Ellagic acid / BioEnh Cancer Research Results

EA, Ellagic acid: Click to Expand ⟱
Features:
Polyphenol found in fruits, vegetables, nuts and some mushrooms. Strawberries, raspberries, blackberries, cherries and walnuts, green tea and red wine. Pomegranate arils are a well known source.
Ellagic acid (EA) is a dietary polyphenol found in berries and pomegranate-related foods, with reported anti-inflammatory (NF-κB↓), survival-pathway suppression (PI3K/AKT↓), and anti-proliferative effects including G1 arrest and apoptosis in many cancer models. A key practical nuance is that EA/ellagitannins are extensively transformed by gut microbiota into urolithins, which are more bioavailable and may account for a large share of systemic effects.

- Ellagitannins are high molecular weight polyphenols with a complex structure that includes one or more HHDP groups attached to a sugar.
- Ellagic Acid is the simpler, bioactive compound released when the HHDP groups in ellagitannins cyclize during hydrolysis.
- one best source is raspberries. 100g gives ~50mg(reasonable dose)
- Ellagic acid has very poor oral bioavailability
- Peak plasma EA after high oral intake is typically: <50–100 nM, often much lower, this is far below concentrations used in many in-vitro anticancer studies (5–50 µM).
- efficacy depends on gut metabolism (ie ability to produce Urolithin A)
- also look at Urolithin supplements

Pathways:
Apoptosis Regulation: (Bax, Bad) (Bcl-2, Bcl-xL)
Cell Cycle Arrest: G0/G1 or G2/M phases)
NF-κB (inhibit):
MAPK Pathways: (including ERK1/2, JNK, and p38 MAPK)
PI3K/Akt/mTOR: might downregulate this pathway
p53 Pathway: may influence the expression or activation of p53
Oxidative Stress and Nrf2 Pathway:exhibits antioxidant properties,
Summary:
- Anti-oxidant and metal chelating
- with some evidence it can induce ROS in cancer tumor conditions (mitochondrial stress, redox-unstable cells)
- reported synergy with Curcumin
- Reported, reduced the viability of cancer cells at a concentration of 10 µmol/L, while in healthy cells, this effect was observed only at a concentration of 200 µmol/L
- Pomegranate juice (PJ) (180 ml) containing EA (25 mg) and ETs (318 mg, as punicalagins, the major fruit ellagitannin). Plasma concentration (31.9 ng/ml) after 1 h post-ingestion but was rapidly eliminated by 4 h. (Hence might be difficult to consume enough EA!!!! to match vitro requirements)
- Increased the expression of p53 and p21 proteins as well as markers of apoptosis (Bax and caspase-3), and decreases Bcl-2, NF-кB, and iNOS
- EA has restricted bioavailability, primarily due to its hydrophobic nature and very low water solubility.
- Processing methods can alter EA content; peel extraction often increases measured EA, while prolonged storage/freezing may reduce levels.

Total ellagic acid equivalents (free + bound).
Punica granatum L. Pomegranate 700mg/kg (arils), 38700mg/kg(mesocarp)
Rubus idaeus L. Raspberry 2637–3309mg/kg
jaglandaceae Walnut 410mg/kg(freeEA) 8230mg/kg(totalEA)

Ellagic acid — a naturally occurring hydrolysable polyphenol and dilactone derived from hexahydroxydiphenic acid. It occurs as free ellagic acid and, more commonly, as a structural component or hydrolysis product of ellagitannins in pomegranate, raspberries, blackberries, strawberries, walnuts, muscadine grapes, and related foods. It is formally classified as a dietary polyphenolic phytochemical rather than an approved anticancer drug. Oral EA has low aqueous solubility, limited absorption, rapid conjugation, and extensive microbiome-dependent conversion into urolithins; therefore, free EA and its microbial metabolites should be treated as related but pharmacokinetically distinct agents.

Primary mechanisms (ranked):

