
16 Carrero et al.
Investigación Clínica 63(1): 2022
this regard, interleukin-1b-converting en-
zyme (ICE)-like family of proteases such as
Nedd2 / Ich-1, CPP32 / Apopain / Yama, TX
/ ICErelII, TY / ICErelIII, Mch 2, Mch 3 / ICE-
LAP3, Mch 4, and FLICE are implicated in
actin degradation during apoptosis 15.
Nitric oxide has been involved in the
cancer biology probably by induction of
angiogenesis, apoptosis, increased HIF-
1 and alterations of cellular motility 3-5.
Some of these effects can induces cancer
metastasis, spread and growth of tumor
cells through angiogenesis and high pro-
duction of HIF-1; however, other effects
such as apoptosis and alterations of actin
may impede or eliminate metastatic pro-
gression 2. Angiogenesis is the growth of
new blood vessels and is essential for tu-
mor progression and metastasis 16. It has
been reported that increased activity of
isoform enzyme iNOS (inducible nitric ox-
ide synthase) facilitates tumor cell angio-
genesis and metastasis 3, probably medi-
ated by interleukin-33 17.
HIF-1 is a transcription factor that reg-
ulates hundreds of genes, and it is activated
by hypoxia (reduced oxygen availability) 18.
HIF-1 is stabilized by hypoxia-dependent or
independent pathways and associated with
pro-carcinogenic effects 19. Stabilization of
HIF-1 leads to changes in glycolysis, nutri-
ent uptake, angiogenesis, cell migration and
apoptosis promoting survival of tumor and
metastasis 20, 21. However, HIF can be acti-
vated by non-hypoxic pathways. In this re-
gard, NO• can induce this transcription fac-
tor that enhances many hypoxia-inducible
genes, via the PI3k/Akt pathway 5.
Previous studies have shown that plant
extracts and polyphenolic compounds may
have a beneficial role in several diseases
including cancer 22-26. Mechanisms related
to the regulation of immune system, inac-
tivation of arachidonic acids pathways, in-
activation of NF-κB (nuclear factor kappa-
light-chain-enhancer of activated B cells),
suppression of toll-like receptor and antioxi-
dant activity 27 may be involved. Biochemical
analysis of WAXB and RAXB shows that both
are phenolic compounds and the effects pre-
viously reported for phenolic compounds
probably are implicated in ours results. In
this regard, WAXB and RAXB have antioxi-
dant activity as shown by the Trolox assay.
In addition, these plant extracts induced a
decreased content of NO•, suggesting that
these extract plants can act on nitrogen re-
active species and may represent one of their
anti-cancer mechanisms.
In conclusion, in this study Hela cells
were capable of producing NO• and HIF-1,
compounds that are related to cancer pro-
gression. WABX and RABX extracts induced
decreased expressions of NO• and HIF-1 and
actin-β in treated cultures. These effects as-
sociated with anti-cancer progression were
similar to the effect of methotrexate, a
well-known anti-cancer drug. As an impor-
tant point, not included in this study, it is
necessary to determine the effect of WAXB
and RWABX on other types of cancer to de-
termine if these plant extracts have a gen-
eral effect on cancer. Further investigation
should explore the clinical benefits of WAXB
and RWABX (dietary or alcoholic extract) in
human cancer.
ACKNOWLEDGMENTS AND FUNDING
The authors express their gratitude to
the Dirección de Investigación de la Univer-
sidad Técnica de Ambato (DIDE) for fund-
ing the Project ESTUDIO ETNOBOTÁNICO
Y BIOENSAYOS DE PLANTAS MEDICINALES
RELACIONADAS CON EL TRATAMIENTO
DE CÁNCER DE CÉRVIX EN LA CIUDAD DE
AMBATO, PROVINCIA DE TUNGURAHUA,
ECUADOR, with resolution 0904-CU-P-2018.
Declaration of conflict
of interest
The manuscript has no conflict of in-
terest.