Doi:10.1016/j.biocel.2004.08.002
The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
Insulin in aging and cancer: antidiabetic drug diabenol as
geroprotector and anticarcinogen
Irina G. Popovich, Mark A. Zabezhinski, Peter A. Egormin,
Margarita L. Tyndyk, Ivan V. Anikin, Alexander A. Spasov,
Anna V. Semenchenko, Anatoly I. Yashin, Vladimir N. Anisimov
a
Department of Carcinogenesis and Oncogerontology, N.N. Petrov Research Institute of Oncology, St. Petersburg 197758, Russia
b
Department of Pharmacology, Volgograd State Medical University, Volgograd, Russia
c
Max-Planck Institute for Demographic Research, Rostock, Germany
d
Center for Demographic Sciences, Duke University, Durham, NC, USA
Received 18 May 2004; received in revised form 20 July 2004; accepted 4 August 2004
The effects of new antidiabetic drug Diabenol® (9--diethylaminoethyl-2,3-dihydroimidazo-(1,2-␣)benzimidazol dihy-
drochloride) on life span and spontaneous tumor incidence in NMRI and transgenic HER-2/neu mice as well as on coloncarcinogenesis induced by 1,2-dimethylhydrazine in rats are studied. It is shown that treatment with the drug failed influencebody weight gain dynamics, food and water consumption and the body temperature, slowed down age-related disturbances inestrous function and increased life span of all and 10% most long-living NMRI mice. The treatment with diabenol inhibited spon-taneous tumor incidence and increased the mammary tumor latency in these mice. Diabenol treatment slowed down age-relatedchanges in estrous function in HER-2/neu mice, failed influence survival of these mice and slightly inhibited the incidence anddecreased the size of mammary adenocarcinoma metastases into the lung. In rats exposed to 1,2-dimethylhydrazine, treatmentwith diabenol significantly inhibited multiplicity of all colon tumors, decreased by 2.2 times the incidence of carcinomas inascending colon and by 3.1 times their multiplicity. Treatment with diabenol was followed by higher incidence of exophytic andwell-differentiated colon tumors as compared with the control rats exposed to the carcinogen alone (76.3% and 50%, and 47.4%and 14.7%, respectively). Thus, the drug increases survival and inhibits spontaneous carcinogenesis in mice and inhibits coloncarcinogenesis in rats.
2004 Elsevier Ltd. All rights reserved.
Keywords: Diabenol; Antidiabetic drugs; Aging; 1,2-Dimethylhydrazine; Mammary carcinoma; Colon cancer; Carcinogenesis
∗ Corresponding author. Tel.: +7 812 596 8607;
The potential link between aging and insulin/IGF-1
fax: +7 812 596 8947.
E-mail address: [email protected] (V.N. Anisimov).
signaling has attracted substantial attention during last
1357-2725/$ – see front matter 2004 Elsevier Ltd. All rights reserved.
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
years, on the basis of evidence including age-related
The concept of CR mimetics is now being in-
increase in incidence of insulin resistance and type 2
tensively explored (;
diabetes in accelerated aging syndromes as well as life
span extension by caloric restriction (CR) in rodents.
volve interventions that produce physiological and
Concomitant reduction in plasma insulin and plasma
anti-aging effects similar to CR. It was suggested to
glucose levels, which implies increases sensitivity to
use biguanide antidiabetics as a potential anti-aging
insulin, emerges as a hallmark of increased longevity
Hyperglycemia is an important aging factor involved
The antidiabetic drugs, phenformin,
in generation of advanced glycosylation endproducts
buformin, and metformin, were observed to reduce hy-
perglycemia and produce the following effects: im-
There is evidence that hyperinsuline-
proved glucose utilization; reduced free fatty acid uti-
mia favors accumulation of oxidized protein by reduc-
lization, gluconeogenesis, serum lipids, insulin and
ing its degradation as well as facilitates protein oxida-
IGF-1, and reduced body weight both in humans and
tion by increasing steady-state level of oxidative stress
experimental animals There are no
available data on the effect of other than biguanides
abetics with elevated glucose levels suffer many mani-
antidiabetic drugs on life span of animals.
festations of accelerated aging, such as impaired wound
healing, obesity, cataracts, vascular and microvascular
damage (It is important to stress that
synthesised in Rostov State University, and its hy-
hyperinsulinemia is an important factor not only in ag-
poglycemic activity was evaluated as 1.5 times more
ing but also in the development of cancer (
effective than of maninil (glibenclamide) and equal to
the effect of glyclazide (pioglitazone) in rats, rabbits
It was shown that hypoglycemic
In organisms ranging from yeast to rodents, both
effect of diabenol included both pancreatotropic and
calorie restriction and mutations in insulin/IGF-1
extrapancreatic pathways. Diabenol restores physio-
signaling pathway extend life span
logical profile of insulin secretion and decreases tissue
resistance to insulin, prolongs hypoglycemic effect
of insulin. It increases glucose utilization in glucose
loading test in the old obese rats. It was suggested that
Both approaches have
diabenol influence insulin receptors in peripheral tis-
some side effects. For example, calorie restriction in-
sues. Diabenol increases uptake of glucose by isolated
creases the level of serum glucocorticoids and de-
rat diaphragm in vitro both without supplementation of
creases resistance to infection (
insulin into the medium or with supplemented insulin.
