Safety of Antimetabolite 2-Deoxy-D-arabinohexose (2DG) as a Coadjuvant Metabolic Intervention in 268 Cancer Patients

Although previously found to be quite safe and potentially useful as a metabolic sensitizer against a wide spectrum of cancer subtypes, 2-Deoxy-D-Arabinohexose, commonly known as 2-Deoxy-D-Glucose (2DG), has remained somewhat ignored in the clinical setting. As a glycolysis inhibitor, 2DG preferentially targets tumour cells, which densely overexpress glucose transporters (GLUTs) in their cytoplasmic membranes, as well as glycolytic and fermentation enzymes hexokinase 2 (HK-2) and lactic dehydrogenase isoenzyme A (LDH-A). The pronounced functional asymmetry, the distinct metabolic phenotypes that set apart neoplastic and normal cells offer a therapeutic window of opportunity to overcome multidrug resistance in the treatment of cancer. Nutripharmacological corrections of blood glucose, followed by the timely introduction of several nonmetabolizable structural analogues, is a cost-effective, minimally invasive coadjuvant treatment for solid tumours. Further, our research group has shown that a metabolic intervention with antimetabolites of glucose and pyruvate is strongly enhanced by a systemic suppression of the natural substrates of their catalyzing, rate-limiting enzymes within cancer cells. Here, we demonstrate that 2DG, perhaps the archetypal glucose antimetabolite, is very safe in humans.

Usefulness of Dialysate Fibrin Degradation Products and Lactic Dehydrogenase Isoenzyme Patterns in Assessing the Clinical Course of Peritonitis

Objective To establish the usefulness of fibrin degradation products (FDP) and lactic dehydrogenase isoenzyme patterns (LDH isoenzyme) in assessing the clinical course of peritonitis. Design A retrospective study of patients with peritonitis who were divided into three groups according to their clinical course. Setting Single dialysis unit of a general hospital. Interventions Patients were treated by intraperitoneal and oral antibiotics. Patients Twenty-six patients with 34 episodes of peritonitis were studied. Group 1 consisted of 21 patients with 26 recoveries from peritonitis; Group 2 consisted of 5 patients with 5 relapsing episodes of peritonitis, and Group 3 consisted of 3 patients with 3 persistent episodes of peritonitis. Main Outcome Measures Concentrations of WBCs, FDP, LDH isoenzyme and microbiological culture of the dialysate were determined. Results In most of Group 1, WBCs, FDP, and LDH isoenzyme returned to normal within 2 weeks. In 4 patients of Group 1, who had complications (diverticulitis, cholecystitis, cystitis, and tunnel infection), WBCs, FDP, and LDH isoenzyme returned to normal gradually within 3 weeks. In Group 2, WBCs returned to normal, but FDP remained relatively high and LDH isoenzyme did not normalize. In Group 3, WBCs, FDP and LDH isoenzyme did not normalize. Conclusions Failure of normalization of FDP and LDH isoenzyme suggests an incomplete recovery from peritonitis. FDP and LDH isoenzyme are useful in assessing the course of peritonitis.