The biochemistry and medical significance of the flavonoids.

Plants consumed by humans contain thousands of phenolic compounds. The effects of dietary polyphenols are of great current interest due to their antioxidative and possible anticarcinogenic activities. A popular belief is that dietary polyphenols are anticarcinogens because they are antioxidants, but direct evidence for this supposition is lacking. This chapter reviews the inhibition of tumorigenesis by phenolic acids and derivatives, tea and catechins, isoflavones and soy preparations, quercetin and other flavonoids, resveratrol, and lignans as well as the mechanisms involved based on studies in vivo and in vitro. Polyphenols may inhibit carcinogenesis by affecting the molecular events in the initiation, promotion, and progression stages. Isoflavones and lignans may influence tumor formation by affecting estrogen-related activities. The bioavailability of the dietary polyphenols is discussed extensively, because the tissue levels of the effective compounds determine the biological activity. Understanding the bioavailability and blood and tissue levels of polyphenols is also important in extrapolating results from studies in cell lines to animal models and humans. Epidemiological studies concerning polyphenol consumption and human cancer risk suggest the protective effects of certain food items and polyphenols, but more studies are needed for clear-cut conclusions. Perspectives on the application of dietary polyphenols for the prevention of human cancer and possible concerns on the consumption of excessive amounts of polyphenols are discussed.

Inhibition of carcinogenesis by dietary polyphenolic compounds

Dietary agents in cancer prevention: flavonoids and isoflavonoids.

Flavonoids are polyphenolic compounds that are ubiquitously in plants. They have been shown to possess a variety of biological activities at nontoxic concentrations in organisms. The role of dietary flavonoids in cancer prevention is widely discussed. Compelling data from laboratory studies, epidemiological investigations, and human clinical trials indicate that flavonoids have important effects on cancer chemoprevention and chemotherapy. Many mechanisms of action have been identified, including carcinogen inactivation, antiproliferation, cell cycle arrest, induction of apoptosis and differentiation, inhibition of angiogenesis, antioxidation and reversal of multidrug resistance or a combination of these mechanisms. Based on these results, flavonoids may be promising anticancer agents.

Flavonoids: Promising anticancer agents

Chronic inflammation is being shown to be increasingly involved in the onset and development of several pathological disturbances such as arteriosclerosis, obesity, diabetes, neurodegenerative diseases and even cancer. Treatment for chronic inflammatory disorders has not been solved, and there is an urgent need to find new and safe anti-inflammatory compounds. Flavonoids belong to a group of natural substances occurring normally in the diet that exhibit a variety of beneficial effects on health. The anti-inflammatory properties of flavonoids have been studied recently, in order to establish and characterize their potential utility as therapeutic agents in the treatment of inflammatory diseases. Several mechanisms of action have been proposed to explain in vivo flavonoid anti-inflammatory actions, such as antioxidant activity, inhibition of eicosanoid generating enzymes or the modulation of the production of proinflammatory molecules. Recent studies have also shown that some flavonoids are modulators of proinflammatory gene expression, thus leading to the attenuation of the inflammatory response. However, much work remains to be done in order to achieve definitive conclusions about their potential usefulness. This review summarizes the known mechanisms involved in the anti-inflammatory activity of flavonoids and the implications of these effects on the protection against cancer and cardiovascular disease.

Flavonoids as anti-inflammatory agents: implications in cancer and cardiovascular disease.