Diabenol also decreases platelet and erythrocyte
whereas genetic modifications on insulin/IGF-1 signal-
aggregation and blood viscosity, inhibits mutagenic
ing pathway cause obesity, dwarfism and cardiopul-
effect of 2-acetylaminofluorene and has antioxidant
monary lesions (). Reviewing
the available data on the benefits and adverse effects
of calorie restriction and genetic modifications,
three categories of drugs
Thus, these results suggest that like
which may have potential to prevent or postpone age-
biguanides diabenol has a potential to increase the life
related diseases and extend life span: drugs that (1)
span and inhibit carcinogenesis.
stimulate dwarf mutations, and therefore, decrease pi-
In this paper, we present the results of experiments
tuitary production of GH; (2) prevent IGF-1 release
with diabenol on some ageing related biological pa-
from the liver; or (3) decrease IGF-1 signaling by the
rameters, survival and spontaneous tumorigenesis in fe-
action on either extracellular or intracellular targets.
male NMRI and transgenic HER-2/neu mice as well as
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
on 1,2-dimethylhydrazine-induced colon carcinogene-
Once every 3 months, simultaneously with weigh-
sis in rats.
ing, the amount of drinking water and consumed foodwas measured and the rate of consumed food (grams)per mouse was calculated.
2. Material and methods
Once every 3 months, vaginal smears, taken daily
for 2 weeks from the animals, were cytologically exam-
2.1. Animals
ined to estimate the phases of their estrous functions. Inthe same period, rectal body temperatures of the mice
One hundred female NMRI 2-month-old mice and
were measured with an electronic thermometer, TPEM
39 female 2-month-old LIO rats
(KMIZ, Russia). The animals were observed until their
were obtained from the Animal Department of N.N.
natural deaths. The date of each death was registered,
Petrov Research Institute of Oncology. Homozygous
and the mean life span, the age at which 90% of the an-
HER-2/
neu transgenic mice obtained from Charles
imals died, and the maximum life span were estimated.
River (Hollister, CA) by the Italian National ResearchCenter for Aging were housed and breed in the Labora-
2.3.2. HER-2/neu mice
tory of Carcinogenesis and Aging. The mice were kept
At the age of 2 months, HER-2/neu 57 mice were
5–7 in polypropylene cages (30 cm × 21 cm × 10 cm)
randomly divided into two groups. All mice were in-
and rats were kept 5 in cages (46 cm × 32 cm × 16 cm)
dividually marked. One group of 28 mice were given
under standard light/dark regimen (12 h light:12 h dark-
diabenol in drinking water (0.1 mg/ml) 5 days a week
ness) at temperature 22 ± 2 ◦C and received standard
monthly until their natural deaths. Twenty-nine con-
laboratory chow (and tap water
trol mice were given tap water without diabenol. Fresh
solution was prepared ex tempore three times a week.
Animals were checked daily by animal care person-
The observation schedule and tests were the similar to
nel and weekly by a veterinarian. The study was carried
these in experiments with NMRI mice.
out in accordance with the regulations for ensuring thehumane treatment of animals under the approval of the
2.3.3. LIO rats
Committee on Animal Research of the N.N. Petrov Re-
Thirty-nine 3-month-old outbred LIO rats were ran-
search Institute of Oncology.
domly subdivided into two groups. All rats were ex-posed weekly to five subcutaneous injections of DMH
2.2. Chemicals
at a single dose of 21 mg/kg of body weight (calcu-lated as a base). In this regimen, the carcinogen in-
Diabenol, 100% pure, was provided by Dr. V.A.
duced colon tumors in the majority of rats (
Anisimova, Ph.D., Physical Chemistry Research Insti-
tute, Rostov-on-Don, Russia (
DMH was ex tempore dissolved in normal saline and
1,2-Dimethylhydrazine dihydrochloride (DMH)
neutralized with sodium bicarbonate (pH 7.0). Addi-
was provided by Sigma (USA), and was kept at
tionally, 5 days a week, 20 rats of one group were given
diabenol with tap water (0.1 mg/ml) starting from theday of the first injection of the carcinogen during 26
2.3. Experiment
weeks whereas 19 rats of another group were not giventhe drug. The experiment was finalized 6 months after
2.3.1. NMRI mice
the first injection of the carcinogen, and all rats were
At the age of 2 months, NMRI mice were randomly
sacrificied by ether vapor.
divided into 2 groups, 50 animals in each, and they wereindividually marked. One group of mice were given
2.4. Pathomorphological examination
diabenol in drinking water (0.1 mg/ml) 5 days a weekmonthly until their natural deaths. Control mice were
All the animals that died or that were sacrificed when
given tap water without diabenol. Fresh solution was
moribund were autopsied. At autopsy their skin and
prepared ex tempore three times a week.
all internal organs were examined. Revealed neopla-
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
sia were classified according to the recommendations
Parameter
α is often characterized by the value of
of the International Agency of Research on Cancer
mortality rate doubling time (MRDT), calculated as
(IARC) as "fatal" (i.e., those, that directly caused the
ln(2)/
α. Parameters for the model were estimated from
death of the animal) or as "incidental" (for the cases
empirical data by use of the maximum likelihood
in which the animal died of a different cause) (
method implemented in the Gauss statistical system
(Confidence intervals for the
mors, as well as the tissues and organs with suspected
aging rate parameter estimates were calculated by
tumor development, were excised and fixed in 10%
profiling the log-likelihood function
neutral formalin. In rats, intestines were opened lon-
gitudinally. The position and size of each tumor wererecorded on special charts (Afterroutine histological processing, the tissues were em-
3. Results
bedded in paraffin. Thin, 5–7 m histological sectionswere stained with hematoxylin–eosine and were micro-
3.1. Experiment with female NMRI mice
scopically examined; regarding the experimental groupto which the mice belonged this was a blind process.
