Apoptosis induced by different doses of caffeine on Chinese hamster ovary cells

Does Drinking Coffee and Tea Affect Bone Metabolism in Patients with Inflammatory Bowel Diseases?

Patients suffering from Crohn’s disease and ulcerative colitis are at higher risk of osteoporosis due to lower bone mineral density. Risk factors of osteoporosis are divided into unmodifiable, namely, age, gender, genetic factors, as well as modifiable, including diet, level of physical activity, and the use of stimulants. Coffee and tea contain numerous compounds affecting bone metabolism. Certain substances such as antioxidants may protect bones; other substances may increase bone resorption. Nevertheless, the influence of coffee and tea on the development and course of inflammatory bowel diseases is contradictory.

Nonpharmacological interventions for osteoporosis treatment: Systematic review of clinical practice guidelines

Objectives

The aim of this study was to perform a systematic review of clinical practice guidelines to identify nonpharmacologic recommendations for osteoporosis treatment.

Methods

A systematic review of literature following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-statement methodology for clinical practice guidelines was conducted; PROSPERO CRD42019138548. Assessment of selected clinical practice guidelines with the AGREE (Appraisal of Guidelines for Research & Evaluation)-II methodological quality instrument was performed, and those graded over 60 points were selected for recommendations extraction and evidence analysis.

Results

Only 6 clinical practice guidelines fulfilled criteria, 69 nonpharmacological recommendations were extracted: 13 from American Association of Clinical Endocrinologists and American College of Endocrinology guideline, 16 from Malaysian Osteoporosis Society guideline, 15 from the Ministry of Health in Mexico guideline, 14 from Royal Australian College of General Practitioners guideline, 7 from Sociedad Española de Investigación Ósea y del Metabolismo Mineral guideline, and 7 from National Osteoporosis Guideline Group guideline. Percentage by theme showed that the highest number of recommendations were 12 (17.1%) for vitamin D, 11 (15.7%) for a combination of calcium and vitamin D, and 11 (15.7%) for exercise.

Conclusions

These recommendations address integrating interventions to modify lifestyle, mainly calcium and vitamin D intake, and exercise. Other recommendations include maintaining adequate protein intake, identification and treatment of risk factors for falls, and limiting the consumption of coffee, alcohol and tobacco. Considerations on prescription must be taken.

Caffeine induces sustained apoptosis of human gastric cancer cells by activating the caspase‑9/caspase‑3 signalling pathway

Caffeine is one of the most widely consumed substances found in beverages, and has demonstrated anticancer effects in several types of cancer. The present study aimed to examine the anticancer effects of caffeine on gastric cancer (GC) cells (MGC‑803 and SGC‑7901) in vitro, and to determine whether the apoptosis‑related caspase‑9/-3 pathway is associated with these effects. The sustained antiproliferative effects of caffeine on gastric cancer were also investigated. GC cell viability and proliferation were evaluated using cell counting and colony forming assays, following treatment with various concentrations of caffeine. Flow cytometry was performed to assess cell cycle dynamics and apoptosis. Western blot analysis was conducted to detect the activity of the caspase‑9/-3 pathway. The results indicated that caffeine treatment significantly suppressed GC cell growth and viability and induced apoptosis by activating the caspase‑9/-3 pathway. Furthermore, the anticancer effects of caffeine appeared to be sustained, as the caspase‑9/-3 pathway remained active following caffeine withdrawal. In conclusion, caffeine may function as a sustained anticancer agent by activating the caspase‑9/-3 pathway, which indicates that it may be useful as a therapeutic candidate in gastric cancer.

Inhibiting c-Jun N-terminal kinase partially attenuates caffeine-dependent cell death without alleviating the caffeine-induced reduction in mitochondrial respiration in C2C12 skeletal myotubes

