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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">738235</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2021.738235</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Molecular Basis of Prostate Cancer and Natural Products as Potential Chemotherapeutic and Chemopreventive Agents</article-title>
<alt-title alt-title-type="left-running-head">Bai et&#x20;al.</alt-title>
<alt-title alt-title-type="right-running-head">Natural Products for Prostate Cancer</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Bai</surname>
<given-names>Bingke</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476270/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Qianbo</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1473815/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jing</surname>
<given-names>Rui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/876152/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>He</surname>
<given-names>Xuhui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476203/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Hongrui</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476208/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ban</surname>
<given-names>Yanfei</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476254/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Ye</surname>
<given-names>Qi</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476245/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Xu</surname>
<given-names>Weiheng</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1476197/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Zheng</surname>
<given-names>Chengjian</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/471907/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<label>
<sup>1</sup>
</label>Department of Chinese Medicine Authentication, School of Pharmacy, Second Military Medical University, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<label>
<sup>2</sup>
</label>Department of Anesthesiology, Shanghai Eastern Hepatobiliary Surgery Hospital, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<label>
<sup>3</sup>
</label>Department of Biological Science, College of Life Science, Fujian Agriculture and Forestry University, <addr-line>Fuzhou</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<label>
<sup>4</sup>
</label>Department of Biochemical Pharmacy, School of Pharmacy, Second Military Medical University, <addr-line>Shanghai</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/715217/overview">Wei Peng</ext-link>, Chengdu University of Traditional Chinese Medicine, China</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1408708/overview">Tao Guo</ext-link>, Henan University of Traditional Chinese Medicine, China</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/254560/overview">Loh Teng Hern Tan</ext-link>, Monash University Malaysia, Malaysia</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Qi Ye, <email>qipharm@126.com</email>; Weiheng Xu, <email>xuweiheng7114@163.com</email>; Chengjian Zheng, <email>cjzheng1984@126.com</email>
</corresp>
<fn fn-type="equal" id="fn1">
<label>
<sup>&#x2020;</sup>
</label>
<p>These authors have contributed equally to this&#x20;work</p>
</fn>
<fn fn-type="other">
<p>This article was submitted to Ethnopharmacology, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>23</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>738235</elocation-id>
<history>
<date date-type="received">
<day>08</day>
<month>07</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>09</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2021 Bai, Chen, Jing, He, Wang, Ban, Ye, Xu and Zheng.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Bai, Chen, Jing, He, Wang, Ban, Ye, Xu and Zheng</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these&#x20;terms.</p>
</license>
</permissions>
<abstract>
<p>Prostate cancer is the second most common malignant cancer in males. It involves a complex process driven by diverse molecular pathways that closely related to the survival, apoptosis, metabolic and metastatic characteristics of aggressive cancer. Prostate cancer can be categorized into androgen dependent prostate cancer and castration-resistant prostate cancer and cure remains elusive due to the developed resistance of the disease. Natural compounds represent an extraordinary resource of structural scaffolds with high diversity that can offer promising chemical agents for making prostate cancer less devastating and curable. Herein, those natural compounds of different origins and structures with potential cytotoxicity and/or <italic>in vivo</italic> anti-tumor activities against prostate cancer are critically reviewed and summarized according to the cellular signaling pathways they interfere. Moreover, the anti-prostate cancer efficacy of many nutrients, medicinal plant extracts and Chinese medical formulations were presented, and the future prospects for the application of these compounds and extracts were discussed. Although the failure of conventional chemotherapy as well as involved serious side effects makes natural products ideal candidates for the treatment of prostate cancer, more investigations of preclinical and even clinical studies are necessary to make use of these medical substances reasonably. Therefore, the elucidation of structure-activity relationship and precise mechanism of action, identification of novel potential molecular targets, and optimization of drug combination are essential in natural medicine research and development.</p>
</abstract>
<kwd-group>
<kwd>prostate cancer</kwd>
<kwd>natural compounds</kwd>
<kwd>apoptosis</kwd>
<kwd>androgen receptor</kwd>
<kwd>mechanism</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>It is nowadays evident that prostate cancer (PCa) is recognized as the second most common cancer and the fifth cause of cancer death in males (<xref ref-type="bibr" rid="B255">Torre et&#x20;al., 2015</xref>)Initially, the usual therapy for prostate cancer is prostatectomy or radiation, which aims to remove or kill the malignant cells that have not spread or metastasized (<xref ref-type="bibr" rid="B73">Feldman and Feldman, 2001</xref>). However, numerous patients cannot be cured thoroughly by this treatment, and then followed by cancer recurrence and/or metastasis. The majority of prostate cancer growth is androgen dependent. Androgen deprivation therapy (ADT) such as surgery or gonadotropin-releasing hormone (GnRH) analog treatment, is the main therapeutic and dramatically effective intervention for the treatment of androgen dependent prostate cancer (ADPC) in putting patients with tumors in remission, as documented by the work on castration of Huggins, who was awarded the Nobel prize in 1966 (<xref ref-type="bibr" rid="B113">Huggins, 1978</xref>). Nevertheless, after this therapy, most of these prostate cancer patients gradually become androgen independent, go on to progress, metastasize and resist to ADT within 13&#x2013;24&#xa0;months accompanied by increased levels of prostate-specific antigen (PSA). Siegel et&#x20;al. reported that failure of ADT is responsible for the &#x223c;27,000 metastatic prostate cancer deaths in the United&#x20;States annually (<xref ref-type="bibr" rid="B231">Siegel et&#x20;al., 2017</xref>). This stage of prostate cancer is called castration-resistant prostate cancer (CRPC), which has poor prognosis (<xref ref-type="bibr" rid="B234">Small et&#x20;al., 2004</xref>). At present, there is no effective therapy for CRPC besides docetaxel, which has been demonstrated to prolong overall survival in this patient population. However, the efficacy of docetaxel is not satisfactory and there are many severe adverse effects such as anemia, neutropenia, diarrhea, and sensory neuropathy. Although, therapeutic options have expanded rapidly since 2011, including AR inhibitors (enzalutamide, abiraterone), immunotherapy (sipuleucel-T), bone seeking radionuclides (radium-223), and second-line chemotherapy (cabazitaxel), all of these agents or interventions only have shown a median survival benefit of 2&#x2013;5&#xa0;months (<xref ref-type="bibr" rid="B207">Ritch and Cookson, 2016</xref>). So searching for more effective anti-prostate cancer drugs, especially with high efficacy and low toxicity, remains an urgent problem that needs to be resolved. Natural compounds represent an irreplaceable resource of structural scaffolds that can offer chemical agents for making prostate cancer less devastating and curable. In recent years, many natural products and extracts have been scientifically investigated <italic>in&#x20;vitro</italic> and/or <italic>in vivo</italic> and proved as potential anti-prostate cancer agents, which are currently scattered across various publications. So a systematic summary and knowledge of future prospects are necessary to facilitate further chemical and pharmacological studies for anti-prostate cancer agents.</p>
<p>Herein, we reviewed the detailed molecular causes of prostate cancer and critically summarized the natural compounds (or extracts and Chinese herb preparations) that have been reported to inhibit prostate cancer cells proliferation/tumor growth, induce prostate cancer cells apoptosis or exhibit effects on specific signaling pathways involved in prostate cancer <italic>in vivo</italic> and <italic>in&#x20;vitro</italic>. In addition, we also provided possible novel targets for screening natural compounds (or extracts or Chinese herb preparations) with anti-prostate cancer activity and discuss the future prospects for the application of these compounds and extracts and the novel available approaches and technological improvements that should be explored to treat prostate cancer.</p>
</sec>
<sec id="s2">
<title>Overview of the Molecular Basis of Prostate Cancer</title>
<sec id="s2-1">
<title>Molecular Basis of Androgen Dependent Prostate Cancer</title>
<p>Androgens, principally testosterone (T) and dihydrotestosterone (DHT), are synthesized from cholesterol as the initial 27-carbon substrate via multiple enzymatic steps (<xref ref-type="bibr" rid="B265">Wadosky and Koochekpour, 2016</xref>). As a member of the ligand-activated nuclear hormone receptors superfamily, androgen receptor (AR) is a modular protein with four functional domains: an N-terminal regulatory domain (NTD), a DNA-binding domain (DBD), a small hinge region (H) and a ligand-binding domain (LBD) (<xref ref-type="bibr" rid="B97">Ho and Dehm, 2017</xref>). Upon binding to androgens, AR undergoes a conformational change, leading to nuclear translocation, phosphorylation, homodimer, and interaction with DNA (<xref ref-type="bibr" rid="B153">Li and Al-Azzawi, 2009</xref>). Subsequently, AR dimer binds to androgen-response elements (AREs), recruits essential co-factors and regulates the expression of androgen-regulated genes (<xref ref-type="bibr" rid="B97">Ho and Dehm, 2017</xref>).</p>
<p>The development and maintenance of the prostate is inseparable from androgen acting through the AR. Since Huggins and Hodges first demonstrated the responsiveness of prostate cancer to androgen deprivation, it has been clear that prostate cancer is dependent on androgen and AR activation for growth and survival (<xref ref-type="bibr" rid="B114">Huggins and Hodges, 1941</xref>). From then, hundreds of studies have demonstrated that androgen withdrawal results in initial regression of essentially all prostate cancers, albeit for a finite period, with the ultimate development of castration-resistant disease. Androgen deprivation therapy, via either orchidectomy or use of a gonadotropin-releasing hormone (GnRH) agonist has become the cornerstone of therapy in the treatment of prostate cancers. Newer agents, such as abiraterone, which block androgen synthetic pathways, have added clinical benefit in disseminated disease, demonstrating that even in &#x201c;castration resistant disease&#x201d; androgens may still be supporting prostate cancer growth (<xref ref-type="bibr" rid="B193">Morgentaler, 2009</xref>). These data support the notion that prostate cancer, in most cases, is a hormone (androgen) sensitive disease.</p>
</sec>
<sec id="s2-2">
<title>Overview of the Mechanisms of Castration-Resistant Prostate Cancer</title>
<p>Historically, there are much debate about the mechanisms of castration resistance, which are mainly summarized as the following by recent studies: canonical AR signaling, relying on AR nuclear translocation and AR-DNA binding, and non-nuclear AR signaling which requires neither AR nuclear translocation nor AR-DNA binding(Qin and Bin, 2019; Pisano et&#x20;al., 2021).</p>
<sec id="s2-2-1">
<title>Canonical AR Signaling</title>
<p>The potential mechanisms of canonical AR signaling that lead to CRPC can be categorized into three parts. 1) common alterations in AR, which can lead to AR increase its sensitivity to very low levels of androgens or constitutive activation of AR signaling; 2) AR activation by androgens converted from adrenalandrogens or synthesized intratumorally via the <italic>de novo</italic> route; 3) alterations in cofactors of the AR pathway (<xref ref-type="fig" rid="F1">Figure&#x20;1</xref>
<bold>)</bold>.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>Canonical AR in castration-resistant prostate cancer. Common alterations in <italic>AR</italic>, including <italic>AR</italic> amplification or overexpression, <italic>AR</italic> mutations and truncated <italic>AR</italic> lacking ligand-binding domains (<italic>AR</italic>&#x394;LBD), can increase its sensitivity to very low levels of androgens or lead to constitutive activation of AR signaling. There are two possible ways for the initial substrates to convert to intratumoral DHT in CRPC. The first way is that androgens are synthesized intratumorally via the <italic>de novo</italic> route and the second is that androgens are converted from adrenal androgens. Genomic and transcriptomic alterations in AR pathway coregulators are also associated with resistance to AR-targeted therapies in CRPC.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g001.tif"/>
</fig>
<sec id="s2-2-1-1">
<title>Common Alterations in <italic>AR</italic>
</title>
<p>One possible mechanism by which the prostate cancer becomes resistant to androgen deprivation therapy is alterations in <italic>AR</italic>, including <italic>AR</italic> amplification or overexpression, <italic>AR</italic> mutations and truncated <italic>AR</italic> lacking ligand-binding domains (<italic>AR</italic>&#x394;LBD). Thus, these changes in AR increase its sensitivity to very low levels of androgens or lead to constitutive activation of AR signaling. Strictly speaking, this mechanism of prostate cancers is not androgen-independent and the responses still depend on AR and androgen.</p>
<sec id="s2-2-1-1-1">
<title>
<italic>AR</italic> Amplification or Overexpression</title>
<p>Despite low circulating androgens in the CRPC patients, one potential mechanism that would allow tumor cell proliferation is by promoting the expression of the AR itself, which increases ligand-occupied receptor content (<xref ref-type="bibr" rid="B73">Feldman and Feldman, 2001</xref>). Plenty of studies have shown that approximately 50% of tumors that become castration resistant after ADT have amplified the AR gene, the most frequent genetic alteration reported for CRPC tumors, whereas none of the untreated primary tumors before androgen ablation had an AR gene amplification (<xref ref-type="bibr" rid="B208">Robinson et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B65">Djusberg et&#x20;al., 2017</xref>).</p>