3.1.1. Age-related body weight dynamics
Tumors were classified in accordance with IARC rec-
The body weight gain dynamics was studied in the
control and treated with diabenol groups of mice. Itwas shown that the body weight of the mice in both
2.5. Statistics
groups increased with age, exceeding by 12 monthsthe body weight of 3-month-old animals by 17.6%
Experimental results were statistically processed by
in the control group, and by 18.6% in the group
the methods of variation statistics (The
given diabenol. There were no differences in the mean
significance of the discrepancies was defined accord-
body weight of mice exposed and non-exposed to the
ing to Student's
t-criterion, Fischer's exact method,
drug during the all period of observation (data not
a chi-square analysis, and a non-parametric crite-
rion of Wilcoxon–Mann–Whitney (For discrepancies in neoplasm incidence to be esti-
3.1.2. Age-related dynamics of food and water
mated, an IARC method of combined contingency
tables calculated individually for the fatal and inci-
Regular measurements have shown that the amount
dental tumors as well as a preva-
of food and water daily consumed by the mice in
lence analysis () were
the control group and treated with diabenol group
were practically the same during the all period of
For survival and risk analysis, Cox's method (
observation and varied from 4.9 ± 0.40 to 5.9 ±
was used; for testing two groups survival
0.21 g/mouse of food in control group and from 4.8
equality, Taron's life table test (was used.
± 0.51 to 5.7 ± 0.17 g/mouse of food in diabenol-
All reported values for survival tests are two sided.
treated mice whereas water consumption varied from4.3 ± 0.33 to 5.3 ± 0.23 ml/mouse in the controls and
2.6. Mathematical models and estimations
from 4.0 ± 0.36 to 5.2 ± 0.43 ml/mouse in mice givendiabenol.
The mathematical model was used to describe sur-
vival under the treatment. The model is the traditional
3.1.3. Age-related dynamics of estrous function in
Gompertz model with survival function
Investigations of the estrous function in the animals
S(
x) = exp −
of both groups were performed every 3 months, starting
α exp (
αx) − 1
when the mice were 3 months of age. The following pa-
where parameters
α and
β are associated with the
rameters of estrous function were estimated: the length
aging rate and the initial mortality rate, respectively.
of the estrous cycle, the relative rate of estrous cycle
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
Table 1Effect of diabenol on age-related dynamics of estrus functional parameters in NMRI mice
Rate of estrous cycles of various length (%)
∗ The difference with the controls of corresponding age in the control group is significant:
p < 0.05 (Fischer's exact test).
∗∗ The difference with the controls of corresponding age in the control group is significant:
p < 0.01 (Student's
t-test).
# The difference from the parameter at the age of 3 months in the same group:
p < 0.05.
phases (in percent); and the relative number of short (<5
3.1.4. Age-related dynamics of body temperature
days) and long (>7 days) estrous cycles. The relative
number of animals with regular cycles and irregular
Both the control and exposed to the drug mice re-
cycles (persistent estrus and anestrus) was calculated
vealed significant decrease in body temperature with
as well. Judging by the data presented in the
age, but only at the age of 6 months, the body tem-
length of estrous cycle in the control female NMRI
perature was decreased in diabenol-treated mice as
mice was increased with the advance in age, whereas
compared with the controls: 38.6 ± 0.14 and 38.1 ±
was not changed with age in the group treated with
0.19 ◦C, respectively,
p < 0.05.
diabenol. In control mice, the relative number of shortestrous cycles slightly decreased with age (29.6% at the
3.1.5. Survival and longevity of female NMRI mice
age of 6 months and 12.5% at the age of 12 months),
Survival rate dynamics in the mice treated and non-
whereas in the mice exposed with diabenol, it was prac-
treated with diabenol are demonstrated in As
tically constant during the entire period of observation.
shown in the table, the survival rate dynamics were
In the controls of the oldest age group, irregular cy-
in general similar in both groups up to the age of 12
cles were registered in 57.9% of animals and only in
months. However, it is worthy to note that the mortality
6.5–10% at the age of 3 or 6 months. Treatment with di-
in the group given diabenol was decreased between the
abenol significantly reduced a relative number of mice
12th and the 15th months of their life as compared to
with irregular estrous cycles at the age of 12 months as
the control group (Drastic increase in mortality
compared with controls (
p < 0.05).
between months 12 and 13 in control group related
Thus, these data suggest that the long-term admin-
mainly to death of tumor-bearing animals in this period
istration of diabenol slows down age-related changes
(lymphomas and metastasizing mammary carcinomas)
in estrous function.
Table 2Effect of diabenol on survival distribution in female NMRI mice
No. of survivors at the age (months)
∗ The difference with the corresponding age in the control group is significant:
p < 0.01 (Fischer's exact test).
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
Table 4Effect of diabenol on incidence, localization and type of tumors infemale NMRI mice
Number of tumor-bearing
Age of the first mammary
tumor detection (days)
Mean latency of mammary
adenocarcinomas (days)
Total number of mammary
Number of mammary
Number of mammary
adenocarcinomas permouse
Maximum tumor size (cm)
Number of mice with
metastases of mammaryadenocarcinoma intolungs (%)
Number of mice with
malignant lymphoma
∗ The difference with controls is significant:
p < 0.05 (Fischer's
exact test).
∗∗ The difference with controls is significant:
p < 0.01 (Student's
The mean and maximum life span of mice in the
control group and in the group given diabenol was prac-tically the same. However, the life span in the last 10%
Fig. 1. Effect of diabenol on survival and tumor yield curves in
of the mice increased by the duration of diabenol treat-
female NMRI mice. (A) Ordinate, number of mice (%); abscissa,
ment (by +5.0%,
p < 0.05) (According to the
age (days); 1, control; 2, diabenol. (B) Ordinate, number of tumor-
log-rank test difference between distributions of life
bearing mice (%); abscissa, age (days); 1, control; 2, diabenol.
spans in the control and experimental groups is statis-tically significant with
p-value = 0.0737.
Table 3Effect of diabenol on parameters of life span in female NMRI mice
Mean life span (days, mean ± S.E.)
Mean life span of last 10% of survivors (days)
Maximum life span (days)
Ageing rate,
α (days−1)
0.0140 (0.0139; 0.0157)
0.0136 (0.0133; 0.0145)
49.62 (44.13; 49.85)
51.09 (47.94; 51.99)
Note: Mean life span are given as mean ± standard error; 95% confidence limits are given in parentheses; MRDT, mortality rate doubling time.
∗ The difference with controls is significant:
p < 0.05.
