Repositioning Drugs to Target Lactate Dehydrogenase and Cancer Stem Cell Activity
Pursuing novel methods to disrupt the metabolic and regenerative pathways in cancer.
In 2017, a novel drug, stiripentol, was introduced to the market, intriguingly dubbed "the ketogenic diet pill" by some.
Despite the mechanisms of action being distinctly different, this term may have arisen due to stiripentol’s impact on Dravet syndrome, favourably modifying brain chemistry in a manner akin to the ketogenic diet by augmenting central GABA neurotransmission and inhibiting lactate dehydrogenase, a pivotal enzyme in the energy metabolism of neurons. In the case of Dravet syndrome, as with the ketogenic diet, the drug has shown effectiveness at preventing or at least reducing the severity and frequency of seizures for those who suffer, with minimal safety concerns.
Another possible reason stiripentol may have earned the nickname "The Ketogenic Diet pill" is because, similar to the diet, few treatments are as effective in managing the condition. Conventional anti-seizure medications often fall short, and when they do, the ketogenic diet tends to show some effectiveness. Given the promising outcomes of stiripentol, this analogy becomes clearer.
What does this mean in the context of cancer?
In cancer, lactate dehydrogenase expression is enhanced as a result of the Warburg Effect, so stiripentol could be useful not just for seizure control of drug resistant epilepsy, but also to compliment a metabolic protocol for cancer management to take advantage of this metabolic defect. There are key aspects of this to be mindful of however. I will attempt to explain these, as well as what I might do if I were to experience a recurrence of my disease. There are of course alternatives and different ways of looking at this to see the bigger picture.
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