Caffeine is a widely consumed stimulant that has previously been shown to promote cytotoxic stress and even cell death in numerous mammalian cell lines. Thus far there is little information available regarding the toxicity of caffeine in skeletal muscle cells. Our preliminary data revealed that treating C2C12 myotubes with 5 mM caffeine for 6 h increased nuclear fragmentation and reduced basal and maximal oxygen consumption rate (OCR) in skeletal myotubes. The purpose of this study was to further elucidate the pathways by which caffeine increased cell death and reduced mitochondrial respiration. We specifically examined the role of c-Jun N-terminal kinase (JNK), which has previously been shown to simultaneously increase caspase-dependent cell death and reduce mitochondrial respiration in other mammalian cell lines. We found that caffeine promoted a dose-dependent increase in cell death in multinucleated myotubes but did not in mononucleated myoblasts. The addition of 10 μM Z-DEVD-FMK, a specific inhibitor of executioner caspases, completely inhibited caffeine-dependent cell death. Further, the addition of 400 μM dantrolene, a specific ryanodine receptor (RYR) inhibitor, prevented the caffeine-dependent increase in cell death and the reduction in basal and maximal OCR. We also discovered that caffeine treatment significantly increased the phosphorylation of JNK and that the addition of 30 μM SP600125 (JNKi), a specific JNK inhibitor, partially attenuated caffeine-induced cell death without preventing the caffeine-dependent reduction in basal and maximal OCR. Our results suggest that JNK partially mediates the increase in caspase-dependent cell death but does not contribute to reduced mitochondrial respiration in caffeine-treated skeletal muscle cells. We conclude that caffeine increased cell death and reduced mitochondrial respiration in a calcium-dependent manner by activating the RYR and promoting reticular calcium release.

Dielectric model for Chinese hamster ovary cells obtained by dielectrophoresis cytometry

We present a dielectric model and its parameters for Chinese hamster ovary (CHO) cells based on a double-shell structure which includes the cell membrane, cytoplasm, nuclear envelope, and nucleoplasm. Employing a dielectrophoresis (DEP) based technique and a microfluidic system, the DEP response of many single CHO cells is measured and the spectrum of the Clausius-Mossotti factor is obtained. The dielectric parameters of the model are then extracted by curve-fitting to the measured spectral data. Using this approach over the 0.6-10 MHz frequency range, we report the values for CHO cells' membrane permittivity, membrane thickness, cytoplasm conductivity, nuclear envelope permittivity, and nucleoplasm conductivity. The size of the cell and its nuclei are obtained using optical techniques.

Efeitos da ingestão de cafeína durante a gestação e a lactação sobre a pele de ratas e de filhotes e sua relação com as concentrações séricas do cortisol materno

O objetivo deste trabalho foi verificar os efeitos da ingestão materna de diferentes doses de cafeína durante a gestação e a lactação, na pele de ratas-mães e filhotes, bem como sua relação com as concentrações séricas do cortisol materno. Vinte e quatro ratas Wistar adultas foram distribuídas em quatro grupos, representados pelo controle e tratados, com cafeína nas doses de 25, 50 e 100mg/kg. Os grupos tratados receberam cafeína por sonda orogástrica durante toda a gestação e a lactação. O controle recebeu água destilada como placebo. Foram avaliados e quantificados os diferentes tipos de folículos pilosos e a espessura da epiderme. A técnica de imuno-histoquímica, com o uso do anticorpo anti-CDC47, foi utilizada para avaliar a proliferação celular da epiderme e dos folículos pilosos das mães. Na mãe, também foram mensurados os níveis séricos de cortisol pela técnica da quimioluminescência. Os dados foram submetidos à análise de variância com comparação das médias pelos testes Kruskal-Wallis e SNK. Nos grupos tratados com cafeína nas doses de 25 e 50mg/kg, tanto as mães quanto seus filhotes apresentaram hipotricose e/ou alopecia focal. Apesar de a frequência de alterações macroscópicas das mães ter sido superior a dos filhotes, nestes as lesões, quando presentes, foram difusas. A análise histológica demonstrou calcinose de folículos pilosos nas mães e nos filhotes. Mas a morfometria somente revelou diferença significativa no número de folículos pilosos das mães, bem como redução significativa da proliferação celular dos folículos pilosos do grupo tratado com 50mg/kg de cafeína. Os níveis de cortisol materno somente foram significativamente elevados no grupo tratado com 100mg/kg de cafeína. Conclui-se que a cafeína ingerida pelas ratas gestantes e lactantes pode causar lesões cutâneas tanto nas mães quanto nos filhotes, caracterizadas por hipotricose e/ou alopecia, independentemente dos níveis séricos do cortisol materno.

