Effect of Cowpea Extract on PCNA Expression and BAX/BCL2 Ratio in Mice Epithelial Cells Menopause Model

Similar documents
This brings me to my point. Disease starts when there is a surplus or deficiency of certain nutritive or non-nutritive substances in the human body.

Soy phytoestrogen effects on progesterone receptor and ovalbumin synthesis in the chick oviduct.

Approved for Public Release; Distribution Unlimited

Research Article The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women

Nuclear Receptors. Estrogen and Thyroid Hormone Receptors and their Interaction. Estrogen Hormone Receptor.

Catechin s anti-angiogenic effects in epithelial ovarian cancer

Kwao Krua Kao (Pueraria mirifica)

5. Summary of Data Reported and Evaluation

Melatonin and its Role in the Inhibition of Breast Cancer Ciara Nicol Ross Copyright 2014 by Ciara Ross and Koni Stone

Non medical alternative treatment of vasomotor symptomes

Reproductive. Estrone sulfate Analyte Information

Immunostaining was performed on tumor biopsy samples arranged in a tissue-microarray format or on

HEPATIC CELL INJURY BY ETHINYL OESTRADIOL ESTROGEN Pandey Govind a*, Pandey S.P. b and Madhuri S. c

Crosstalk between Adiponectin and IGF-IR in breast cancer. Prof. Young Jin Suh Department of Surgery The Catholic University of Korea

Menopause and HIV. Together, we can change the course of the HIV epidemic one woman at a time.

By Soha Mohamed Hamdy (1),Abdelkarim Mohamed Abdellatif (2) and Rania Mortada Mahmuod (1)

Estrogen receptor α- (ERα), but not ERβ-signaling, is crucially involved in mechanostimulation of bone fracture healing by whole-body vibration

5. Summary of Data Reported and Evaluation

Effects of Genistein in Over-the-Counter Phytoestrogen Supplements on Ovarian Cancer Cells

Outline. Estrogens and SERMS The forgotten few! How Does Estrogen Work in Bone? Its Complex!!! 6/14/2013

In Silico Analysis of the Potential for Gingerol to IRS-1, GLUT-4, PPAR Γ, and PI3K Activation in Insulin Resistance Condition

Devyanto Hadi Triutomo*, Amalia Miranda, Lora Johana Tamba, Endang Lukitaningsih. Fakultas Farmasi, Universitas Gadjah Mada, Yogyakarta, Indonesia

Estrogenic Activities of Pueraria candollei Grah. Tuberous Roots

Innovative Nuclear Receptor Modulation Medicine

Management of Menopausal Symptoms

Biologist s and Investigator Perspective. Has Sloppy Communication Slowed Progress??

Hormone. Free Androgen Index. 2-Hydroxyestrone. Reference Range. Hormone. Estrone Ratio. Free Androgen Index

The Effects of Phytoestrogens Found in Promensil on Human Ductal Carcinoma

Contents 1 The Windows of Susceptibility to Breast Cancer 2 The So Called Pre-Neoplastic Lesions and Carcinoma In Situ

EDUCATIONAL COMMENTARY CA 125. Learning Outcomes

New Cancer Cases By Site Breast 28% Lung 14% Colo-Rectal 10% Uterus 6% Thyroid 5% Lymphoma 4% Ovary 3%

Hormonal Control of Human Reproduction

Metabolic changes in menopausal transition

EFFECT OF SELECTED FOOD AND MEDICAL PLANTS AND PLANT MOLECULES ON OVARIAN FUNCTIONS

ESTRADIOL LEVELS AND SERUM LIPIDS

Phytoestrogen Project:

North American Menopause Society (NAMS)

Tissue-selective estrogen complexes for postmenopausal women. BMS Satellite Symposium 14 nov 2015 A Pintiaux ULg

The Adolescent: A Patient at Risk: Ovarian Failure in Adolescent Cancer Survivors

PERIMENOPAUSE. Objectives. Disclosure. The Perimenopause Perimenopause Menopause. Definitions of Menopausal Transition: STRAW.

