Does Exercise Affect Cancer via Reverse Cholesterol Transport Process? A Hypothesis Which Needs to Be Clarified by Researchers

Saleh Rahmati; Hasan Taherkhani; Aliasghar Zarezadehmehrizi; Lida Moradi

doi:10.34172/apb.2024.008

Advanced pharmaceutical bulletin. 14(1):9-10. doi: 10.34172/apb.2024.008

Letter to Editor

Does Exercise Affect Cancer via Reverse Cholesterol Transport Process? A Hypothesis Which Needs to Be Clarified by Researchers

Saleh Rahmati ^{Conceptualization,}^{Investigation,}^{Project administration,}^Resources,^Supervision,^Validation,^{Visualization,}^{Writing – original draft,}^{Writing – review & editing,}^1,^*
Hasan Taherkhani ^{Writing – review & editing,}¹
Aliasghar Zarezadehmehrizi ^Validation,^{Writing – original draft,}^{Writing – review & editing,}²
Lida Moradi ^Resources,^{Visualization,}^{Writing – review & editing,}³

Author information:

¹Department of Physical Education, Pardis Branch, Islamic Azad University, Pardis, Iran.

²Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX, USA.

³Department of Physical Education and Sports Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran.

*Corresponding Author: Saleh Rahmati, Email: salehrahmati@pardisiau.ac.ir

Copyright and License Information

©2024 The Authors.
This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.

Dear editor,

Although medical science has made significant advancements in cancer treatment, complementary therapies such as exercise are also essential for the treatment and improvement of cancer patients.^1,2 Exercise can induce various beneficial effects on cancer patients through different mechanisms.^2,3 However, the role of exercise in the reverse cholesterol transport (RCT) process in cancer patients has not been explored. The RCT process is responsible for transporting cholesterol from the blood to the liver,⁴ and many studies have investigated the effect of exercise on the elements of this process in relation to cardiovascular disease, particularly atherosclerosis.⁵ Recently, it has been discovered that RCT is also involved in cancer by regulating cell cholesterol.⁶ Cholesterol accumulation is a characteristic feature of tumor cells that affects membrane structure and function and the signaling pathways related to tumor growth.⁶ Scavenger Receptor Class B type 1 (SR-B1), ATP Binding Cassette Subfamily A and G Member 1 (ABCA1, ABCG1), and the Liver X receptors (LXRs) are key molecules involved in cholesterol efflux.⁶ The expression of ABCA1 and LXR appears to inhibit tumor growth.⁶ However, there are some contradictory findings that need further investigation.⁶ Overexpression of SR-B1 and ABCG1 can cause tumor formation and act as an oncogene.⁶ Several studies have explored the impact of physical activity on the elements of the RCT process.^5,7 However, the effects of exercise on the RCT process in cancer conditions have not been fully investigated. The results of some studies appear to contradict exercise’s anti-cancer properties; for example, cancer can increase the expression of the ABCG1 gene, while exercise has been shown to increase tissue ABCG1 gene expression in non-cancerous subjects.⁵ It is unclear how much this gene will change in response to exercise in cancer conditions. Therefore, changes in the RCT process elements in response to exercise in cancer conditions require extensive investigation. These studies may lead to the discovery of new mechanisms associated with cancer.

Competing Interests

The author declares that there are no competing interests.

Ethical Approval

Ethics approval and consent to participate not applicable.

Funding

None.

References

Ussing A, Mikkelsen MK, Villumsen BR, Wejlgaard J, Bistrup PE, Birkefoss K. Supervised exercise therapy compared with no exercise therapy to reverse debilitating effects of androgen deprivation therapy in patients with prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2022; 25(3):491-506. doi: 10.1038/s41391-021-00450-0 [Crossref] [ Google Scholar]
O’Connor D, Lennon O, Fernandez MM, Signorelli GR, Caulfield B. Functional, physiological and subjective responses to concurrent neuromuscular electrical stimulation (NMES) exercise in adult cancer survivors: a controlled prospective study. Sci Rep 2020; 10(1):14008. doi: 10.1038/s41598-020-71006-w [Crossref] [ Google Scholar]
Wang Q, Zhou W. Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. J Sport Health Sci 2021; 10(2):201-10. doi: 10.1016/j.jshs.2020.07.008 [Crossref] [ Google Scholar]
Sun Y, Li X. Cholesterol efflux mechanism revealed by structural analysis of human ABCA1 conformational states. Nat Cardiovasc Res 2022; 1(3):238-45. doi: 10.1038/s44161-022-00022-y [Crossref] [ Google Scholar]
Rahmati-Ahmadabad S, Broom DR, Ghanbari-Niaki A, Shirvani H. Effects of exercise on reverse cholesterol transport: a systemized narrative review of animal studies. Life Sci 2019; 224:139-48. doi: 10.1016/j.lfs.2019.03.058 [Crossref] [ Google Scholar]
Sharma B, Agnihotri N. Role of cholesterol homeostasis and its efflux pathways in cancer progression. J Steroid Biochem Mol Biol 2019; 191:105377. doi: 10.1016/j.jsbmb.2019.105377 [Crossref] [ Google Scholar]
Rahmati-Ahmadabad S, Azarbayjani MA, Farzanegi P, Moradi L. High-intensity interval training has a greater effect on reverse cholesterol transport elements compared with moderate-intensity continuous training in obese male rats. Eur J PrevCardiol 2021; 28(7):692-701. doi: 10.1177/2047487319887828 [Crossref] [ Google Scholar]