School of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, , People s Republic of China; 2

Similar documents
Department of General Surgery, The Third People s Hospital of Dalian, Dalian Medical University, Dalian, Liaoning, China,

Key words: apoptosis, beta-amyrin, cell cycle, liver cancer, tritepenoids

Respiratory and Critical Care Discipline, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning,110024, China

Geraniol and geranyl acetate induce potent anticancer effects in colon cancer Colo-205 cells by inducing apoptosis, DNA

Tanshinone l exhibits anticancer effects in human

Linderalactone inhibits human lung cancer growth b

Sorghumol triterpene inhibits the gro

Methyl eugenol induces potent anticancer effects in

Impact factor: Reporter:4A1H0019 Chen Zi Hao 4A1H0023 Huang Wan ting 4A1H0039 Sue Yi Zhu 4A1H0070 Lin Guan cheng 4A1H0077 Chen Bo xuan

The effect of insulin on chemotherapeutic drug sensitivity in human esophageal and lung cancer cells

Proteomic profiling of small-molecule inhibitors reveals dispensability of MTH1 for cancer cell survival

Protocol for Gene Transfection & Western Blotting

Supporting Information

The Schedule and the Manual of Basic Techniques for Cell Culture

The Annexin V Apoptosis Assay

β-aescin shows potent antiproliferative activity in osteosarcoma cells by inducing autophagy, ROS generation and mitochondrial

PUMA gene transfection can enhance the sensitivity of epirubicin-induced apoptosis of MCF-7 breast cancer cells

Annals of Oncology Advance Access published January 10, 2005

School of Traditional Chinese Medicine, Chongqing Medical University, Huxi University City, Chongqing , China; 2

Protein MultiColor Stable, Low Range

Bile acids initiate cholestatic liver injury by triggering a hepatic specific inflammatory response. Supplementary Results

SUPPLEMENTARY INFORMATION

Supplementary Figure 1 Lymphocytes can be tracked for at least 4 weeks after

Chengfei Hao, Xibo Zhang, Hongtao Zhang, Haitao Shang, Jianheng Bao, Haibo Wang, Zhonglian Li

Department of Clinical Laboratory, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, , China; 4

Instructions for Use. APO-AB Annexin V-Biotin Apoptosis Detection Kit 100 tests

Supplementary Materials and Methods

Essential Medium, containing 10% fetal bovine serum, 100 U/ml penicillin and 100 µg/ml streptomycin. Huvec were cultured in

HCC1937 is the HCC1937-pcDNA3 cell line, which was derived from a breast cancer with a mutation

IMMP8-1. Different Mechanisms of Androg and IPAD on Apoptosis Induction in Cervical Cancer Cells

8. CHAPTER IV. ANTICANCER ACTIVITY OF BIOSYNTHESIZED SILVER NANOPARTICLES

RNA extraction, RT-PCR and real-time PCR. Total RNA were extracted using

Supporting Information

Supplementary data Supplementary Figure 1 Supplementary Figure 2

Pterostilbene (3,5 -dimethoxy-resveratrol) exerts

B16-F10 (Mus musculus skin melanoma), NCI-H460 (human non-small cell lung cancer

Ginkgo biloba leaf extract induces DNA damage by inhibiting topoisomerase II activity in human hepatic cells

Supplementary Fig. 1. Identification of acetylation of K68 of SOD2

ORIGINAL ARTICLE. Hang Huang 1,2, Lin-Jin Li 3, Hai-Bo Zhang 4, An-Yang Wei 4. Summary. Introduction

SUPPLEMENTARY INFORMATION

For the rapid, sensitive and accurate measurement of apoptosis in various samples.

Sodium selenite induces apoptosis in colon cancer cells via Bax-dependent mitochondrial pathway

Effect of starvation-induced autophagy on cell cycle of tumor cells

Apoptosis Mediated Cytotoxicity of Curcumin Analogues PGV-0 and PGV-1 in WiDr Cell Line

Ethanolic Extract of Moringa oleifera L. Increases Sensitivity of WiDr Colon Cancer Cell Line Towards 5-Fluorouracil

Potential antitumor effects of panaxatriol against

The effect of elemene reversing the multidurg resistance of A549/DDP lung cancer cells

Research Article Ginseng Extract Enhances Anti-cancer Effect of Cytarabine on Human Acute Leukemia Cells