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
Table 5Effect of diabenol on age-related dynamics of estrus functional parameters in HER-2/neu mice
Rate of estrous cycles of various lengths (%)
∗ The difference with the controls of corresponding age in the control group:
p < 0.05.
∗∗∗ The difference with the controls of corresponding age in the control group:
p < 0.002 (Student's
t-test).
3.1.6. Spontaneous tumor development in female
detected whereas in the diabenol-treated group, one
case of lymphoma has been observed. The treatment
The total tumor incidence in the control mice was
with diabenol significantly shifted to right the total tu-
50% (Mammary carcinomas and malignant
mor yield curve as compared with the control group
lymphomas developed most frequently, which cor-
responded to the oncological characteristics of fe-
Thus, it is worth noting that the treatment with di-
male NMRI mice ). The
abenol inhibits the development of mammary carcino-
time of the first mammary tumor detection was in-
mas and malignant lymphomas in NMRI mice.
creased by 3 months in the group treated with dia-benol, and the mean latent time of mammary tumors
3.2. Experiment with female transgenic
was increased by 2.3 months by the drug
HER-2/neu mice
According to the log-rank test, difference betweendistributions of age of first mammary adenocarcino-
3.2.1. Age-related body weight dynamics
mas is statistically significant with
p-value = 4.15 ×
The body weight of the mice in both control and
10−13; difference between distributions of life spans
diabenol-treated groups increased with age, exceeding
of mice with fatal tumors (both mammary adenocar-
by 11 months the body weight of 3-month-old animals
cinoma and lymphoma) is statistically significant with
by 77.3% in the control group, and by 73.2% in the
p-value = 0.182. The incidence of lung metastases of
group given diabenol. There were no differences in the
mammary carcinomas was 10% in the control group
mean body weight of mice exposed and non-exposed
and 0% in the group given diabenol. In the control
to the drug during the all period of observation (data
group, four cases of malignant lymphoma have been
are not shown).
Table 6Effect of diabenol on parameters of life span in female HER-2/neu mice
Mean life span (days, mean ± S.E.)
Mean life span of last 10% of survivors (days)
Maximum life span (days)
Aging rate,
α (days−1)
0.0307 (0.0281; 0.0337)
0.0374 (0.0351; 0.0415)
22.58 (20.58; 24.66)
Note: Mean life spans are given as mean ± standard error; 95% confidence limits are given in parentheses; MRDT, mortality rate doubling time.
∗ The difference with controls is significant:
p < 0.05.
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
3.2.2. Age-related dynamics of food and waterconsumption
The amount of food and water daily consumed by
the mice in the control group and treated with diabenolgroup were practically the same during the all periodof observation and were similar in both groups andvaried from 3.27 ± 0.48 to 4.20 ± 0.14 g/mouse offood in control group and from 2.63 ± 0.14 to 4.03 ±0.24 g/mouse of food in diabenol-treated mice whereaswater consumption varied from 4.5 ± 0.51 to 5.85 ±0.77 ml/mouse in the controls and from 4.15 ± 0.84 to5.73 ± 0.45 ml/mouse in mice given diabenol.
3.2.3. Age-related dynamics of estrous function inmice
The length of estrous cycle in the control female
HER-2/neu mice was increased with the advance inage, whereas it was not changed with age in the miceexposed to the drug (In control mice, the rel-ative number of short estrous cycles slightly decreasedwith age (36.4% at the age of 5 months and 14.3% atthe age of 9 months), whereas in the mice exposed todiabenol it was practically constant during the entireperiod of observation. In the control group irregularcycles were registered in 33.3% of mice at the age of5 months and in 19.2% mice at the age of 9 months.
The exposure to diabenol significantly reduced a rela-tive number of mice with irregular estrous cycles at theage of 5 and 9 months (
Thus, these data suggest that the long-term adminis-
tration of diabenol inhibits the aging of the reproductive
Fig. 2. Effect of diabenol on survival and tumor yield curves in fe-
male HER-2/neu mice. (A) Ordinate, number of mice (%); abscissa,age (days); 1, control; 2, diabenol. (B) Ordinate, number of tumor-
3.2.4. Age-related dynamics of body temperature
bearing mice (%); abscissa, age (days); 1, control; 2, diabenol.
Both the control and exposed to the drug mice re-
experimental groups are identically distributed with
vealed significant decrease in body temperature with
probability
p = 0.923. However, maximum life span
age. There was no difference in average body temper-
was increased by 1 months in the group treated with
ature between the both groups during the entire period
diabenol as compared with the controls al-
of observation (data are not shown).
though aging rate parameter
α was slightly higher indiabenol-treated mice.
3.2.5. Survival and longevity of female HER-2/neumice
3.2.6. Spontaneous tumor development in female
Survival dynamics in the mice treated and non-
HER-2/neu mice
treated with diabenol are demonstrated at The
The incidence of mammary adenocarcinomas in the
survival dynamics were in general similar in both
control female HER-2/neu mice was 100%. The treat-
groups during the all period of observation. Accord-
ment with diabenol failed influence significantly any
ing to the log-rank test life spans in the control and
parameter of carcinogenesis in this strain of mice. Nev-
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
ertheless, some parameters of spontaneous carcinogen-
esis have a tendency to decrease in the group treated by
Effect of diabenol on 1,2-dimethylhydrazine (DMH)-induced colontumorigenesis in rats
diabenol: total incidence of tumors (100% and 92%);total number of mammary adenocarcinoma (195 and
179), number of mice with metastases of mammary
adenocarcinoma in the lung (48.3% and 35.7%), max-
Number of tumor-bearing
imum size of the metastases (0.52 ± 0.11 and 0.46
Colon (all parts)
0.08 cm), in control and diabenol-treated group, re-
No. of tumor-bearing
spectively. The treatment with diabenol also slightly
shifted to the right the tumor yield curve as compared
with the control group (
No. of tumors per rat
Thus, the treatment with diabenol revealed only
In tumor-bearing rats
slight tendency to the inhibition of the developmentof mammary carcinomas in HER-2/neu mice.
