR were quantitatively analyzed by an enzyme-linked immunosorbent assay. The distribution of hepatic IGF-IR was located by immunohistochemistry. The fragments of IGF-IR gene were amplified by reverse transcription-polymerase chain reaction, and confirmed by sequencing. RESULTS: Rat hepatocytes after induced by 2-FAA were changed dynamically from granule-like degeneration, precancerous to hepatoma formation with the progressing increasing of hepatic mRNA or IGF-IR expression. The incidences of liver IGF-IR, IGF-IR mRNA, specific IGF-IR concentration (ng/mg wet liver), and serum IGF-IR level (ng/mL) were 0.0%, 0.0%, 0.63 ± 0.17, and 1.33 ± 0.47 in the control; 50.0%, 61.1%, 0.65 ± 0.2, and 1.51 ± 0.46 in the degeneration; 88.9%, 100%, 0.66 ± 0.14, and 1.92 ± 0.29 in the precancerosis; and 100%, 100%, 0.96 ± 0.09, and 2.43 ± 0.57 in the cancerous group, respectively. IGF-IR expression in the cancerous group was significantly higher (P < 0.01) than that in any of other groups at mRNA or protein level. The closely positive IGF-IR relationship was found between livers and sera (r = 0.91, t = 14.222, P < 0.01), respectively. CONCLUSION: IGF-IR expression may participate in rat hepatocarcinogenesis and its abnormality should be an early marker for hepatocytes malignant transformation.

[Short hairpin RNA mediated glypican-3 silencing inhibits hepatoma cell invasiveness and disrupts molecular pathways of angiogenesis].

OBJECTIVE: To construct glypican-3 (GPC-3) short hairpin RNA (shRNA) and investigate the effects of GPC-3 transcription silencing on hepatoma cell invasion and angiogenesis mechanisms. METHODS: GPC-3-specific shRNA and non-target control shRNA were constructed and transfected into the human hepatoma cell lines HepG2, MHCC-97H, and Huh7. shRNA-mediated silencing of GPC-3 expression was confirmed at the mRNA and protein levels by fluorescence quantitative reverse transcription (FQRT)-PCR and western blotting, respectively. The effect of silenced GPC-3 expression on cell proliferation was detected by EdU and sulforhodamine B assays, on migration by wound healing (scratch) assay, on invasion by transwell chamber assay, and on apoptosis by luminescence assay of caspase-3/7 activity. The effect of silenced GPC-3 expression on angiogenesis-related signaling factors was detected by FQRT-PCR (for the glioma-associated oncogene homolog-1 hedgehog signaling factor, GLI1, and the beta-catenin Wnt signaling factor, b-catenin), immunofluorescent staining (for the insulin-like growth factor-II, IGF-II), and ELISA (for the vascular endothelial growth factor, VEGF). Pairwise comparisons were made by the independent sample t-test, and multiple comparisons were made by one-way ANOVA. RESULTS: In all cell lines, transfection with the GPC-3-specific shRNA significantly reduced GPC-3 mRNA levels (% reduction as compared to the non-target control shRNA: HepG2, 89.2+/-6.0%, t = -25.753, P less than 0.001; MHCC-97H, 75.3+/-4.9%, t = -26.487, P less than 0.001; Huh7, 73.6+/-4.6%, t = -27.607, P less than 0.001); the GPC-3 protein levels were similarly reduced. The GPC-3 shRNA-silenced cells showed significantly reduced proliferative, migratory and invasive capacities, as well as significantly increased apoptosis. The shRNA-mediated GPC-3 silencing was accompanied by significant down-regulation of b-catenin mRNA (HepG2, 46.9+/-0.6%; MHCC-97H, 67.5+/-2.7%; Huh7, 56.3+/-8.4%) and significant up-regulation of GLI1 mRNA (HepG2, 49.2+/-28.6%; MHCC-97H, 54.6+/-24.4%; Huh7, 31.6+/-15.7%). At 72 h after transfection, the HepG2 cells showed significant down-regulation of VEGF protein (54.3+/-1.5%, t = 46.746, P less than 0.001). CONCLUSION: GPC-3 contributes to migration, invasion, angiogenesis, and apoptosis of hepatoma cells, possibly through its interactions with the Wnt/b-catenin and Hedgehog signaling pathways. GPC-3 may represent a useful target for gene silencing by molecular-based therapies to treat hepatocellular carcinoma.