ONCOLOGY LETTERS 7: , 2014

Journal of Chemical and Pharmaceutical Research, 2017, 9(12): Research Article

ROS Activity Assay Kit

RESEARCH ARTICLE. Ginsenoside-Rh2 Inhibits Proliferation and Induces Apoptosis of Human Gastric Cancer SGC-7901 Side Population Cells

Supporting Information

Original Article Ginkgo biloba extract induce cell apoptosis and G0/G1 cycle arrest in gastric cancer cells

Original Article Bufalin attenuates the proliferation of breast cancer MCF-7 cells in vitro and in vivo by inhibiting the PI3K/Akt pathway

ab65311 Cytochrome c Releasing Apoptosis Assay Kit

SUPPLEMENTAL MATERIAL. Supplementary Methods

ab E3 Ligase Auto- Ubiquitilylation Assay Kit

IN VITRO ANTICANCER ACTIVITY OF FLOWER EXTRACTS OF COUROUPITA GUIANENSIS

Annexin V-APC/7-AAD Apoptosis Kit

http / / cjbmb. bjmu. edu. cn Chinese Journal of Biochemistry and Molecular Biology COX-2 NTera-2 NTera-2 RT-PCR FasL caspase-8 caspase-3 PARP.

Bakuchiol inhibits cell proliferation and induces apoptosis and cell cycle arrest in SGC-7901 human gastric cancer cells.

Supplementary Information POLO-LIKE KINASE 1 FACILITATES LOSS OF PTEN-INDUCED PROSTATE CANCER FORMATION

Johannes F Fahrmann and W Elaine Hardman *

In-vitro assay for Cytotoxicity activity in ethonolic extract of fruit rind of Couropita Guianensis aubl

SUPPLEMENTARY INFORMATION. Involvement of IL-21 in the epidermal hyperplasia of psoriasis

Berberine Sensitizes Human Ovarian Cancer Cells to Cisplatin Through mir-93/ PTEN/Akt Signaling Pathway

Sorafenib inhibits liver cancer growth by decreasing mtor, AKT, and PI3K expression

Chloroquine inhibits cell growth and induces cell death in A549 lung cancer cells

Research on the inhibitory effect of metformin on human oral squamous cell carcinoma SCC-4 and CAL-27 cells and the relevant molecular mechanism.

RayBio Annexin V-FITC Apoptosis Detection Kit

Arthogalin inhibits the growth of murine malignant prostate sarcoma cells in vitro.

Chemical Chaperones Mitigate Experimental Asthma By Attenuating Endoplasmic

Marine Streptomyces sp. derived antimycin analogues. suppress HeLa cells via depletion HPV E6/E7 mediated by

Oncolytic Adenovirus Complexes Coated with Lipids and Calcium Phosphate for Cancer Gene Therapy

Mitochondrial DNA Isolation Kit

p47 negatively regulates IKK activation by inducing the lysosomal degradation of polyubiquitinated NEMO

Focus Application. Compound-Induced Cytotoxicity

Effect of ST2825 on the proliferation and apoptosis of human hepatocellular carcinoma cells

Effect of Survivin-siRNA on Drug Sensitivity of Osteosarcoma Cell Line MG-63

Cinnamomum Essential Oil Prevents DNA Damage- Induced by Doxorubicin on CHO-K1 Cells

Anti-Aging Activity Of Cucurbita moschata Ethanolic Extract Towards NIH3T3 Fibroblast Cells Induced By Doxorubicin

Supplementary Information

Contragestazol (DL111-IT) inhibits proliferation of human androgen-independent prostate cancer cell line PC3 in vitro and in vivo

Figure S1. PMVs from THP-1 cells expose phosphatidylserine and carry actin. A) Flow

Protein-Mediated Anti-Adhesion Surface against Oral Bacteria

Multi-Parameter Apoptosis Assay Kit

ab Membrane fluidity kit Instructions for Use For the detection of membrane fluidity in cells

(A) PCR primers (arrows) designed to distinguish wild type (P1+P2), targeted (P1+P2) and excised (P1+P3)14-

A novel bfgf antagonist peptide inhibits breast cancer cell growth

Effects of COX-2 Inhibitor on the Proliferation of MCF-7 and LTED MCF-7 Cells

Introduction: 年 Fas signal-mediated apoptosis. PI3K/Akt

Autophagy induction by low-dose cisplatin: The role of p53 in autophagy

SUPPLEMENT. Materials and methods

Protocol for protein SDS PAGE and Transfer

Serum Amyloid A3 Gene Expression in Adipocytes is an Indicator. of the Interaction with Macrophages