Mean tumor size (mm2)
3.3. Effect of diabenol on
No. of tumor-bearing
carcinogenesis in rats
No. of tumors per rat
The treatment with diabenol failed influence the
In tumor-bearing rats
body weight gain, water and food consumption in rats
Mean tumor size (mm2)
exposed to DMH as compared to those treated with thecarcinogen alone (data are not shown). At the end of ex-
periment, intestinal tumors were found in the majority
No. of tumor-bearing
Macroscopically, these neoplasms were exophytic
No. of tumors per rat
or endophytic. Several cases of ulcerative-infiltrative
forms were observed as well. Microscopically, differ-
In tumor-bearing rats
ent types of malignant intestinal tumors were found,
Mean tumor size (mm2)
predominantly, tubular adenocarcinomas. Ca in situ,superficial carcinomas, mucinous and signet-ring car-
cinomas were also registered. All these types of car-
No. of tumor-bearing
cinomas are typical for neoplasms induced by DMH
No. of tumors per rat
The data on the effect of diabenol on the develop-
ment of colon tumors induced by DMH are presented in
In tumor-bearing rats
otal incidence of intestinal tumors was
Mean tumor size (mm2)
similar in both groups. However, the multiplicity (meannumber of tumors per rat in a group) in animals treated
∗ The difference from the controls is significant:
p < 0.05.
with diabenol was decreased by 30% as compared with
The difference from the controls is significant:
p < 0.01.
∗∗∗ The difference from the controls is significant:
p < 0.002.
the parameter in rats exposed to DMH alone. Most ex-pressed inhibiting effect of diabenol was revealed inascending colon. The incidence of tumors of this site
control animals (DMH alone), the number of rats with
was decreased more than two times as compared to
six and more tumors per animal was 2.1 times higher
the control group, and the multiplicity of tumors was
than in the group treated with the carcinogen and dia-
decreased by three times.
benol (42.1% and 20%, correspondingly). Analysis of
The claster analysis of distribution of animals with
tumor size distribution has shown that in the descend-
different numbers of colon tumors has shown that in
ing colon of animals from the control group small tu-
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
icantly inhibited colon carcinogenesis. These observa-
Effect of diabenol on a distribution of colon tumors by growth pattern,
tions are in agreement with the data obtained with an-
differentiation rate and invasion depth (in percent to total number of
tidiabetic biguanides phenformin, buformin and met-
formin. It was shown in earlier studies that phenformin
and buformin increase the life span and inhibits sponta-
neous carcinogenesis in female C3H/Sn mice (
female outbred rats (
inhibits colon carcinogenesis induced by DMH
Differentiation rate
well as carcinogenesis induced by some other chemical
carcinogens and ionizing radiation (
∗ The significance from the control (DMH) is significant:
p < 0.001
ment with metformin prolongs life span of rats (G.
(Fischer's exact test).
Roth, personal communication) and mice (
∗∗ The significance from the control (DMH) is significant:
p < 0.05.
and inhibits pancreatic carcinogenesis in ham-sters (
mors (<51 mm2) appeared less frequently in compari-
Like the biguanides, diabenol slows down the age-
son with the group given diabenol (58.7% and 71.4%,
related disturbanses in the estrus function of rodents. It
is worthy of note that metformin improves menstrual
The results of morphological analysis (ave
regularity, leading to spontaneous ovulation, and en-
shown that the tumors with exophitic pattern of growth
hanced the induction of ovulation with clomiphene
more frequently developed in diabenol-treated rats in
citrate in women with polycystic ovary syndrome
comparison with the controls. Opposite situation was
with endophytic colon tumors. Tumors in the group
treated with diabenol more frequently were highly dif-
The use of phenformin in humans has been limited
ferentiated and less invasive as compared with the con-
the last two decades because of an association with lac-
trol group. Thus, these data show the inhibitory effect
tic acidosis. Metformin does not increase risk for lactic
of diabenol on DMH-induced colon carcinogenesis.
acidosis or increase lactate levels in type 2 diabetes(but has some adverse effects, includingrenal insufficiency (
and gastrointestinal side effects (
Our experiments have shown that the long-term
Diabenol is not biguanide and belongs to deriva-
treatment with the antidiabetic drug diabenol slowed
tives of benzoimidazole. It seems that this drug could
down age-related disturbances in estrous function and
be free of adverse effects typical for biguanides. It was
increased life span of all and 10% most long-living
shown that diabenol decreases aggregation of throm-
female NMRI mice. The treatment with diabenol in-
bocytes and erhythrocytes as well as blood viscosity
hibited spontaneous tumor incidence and increased the
in diabetic animals (This
mammary tumor latency in these mice. In short-living
effect gives an additional advantage to use of diabenol
transgenic HER-2/neu mice, the drug also slowed down
as a geroprotector.