<p>Numerous studies provide the simplest explanation of how increased androgen receptor expression leads to resistance to anti-androgen therapy. According to one study, a three-to-five-fold increase in receptor levels could compensate for low ligand levels and restore androgen receptor signaling in xenotransplantation models. (<xref ref-type="bibr" rid="B42">Chen et&#x20;al., 2004</xref>). Although tumors with AR amplification have increased levels of AR, the signal for cell proliferation presumably continues to require androgen (<xref ref-type="bibr" rid="B262">Visakorpi et&#x20;al., 1995</xref>). Maybe this can explain why tumors with castration resistance have increased sensitivity to androgens in a low androgen environment.</p>
</sec>
<sec id="s2-2-1-1-2">
<title>
<italic>AR</italic> Mutations</title>
<p>In CRPC, the frequency of <italic>AR</italic> mutations in pre-treated tumors is 5&#x2013;30% (<xref ref-type="bibr" rid="B84">Grasso et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B208">Robinson et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B139">Kumar et&#x20;al., 2016</xref>). Most mutations identified in CRPC were located in the AR-LBD. These alterations could facilitate AR signaling in CRPC by offering: 1) ligand facilitation, thereby inducing AR activation even in the presence of low or absent levels of androgens and 2) agonist properties to AR antagonists (<xref ref-type="bibr" rid="B54">Coutinho et&#x20;al., 2016</xref>). In addition, mutations can also occur in the AR-NTD that account for about a third of all mutations described in AR. And mutations can usually cause alterations that contribute to AR transactivation, such as facilitated recruitment of co-factors and other components of the transcriptional machinery, promoted N/C interaction, increased response to DHT activation and enhanced protein stability and nuclear retention (<xref ref-type="bibr" rid="B198">Network C. G. A., 2015</xref>; <xref ref-type="bibr" rid="B54">Coutinho et&#x20;al., 2016</xref>).</p>
</sec>
<sec id="s2-2-1-1-3">
<title>Truncated <italic>AR</italic> Lacking Ligand-Binding Domains (<italic>AR</italic>&#x394;LBD)</title>
<p>Latest RNA sequencing data from big data sets, strongly suggests that constitutively active AR&#x394;LBD may play a role in 40&#x2013;50% of patients with CRPC (<xref ref-type="bibr" rid="B208">Robinson et&#x20;al., 2015</xref>). Compared with hormone na&#xef;ve PCa, AR&#x394;LBDs are frequently upregulated in CRPC, and may serve as an adaptive response to therapies targeting the androgen/AR-signaling axis (<xref ref-type="bibr" rid="B88">Guo et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B161">Li et&#x20;al., 2013</xref>). The recent genomic data on unique exon junctions reveals that at least 12 distinct <italic>AR-V</italic> mRNA species are detectable in primary PCa and 23 in CRPC (<xref ref-type="bibr" rid="B2">Abeshouse et&#x20;al., 2015</xref>). However, among these variants, AR-V3/AR-V7 appears to be one of the most abundantly and ubiquitously expressed isoforms in our screening of a panel of human prostate cancer cell lines and tissues (<xref ref-type="bibr" rid="B88">Guo et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B223">Schweizer and Plymate, 2016</xref>). In addition, nonsense mutations leading to premature chain termination (Q641X, formerly Q640X) as well as enzymatic cleavage (tr-AR) were also shown to induce AR&#x25b3;LBDs (<xref ref-type="bibr" rid="B90">Haile and Sadar, 2011</xref>). F. Zengerling et&#x20;al. reported that inhibition of IGF-1R resulted in a down-regulation of AR, Q641X and AR-V7 signaling in PCa cells (<xref ref-type="bibr" rid="B302">Zengerling et&#x20;al., 2016</xref>), which suggests that IGF-1/IGF-1R axis is a modulator of the AR&#x25b3;LBD signaling, providing a rationale by targeting growth factor receptor for CRPC treatment.</p>
</sec>
</sec>
<sec id="s2-2-1-2">
<title>AR Activation by DHT Synthesized Intratumorally via the <italic>de novo</italic> Route or Converted From Adrenal Androgens</title>
<p>There are two possible ways for the initial substrates to convert to intratumoral DHT in CRPC. The first way is that androgens are synthesized intratumorally via the <italic>de novo</italic> route and the second is that androgens are converted from adrenal androgens.</p>
<sec id="s2-2-1-2-1">
<title>DHT Intratumorally via the <italic>de novo</italic> Route</title>
<p>The use of cholesterol for <italic>de novo</italic> steroidogenesis requires the components of the steroidogenic machinery present in the adrenals and gonads, including steroidogenic acute regulatory proteins, CYP11A1 and CYP17A1 (<xref ref-type="bibr" rid="B188">Miller and Auchus, 2011</xref>), which may play important roles in prostate cancer (<xref ref-type="bibr" rid="B173">Locke et&#x20;al., 2008</xref>). Comparisons between primary prostate cancer and CRPC demonstrate that the transcription levels of these proteins are upregulated in CRPC (<xref ref-type="bibr" rid="B191">Montgomery et&#x20;al., 2008</xref>) and CYP17A1 protein is detectable in a subset of metastatic CRPC cases (<xref ref-type="bibr" rid="B68">Efstathiou et&#x20;al., 2012</xref>). In contrast to steroidogenesis in the adrenals and gonads, CRPC expresses steroid-5&#x3b1;-reductase (SRD5A1) with obvious 5&#x3b1;-reductase activity (<xref ref-type="bibr" rid="B39">Chang et&#x20;al., 2011</xref>). One of the functions of robust SRD5A enzyme activity is that any <italic>de novo</italic> steroidogenesis would likely occur through the back door pathway that bypasses the requirement for T and involves 5-reduction of a 21-carbon steroid (progesterone or 17&#x3b1;-hydroxyprogesterone) instead of a 19-carbon androgen (<xref ref-type="bibr" rid="B227">Shaw et&#x20;al., 2000</xref>; <xref ref-type="bibr" rid="B17">Auchus, 2004</xref>). Although this biochemical pathway may be engaged in CRPC, the relatively lengthy eight enzymatic steps required for conversion from cholesterol to DHT, the abundance of adrenal precursors present in serum, and the much closer pathway proximity of adrenal precursors to DHT, together suggest that adrenal precursors serve as the major substrate&#x20;pool.</p>
</sec>
<sec id="s2-2-1-2-2">
<title>DHT Converted From Adrenal Androgens</title>
<p>There are two possible pathways from adrenal precursor steroids to DHT (<xref ref-type="bibr" rid="B175">Luu-The et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B40">Chang and Sharifi, 2012</xref>). The canonical adrenal pathway is the route that results in T synthesis as the penultimate metabolite, which undergoes 5-reduction to DHT (<xref ref-type="bibr" rid="B220">Scher and Sawyers, 2005</xref>; <xref ref-type="bibr" rid="B213">Ryan and Tindall, 2011</xref>; <xref ref-type="bibr" rid="B98">Hofland et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B237">Stein et&#x20;al., 2012</xref>). This pathway is probably favored in the field because of the general notion that T must be the precursor to DHT and T is frequently detectable at concentrations greater than DHT in CRPC, as occurs with gonadal androgen physiology (<xref ref-type="bibr" rid="B252">Titus et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B191">Montgomery et&#x20;al., 2008</xref>). In this pathway, DHEA is converted by 3&#x3b2;-hydroxysteroid dehydrogenase (3&#x3b2;HSD) to androstenedione (AD), which is then 17-keto reduced by aldo-keto reductase 1C3 (AKR1C3) or 17&#x3b2;HSD3 to T, the immediate precursor to DHT. The second possible pathway is that AD, like T, a 3-keto, &#x25b3;4-steroid, is also a potential substrate for SRD5A (<xref ref-type="bibr" rid="B253">Tomkins, 1957</xref>). AD is reduced to 5&#x3b1;-androstanedione (5&#x3b1;-dione), which then becomes the immediate precursor to DHT. The 5&#x3b1;-dione pathway is the major pathway for the synthesis of DHT in CRPC (<xref ref-type="bibr" rid="B39">Chang et&#x20;al., 2011</xref>).</p>
</sec>
</sec>
<sec id="s2-2-1-3">
<title>Alterations in Cofactors of the AR Pathway</title>
<p>Resistance to AR-targeted therapies in CRPC was also associated with genomic and transcriptomic alterations in coregulators of the AR pathway. Expression of 50 of the &#x223c;200&#x20;AR-associated coregulators is aberrant in clinical CRPC specimens (<xref ref-type="bibr" rid="B169">Liu et&#x20;al., 2017</xref>). For example, a higher frequency of mutations in <italic>FOXA1</italic>, the gene encoding a pioneer factor that facilitates AR chromatin binding and transcriptional activation, was found in CRPC (12%) than in primary prostate cancer (4%) (<xref ref-type="bibr" rid="B276">Watson et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B2">Abeshouse et&#x20;al., 2015</xref>). In addition, as one class of coregulators, steroid receptor coactivators (SRC-1, SRC-2 and SRC-3) play a key role in facilitating aberrant AR signaling in CRPC e. There have been studies reported that all 3 SRCs is elevated in CRPC (<xref ref-type="bibr" rid="B247">Taylor et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B84">Grasso et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B2">Abeshouse et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B24">Beltran et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B27">Bernemann et&#x20;al., 2016</xref>). GATA2, another AR pioneer factor in the AR signaling axis, is aberrant expressed in CRPC and associated with poor outcome (<xref ref-type="bibr" rid="B95">He et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B45">Yan et&#x20;al., 2014</xref>). Gupta et&#x20;al. detected genomic copy number changes of circulating tumor cells from 16 patients with CRPC resistant to abiraterone or enzalutamide and revealed that multiple genes encoding AR coregulators had copy number alterations, including copy number gains BRD4 (43.75%) (<xref ref-type="bibr" rid="B89">Gupta et&#x20;al., 2017</xref>). Moreover, changes of AR corepressors also play a key role in CRPC. For example, loss of activity of the key nuclear receptor corepressors NCOR1 and NCOR2, is prevalent in CRPC due to mutation and/or deletion (<xref ref-type="bibr" rid="B84">Grasso et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B2">Abeshouse et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B139">Kumar et&#x20;al., 2016</xref>).</p>
</sec>
</sec>
<sec id="s2-2-2">
<title>Non-nuclear AR Signaling</title>
<p>Trafficking from the nucleus into the cytoplasm, AR may have unexpected consequences because AR has known functions in the cytoplasm, which is called non-genomic signaling (<xref ref-type="bibr" rid="B76">Foradori et&#x20;al., 2008</xref>). One of the main characteristics of non-nuclear signaling is its rapidity with which it occurs. When steroid receptors stay in the cytosol, they can undergo several protein&#x2013;protein interactions within seconds to minutes after steroid stimulation, which activates a variety of signaling pathways to promote the development of CRPC (<xref ref-type="fig" rid="F2">Figure&#x20;2</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Non-nuclear AR signaling in castration-resistant prostate cancer. Cytokines, interleukins and the growth factors secreted by the prostate cancer cells activate various signaling cascades like PI3K/AKT, Src, MAPKs and JAK/STAT3 pathways involved in castration-resistant prostate cancer, leading to cell proliferation, survival and tumor metastasis. Intracellular Ca<sup>2&#x2b;</sup> centration can be modulated through Calcium channel. This increase in intracellular Ca<sup>2&#x2b;</sup> can lead to activation of PKC and filamin A, ultimately influencing gene transcription through phosphorylation. TRPM4 is also activated by a rise in intracellular Ca<sup>2&#x2b;</sup> in prostate cancer cells. Upon activation, a Na<sup>&#x2b;</sup> influx via TRPM4 depolarizes the membrane potential, which decreases the driving force for Ca<sup>2&#x2b;</sup>, and thus contributes to migration of androgen-insensitive prostate cancer cells. There are other genomic alterations in castration-resistant prostate cancer, including <italic>PTEN</italic> mutation, <italic>SPOP</italic> mutation and <italic>TMPRSS2-ERG</italic> rearrangement.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g002.tif"/>
</fig>
<sec id="s2-2-2-1">
<title>PI3K/AKT Signaling Pathway</title>
<p>The PI3K/AKT pathway is one of the most frequently activated signal transduction pathways in human cancer, including prostate cancer(Hoxhaj and Manning, 2020; Park et&#x20;al., 2018; Braglia et&#x20;al., 2020). Alterations of the PI3K/AKT pathway, including altered expression, mutation, and copy number alterations, have been reported in 42% of primary prostate tumors and 100% of metastatic tumors (<xref ref-type="bibr" rid="B247">Taylor et&#x20;al., 2010</xref>). Androgens induce the accumulation of TORC2 complex, rapamycin insensitive chaperone of mTOR and stress activated protein kinase interacting protein 1 in the nucleus, thus stimulating TORC2 to activate Akt (<xref ref-type="bibr" rid="B72">Fang et&#x20;al., 2012</xref>). Activated AKT can stimulate many downstream functions via its kinase activity, including glycogen synthase kinase 3 (GSK3), tuberous sclerosis complex (TSC), FOXO transcription factors, NF-kappa-B and Bcl-2 family members BAD, which regulate a range of cellular processes (<xref ref-type="bibr" rid="B168">Liu et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B53">Courtney et&#x20;al., 2010</xref>). It is estimated that genomic phosphatase and tensin homolog gene (PTEN) alterations, which is a negative inhibitor of PI3K/AKT pathway, occur in 9&#x2013;45% of high-grade prostate intra-epithelial neoplasia (HG-PIN), 20&#x2013;60% of localized prostate cancer, and up to 100% of cases of metastatic prostate cancer (<xref ref-type="bibr" rid="B247">Taylor et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B118">Jia et&#x20;al., 2013</xref>).</p>
</sec>
<sec id="s2-2-2-2">
<title>Src Signaling Pathway</title>
<p>Preclinical studies have confirmed that non receptor tyrosine kinase c-Src and Src family kinase (SFK) regulate a complex signal network, driving the development of castration-resistance prostate cancer and bone metastasis. (<xref ref-type="bibr" rid="B34">Cai et&#x20;al., 2011</xref>). After the establishment of bone metastasis, prostate cancer cells destroy the balance of osteoclasts and osteoblasts by secreting a variety of molecules, such as growth factors and cytokines that disrupt the normal process of bone maintenance and reconstruction (<xref ref-type="bibr" rid="B291">Yang et&#x20;al., 2001</xref>; <xref ref-type="bibr" rid="B195">Mundy, 2002</xref>). The balance is in favor of osteoblastogenesis, which explains the usual condensing aspect of PCa-derived bone metastases. Src activity specifically affects ruffled borders of osteoclasts (essential for bone resorption), through dynamic regulating the interactions of actin cytoskeleton and formation of podosomes (<xref ref-type="bibr" rid="B102">Horne et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B63">Destaing et&#x20;al., 2011</xref>). Src and other SFKs also play important roles in the antiapoptotic signal transduction of RANKL and other tumor necrosis factor family members in osteoclasts (<xref ref-type="bibr" rid="B283">Xing et&#x20;al., 2001</xref>). One essential role for Src in osteoblasts has also been demonstrated that reduction of Src expression decreases osteoblast(responsible for bone formation) proliferation and increases differentiation (<xref ref-type="bibr" rid="B179">Marilena et&#x20;al., 2000</xref>).</p>
<p>Recently, a large number of studies have shown that the activation of SRC is an important mediator of AR signaling. (<xref ref-type="bibr" rid="B16">Asim et&#x20;al., 2008</xref>). AR can form a tertiary complex with the scaffold protein modulator of non-genomic actions of the estrogen receptor (MNAR/PELP1) and Src (<xref ref-type="bibr" rid="B259">Unni et&#x20;al., 2004</xref>). Initially, Src is inactive within this complex. However, when AR binds to Src, this results in the activation of Src in this complex (AR/MNAR/Src) and the subsequent activation of a downstream effector, MEK (<xref ref-type="bibr" rid="B259">Unni et&#x20;al., 2004</xref>). Subsequent studies have shown that AR-induced Src activation can promote cell proliferation through cell cycle progression from G1 phase to S phase (<xref ref-type="bibr" rid="B187">Migliaccio et&#x20;al., 2002</xref>).</p>
