published_or_final_version / Public Health / Master / Master of Public Health

M. Tech. / AIM: To determine the efficacy of Astragalus membranaceous tincture at maintaining the circulating white blood cell count (WBC) and absolute neutrophil count (ANC) of breast cancer patients receiving chemotherapy. METHODS: This is an open-label study with an active control group. Both the study and control group consisted of fifteen participants. The participants in the study group each received ten millilitres of Astragalus membranaceous 1:2 tincture daily for the duration of their course of chemotherapy. RESULTS: The overall decrease in the WBC and ANC in the control was 4.9 and 3.13 parts per billion per litre, respectively. The study group showed an overall decrease of 2.7 and 1.9 parts per billion per litre, respectively. The average overall reduction in chemotherapy dose was 4.79 percent in the study group and 20.21 percent in the control. In all of the analyses p > 0.05. The small sample size, poor patient compliance and skewed distribution of the variables hindered the reliability of the results. CONCLUSION: The positive effects observed in the study group cannot be extrapolated to the entire population, however further research is strongly motivated.

published_or_final_version / abstract / Chinese Medicine / Master / Master of Philosophy

Second only to lung cancer, breast is the leading type of cancer among women in the US. Despite all the medical advances over the past few decades, toxicity and increased resistance to standard drug therapy still remains a significant problem. The heterogeneic nature of all cancers has led to a shift in treatment approaches, in that more research is being carried out with combination treatments in the hope that a multidirectional targeting of cancer will be far more effective than the current single treatment options. Our goal was to gain a better understanding of the molecular mechanisms of a nonhydrolyzable ether analog of RRR-[alpha]-tocopherol, 2, 5, 7, 8-tetramethyl-2R-(4R, 8R, 12-trimethyltridecyl)chroman-6-yloxyacetic acid (abbreviated [alpha] -TEA), and to investigate its efficacy when used in combination with known chemotherapeutics 9-nitro-camptothecin (9NC), and Paclitaxel (Taxol). The data presented here looks encouraging as it shows a clinically relevant delivery method using [alpha]-TEA and 9NC has the unique ability to reduce primary tumor burden as well as macro and micrometastatic lung and lymph node lesions in an aggressive syngeneic mouse mammary model, while displaying no obvious toxic side effects. The effect of combination treatments on tumor volume appears in part to be moderated by an increase in tumor cell apoptosis and a decrease in tumor cellular proliferation. Next, the intricate molecular mechanism of how [alpha]-TEA alone and in combination with 9NC is able to induce apoptosis in 66cl-4-GFP murine mammary cancer was investigated. The data suggest that the signaling pathway that ultimately leads to apoptosis is caspase dependent, is able to upregulate pro-death players while at the same time downregulate pro-survival proteins such as c-Flip and survivin. Finally, we investigated the efficacy of [alpha]-TEA used in an allograft mouse model following treatment with Taxol. Combination treatments were able to significantly reduce primary tumor burden, decrease lung and lymph node micrometastases, tumor cell proliferation, tumor blood vessel density as well as increase tumor cell apoptosis. Based on the results presented, we propose that [alpha]-TEA when used alone and in combination is an effective, non-toxic option for cancer treatment which warrants further investigation. / text

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There is no abstract available for this dissertation. / Department of Educational Studies

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references. / viii, 12 leaves, bound ill. 29 cm

Breast cancer is the most frequently diagnosed cancer in women worldwide.A treatment regime, both effective and safe and can only be achieved once more effective chemotherapeutic agents are discovered or identified. These “drugs” must selectively induce cell death such as apoptosis or necroptosis in the cancer cells. Apoptotic cell death allows a cell to “commit suicide” in genetically- controlled or programmed mechanism(s). The microenvironment of the tumour is important since a nurturing malignant environment is required for tumour maintenance, progression and ultimately the development of metastasis. Due to the correlation of the tumour microenvironment to aggressive tumour progression, emphasis should be placed on the constituents of the tumour’s microenvironment. In recent years, the understanding of intracellular pathways in cancer cells has increased rapidly, contributing to the development of drugs with more specific targets such as growth factors, signalling molecules, cell adhesion proteins, proteases, cell-cycle proteins, modulators of apoptosis and molecules that promote angiogenesis and metastasis. The main aim of this study was thus to identify a few potential or active compounds from a library of synthetically-derived compounds as possible alternative breast cancer treatment candidates.