age-related changes in estrous function in HER-2/neu
Several years ago, it was firstly suggested to use
mice, slightly inhibited tumrigenesis but failed influ-
biguanide antidiabetics as mimetics of CR and a poten-
ence survival of these mice. In rats exposed to 1,2-
tial anti-aging treatment (
dimethylhydrazine, the treatment with diabenol signif-
Although it is known that free radicals are produced
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
during metabolic reactions, it is largely unknown which
Recently, it was shown that the expres-
factor(s), of physiological or pathophysiological signif-
sion of mammalian Sir2 (SIRT1) is induced in CR
icance, modulate their production in vivo. It has been
rats as well as in human cells that were treated with
suggested that hyperinsulinemia may increase free rad-
serum from these animals (Long-
icals, and therefore, promote aging, independent of
lived mutant mice and CR rodents are protected from
cancer despite attenuating apoptosis possibly because
Plasma levels of lipid hydroperoxides are higher, and
their cells possess increased defences and repair mech-
antioxidant vitamins are lower in individuals who are
anism and they retain the ability to undergo apoptosis
resistant to insulin-stimulated glucose disposal but oth-
if the damage is beyond repair (
erwise glucose tolerant, nonobese, and normotensive
It was observed that phenformin inhibits proliferation
(This finding indicates that en-
and induced enhanced and transient expression of the
hanced oxidative stress is present before diabetes en-
cell cycle inhibitor p21 and apoptosis in human tumor
sues, and therefore, cannot simply be explained by
cells lines (The possibility that di-
overt hyperglycemia. There is substantial evidence
abenol stimulate an active defence response in the ani-
supporting the hypothesis that selective resistance to
mal can not to be excluded and needs an experimental
insulin-stimulated (muscle) glucose disposal and the
testing. Thus, the results of our experiments together
consequential compensatory hyperinsulinemia trigger
with the data and findings discussed above provide ev-
a variety of metabolic effects, likely resulting in ac-
idence that diabenol is promising geroprotector and
celerated oxidative stress and aging (
The anti-diabetics biguanides inhibit fatty acid
oxidation, inhibit gluconeogenesis in the liver, in-
crease the availability of insulin receptors, inhibitmonoamine oxidase (increase sensi-
Alexandrov, V. A., Anisimov, V. N., Belous, N. M., Vasilyeva, I. A., &
tivity of hypothalamo–pituitary complex to negative
Mazon, V. B. (1980). The inhibition of the transplacental blasto-mogenic effect of nitrosomethylurea by postnatal administration
feedback inhibition, reduce excretion of glucocorti-
of buformin to rats.
Carcinogenesis,
1, 975–978.
coid metabolites and dehydroepiandrosterone-sulfate
Anisimov, V. N. (1980). Effect of buformin and diphenylhydantoin
(Recently it was shown that metformin
on life span, estrus function and spontaneous tumor incidence in
decreases platelet superoxide anion production in dia-
female rats.
Voprosy Onkologii,
26(6), 42–48.
betic patients (Like antidiabetic
Anisimov, V. N. (2003). Insulin/IGF-1 signaling pathway driving
aging and cancer as a target for pharmacological intervention.
biguanides, diabenol increases tissue glucose utiliza-
Experimental Gerontology,
38, 1041–1049.
tion in old obese rats and has antimutagen and antiox-
Anisimov, V. N., Belous, N. M., Vasilyeva, I. A., & Dilman, V. M.
idant activities
(1980). Inhibitory effect of phenformin on the development of
mammary tumors induced by
N-nitrosomethylurea in rats.
Ex-
It is worthy to note, that experiments in yeast and
perimental Onkology,
2(3), 40–43.
Anisimov, V. N., Ostroumova, M. N., & Dilman, V. M. (1980). Inhibi-
Caenonhabditis elegans show that the life extension
tion of blastomogenic effect of 7,12-dimethylbenz(a)anthracene
by CR is not a mechanical output of low calories and
in female rats by buformin, dipheninhydantoin, polypeptide
consequence of a reduction in ROS or AGE forma-
pineal extract and L-DOPA.
Bulletin of Experimental Biology
tion, but a process that is highly regulated, triggering
and Medicine,
89, 723–725.
metabolic shift toward respiration that activates the reg-
Anisimov, V. N., Pozharisski, K. M., & Dilman, V. M. (1980).
Effect of phenformin on the blastomogenic action of 1,2-
ulator SIR2 (). In yeast
dimethylhydrazine in rats.
Voprosy Onkologii,
26(8), 54–58.
and worms, life span is extended by extracopies of
Anisimov, V. N., Belous, N. M., & Prokudina, E. A. (1982). Inhibition
SIR2/Sir-2.1 gene (by
by phenformin of the radiation carcinogenesis in female rats.
SIR2 orthologue,
Sirt1 (sirtuin 1) (
Experimental Onkology,
4(6), 26–29.
or by small molecule sirtuin-1 agonists, e.g. resvera-
Anisimov, V. N., Pliss, G. B., Iogannsen, M. G., et al. (1989). Spon-
taneous tumors in outbred LIO rats.
Journal of Experimental and
trol In mammals, it is suggested
Clinical Cancer Research,
8(4), 254–262.
that SIRT1 is a key regulator of cell defences and sur-
Anisimov, V. N., Khavinson, V. Kh., Popovich, I. G., et al. (2002).
vival in response to stress (
Inhibitory effect of the peptide epitalon on the development of
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
spontaneous mammary tumors in HER-2/neu transgenic mice.
Elahi, D., Muller, D. C., Egan, J. M., Andres, R., Veldhuist, J., &
International Journal of Cancer,
101, 7–10.
Meneilly, G. S. (2002). Glucose tolerance, glucose utilization
Anisimov, V. N., Semenchenko, A. V., & Yashin, A. I. (2003). In-
and insulin secretion in aging.
Novartis Foundation Symposium,
sulin and longevity: antidiabetic biguanides as geroprotectors.
Biogerontology,
4, 297–307.
Facchini, F. S., Hua, N. W., Reaven, G. M., & Stoohs, R. A. (2000).
Anisimova, V. A., Osipova, V. V., Spasov, A. A., et al. (2002). Syn-
Hyperinsulinemia: the missing link among oxidative stress and
thesis and pharmacological activity of 1- and 10-
N-substituted
age-related diseases?
Free Radical Biology and Medicine,
29,
Chemico-Pharmaceutical Journal,
36(9), 11–16.
Facchini, F. S., Hua, N., Abbasi, F., & Reaven, G. M. (2001). In-
Awartani, K. A., & Cheung, A. P. (2002). Metformin and polycystic
sulin resistance as a predictor of age-related diseases.
Journal of
ovary syndrome: a literature review.
Journal of Obstetrics and
Clinical Endocrinology and Metabolism,
86, 3574–3578.
Gynecology Canada,
24, 393–401.
