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How to obtain severe hypoglycemia without causing brain or cardiac damage
Martina Baiardo Redaelli1, Alberto Zangrillo2, Vanesa Gregorc3
1Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Abstract:
Cancer is the second cause of death worldwide, but current therapies are often insufficient or linked with toxicity. Initial evidence in scientific literature seems to support the role of non-pharmacological strategies, including hypoglycemia, in cancer treatment. The biological rationale for hypoglycemia-based treatment of cancer resides in the evidence that cancer cells predominantly utilize glucose as an energy source; notably, cancer cells seem to have damaged glycolysis regulation and few, defective mitochondria showing impaired oxidative phosphorylation. Preliminary data arising from both preclinical and human studies support the role of hypoglycemia in inducing apoptosis on cancer cells. In this paper, we describe how to induce and maintain severe hypoglycemia without causing damage to either the brain or the heart. Our hypothesis is that ExtraCorporeal Membrane Oxygenation (ECMO) and selective glucose perfusion of the carotid vessels are able to maintain severe hypoglycemia without causing cardiac or brain damage. This will allow physicians to study the effect of severe hypoglycemia on cancer cell apoptosis in vivo.
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