Definition : Apoptosis is a highly regulated process of cell death and plays a fundamental role in the maintenance of tissue homeostasis. Numerous studies in recent years have revealed that apoptosis is a suicide program expressed in most, if not all cells, and can be triggered by a variety of extrinsic and intrinsic signals. Many human diseases can be attributed directly or indirectly to a derangement of apoptosis, resulting in either cell accumulation, in which cell eradication or cell turnover is impaired, or cell loss, in which the apoptotic program is inadvertently triggered. In addition, defective macrophage engulfment and degradation of cell corpses may also contribute to a dysregulation of tissue homeostasis. An increased understanding of the signaling pathways that govern the execution of apoptosis and the subsequent clearance of dying cells may yield novel targets for therapeutic intervention in a wide range of human maladies.

Apoptosis, cancer, and herbs
A number of natural herbs and herbal extracts can induce apoptosis in cancer cells in the laboratory. Whether these same effects would occur in a clinical setting in humans with cancer is still being determined. Some of the herbs that induce apoptosis include:
Tribulus terrestris which has saponins
Curcumin which is an extract from turmeric can cause apoptosis
Bilberry used for vision enhancement
Mangosteen has xanthones
Saw palmetto also called serenoa repens
Quercetin is a flavonoid
AHCC has an influence on the immune system
Resveratrol found in grapes and wine
Parthenolide is found in feverfew plant
Evodiamine is an alkaloid extract
Capsaicin in hot pepper can cause apoptosis in prostate cancer cells and pancreatic cancer cells in mice
Tongkat ali is an aphrodisiac herb
Andrographis paniculata
Arjuna terminalia
Xanthohumol found in hops

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Diet, Apoptosis, and Cancer
Apoptosis is an important defense against the occurrence of cancer. Apoptosis involves elimination of potentially harmful cells. Many diseases have been associated with inefficiently regulated apoptotic cell death, ultimately leading to inhibition of apoptosis and propagation of diseases such as cancer. Elucidation of the critical events associated with carcinogenesis provides the opportunity for dietary intervention to prevent cancer development through induction of apoptosis, particularly by bioactive agents or functional foods. Diet is a significant environmental factor in the overall cancer process and can exacerbate or interfere with cancer formation. In addition to diet's effects on protein expression and function, evidence is also accumulating that a large number of dietary food components can exert effects on the human genome, either directly or indirectly, to modulate gene expression. In fact, many diet-related genes are involved in carcinogenesis as well as apoptosis, and thus are ultimately molecular targets for dietary chemoprevention.

Apoptosis Research Update
Effects of Terminalia arjuna bark extract on apoptosis of human hepatoma cell line HepG2.
World J Gastroenterol. 2006 Feb 21;12(7):1018-24.
AIM: To investigate the effects of Terminalia arjuna (T. arjuna) extract on human hepatoma cell line (HepG2) and its possible role in induction of apoptosis. CONCLUSION: T. arjuna induced cytotoxicity in HepG2 cells in vitro. Apoptosis of HepG2 cells may be due to the DNA damage and expression of apoptotic proteins. Depletion of GSH may be involved in the induction of apoptosis of HepG2 cells.

Hot water-extracted Lycium barbarum and Rehmannia glutinosa inhibit proliferation and induce apoptosis of hepatocellular carcinoma cells.
World J Gastroenterol. 2006 Jul 28;12(28):4478-84. School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan, China.
To investigate the effect of hot water-extracted Lycium barbarum and Rehmannia glutinosa on cell proliferation and apoptosis in rat and/or human hepatocellular carcinoma (HCC) cells. CONCLUSION: Hot water-extracted crude lycium barbarum and rehmannia glutinosa inhibit proliferation and stimulate p53-mediated apoptosis in HCC cells.

Flavokawain A, a novel chalcone from kava extract, induces apoptosis in bladder cancer cells by involvement of Bax protein-dependent and mitochondria-dependent apoptotic pathway and suppresses tumor growth in mice.
Cancer Res. 2005 Apr 15;65(8):3479-86. Department of Urology and Chao Family Comprehensive Cancer Center, University of California, Irvine, Orange, CA
We have identified flavokawain A, B, and C but not the major kavalactone, kawain, in kava extracts as causing strong antiproliferative and apoptotic effect in human bladder cancer cells.

Andrographolide isolated from Andrographis paniculata induces cell cycle arrest and mitochondrial-mediated apoptosis in human leukemic HL-60 cells.
Planta Med. 2005 Dec;71(12):1106-11. Department of Biology and Chemistry, City University of Hong Kong, Hong Kong SAR, China.
It is concluded that Andrographis extractand andrographolide induce cell cycle arrest and affect an intrinsic mitochondria-dependent pathway of apoptosis by regulating the expression of some pro-apoptotic markers in HL-60 cells.

Induction of apoptosis by xanthones from mangosteen in human leukemia cell lines.
J Nat Prod. 2003 Aug;66(8):1124-7.
We examined the effects of six xanthones from the pericarps of mangosteen, Garcinia mangostana, on the cell growth inhibition of human leukemia cell line HL60. All xanthones displayed growth inhibitory effects. Among them, alpha-mangostin showed complete inhibition at 10 microM through the induction of apoptosis.

Induction of apoptosis in HL-60 cells treated with medicinal herbs.
Am J Chin Med. 2003;31(4):551-62.
Kinki University School of Pharmaceutical Sciences 3-4-1 Kowakae, Higashiosaka, Osaka 577-8502, Japan.
In order to develop a new apoptosis inducer, we screened 22 crude drugs for their apoptosis-inducing activity. It was found that Glycyrrhiza uralensis, Cynomorium songaricum, Eucommia ulmoides, Phellodendron amurense, Cinnamomum cassia and Paeonia lactiflora induced the death of HL-60 cells.

Apoptosis Questions
Q. Do vinpocetine and lipoic acid cause apoptosis?
   A. I have not seen any research regarding these two supplements and apoptosis.