WEIGHT GAIN DURING MENOPAUSE EMERGING RESEARCH

SERMS, Hormone Therapy and Calcitonin

Invited Re vie W. Steroid hormones and bone. Histology and Histopathology

Guide to Small Animal Reproductive Imaging using the Vevo 770

Neonatal Phytoestrogen Exposure Alters Oviduct Mocosal Immune Response to Pregnancy and Affects Preimplantation Embryo Development in the Mouse

The presence and effect of endocrine disruptors on reproductive organs of fish in a reservoir used for aquiculture

Progesterone responsiveness is not downregulated in adenomyosis.

BYU ScholarsArchive. Brigham Young University. Crystal Blake Brigham Young University - Provo. All Theses and Dissertations

SPRMs, androgens and breast cancer

Hormone Treatments and the Risk of Breast Cancer

Fukushima-ku, Osaka. Synopsis. and LH release by investigating the effects of exogenous estrogen on the progesteroneinduced

Ohio Northern University HealthWise. Authors: Alexis Dolin, Andrew Duska, Hannah Lamb, Eric Miller, Pharm D Candidates 2018 May 2018

How Neurosteroids Modulate Seizures in Children and Adults November 30, 2012

Everyday Chemical Exposures and Breast Cancer: Why are we concerned? What can we do? Janet M. Gray, Ph.D. Vassar College Breast Cancer Fund

Roles of the AIB1 protein in the proliferation and transformation of human esophageal squamous cell carcinoma

Cancer in Women after Menopause

Menopause Symptoms and Management: After Breast Cancer

Appeal decision. Appeal No USA HILL'S PET NUTRITION, INC. Osaka, Japan

IN VITRO ANTICANCER SCREENING OF ASPARAGUS LARICINUS EXTRACTS. S. Mashele and N. Kolesnikova

CANCER = Malignant Tumor = Malignant Neoplasm

Post-menopausal hormone replacement therapy. Evan Klass, MD May 17, 2018

WHI - Volume 3, Form 32 - Family History Questionnaire (Ver. 3) Page 1. Self-administered; 12-page booklet; data entered at Clinical Center (CC).

Uterine Fibroids: No financial disclosures. Current Challenges, Promising Future. Off-label uses of drugs. Alison Jacoby, MD.

Managing menopause in Primary Care and recent advances in HRT

Supplementary Figure 1: Neuregulin 1 increases the growth of mammary organoids compared to EGF. (a) Mammary epithelial cells were freshly isolated,

improved with an MIS approach. This clinical benefit for American women has been demonstrated with Level I evidence. Hysterectomy is one of the most

Flashpoint: Regulating Your Body s Temperature. Presented by: Shari M. Lawson, MD MBA Date Presented: November 1,

Dietary Genistein Decreases the Age and Body Weight of Puberty Onset in Female Syrian Hamsters

Learning Objectives. Peri menopause. Menopause Overview. Recommendation grading categories

Soyfood Consumption and Breast Cancer Survival. Xiao Ou Shu, M.D., Ph.D. Ingram Professor of Cancer Research Vanderbilt University, U.S.A.

Correlation Between GATA-3, Ki67 and p53 Expressions to Histopathology Grading of Breast Cancer in Makassar, Indonesia

EFFECTS OF Pueraria mirifica ON NEUROPATHIC PAIN IN RATS

To: National Toxicology Program (NTP); Center for the Evaluation of Risks to Human Reproduction (CERHR)

Natural Herbal Extracts

Antitumor Activity of CUDC-305, a Novel Oral HSP90 Inhibitor, in Solid and Hematological Tumor Xenograft Models

CONTRACTING ORGANIZATION: University of Colorado Health Sciences Aurora, CO 80045

Milk micro-rna information and lactation

Department of Nutrition and Food Science Texas A&M University

Effect of Promensil on Breast Cancer Cells in regard to the Estrogen Receptor Beta

Research Article Hypoxia-Inducible Factor-1α Expression in Indonesian Laryngeal Squamous Cell Carcinoma Patients

Developing Best in Class BET Inhibitors for Oncology & AI: from Discovery to the Clinic. Kevin G. McLure, PhD EpiCongress July 2014

METACELL. PERSONALIZED CANCER THERAPY USING CIRCULATING TUMOR CELLS (CTCs) METACELL LIQUID BIOPSY

Effects of estradiol and progesterone on the growth of HeLa cervical cancer cells

SUPPLEMENTARY INFORMATION

Arimidex and mushroom supplements bank of america line of credit payoff address rachael ray weight gain 2017