Protecting effect of caffeine against vinblastine (an anticancer drug) induced genotoxicity in mice

Vinblastine a DNA non-intercalating agent has wide application against several human neoplasms, and found to cause cytogenotoxicity. In this study, clastogenotoxicity of vinblastine (1.5 mg/kg b w) and its prevention by caffeine at different doses (25, 50 and 100 mg/kg b w) administered intraperitoneally was assessed in in vivo mice. It was found that micronucleus level had decreased significantly (up to 28.8%) in 100 mg caffeine treated group at 30 h post treatment. However, it did not exhibit protective effect against chromosomal aberration in spaermatogonial cells at 24 h post treatment. The frequencies of aberrant primary spermatocytes had decreased significantly in 25 and 100 mg caffeine at 4th week of post treatment. Similarly, in 100 mg of caffeine administered, abnormal sperm level had reduced (4.01%) significantly at 8th week post treatment. Thus, caffeine decreased the vinblastine induced chromosomal aberrations and mitotic index in bone marrow cells. In conclusion, this study shows that caffeine exerts protective effect against vinblastin induced cytogenotoxicity. Further studies on molecular mechanism are interesting in order to develop it as an effective drug in cancer chemotherapy.

Protective effect of caffeine on ethyl methanesulfonate-induced wing primordial cells of Drosophila melanogaster

OBJECTIVES

The antimutagenic effect of caffeine is evaluated against ethyl methanesulfonate (EMS)-induced mutation rate in Drosophila.

MATERIALS AND METHODS

The mutation rate is evaluated using wing mosaic assay. In transheterozygous larvae, multiple wing hair (mwh 0.3-3) and flare (flr 3-38.8) genes were used as markers of the extent of mutagenicity.

RESULTS

The results at 0.5 and 1.0 mM EMS concentration at both 48 ± 4 and 72 ± 4 h have shown consistent increase in mutation rate, which was being measured as frequency of clone formation per 105 cells. Toxicity of caffeine at 5 mM concentration was parallel to that of distilled water alone. At 0.5 mM EMS concentration at 42 ± 4 and 72 ± 4 h, Drosophila larvae mutation rate was significantly increased. Although caffeine prevented mutation rate in all pre, post, and combined treatment, it was more significant in pretreatment experiments where it was found to be effective in reducing the genotoxicity of EMS. However, the concentration of caffeine as recommended in dietary allowance did not induce the frequency of mutant clones in somatic mutation and recombination test (SMART) recorded.

CONCLUSION

This study shows that caffeine significantly reduced the genotoxicity induced by EMS. However, the limitation in completely abolishing genotoxicity induced by EMS as observed at the dietary allowance of caffeine makes it interesting for further in-depth study. Further studies on the molecular mechanism of antigenotoxic effect of caffeine will also be interesting.

Caffeine enhances osteoclast differentiation and maturation through p38 MAP kinase/Mitf and DC-STAMP/CtsK and TRAP pathway

The consumption of caffeine from some common beverages has been associated with low bone mass by inducing urinary calcium loss and deceasing bone mineral density. However, the effect of caffeine on osteoclast differentiation is still unclear. Here, we demonstrate that caffeine directly enhances osteoclast differentiation and maturation. TRAP staining showed that the number of larger (>100 μm) osteoclastic cells as well as of TRAP-positive multinucleated cells was increased by caffeine treatment. Among the MAP kinases, caffeine specifically activated p38 MAP kinase, which in turn, controlled osteoclast differentiation and maturation. This is evidenced by the abolishment of activated p38 MAP kinase by pretreatment with SB203580, a p38-specific inhibitor, resulting in suppressed osteoclast differentiation and maturation that should be increased by caffeine. Caffeine significantly induced the expression of Mitf and pretreatment with SB203580 markedly suppressed the expression of Mitf induced by caffeine. Whereas it failed to regulate the expression of NFATc1 and Oscar, the expressions of Cathepsin K and TRAP were induced by caffeine treatment in primary preosteoclasts. Real-time PCR and luciferase assays showed that the increase of osteoclastic cell-cell fusion by caffeine was through the transcriptional up-regulation of DC-STAMP expression but not of Atp6v0d2. These results strongly suggest that caffeine directly enhances osteoclast differentiation and maturation through p38 MAP kinase activation, thus inducing Mitf expression and transcriptional activation of DC-STAMP, and finally CtsK and TRAP.

