• Development and Reproduction
• /
• v.25 no.2
• /
• pp.93-104
• /
• 2021

Cutaneous melanoma is a fatal disease for patients with distant metastasis. Metformin is the most widely used anti-diabetic drug, and proved to suppress cell proliferation and metastasis in diverse cancers including melanoma. We previously reported that MEK inhibitor trametinib increases the expression of epithelial-mesenchymal transition (EMT) regulators and melanoma cell motility, which are suppressed by addition of metformin in A375 melanoma cells. To confirm our findings further, we first evaluated the effect of metformin in combination with another MEK inhibitor binimetinib on cell viability in G361 melanoma cells. We then investigated whether binimetinib affects the expression of EMT regulators and cell motility. We finally monitored the effect of metformin on binimetinib-induced cell migration. Cell viability assay showed that combination index (CI) value at ED₅₀ is 0.80, suggesting synergy for the combination of metformin with binimetinib. Our results also revealed that binimetinib increased the expression of EMT regulators such as integrin αV, fibronectin and slug, which correlate well with the enhanced cell migration in wound healing assay. Metformin, on the contrary, suppressed the expression of sparc, integrin αV, fibronectin and N-cadherin with the reduced cell motility. The combination treatment showed that metformin counteracts the binimetinib-induced increase of cell motility. Overall, these results suggest that metformin with binimetinib might be useful as a potential therapeutic adjuvant against cell survival and metastatic activity in melanoma patients.

• Molecular & Cellular Toxicology
• /
• v.5 no.4
• /
• pp.298-303
• /
• 2009

(-)-Epigallocatechin-3-gallate (EGCG), a major flavonoid in green tea has multiple health benefits including chemoprevention, anti-inflammatory, anti-diabetic, and anti-obesity effects. In connection with these effects, EGCG can be a candidate to help the treatment of metabolic diseases. Metformin is a widely used anti-diabetic drug regulating cellular energy homeostasis via AMP-activated protein kinase (AMPK) activation. Therefore, the combination of metformin with EGCG may have additive or synergistic effects on treatment of type 2 diabetes. Nevertheless, there is no report for the pharmacokinetic and/or pharmacodynamic interaction of EGCG with metformin. Here, we evaluated the pharmacokinetic and pharmacodynamic interaction between metformin and EGCG in rats. Pharmacokinetics parameters of metformin were measured after oral administration of metformin in rats pre-treated with EGCG (10 mg/kg) or saline for 7 days. The results showed that there is no significant difference in pharmacokinetic parameters between saline control and EGCG-treated group. In addition, the hepatic AMPK activation by metformin in EGCG-treated rats was also similar to the control. The lack of additive effects of EGCG on AMPK activation or intracellular uptake of metformin was also evaluated in cells in the presence or absence of EGCG. Treatment of HepG2 cells with EGCG inhibited the metformin-induced AMPK activation. Combined results suggested that EGCG has no effect on the pharmacokinetics of metformin but may contribute to metformin action.

• Clinical and Experimental Reproductive Medicine
• /
• v.35 no.3
• /
• pp.223-229
• /
• 2008

Objective: This pilot study was performed to investigate the effect of metformin on insulin resistance, hormone levels, and lipid profiles in non-obese patients with polycystic ovary syndrome. Methods: This study included 16 non-obese patients with polycystic ovary syndrome diagnosed at our hospital from June 2006 to September 2007. Blood samples were collected before and 6 months after metformin treatment for analysis of fasting serum glucose levels, fasting serum insulin levels, a glycemic response to 75 g oral glucose tolerance test (OGTT), and hormonal blood profile including FSH, LH, estradiol, testosterone, free testosterone, serum lipid profiles. Insulin resistance was estimated by calculating fasting glucose/insulin ratio (FGIR), 2 hr glucose/insulin ratio after 75 g glucose load. And we investigated insulin resistance and pancreatic beta cell function by calculating HOMA beta cell function and HOMA IR. Results: After the treatment of metformin, there was significant increase in 2 hr glucose/insulin ratio after 75 g glucose load (p=0.04) and decrease in HOMA IR (p=0.000). But serum lipid profiles did not change significantly. Also the metformin treatment induced a significant reduction in serum free testosterone and LH levels, and LH/FSH ratio (p=0.001, p=0.000, p=0.034). Conclusion: This pilot study showed that metformin might be effective in improving insulin sensitivity, ameliorating hyperandrogenemia in non-obese patients with polycystic ovary syndrome. Further investigations with larger number of patients and long-term observations are necessary to determine the role of metformin.