Gargiulo, P., Caccese, D., Pignatelli, P., et al. (2002). Metformin de-
Bartke, A., Chandrashekar, V., Dominici, F., et al. (2003). Insulin-
creases platelet superoxide anion production in diabetic patients.
like growth factor 1 (IGF-1) and aging: controverses and new
Diabetes Metabolism Research and Reviews,
18, 156–159.
insights.
Biogerontology,
4, 1–8.
Gart, J. J., Krewski, D., Lee, P. N., Tarone, S., & Wahrendorf, J.
Bespalov, V. G., & Alexandrov, V. A. (1985). Influence of anti-
(1986).
Statistical methods in cancer research. Vol. III. The de-
carcinogenic agents on the transplacental carcinogenic effect
sign and analysis of long-term animal experiments (p. 79). IARC,
of
N-nitroso-
N-ethylurea.
Bulletin of Experimental Biology and
Lyon: IARC Scientific Publication.
Medicine,
100, 73–76.
Gauss system and graphic manual. (1994). Maple Valley: Aptech
Bomhard, E., & Mohr, U. (1989). Spontaneous tumors in NMRI
Systems Inc.
mice from carcinogenicity studies.
Experimental Pathology,
36,
Goubler, E. V. (1978).
Computing methods of pathology analysis and
recognition. Leningrad: Meditsina.
Brunet, A., Sweeney, L. B., Sturgill, F., et al. (2004). Stress-
Gupta, K., Krishnaswamy, G., Karnad, A., & Peiris, A. N. (2002).
dependent regulation of FOXO transcription factors by the SIRT1
Insulin: a novel factor in carcinogenesis.
American Journal of
deacetylase.
Science,
303, 2011–2015.
the Medical Sciences,
323, 140–145.
Caraci, F., Chisari, M., Frasca, G., et al. (2003). Effects of phenformin
Hadley, E. C., Dutta, C., Finkelstein, J., et al. (2001). Human impli-
on the proliferation of human tumor cell lines.
Life Science,
74,
cations of caloric restriction's effect on laboratory animals: an
overview of opportunities for research.
Journal of Gerontology
Chiba, T., Yamaza, H., Higami, Y., & Shimokawa, I. (2002). Anti-
Ser. A, 56A(Special issue I), 5–6.
aging effects of caloric restriction: Involvement of neuroen-
Howitz, K. T., Bitterman, K. J., Cohen, H. Y., et al. (2003). Small
docrine adaptation by peripheral signaling.
Microscopy Research
molecule activators of sitruins extend
Saccharomyces cerevisiae
and Technique,
59, 317–324.
lifespan.
Nature,
425, 191–196.
Cohen, H. Y., Miller, C., Bitterman, K. J., et al. (2004). Calo-
Koubova, J., & Guarente, L. (2003). How does calorie restriction
rie restriction promotes mammalian cell survival by inducing
work?
Genes and Development,
17, 313–321.
the SIRT1 deacetylase.
Science,
Krentz, A. J., Ferner, R. E., & Balley, C. J. (1994). Comparative
tolerability profilesof oral antidiabeticagents.
Drug Safety,
11,
Colangelo, L. A., Gapstur, S. M., Gann, P. H., Dyer, A. R., & Liu,
K. (2002). Colorectal cancer mortality and factors related to the
Kruse, J. A. (2004). Review: metformin does not increase risk for
insulin resistance syndrome.
Cancer Epidemiology, Biomarkers
lactic acidosis or increase lactate levels in type 2 diabetes.
ACP
and Prevention,
11, 385–391.
Journal Club, 141, 7.
Cox, D. R., & Oakes, D. (1996).
Analysis of survival data. London:
Longo, V. D., & Finch, C. E. (2003). Evolutionary medicine: from
Chapman & Hall.
dwarf model systems to healthy centenarians.
Science,
299,
Dilman, V. M. (1971). Age-associated elevation of hypothalamic
threshold to feedback control and its role in development, aging
Masoro, E. J. (2000). Caloric restriction and ageing: an update.
Ex-
and disease.
Lancet,
1, 1211–1219.
perimental Gerontology,
35, 299–305.
Dilman, V. M. (1978). Ageing, metabolic immunodepression and
Masoro, E.J. (2003). Subfield history: caloric restriction, slow-
carcinogenesis.
Mechanisms of Ageing and Development,
8,
ing aging, and extending life. Science's SAGE KE, 2003.
ns2 (26 February 2003).
Dilman, V. M. (1994). Development, aging and disease: In a new
rationale for an intervention. Chur: Harwood Academic Publ.
Mattson, M. P., Duan, W., Lee, J., et al. (2001). Progress in the de-
Dilman, V. M., & Anisimov, V. N. (1980). Effect of treatment with
velopment of caloric restriction mimetic dietary supplements.
phenofromin, dyphenylhydantoin or L-DOPA on life span and
Journal of Anti-Ageing Medicines,
4, 225–232.
tumor incidence in C3H/Sn mice.
Gerontology,
26, 241–245.
McCarty, M. F. (2004). Chron activation of AMP-activated kinase as
Dilman, V. M., Berstein, L. M., Zabezhinski, M. A., Alexandrov, V.
a strategyforslowing aging.
Medical Hypotheses,
63, 334–339.
A., & Pliss, G. B. (1978). Inhibition of DMBA-induced carcino-
McKnight, B., & Crowley, J. (1984). Tests for differences in tumor
genesis by phenformin in the mammary gland of rats.
Archives
incidence based on animal carcinogenesis experiments.
Journal
of Geschwulstforsch,
48, 1–8.
of American Statistical Association,
80, 639–648.
I.G. Popovich et al. / The International Journal of Biochemistry & Cell Biology 37 (2005) 1117–1129
Mezheritski, V. V., Pikus, A. L., Spasov, A. A., et al. (1998).
Spasov, A. A., Dudchenko, G. P., & Gavrilova, E. S. (1997).