Exposure time to caffeine affects heartbeat and cell damage-related gene expression of zebrafish Danio rerio embryos at early developmental stages

Caffeine is white crystalline xanthine alkaloid that is naturally found in some plants and can be produced synthetically. It has various biological effects, especially during pregnancy and lactation. We studied the effect of caffeine on heartbeat, survival and the expression of cell damage related genes, including oxidative stress (HSP70), mitochondrial metabolism (Cyclin G1) and apoptosis (Bax and Bcl2), at early developmental stages of zebrafish embryos. We used 100 µm concentration based on the absence of locomotor effects. Neither significant mortality nor morphological changes were detected. We monitored hatching at 48 h post-fertilization (hpf) to 96 hpf. At 60 and 72 hpf, hatching decreased significantly (P < 0.05); however, the overall hatching rate at 96 hpf was 94% in control and 93% in caffeine treatment with no significant difference (P > 0.05). Heartbeats per minute were 110, 110 and 112 in control at 48, 72 and 96 hpf, respectively. Caffeine significantly increased heartbeat - 122 and 136 at 72 and 96 hpf, respectively. Quantitative RT-PCR showed significant up-regulation after caffeine exposure in HSP70 at 72 hpf; in Cyclin G1 at 24, 48 and 72 hpf; and in Bax at 48 and 72 hpf. Significant down-regulation was found in Bcl2 at 48 and 72 hpf. The Bax/Bcl2 ratio increased significantly at 48 and 72 hpf. We conclude that increasing exposure time to caffeine stimulates oxidative stress and may trigger apoptosis via a mitochondrial-dependent pathway. Also caffeine increases heartbeat from early phases of development without affecting the morphology and survival but delays hatching. Use of caffeine during pregnancy and lactation may harm the fetus by affecting the expression of cell-damage related genes.

The Chinese or Striped-Back Hamster

Chinese hamsters are small rodents with a grayish black coat and a black dorsal stripe. Adult animals weigh approximately 39–46 gm, and measure approximately 9 cm in length. This species has been shown to be susceptible to a number of experimentally induced viral, bacterial, and parasitic infections. In recent years, the Chinese hamster's contributions as a laboratory animal have been largely overshadowed by the focus on its cell lines and the role it plays in scientific research and biotechnology. The Chinese hamster used in biomedical research is traditionally classified as Cricetulus griseus. It has several biological features that have helped promote its use in biomedical research and these attributes include its small size, polyestrous cycle, short gestation period, and low chromosome number. The Chinese hamster has a low incidence of spontaneous and endogenous viral infections. This species has been shown to be susceptible to a number of experimentally induced viral, bacterial, and parasitic infections. Chinese hamster-derived cells have played a major role in cytogenetic toxicity assays and the production of glycosylated therapeutic proteins. The behavior, research uses, and general toxicology of the Chinese hamster are summarized in this chapter.

Caffeine induces cell death via activation of apoptotic signal and inactivation of survival signal in human osteoblasts

Caffeine consumption is a risk factor for osteoporosis, but the precise regulatory mechanisms are currently unknown. Here, we show that cell viability decreases in osteoblasts treated with caffeine in a dose-dependent manner. This cell death is attributed primarily to apoptosis and to a smaller extent, necrosis. Moreover, caffeine directly stimulates intracellular oxidative stress. Our data support caffeine-induced apoptosis in osteoblasts via a mitochondria-dependent pathway. The apoptotic biochemical changes were effectively prevented upon pretreatment with ROS scavengers, indicating that ROS plays a critical role as an upstream controller in the caffeine-induced apoptotic cascade. Additionally, p21-activated protein kinase 2 (PAK2) and c-Jun N-terminal kinase (JNK) were activated in caffeine-treated osteoblasts. Experiments further found that PAK2 activity is required for caffeine-induced JNK activation and apoptosis. Importantly, our data also show that caffeine triggers cell death via inactivation of the survival signal, including the ERK- and Akt-mediated anti-apoptotic pathways. Finally, exposure of rats to dietary water containing 10~20 μM caffeine led to bone mineral density loss. These results demonstrate for the first time that caffeine triggers apoptosis in osteoblasts via activation of mitochondria-dependent cell death signaling and inactivation of the survival signal, and causes bone mineral density loss in vivo.

