A mini review: the trio of artichoke ( <i>Cynara scolymus L.</i> ), cytotoxicity, and apoptosis

Abstract The artichoke, also known as C scolymus L. , is an edible plant that is commonly grown worldwide, particularly in the Mediterranean region. C scolymus L . has different nutritious by-products , and while it depends on the culture, nearly all of them are consumable. Cancer is the second leading cause of death worldwide, and many molecular pathways are effective in both the development and prevention of cancer. This narrative article aims to review the effects of C scolymus L . on cytotoxicity and apoptosis, also known as programmed cell death. Current in vitro studies published in the last decade have shown that different by-products of C scolymus L. extracts increase cytotoxicity, which is the specific destructive action of an agent on cancer cells, and may also induce apoptosis. Moreover, C scolymus L . causes the stimulation of pro-apoptotic and suppression of anti-apoptotic cancer pathways. It increases initiating caspases 8 and 10 activities in the extrinsic pathway of apoptosis. While different C scolymus L. extracts potentially increase Bax expression, they suppress Bcl-2 in the intrinsic pathway of apoptosis. These effects cause an increase in caspase 9 activity. Increased activities of these initiating caspases (8-9-10) stimulate effector caspases 3 and 7, thus apoptosis. These are important beneficial effects for apoptosis and thus preventing cancer. However, these potential effects are limited to the results of in vitro studies. More in vitro studies on different cancer cell lines, in vivo studies, and randomised controlled human trials are therefore necessary to increase the level of evidence.