</sec>
<sec id="s2-2-2-3">
<title>MAPKs Signaling Pathway</title>
<p>The MAPKs signaling cascade play important roles in regulating diverse biological functions including cell proliferation, motility and survival, which are essential to prostate carcinogenesis (Rossomando et&#x20;al., 1989; Armenia et&#x20;al., 2018; Abida et&#x20;al., 2019). Studies of DHT-responsiveness in prostate cancer cells show that DHT treatment induces phosphorylation of ERK-1/2 within 1&#x2013;2&#xa0;min and peak levels of phosphorylation within 5&#x2013;10&#xa0;min (<xref ref-type="bibr" rid="B163">Liao et&#x20;al., 2013</xref>). Activated ERK-1/2 then translocate to the nucleus and directly interact with and phosphorylate transcription factors (TFs), such as nuclear ETS domain-containing Elk1 (<xref ref-type="bibr" rid="B178">Marais et&#x20;al., 1993</xref>; <xref ref-type="bibr" rid="B81">Gille et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B293">Yang et&#x20;al., 1998</xref>). Elk1 transcriptionally regulates immediate early genes (IEGs) such as c-fos (<xref ref-type="bibr" rid="B81">Gille et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B259">Unni et&#x20;al., 2004</xref>), and regulates the expression of several genes related to cell proliferation (<xref ref-type="bibr" rid="B178">Marais et&#x20;al., 1993</xref>; <xref ref-type="bibr" rid="B259">Unni et&#x20;al., 2004</xref>). In addition, recent studies showed that other molecules induce prostate cancer via MAPK signaling. Jason et&#x20;al. reported that ADP-ribosylation factor 1 (ARF1), a crucial regulator in vesicle-mediated membrane trafficking and involved in the activation of signaling molecules, promotes the occurrence of prostate cancer via targeting oncogenic MAPK signaling (<xref ref-type="bibr" rid="B60">Davis et&#x20;al., 2016</xref>). Gonzalo et&#x20;al. reported that epidermal growth factor (EGF) could stimulate G0/G1-S transition via p38 MAPK to overcome the growth restriction of androgen deprivation in prostate cancer cells (<xref ref-type="bibr" rid="B210">Rodriguez-Berriguete et&#x20;al., 2016</xref>).</p>
</sec>
<sec id="s2-2-2-4">
<title>JAK-STAT3 Signaling Pathway</title>
<p>Janus kinases (JAK) signal transducers and activator of transcription (STAT) pathway play an important role in differentiation, hematopoiesis, immune function and cell growth (<xref ref-type="bibr" rid="B29">Bolli et&#x20;al., 2003</xref>). Recently, accumulating evidence indicated that IL-6 is indispensable for activation of JAK/STAT pathway, which is involved in the oncogenesis of prostate cancer (<xref ref-type="bibr" rid="B171">Liu X. et&#x20;al., 2012</xref>). Compared with men with normal prostates, benign prostatic hyperplasia, prostatitis and localized disease, approximately 50% of patients with advanced prostate cancer have increased levels of serum IL-6 (<xref ref-type="bibr" rid="B258">Twillie et&#x20;al., 1995</xref>). Upon the binding of IL-6 to the IL-6 receptor, JAK-1 and STAT-3 become activated in sequence (<xref ref-type="bibr" rid="B221">C Schindler and Jr, 1995</xref>). L Tam et&#x20;al. reported that cytoplasmic expression of IL-6 receptor and pSTAT3 Tyr705 are associated with the shortened biochemical recurrence time and death time from hormone relapse, respectively. Therefore, it is reasonable to target this pathway in hormone-refractory prostate cancer treatments (<xref ref-type="bibr" rid="B244">Tam et&#x20;al., 2007</xref>).</p>
</sec>
<sec id="s2-2-2-5">
<title>Ca<sup>2&#x2b;</sup> Signaling Pathway</title>
<p>Ca<sup>2&#x2b;</sup>signaling is also involved in prostate cancer progression (Figiel et&#x20;al., 2019; Chalmers and Monteith et&#x20;al., 2018). Increased calcium intake from dairy products has been considered as a risk factor for prostate cancer (<xref ref-type="bibr" rid="B77">Foradori et&#x20;al., 2007</xref>; <xref ref-type="bibr" rid="B75">Flourakis and Prevarskaya, 2009</xref>). As a primary signaling molecule, extracellular Ca<sup>2&#x2b;</sup> works through the Ca<sup>2&#x2b;</sup>-sensing receptor (CaR, a G protein coupled receptor) which directly regulates cell signal transduction and the Ca<sup>2&#x2b;</sup> channels (<xref ref-type="bibr" rid="B261">Vaz et&#x20;al., 2015</xref>). Depletion of intracellular Ca<sup>2&#x2b;</sup> stores serves as a signal for the activation of Ca<sup>2&#x2b;</sup> influx across the plasma membrane. The proteins STIM1 and ORAI1 were identified as the key components of store-operated Ca<sup>2&#x2b;</sup> entry (SOCE). When Ca<sup>2&#x2b;</sup> is released from intracellular Ca<sup>2&#x2b;</sup> pool, Ca<sup>2&#x2b;</sup> dissociates from a luminal EF hand motif of STIM1. As a consequence, STIM1 proteins aggregate and recruit Orai1 Ca<sup>2&#x2b;</sup>channels, which then mediate SOCE (<xref ref-type="bibr" rid="B131">Kilch et&#x20;al., 2016</xref>).</p>
<p>Recently, Huang et&#x20;al. found that Ca<sup>2&#x2b;</sup> via CaR-mediated signaling induces filamin A cleavage, which is an actin-binding protein, and promotes the migration of AR-deficient and highly metastatic prostate cancer cells (<xref ref-type="bibr" rid="B108">Huang et&#x20;al., 2016</xref>). In one additional study, Christian demonstrated that transient receptor potential melastatin 4 channel (TRPM4) is activated by a rise in intracellular Ca<sup>2&#x2b;</sup> in prostate cancer cells. Upon activation, a Na<sup>&#x2b;</sup> influx via TRPM4 depolarizes the membrane potential, which reduces the driving force for Ca<sup>2&#x2b;</sup> and limits SOCE, and thus promotes migration of androgen-insensitive prostate cancer cells (<xref ref-type="bibr" rid="B100">Christian et&#x20;al., 2015</xref>).</p>
</sec>
<sec id="s2-2-2-6">
<title>Other Genomic Alterations in Castration-Resistant Prostate Cancer</title>
<p>Prostate cancer is characterized by a high genetic heterogeneity due to genomic alterations and instabilities associated with diverse PCa risk factors (<xref ref-type="bibr" rid="B235">Squire et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B294">Yap et&#x20;al., 2016</xref>; <xref ref-type="bibr" rid="B49">Ciccarese et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B209">Rodrigues et&#x20;al., 2017</xref>), which was evidenced by extensive genomic profiling analysis conducted on primary tumors (<xref ref-type="bibr" rid="B199">Network T. C. G. A., 2015</xref>) and on metastatic samples (<xref ref-type="bibr" rid="B58">Dan et&#x20;al., 2015</xref>).</p>
<p>Speckle-type POZ protein (SPOP) is the substrate-binding subunit of a cullin-3 (CUL3)-based E3 ubiquitin ligase complex, which mediates the ubiquitylation and degradation of many target proteins. SPOP binds to the substrates through its N-terminal meprin and traf homology (MATH) domain, whereas it interacts with cullin-3 via BTB domain on its C terminal (<xref ref-type="bibr" rid="B203">Pintard et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B284">Xu et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B316">Zhuang et&#x20;al., 2009</xref>). Recent cancer whole-genome and exome sequencing studies have shown that <italic>SPOP</italic> is the most frequently mutated gene (in up to 15% of cases) in primary prostate cancer (<xref ref-type="bibr" rid="B21">Barbieri et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B199">Network T. C. G. A., 2015</xref>). Interestingly, all <italic>SPOP</italic> somatic mutations identified in prostate cancer are clustered in its substrate binding MATH domain, thus having a dominant-negative effect on substrate binding and degradation (<xref ref-type="bibr" rid="B249">Theurillat et&#x20;al., 2014</xref>). Recent studies have unanimously reported that SPOP interacts with bromodomain and extraterminal (BET) proteins that largely act as transcriptional coactivators and play vital roles in cell cycle, apoptosis, migration and invasion in physiological conditions. In addition, SPOP also promotes the ubiquitylation and proteasomal degradation of bromodomain-containing protein 2 (BRD2), BRD3 and BRD4, (<xref ref-type="bibr" rid="B57">Dai et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B115">Janouskova et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B306">Zhang et&#x20;al., 2017</xref>). Pathologically, BET proteins are frequently overexpressed and are clinically linked to various types of human cancer (<xref ref-type="bibr" rid="B78">French et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B55">Crawford et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B23">Belkina and Denis, 2012</xref>). Recently, Janouskova <italic>et&#x20;al.</italic> reported prostate cancer&#x2013;associated <italic>SPOP</italic> mutants impaired its binding to BET proteins, leading to the reduced proteasomal degradation and accumulation of these proteins in prostate cancer cell lines and patient specimens, which subsequently causes resistance to BET inhibitors (<xref ref-type="bibr" rid="B115">Janouskova et&#x20;al., 2017</xref>). Similar study has also demonstrated that <italic>SPOP</italic>-mutated prostate cancer cell lines and patient-derived organoids were intrinsically resistant to BET inhibitor-induced growth arrest and apoptosis (<xref ref-type="bibr" rid="B57">Dai et&#x20;al., 2017</xref>). Furthermore, Dai et&#x20;al. provided that stabilization of BRD4 may be a molecular mechanism for resistance to BET inhibitors in patients with prostate cancer bearing <italic>SPOP</italic> mutations (<xref ref-type="bibr" rid="B57">Dai et&#x20;al., 2017</xref>). Taken together, these findings offer mechanistic insights into how <italic>SPOP</italic> mutations influence prostate cancer.</p>
<p>The <italic>TMPRSS2</italic>-<italic>ERG</italic> fusion gene arising from genetic rearrangement (fusion of encoding transmembrane protease serine 2, <italic>TMPRSS2</italic> gene, and <italic>EST</italic>-related gene, <italic>ERG</italic>) has also been a central focus in prostate cancer, which leads to aberrant expression of the <italic>ETS</italic> transcription factor <italic>ERG</italic> (<xref ref-type="bibr" rid="B254">Tomlins et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B125">Kandoth, 2013</xref>). <italic>TMPRSS2-ERG</italic> is the most common gene rearrangement in prostate cancer and is present in approximately 50% of prostate cancer tissues in Western countries (<xref ref-type="bibr" rid="B35">Cary and Cooperberg, 2013</xref>). Previous studies indicated that <italic>ERG</italic> overexpression was driven by hijacking of androgen-responsive elements within the <italic>TMPRSS2</italic> promoter (<xref ref-type="bibr" rid="B254">Tomlins et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B271">Wang et&#x20;al., 2007</xref>; <xref ref-type="bibr" rid="B248">Thangapazham et&#x20;al., 2014</xref>). However, Kron et&#x20;al. found that the molecular process is more complex. Their study indicated that the frequent deletion allows a cluster of regulatory elements (CORE) in the <italic>TMPRSS2</italic> promoter to expand into the rearranged ERG allele. This expanded CORE contains some CREs within the <italic>ERG</italic> locus that can promote <italic>ERG</italic> overexpression. Studies also revealed that overexpressed <italic>ERG</italic> co-opts prostate-specific master regulatory transcription factors, including AR, HOXB13 and FOXA1, in a process facilitated by their physical interaction with ERG and actives NOTCH signaling in primary prostate cancer (<xref ref-type="bibr" rid="B138">Kron et&#x20;al., 2017</xref>). <italic>ERG</italic> overexpression is now an instrumental indicator in the diagnosis of prostate cancer. In addition, Graff et&#x20;al. recently found that obesity and height might be correlated with the development of <italic>TMPRSS2-ERG</italic>-positive prostate cancer (<xref ref-type="bibr" rid="B83">Graff et&#x20;al., 2018</xref>). Collectively, the functions and mechanisms of <italic>TMPRSS2-ERG</italic> increase the opportunities for finding new therapeutic targets for prostate cancer(Wang et&#x20;al., 2017; Kong et&#x20;al., 2020).</p>
</sec>
</sec>
</sec>
</sec>
<sec id="s3">
<title>Natural Compounds That Exert Anti-Prostate Effects</title>
<p>Natural compounds that have been found to inhibit prostate cancer cells proliferation/tumor growth, promote prostate cancer cells apoptosis, or modulate specific signaling pathways involved in prostate cancer <italic>in vivo</italic> and <italic>in&#x20;vitro</italic> are categorized and presented according to their source of isolation (marine organisms, microorganisms and plants) and the structural scaffolds. Besides the effects on prostate cancer cells growth or apoptosis, special emphasis was given to the mechanism of action of a compound interfering specific signaling pathways involved in prostate cancer.</p>
<sec id="s3-1">
<title>Natural Compounds Obtained From Marine Organisms or Microorganisms</title>
<p>As is well known, marine organisms or microorganisms possess the capacity to produce a large amount of diverse secondary metabolites with unique structural features and biological properties. Thus, marine and microbial organisms represent interesting and important sources of single molecules with promising skeletons and significant anti-prostate cancer activity. Up to now, a total of 24 natural compounds (<xref ref-type="fig" rid="F3">Figures 3</xref>) isolated from marine organisms have been found to exhibit significant anti-prostate cancer activity either <italic>in vivo</italic> or <italic>in&#x20;vitro</italic>. Detailed information about the compounds origin, activity and mechanism of action is listed in <xref ref-type="table" rid="T1">Table&#x20;1</xref>. Most of them exhibit antiproliferative, apoptosis inducing or metastasis inhibitory activities, with various acting mechanisms such as induction of autophagy, inhibition of AR activation, PI-3K/AKT/mTOR or JAK/STAT signaling pathways (<xref ref-type="bibr" rid="B224">Senderowicz et&#x20;al., 1995</xref>; <xref ref-type="bibr" rid="B170">Liu et&#x20;al., 2006</xref>; <xref ref-type="bibr" rid="B273">Wang WL. et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B96">Hellsten et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B79">Gantar et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B183">Meimetis et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B230">Shin et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B164">Liberio et&#x20;al., 2015</xref>; <xref ref-type="bibr" rid="B172">Liu et&#x20;al., 2016</xref>). Especially, frondoside A not only caused cell type specific cell cycle arrest and induction of caspase-dependent or -independent apoptosis <italic>in vivo</italic> but also significantly inhibited the cell growth of PC-3 and DU145 with a notable reduction of lung metastasis and decrease of circulating tumor cells in the peripheral blood (<xref ref-type="bibr" rid="B67">Dyshlovoy et&#x20;al., 2016</xref>). In addition, gliotoxin, chaetocin and chetomin exhibited antiangiogenic effects <italic>in&#x20;vitro</italic> and attenuated tumor growth mainly by disrupting the HIF-1&#x3b1;/p300 complex, which makes them attractive molecules for the design of future chemotherapeutic agents (<xref ref-type="bibr" rid="B52">Cook et&#x20;al., 2009</xref>).</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Natural compounds obtained from marine organisms or microorganisms with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Sort</th>
