In Vitro Studies
In vitro studies have evaluated the anticancer properties of alkaloid components harvested from blood root. Sanguinarine accumulates in the cell nucleus and intercalates with DNA to induce DNA strand breaks, and intercalates with messenger RNA poly (A) inducing self-structure formation to prevent poly (A) polymerase transcription.1 It also binds to multiple oncogenes, resulting in cell cycle termination, and inhibits proliferation by depolymerizing microtubules. All of these mechanisms can lead to cell death. Multiple studies have demonstrated that sanguinarine treatment is cytotoxic to various cancer cell lines, including breast, glioma, leukemia, oral squamous cell, and colon, and inhibits cell growth and invasion of prostate cancer cells.5-9
Chelerythrine is also an active alkaloid found in bloodroot that has been studied for its anticancer activity. It has a lower affinity for DNA compared with sanguinarine, but has been demonstrated to inhibit protein kinase C and downregulate the expression of VEGF, BCL2, and KRAS.1,9,10 Studies show that chelerythrine inhibits the proliferation of triple-negative breast cancer cells, induces apoptosis of renal cancer cells, and, when combined with erlotinib, inhibits cell growth and migratory/invasive activity of non–small cell lung cancer cells.9,11,12
In vitro studies suggest that some alkaloid components of bloodroot have anticancer activity. Further studies are warranted to determine if these agents should be developed as anticancer therapies.
Bloodroot-containing products sold as a cure for cancer, however, can be highly toxic and result in disfigurement. These products are unlikely to result in a cure and may appear to resolve a tumor to the patient while it continues to grow undetected. Black salve–like products, therefore, should not be recommended to treat any condition.
- Croaker A, King GJ, Pyne JH, Anoopkumar-Dukie S, Liu L. Sanguinaria canadensis: traditional medicine, phytochemical composition, biological activities and current uses. Int J Mol Sci. 2016;17:1414-46. doi: 10.3390/ijms17091414
- McDaniel S, Goldman GD. Consequence of using escharotic agents as primary treatment for nonmelanoma skin cancer. Arch Dermatol. 2002;138:1593-6.
- Eastman KL, McFarland LV, Raugi GJ. Buyer beware: a black salve caution. J Am Acad Dermatol. 2011;65:e154-5. doi: 10.1016/j.jaad.2011.07.031
- Croaker A, King GJ, Pyne JH, Anoopkumar-Dukie S, Simanek V, Liu L. Carcinogenic potential of sanguinarine, a phytochemical used in ‘therapeutic’ black salve and mouthwash. Mutat Res. 2017;774:46-56. doi: 10.1016/j.mrrev.2017.09.001
- Almeida IV, Fernandes LM, Biazi BI, Vicentini VEP. Evaluation of the anticancer activities of the plant alkaloids sanguinarine and chelerythrine in human breast adenocarcinoma cells. Anticancer Agents Med Chem. 2017;17:1586-92. doi: 10.2174/1871520617666170213115132
- Rahman A, Thayyullathil F, Pallichankandy S, Galadri S. Hydrogen peroxide/ceramide/Akt signaling axis play a critical role in the antileukemic potential of sanguinarine. Free Radic Biol Med. 2016;96:273-89. doi: 10.1016/j.freeradbiomed.2016.05.001
- Lee TK, Parc C, Jeong SJ, et al. Sanguinarine induces apoptosis of human oral squamous cell carcinoma KB cells via inactivation of the PI3K/Akt signaling pathway. Drug Dev Res. 2016;77:227-40. doi: 10.1002/ddr.21315
- Sun M, Liu C, Nadiminty N, et al. Inhibition of Stat3 activation by sanguinarine suppresses prostate cancer cell growth and invasion. Prostate. 2012;72:82-9. doi:10.1002/pros.21409
- Lin W, Huang J, Yuan Z, Feng S, Xie Y, Ma W. Protein kinase C inhibitor chelerythrine selectively inhibits proliferation of triple-negative breast cancer cells. Sci Rep. 2017;7:2022. doi: 10.1038/s41598-017-02222-0
- Jana J, Mondal S, Bhattacharjee P, et al. Chelerythrine down regulates expression of VEGFA, BCL2 and KRAS by arresting G-Quadruplex structures at their promoter regions. Sci Rep. 2017;7:40706. doi: 10.1038/srep40706
- Chen XM, Zhang M, Fan PL, Qin YH, Zhao HW. Chelerythrine chloride induces apoptosis in renal cancer HEK-293 and SW-839 cell lines. Oncol Lett. 2016;11:3917-24.
- He M, Yang Z, Zhang L, Song C, Li Y, Zhang X. Additive effects of cherlerythrine chloride combination with erlotinib in human non-small cell lung cancer cells. PLoS One. 2017;12:e0175466. doi: 10.1371/journal.pone.0175466