The modifying effects of dietary exposure of three flavonoids, chalcone, 2-hydroxychalcone, and quercetin, during the initiation and postinitiation phases of oral tumorigenesis initiated with 4-nitroquinoline-1-oxide (4-NQO) were investigated in male F344 rats. At 6 weeks of age, animals were divided into experimental and control groups. At 7 weeks of age, all animals except those treated with test chemicals alone and the untreated control group were given 4-NQO [20 parts/million (ppm)] in the drinking water for 8 weeks to induce oral neoplasms. For chemopreventive study by feeding of test compounds during the initiation phase, groups of animals were given diets containing 500 ppm chalcone, 500 ppm 2-hydroxychalcone, or 500 ppm quercetin for 10 weeks, starting 1 week before 4-NQO exposure. Seven days after stopping 4-NQO exposure, these groups were switched to the basal diet and kept on this diet until the end of the experiment. For chemopreventive study by treatment with test chemicals during the postinitiation phase, starting 1 week after the cessation of 4-NQO administration, the groups given 4-NQO and the basal diet were switched to the diets mixed with test chemicals and maintained on these diets for 22 weeks. The other groups consisted of rats fed diets containing 500 ppm test chemicals alone or of untreated rats. Thirty-two weeks after the start of the study, the incidence of tongue neoplasms and preneoplastic lesions, polyamine levels in the tongue epithelium, and cell proliferation activity estimated by bromodeoxyuridine labeling index were compared among the different dietary groups. Feeding of all test chemicals during either initiation or postinitiation phases caused a significant reduction in the frequency of tongue carcinoma (68-88% reduction; P < 0.05). Dietary administration of these test chemicals also significantly decreased the bromodeoxyuridine labeling index of the tongue squamous epithelium (P < 0.05). In addition, polyamine levels in the oral mucosa were lowered in rats treated with 4-NQO and test chemicals when compared to those given 4-NQO alone. These results indicate that the flavonoids chalcone, 2-hydroxychalcone, and quercetin present in our daily foods have an inhibitory effect on oral carcinogenesis initiated with 4-NQO, and such a modifying effect may be related partly to the suppression of cell proliferation.

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Chemoprevention of 4-Nitroquinoline 1-Oxide-induced Rat Oral Carcinogenesis by the Dietary Flavonoids Chalcone, 2-Hydroxychalcone, and Quercetin

The modifying effects of dietary exposure of the flavonoid morin on 4-nitroquinoline 1-oxide (4-NQO)-induced tongue tumorigenesis, the activities of phase II detoxifying enzymes glutathione S-transferase (GST) and quinone reductase (QR) in liver and tongue, and cell proliferation activity in tongue were investigated in male F344 rats. At 7 weeks of age, all animals except those treated with morin alone and control group were given 4-NQO (20 ppm) in drinking water for 8 weeks to induce oral neoplasms. Starting 7 days before 4-NQO exposure, experimental groups were fed experimental diets containing morin (100 and 500 ppm) for 10 weeks ("initiation feeding"). Starting 1 week after the cessation of exposure to 4-NQO, other experimental groups given 4-NQO and a basal diet were given experimental diets for 22 weeks ("post-initiation feeding"). At week 32 week, "initiation feeding" of morin caused a significant reduction in the incidence of tongue carcinoma (by 44-100%). "Post-initiation feeding" with morin also significantly decreased the frequency of tongue carcinoma (by 44%). Morin feeding elevated liver GST and QR activities and GST activity in the anterior portion of tongue. Feeding with morin significantly lowered QR activity of the posterior part of the tongue. Dietary exposure to morin significantly decreased the proliferating cell nuclear antigen-positive index in the posterior portion. Also, morin feeding lowered tongue polyamine levels, especially in the "post-initiation feeding" group. Our results indicate that morin acts as a chemopreventive agent against tongue carcinogenesis induced by 4-NQO through modification of detoxifying enzyme activities and/or cell proliferation activities.

Norichika Tatematsu

Papers

Chemoprevention of 4-Nitroquinoline 1-Oxide-induced Rat Oral Carcinogenesis by the Dietary Flavonoids Chalcone, 2-Hydroxychalcone, and Quercetin

Chemopreventive effect of dietary flavonoid morin on chemically induced rat tongue carcinogenesis

Effect of estrogen replacement on temporomandibular joint remodeling in ovariectomized rats.

Adenomatoid odontogenic tumor: report of two cases and survey of 126 cases in Japan.

Squamous cell carcinoma arising in a dentigerous cyst.