  1. Induction of mitochondrial apoptosis through mitochondrial membrane depolarization, cytochrome-c release, Bax/Bcl-2 rebalancing, caspase activation, and suppression of anti-apoptotic proteins.
  2. Suppression of PI3K/AKT/mTOR and related survival signaling, with context-dependent inhibition of STAT3, ERK, and oncogenic growth programs.
  3. Cell-cycle arrest through p53 and p21 activation and suppression of cyclins and cyclin-dependent kinases.
  4. Suppression of NF-κB-regulated inflammatory, survival, invasion, and cytokine programs.
  5. Context-dependent redox modulation: antioxidant and NRF2-associated cytoprotection in normal or injured tissues, but ROS generation and oxidative mitochondrial injury in susceptible cancer cells, particularly at higher experimental concentrations or in combination treatments.
  6. Inhibition of glycolysis and tumor pH regulation through reduced glucose utilization, lactate production, PKM2 or LDH activity, and NHE1-dependent proton extrusion in selected cancer models.
  7. Suppression of epithelial-mesenchymal transition, migration, invasion, and metastasis through modulation of TGF-β/SMAD, Snail, β-catenin, MMP2, MMP9, and adhesion pathways.
  8. Anti-angiogenic effects involving reduced HIF-1α, VEGF, and VEGFR2 signaling.
  9. Context-dependent chemosensitization and radiosensitization through suppression of survival signaling, increased DNA damage or ROS, and reduced drug-resistance or EMT programs.

Bioavailability / PK relevance: Free EA has very poor oral bioavailability because of low water solubility, limited intestinal permeability, rapid methylation and glucuronidation, and short systemic persistence. Human plasma exposure to unchanged EA after ellagitannin-rich foods is generally transient and substantially below the micromolar concentrations commonly used in cancer-cell experiments. Gut bacteria convert unabsorbed EA and ellagitannins into urolithins, which circulate mainly as glucuronide or sulfate conjugates and may account for much of the systemic biological activity. Urolithin production varies markedly among individuals according to microbiome metabotype. Liposomal, nanoparticle, phospholipid, and other delivery systems improve exposure experimentally, but none has established clinical anticancer efficacy.

In-vitro vs systemic exposure relevance: Many anticancer studies use approximately 5–100 µM EA for hours to days. These concentrations commonly exceed achievable circulating free-EA exposure after food or conventional oral supplementation. Direct relevance is greater for gastrointestinal luminal exposure, local tissue exposure, specialized formulations, or experiments involving metabolites. Results obtained at high micromolar concentrations should not be interpreted as evidence that an ordinary dietary dose will produce equivalent systemic tumor effects.

Clinical evidence status: Predominantly preclinical. EA has extensive cell-culture evidence and several animal tumor studies, but human oncology evidence remains limited to an older small adjunctive prostate-cancer trial, observational or combination-product studies, tissue-disposition studies, and trials of ellagitannin-rich pomegranate, berry, or muscadine extracts. These mixed extracts cannot establish EA-specific efficacy. Human randomized trials in metabolic, inflammatory, gastrointestinal, and neurologic conditions provide preliminary safety and biomarker data but do not validate EA as a cancer treatment. EA is not an FDA-approved anticancer agent and should be classified as investigational or dietary adjunct evidence, not established oncology therapy.

Safety / interaction constraints: Food-derived exposure is generally well tolerated, and small supplementation trials have not identified a consistent major toxicity signal. Long-term safety of purified high-dose EA in oncology populations is insufficiently characterized. Potential interaction concerns include inhibition or modulation of drug-metabolizing enzymes and transporters, antiplatelet activity, and uncertain effects when combined with cytotoxic chemotherapy or radiotherapy. The antioxidant-versus-pro-oxidant direction is dose-, tissue-, and treatment-dependent; concurrent use during cancer therapy therefore requires clinical review rather than assuming either protection or sensitization.