Caspase-3 Assay Cat. No. 8228, 100 tests. Introduction

Effect of Taurine on Acinar Cell Apoptosis and Pancreatic Fibrosis in Dibutyltin Dichloride-induced Chronic Pancreatitis

Choline Assay Kit (Fluorometric)

SensoLyte pnpp Alkaline Phosphatase Assay Kit *Colorimetric*

Transcription:

JBUON 2018; 23(3): 574-578 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mail: editorial_office@jbuon.com ORIGINAL ARTICLE Anticancer activity of safranal against colon carcinoma is due to induction of apoptosis and G2/M cell cycle arrest mediated by suppression of mtor/pi3k/akt pathway Yibing Zhang 1, Yong Zhao 2, Jianyou Guo 3, Haifeng Cui 2, Sha Liu 1 1 School of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, 401331, People s Republic of China; 2 Institute of Chinese Materia Medica, China Academy of Traditional Chinese Medicine, Beijing, 100700, People s Republic of China; 3 Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, People s Republic of China Summary Purpose: Colon cancer is among the deadliest malignancies and is responsible for a significant number of deaths across the globe. The treatment options for colon cancer are limited and with lot of side effects. In this study we evaluated the potential anticancer effects of safranal against colo-205 colon cancer cells along with evaluation of its effects on apoptosis, cell cycle phase distribution, reactive oxygene species (ROS) and PI3K/AKT/m-TOR signalling pathway. Methods: Cell viability was examined by MTT assay. Apoptosis was checked by DAPI staining, comet assay and annexin V/propidium iodide (PI) staining involving the use of fluorescence microscopy and flow cytometry. ROS, mitochondrial membrane potential (MMP) and cell cycle phase distribution were checked by flow cytometry using different fluorescent probes. Effects of safranal on the protein expression of PI3K/AKT/m-TOR were studied by western blot assay. Results: The results revealed that safranal suppressed the proliferation of colo-205 cancer cells with an IC 50 of 20 µm. Furthermore, the anticancer effects of safranal were found to be due to accretion of ROS and decrease in the MMP, ultimately leading to apoptosis of colo-205 cancer cells. In addition, safranal caused increase in the expression of Bax in parallel with concomitant reduction in the expression of Bcl-2. Safranal also triggered G2/M cell cycle arrest and inhibition of PI3K/AKT/mTOR signalling pathway. Conclusion: In conclusion, the above results indicate that safranal could prove a potential lead molecule in the treatment of colon cancer, provided further in vivo studies are carried out. Key words: apoptosis, cell cycle, colon cancer, ROS, safranal Introduction Plants synthesize a diversity of molecules that display impressive pharmacological activities [1]. Among the plant-derived secondary metabolites, carotenoids form a very large group. These compounds have a number of functions in plants [2]. In some plants carotenoids are broken down by incorporating molecular oxygen, leading to the formation of a group of metabolites called apocarotenoids. Among these apocarotenoids safranal is an important molecule that is mainly found in Crocus sativus [3,4]. Safranal exerts several neuroprotective and anti-inflammatory bioactivities. Moreover, there are several apocarotenoids, such as crocin and crocetin, that have been reported to exhibit anticancer activity. Constantly, we presumed that safranal may also exhibit anticancer activities. Over the years there has been drastic alterations in human lifestyles, accompanied with increased incidence of cancer around the globe. Studies have shown that colon cancer is among the Correspondence to: Sha Liu, PhD. School of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, 401331, People s Republic of China. Tel/Fax: +86 23 6848 5004, Email: LeroyoThompsonfv@yahoo.com Received: 04/02/2018; Accepted: 20/02/2018