The enigmatic effects of caffeine in cell cycle and cancer

Caffeine may very well be the most frequently ingested neuroactive drug in the world. Mechanistically, caffeine has been reported to affect cell cycle function, induce programmed cell death or apoptosis and perturb key cell cycle regulatory proteins. Although the effects of caffeine have been heavily investigated, much of the research data regarding caffeine's effects on cell cycle and proliferation seem ambiguous. One important factor may be that caffeine has been used experimentally in numerous cell types under a variety of conditions at concentrations ranging from micromolar to high millimolar. Physiologically, achieving experimental blood levels of caffeine would be extremely difficult without adverse side effects. Therefore, the relevance of experimental data obtained by using high concentrations of caffeine is not clear and may account for some of the discrepancies in the literature. This review attempts to reconcile data regarding the cellular effects of caffeine by examining reported effects on cell cycle, proliferation and apoptosis with careful attention to differences in experimental conditions and caffeine concentration utilized.

Modulation of methotrexate-induced cytogenotoxicity in mouse spermatogonia and its transmission in the male germline by caffeine

Apart from its own controversial cytogenotoxic effects, caffeine (CAF), one of the most commonly consumed alkaloids worldwide, is found potentiative to and so also protective from the cytogenotoxic effects of numerous chemical and physical mutagens. It also has modulated the actions of several antineoplastic agents. Additionally, it has been tested as a chemopreventive of cancer and is reportedly associated inversely with different cancer risks. Therefore, in the present study, three different sub-lethal doses of CAF, 25, 50 and 100mg/kg, were tested in mouse to assess their cytogenotoxic effects on dividing spermatogonia at 24h post-treatment, and transmission of such effects in the male germline from the primary spermatocytes and sperm at week 4 and week 8 post-treatment, respectively. CAF was found to be weakly clastogenic to mouse spermatogonia and the effects were also found transmitted in the male germline. Interestingly, such induced effects were quantitatively related to the dose of CAF tested. On the other hand, methotrexate (MTX), an antifolate antimetabolite, is prescribed frequently for the treatment of various types of cancers. However, MTX is reportedly clastogenic. Modulation of the said three different pre-treated doses of CAF on MTX 10mg/kg-induced cytogenotoxic effects, tested in the same experimental protocol, indicated that CAF pre-treatment was decreasing the MTX-induced clastogenicity in spermatogonia, and was lowering the concurrent transmission of such effects in the male germline of mice, significantly. Such decreases were related to the dose of CAF tested, i.e. higher the dose of CAF more was the decrease in the MTX-induced cytogenotoxic effects and in their transmission. The possible mechanisms that might have caused the manifestation of a weak clastogenic action of CAF on spermatogonia and in its transmission in the male germline, and the CAF modulation of MTX-induced cytogenotoxic effects in spermatogonia and in their transmission have been discussed.

Caffeine induces apoptosis of human umbilical vein endothelial cells through the caspase-9 pathway

Caffeine is known to modulate placental and fetal umbilical circulation. It is demonstrated that apoptosis of human umbilical vein endothelial cells (HUVECs) is associated with placental umbilical vascular diseases. The present study was conducted to investigate the effects of caffeine on apoptosis of HUVECs. Isolated HUVECs were cultured under serum-free conditions for 24 h, and then treated with graded concentrations of caffeine (30, 100 and 300 microM) for additional 24 h and 48 h. The number of viable HUVECs was determined by cell counting. Apoptotic HUVECs were assessed by Hoechst33342 dye staining. The expression of caspase-9, caspase-8, caspase-3 and poly(ADP-ribose) polymerase (PARP) was assessed by Western blot analysis. Caffeine induced a dose- and time-dependent decrease in the number of viable HUVECs. Caffeine at concentrations higher than 100 microM significantly increased the percentage of apoptotic HUVECs. Caffeine at concentrations higher than 100 microM significantly increased cleaved caspase-9, caspase-3 and PARP expression in HUVECs at 24-h treatment compared with untreated cultures, whereas 30 microM caffeine significantly increased only caspase-3 expression at 24 h. Caffeine did not affect cleaved caspase-8 expression at 48 h. These results suggest that high concentrations of caffeine inhibit cell growth of HUVECs and induce apoptosis through the caspase-9 pathway.