<th align="center">Name of microorganisms</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">C-phycocyanin</td>
<td align="left">Proteins</td>
<td align="left">
<italic>Limnothirix</italic> sp.</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Increase of radical oxygen species (ROS) generation; increase of caspase-9 and caspase-3 activities.</td>
<td align="left">
<xref ref-type="bibr" rid="B79">Gantar et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">Eusynstyelamide B(1)</td>
<td align="left">Alkaloids</td>
<td align="left">
<italic>Didemnum candidum</italic>
</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Induction of G2 cell cycle arrest; increase of CHK2 phosphorylation; upregulation of p21CIP1/WAF1; decrease of CDC2 expression.</td>
<td align="left">
<xref ref-type="bibr" rid="B164">Liberio et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td rowspan="4" align="left">Frondoside A(2)</td>
<td rowspan="4" align="left">Triterpene glycosides</td>
<td rowspan="4" align="left">
<italic>Cucumaria okhotensis</italic>
</td>
<td rowspan="4" align="left">DU145 LNCaP PC3 22Rv1 VCaP</td>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="4" align="left">Induction of G2/M cell cycle arrest; upregulation of Bax, Bad, PTEN, cleavage of PARP and caspase-3; downregulation of anti-apoptotic proteins (survivin and Bcl-2); inhibition of pro-survival autophagy by upregulation of phospho-mTOR.</td>
<td rowspan="4" align="left">
<xref ref-type="bibr" rid="B67">Dyshlovoy et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of metastasis</td>
</tr>
<tr>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Galiellalactone(3)</td>
<td rowspan="2" align="left">Ketones</td>
<td rowspan="2" align="left">
<italic>Galiella ruffle</italic>
</td>
<td rowspan="2" align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Inhibition of Stat3 activity; downregulation of the expressions of Bcl-2, Bcl- xL, c-myc and cyclin D1.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B96">Hellsten et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Chaetocin(4)</td>
<td rowspan="2" align="left">Ketones</td>
<td rowspan="2" align="left">
<italic>Trichoderma virens</italic>
</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Antiangiogenesis</td>
<td rowspan="2" align="left">Disruption of the HIF-1&#x3b1;/p300 complex.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B52">Cook et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Chetomin(5)</td>
<td rowspan="2" align="left">Ketones</td>
<td rowspan="2" align="left">
<italic>Trichoderma virens</italic>
</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td rowspan="2" align="left">Antiangiogenesis Inhibition of tumor growth</td>
<td rowspan="2" align="left">Disruption of the HIF-1&#x3b1;/p300 complex.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B52">Cook et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vitro</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Gliotoxin(6)</td>
<td rowspan="2" align="left">Ketones</td>
<td rowspan="2" align="left">
<italic>Trichoderma virens</italic>
</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Antiangiogenesis</td>
<td rowspan="2" align="left">Disruption of the HIF-1&#x3b1;/p300 complex.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B52">Cook et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td align="left">Halichondramide(7)</td>
<td align="left">Trisoxazol-e macrolides</td>
<td align="left">
<italic>Chondrosia corticata</italic>
</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Antiproliferation Inhibition of metastasis</td>
<td align="left">The suppression of PRL-3 via downregulation phosphoinositide 3-kinase (PI3K) subunits p85 and p110 the expression; downregulation of matrix metalloproteases (MMPs).</td>
<td align="left">
<xref ref-type="bibr" rid="B230">Shin et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Lejimalide B(8)</td>
<td rowspan="2" align="left">Macrolide-s</td>
<td rowspan="2" align="left">
<italic>Eudistoma cf. rigida</italic>
</td>
<td align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
<td rowspan="2" align="left">Antiproliferate Induction of apoptosis</td>
<td rowspan="2" align="left">Induction of G0/G1 cell cycle arrest and expression of p21waf1/cip1; downregulation of the expression of cyclin A, E, D survivin, p21B and BNIP3.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B273">Wang et&#x20;al. (2008b)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td rowspan="2" align="left">Jasplakinolide(9)</td>
<td rowspan="2" align="left">Cyclopent-apeptides</td>
<td rowspan="2" align="left">
<italic>Jaspis johnstoni</italic>
</td>
<td align="left">LNCaP PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Not investigated.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B224">Senderowicz et&#x20;al. (1995)</xref>
</td>
</tr>
<tr>
<td align="left">TSUPrl</td>
</tr>
<tr>
<td align="left">Malformin A1(10)</td>
<td align="left">Cyclopent-apeptides</td>
<td align="left">
<italic>Aspergillus niger</italic>
</td>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis and necrosis</td>
<td align="left">Induction of mitochondrial damage and autophagy.</td>
<td align="left">
<xref ref-type="bibr" rid="B172">Liu et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">Stellettin A(11)</td>
<td align="left">Triterpene-s</td>
<td align="left">
<italic>Geodia japonica</italic>
</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of oxidative stress and apoptosis</td>
<td align="left">Upregulation of FasL and caspase-3 expression.</td>
<td align="left">
<xref ref-type="bibr" rid="B170">Liu et&#x20;al. (2006)</xref>
</td>
</tr>
<tr>
<td align="left">Niphatenone B(12)</td>
<td align="left">Glycerol ethers</td>
<td align="left">
<italic>Niphates digitalis</italic>
</td>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Binding with the activation function-1 (AF1) region of the AR N-terminus domain (NTD).</td>
<td align="left">
<xref ref-type="bibr" rid="B183">Meimetis et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">4H-1,3-dioxin-4-one-2,3,6-trimethyl</td>
<td rowspan="2" align="left">Dioxin</td>
<td rowspan="2" align="left">
<italic>Trichoderma atroviride</italic>
</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of expression of caspase -3</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B217">Ks et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Alternol</td>
<td align="left">unknown</td>
<td align="left">
<italic>mutant fungus</italic>
</td>
<td align="left">PC-3; 22RV1;BPH1</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Antiproliferation;Induction of apoptosis;</td>
<td align="left">Interaction with multiple Krebs cycle enzymes</td>
<td align="left">
<xref ref-type="bibr" rid="B152">Li et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">Hapalindole H (13)</td>
<td align="left">indole-alkaloid</td>
<td align="left">
<italic>Fischerella muscicola</italic>
</td>
<td align="left">PC-3</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Antiproliferation;</td>
<td align="left">Through the intrinsic mitochondrial pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B5">Acua et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Heteronemin (14)</td>
<td rowspan="2" align="left">sesterterpenoid</td>
<td rowspan="2" align="left">
<italic>Hyrtios</italic> sp.</td>
<td rowspan="2" align="left">LNcap; PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Oxidative and ER Stress Combined with the Inhibition of Topoisomerase II and Hsp90</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B143">Lee et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">xanthoquinodin JBIR-99 (15)</td>
<td align="left">Quinolines</td>
<td align="left">
<italic>Parengyodontium album</italic> MEXU 30054</td>
<td align="left">PC-3</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Though intrinsic and extrinsic apoptotic pathways</td>
<td align="left">
<xref ref-type="bibr" rid="B9">Anaya-Eugenio et&#x20;al. (2019b)</xref>
</td>
</tr>
<tr>
<td align="left">Giluterrin (16)</td>
<td align="left">alkaloid</td>
<td align="left">
<italic>Aspergillus terreus</italic> P63</td>
<td align="left">PC-3</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B86">Gubiani et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Elaiophylin (17)</td>
<td rowspan="2" align="left">antibiotic</td>
<td rowspan="2" align="left">
<italic>Actinomycete streptomyces</italic>
</td>
<td rowspan="2" align="left">22Rv1&#xff1b; VCaP</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td rowspan="2" align="left">blocking RORg transcriptional regulation activities</td>
<td rowspan="2" align="left">Inhibition of the expression of RORg target genes AR and AR variant</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B313">Zheng et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>in vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Urupocidin C (18)</td>
<td rowspan="2" align="left">bicyclic guanidine alkaloid</td>
<td rowspan="2" align="left">
<italic>Monanchora pulchra</italic>
</td>
<td align="left">22Rv1;</td>
<td rowspan="2" align="left">
<italic>in&#x20;vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Though mitochondria targeting</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B66">Dyshlovoy et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">Pseudopterosin H</td>
<td align="left">diterpene glycosides</td>
<td align="left">
<italic>Pseudopterogorgia elisabethae</italic>
</td>
<td align="left">PC-3</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">reducing PC-3 cell viability</td>
<td align="left">Inducing apoptosis and downregulating the production of intracellular reactive oxygen species</td>
<td align="left">
<xref ref-type="bibr" rid="B31">Bowers et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">Nalidixic acid (19)</td>
<td align="left">quinolone antibiotic</td>
<td align="left">
<italic>Streptomyces</italic> sp. (C-7)</td>
<td align="left">PC3</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">cytotoxic effect</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B12">Arora et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">Discorhabdin L (20)</td>
<td align="left">alkaloid</td>
<td align="left">
<italic>Latrunculia</italic> sp.</td>
<td align="left"/>
<td align="left">
<italic>in vivo</italic>
</td>
<td align="left">Inhibition of cell growth</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B93">Harris et&#x20;al. (2018)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>Natural compounds obtained from marine organisms or microorganisms with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g003.tif"/>
</fig>
</sec>
<sec id="s3-2">
<title>Natural Compounds Isolated From Plants</title>
<p>Medicinal plants have always been a very good source of drugs, which could produce plenty of secondary metabolites with high structural diversity and versatile bioactivities. Many candidates with promising anti-prostate activity have been reported, including 7 alkaloids, 23 flavanoids, 25 terpenoids, 13 polyphenols, 10 lignans and 48 other compounds (<xref ref-type="fig" rid="F4">Figures 4</xref>&#x2013;<xref ref-type="fig" rid="F9">9</xref>). Almost all these candidates show anti-prostate cancer activities via anti-proliferation, apoptosis induction or metastasis and invasion inhibition, involved in canonical AR signaling and non-AR signaling like caspase cascades, AKT/mTOR pathway, MAPKs pathway, NF-&#x3ba;B pathway, Ca2&#x2b; pathway and JAK/STATs pathway. Additionally, there exist other acting mechanisms, for example, anibamine exhibited anti-prostate cancer activity by binding to the chemokine receptor CCR5; fisetin inhibited tumor growth by downregulating the expression of NudC protein, MMP-2 and MMP-9; lycopene showed anti-prostate cancer effects by inhibiting androgen receptor element and signaling of insulin-like growth factor-1 (<xref ref-type="bibr" rid="B6">Afaq et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B130">Khan et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B32">Bureyko et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B278">Wertz, 2009</xref>; <xref ref-type="bibr" rid="B307">Zhang et&#x20;al., 2010b</xref>; <xref ref-type="bibr" rid="B46">Chien et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B240">Suh et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B246">Tang et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B99">Holzapfel et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B194">Mukhtar et&#x20;al., 2015</xref>). Detailed information is provided in <xref ref-type="table" rid="T2">Tables 2</xref>&#x2013;<xref ref-type="table" rid="T7">7</xref>.</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>Alkaloids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g004.tif"/>
</fig>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Flavanoids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g005.tif"/>
</fig>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Terpenoids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g006.tif"/>
</fig>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>Polyphenols obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g007.tif"/>
</fig>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption>
<p>Lignans obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g008.tif"/>
</fig>
<fig id="F9" position="float">
<label>FIGURE 9</label>
<caption>
<p>Other compounds obtained from plants with anti-prostate cancer activities.</p>
</caption>
<graphic xlink:href="fphar-12-738235-g009.tif"/>
</fig>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Alkaloids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Anibamine(21)</td>
<td rowspan="2" align="left">
<italic>Aniba panurensis</italic>
</td>
<td align="left">DU145 M12</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Binding to the chemokine receptor CCR5.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B307">Zhang et&#x20;al. (2010b)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td align="left">Inhibition of metastasis and invasion</td>
</tr>
<tr>
<td rowspan="2" align="left">Berberine(22)</td>
<td rowspan="2" align="left">
<italic>Coptis chinensis</italic> Franch.</td>
<td align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation Induction of apoptosis and programmed necrosis</td>
<td rowspan="2" align="left">Inhibition of p53-Cyp-D association via decreasing the ROS production; downregulation of HIF-1&#x3b1; and VEGF expression; induction of G1 and G2/M cell cycle arrest by activating ATM-Chk1; induction of caspase-3 and -9 activation; upregulation of bax/bcl-2 expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B275">Wang et&#x20;al. (2012)</xref>, <xref ref-type="bibr" rid="B305">Zhang et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td align="left">PC82 PWR1E</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Pipernonaline(23)</td>
<td align="left">
<italic>Piper longum</italic> L.</td>
<td align="left">DU145 LNCap PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Induction of sub-G1 and G0/G1 cell cycle arrest through downregulation of CDK2, CDK4, cyclin D1 and cyclin E; upregulation of procaspase-3/PARP cleavage; induction of ROS production and intracellular Ca2&#x2b;, and mitochondrial membrane depolarization.</td>
<td align="left">
<xref ref-type="bibr" rid="B147">Lee et&#x20;al. (2013b)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Piperlongumine(24)</td>
<td rowspan="2" align="left">
<italic>Piper longum</italic> L.</td>
<td align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G2/M phase cell cycle arrest; upregulation of bax/bcl-2 expression; activation of caspase-3; downregulation of PARP expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B136">Kong et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td align="left">Sanguinarine(25)</td>