• Korean Journal of Clinical Pharmacy
• /
• v.24 no.3
• /
• pp.193-198
• /
• 2014

Objective: This study was conducted to compare the adherence, clinical and economical utility of fixed-dose combination tablets of sitagliptin/metformin with concomitant administration of sitagliptin and metformin in patients with type 2 diabetes mellitus. Methods: Adherence was measured as the medication possession ratio (MPR) of ${\geq}80%$, and MPR was calculated as the number of total prescription days divided by the total treatment period. Hemoglobin $A_{1C}$ ($HbA_{1c}$) differences between baseline and predetermined periods were analyzed. Proportions of patients who achieved $HbA_{1c}$ less than 6.5% for three or more consecutive times were compared. To evaluate cost-effectiveness, prices of sitagliptin, metformin and sitagliptin/metformin tablets were investigated. Results: More than 90% of patients showed adherence in both groups (92.0% in fixed-dose combination group vs 95.9% in concomitant administration group), and there was no statistically significant difference (P = 0.113). Proportion of patients with HbA1c less than 6.5% for three or more consecutive times tended to be somewhat higher in fixed dose combination group than in concomitant administration group without a statistically significant difference (32.6% vs. 28.0%, P = 0.344). Total price of metformin and sitagliptin was cheaper up to 222 KRW in the case of fixed-dose combination tablets compared to the case of concomitant administration. Conclusion: The sitagliptin/metformin fixed-dose combination tablet had a similar patient adherence and was not significantly different in efficacy to the concomitant administration of each component. In terms of drug prices, fixed-dose combination tablets were cheaper than concomitant administration of each tablet.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.5
• /
• pp.2287-2290
• /
• 2014

Background: In the past few years, a considerable number of preclinical studies have been proposed metformin as a potential anticancer agent, but some of these studies suffer from a number of methodological limitations such as assessment of cytotoxicity in the presence of supraphysiological glucose concentrations or applying suprapharmacological levels of the drug. These objections have limited the translation of published preclinical data to the clinical setting. The present study aimed to investigate direct anticancer effects of metformin on different molecular subtypes of breast cancer with pharmacological concentrations and under normoglycemic conditions in vitro. Materials and Methods: Breast cancer cell lines from luminal A, luminal B, ErbB2 and triple-negative molecular subtypes were treated with a pharmacological concentration of metformin (2mM) at a glucose concentration of 5.5mM. Time-dependant cell viability was assessed by dye exclusion assay. MTTbased cytotoxicity assays were also performed with metformin alone or in combination with paclitaxel. Results: Metformin did not show any growth inhibitory effects or time-dependant cytotoxicity on breast cancer cell lines in the presence of normal glucose concentrations at the therapeutic plasma level. No augmentation of the antineoplastic properties of paclitaxel was apparent under the tested conditions. Conclusions: Metformin is probably unable to exert cytotoxic or cytostatic effects on breast cancer subtypes at pharmacological concentrations and normal plasma glucose levels. These results highlight the importance of establishing a higher steady-state plasma concentration of metformin in the clinical setting for assessment of anticancer effects in normoglycemic patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.11
• /
• pp.7838-7843
• /
• 2015

In this study, metformin hydrochloride for first choice of type 2 diabetes patient is administered relatively high dose, 1000 to 2000 mg orally once a day, and had very high water solubility, so it make difficult to swallow tablet to requires high amount of sustained release agent. To overcome these challenges, we used novel metformin salts had relatively low water solubility to minimize sustaining excipient for small size of dosage form. six novel metformin salts were synthesized by making metformin free form under reaction with NaOH and adding acid salts. we confirmed metformin stearate had the lowest water solubility and showed half drug release in dissolution study at 12hour. In conclusion, novel metformin salts had low water solubility can be used to reduce the size of sustained metformin tablet for improving patient compliance.