Ellagic Acid Mechanistic Profile

Rank Pathway / Axis Cancer Cells Normal Cells TSF Primary Effect Notes / Interpretation
1 Mitochondrial apoptosis Mitochondrial membrane potential ↓; Bax and cytochrome-c ↑; Bcl-2 and Bcl-xL ↓; caspase-3 and caspase-9 ↑ Apoptotic injury ↓ or ↔ (context-dependent) R, G Programmed tumor-cell death A recurrent downstream mechanism, usually following survival-pathway inhibition, mitochondrial stress, or ROS accumulation.
2 PI3K AKT mTOR survival signaling PI3K ↓; phosphorylated AKT ↓; mTOR ↓; PTEN ↑ (model-dependent) AKT survival signaling ↔ or ↑ during tissue injury (context-dependent) R, G Growth and survival suppression The direction can differ in nonmalignant injury models, where EA may preserve physiological AKT signaling.
3 Cell-cycle and p53 p21 control p53 ↑; p21 ↑; cyclin D1 and cyclin E ↓; CDK2, CDK4, and CDK6 ↓; arrest ↑ Aberrant proliferation ↓; normal cycling cells usually less affected G Cytostasis and apoptosis priming G0/G1 arrest is frequent, although G2/M or S-phase effects occur depending on tumor type and exposure.
4 NF-κB inflammatory survival signaling NF-κB activation ↓; COX-2 ↓; iNOS ↓; IL-6 and IL-8 ↓; anti-apoptotic transcription ↓ Inflammatory signaling ↓ R, G Anti-inflammatory and anti-survival activity NF-κB suppression can contribute to reduced proliferation, invasion, treatment resistance, and inflammatory cytokine production.
5 Mitochondrial ROS increase ROS ↑; oxidative DNA damage ↑; mitochondrial stress ↑ (dose-dependent) ROS injury ↓ or ↔ through antioxidant activity (context-dependent) P, R Selective oxidative stress Pro-oxidant effects are most evident in redox-unstable cancer cells, high-concentration experiments, and combination treatments. EA is not uniformly pro-oxidant.
6 NRF2 antioxidant response NRF2 and HO-1 ↔, ↑, or ↓ (model-dependent) NRF2 ↑; HO-1 and antioxidant enzymes ↑; lipid peroxidation ↓ R, G Secondary redox adaptation Normal-tissue protection is relatively consistent, whereas cancer-cell NRF2 modulation is heterogeneous and may depend on baseline NRF2 activity.
7 Glycolysis and intracellular pH regulation Glucose consumption ↓; lactate production ↓; LDH and PKM2 ↓; NHE1 ↓; intracellular pH ↓ (model-dependent) R, G Metabolic restriction and acidification Demonstrated in selected cancer models and should not be generalized to every tumor type.
8 STAT3 and MAPK growth signaling STAT3 ↓; phosphorylated STAT3 ↓; ERK signaling ↓; JNK or p38 modulation (context-dependent) Stress-responsive MAPK signaling ↔ or normalized R, G Proliferation and survival inhibition MAPK direction varies with tumor type, concentration, and whether stress-mediated apoptosis is being induced.
9 EMT invasion and metastasis TGF-β and SMAD signaling ↓; Snail and Twist ↓; vimentin ↓; E-cadherin ↑; MMP2 and MMP9 ↓ Pathological matrix remodeling ↓ G Reduced migration and invasion Includes reversal of EMT and, in some models, partial resensitization of drug-resistant cancer cells.
10 HIF-1α VEGF angiogenesis HIF-1α ↓; VEGF ↓; VEGFR2 signaling ↓; angiogenesis ↓ Pathological angiogenesis ↓; physiological effect uncertain G Anti-angiogenic activity Supported mainly by cell, endothelial-assay, and animal evidence rather than validated clinical anti-angiogenic activity.
11 DNA damage and repair balance Oxidative DNA damage ↑; PARP cleavage ↑; p53-dependent damage response ↑ (dose-dependent) Genotoxic injury ↓ through antioxidant and antimutagenic activity (context-dependent) R, G Tumor-cell damage with normal-cell protection potential The bidirectional profile reflects differing redox conditions and exposure levels in malignant versus normal systems.
12 Chemosensitization Drug sensitivity ↑; EMT and survival signaling ↓; apoptosis ↑ (combination-dependent) Chemotherapy-associated injury may ↓ in some models R, G Adjunctive treatment modulation Reported with agents including gemcitabine and several experimental combinations. Clinical confirmation is inadequate.
13 Radiosensitization Radiation response ↑; ROS and DNA damage ↑; clonogenic survival ↓ (model-dependent) Radiation injury may ↓ through antioxidant and anti-inflammatory effects (model-dependent) P, R, G Differential radiation response Recent preclinical work supports possible simultaneous tumor sensitization and normal-tissue protection, but this has not been established clinically.
14 Microbiome conversion to urolithins Direct EA exposure limited; systemic effects may be mediated partly by urolithin metabolites Urolithin production and conjugate exposure vary markedly among individuals G Metabolite-dependent systemic activity Metabotype 0, A, or B and microbial composition can materially alter metabolite identity, quantity, and biological response.
15 Clinical Translation Constraint Free EA exposure commonly below active in-vitro concentrations; tumor delivery unproven Food exposure generally tolerated; high-dose long-term safety and drug interactions incompletely defined G Bioavailability and evidence limitation Poor solubility, rapid metabolism, microbiome heterogeneity, mixed-extract trials, limited oncology RCT evidence, and lack of an approved pharmaceutical formulation restrict translation.