[Effects of inhibited IGF-IR expression on proliferation and apoptosis of human hepatocellular carcinoma cell lines].

OBJECTIVE: To investigate the therapeutic value of inhibiting the expression of insulin-like growth factor-I receptor (IGF-IR) using picropodophyllin (PPP) by studying the effects on proliferative and metastatic potentials of human hepatocellular carcinoma (HCC) using an in vitro cultured cell system. METHODS: IGF-IR expression in human HCC cell lines (Bel-7404, Bel-7402, HepG2, and Huh-7) and human hepatocytes (L02) was assessed at baseline (pre-treatment) and after PPP treatment by western blotting. Changes in cell cycle were analyzed by flow cytometry and in cell viability by sulforhodamine B staining. Early apoptosis was detected by annexin-V/FITC and propidium iodide double-staining assay. Caspase-3/7 activity was suppressed by z-VAD-FMK and analyzed by homogeneous luminescence assay. Effects on cell motility were tested by wound-scratch test. Between-group differences were assessed by t-test or one-way analysis of variance. RESULTS: IGF-IR was markedly up-regulated in all HCC cell lines (vs. non-hepatoma hepatocytes). HCC cells with PPP-inhibited IGF-IR showed time-dependent decreases in cell motility and viability. After treatment with PPP for 24 hours, the proportion of HCC cells in G1 phase was 2.1% +/- 0.4%, in S phase was 11.0% +/- 0.7%, and in G2/M phase was 87.1% +/- 0.6%, and no healing was observed in the wound-scratch assay. The PPP treatment induced cell apoptosis, as evidenced by enhanced caspase-3/7 activity; the proportion of annexin-V+/PI- cells was significantly higher in the HepG2 cells than in the non-hepatoma hepatocytes (16.4% +/- 0.4% vs. 5.8% +/- 0.2%, t = 14.05, P less than 0.01). After z-VAD-FMK treatment, the apoptosis rate was significantly higher in the HepG2 cells than in the non-hepatoma hepatocytes (11.3% +/- 0.7% vs. 5.8% +/- 0.2%, t = 11.83, P less than 0.01). CONCLUSION: IGF-IR is associated with proliferation, cell motility, and apoptosis of HCC cells, and may be a promising molecular target for HCC.

[Abnormal expression of insulin-like growth factor-II and intervening of its mRNA transcription in the promotion of HepG2 cell apoptosis].

OBJECTIVE: To explore the expression and pathological features of insulin-like growth factor-II (IGF-II) in tissues and sera of hepatocellular carcinoma (HCC) patients and the siRNA-mediated inhibition of IGF-II mRNA transcription in human HepG2 cells. METHODS: From December 2009 to August 2010, the self-control HCC, paracancerous and distal cancerous tissues were collected to analyze the expression of IGF-II. The serum levels of IGF-II expression were detected for pathological features. IGF-II expression in HepG2 cells was intervened by siRNA. IGF-II mRNA or IGF-II level and analyzed by reverse transcription-polymerase chain reaction (RT-PCR), real-time PCR or enzyme-linked immunosorbent assay (ELISA). And the ratio of cell apoptosis was analyzed by EdU/Hoechst33342. RESULTS: The levels of IGF-II expression in HCC tissues at mRNA (100%, 30/30) or protein (83.3%, 25/30) were significantly higher (P < 0.01) than those in para-cancerous (46.7%, 53.3%) or distal cancerous tissues (0, 0). The serum level of IGF-II was significantly higher in HCC patients (3.74 ± 0.67) ng/L than that in cases with benign liver diseases (1.93 ± 0.17) ng/L and controls (1.14 ± 0.14) ng/L (P < 0.001). The expression of IGF-II in the HCC group was associated with HBV infection (t = 5.390, P < 0.001). After siRNA transfection, the expression of IGF-II decreased significantly in HepG2 cells at mRNA or protein levels. The down-regulated expression of IGF-II was dependent on the dose and time of IGF-II siRNA. And the apoptotic index of HepG2 cells and the sensitivity to adriamycin both increased. CONCLUSION: The expression of IGF-II is closely associated with the progression of HCC. And the intervening of its transcription may promote apoptosis and sensitize to adriamycin.