<td align="left">
<italic>Argemone mexicana</italic> L.</td>
<td align="left">PC3E RWPE1&#x20;TEM4-18</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Cytotoxicity</td>
<td align="left">Inhibition of RGS17 activity.</td>
<td align="left">
<xref ref-type="bibr" rid="B28">Bodle et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">Piperine (26)</td>
<td align="left">
<italic>Piper nigrum</italic> L. <italic>and Piper longum</italic> L.</td>
<td align="left">DU145</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Inhibition of migration progression</td>
<td align="left">downregulating the Akt/mTOR/MMP-9 signaling pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B301">Yuan and Ying (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Neferine (27)</td>
<td rowspan="2" align="left">
<italic>Nelumbo nucifera</italic> Gaertn.</td>
<td align="left">PC3, CD44<sup>&#x2b;</sup>
</td>
<td rowspan="2" align="left">
<italic>in&#x20;vitro</italic>
</td>
<td rowspan="2" align="left">Inhibition of proliferation and migration</td>
<td rowspan="2" align="left">through p38 MAPK/JNK activation</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B69">Erdogan and Turkekul (2020)</xref>
</td>
</tr>
<tr>
<td align="left">CSCs&#xff1b; LNCaP</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T3" position="float">
<label>TABLE 3</label>
<caption>
<p>Flavanoids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="center">Natural compound</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="3" align="left">Apigenin(28)</td>
<td rowspan="3" align="left">Distributed in various plants</td>
<td align="left">C4-2B DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Binding with IKK&#x3b1;; inhibition of NF-&#x138;B/p65 activity; inhibition of apoptosis proteins and Ku70-Bax interaction; inhibition of tumor suppressor ER-&#x3b2; degradation; inhibition of class I HDACs expression; inhibition of ABCB1 expression and sensitivity improvement of docetaxel-resistant prostate cancer cells to docetaxel treatment.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B315">Zhu et&#x20;al. (2013)</xref>, <xref ref-type="bibr" rid="B216">Salmani et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
<td align="left">Anti-invasion</td>
</tr>
<tr>
<td align="left">22Rv1</td>
<td align="left">Suppression of prostate cancer growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Baicalein(29)</td>
<td rowspan="2" align="left">
<italic>Scutellaria baicalensis</italic> Georgi</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G1 cell cycle arrest; inhibition of androgen receptor (AR) expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B30">Haimson et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td align="left">Cajanol(30)</td>
<td align="left">
<italic>Cajanus cajan</italic> (L.) Huth</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Induction of G1 and G2/M cell cycle arrest; modulation of the ERa-dependent PI3K pathway and induction of GSK3 and CyclinD1 activation.</td>
<td align="left">
<xref ref-type="bibr" rid="B30">Haimson et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Cryptocaryone(<bold>31</bold>)</td>
<td rowspan="2" align="left">
<italic>Cryptocarya wightiana</italic> Thwaites</td>
<td rowspan="2" align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of caspase-8 and 3 activation; upregulation of DR5 surface expression; induction of Fas clustering and the association of downstream signaling molecules, including FADD and procaspase-8; induction of DR4 and DR5 aggregation.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B44">Chen et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">CG901(32)</td>
<td rowspan="2" align="left">
<italic>Artocarpus altilis</italic> (Parkinson) Fosberg</td>
<td align="left">C4-2B DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Selective inhibition of prostate cancer cell lines proliferation and mouse xenograft growth by inhibiting the expression of STAT3 target genes.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B116">Jeon et&#x20;al. (2015a)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Daidzein(33)</td>
<td rowspan="2" align="left">
<italic>Glycine max</italic> (L.) Merr.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Decrease the expression of VEGF and AR genes; induction of G2/M phase in the PC3 cells by downregulating Cyclin B1 and CDK1, and upregulating CDK inhibitors (p21 and p27); upregulation of Fas ligand (FasL) and the expression of proapoptotic Bim; downregulation of the expression of p-FOXO3a and increase of the nuclear stability of FOXO3a.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B140">Labow and Layne, (1972)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Fisetin(34)</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of the expression of NudC protein; downregulation of MMP-2 and MMP-9 expressions.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B134">Shimoi, 1998</xref>; <xref ref-type="bibr" rid="B6">Afaq et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B130">Khan et&#x20;al., 2008</xref>; <xref ref-type="bibr" rid="B46">Chien et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B240">Suh et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B194">Mukhtar et&#x20;al., 2015</xref>)</td>
</tr>
<tr>
<td align="left">22Rv1</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Formononetin(35)</td>
<td rowspan="2" align="left">
<italic>Trifolium pratense</italic> L.</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G0/G1 phase cell cycle arrest; inhibition of the IGF-1/IGF-1R pathway and alteration of the Bax/Bcl-2 ratio; downregulation of expression levels of cyclin D1 and CDK4.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B110">Huang et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B309">Bi, 2014</xref>; <xref ref-type="bibr" rid="B155">Li et&#x20;al., 2014</xref>)</td>
</tr>
<tr>
<td align="left">RWPE1</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="4" align="left">Flavokawain B(36)</td>
<td rowspan="4" align="left">
<italic>Piper methysticum</italic> G.Forst.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="4" align="left">Selective inhibition on androgen receptor (AR)-negative prostate cancer cell growth; induction of apoptosis with associated increased expressions of proapoptotic proteins: death receptor-5, Bim, Puma and downregulation of XIAP and survivin expressions.</td>
<td rowspan="4" align="left">
<xref ref-type="bibr" rid="B245">Tang et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td rowspan="3" align="left">
<italic>In vivo</italic>
</td>
<td rowspan="3" align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">LAPC4</td>
</tr>
<tr>
<td rowspan="2" align="left">Genistein(37)</td>
<td rowspan="2" align="left">
<italic>Glycine max</italic> (L.) Merr<italic>.</italic>
</td>
<td rowspan="2" align="left">DU145 PC3&#x20;PC-3M</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Inhibition of migration</td>
<td rowspan="2" align="left">Prevention of metastasis by directly binding to MEK4 and downregulation of p38 expression; downregulation of expression and activity of MMP-2.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B162">Li and Sarkar, 2002</xref>; <xref ref-type="bibr" rid="B104">Hsu et&#x20;al., 2010</xref>)</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Ginkgetin(38)</td>
<td rowspan="2" align="left">
<italic>Ginkgo biloba</italic> L.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation Induction of apoptosis Inhibition of tumor growth</td>
<td rowspan="2" align="left">Induction of G0/G1 cell cycle arrest; selective suppression of STAT3 Tyr705 phosphorylation but not through inhibiting upstream tyrosine kinases and tyrosine phosphatase.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B117">Jeon et&#x20;al. (2015b)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Isoliquiritigenin(39)</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td align="left">D4-2B</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of the expression of NudC protein; downregulation of MMP-2 and MMP-9 expressions.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B308">Zhang et&#x20;al. (2010a)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="3" align="left">Isoangustone A(40)</td>
<td rowspan="3" align="left">
<italic>Ginkgo biloba</italic> L.</td>
<td rowspan="3" align="left">DU145 PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Induction of p27kip1 tumor suppressor gene accumulation by attenuating p27kip1 at Thr 187 phosphorylation; inhibition of CDK2 activation through binding with the CDK2 complex; inhibition of mTOR kinase activity by binding with the mTOR complex.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B142">Lee et&#x20;al. (2013a)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Luteolin(41)</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Inhibition of ANO1 expression; inhibition of the expression and/or function of ARs via regulation of prostate derived Ets transcription factor(PDEF); inhibition of IGF-1/IGF-1R system; decrease of the expression of E-cadherin through MDM.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B225">Seo et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Prevention of metastasis</td>
</tr>
<tr>
<td rowspan="2" align="left">Licochalcone A(42)</td>
<td rowspan="2" align="left">
<italic>Glycyrrhiza glabra</italic> L.</td>
<td rowspan="2" align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G2/M cell cycle arrest; downregulation of cyclin B1 and cdc2 expression; inhibition of phosphorylation of retinoblastoma (Rb); decrease of expression of transcription factor E2F, cyclin D1, CDKs 4 and 6; increase of expression of cyclin E.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B238">Su et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">Quercetin-6-C-b-D-glucopyranoside(43)</td>
<td rowspan="3" align="left">
<italic>Ulmus wallichiana</italic> Planch.</td>
<td align="left">DU145</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Induction of apoptosis via induction of cleaved PARP and Cas-3; induction of G0/G1 cell cycle arrest; inhibition of reactive oxygen generation and AKT/mTOR survival pathway via directly binding with aryl hydrocarbon receptor.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B91">Hamidullah et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">RWPE1</td>
</tr>
<tr>
<td rowspan="2" align="left">Quercetin(44)</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of expression of c-Jun and its phosphorylation; decrease of expression of HSP72; intervention of BaP toxicity.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B15">Asea et&#x20;al. (2001)</xref>, <xref ref-type="bibr" rid="B298">Yuan et&#x20;al. (2004)</xref>, <xref ref-type="bibr" rid="B41">Chaudhary et&#x20;al., (2007)</xref>, <xref ref-type="bibr" rid="B1">Aalinkeel et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Xanthohumol(45)</td>
<td rowspan="2" align="left">
<italic>Humulus lupulus</italic> L.</td>
<td rowspan="2" align="left">BPH-1 PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of S and Sub G1 cell cycle arrest; inhibition of NFkB activity and expression. Upregulation of pro- apoptotic proteins Bax and p53 expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B51">Colgate et&#x20;al. (2007)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">Vitexicarpin(46)</td>
<td align="left">
<italic>Vitex rotundifolia</italic> L.f.</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Induction of G2/M cell cycle arrest.</td>
<td align="left">
<xref ref-type="bibr" rid="B184">Meng et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">2&#x2032;,4&#x2032;-dihydroxychalcone (47)</td>
<td align="left">
<italic>Herba oxytropis</italic>
</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Induction of G1/S cell cycle arrest.</td>
<td align="left">
<xref ref-type="bibr" rid="B228">Sheng et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Auriculasin (48)</td>
<td rowspan="2" align="left">
<italic>Flemingia macrophylla</italic> var. <italic>philippinensis</italic> (Merr. &#x26; Rolfe) H.Ohashi</td>
<td rowspan="2" align="left">LNCaP-FGC&#xff1b;RWPE-1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis; antiproliferation</td>
<td rowspan="2" align="left">Regulation of the PI3K/AKT/mTOR pathway in LNCaP prostate cancer cells;ROS accumulation</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B48">Cho et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Naringenin (49)</td>
<td align="left">
<italic>citrus fruits and tomatoes</italic>
</td>
<td align="left">MAT-LyLu cells</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of metastasis</td>
<td align="left">Blocking voltage-gated sodium channels</td>
<td align="left">
<xref ref-type="bibr" rid="B87">Gumushan Aktas and Akgun (2018)</xref>
</td>
</tr>
<tr>
<td align="left">Casticin (50)</td>
<td align="left">
<italic>Vitex rotundifolia</italic> L.f.,</td>
<td align="left">DU 145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of prostate cancer cell metastasis</td>
<td align="left">Inhibition of the protein levels of AKT, GSK3&#x3b1;&#x3b2;, Snail, and MMPs (MMP-2, -9, -13, and -7);diminision of the expressions of NF-&#x3ba;B p65, GRB2, SOS-1, MEK,p-ERK1/2, and p-JNK1/2</td>
<td align="left">
<xref ref-type="bibr" rid="B165">Lin et&#x20;al. (2019)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T4" position="float">
<label>TABLE 4</label>
<caption>
<p>Terpenoids obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Artemisinin(51)</td>
<td rowspan="2" align="left">
<italic>Artemisia annua</italic> L.</td>
<td align="left">DU145</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of synthesis, and cleavage of procaspase-9, cleavage of caspase-3, and PARP-1 degradation.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B196">Nakase et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td rowspan="2" align="left">Betulinic Acid(52)</td>
<td rowspan="2" align="left">
<italic>Bacopa monnieri</italic> (L.) Wettst.</td>
<td rowspan="2" align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Activation of selective proteasome-dependent degradation of the transcription factors specificity protein 1(Sp1), Sp3, and Sp4; regulation of survivin and VEGF expression; downregulation of NF-kappaB expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B47">Chintharlapalli et&#x20;al. (2007)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Celastrol(53)</td>
<td rowspan="2" align="left">
<italic>Tripterygium wilfordii</italic> Hook.f.</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Accumulation of ubiquitinated proteins and three natural proteasome substrates IKB-A, Bax, and p27.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B279">Wolfram et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Caseamembrin C(54)</td>
<td rowspan="2" align="left">
<italic>Casearia membranacea</italic>
</td>
<td rowspan="2" align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of Bcl-2 and Bcl-xL expression; upregulation of Mcl-1S protein and activation of caspase-9 and caspase-3.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B109">Huang et&#x20;al. (2004)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Glycyrrhizin(55)</td>
<td rowspan="2" align="left">
<italic>Glycyrrhiza glabra</italic> L.</td>
<td rowspan="2" align="left">DU145 LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of the expression of caspase-3 and caspase-8.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B250">Thirugnanam et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Lycopene(56)</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Antimetasis</td>