Safranal exerts anticancer activity in colon cancer 575 top deadly malignancies in humans [5]. Currently, the treatment of colon cancer involves surgery followed by chemotherapy. Nevertheless the prognosis of this disease is rather poor and the mortality rate is high [6]. Hence, there is an imperative need to develop novel treatment strategies or explore novel targets for the treatment of this disease. The main purpose of the present study was to evaluate the potential anticancer effects of safranal against colo-205 colon cancer cells along with evaluation of its effects on apoptosis, cell cycle phase distribution, ROS and PI3K/AKT/m-TOR signalling pathway. Methods Chemicals, reagents and culture conditions All chemicals and reagents were procured from Sigma-Aldrich Co. (St. Louis, MO, USA) or otherwise mentioned. Antibodies were purchased from Santa Cruz Biotechnology Inc (Santa Cruz, CA, USA). Human colon cancer colo-205 line was purchased from Type Culture Collection of Chinese Academy of Sciences, Shanghai, China. The cells were cultured in RPMI-1640 medium containing 10% fetal bovine serum (FBS), penicillin and streptomycin (100 U/mL and 100 mg/ml, respectively) and maintained in air containing 5% CO 2 at 37 C. MTT assay For assessment of the cell viability, the colo-205 cells were cultured in a 96-well plate at a density of 5 10 3 cells/well. The cells were incubated overnight and then the RPMI-1640 medium was removed and replaced with fresh RPMI-1640 medium with safranal at different concentrations (0-200 µm) for 24 hrs. Thereafter, MTT solution of 0.5 mg/ml was added for the last 4 hrs of incubation and finally the sample absorbance was assessed at 570 nm using Eliza Plate Reader. Apoptosis assay For detection of apoptosis colon cancer HCT-116 cells were cultured (2 10 5 cells/well) in 6-well plates. The cells were then exposed to different doses of safranal and incubated for 24 hrs. DAPI staining was carried out by treating the cells in 6-well plates. The cells were then washed with phosphate buffered saline (PBS) and fixed with 10% formaldehyde. The DAPI-stained cells were then observed with fluorescence microscope for estimation of apoptotic cell populations. For the estimation of the percentage of the apoptotic cells a FITC-Annexin V/PI Apoptosis detection kit was employed as per the instructions of the manufacturer using a flow cytometer. Comet assay DNA damage triggered by safranal was assessed by the comet assay. Briefly, safranal-treated colo-205 colon cancer cells were harvested and suspended in cold PBS. The cells in the 0.5% low melting point agarose were kept on a slide precoated with a layer of 1% regular agarose. Afterwards, these two layers were allowed to solidify at 4ºC, and then suspended in a cold lysis buffer for 50 min at 4ºC. Then, the gel slides were allowed to dry and the dried slides were soaked in fresh electrophoresis solution for 25 min. Then, electrophoresis was carried out at 300 ma, 25 V for 25 min at 4ºC. This was followed by staining with ethidium bromide (20 μg/ml) for 12 min, and neutralization of the slides with 0.4 M Tris-HCl (ph 7.5). Finally, the slides were washed and observed under a fluorescent microscope (BX51; Olympus, Tokyo, Japan). Cell cycle analysis For estimating the distribution of Colo-205 colon cancer cells in different phases of the cell cycle, the safranal-treated cells were harvested and washed twice with PBS. Then, the cells were fixed with 70% ethanol for about an hour and washed again with PBS. The cells were finally resuspended in solution of PI (50 µl/ml) and RNase1 (250 µg/ml). This was followed by incubation for 30 min at room temperature and fluorescence-activated cell sorting cater-plus cytometer was used with 10,000 cells/group. Western blotting The Colo-205 colon cancer cells treated with safranal were collected and treated with lysis buffer [Tris- HCl, sodium-dodecyl sulfate (SDS), mercaptoethanol and glycerol. The extracts were boiled for 10 min in the presence of loading buffer followed by separation of cell extracts using 15% SDS-PAGE gel. The samples were then put onto polyvinylidene fluoride membranes and blocked using 5% skimmed milk powder. Membrane incubation with primary antibodies was performed overnight at 4 C. The membranes were incubated with horseradish peroxidase-linked secondary biotinylated antibodies at 1:1,000 dilution for 2 hrs. Washing of the membranes with PBS was followed by visualization of the immunoreactive bands using the ECL-PLUS / Kit according to the manufacturer s instructions. The immune complexes development was carried out using an ECL detection kit according to the manual protocol (ECL GST western blotting detection kit, Pierce Biotechnology, Inc., Waltham, MA, USA). The bands were analyzed using GelGDoc2000 imaging system (Bio-Rad Laboratories GmbH, Munich, Germany). Statistics All the experiments were carried in triplicate and the values were expressed as mean ± SD. Differences between the control and treated cells were analyzed using Student s t-test, and statistical significance was considered at p <0.05. Results Safranal exerts antiproliferative effects on Colo-205 cells To examine the antiproliferative effects of the safranal (Figure 1), the Colo-205 cells were treated JBUON 2018; 23(3): 575