Annexin A2 silencing inhibits invasion, migration, and tumorigenic potential of hepatoma cells.

AIM: To investigate the effects of Annexin A2 (ANXA2) silencing on invasion, migration, and tumorigenic potential of hepatoma cells. METHODS: Human hepatoma cell lines [HepG2, SMMC-7721, SMMC-7402, and MHCC97-H, a novel human hepatocellular carcinoma (HCC) cell line with high metastasis potential] and a normal hepatocyte cell line (LO2) were used in this study. The protein and mRNA expression levels of ANXA2 were analysed by western blotting and real-time polymerase chain reaction, respectively. The intracellular distribution profile of ANXA2 expression was determined by immunofluorescence and immunohistochemistry. Short hairpin RNA targeting ANXA2 was designed and stably transfected into MHCC97-H cells. Cells were cultured for in vitro analyses or subcutaneously injected as xenografts in mice for in vivo analyses. Effects of ANXA2 silencing on cell growth were assessed by cell counting kit-8 (CCK-8) assay (in vitro) and tumour-growth assay (in vivo), on cell cycling was assessed by flow cytometry and propidium iodide staining (in vitro), and on invasion and migration potential were assessed by transwell assay and wound-healing assay, respectively (both in vitro). RESULTS: The MHCC97-H cells, which are known to have high metastasis potential, showed the highest level of ANXA2 expression among the four HCC cell types examined; compared to the LO2 cells, the MHCC97-H expression level was 8-times higher. The ANXA2 expression was effectively inhibited (about 80%) by ANXA2-specific small hairpin RNA (shRNA). ANXA2 expression in the MHCC97-H cells was mainly localized to the cellular membrane and cytoplasm, and some localization was detected in the nucleus. Moreover, the proliferation of MHCC97-H cells was obviously suppressed by shRNA-mediated ANXA2 silencing in vitro, and the tumour growth inhibition rate was 38.24% in vivo. The percentage of MHCC97-H cells in S phase dramatically decreased (to 27.76%) under ANXA2-silenced conditions. Furthermore, ANXA2-silenced MHCC97-H cells showed lower invasiveness (percentage of invading cells decreased to 52.16%) and suppressed migratory capacity (migration distance decreased to 63.49%). It is also worth noting that shRNA-mediated silencing of ANXA2 in the MHCC97-H cells led to abnormal apoptosis. CONCLUSION: shRNA-mediated silencing of ANXA2 suppresses the invasion, migration, and tumorigenic potential of hepatoma cells, and may represent a useful target of future molecular therapies.

Expression characteristics and diagnostic value of annexin A2 in hepatocellular carcinoma.

