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Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC), one of the most prevalent types of cancers worldwide, continues to maintain high levels of resistance to standard therapy. As clinical data revealed poor response rates, the need for developing new methods has increased to improve the overall wellbeing of patients wit...

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Main Author: Mohamed Tawfik, Sherouk
Format: Thesis
Published: AUC Knowledge Fountain 2022
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access_status_str Open Access
author Mohamed Tawfik, Sherouk
author_browse Mohamed Tawfik, Sherouk
author_facet Mohamed Tawfik, Sherouk
author_sort Mohamed Tawfik, Sherouk
collection Thesis
description Hepatocellular carcinoma (HCC), one of the most prevalent types of cancers worldwide, continues to maintain high levels of resistance to standard therapy. As clinical data revealed poor response rates, the need for developing new methods has increased to improve the overall wellbeing of patients with HCC. Due to its safety, wide availability and previously reported anti-cancer effects, metformin (MET) serves to be a possible therapeutic agent when combined with other well-known anti-cancer agents. The aim of this study was to investigate the potential anti-cancer effects of MET, an anti-diabetic agent, when combined with two antifolate drugs: trimethoprim (TMP) or methotrexate (MTX), and the underlying mechanisms involved. In this study, single drugs and combinations were investigated using in vitro assays, cytotoxicity assay (MTT), RT-PCR, flow cytometry, scratch wound assay and Seahorse XF analysis, to reveal their potential anti-cancer effects on a human HCC cell line, HepG2. The cytotoxicity assay was performed to determine the IC50 concentration of MET alone and in combination with antifolates. The co-treatment of both drugs increased Bax and p53 apoptotic markers, while decreased the anti-apoptotic marker; Bcl-2. Both combinations increased the percentage of apoptotic cells and halted cancer cell migration, when compared to MET alone. Furthermore, both combinations decreased the MET-induced increase in glycolysis, while also induced mitochondrial damage, altering cancer cell bioenergetics. This study introduces two novel therapeutic combinations, which enhance the anti-proliferative and apoptotic effects of MET on HepG2 cells, and hence, potentially combat the aggressiveness of HCC.
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id oai:fount.aucegypt.edu:etds-2708
institution American University in Cairo (Egypt)
last_indexed 2026-06-10T12:35:51.500Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from AUC Knowledge Fountain — bepress
publishDate 2022
publishDateRange 2022
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publisher AUC Knowledge Fountain
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source_str AUC Knowledge Fountain — bepress
spelling oai:fount.aucegypt.edu:etds-2708 Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma Mohamed Tawfik, Sherouk Hepatocellular carcinoma (HCC), one of the most prevalent types of cancers worldwide, continues to maintain high levels of resistance to standard therapy. As clinical data revealed poor response rates, the need for developing new methods has increased to improve the overall wellbeing of patients with HCC. Due to its safety, wide availability and previously reported anti-cancer effects, metformin (MET) serves to be a possible therapeutic agent when combined with other well-known anti-cancer agents. The aim of this study was to investigate the potential anti-cancer effects of MET, an anti-diabetic agent, when combined with two antifolate drugs: trimethoprim (TMP) or methotrexate (MTX), and the underlying mechanisms involved. In this study, single drugs and combinations were investigated using in vitro assays, cytotoxicity assay (MTT), RT-PCR, flow cytometry, scratch wound assay and Seahorse XF analysis, to reveal their potential anti-cancer effects on a human HCC cell line, HepG2. The cytotoxicity assay was performed to determine the IC50 concentration of MET alone and in combination with antifolates. The co-treatment of both drugs increased Bax and p53 apoptotic markers, while decreased the anti-apoptotic marker; Bcl-2. Both combinations increased the percentage of apoptotic cells and halted cancer cell migration, when compared to MET alone. Furthermore, both combinations decreased the MET-induced increase in glycolysis, while also induced mitochondrial damage, altering cancer cell bioenergetics. This study introduces two novel therapeutic combinations, which enhance the anti-proliferative and apoptotic effects of MET on HepG2 cells, and hence, potentially combat the aggressiveness of HCC. 2022-01-31T08:00:00Z thesis application/pdf https://fount.aucegypt.edu/etds/1836 https://fount.aucegypt.edu/context/etds/article/2708/viewcontent/sherouk_mohamed_tawfik_thesis.pdf Theses and Dissertations AUC Knowledge Fountain Hepatocellular carcinoma metformin trimethoprim methotrexate antifolates glycolysis oxidative phosphorylation seahorse Cancer Biology Molecular Biology Neoplasms Pharmacology
spellingShingle Hepatocellular carcinoma
metformin
trimethoprim
methotrexate
antifolates
glycolysis
oxidative phosphorylation
seahorse
Cancer Biology
Molecular Biology
Neoplasms
Pharmacology
Mohamed Tawfik, Sherouk
Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title_full Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title_fullStr Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title_full_unstemmed Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title_short Repurposing Metformin and Antifolates for the Treatment of Hepatocellular Carcinoma
title_sort repurposing metformin and antifolates for the treatment of hepatocellular carcinoma
topic Hepatocellular carcinoma
metformin
trimethoprim
methotrexate
antifolates
glycolysis
oxidative phosphorylation
seahorse
Cancer Biology
Molecular Biology
Neoplasms
Pharmacology
url https://fount.aucegypt.edu/etds/1836
https://fount.aucegypt.edu/context/etds/article/2708/viewcontent/sherouk_mohamed_tawfik_thesis.pdf
work_keys_str_mv AT mohamedtawfiksherouk repurposingmetforminandantifolatesforthetreatmentofhepatocellularcarcinoma