<td rowspan="2" align="left">Inhibition of the androgen receptor element, resulting in decreased PSA velocity; inhibition signaling of insulin-like growth factor-I (IGF-I); decrease of the expression of &#x3b1;v&#x3b2;3 and &#x3b1;v&#x3b2;5 integrin.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B32">Bureyko et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B278">Wertz, 2009</xref>; <xref ref-type="bibr" rid="B246">Tang et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B99">Holzapfel et&#x20;al., 2013</xref>)</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">Oridonin(57)</td>
<td rowspan="3" align="left">
<italic>Isodon rubescens</italic> (Hemsl.) H.Hara</td>
<td rowspan="3" align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Increase of expression of P21 and the mRNA level of beclin; increase of caspase-3 activity.</td>
<td rowspan="3" align="left">(<xref ref-type="bibr" rid="B61">Deepak and Handa, 2000</xref>; <xref ref-type="bibr" rid="B160">Xiang et&#x20;al., 2012</xref>; <xref ref-type="bibr" rid="B189">Ming et&#x20;al., 2016</xref>)</td>
</tr>
<tr>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td align="left">Antiproliferation</td>
</tr>
<tr>
<td rowspan="2" align="left">Pachymic acid(58)</td>
<td rowspan="2" align="left">
<italic>Poria cocos</italic>
</td>
<td rowspan="2" align="left">DU145 LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Decrease of prostaglandin synthesis and AKT activity.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B80">Gapter et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Pseudolaric acid B(59)</td>
<td rowspan="2" align="left">
<italic>Larix kaempferi</italic> (Lamb.) Carri&#xe8;re</td>
<td rowspan="2" align="left">DU145</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Increase of ROS generation and Bcl-2 degradation.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B310">Zhao et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">Sugiol(60)</td>
<td rowspan="3" align="left">Salvia prionitis Hance</td>
<td align="left">DU145</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Antiproliferation</td>
<td rowspan="3" align="left">Induction of G0/G1 cell cycle arrest; downregulation the expression of STAT3; interaction with TKT.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B124">Jung et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td rowspan="3" align="left">Triptolide(61)</td>
<td rowspan="3" align="left">
<italic>Tripterygium wilfordii</italic> Hook.f.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Decrease of CDK7-mediated phosphorylation; disruption of the phosphorylation of AR through XPB/CDK7.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B311">Fei et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">22Rv1</td>
</tr>
<tr>
<td rowspan="2" align="left">Ursolic Acid(62)</td>
<td rowspan="2" align="left">
<italic>Distributed in various plants</italic>
</td>
<td rowspan="2" align="left">DU145 LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Upregulation of DR5 activation of JNK; inhibition of NF-&#x3ba;B and STAT3 pathways.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B61">Deepak and Handa, 2000</xref>; <xref ref-type="bibr" rid="B226">Shanmugam et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B185">Meng et&#x20;al., 2015</xref>)</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="4" align="left">Zerumbone(63)</td>
<td rowspan="4" align="left">
<italic>Zingiber zerumbet</italic> (L.) Roscoe ex Sm.</td>
<td rowspan="2" align="left">DU145</td>
<td rowspan="4" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="4" align="left">Increase of MPM-2 expression; increase of Bcl-2 and Bcl-xL phosphorylation; induction of Cdk1 activity; induction of Cdc25C downregulation.</td>
<td rowspan="4" align="left">
<xref ref-type="bibr" rid="B37">Chan et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td rowspan="3" align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">HRPC</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td rowspan="2" align="left">&#x3b2;-elemene(64)</td>
<td rowspan="2" align="left">Distributed in various of plants</td>
<td rowspan="2" align="left">DU145 PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of Bcl-2 expression; increase of cytochrome c; activation of PARP and caspase-3, -7, -9, and -10.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B154">Li et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">7-xylosyl-10-deacetyl paclitaxel(65)</td>
<td rowspan="2" align="left">
<italic>Taxus wallichiana</italic> Zucc.</td>
<td rowspan="2" align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G2/M cycle arrest; upregulation of pro-apoptotic Bax and Bad protein expressions and downregulation of anti- apoptotic Bcl-2 and Bcl-XL expressions.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B121">Jiang et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">25-OCH3-PPD (GS25)(66)</td>
<td rowspan="3" align="left">
<italic>Panax notoginseng</italic> (Burkill) F.H.Chen</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Decrease of MDM2 protein level; increase of the protein levels of the wild-type p53, Bax, cleaved-PARP.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B272">Wang et&#x20;al. (2008a)</xref>
</td>
</tr>
<tr>
<td align="left">LNCAP</td>
<td rowspan="2" align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td align="left">Bakuchiol (67)</td>
<td align="left">
<italic>Cullen corylifolium</italic> (L.) Medik.</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell proliferation and migration;</td>
<td align="left">Inactivating NF-&#x3ba;B signaling via AR and ER&#x3b2;</td>
<td align="left">
<xref ref-type="bibr" rid="B186">Miao et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Afrocyclamin A (68)</td>
<td rowspan="2" align="left">
<italic>Androsace umbellata</italic> (Lour.) Merr.</td>
<td rowspan="2" align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>;</td>
<td rowspan="2" align="left">Induction of apoptosis;inhibition of migration and invasion; inhibition of cell growth</td>
<td rowspan="2" align="left">Via the PI3k/Akt/mTOR pathway</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B214">Sachan et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Corosolic acid (69)</td>
<td align="left">
<italic>Eriobotrya japonica</italic> (Thunb.) Lindl<italic>.; Crataegus pinnatifida</italic> Bunge<italic>; Actinidia chinensis</italic> Planch.</td>
<td align="left">PC-3;DU145;22RV1;WPMY-1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth;Induction of apoptosis</td>
<td align="left">The activation of endoplasmic reticulum (ER) stress-associated two pro-apoptoticsignaling pathways</td>
<td align="left">
<xref ref-type="bibr" rid="B176">Ma et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">3-oxo-4-oxa-A-homo-25,26,27-trinordammarano-24,20-lactone triterpene (70)</td>
<td align="left">
<italic>Cleome khorassanica</italic> Bunge &#x26; Bien</td>
<td align="left">DU-145 &#xff1b; LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Cell growth inhibition</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B215">Sajjadi et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">20,25-dihydroxy-3-oxodammarane triterpene (71)</td>
<td align="left">
<italic>Cleome khorassanica</italic> Bunge &#x26; Bien</td>
<td align="left">DU-145 &#xff1b; LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Cell growth inhibition</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B215">Sajjadi et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Britanin (72)</td>
<td rowspan="2" align="left">
<italic>Inula linariifolia</italic> Turcz.</td>
<td rowspan="2" align="left">PC-3&#xff1b; PC-3-LU&#xff1b; DU-145</td>
<td align="left">
<italic>In vitro</italic>;</td>
<td rowspan="2" align="left">Inhibition of cell proliferation, migration, and motility</td>
<td rowspan="2" align="left">Through PI3K/Akt/NF-&#x3ba;B Signaling Pathways</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B300">Zeng et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Linalool (73)</td>
<td rowspan="2" align="left">
<italic>herbs, spices and fruits</italic>
</td>
<td rowspan="2" align="left">22Rv1</td>
<td align="left">
<italic>In vitro</italic>;</td>
<td rowspan="2" align="left">Antiproliferation;Induction of apoptosis;Inhibition of migration invasion</td>
<td rowspan="2" align="left">Mitochondria-mediated intrinsic and death-receptor-mediated extrinsic pathways; inhibition of expression of Ki-67 and PCNA in the 22Rv1 xenograft model.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B312">Zhao et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">&#x3b2;-elemonic acid (74)</td>
<td align="left">
<italic>Boswellia carterii</italic> Birdw</td>
<td align="left">DU145, PC-3 and 22RV1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Through the suppression of JAK2/STAT3/MCL-1 and NF-&#x138;B signal pathways</td>
<td align="left">
<xref ref-type="bibr" rid="B20">Bao et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Heliantriol B2 (75)</td>
<td rowspan="2" align="left">
<italic>Chuquiraga erinacea</italic> subsp. erinacea (Asteraceae)</td>
<td align="left">PC-3;</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation;Induction of apoptosis;Inhibition of migration invasion</td>
<td rowspan="2" align="left">Not investigated</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B36">Castro et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T5" position="float">
<label>TABLE 5</label>
<caption>
<p>Polyphenols obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Atraric acid (76)</td>
<td align="left">
<italic>Prunus africana</italic> (Hook.f.) Kalkman</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of prostate cancer cell growth</td>
<td align="left">Inhibition of AR nuclear translocation.</td>
<td align="left">
<xref ref-type="bibr" rid="B222">Schleich et&#x20;al. (2006)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Curcumin(77)</td>
<td rowspan="2" align="left">
<italic>Curcuma longa</italic> L.</td>
<td align="left">DU145</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Inhibition of the expression of MT1-MMP and MMP2 proteins; inhibition of the DNA-binding ability of NICD.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B292">Yang et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td align="left">Ellagic Acid(78)</td>
<td align="left">Distributed in various plants</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis</td>
<td align="left">Increase of Bax/Bcl2 ratio and increase caspases 3, caspases 6, caspases 8, and caspases 9 and PARP cleavage; inhibition of mTOR activation and reduction of intracellular levels of &#x3b2;-catenin; downregulation of the expressions of anti-apoptotic proteins, silent information regulator 1 (SIRT1), human antigen R (HuR) and heme oxygenase-1 (HO-1).</td>
<td align="left">
<xref ref-type="bibr" rid="B260">Vanella et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Gallic Acid(79)</td>
<td rowspan="2" align="left">
<italic>Toona sinensis</italic> (Juss.) M.Roem.</td>
<td rowspan="2" align="left">DU145 PC3 22Rv1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Inhibition of migration Induction of apoptosis</td>
<td rowspan="2" align="left">Activation of Chk1 and Chk2 and inhibition of Cdc25C and Cdc2 activities; blocking of the p38, JNK, PKC and PI3K/AKT signaling pathways and downregulation of NF-&#x3ba;B protein level; inhibition of MMP2 and MMP 9 gene expression.</td>
<td rowspan="2" align="left">(<xref ref-type="bibr" rid="B94">Hastak et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B127">Kaur et&#x20;al., 2009</xref>)</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Gossypol(80)</td>
<td rowspan="2" align="left">
<italic>Gossypium hirsutum</italic> L.</td>
<td rowspan="2" align="left">DU145 PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation Induction of apoptosis</td>
<td rowspan="2" align="left">Downregulation of Bcl-2 and Bcl-xl and the upregulation of Bax; activation of caspase3, caspase8 and caspase9 through the ROS-independent mitochondrial dysfunction pathway and the increase of PARP cleavage; suppression of the expression of AP-1and NF-&#x3ba;B blocked the activation of VEGF receptor 2 kinase.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B112">Huang et&#x20;al. (2006)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Honokiol(81)</td>
<td rowspan="2" align="left">Magnolia officinalis</td>
<td align="left">PC3 LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Activation of Bax and/or Bak; decrease of expression of c-Myc.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B229">Shigemura et&#x20;al. (2007)</xref>
</td>
</tr>
<tr>
<td align="left">Myc-CaP</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of prostate tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Nordihydroguaiaretic acid(82)</td>
<td rowspan="2" align="left">
<italic>Larrea tridentata</italic> (DC.) Coville</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Inhibition of migration Antiproliferation</td>
<td rowspan="2" align="left">Suppression of NRP1 function.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B158">Li et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Obovatol(83)</td>
<td align="left">
<italic>Magnolia obovata</italic> Thunb.</td>
<td align="left">PC3 LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Inhibition of TNF-&#x3b1; and TPA-induced DNA binding activity of NF-&#x3ba;B; translocation inhibition of p65 and p50 into nucleus via decreasing I&#x3ba;B phosphorylation; increase of the apoptotic genes expression: Bax, caspase-3, caspase-9; inhibition of the anti-apoptotic genes expression: Bcl-2, inhibitor of apoptosis protein (IAP-1) and X chromosome IAP (XIAP).</td>
<td align="left">
<xref ref-type="bibr" rid="B146">Soyong et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Resveratrol(84)</td>
<td rowspan="2" align="left">
<italic>Reynoutria japonica</italic> Houtt.</td>
<td rowspan="2" align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Downregulation of Bcl-2 and Bcl-xL and upregulation of Bax; activation of caspases-3, -8 and -9 and increased PARP cleavage.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B38">Chang et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Procyanidin</td>
<td align="left">
<italic>Arachis hypogaea</italic> L.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Induction of apoptotic cell death and cell cycle arrest at S phase;increase of intracellular ROS level and the decrease of Bcl-2/Bax ratio, and the activation of p53 and caspases-3</td>
<td align="left">
<xref ref-type="bibr" rid="B43">Chen et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Sinapic acid (85)</td>
<td rowspan="2" align="left">
<italic>various vegetables and fruit species</italic>
</td>
<td align="left">PC3;</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation;Induction of apoptosis;Inhibition of migration invasion</td>
<td rowspan="2" align="left">Increase of the expression of BAX, CASP3, CASP8, CYCS, FAS, TIMP-1 and CDH1,decrease of expression of MMP-9 in PC-3 cells;decrease of in the expressions of CDH2, MMP-2 and MMP-9 in LNCaP cells;increase of caspase-3 activity</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B70">Ero&#x11f;lu et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">Carvacrol (86)</td>
<td align="left">
<italic>Origanum and Thymus</italic>
</td>
<td align="left">Human OSCC Tca-8113; SCC-25</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation, inhibition of metastasis and invasion;Induction of apoptosis</td>
<td align="left">Regulating the cell cycle-associated proteins (P21, CCND1 and CDK4) and apoptosis-associated proteins (Cox2, Bcl-2, and Bax); inhibiting P-FAK, and reducing &#x3b2;-catenin, ZEB1, and MMP-2/9 expression</td>
<td align="left">
<xref ref-type="bibr" rid="B56">Dai et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">Hispolon (87)</td>
<td align="left">