Soy and Soy Extract. James Meschino DC, MS,ND

Parathyroid Hormone Analogs

Novel RCC Targets from Immuno-Oncology and Antibody-Drug Conjugates

CASE 4- Toy et al. CASE FILES: Obstetrics & Gynecology

Nutrigenomics. Sejal Parekh Biochem 118Q December 2, 2010 Doug Brutlag

ISOFLAVONE CHARACTERIZATION FROM LEGUMES OTHER THAN SOYBEANS. Koh L.W. 1 and Perera C.O. 2

The Effects of Genistein on Breast Epithelial Cancer Cells

Deepa Taggarshe MD MRCS M Phil, Catherine Lobocki MS, Alasdair McKendrick MD FACS, Vijay K Mittal MD FACS

[ NASDAQ: MSHL ] Southern California Investor Conference August 29, 2011

Convergent and Divergent Mechanisms in Aging and Cancer

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?

Claudin-4 Expression in Triple Negative Breast Cancer: Correlation with Androgen Receptors and Ki-67 Expression

WOMENCARE A Healthy Woman is a Powerful Woman (407) Mammography

COURSE OUTLINE - Module I

Academic Script Surgical Techniques Like Ovariectomy, Orchidectomy, Adrenalectomy, Etc

Transcription:

Cronicon OPEN ACCESS EC ENDOCRINOLOGY AND METABOLIC RESEARCH Research Article Effect of Cowpea Extract on PCNA Expression and BAX/BCL2 Ratio in Mice Epithelial Cells Menopause Model Hermawan Wibisono 1 *, Hendy Hendarto 2 and Pande Made 3 1 Department of Obstetrical and Gynecology, Brawijaya University, Indonesia 2 Department of Obstetrical and Gynecology, Consultant of Fertility Endocrinologist Reproductive, Airlangga University, Indonesia 3 Department of Obstetrical and Gynecology, Consultant of Fertility Endocrinologist Reproductive, Brawijaya University, Indonesia *Corresponding Author: Hermawan Wibisono, Department of Obstetrical and Gynecology, Brawijaya University, Indonesia. Received: March 19, 2019; Published: April 02, 2019 Abstract Objective: In biology, breast cancer has two main biological factors - proliferation and apoptosis. Currently, therapeutic agents focus on the regulation of these factors that can manage and prevent progression of the cancer. However, current drugs provide not only therapeutic benefits but also serious side effects that eventually adds burden to the patient. With this, medicinal plants were explored as a potential source of therapeutic agents such as Cowpea that are abundant in Indonesia that showed a potential regulation of the progression of breast cancer. To evaluate the effects of Cowpea extract in the two biological factors of breast cancer, PCNA expression and ratio of BAX/BCL2 were measured in mice epithelial cells menopause model. Design: Prospective controlled experimental trial. Setting: University medical center. Animal: Rattus norvegicus Strain Wistar. Intervention: The experimental mice oovorectomy were divided into 3 groups: Group I: the control group; no treatment was given and experimental mice Group II: experimental mice given Cowpea extract (15 mg/kgbw/day), Group III: experimental mice given cowpea extract (60 mg/kgbw/day). Main Outcome Measurement: Histopathological assessment. Result: The effect of Cowpea extract with two dose-response showed a significant difference between the control group (85 ± 13.87a) and the test groups, group 2 (61 ± 6.67b) and group 3 (47.8 ± 6.14c) (p = 0.00) in PCNA expression. This indicates that the test groups, both the two different doses significantly decrease the PCNA expression in female rats. In BAX/BCL2 expression the control group (0.32 ± 0.18a and group 2 (0.56 ± 0.50a), group 3 (1.33 ± 0.78b). This indicates that the test groups, both the two different doses significantly decreases the BAC/BCLA2 expression in female rats. Conclusion: The remarkable effects of Cowpea extract on the inhibition of PCNA expression and upregulation of BAX/BCL2 will served as a good platform for pharmaceutical and medical industries to explore Cowpea which is abundant in Indonesia as a source of effective therapeutic treatment for breast cancer. Keywords: Cowpea Extract; PCNA; BAX/BCL2 Ratio; Mice Epithelial Cells Introduction Breast cancer is the most frequent cancer among women with a mortality rate 22.9% worldwide. In Indonesia, breast cancer ranks second after cervical cancer. Moreover, the Dharmais cancer hospital reports that there is a 2.3% increase/year of breast cancer morbidity.