TSF: P: 0–30 min    R: 30 min–3 hr    G: >3 hr



BioEnh, bioenhancer: Click to Expand ⟱
Source:
Type:
A bioenhancer is an agent capable of enhancing bioavailability and efficacy of a drug with which it is co-administered

Query Database for BioEnhancers but the bioenhancers mainly show up under the target notes

Bioenhancers
- piperine and quercetin are considered bio-enhancers
- genistein
Piperine act by suppressing P-gp and cytochrome P450 enzymes, which counteract the metabolism of rifampicin via these proteins, thus enhancing the oral bioavailability of rifampicin. It also decreases the intestinal production of glucuronic acid, thus allowing more substances to enter the body in active form. It was found to increase the bioavailability of various drugs from 30% to 200%.[25]
Table 1: Published research on bioenhancer effect of piperine with various medicines
Drug Studied in Reference
Antimicrobial agents
Rifampicin In vitro Balakrishnan et al, 2001[11]
Isoniazid Rabbits Karan et al, 1998 [12]
Pefl oxacin Mountain Gaddi goats Madhukar et al, 2008[13]
Tetracycline Rats Atal et al, 1980[14]
Sulfadiazine Rats and dogs Atal et al, 1980[14]
Oxytetracycline Poultry birds Singh et al, 2005[15]
Ampicillin Rabbits Janakiraman and Manavalan, 2008[16]
Norfl oxacin Rabbits Janakiraman and Manavalan, 2008 [16]
Nevirapine Adult males Kasibhatta et al, 2007 [17]
Metronidazole In vitro Singh et al, 2010[18]
Analgesics
Diclofenac sodium Albino mice Pooja et al, 2007[19]
Pentazocine Albino mice Pooja et al, 2007[19]
Nimesulide Mice Gupta et al, 1998[20]
Antiepileptics
Carbamazepine In vitro Pattanaik et al, 2009 [21]
Phenytoin Human volunteers Bano et al, 1987[22]
Pentobarbitone Rats Majumdar et al, 1990[23]
Other drugs
Propranolol In vitro Bano et al, 1991 [24]
Theophylline In vitro Bano et al, 1991 [24]
Nutrients In vitro Pooja et al, 2007 [19
***Borneol
-Borneol is thought to temporarily open tight junctions between endothelial cells, enhancing drug penetration. It may also downregulate efflux transporters such as P-glycoprotein (P-gp), allowing higher intracellular concentrations of co-administered drugs.

-presence of urea (as a carrier) increased the aqueous solubility of capsaicin by 3.6-fold compared to pure capsaicin

Quercetin is found in citrus fruits and is a dual inhibitor of cytochrome P 3A4 (CYP3A4) and P-gp.
Table 2: Effect of quercetin pretreatment/co-treatment on pharmacokinetic parameters of different drugs
Drugs combined Increase in pharmacokinetic parametera
Cmax AUC ABA
Verapamil Two fold Two fold SH
Diltiazem SH SH Not known
Paclitaxel SH SH T wo fold
Digoxin 413% 170% Not known
Tamoxifen SH SH 59%
Compared to drug in question alone. Cmax, peak plasma concentration; AUC, area under the curve; ABA, absolute bioavailability; SH, significantly higher.

Another flavonoid, genistein belongs to the isoflavone class of flavonoids. It is a well-known phytoestrogen. The presence of genistein (10 mg/kg) caused an increase in AUC (54.7%) and a decrease in the total plasma clearance (35.2%) after oral administration of paclitaxel at a dose of 30 mg/kg in rats.[37]
Naringin is the major flavonoid glycoside found in grapefruit and makes grapefruit juice taste bitter. Oral naringin (3.3 and 10 mg/kg) was pretreated 30 min before and after intravenous administration of paclitaxel (3 mg/kg), the AUC was significantly improved (40.8% and 49.1% for naringin doses of 3.3 and 10 mg/kg, respectively).[38

Carum carvi/Cuminum cyminum ( Jeera)
Carum carvi seeds are a prized culinary herb. Extracts of its parts increased significantly (25%–300%), the bioavailability of a number of classes of drugs, such as antibiotics, antifungals, antivirals, anticancer, cardiovascular, anti-inflammatory/ antiarthritic, anti-TB, antileprosy, antihistaminic/respiratory disorders, corticosteroids, immunosuppressants, and antiulcers. Such extracts either in the presence or absence of piperine have been found to be highly selective in their bioavailability/bioefficacy-enhancing action.[40]
Capmul
One of the widely used bioenhancers is Capmul MCM C10, a glyceryl monocaprate, produced from edible fats and oils and is commonly used in lip products. In a study in rats, antibiotic ceftriaxone when given concomitantly with capmul, increased the bioavailability of ceftriaxone by 80%.[41]
Nitrile glycoside
Nitrite glycoside is a bioenhancer for drugs and nutrients. Novel bioactive nitrile glycosides, niaziridin and niazirin is obtained from the leaves, pods, and bark of Moringa oleifera. [42] An immunoenhancing polysaccharide and niaziminin, having structural requirement to inhibit tumor promoter-induced Epstein–Barr virus activation have been reported from the leaves of Moringa.[43,44] It enhances the bioactivity of commonly used antibiotics, such as rifampicin, tetracycline, and ampicillin, and also facilitate the absorption of drugs, vitamins, and nutrients through the gastrointestinal membrane, thus increasing their bioavailability. [41] Niazirin is another bioactive nitrile glycoside belonging to M. oleifera. [45,46] Process of isolation of nitrite glycoside from M. oleifera has been patented (US 6858588) by Khanuja et al in 2004–2005. [42

