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Cyclodextrin for cardiovascular diseases treatment?

Cardiovascular diseases are the leading cause of deaths worldwide. Atherosclerosis is a state when plaques consisting also of free cholesterol are continuously clogging arteries and this leads to high heart pressure and at the end to brain strokes or heart infarcts.

As a prospective promising therapy for treating atherosclerosis, scientists found out that cyclodextrin can be used. Findings were published in Science Translational Medicine in April 6th.

Cyclodextrin mediates its effect in vivo on reprogramming macrophages and decreasing inflammatory response in cholesterol-containing arteries. Cyclodextrin also increases cholesterol solubility, so it dissolves cholesterol crystals. Interestingly, the effect was observed even after continuing a cholesterol-rich diet.

Cyclodextrins form a family of cyclic oligosaccharides and they are used e.g in food industry for preparation of cholesterol-free products. They are also important for pharmaceutical industry since they can increase solubility of water insoluble drugs and therefore increase their availability in a body. One of the cyclodextrins- α-cyclodextrin- has a verified health claim in EU for its ability to decrease sugar after a high-starch meal and is part of some weight loss supplements.

What is interesting on the above mentioned article is also a fact that it was initiated by a mother of two children who have a rare Niemann-Pick Type C disease.

The disease is accompanied by a cholesterol accumulation in a body. The twins were the first people with this fatal disease treated by cyclodextrin. Treatment had good results and the mother contacted scientists and suggested them to use the agent for treatment of atherosclerosis. After series of animal experiments scientists were able to show that cyclodextrin has indeed effect on cholesterol and atherosclerosis. A mother of twins is also a co-author of the scientific paper.

Sources:

  1. News source: Cyclodextrin dissolves away cholesterol crystals. Eurekalert
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Prostate cancer and combined therapy

“Prostate cancer patients and their doctors may want to think twice about the best timing for chemotherapy or radiation therapy in conjunction with a common nonsurgical treatment, based on international research findings led by UT Southwestern Medical Center investigators.”

Scientists found out that usual medical androgen deprivation therapies (ADTs) like chemotherapy or radiotherapy deprive also patient´s adaptive immune system and any subsequent immunotherapy will be then compromised. The surgical ADT- castration- works in combination with immunotherapy.

The ADTs are used for 50 years. Progress in immunotherapy led to some promising candidates and as a logical step, combination of ADTs and immunotherapy for prostate cancer started to be used. However, using medical ADT in this combination order leads to the relapses in prostate cancer commonly seen in clinical trials.

Reduction of T-cell response against the prostate cancer induced by some androgen receptor antagonists was found by researchers as a main mechanism of this effect.

As a take-home message from this scientific work is that physicians will have to carefully think about possible combination strategies in advance before starting radiotherapy or chemotherapy for prostate cancer. And if immunotherapy is an option, one should consider timing and method of the ADT to be used.

Sources:

  1. News source: Common prostate cancer treatments suppress immune response and may promote relapse, Eurekalert.
  2. Scientific paper: Androgen receptor antagonists compromise T cell response against prostate cancer leading to early tumor relapse. DOI: 10.1126/scitranslmed.aad5659