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: Cancer is an emerging health problem in South Africa, with breast cancer being one of the leading cancers affecting women globally. Therefore, there is a need to find novel targets to improve the therapeutic options for these patients. A recently proposed target is the mitogen-activated protein kinase phosphatase-1 (MKP-1). Studies have suggested that mitogen-activated protein kinase phosphatases are involved in the development of cancer and play an important role in the response of cancer cells to chemotherapy. Additionally, numerous studies have indicated that there is increased expression of MKP-1 in breast cancers where its over-expression is proposed to be a significant mediator in chemo-resistance. We propose that inhibition of MKP-1 will increase the cytotoxic effect of doxorubicin in breast cancer cells, thus making the cells more responsive to treatment leading to increased cell death through autophagy and apoptosis. Methods: In MDA-MB231 cells, MKP-1 was inhibited using sanguinarine or MKP-1 siRNA and this was compared to a known inducer of MKP-1, dexamethasone. MDA-MB231 cells were treated with doxorubicin alone or in combination with MKP-1 inhibitors or an inducer. Following treatment, cell death was determined by trypan blue and a caspase glo assay as well as with western blotting. Autophagy was determined by western blotting and flow cytometry. LC3 and p62 were used as markers of autophagy and caspase 3 and PARP as apoptosis markers. Likewise, the level of MKP-1 expression under conditions of MKP-1 induction, inhibition or silencing was evaluated by means of western blotting. C57BL6 tumour bearing mice was used to analyse apoptosis and autophagy in vivo under conditions of MKP-1 inhibition, using sanguinarine, together with doxorubicin treatment. Western blotting was used to determine levels of caspase 3, LC3, p62 and MKP-1 expression. Results and discussion: A concentration and time curve indicated that 5 μM doxorubicin reduced cell viability in the MDA-MB231 cells significantly after 24 hours of treatment. MKP-1 expression was significantly reduced with sanguinarine and MKP-1 siRNA. Furthermore, our results indicate a significant increase in apoptosis in MDA-MB231 cells when treated with doxorubicin, under conditions of MKP-1 inhibition or MKP-1 silencing. Also, an increase in autophagic activity was observed following treatment with doxorubicin in combination with sanguinarine. Whole excised tumours of C57BL6 mice also showed an increase in apoptosis and autophagy following treatment with sanguinarine in combination with doxorubicin. This indicates that the inhibition of MKP-1 with sanguinarine sensitized the MDA-MB231 cells and E0771 cell tumours to doxorubicin-induced-apoptosis through a mechanism involving autophagy. Conclusion: This is an encouraging finding that could hopefully be used in future studies to overcome doxorubicin-resistance in breast cancer cells overexpressing MKP-1. Targeting MKP-1 can have potential therapeutic benefits for breast cancer patients by making chemotherapy more effective. Sanguinarine thus has potential to be developed as a clinically relevant inhibitor of MKP-1 which could provide a novel avenue for therapeutic intervention in combination with chemotherapy in breast cancer patients. / AFRIKAANSE OPSOMMING: Inleiding: Kanker is 'n vinnig groeiende gesondheidsprobleem in Suid-Afrika, met borskanker as een van die vernaamste kankers wat vroue wêreldwyd raak. Daar is dus 'n behoefte aan nuwe terapeutiese opsies vir hierdie pasiënte en mitogeen-geaktiveerde proteïenkinase fosfatase-1 (MKP-1) is onlangs voorgestel as ‘n moontlike teiken. Verskeie studies toon dat mitogeen-geaktiveerde proteïenkinase fosfatases betrokke is by die ontwikkeling van kanker en ook belangrike rolspelers is in die reaksie van kanker op chemoterapie. Daarbenewens toon talle studies dat daar verhoogde MKP-1 uitdrukking in borskanker is, asook dat dit ‘n belangrike bemiddelaar is vir die weerstand wat borskanker teen chemoterapie bied. Ons het dus voorgestel dat die inhibisie van MKP-1 die sitotoksiese effek van doxorubicin op borskanker selle sal verhoog; sodoende sal die kanker selle beter reageer op behandeling en dit sal dus lei tot verhoogde seldood deur autofagie en apoptose. Metodes: MKP-1 is geïnhibeer met behulp van sanguinarine of MKP-1 siRNA in MDA-MB231 selle en dit is vergelyk met 'n bekende MKP-1 induseerder, dexamethasone. MDA-MB231 selle is met doxorubicin alleen behandel of in kombinasie met MKP-1 inhibeerders of ‘n induseerder. Seldood is bepaal deur middel van ‘n trypan blou en kaspase toetsingsmetode, asook met die westelike kladtegniek. Autofagie is bepaal deur westelike kladtegniek en vloeisitometrie. LC3 en p62 is gebruik as merkers van autofagie en kaspase 3 en PARP is as apoptose merkers gebruik. MKP-1 uitdrukking is geëvalueer deur middel van westelike kladtegniek. C57BL6 muise met kankeragtige gewasse is gebruik om apoptose en autofagie in vivo te ondersoek. MKP-1 is geïnhibeer met sanguinarine en die muise is behandel met ‘n kombinasie van sanguinarine en doxorubicin. Kaspase 3, LC3, p62 en MKP-1 uitdrukking is bepaal deur middel van die westelike kladtegniek. Resultate en bespreking: ‘n Konsentrasie en tyd kurwe het aangedui dat 5 μM doxorubicin die MDA-MB231 selle se lewensvatbaarheid aansienlik verminder het na 24 uur. MKP-1 uitdrukking is ook aansienlik verminder met sanguinarine en MKP-1 siRNA. Verder dui die resultate op 'n beduidende toename in apoptose in MDA-MB231 selle na behandeling met doxorubicin onder toestande van MKP-1 inhibisie. 'n Toename in autofagiese aktiwiteit is waargeneem na behandeling met doxorubicin en sanguinarine. Die kankeragtige gewasse van die C57BL6 muise toon ook 'n toename in apoptose en autofagie na behandeling met sanguinarine en doxorubicin. Hierdie resultate dui daarop dat die inhibisie van MKP-1 met sanguinarine die MDA-MB231 selle en E0771 sel gewasse gesensitiseer het tot doxorubicin-geïnduseerde apoptose deur middel van ‘n meganisme wat autofagie insluit. Gevolgtrekking: Hierdie bevinding kan hopelik in toekomstige studies gebruik word om doxorubicin weerstand te oorkom in borskanker selle waar MKP-1 verhoog is. Deur MKP-1 te teiken, kan dit lei tot potensiële terapeutiese voordele vir borskanker pasiënte en sodoende kan dit chemoterapie meer effektief maak. Sanguinarine het dus die potensiaal om ontwikkel te word as ‘n klinies relevante inhibeerder van MKP-1 wat sodoende kan dien as terapeutiese intervensie in kombinasie met chemoterapie vir borskanker pasiënte.