AIM: To investigate the characteristics and diagnostic value of annexin A2 (ANXA2) expression in cancerous tissues and sera of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). METHODS: Levels of liver ANXA2 gene transcription or protein expression were analyzed in HCC-, their self-controlled precancerous-, and distant cancerous- tissues from 30 HCC. Serum levels of ANXA2 expression in 115 patients with HCC, 25 with metastatic liver cancer, 35 with chronic hepatitis, 28 with acute hepatitis, 38 with cirrhosis, and 30 healthy controls were determined. Clinicopathological characteristics of circulating ANXA2 expression were analyzed, and its diagnostic efficiency and clinical values in HCC were evaluated. RESULTS: ANXA2 expression was localized in both cell membrane and cytoplasm in HCC tissue, mainly in the cytoplasm of matched adjacent cancerous tissue, and there was almost no positive staining in matched distant cancerous tissue. Abnormal expression of liver ANXA2 was present in HCC tissues compared with self-controlled adjacent- and distant-cancerous tissues at protein or mRNA level. Circulating ANXA2 in HCC patients was significantly higher than that of other liver diseases (P < 0.01) except metastatic liver cancer. If the diagnostic cutoff value of ANXA2 level was more than 18 ng/mL, the incidence of serum ANXA2 was 86.96% in the HCC group, 80% in the metastatic liver cancer group, 31.58% in the liver cirrhosis group, none in the chronic hepatitis or acute hepatitis or normal control group, respectively. Serum ANXA2 expression in HCC patients was correlated with HBV infection (27.38 ± 5.67 ng/mL vs 18.58 ± 7.83 ng/mL, P < 0.01), extrahepatic metastasis (26.11 ± 5.43 ng/mL vs 22.79 ± 5.64 ng/mL, P < 0.01), and portal vein thrombus (26.03 ± 5.99 ng/mL vs 23.06 ± 5.03 ng/mL, P < 0.01), and was significantly higher (P < 0.01) in the moderately- (26.19 ± 5.34 ng/mL) or the poorly- differentiated group (27.05 ± 5.13 ng/mL) than in the well differentiated group (20.43 ± 4.97 ng/mL), and in the tumor node metastasis stages III-IV (P < 0.01) than in stages I-II. ANXA2 was not correlated with patient sex, age, size or α-fetoprotein (AFP) level. Area under the receiver operating characteristic curve for the whole range of sensitivities and specificities was 0.796 for ANXA2 and 0.782 for AFP. Combining detection of serum ANXA2 and AFP substantially improved the diagnostic efficiency (96.52%) and the negative predictive value (96.61%) for HCC. CONCLUSION: The characteristics and distribution of ANXA2 expression has good diagnostic potential for HCC diagnosis.

[Effect of different analgesia combined with low molecular heparin on hemorheology and coagulation in patients undergoing total hip replacement].

OBJECTIVE: To observe the effect of different analgesia combined with low molecular heparin (LMWH) on hemorheology and coagulation in patients undergoing total hip replacement (THR). METHODS: Patients undergoing THR with spinal combined epidural anesthesia (SCEA) were randomized to one of four groups: group E(0) received patient-controlled epidural analgesia (PCEA) without LMWH; group E(L) sames but combined with LMWH; group I(0) received patient-controlled intravenous analgesia (PCIA) without LMWH and I(L) the sames but combined with LMWH. Venous blood samples were taken after hospitalization, at the end of operation, 24 h, 48 h and 7 d after operation for determination of hemorheology, indexes of coagulation function. Visual analogue scale (VAS) scores were recorded at 24 h and 48 h postoperation. All the patients received colour Doppler ultrasonography examination before operation, and on the 7th day after operation. Complication of preoperation were recorded. RESULTS: There was no significant change in VAS among the four groups. The rates of DVT occurrence in group I(L) and E(L) were significantly lower than in group I(0) and E(0)(P < 0.05), and there was no significant difference between group I(L) and E(L) or between group I(0) and E(0). The incidence of nausea was markedly higher in group I(L) than that in group E(0) and E(L). Fib of all patients were significantly decreased at the end of operation and 24 h postoperation compared with base line values (P < 0.05), there was no significant difference each other in the four groups. Plasma viscosity and blood viscosity were lower in group E(0) than in group I(0) after operation (P < 0.05), and lower in group I(L) and E(L) than in group E(0) and group I(0) after operation (P < 0.05). There was no significant difference in plasma viscosity and blood viscosity between group I(L) and E(L). There was no significant change in PT and APTT in group I(0) and E(0) at all times, and no difference between the two groups. PT and APTT in group I(L) and E(L) were significantly prolonged at the end of operation and after operation compared with baseline values (P < 0.05), and prolonged compared with group I(0) and E(0) (P < 0.05). There was no difference in preoperation bleeding among all groups. CONCLUSION: PCEA can improve hemorheology significantly compared with PCIA in patients undergoing THR without LMWH. Combined with LMWH preoperation, both PCEA and PCIA can reduce occurrence of venous thrombosis, improve coagulation function and hemorheology without increase of bleeding. Intraspinal anesthesia and PCEA are safe and feasible in patients received LMWH preoperation of THR. PCEA wasn't superior to PCIA in prophylaxis against postoperative venous thromboembolism when combined with LMWH.