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Epidemiological evidences establish sulforaphane (SFN), a hormetic dietary isothiocyanate to be a promising chemopreventive, anti-inflammatory and anti-cancer agent. Beyond a concentration threshold SFN exerts pro-death activities (cell cycle arrest, epigenetic modifications and apoptosis) and below the threshold it either promotes prosurvival autophagy or remains latent. There is a significant lacuna in understanding the underpinning dynamic molecular networks that alternate the pharmacological responses with respect to the intracellular concentration and exposure time that renders SFN to be a characteristic hormetic molecule (display characteristic biphasic dose response curve). Unraveling this multi-targeted SFN triggered molecular interplay between apoptosis and pro-survival autophagy may have great therapeutic implications. From the available literature, here we present a review that illustrates the existence of a hormetic window and briefly discussed its role in the spectrum of activity of SFN in different pathological conditions (cancer and immune-mediated diseases). Further, we hypothesize a hormetic signaling event on how SFN triggers mutually exclusive molecular pathways such as cell survival or death signals depending on its pathophysiological environment, exposure time and in vitro working concentrations. By better understanding these altered events and underpinning mechanisms in different combinations such as concentrations and time a proper therapeutic can be designed.

Purpose: Treatment approaches using Hsp90 inhibitors at their maximum tolerated doses (MTDs) have not produced selective tumor toxicity. Inhibition of Hsp90 activity causes degradation of client proteins including those involved in recognizing and repairing DNA lesions. We hypothesized that if DNA repair proteins were degraded by concentrations of an Hsp90 inhibitor below those required to cause nonspecific cytotoxicity, significant tumor-selective radiosensitization might be achieved.Experimental Design: Tandem mass tagged-mass spectrometry was performed to determine the effect of a subcytotoxic concentration of the Hsp90 inhibitor, AT13387 (onalespib), on global protein abundance. The effect of AT13387 on in vitro radiosensitization was assessed using a clonogenic assay. Pharmacokinetics profiling was performed in mice bearing xenografts. Finally, the effect of low-dose AT13387 on the radiosensitization of three tumor models was assessed.Results: A subcytotoxic concentration of AT13387 reduced levels of DNA repair proteins, without affecting the majority of Hsp90 clients. The pharmacokinetics study using one-third of the MTD showed 40-fold higher levels of AT13387 in tumors compared with plasma. This low dose enhanced Hsp70 expression in peripheral blood mononuclear cells (PBMCs), which is a biomarker of Hsp90 inhibition. Low dose monotherapy was ineffective, but when combined with radiotherapy, produced significant tumor growth inhibition.Conclusions: This study shows that a significant therapeutic ratio can be achieved by a low dose of Hsp90 inhibitor in combination with radiotherapy. Hsp90 inhibition, even at a low dose, can be monitored by measuring Hsp70 expression in PBMCs in human studies.