Breast cancer, in biology, have two main biological factors that influence its occurrence - proliferation and apoptosis. In diagnosis, proliferation is often done by measuring Proliferating Cell Nuclear Antigen (PCNA) which is a cell nucleus protein. The PCNA measurement of proliferation has an inverse relationship to apoptosis; the lower the PCNA score the higher the apoptosis will occur. On the other hand, the most commonly used apoptosis marker is the ratio of pro-apoptotic members BAX/B-Cell Lymphoma2 (BAX/Bcl2). BAX is a factor that triggers BCL2 as an inhibiting factor, the more it increases, the more apoptosis will occur [1,2]. Notably, physiological condition such as menopause also influences the occurrence of breast cancer; as menopause women have more pronounced incidence of breast cancer [3]. At menopausal stage various short-term and long-term problems will emerge as a result of decrease in estrogen termed as hypo estrogenemia. This condition can be managed by administering hormone replacement therapy (HRT). Moreover, the hormone replacement therapy has remarkable benefits in decreasing the risk of colorectal cancer and osteoporosis fractures. However, prolonged use HRTs increases the risk of cardiovascular disease with and breast cancer [4]. With this serious side effects of HRTs, ethnobotanical resources such as plants are explored as a potent source of estrogen or its derivatives. There were existing studies that provide evidence of high content of estrogen and its derivatives in Bitok (Pueraria lobata) and Cowpea (Vigna Unguiculata) which are abundantly found in Indonesia. However, there were no dose-response studies were made using animal models to screen the potential effects of these plants as a natural source of estrogen. With this, the study utilized Cowpea as a source of phytoestrogen and to possibly elucidate its mechanism of action on proliferation and apoptosis pathways. The goal of the study is to determine the potential of Cowpea as an alternative natural source of phytoestrogen and to explore its possible anti-cancer activity using PCNA expression and BAX/ BCL-2 ration in mice menopause model. Material and Methods Cowpea Extract preparation and Administration The cowpea extract is dissolved with aquabidest to a total volume of 5 ml. Given only once a day. Special foods for mice are given as much as 40 grams/day/1 mouse. The cowpea extract was given a gastric dose (inserted), carried out for 21 days at a dose according to the group. Mice menopause model The rat model of Rattus norvegicus Strain Wistar hypoestrogen were house at the Pharmacology Laboratory of the Faculty of Medicine, Universitas Brawijaya. The study followed a strict inclusion and exclusion criteria as follows: Adult (8-9 weeks), with a weight between 300-350 grams, female mice, not pregnant, and apparently healthy (active, pure white fur, bright eyes and not deformed). Experimental mice died during the experiment were excluded. Briefly, the experimental mice were divided into 3 groups: Group I: The control group; no treatment was given and experimental mice. Group II: Experimental mice given Cowpea extract (15 mg/kgbw/day). Group III: Experimental mice given cowpea extract (60 mg/kgbw/day). Mouse ovariectomy The body weight of the mice was weighed, anesthetized with an i.m meter dose of 10 mg/kg Fur. The experimental rats were laid on the operating table, sterilization of the operating area with betadine and 70% alcohol, then covered with sterile duk. The operating area (abdomen) is shaved, and a trans-abdominal incision of 1.5-2 cm is made above the uterus. Binding is done in 2 places, which are proximal and distal to the ovary, then followed by removal of the left and right ovary. During the search process and removal of the ovary the humidity of other organs must be maintained by dripping with physiological fluids. Before suturing, nebacetin powder is spread into the abdominal cavity. After the wound is sewn and closed, the mice are inserted into the cage. Each cage contains only one mouse. Days I, 65

