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Understanding the benefit of metformin use in cancer treatment

Ryan JO Dowling, Pamela J Goodwin and Vuk Stambolic*

BMC Medicine 2011, 9:33  doi:10.1186/1741-7015-9-33

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Complicated biochemical effects of metformin

Heikki Savolainen   (2011-05-12 11:37)  Dept. of Occup. safety & hlth., Tampere, Finland email

Dear Editor,

This review summarizes in a very interesting way the many aspects of metformin effects. While supporting the views expressed in the paper, I would like to mention that biguanidines are inhibitors of the complex I in the mitochondrial respiratory chain. The inhibiting effect might reduce the intracellular stress thereby sensitizing the cells to insulin as described in the review.

Another aspect is that the increased intracellular glucose also leads to increased D-lactate formation (1)which may hamper many cellular functions. On the other hand, the increased intracellular glucose concentration theoretically favors the so-called Warburg effect (2).

1 Talasniemi JP, Pennanen S, Savolainen H, et al. Assay of D-lactate in diabetic plasma and urine. Clin Biochem 2008; 41: 1099

2 Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: The metabolic requirements of cell proliferation. Science 2009; 324: 1029

Competing interests

None declared

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