• Clinical and Experimental Reproductive Medicine
• /
• v.48 no.3
• /
• pp.221-228
• /
• 2021

Objective: This study investigated the effect of crocin in methylglyoxal (MGO)-induced diabetic male mice. Methods: Seventy 1-month-old male NMRI mice weighing 20-25 g were divided into seven groups (n=10): sham, MGO (600 mg/kg/day), MGO+crocin (15, 30, and 60 mg/kg/day), MGO+metformin (150 mg/kg/day), and crocin (60 mg/kg/day). MGO was administered orally for 30 days. Starting on day 14, after confirming hyperglycemia, metformin and crocin were administered orally. On day 31, plasma and tissue samples were prepared for experimental assessments. Results: Blood glucose and insulin levels in the MGO group were higher than those in the sham group (p<0.001), and decreased in response to metformin (p<0.001) and crocin treatment (not at all doses). Testis width and volume decreased in the MGO mice and improved in the crocin-treated mice (p<0.05), but not in the metformin group. Superoxide dismutase levels decreased in diabetic mice (p<0.05) and malondialdehyde levels increased (p<0.001). Crocin and metformin improved malondialdehyde and superoxide dismutase. Testosterone (p<0.001) and sperm count (p<0.05) decreased in the diabetic mice, and treatment with metformin and crocin recovered these variables. Luteinizing hormone levels increased in diabetic mice (p<0.001) and crocin treatment (but not metformin) attenuated this increase. Seminiferous diameter and height decreased in the diabetic mice and increased in the treatment groups. Vacuoles and ruptures were seen in diabetic testicular tissue, and crocin improved testicular morphology (p<0.01). Conclusion: MGO increased oxidative stress, reduced sex hormones, and induced histological problems in male reproductive organs. Crocin and metformin improved the reproductive damage caused by MGO-induced diabetes.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.23
• /
• pp.10067-10070
• /
• 2015

Background: Unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. The aim of this study was to evaluate the anti-estrogenic effect of metformin on endometrial histology in comparison with progesterone. Materials and Methods: A total of 43 patients who were referred to our center for abnormal uterine bleeding and had a histologic diagnosis were disordered proliferative endometrium or simple endometrial hyperplasia were included and randomly distributed in two groups treated with metformin (500mg Bid) or megestrol (40mg daily), respectively, for three months. After this period the patients were evaluated by another endometrial biopsy to assess the impact of the two drugs in restoring normal endometrial histology. Results: Our findings revealed that metformin could induce endometrial atrophy in 21 out of 22 patients (95.5%) while this positive response was achieved in only 13 out of 21 patients (61.9%) in the megstrol group. In addition two low grade endometrial carcinomas in the metformin group responded very well. Conclusions: We conclude that metformin could be used as an effective antiestrogenic agent in control of abnormal endometrial proliferative disorders.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.18
• /
• pp.8053-8058
• /
• 2016

Metformin is known as a hypoglycaemic agent that regulates glucose homeostasis by inhibiting liver glucose production and increasing muscle glucose uptake. Colorectal cancer (CRC) is one of the most common cancers worldwide, with about a million new cases diagnosed each year. The risk factors for CRC include advanced age, smoking, black race, obesity, low fibre diet, insulin resistance, and the metabolic syndrome. We have searched Medline for the metabolic syndrome and its relation to CRC, and metformin as a potential treatment of colorectal cancer. Administration of metformin alone or in combination with chemotherapy has been shown to suppress CRC. The mechanism that explains how insulin resistance is associated with CRC is complex and not fully understood. In this review we have summarised studies which showed an association with the metabolic syndrome as well as studies which tackled metformin as a potential treatment of CRC. In addition, we have also provided a summary of how metformin at the cellular level can induce changes that suppress the activity of cancer cells.

• Development and Reproduction
• /
• v.21 no.2
• /
• pp.139-150
• /
• 2017

Metformin is the most commonly prescribed anti-diabetic drug with relatively minor side effect. Substantial evidence has suggested that metformin is associated with decreased cancer risk and anticancer activity against diverse cancer cells. The tyrosine kinase inhibitor imatinib has shown powerful activity for treatment of chronic myeloid leukemia and also induces growth arrest and apoptosis in colorectal cancer cells. In this study, we tested the combination of imatinib and metformin against HCT15 colorectal cancer cells for effects on cell viability, cell cycle and autophagy. Our data show that metformin synergistically enhances the imatinib cytotoxicity in HCT15 cells as indicated by combination and drug reduction indices. We also demonstrate that the combination causes synergistic down-regulation of pERK, cell cycle arrest in S and $G_2/M$ phases via reduction of cyclin B1 level. Moreover, the combination resulted in autophagy induction as revealed by increased acidic vesicular organelles and cleaved form of LC3-II. Inhibition of autophagic process by chloroquine led to decreased cell viability, suggesting that induction of autophagy seems to play a cell protective role that may act against anticancer effects. In conclusion, our present data suggest that metformin in combination with imatinib might be a promising therapeutic option in colorectal cancer.