66 II, and III after ovariectomy, Gentamicin i.m was injected at a dose of 60-80 mg/kgbw/day. During maintenance, adequate drinking and food are given, light is set light/dark alternately for 12 hours and at room temperature. Sample preparation Rat breast tissue was soaked in fixative solution in the form of formalin or PFA (1-7 days), then immersed in 70% ethanol at least 24 hours and continued with 80% ethanol for 2 hours. Standard tissue processing was done to all rat breast tissue samples. Immunohistochemistry Deparaffinization and Rehydration were performed in preparation of immunohistochemistry using xylol and multilevel alcohol (100%, 90%, 80%, 70%, 30%), and distilled water in sequence. After, cell blocking of the tissues were made. For immunohistochemistry Primary Antibodies in Serum Goat/FBS/BSA to desired concentration and volume (Leptin Antibody 1: 500 in serum Goat or FBS) were used. Cell incubation in primary antibodies at 4 C for 12 hours or at room temperature for 2 hours. Secondary Antibodies (Gout-Anti Rabbit IgG Biotin Labeled) were then utilized labeled biotin in PBS to the desired concentration and volume (Anti Rabbit IgG Labeled Biotin 1: 500 in PBS). Counterstaining using with Mayer s hematoxylin for 10 minutes were used for visualization. Ethical considerations This research was approved by the research ethics committee in the health field of the Faculty of Medicine, University of Brawijaya Malang. Statistical analysis Data were analyzed using one way ANOVA and MANOVA tests, to test the relationship of cowpea extract and the number of postmenopausal β estrogen receptors in the five treatments. The calculation process is carried out with the help of the SPSS computer software program with the alpha of 0.05. Result and Discussion Cowpea extract effect on PCNA expression The effect of Cowpea extract with two dose-response showed a significant difference between the control group and the test groups (p = 0.00) in PCNA expression. This indicates that the test groups, both the two different doses significantly decrease the PCNA expression in female rats (Table 1). Groups n Mean±SD p value Group I: Control (OVX) 5 85 ± 13.87 a 0.000 Group II: OVX + Cowpea ext 15 mg/kg/body/day 5 61 ± 6.67 b Group III: OVX + Cowpea ext 60 mg/kg/body/day 5 47.8 ± 6.14 c Table 1: Testing the significant difference of control group and test groups in PCNA expression in female rats Description: The mean ± SD column containing the same letters indicates none significant difference (p > 0.05), when loading different letters indicates there is a significant difference (p 0.05). Remarkably, the cowpea dosage 15 mg/kg/body/day and dosage 60 mg/kg/body/day showed a significant difference; this shows a decrease in PCNA expression depending on the dosage of cowpea. Therefore, the dose-response relationship of the Cowpea extract and the expression of PCNA has positive inverse relationship. The higher the dosage of cowpea given, the lower the PCNA expression.

67 In clinical interpretation, it may decrease the proliferation of the tumor size. The mechanism behind this relationship can be explained with the study of Basu and colleagues [5]. In their study, the phytoestrogen showed a potent anti-proliferative effect [5]. However, this claim is still not well-established, leaving phytoestrogen as a potential chemopreventive agent for breast cancer [6], or trigger [7]. Thus, with the result of this study, this good be a good platform to pharmaceutical industries to explore the potentials of Cowpea as a potent chemoprotective agent. Histologic effect of cowpea extract on PCNA mice epithelial cells Plate 1: Control Group. Plate 2: Group II (15 mg/kgbw). Plate 3: Group III (60 mg/kgbw). *Legend: Red-broken line: Cell target; Black-solid line: Normal cells. Cowpea extract effect on BAX/BCL2 expression The effect of Cowpea extract with two dose-response showed a significant difference between the control group and the test groups (p = 0.03) in BAX/BCLA2 expression. This indicates that the test groups, both the two different doses significantly decrease the BAC/BCLA2 expression in female rats (Table 2). Groups N Means ± stand.devs p-value Control (OVX) 5 0.32±0.18 a 0.039 Group II: OVX + Cowpea ext 15 mg/kg/body/day 5 0.56 ± 0.50 a Group III: OVX + Cowpea ext 60 mg/kg/body/day 5 1.33 ± 0.78 b Table 2: Testing the significant difference of control group and test groups in BAX/BCL2 expression in female rats. Description: The mean ± stand.devs column containing the same letters indicates none significant difference (p> 0.05), when loading different letters indicates there is a significant difference (p 0.05). Table 2 shows the higher the Cowpea extract dose will significantly increase the BAX/BCL2 expression. Based on the average Bax/BCl2 ratio, it appears that the treatment effect shows an increase in the Bax/BCl2 ratio compared to the control group. This signifies that the dose concentration of the Cowpea extract influences the apoptosis pathway, therefore, inhibits progression of malignancies. The results indicated that the Cowpea extract-treated mice have upregulation effects to BAX/BCL2 ratio. This can be supported with the study of Tang and colleagues [8] were phytoestrogen induces apoptosis with increasing expression of BAX and decreasing expression of BCL2; the BAX/ BCL2 ratio will increase accelerating the apoptosis process [8-10]. Although, in the current study, it was not elucidated the upregulation properties of Cowpea however, the results suggest that the Cowpea extract is a good candidate for an effective therapeutic agent for breast cancer with which to induce apoptosis in epithelial cells [11-13].

