Anticancer Molecular Mechanisms of Phytosterols: An Updated Review on Clinical Trials
Muhammad Shahbaz, Ushna Momal, Asfa Perween, Hammad Naeem, Muzzamal Hussain, Muhammad Imran, Gamal A. Mohamed, Sabrin R. M. Ibrahim, Suliman A. Alsagaby, Waleed Al Abdulmonem, Entessar Al Jbawi, Mohamed A. Abdelgawad, Samy Selim, Soad K. Al Jaouni, Hagar M. Mohamed
Abstract
Phytosterols, a form of naturally occurring substance structurally related to cholesterol, have been getting considerable interest due to their possible anticancer property. They have multifactorial modes of action such as antioxidant, anti-inflammatory, and apoptotic, which render them useful in the prevention and treatment of prostate, breast, colon, bladder, and skin cancer. Phytosterol prevents cancer development by scavenging reactive oxidative species (ROS) and boosting antioxidant enzymes, thus inhibiting DNA damage and cell mutations that cause cancerous development. They also regulate important signal transduction processes such as NF-kB, PI3K/Akt, and MAPK/ERK that drive cell growth, survival, and metastasis. Phytosterols induce apoptosis, block the cell cycle, and abrogate the invasion and metastasis of cancer cells, offering a multi-manifestation treatment of cancer. Nevertheless, their clinical use is limited due to factors like low bioavailability, which can be overcome with research in nanotechnology and drug delivery schemes. However, based on preclinical and epidemiological studies, phytosterols can be used as a useful adjunctive component to cancer treatments. More studies are required to work out clinical testing and streamlined delivery to maximize their effectiveness in cancer treatment.