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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2016; 8(1): 30-39
Published online Jan 15, 2016. doi: 10.4251/wjgo.v8.i1.30
Antitumor effects of the benzophenanthridine alkaloid sanguinarine: Evidence and perspectives
Roberta Gaziano, Gabriella Moroni, Cristina Buè, Martino Tony Miele, Paola Sinibaldi-Vallebona, Francesca Pica
Roberta Gaziano, Gabriella Moroni, Cristina Buè, Martino Tony Miele, Paola Sinibaldi-Vallebona, Francesca Pica, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy
Author contributions: Gaziano R, Moroni G, Buè C, Miele MT, Sinibaldi-Vallebona P and Pica F contributed to this paper.
Conflict-of-interest statement: Authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Francesca Pica, MD, PhD, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier, 1, 00133 Rome, Italy. pica@uniroma2.it
Telephone: +39-6-72596462 Fax: +39-6-72596550
Received: June 12, 2015
Peer-review started: June 15, 2015
First decision: August 25, 2015
Revised: October 9, 2015
Accepted: November 3, 2015
Article in press: November 4, 2015
Published online: January 15, 2016
Abstract

Historically, natural products have represented a significant source of anticancer agents, with plant-derived drugs becoming increasingly explored. In particular, sanguinarine is a benzophenanthridine alkaloid obtained from the root of Sanguinaria canadensis, and from other poppy Fumaria species, with recognized anti-microbial, anti-oxidant and anti-inflammatory properties. Recently, increasing evidence that sanguinarine exibits anticancer potential through its capability of inducing apoptosis and/or antiproliferative effects on tumor cells, has been proved. Moreover, its antitumor seems to be due not only to its pro-apoptotic and inhibitory effects on tumor growth, but also to its antiangiogenic and anti-invasive properties. Although the precise mechanisms underlying the antitumor activity of this compound remain not fully understood, in this review we will focus on the most recent findings about the cellular and molecular pathways affected by sanguinarine, together with the rationale of its potential application in clinic. The complex of data currently available suggest the potential application of sanguinarine as an adjuvant in the therapy of cancer, but further pre-clinical studies are needed before such an antitumor strategy can be effectively translated in the clinical practice.

Keywords: Sanguinarine, Cancer, Apoptosis, Cell-cycle, Chemotherapy

Core tip: Sanguinarine is a benzophenanthridine alkaloid isolated from the root of Sanguinaria canadensis, and other poppy Fumaria species, which exibits a clear-cut anticancer potential by inducing apoptosis and/or antiproliferative effects on tumor cells. Sanguinarine also shows antiangiogenic and anti-invasive properties, as demonstrated in vitro and in vivo. In consideration of the multiple biological effects of sanguinarine, which suggest its possible use in cancer therapy, further detailed pharmacokinetic and toxicologic studies are required to assess both the efficacy and safety of the compound before proposing a possible translation into the clinic.