Mechanism of Action Of Bioenhancers
Bioavailability-enhancing activity of natural compounds from the medicinal plants may be attributed to various mechanisms, such as P-gp inhibition activity by flavone, quercetin, and genistein; [51] inhibition of efflux transporters, such as P-gp and breast cancer resistance protein (BCRP),[52,53] by naringin and sinomenine thus preventing drug resistance; DNA receptor binding, modulation of cell signaling transduction, and inhibition of drug efflux pumps[54-56] ; by stimulating leucine amino peptidase and glycyl–glycine dipeptidase activity, thus modulating the cell membrane dynamics related to passive transport mechanism as seen with piperine [57] ; nonspecific mechanisms, such as increased blood supply to the gastrointestinal tract, decreased hydrochloric acid secretion, preventing breakdown of some drugs[6] ; and inhibition of metabolic enzymes participating in the biotransformation of drugs, thus preventing inactivation and elimination of drugs and thereby, increasing their bioavailability. [57-5]


Scientific Papers found: Click to Expand⟱
1608- EA,    Ellagic Acid from Hull Blackberries: Extraction, Purification, and Potential Anticancer Activity
- in-vitro, Cerv, HeLa - in-vitro, Liver, HepG2 - in-vitro, BC, MCF7 - in-vitro, Lung, A549 - in-vitro, Nor, HUVECs
eff↑, Dose∅, *BioAv↑, selectivity↑, TumCP↓, Casp↑, PTEN↑, TSC1↑, mTOR⇅, Akt↓, PDK1↓, E6↓, E7↓, DNAdam↑, ROS↑, *BioAv↓, *BioEnh↑, *Half-Life∅,
1614- EA,    Bioavailability of ellagic acid in human plasma after consumption of ellagitannins from pomegranate (Punica granatum L.) juice
- Human, Nor, NA
*BioEnh↝, *Half-Life∅,

Showing Research Papers: 1 to 2 of 2

* indicates research on normal cells as opposed to diseased cells
Total Research Paper Matches: 2

Pathway results for Effect on Cancer / Diseased Cells:


Redox & Oxidative Stress(tgid=1)

ROS↑, 1,  

Core Metabolism/Glycolysis(tgid=4)

PDK1↓, 1,  

Cell Death(tgid=5)

Akt↓, 1,   Casp↑, 1,  

DNA Damage & Repair(tgid=10)

DNAdam↑, 1,  

Proliferation, Differentiation & Cell State(tgid=12)

mTOR⇅, 1,   PTEN↑, 1,  

Migration(tgid=13)

TSC1↑, 1,   TumCP↓, 1,  

Drug Metabolism & Resistance(tgid=21)

Dose∅, 1,   eff↑, 1,   selectivity↑, 1,  

Clinical Biomarkers(tgid=22)

E6↓, 1,   E7↓, 1,  
Total Targets: 14

Pathway results for Effect on Normal Cells:


Drug Metabolism & Resistance(tgid=21)

BioAv↓, 1,   BioAv↑, 1,   BioEnh↑, 1,   BioEnh↝, 1,   Half-Life∅, 2,  
Total Targets: 5

Scientific Paper Hit Count for: BioEnh, bioenhancer
Query results interpretion may depend on "conditions" listed in the research papers.
Such Conditions may include : 
  -low or high Dose
  -format for product, such as nano of lipid formations
  -different cell line effects
  -synergies with other products 
  -if effect was for normal or cancerous cells
Filter Conditions: Pro/AntiFlg:%  IllCat:%  CanType:%  Cells:%  prod#:74  Target#:1310  State#:%  Dir#:%
wNotes=0 sortOrder:rid,rpid

 

Home Page