576 Safranal exerts anticancer activity in colon cancer with safranal at different doses and the cell viability was investigated by MTT assay. The results revealed that safranal (Figure 2) exhibited significant antiproliferative activity on the colo-205 cells which was concentration-dependent. The IC 50 of safranal against colo-205 colon cancer cells was 20 µm. Figure 3. Induction of apoptosis at IC 50 of safranal as indicated by DAPI staining. The experiments were carried out in triplicate and showed that safranal triggered apoptosis at IC 50 (20 μμ). Figure 1. Chemical structure of safranal. Safranal induces apoptosis in Colo-205 cells Next we investigated by DAPI staining whether safranal also triggers apoptosis in colo-205 colon cancer cells. These cells were first exposed to safranal at IC 50 concentrations and then subjected to DAPI and observed under fluorescence microscope. It was observed that safranal induced apoptosis in colo-205 colon cancer as evidenced from the increased number of cells with white color nuclei (Figure 3). Further, the percentage of apoptotic cell populations increased from 2.43% to 39.66 % at IC 50 (Figure 4). To find out if safranal induced mitochondrial-related apoptosis we checked the Bax and Bcl-2 protein levels (Figure 5). The results clearly showed that safranal treatment increased the expression of Bax protein and decreased the Bcl-2 protein, indicative of mitochondrial apoptosis. The mitochondrial-mediated apoptosis was further confirmed by accretion of ROS by safranal (Figure 6) and reduction in MMP in a concentration-dependent manner (Figure 7). Figure 4. Comet assay showing DNA damage induced by safranal at IC 50 (20μΜ). Figure 5. Estimation of apoptotic cell populations of colo- 205 cells after treatment with safranal at IC 50. The experiments were carried out in triplicate.the Figure reveals that Bax expression increased and Bcl-2 decreased in a concentration-dependent manner. Figure 2. Effect of safranal on cell viability as determined by MTT assay. The experiments were carried out in triplicate and expressed as mean±sd (p<0.05). The Figure shows that the cell viability decreased with increasing safranal concentration (dose-dependent response). Figure 6. Annexin V/PI showing apoptotic cell populations. The experiment were carried out in triplicate. The Figure shows that safranal triggered apoptosis at IC 50 (20μΜ). JBUON 2018; 23(3): 576

Safranal exerts anticancer activity in colon cancer 577 Safranal induces DNA damage in Colo-205 cells We also assessed whether safranal caused DNA damage in colo-205 colon cancer cells by comet assay. It was observed that safranal induced DNA damage in colon cancer colo-205 cells at IC 50 concentrations. The DNA damage was evidenced from the formation of tail DNA (Figure 8). Safranal causes G2/M cell cycle arrest in Colo-205 cells The distribution of Colo-205 cells in the different cell cycle phases after treatment with safranal was studied at IC 50 concentration. The results showed safranal led to accumulation of colo-205 colon cancer cells in G2/M phase of the cell cycle, ultimately leading to G2/M cell cycle arrest (Figure 9). Safranal inhibits PI3K/AKT/mTOR signalling pathway Evaluation of the effect of safranal on the PI3K/AKT/mTOR signalling pathway revealed that safranal caused reduction in the protein expression levels of p-pi3k, p-akt and p-mtor. However, the expression of PI3K, AKT and mtor remained almost unaltered (Figure 10). Figure 9. Effect of safranal on cell cycle phase distribution of colo-205 cells. The experiments were carried out in triplicate. The Figure depicts that safranal at IC 50 caused increase in the G2 phase cells, leading to G2/M cell cycle arrest. Figure 7. Effect of indicated concentrations of safranal on ROS generation. The experiments were carried out in triplicate and expressed as mean±sd (p<0.05). The Figure shows that safranal led to the production of ROS in a concentration-dependent manner. Figure 8. Effect of indicated concentrations of safranal on MMP. The experiments were carried out in triplicate and expressed as mean±sd (p<0.05). The Figure shows that safranal led to reduction of MMP in a concentrationdependent manner. Figure 10. Western blot showing the effect of safranal on the protein expression of PI3K/AKT/mTOR signalling pathway. The experiments were carried out in triplicate The Figure shows that the expression of p-pi3k, p-akt and p-mtor decreased with increasing concentrations of safranal. JBUON 2018; 23(3): 577

