In this study, the potential effects of bacteria on the efficacy of frequently used chemotherapies was examined. Bacteria and cancer cell lines were examined in vitro and in vivo for changes in the efficacy of cancer cell killing mediated by chemotherapeutic agents. Of 30 drugs examined in vitro, the efficacy of 10 was found to be significantly inhibited by certain bacteria, while the same bacteria improved the efficacy of six others. HPLC and mass spectrometry analyses of sample drugs (gemcitabine, fludarabine, cladribine, CB1954) demonstrated modification of drug chemical structure. The chemoresistance or increased cytotoxicity observed in vitro with sample drugs (gemcitabine and CB1954) was replicated in in vivo murine subcutaneous tumour models. These findings suggest that bacterial presence in the body due to systemic or local infection may influence tumour responses or off-target toxicity during chemotherapy.

Phytosterols contain an unsaturated ring structure and therefore are susceptible to oxidation under certain conditions. Whilst the cytotoxicity of the analogous cholesterol oxidation products (COP) has been well documented, the biological effects of phytosterol oxidation products (POP) have not yet been fully ascertained. The objective of the present study was to examine the cytotoxicity of b-sitosterol oxides and their corresponding COP in a human monocytic cell line (U937), a colonic adenocarcinoma cell line (CaCo-2) and a hepatoma liver cell line (HepG2). 7b-Hydroxysitosterol, 7-ketositosterol, sitosterol3b,5a,6b-triol and a sitosterol-5a,6a-epoxide-sitosterol-5b,6b-epoxide (6:1) mixture were found to be cytotoxic to all three cell lines employed; the mode of cell death was by apoptosis in the U937 cell line and necrosis in the CaCo-2 and HepG2 cells. 7b-Hydroxysitosterol was the only b-sitosterol oxide to cause depletion in glutathione, indicating that POP-induced apoptosis may not be dependent on the generation of an oxidative stress. A further objective of this study was to assess the ability of the antioxidants a-tocopherol, g-tocopherol and b-carotene to modulate POP-induced cytotoxicity in U937 cells. Whilst a/g-tocopherol protected against 7b-hydroxycholesterol-induced apoptosis, they did not confer protection against 7b-hydroxysitosterolor 7-ketositosterol-induced toxicity, indicating that perhaps COP provoke different apoptotic pathways than POP. b-Carotene did not protect against COPor POP-induced toxicity. In general, results indicate that POP have qualitatively similar toxic effects to COP. However, higher concentrations of POP are required to elicit comparable levels of toxicity.

Beta-sitosterol is the most prevalent plant cholesterol derivative (phytosterol) and can undergo similar oxidation to cholesterol, leading to beta-sitosterol oxides. The biological impact of phytosterol oxides has only been evaluated in a phytosterol blend (usually of beta-sitosterol, campesterol, stigmasterol and dihydrobrassicasterol). The lack of pure phytosterols, including beta-sitosterol, hinders the collection of significant toxicity data on the individual beta-sitosterol oxides. An efficient synthetic route to multi-gram quantities of pure beta-sitosterol is described here, together with the first syntheses and characterisation of pure beta-sitosterol oxides.

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