68 Histologic effect of cowpea extract on BAX/BCL2 mice epithelial cells Plate 4: Control Group. Plate 5: Group II (15 mg/kgbw). Plate 6: Group III (60 mg/kgbw). *Legend: Red-broken line: Cell target; Black-solid line: Normal cells. Histologic effect of cowpea extract on BCL2 mice epithelial cells Plate 7: Control Group. Plate 8: Group II (15 mg/kgbw). Plate 9: Group III (60 mg/kgbw). *Legend: Red-broken line: Cell target; Black-solid line: Normal cells. Conclusion The remarkable effects of Cowpea extract on the inhibition of PCNA expression and upregulation of BAX/BCL2 will served as a good platform for pharmaceutical and medical industries to explore Cowpea which is abundant in Indonesia as a source of effective therapeutic treatment for breast cancer. Bibliography 1. Srivastava R. Apoptosis, cell signaling and human disease. Humana Press (2007). 2. Rajah TT., et al. Physiological concentration of genistein and 17β-estradiol inhibit MDA-MB-231 breast cancer growth by increasing BAX/Bcl2 and reducing perk1/2. Anticancer Research 32.4 (2012): 1181-1191. 3. Biro Pusat Statistik (BPS). Proyeksi Penduduk Indonesia, Jakarta (2000). 4. Women s Health Initiative (WHI). Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results from the Women s Health Initiative Randomized Controlled Trial. Journal of the American Medical Association 288.3 (2002): 321-333.

69 5. Basu P and Maier C. Phytoestrogens and breast cancer: In vitro anticancer activities of isoflavones, lignans, coumestans, stilbenes and their analogs and derivatives. Biomedicine and Pharmacotherapy 107 (2018): 1648-1666. 6. Douglas CC., et al. Soy and its isoflavones: the truth behind the science in breast cancer. Anti-Cancer Agents in Medicinal Chemistry 13.8 (2013): 1178-1187. 7. Helle J., et al. Assessment of the proliferative capacity of the flavanones8-prenylnaringenin, 6-(1.1-dimethylallyl) naringenin and naringenin in MCF-7 cells and the rat mammary gland. Molecular and Cellular Endocrinology 392.1-2 (2014): 125-135. 8. Tang S., et al. Daidzein Induced Apoptosis via Down-Regulation of Bcl-2/Bax and Triggering of the Mitochondrial Pathway in BGC- 823 Cells. Cell Biochemistry and Biophysics 65.2 (2013): 197-202. 9. Hu W and Xiao ZM. Formononetin Induces Apoptosis of Human Osteosarcoma Cell Line U2OS by Regulating the Expression of Bcl-2, Bax and MiR-375 In Vitro and In Vivo. Cellular Physiology and Biochemistry 37.3 (2015): 933-939. 10. Zhang X., et al. Formononetin induces apoptosis in PC-3 prostate cancer cells through enhancing the Bax/Bcl-2 ratios and regulating the p38/akt pathway. Nutrition and Cancer 66.4 (2014): 656-661. 11. Lee GA., et al. Kaempferol, a phytoestrogen, suppressed triclosan-induced epithelial-mesenchymal transition and metastatic-related behaviors of MCF-7 breast cancer cells. Environmental Toxicology and Pharmacology 49 (2017): 48-57. 12. Paunesku T., et al. Proliferating cell nuclear antigen (PCNA): ringmaster of the genome. International Journal of Radiation Biology 77.10 (2001): 1007-1021. 13. Grajales DM., et al. Phytoestrogens and mycoestrogens interacting with breast cancer proteins. Steroids 134 (2018): 9-15. Volume 4 Issue 2 April 2019 All rights reserved by Hermawan Wibisono., et al.