Cancer, TGF-β and curcumin

Cytokines are signalling molecules that orchestrate immune system activity, among which TGF-β (Transforming Growth Factor-Beta) is being recognized by numerous studies to have an important role in the immune response to cancers.

European Journal of CancerThe authors of a  paper just now being published in the European Journal of Cancer note the dual activity of TGF-β, and acknowledge that related treatments are being pursued:

“Transforming growth factor (TGF)-β signalling plays a dichotomous role in tumour progression, acting as a tumour suppressor early and as a pro-metastatic pathway in late-stages. There is accumulating evidence that advanced-stage tumours produce excessive levels of TGF-β, which acts to promote tumour growth… In light of the pro-metastasis function, many strategies are currently being explored to antagonise the TGF-β pathway as a treatment for metastatic cancers.”

Expert Opinion on Investigational DrugsA similar paper published in the journal Expert Opinion on Investigational Drugs also states:

“The transforming growth factor-ß (TGF-β) signaling pathway plays a pivotal role in diverse cellular processes. TGF-β switches its role from a tumor suppressor in normal or dysplastic cells to a tumor promoter in advanced cancers.”

They too note the enthusiasm for TGF-β inhibition in developed malignancies:

“TGF-β signaling has been considered a useful therapeutic target. The discovery of oncogenic actions of TGF-β has generated a great deal of enthusiasm for developing TGF-β signaling inhibitors for the treatment of cancer.”

Expert Opinion on Therapeutic TargetsA review published a month later in Expert Opinion on Therapeutic Targets considers inhibition of TGF-β specifically for prostate cancer:

TGF-β regulates prostate growth by inhibiting epithelial cell proliferation and inducing apoptosis through eliciting a dynamic signaling pathway. In metastatic prostate cancer, however, TGF-β serves as a tumor promoter.”

They define very nicely the need to take a balanced approach in consideration of the dual role of TGF-β:

“”The molecular basis for effective therapeutic targeting of TGF-β must be directed towards the double-edge-sword nature of the cytokine: Inhibiting the TGF-β tumor promoter capabilities in advanced metastatic prostate cancer, although retaining the growth-inhibitory abilities exhibited in early stages of prostate tumorigenesis.”

Cellular & Molecular BiologyNow consider this fascinating research just now being published in the journal Cellular & Molecular Immunology on the ability of curcumin (an extract of turmeric) to reduce the undesirable action of TGF-β. The authors begin by observing:

“Immune dysfunction is well documented during tumor progression and likely contributes to tumor immune evasion…Tumors often target and inhibit T-cell function to escape from immune surveillance. This dysfunction includes loss of effector and memory T cells, bias towards type 2 cytokines and expansion of T regulatory (Treg) cells.”

Interestingly, not only did curcumin prevent the loss of T cells and reverse the type 2 immune bias…

“Further investigation revealed that tumor burden upregulated Treg cell populations and stimulated the production of the immunosuppressive cytokines transforming growth factor (TGF)-β and IL-10 in these cells. Curcumin, however, inhibited the suppressive activity of Treg cells by downregulating the production of TGF-β and IL-10 in these cells…curcumin treatment enhanced the ability of effector T cells to kill cancer cells. Overall, our observations suggest that the unique properties of curcumin may be exploited for successful attenuation of tumor-induced suppression of cell-mediated immune responses.”

You may also wish to read an earlier post on cytokines and prostate cancer. I hope this makes it clear why I consider the measurement of TGF-β an important laboratory test for my patients in these circumstances, and curcumin a potentially valuable therapeutic ally. Be sure to discuss these with your doctor if the need arises.

The importance of testing cytokines: prostate cancer

There are many studies that demonstrate the importance of testing cytokines (‘messenger molecules’ of the immune system) for prostate cancer. One  paper published some time ago in the Journal of Clinical Oncology examined whether the cytokines IL-6 Soluble Receptor and TGF-Beta can predict if clinically localized prostate cancer will progress or not. The authors demonstrated that measuring IL6SR and TGF-β1…

“…improved the ability to predict biochemical progression by a prognostically substantial margin.”

In other words, this helps determine who needs a more aggressive intervention and who doesn’t.

The authors of a paper published in the journal Clinical Cancer Research investigated how cytokines before and after surgery correspond to prostate cancer progression:

“We have shown that preoperative plasma levels of transforming growth factor-β1 (TGF-β1), interleukin 6 (IL)-6, and its receptor (IL-6sR) are associated with prostate cancer progression and metastasis. The objectives of this study were to…examine the association of …these markers after surgery with disease progression in a large consecutive cohort of patients.”

Their conclusion:

“For patients undergoing radical prostatectomy, preoperative plasma levels of TGF-β1 and IL-6sR are associated with metastases…and disease progression. After prostate removal, postoperative TGF-β1 level increases in value over preoperative levels for the prediction of disease progression.”

The ProstateAnother study demonstrating that cytokines greatly increase the accuracy of predicting the potential for prostate cancer recurrence was published in the journal The Prostate. The authors  set out to test…

“the ability of several pre-operative blood-based biomarkers to enhance the accuracy of standard post-operative features for the prediction of biochemical recurrence (BCR) after radical prostatectomy (RP).”

They measured the cytokines IL-6, ILsR and TGF-β and concluded:

“Pre-operative plasma biomarkers improved the accuracy of established post-operative prognostic factors of BCR by a significant margin. Incorporation of these biomarkers into standard predictive models may allow more accurate identification of patients who are likely to fail RP thereby allowing more efficient delivery of adjuvant therapy.”