| 1 |
Cyanogenic metabolism and mitochondrial complex IV |
HCN ↑; complex IV ↓; oxidative phosphorylation ↓; ATP ↓ |
HCN ↑; complex IV ↓; oxidative phosphorylation ↓ |
Mitochondrial respiratory inhibition and cytotoxicity |
β-Glucosidase-mediated hydrolysis can release HCN, which inhibits cytochrome-c oxidase. Historically proposed tumor selectivity is not established; cyanide generation can also injure normal cells and is a major toxicity mechanism. |
| 2 |
Mitochondrial intrinsic apoptosis |
BAX ↑; BCL-2 ↓; cytochrome c ↑; caspase-9 ↑; caspase-3 ↑; PARP cleavage ↑ |
Not established |
Apoptotic cell death |
One of the most reproducible direct anticancer effects of amygdalin. Reported in prostate, breast, hepatic and lung cancer models. Evidence remains predominantly preclinical and commonly involves high concentrations. |
| 3 |
Cell-cycle and proliferation control |
CDK1 ↓; CDK2 modulation; cyclin A/B ↓; proliferation ↓; cell-cycle arrest ↑ |
Not established |
Growth arrest and reduced clonogenicity |
Cell-cycle phase is model-dependent. G0/G1, G1 and G2/M arrest have all been reported, indicating that a single universal arrest phase should not be assigned. |
| 4 |
AKT mTOR growth signaling |
AKT signaling ↓; mTOR signaling ↓; Raptor/Rictor signaling altered |
Not established |
Reduced proliferative and survival signaling |
Supported particularly by prostate-cancer and adhesion studies. Changes in AKT-mTOR signaling may contribute to suppression of proliferation, adhesion and metastatic behavior. |
| 5 |
Mitochondrial ROS and oxidative stress |
ROS ↑ (context-dependent); oxidative stress ↑ |
ROS ↑/↓ (context-dependent) |
Oxidative stress and amplification of apoptosis |
Secondary rather than universally established primary mechanism. ROS elevation is mechanistically compatible with mitochondrial respiratory disruption and has been reported in selected cancer and formulation studies, but amygdalin can suppress ROS in other experimental contexts. |
| 6 |
Glycolysis and tumor acid adaptation |
HK2 ↓; CA9 ↓ (model-dependent); glycolytic signaling ↓ |
Not established |
Metabolic disruption and reduced tumor-cell proliferation |
Recent multi-omics work in cervical-cancer models identifies HK2 and CA9 as important candidate targets. This is promising but currently model-specific and preclinical. |
| 7 |
NF-κB apoptotic signaling |
NF-κB signaling ↓; NF-κB1-related pro-apoptotic signaling ↑ (model-dependent) |
NF-κB ↓ (context-dependent) |
Reduced survival signaling and promotion of mitochondrial apoptosis |
Lung-cancer models link amygdalin-induced mitochondrial apoptosis to NF-κB1 activation with suppression of downstream NF-κB signaling. Direction depends on the specific NF-κB component measured. |
| 8 |
p38 MAPK stress signaling |
p38 MAPK ↑ |
Not established |
Pro-apoptotic stress signaling |
Demonstrated in triple-negative breast-cancer cells together with BAX ↑, BCL-2 ↓, caspase-3 activation and PARP cleavage. Currently a secondary and model-dependent mechanism. |
| 9 |
Adhesion migration and cytoskeletal signaling |
Integrin α5/β1 ↓ or altered; adhesion ↓; chemotaxis ↓; migration ↓ |
Not established |
Reduced invasive and metastatic phenotype |
Changes in integrins, catenins, cadherins, vimentin, ezrin and talin have been reported. Effects are generally moderate and primarily demonstrated in vitro. |
| 10 |
Proteasome and proteostasis |
20S proteasome ↓; 26S proteasome ↓; proteotoxic stress ↑ |
Not established |
Protein-homeostasis disruption and apoptosis |
Reported in breast-cancer cells. Mechanistically interesting but supported by fewer studies than apoptosis, cell-cycle or AKT-mTOR effects. |
| 11 |
Inflammatory signaling |
COX-2 ↓; iNOS ↓; inflammatory signaling ↓ (context-dependent) |
NF-κB ↓; NLRP3 ↓; inflammatory mediators ↓ (context-dependent) |
Anti-inflammatory modulation |
Substantial evidence exists outside cancer models, but this appears secondary to the principal anticancer mechanisms and may occur independently of tumor cytotoxicity. |
| 12 |
Clinical Translation Constraint |
Therapeutically relevant parent-drug exposure uncertain |
Cyanide exposure ↑ after oral administration |
Major limitation to clinical translation |
Many anticancer experiments use millimolar or mg/mL concentrations that greatly exceed circulating parent-amygdalin concentrations after oral dosing. Gut microbiota can convert oral amygdalin to cyanide, creating variable systemic toxicity. Clinical anticancer efficacy has not been demonstrated. |