Synthesis and antioxidant activity N.N-substituted 3-amino-
Diabenol—new antidiabetic compounds with haemobiological
1H-1,2-diasaphenalenes.
Chemical-Pharmaceutical Journal,
1,
activity.
Vestnik of Volgograd Medical Academy,
2, 47–51.
Spasov, A. A., Ostrovskii, O. V., Ivakhnenko, I. V., Kosolapov, V. A.,
Motta, M. C., Divecha, N., Lemieux, M., et al. (2004). Mam-
& Anisimova, V. A. (1999). The effect of compounds with an-
malian SIRT1 represses forkhead transcription factors.
Cell,
116,
tioxidant properties on thrombocyte functional activity.
Eksper-
imental'nia i Klinicheskaia Farmakologiia,
62(1), 38–40.
Muntoni, S. (1999). Metformin and fatty acids.
Diabetes Care,
22,
Sun, D., Muthukumar, A. R., Lawrence, R. A., & Fernandes, G.
(2001). Effects of calorie restriction on polymicrobial peritonitis
Nestler, J. E., Stovall, D., Akhther, N., Iorno, M. J., & Jakubowicz,
induced by cecum ligation and puncture in young C57BL/6 mice.
D. J. (2002). Strategies for the use of insulin-sensitizing drugs
Clinical and Diagnostic Laboratory Immunology,
8, 1003–1011.
to treat infertility in women with polycystic ovary syndrome.
Taron, R. E. (1975). Tests for trend in life table analysis.
Biometrika,
Fertility and Sterility,
77, 209–215.
Nisbet, J. C., Strurtevant, J. M., & Prins, J. B. (2004). Metformin
Tatar, M., Bartke, A., & Antebi, A. (2003). The endocrine regulation
and serious adverse effects.
Medical Journal of Australia,
180,
of aging by insulin-like signals.
Science,
299, 1346–1351.
Tissenbaum, H. A., & Guarente, L. (2001). Increased dosage of a
Picard, F., Kurtev, M., Chung, N., et al. (2004). Sirt1 promotes fat
sir-2 gene extendslifespanin
Caenorhabditis elgans.
Nature,
410,
mobilization in white adipocytes by repressing PPAR-␥.
Nature,
Turusov, V. S., & Mohr, U. (Eds.). (1994).
Pathology of tumours in
Pollak, M. N., Schernhammer, E. S., & Hankinson, S. E. (2004).
laboratory animals. Vol. 1. Tumours of the mouse (2nd ed., p.
Insulin-like growth factors and neoplasia.
Nature Reviews Can-
111). IARC, Lyon: IARC Scientific Publication.
cer,
4, 505–518.
Vinnitski, V. B., & Iakimenko, V. A. (1981). Effect of phenformin,
Pozharisski, K. M. (1990).
Tumours of the intestines. In V. Turusov
L–DOPA and para-chlorophenylalanine on the immunological
& U. Mohr (Eds.),
Pathology of tumours in laboratory animals,
reactivity and chemical carcinogenesis in BALB/c mice.
Voprosy
tumours of the rat: vol. 1. IARC, Lyon: IARC Sci. Publ, pp.
Onkologii,
27(6), 45–50.
Weindruch, R., Keenan, K. P., Carney, J. M., et al. (2001). Caloric
Pozharisski, K. M., Likhachev, A. J., Klimashevski, V. F., & Sha-
restriction mimetics: metabolic intervention.
Journal of Geron-
poshnikov, J. D. (1979). Experimental intestinal cancer research
tology Biological Sciences,
56A(1), 20–33 [Special issue].
with special reference to human pathology.
Advances in Cancer
Weindruch, R., & Walford, R. (1988).
The retardation of aging and
Research,
30, 165–237.
disease by dietary restriction. Springield, IL: C.C. Thomas.
Roth, G. S., Ingram, D. K., & Lane, M. A. (1999). Calorie restriction
Xu, L., & Bard, M. Z. (1999). Enhanced potential for oxidative stress
in primates: will it work and how will we know?
Journal of
in hyperinsulinemic rats: imbalance between hepatic peroxiso-
American Geriatric Society,
46, 869–903.
mal hydrogen peroxide production and decomposition due to hy-
Schneider, M. B., Matsuzaki, H., Harorah, J., Ulrich, A., Stand-
perinsulinemia.
Hormone and Metabolic Research,
31, 278–282.
lop, J., Ding, X. Z., et al. (2001). Prevention of pancreatic can-
Zinovieva, V. N., Ostrovskii, O. V., Anisimova, V. A., & Spasov, A.
cer induction in hamsters by metformin.
Gastroenterology,
120,
A. (2003). Benzimidazole derivative inhibition of the mutagenic
activity of 2-aminoanthracene.
Gigiena i Sanitariia,
5, 61–63.
Source: http://www.demografie.eu/publications/files/2716_1189771950_1_Popovich-2005-Diabenol-J.pdf
GUIDELINE FOR THE MANAGEMENT OF HIV INFECTION IN PEOPLE WITH HAEMOPHILIA Australian Haemophilia Centre Directors' Disclaimer This document is a general guide to appropriate practice, to be followed subject to the clinician's expert judgement and the patient's preference in each individual case. The guidelines are designed to provide information to assist decision-
Oncological outcome of malignant colonic obstructionin the Dutch Stent-In 2 trial D. A. M. Sloothaak1, M. W. van den Berg2, M. G. W. Dijkgraaf3, P. Fockens2, P. J. Tanis1,J. E. van Hooft2 and W. A. Bemelman1 on behalf of the collaborative Dutch Stent-In study group 1Department of Surgery, 2Department of Gastroenterology and Hepatology, and 3Clinical Research Unit, Academic Medical Centre, Amsterdam,The NetherlandsCorrespondence to: Professor W. A. Bemelman, Department of Surgery, Academic Medical Centre, PO Box 22660, 1100 DD Amsterdam, The Netherlands(e-mail: [email protected])