Preventive effect of epicatechin and ginsenoside Rb(2) on the inhibition of gap junctional intercellular communication by TPA and H(2)O(2)

Mechanism of up-regulated gap junctional intercellular communication during chemoprevention and chemotherapy of cancer

To develop a strategy for efficacious intervention in order to prevent or treat various cancers, one must understand the basic mechanism(s) by which various anticancer dietary factors prevent or reverse the tumor promotion or progression phases. Carcinogenesis is a multistage, multimechanism process, involving the irreversible alteration of a stem cell (the "initiation" phase), followed by the clonal proliferation of the initiated stem cell (the "promotion" phase), from which the acquisition of the invasive and metastatic phenotypes are generated (the "progression" phase). While intervention to prevent or treat cancer could occur at each step, the objective of this presentation will focus on the rate limiting step, the promotion phase.Gap junctional intercellular communication (GJIC) has been hypothesized to regulate growth control, differentiation and apoptosis. Most normal, contact-inhibited cells have functional GJIC, while most, if not all, tumor cells have dysfunctional homologous or heterologous GJIC. Cancer cells are characterized by the lack of growth control, by the inability to terminally differentiate and by resistance to apoptosis. Chemical tumor promoters (phorbol esters, DDT, phenobarbital, unsaturated fatty acids, saccharin, etc.) inhibit GJIC in a reversible fashion and at doses above particular chemical thresholds. Various oncogenes (e.g. ras, raf, neu, src, mos) down-regulate GJIC while several tumor suppressor genes can up-regulate GJIC. Antitumor promoters (retinoids, carotenoids, green tea components) and antioncogene drugs (i.e. lovastatin) can up-regulate GJIC. Transfection of gap junction genes ("connexins") into GJIC-deficient tumor cells can restore GJIC, growth control and reduce tumorigenicity. On the other hand, antisense gap junction genes can convert the phenotype of a non-tumorigenic cell to that of a tumorigenic one. Recently, a specific connexin knockout mouse was shown to have a higher frequency of spontaneous and induced liver cancers. Evidence from these studies clearly suggests that dietary factors can modulate GJIC by inducing various signal transducing systems. The modulation can either down-regulate GJIC and lead to tumor promotion or it can up-regulate GJIC and lead to suppression of the initiated cells. Multiple mechanisms of up- or down-regulation of GJIC exist, as well as multiple types of pre-malignant and malignant tumor cells that are unable able to have functional GJIC. GJIC can be down-regulated by mutations and by epigenetic means. Alteration of gene expression at the transcriptional, translational or post-translational levels would require specific dietary prevention or treatment of cancer. In conclusion, if dietary prevention or treatment of cancer is to occur, it must ameliorate the growth-stimulatory effects, above threshold levels, of chemicals, growth factors or hormones, that trigger various mitogenic/antiapoptotic signal transducing systems that block GJIC.

Integration of Chinese medicine into supportive cancer care: a modern role for an ancient tradition

Recent evidence suggests that many traditional Chinese medical therapies are effective for the supportive care of cancer patients. This is a review of some of the published literature (indexed in Medline) and our own practical experience. It is not intended to be a systematic review, but does provide various levels of evidence which support further research into a developing model of integrative care. The holistic approach of Traditional Chinese Medicine (TCM) may be integrated into conventional Western Medicine to supplement deficiencies in the current biomedical model. The philosophy of TCM proposes novel hypotheses which will support the development of a science-based holistic medicine.

Modulation of cell-cell communication in the cause and chemoprevention/chemotherapy of cancer

Chemopreventive or chemotherapeutic agents have been those that either kill cancer cells to a differential degree over the non-cancer cells or those chemicals that either block the induction of tumors in carcinogen-treated animals or retard transplanted tumors in animals. Carcinogenesis is a multi-stage, multi-mechanism process, involving the irreversible alteration of a stem cell ("initiation"), followed by the clonal proliferation of the initiated cell ("promotion"). To develop a strategy for intervention with chemoprevention/chemotherapeutic chemicals, the basic mechanism(s) of carcinogenesis must be understood. Gap junction intercellular communication (GJIC) regulates cell growth, differentiation, apoptosis and adaptive functions of differentiated cells. Normal cells have functional GJIC while cancer cells do not. Tumor promoters and oncogenes inhibit GJIC, while anti-tumor promoter and anti-oncogene drugs can reverse the down-regulation of GJIC. Transfection of gap junction genes (connexins) has been shown to reverse the tumorigenic phenotype. If prevention/treatment of cancer is to occur, prevention of the chronic down regulation of GJIC by tumor promoters in non-tumorigenic but initiated cells or the up-regulation of GJIC in stably down-regulated GJIC in tumor cells must occur to prevent or to treat cancers.