<italic>Phellinus linteus</italic>
</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Via modulation of mitochondrial and STAT3 pathways</td>
<td align="left">
<xref ref-type="bibr" rid="B180">Masood et&#x20;al. (2019)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T6" position="float">
<label>TABLE 6</label>
<caption>
<p>Lignans obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Deoxypodophyllotoxin(88)</td>
<td rowspan="2" align="left">
<italic>Anthriscus sylvestris</italic> (L.) Hoffm.</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Accumulation of the reactive oxygen species, intracellular Ca<sup>2&#x2b;</sup>; increase of mitochondrial membrane potential.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B132">Kim et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Magnolol (89)</td>
<td rowspan="2" align="left">
<italic>Magnolia officinalis</italic> Rehder &#x26; E.H.Wilson</td>
<td align="left">PC3</td>
<td rowspan="2" align="left">
<italic>in vivo</italic>
</td>
<td rowspan="2" align="left">Cytotoxicity</td>
<td rowspan="2" align="left">Decrease of MMP-2 and MMP-9 expression; decrease of the level of phosphorylated AKT.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B141">Lee et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">PrEC</td>
</tr>
<tr>
<td rowspan="2" align="left">Silibinin(90)</td>
<td rowspan="2" align="left">
<italic>Silybum marianum</italic> (L.) Gaertn.</td>
<td rowspan="2" align="left">LNCaP 22Rv1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Activation of acetyl-CoA carboxylase; reduction in hypoxia-induced NADPH oxidase (NOX) activity; increase of the lipid accumulation and NOX activity; downregulation of HIF-1&#x3b1; expression, lipid levels, clonogenicity and NOX activity.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B251">Ting et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">VB1(91)</td>
<td rowspan="2" align="left">
<italic>Vitex negundo</italic> L.</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Activation of PARP cleavage.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B314">Zhou et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Magnoline (92)</td>
<td align="left">
<italic>Phellodendri amurensis cortex</italic>
</td>
<td align="left">22RV1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Disturbance of nutrition metabolism and energy metabolism</td>
<td align="left">
<xref ref-type="bibr" rid="B242">Sun et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">Arctigenin (93)</td>
<td align="left">
<italic>Arctium lappa</italic> L.</td>
<td align="left">PC-3M</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis and autophagy</td>
<td align="left">Via PI3K/Akt/mTOR inhibition</td>
<td align="left">
<xref ref-type="bibr" rid="B241">Sun et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">2-(5&#x2032;-allyl-4&#x2034;,9&#x2034;-dihydroxyphenyl-furan)-3-hydroxy-7-methoxy-8-(6&#x2033;,7&#x2033;-dimethyl-furan-2&#x2033;-one)-chromen-4-one. (94)</td>
<td align="left">
<italic>Hosta plantaginea</italic> (Lam.) Aschers</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B277">Wei et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">2-(5&#x2032;-allyl-3&#x2034;,5&#x2034;,9&#x2034;-trihydroxy-4&#x2034;-methoxyphenyl-furan)-3-hydroxy-7,8-furan-ring-chromen-4-one. (95)</td>
<td align="left">
<italic>Hosta plantaginea</italic> (Lam.) Aschers</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B277">Wei et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">2,3-dehydrosilychristin (96)</td>
<td align="left">
<italic>Hosta plantaginea</italic> (Lam.) Aschers</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B277">Wei et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">silychristin A (97)</td>
<td align="left">
<italic>Hosta plantaginea</italic> (Lam.) Aschers</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B277">Wei et&#x20;al. (2020)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="T7" position="float">
<label>TABLE 7</label>
<caption>
<p>Other compounds obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Natural compound</th>
<th align="center">Sort</th>
<th align="center">Botanical name</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Aloe-emodin(98)</td>
<td rowspan="2" align="left">Anthraquin-ones</td>
<td rowspan="2" align="left">
<italic>Rheum palmatum</italic> L.</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Binding with mTOR complex2&#xff1b;Inhibition of mTORC2 kinase activity and downstream substrates of mTORC2, AKT and PKCa activity.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B167">Liu et&#x20;al. (2012a)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Suppression of prostate cancer growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Calcitriol(99)</td>
<td rowspan="2" align="left">Secosteroids</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td align="left">C4-2B</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Upregulation of Vitamin D receptor (VDR) expression; induction of BAX expression; increase of cleaved caspase-3 and downregulation of cdk2 expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B26">Ben-Eltriki et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">Diindolylmethane(100)</td>
<td align="left">Indoles</td>
<td align="left">Distributed in various plants</td>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis</td>
<td align="left">Induction a [Ca<sup>2&#x2b;</sup>] rise by evoking phospholipase C-dependent Ca<sup>2&#x2b;</sup> release from the endoplasmic reticulum and Ca<sup>2&#x2b;</sup> entry via phospholipase A2-sensitive store-operated Ca<sup>2&#x2b;</sup> channels; regulation of FOXO3a/&#x3b2;-catenin/GSK-3&#x3b2; signaling; regulation of estrogen metabolism and acting as an antiandrogen, finally leading downregulation of the AR and PSA.</td>
<td align="left">
<xref ref-type="bibr" rid="B267">Wang et&#x20;al. (2016a)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Diallyl Trisulfide(101)</td>
<td rowspan="2" align="left">Trisulfides</td>
<td rowspan="2" align="left">
<italic>Allium sativum</italic> L.</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Downregulation of XIAP protein expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B133">Kim et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td align="left">LNCap PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="3" align="left">Embelin(102)</td>
<td rowspan="3" align="left">Quinones</td>
<td rowspan="3" align="left">
<italic>Embelia ribes</italic> Burm.f.</td>
<td align="left">C4-2B</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Antiproliferation Induction of apoptosis</td>
<td rowspan="3" align="left">Induction of G1 cell cycle arrest; induction of apoptosis by triggering caspase 3 activation and PARP cleavage; inhibition of survivin expression by inhibiting AKT/NF-&#x3ba;B pathway.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B285">Xu et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">DU145</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td align="left">ESK246(103)</td>
<td align="left">Glycosides</td>
<td align="left">
<italic>Pittosporum venulosum</italic>
</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Inhibition of leucine uptake, leading to reduced mTORC1 signaling, cell cycle protein expression and cell proliferation.</td>
<td align="left">
<xref ref-type="bibr" rid="B270">Wang et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Ginsenoside Rg3(104)</td>
<td rowspan="2" align="left">Steroids</td>
<td rowspan="2" align="left">
<italic>Panax ginseng</italic> C.A.Mey.</td>
<td rowspan="2" align="left">PC-3M</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Suppression of aquaporin 1 (AQP1) water channel protein expression by activating p38 MAPK.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B202">Pan et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">Antimetastasis</td>
</tr>
<tr>
<td rowspan="2" align="left">Guggulsterone(105)</td>
<td rowspan="2" align="left">Steroids</td>
<td rowspan="2" align="left">
<italic>Commiphora mukul</italic> (Hook. ex Stocks) Engl.</td>
<td align="left">DU145 LNCaP PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of Bax expression, downregulation of Bcl-xl and Bcl-2 expression; increase of caspase-9 and caspase-8 cleavage; increase of ROI generation by activating JNK; selective inhibition of androgen receptor promoter activity in LNCaP cell.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B233">Singh et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">PrEC</td>
</tr>
<tr>
<td rowspan="2" align="left">Guttiferone F(106)</td>
<td rowspan="2" align="left">Prenylated benzophenones</td>
<td rowspan="2" align="left">
<italic>Allanblackia stuhlmannii</italic> (Engl.) Engl.</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of sub-G1 fraction and DNA fragmentation; down-regulation of androgen receptor expression and phosphorylation of ERK1/2.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B159">Li et&#x20;al. (2015c)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Indole-3-carbinol (I3C)(107)</td>
<td align="left">Indoles</td>
<td align="left">Distributed in various plants</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Induction of G1&#x20;cell-cycle arrest and downregulation of AR expression and inhibition of AR promoter activity.</td>
<td align="left">
<xref ref-type="bibr" rid="B105">Hsu et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">Juglone(108)</td>
<td align="left">Quinones</td>
<td align="left">
<italic>Juglans mandshurica</italic> Maxim.</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis</td>
<td align="left">Downregulation of AR expression; increase of caspase-3 and -9 activity.</td>
<td align="left">
<xref ref-type="bibr" rid="B119">Jiang et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">Marchantin M(109)</td>
<td align="left">Diphenyls</td>
<td align="left">
<italic>Asterella angusta</italic>
</td>
<td align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Inhibition of the 20S proteasome activity; induction of microtubule-associated protein-1 light chain-3 beta (LC3B) expression and conversion; induction of RNA-dependent protein kinase-like ER kinase activity; suppression of the PI3K/AKT/mammalian target of rapamycin axis through preventing the activation and expression of AKT.</td>
<td align="left">
<xref ref-type="bibr" rid="B119">Jiang et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Moniliformediquinone (110)</td>
<td rowspan="2" align="left">Phenanthradiquinones</td>
<td rowspan="2" align="left">
<italic>Dendrobium moniliforme</italic> (L.) Sw.</td>
<td rowspan="2" align="left">DU145 PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation Induction of apoptosis Inhibition of tumor growth</td>
<td rowspan="2" align="left">Induction of S cell cycle arrest; induction of DNA damage response associated with Chk1, Chk2, c-Jun and JNK activation; induction of caspase-2,-3,7,8 and -9 cleavage through mitochondrial membrane loss and cytochrome c release.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B106">Hsu et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Oleuropein (111)</td>
<td rowspan="2" align="left">Glycosides</td>
<td rowspan="2" align="left">
<italic>Olea europaea</italic> L.</td>
<td rowspan="2" align="left">LNCaP DU145&#x20;BPH-1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Anti-oxidation Cytotoxicity</td>
<td rowspan="2" align="left">Not investigated.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B4">Acquaviva et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor cell growth and invasiveness</td>
</tr>
<tr>
<td align="left">Physapubescin B (112)</td>
<td align="left">Steroids</td>
<td align="left">
<italic>Physalis pubescens</italic> L.</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro In vivo</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Downregulation of Cdc25C protein expression; induction of G2/M cell cycle arrest; decrease of Cdc25C level and increase of levels of CyclinB1, P21 and p-Cdk1 (Tyr15).</td>
<td align="left">
<xref ref-type="bibr" rid="B64">Ding et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td rowspan="3" align="left">Pristimerin (113)</td>
<td rowspan="3" align="left">Esters</td>
<td rowspan="3" align="left">Distributed in various plants</td>
<td align="left">PC3</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Inhibition of proteasomal chymotrypsin-like activity assay and polyubiquitinated protein accumulation&#xff1b;Interaction with the proteasomal &#x3b2;5 subunit in a conformation suitable for proteasome inhibition; increase of caspase-3 activation.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B290">Yang et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">C4-2B</td>
</tr>
<tr>
<td rowspan="2" align="left">Phenethyl-Isothiocyanat(PEITC) (114)</td>
<td rowspan="2" align="left">Isothiocyan-ates</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td align="left">C4-2B</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Increase in the G2-M phase; downregulate AR expression through inhibition of the transcription factor Sp1 and p300/CBP-associated factor (PCAF); upregulation of miR-194 via directly targeting BMP1, and downregulation of BMP1 led to decrease expression of key oncogenic matrix metalloproteinase, MMP2 and MMP9.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B268">Wang et&#x20;al. (2006)</xref>, <xref ref-type="bibr" rid="B295">Yin et&#x20;al. (2009)</xref>, <xref ref-type="bibr" rid="B119">Jiang et&#x20;al. (2013)</xref>, <xref ref-type="bibr" rid="B303">Zhang et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">Putrescine-1,4-dicinnamide (115)</td>
<td align="left">Phenylprop-anoids</td>
<td align="left">Distributed in various plants</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Increase the caspase-3 activity; increase of ROS generation.</td>
<td align="left">
<xref ref-type="bibr" rid="B212">Russo et&#x20;al. (2007)</xref>
</td>
</tr>
<tr>
<td align="left">Physalins A(116)</td>
<td align="left">Secosteriods</td>
<td align="left">
<italic>Physalisalkekengi</italic> var. <italic>franchetii</italic>
</td>
<td align="left">C4-2B 22Rv1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis</td>
<td align="left">Inhibition of JNK and ERK activation; downregulation of AR expression and PAS expression.</td>
<td align="left">
<xref ref-type="bibr" rid="B92">Han et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Physalins B (117)</td>
<td rowspan="2" align="left">Secosteriods</td>
<td rowspan="2" align="left">
<italic>Physalisalkekengi</italic> var. <italic>franchetii</italic>
</td>
<td rowspan="2" align="left">C4-2B 22Rv1</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Inhibition of JNK and ERK activation; downregulation of AR expression and PAS expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B92">Han et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Physachenolide C (118)</td>
<td rowspan="2" align="left">Steroids</td>
<td rowspan="2" align="left">Disbributed in various plants</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Cytotoxicity Inhibition of tumor cell growth</td>
<td rowspan="2" align="left">Not investigated.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B286">Xu et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Reevesioside A (119)</td>
<td align="left">Glycosides</td>
<td align="left">
<italic>Reevesia formosana</italic>
</td>
<td align="left">DU145 PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation Induction of apoptosis</td>
<td align="left">Induction of G1 cell cycle arrest by the downregulation of several related cell cycle regulators, including cyclin D1, cyclin E and CDC25A; increase of association between RB and E2F1 and the subsequent suppression of E2F1 activity via decreasing RB phosphorylation.</td>