Inhibition of epidermal growth factor-induced cell transformation and Akt activation by caffeine

We found that caffeine significantly inhibited epidermal growth factor (EGF)- and 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced cell transformation in the JB6 mouse epidermal cell line. The tumor promoter-induced cell transformation was also blocked by treatment with an adenosine A1 receptor antagonist, 8-phenyltheophylline (8-PTH). Caffeine slightly attenuated activation of EGF-induced activator protein 1 (AP-1) activation, which play important roles in cell transformation, but only at the highest concentration examined (1 mM). Interestingly, pretreatment with caffeine suppressed EGF-induced phosphorylation and activation of Akt and ribosomal p 70 S6 protein kinase (p 70 S 6 K), a target of Akt, without inhibiting phosphatidylinositol 3-kinase (PI 3 K) activation. The inhibition of Akt activation of caffeine was not a result of its adenosine receptor antagonism. Because Akt plays a key role in signal transduction pathways leading to cell proliferation and apoptosis, our results provide novel insight into possible mechanisms of the chemotherapeutic effect of caffeine.

Anti-genotoxicity of coffee against N-methyl-N-nitro-N-nitrosoguanidine in mouse lymphoma cells

The main aim of this work was to test the hypothesis that instant coffee, a commonly consumed polyphenolic beverage with antioxidant activity, can protect mammalian cells against genotoxic effects in vitro. For this purpose, the L5178Y mouse lymphoma cell line was selected to assess modulatory effects of coffee on the genotoxicity of N-methyl-N-nitro-N-nitrosoguanidine (MNNG). We initiated the work with a set of preliminary experiments in which the cytokinesis-block micronucleus test was performed. Results obtained from these experiments demonstrated a dose-related decrease in genotoxicity following co-treatment of mouse lymphoma cells with three doses of caffeinated instant coffee. Both pre-treatment and co-treatment showed significant antigenotoxic effects against MNNG. Caffeinated and decaffeinated instant coffee samples inhibited genotoxicity. There was no significant change in the antigenotoxic effect of caffeinated instant coffee after filtration using a 0.2 microm filter. Similar in vitro experiments demonstrated antigenotoxic effects against MNNG when boiled coffee was used instead of instant coffee. On the basis of the findings from the above preliminary experiments, further work was carried out to evaluate the possible protective effects of caffeinated instant coffee against MNNG-induced DNA damage, mutation and chromosomal damage. Results from three or five independent experiments demonstrated significant protective effects of caffeinated instant coffee against MNNG-induced DNA damage in the comet assay, mutation at the Tk locus and chromosomal damage in the cytokinesis-block micronucleus test.

Modulatory effects of caffeine on methotrexate-induced cytogenotoxicity in mouse bone marrow

Caffeine (CAF), a widely used and extensively studied chemical, is known for the reports on its controversial and inconsistent genotoxic effects, potentiative and protective effects from the genotoxicity of chemical and physical mutagens, and its modulatory effects on the action of antineoplastic drugs. Methotrexate (MTX), an antifolate antimetabolite, is a widely prescribed antineoplastic drug with significant clastogenic effects. In the present study, in addition to the assessment of cytogenotoxicity of CAF 25, 50 or 100mg/kg in mouse bone marrow, their modulatory effects on the cytogenotoxicity of MTX 10mg/kg was assessed from the induced frequencies of aberrant metaphases, chromosomal aberrations (CAs) and percentages of dividing cells at 24h post-treatment and the induced frequency of micronuclei (MN) at 30h post-treatment. All the three doses of CAF induced higher percentages of aberrant metaphases, high frequency of CAs and MN and increased percentages of dividing cells, but the increase in the aberrant metaphases and CAs was statistically significant only with the highest dose of CAF. Thus, CAF was weakly clastogenic to mouse bone marrow cells. However, pre-treatment of each of the three doses of CAF reduced the frequency of MTX 10mg/kg-induced aberrant metaphases, CAs, MN and also the percentage of dividing cells, but significantly only by the two higher doses of CAF. Thus, the higher doses of CAF protected mouse bone marrow cells from the cytogenotoxicity of MTX. The possible mechanisms involved in bringing about the weak clastogenic action of CAF and its protection from the cytogenotoxic effects of MTX have been discussed, and bio-modulation of the effects of antineoplastic drugs has been highlighted.