Autophagy is an evolutionally-conserved catabolic process that degrades damaged organelles, misfolded proteins, and toxic aggregates, reducing oxidative stress. Malfunction of autophagy causes various diseases, including cancer. Autophagy can be either tumor suppressive or promotive. Thus, autophagy modulation is being considered as a new strategy to improve cancer therapy. Areca nut (AN) is a worldwide popular carcinogen and contains apoptosis-inducing ingredients. However, we recently demonstrated that AN may predominantly induce autophagic responses in various types of cells. Furthermore, chronic exposure of cancer cells to this activity generally resulted in increased tolerance against environmental challenges, such as serum starvation, hypoxia, and anti-cancer drugs, through upregulated autophagy activity. We, therefore, propose that AN may have the potential to modulate tumors into an autophagy-addicted manner, raising the possibility of improving cancer therapy through autophagy inhibition especially in AN-addicted users.
Autophagy backgroundThere are three major forms of autophagy: macroautophagy, microautophagy, and chaperon-mediated autophagy. Among them, macroautophagy (referred to as autophagy hereafter) has received extensive studies in the past decade. This evolutionarily conserved self-eating process delivers intracellular components to the lysosomal compartment for either recycling or degradation. It is thought that damaged proteins and organelles are degraded by basal levels of autophagy to maintain cellular homeostasis, or on the other hand, autophagy can be vigorously triggered for cells to survive nutrient-limited conditions [1]. Impairment of autophagy is now known to be associated with diseases including cancers [2]. Modulation of autophagy may nowadays represent a new direction for improved cancer therapy, which attracts great interest [3].