578 Safranal exerts anticancer activity in colon cancer Discussion Colon cancer is the second most important cause of cancer-related deaths among malignant tumors [7]. The treatment options for colon cancer are limited and also have side effects [8]. Thus, novel plant-derived molecules are being screened for their anticancer activities every now and then [9]. In this study we investigated the anticancer potential of safranal against the colo-205 colon cancer cells. Safranal reduced the viability of these cells in a dose-dependent manner and exhibited an IC 50 of 20 µm. It has been reported that safranal together with other saffron apocarotenoids inhibited the growth of human cancer cells [10]. To further decipher the mechanism by which safranal reduced the viability of colo-205 cancer cells, we first carried out DAPI staining and observed that safranal could prompt apoptosis in cancer cells which was further confirmed by the comet assay. Then, annexin V/PI staining revealed that the apoptotic cell populations were 39.66% at IC 50 concentration in comparison to 2.43% in control. Apoptosis is considered one of the important mechanisms to prevent the development of diseases, such as cancer, and the organism eliminates the harmful cells via this process [11]. Furthermore, the anticancer agents that are able to induce apoptosis of cancer cells are considered proficient as they also curb the development of drug resistance by cancer cells [12]. Next, to unveil if the safranal-triggered apoptosis followed the mitochondrial pathway, we evaluated the expression of Bax and Bcl-2 proteins and observed that safranal upregulated the expression of Bax and downregulated the Bcl-2 expression in a concentration-dependent manner. This was further associated with accretion of ROS and reduction MMP. All these changes clearly indicate that safranal induced-apoptosis follows the mitochondrial pathway. Apart from apoptosis, cell cycle is another target by which anticancer agents induce their anticancer effects [13]. In this study it was observed that safranal triggered G2/M cell cycle arrest in the colo-205 cancer cells. Finally, we examined the effect of safranal on the PI3K/AKT/ mtor signalling pathway and the results revealed that safranal could inhibit this pathway. PI3K/ AKT/mTOR signalling pathway is one important pathway that is reported to be activated in several cancer types [14]. Therefore, drugs targeting this pathway may prove very useful in the treatment of malignancies. Conclusion To conclude, the results of the present study indicate that safranal inhibits the growth of cancer cells via induction of mitochondrial apoptosis and induction of G2/M cell cycle arrest. These results clearly indicate that safranal could prove a lead molecule for the treatment and management of colon cancer. Conflict of interests The authors declare no conflict of interests. References 1. Seigler DS. Plant secondary metabolism. Springer Science & Business Media;2012 Dec 6. 2. Britton G, Synnove LJ, Pfander H. Carotenoids in food. Carotenoids 2009:5:431. 3. Walter MH, Floss DS, Strack D. Apocarotenoids: hormones, mycorrhizal metabolites and aroma volatiles. Planta 2010;232:1-7. 4. Hosseinzadeh H, Younesi HM. Antinociceptive and anti-inflammatory effects of Crocus sativus L. stigma and petal extracts in mice. BMC Pharmacol 2002;2:7. 5. Ricci-Vitiani L, Lombardi DG, Pilozzi E et al. Identification and expansion of human colon-cancer-initiating cells. Nature 2007;445:111-5. 6. Morin PJ, Sparks AB, Korinek V et al. Activation of β-catenin-tcf signaling in colon cancer by mutations in β-catenin or APC. Science 1997;275:1787-90. 7. Colon Cancer Laparoscopic or Open Resection Study Group. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 2005:477-84. 8. Tsujii M, Kawano S, Tsuji S, Sawaoka H, Hori M, DuBois RN. Cyclooxygenase regulates angiogenesis induced by colon cancer cells. cell. Cell 1998;93:705-16. 9. Bhakuni DS, Bittner M, Marticorena CL, Silva M, Weldt E, Hoeneisen M. Screening of Chilean plants for anticancer activity. I. Lloydia 1976;39:225-43. 10. Chen M, Wang J. Initiator caspases in apoptosis signaling pathways. Apoptosis 2002;7:313-9. 11. Zhang JY. Apoptosis-based anticancer drugs. Nat Rev Drug Discov 2002;1:101-2. 12. Tolomeo M. Drug resistance and apoptosis in cancer treatment: development of new apoptosis-induced agents in drug resistant malignancies. Curr Med Chem Anticancer Agents 2002;387-401. 13. Hartwell LH, Kastan MB. Cell cycle control and cancer. Science-AAAS-Weekly Paper Edition 1994 Dec 16;266:1821-8. 14. Morgensztern D, McLeod HL. PI3K/Akt/mTOR pathway as a target for cancer therapy. Anticancer Drugs 2005;16:797-803. JBUON 2018; 23(3): 578