<td align="left">
<xref ref-type="bibr" rid="B148">Leu et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Scopoletin(120)</td>
<td rowspan="2" align="left">Coumarins</td>
<td rowspan="2" align="left">
<italic>Erycibe obtusifolia</italic>
</td>
<td rowspan="2" align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G2/M cell cycle arrest by the downregulation of cyclin D1 expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B151">Li et&#x20;al. (2015a)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Sulforaphane(SNF) (121)</td>
<td rowspan="2" align="left">Sulfides</td>
<td rowspan="2" align="left">Disbributed in various plants</td>
<td rowspan="2" align="left">TRAMP C1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Anti-oxidation</td>
<td rowspan="2" align="left">Regulation of Nrf2&#x2019;s CpGs demethylation and reactivation.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B304">Zhang et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="3" align="left">Thymoquinone (122)</td>
<td rowspan="3" align="left">Quinones</td>
<td rowspan="3" align="left">
<italic>Nigella sativa</italic>
</td>
<td align="left">C2-2B</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Not investigated.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B256">Trang et&#x20;al. (1993)</xref>
</td>
</tr>
<tr>
<td align="left">DU145</td>
</tr>
<tr>
<td align="left">LNCaP PC3</td>
</tr>
<tr>
<td rowspan="2" align="left">Wedelolactone(123)</td>
<td rowspan="2" align="left">Esters</td>
<td rowspan="2" align="left">
<italic>Wedelia sinensis</italic>
</td>
<td align="left">DU145 PrEC PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Increase of c-JNK and caspase-3 activity by downregulation of PKC&#x3b5; without AKT inhibition.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B135">Koka et&#x20;al. (2010)</xref>, <xref ref-type="bibr" rid="B218">Sarveswaran et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">Z-Ligustilide(124)</td>
<td align="left">Esters</td>
<td align="left">
<italic>Angelica sinensis</italic> (Oliv.) Diels</td>
<td align="left">TRAMP C1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Cytotoxicity</td>
<td align="left">Increase of Nrf2 expression via the Nrf2 promoter CpGs demethylation.</td>
<td align="left">
<xref ref-type="bibr" rid="B239">Su et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">2,5-dimethylphenol(125)</td>
<td align="left">Phenols</td>
<td align="left">
<italic>Chlaenius cordicolli</italic>
</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Cytotoxicity</td>
<td align="left">Induction of [Ca<sup>2&#x2b;</sup>]i rise through PKC-regulated store-operated Ca<sup>2&#x2b;</sup> channels and PLC- dependent Ca<sup>2&#x2b;</sup> release from the endoplasmic reticulum.</td>
<td align="left">
<xref ref-type="bibr" rid="B267">Wang et&#x20;al. (2016a)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">3-oxo-tirucallic acid(126)</td>
<td rowspan="2" align="left">Lupanic acids</td>
<td rowspan="2" align="left">
<italic>Boswellia carteri</italic> Birdw<italic>.</italic>
</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis Inhibition of tumor cell growth</td>
<td rowspan="2" align="left">Inhibition of Akt activity and Akt signaling pathways, including glycogen synthase kinase-3&#x3b2; and BAD phosphorylation, and nuclear accumulation of p65, androgen receptor, &#x3b2;-catenin, and c-Myc.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B71">Estrada et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">3-&#x3b1;-acetoxy-tirucallic acid(127)</td>
<td rowspan="2" align="left">Lupanic acids</td>
<td rowspan="2" align="left">
<italic>Boswellia carteri</italic> Birdw<italic>.</italic>
</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis Inhibition of tumor cell growth</td>
<td rowspan="2" align="left">Inhibition of Akt activity and Akt signaling pathways, including glycogen synthase kinase-3&#x3b2; and BAD phosphorylation, and nuclear accumulation of p65, androgen receptor, &#x3b2;-catenin, and c-Myc.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B71">Estrada et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">3-&#x3b2;-acetoxy-tirucallic acid(128)</td>
<td rowspan="2" align="left">Lupanic acids</td>
<td rowspan="2" align="left">
<italic>Boswellia carteri</italic> Birdw<italic>.</italic>
</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis Inhibition of tumor cell growth</td>
<td rowspan="2" align="left">Inhibition of Akt activity and Akt signaling pathways, including glycogen synthase kinase-3&#x3b2; and BAD phosphorylation, and nuclear accumulation of p65, androgen receptor, &#x3b2;-catenin, and c-Myc.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B71">Estrada et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">6&#x3b1;-acetoxyanopterine(129)</td>
<td rowspan="2" align="left">Esters</td>
<td rowspan="2" align="left">
<italic>Anopterus macleayanus</italic>
</td>
<td align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Interaction with tubulin.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B149">Levrier et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">24-epibrassinolide(130)</td>
<td rowspan="2" align="left">Brassinoste-roids</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td rowspan="2" align="left">DU145 LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation;</td>
<td rowspan="2" align="left">Induction of G1 cell cycle arrest accompanied by reductions in cyclin D1, CDK4/6 and pRb expression in LNCaP cells; induction of G2/M cell cycle arrest by reductions in cyclin A, cyclin expression in DU145 cells.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B236">Steigerova et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">25-OH-PPD (131)</td>
<td rowspan="3" align="left">Saponins</td>
<td rowspan="3" align="left">
<italic>Panax ginseng</italic> C.A.Mey.</td>
<td rowspan="3" align="left">LNCaP PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Induction of G1 cell cycle arrest by downregulation of MDM2, E2F1, Bcl2, cdk2/4/6, and cyclin D1 expressions; increase of p21, p27, and Bax expressions; induction of PARP cleavage and caspases activation.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B272">Wang et&#x20;al. (2008a)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">28-homocastasterone(132)</td>
<td rowspan="2" align="left">Brassinosteroids</td>
<td rowspan="2" align="left">Distributed in various plants</td>
<td rowspan="2" align="left">DU145 LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation;</td>
<td rowspan="2" align="left">Induction of G1 cell cycle arrest accompanied by reductions in cyclin D1, CDK4/6 and pRb expression in LNCaP cells; induction of G2/M cell cycle arrest via reductions in cyclin A expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B236">Steigerova et&#x20;al. (2012)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">2&#x2032;- Hydroxycinnamaldehyde (133)</td>
<td rowspan="2" align="left">Aldehydes</td>
<td rowspan="2" align="left">Cinnamomum verum J.Presl</td>
<td rowspan="2" align="left">DU145; LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation;Induction of apoptosis</td>
<td rowspan="2" align="left">Signal transducer and activator of transcription 3 inactivation and reactive oxygen species generation</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B296">Yoon et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Methyllucidone (134)</td>
<td align="left">cyclopentenedione</td>
<td align="left">
<italic>Lindera erythrocarpa</italic> Makino (Lauraceae)</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth; Induction of apoptosis</td>
<td align="left">Arrest of the cell cycle at G1 phase;regulation of the expression of the protein tyrosine phosphatase MEG2</td>
<td align="left">
<xref ref-type="bibr" rid="B122">Jin et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Ophiopogonin D&#xff07;(135)</td>
<td rowspan="2" align="left">triterpenoid saponins</td>
<td rowspan="2" align="left">Radix Ophiopogonis</td>
<td rowspan="2" align="left">PC3 &#xff1b; DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Via a RIPK1-related pathway</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B174">Lu et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Corchorusoside C(136)</td>
<td rowspan="2" align="left">steroid</td>
<td rowspan="2" align="left">
<italic>Streptocaulon juventas</italic> (Lour.) Merr. (Apocynaceae)</td>
<td rowspan="2" align="left">DU-145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Inhibition of activity and protein expression of NF-&#x3ba;B (p50 and p65), IKK(&#x3b1; and &#x3b2;), and ICAM-1;decrease of protein expression of Bcl-2 and increase of expression of PARP-1;increase of caspases 3 and 7</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B8">Anaya-Eugenio et&#x20;al. (2019a)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Daucosterol (137)</td>
<td align="left">steroid saponin</td>
<td align="left">
<italic>Crateva adansonii</italic> DC (Capparaceae)</td>
<td align="left">LNCaP;DU145;PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation;inhibition of cell growth;Induction of apoptosis</td>
<td align="left">Downregulation of cell cycle proteins (cdk1, pcdk1, cyclin A and B) in DU145 and PC3 cells;downregulation of cdk2 in PC3 cells;downregulation of Akt, pAKT 18 and Bcl-2 proteins;up-regulation of Bax</td>
<td align="left">
<xref ref-type="bibr" rid="B317">Zingue et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">Cyanidin 3-glucoside (138)</td>
<td align="left">Glycosides</td>
<td align="left">The dark purple glutinous rice (Oryza sativa L.) cultivar Luem Pua (LP)</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of progressive cancer cell behaviors</td>
<td align="left">Inhibit EMT through Smad signaling pathway(s) mediating Snail/E-cadherin expression</td>
<td align="left">
<xref ref-type="bibr" rid="B123">Jongsomchai et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Germacrone (139)</td>
<td align="left">Ketones</td>
<td align="left">Rhizoma Curcuma</td>
<td align="left">PC-3;22RV1</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation;Induction of apoptosis</td>
<td align="left">Inhibiting the Akt/mTOR signaling pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B297">Yu et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Ineupatolide (140)</td>
<td align="left">Esters</td>
<td align="left">
<italic>Carpesium cernuum</italic> L.</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Promoting apoptosis and arresting the cell cycle in the G2and S phases;</td>
<td align="left">
<xref ref-type="bibr" rid="B111">Huang et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Jegosaponin A and B (141 and 142)</td>
<td rowspan="2" align="left">Saponins</td>
<td rowspan="2" align="left">
<italic>Styrax japonica</italic> Siebold et&#x20;al. Zuccarini.</td>
<td rowspan="2" align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Exhibiting cell membrane disruptive properties</td>
<td rowspan="2" align="left">Not investigated</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B201">Nishimura et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Isolobetyol (143)</td>
<td align="left">polyacetylene</td>
<td align="left">
<italic>Platycodon grandiflorus</italic> (Jacq.) A.DC.</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B156">Li, (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Lobetyol (144)</td>
<td align="left">Alkynes</td>
<td align="left">
<italic>Platycodon grandiflorus</italic> (Jacq.) A.DC.</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B156">Li, (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Lobetyolin (145)</td>
<td align="left">Alkynosides</td>
<td align="left">
<italic>Platycodon grandiflorus</italic> (Jacq.) A.DC.</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B156">Li, (2020)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
</sec>
<sec id="s4">
<title>Extracts With Anti-Prostate Cancer Activity</title>
<p>Extracts consist of a group of bioactive natural compounds, which may exert and possess the advantages of synergistic effects against diseases. Recently, nutraceuticals have also received increasing attention as the agents or dietary supplements for cancer prevention and treatment, as well as some extracts derived from edible sources. Thus in this section we will respectively review those extracts and nutraceuticals that have the potential effects against prostate cancer either <italic>in&#x20;vitro</italic> or in prostate cancer mice models. Chinese herbal compound preparations of more than one medicinal plants that have been reported to inhibit prostate cancer are also presented in this review.</p>
<sec id="s4-1">
<title>Herbal Extracts</title>
<p>Traditional and folk herbal medicines from medicinal plants offer great potential for the discovery of novel anti-prostate cancer drugs. The plant extracts listed in <xref ref-type="table" rid="T8">Table&#x20;8</xref> are complex mixtures, which need further investigations to reveal their bioative constituents through bioguided isolation and to clarify the roles of these different compounds in agaisnt prostate cancer when used alone or in combination. Also, the synergistic effect of the individual active components of these extracts and molecular mechanisms involved need further elucidation in order to evaluate the potential of these compounds as antineoplastic agents.</p>
<table-wrap id="T8" position="float">
<label>TABLE 8</label>
<caption>
<p>Extracts obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Extract</th>
<th align="center">Botanical name</th>
<th align="center">Medicinal part</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Ethanol extract</td>
<td rowspan="2" align="left">
<italic>Vitex negundo</italic> L.</td>
<td rowspan="2" align="left">Seed</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of cleavage in poly ADP ribose polymerase protein; upregulation of Bax and downregulation of Bcl-2; increase of caspase-3 and -9.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B314">Zhou et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Methanolic extract</td>
<td align="left">
<italic>Aloe perryi</italic> Baker</td>
<td align="left">Fruit</td>
<td align="left">HTB-81</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Not investigated.</td>
<td align="left">
<xref ref-type="bibr" rid="B7">Al-Oqail et&#x20;al. (2016)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Ethanolic extract</td>
<td rowspan="2" align="left">
<italic>Annona muricata</italic> L.</td>
<td rowspan="2" align="left">Leaf</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Not investigated.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B289">Yang et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Aqueous extract</td>
<td rowspan="2" align="left">
<italic>Camellia sinensis</italic> (L.) Kuntze</td>
<td rowspan="2" align="left">Leaf</td>
<td rowspan="2" align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Increase of Bax/Bcl-2 ratio and decrease of Ki67 protein expression; decrease of blood concentrations of tumor growth factors and tumor concentrations of VEGF and EGF expressions.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B269">Wang et&#x20;al. (2016b)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="3" align="left">Methanolic extract</td>
<td rowspan="3" align="left">
<italic>Artocarpus altilis</italic> (Parkinson) Fosberg</td>
<td rowspan="3" align="left">Leaf and stem</td>
<td rowspan="3" align="left">DU145 LNCap PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="3" align="left">Inhibition of STAT3 Ty705 phosphorylation and STAT3 activation.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B116">Jeon et&#x20;al. (2015a)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Hexane extract</td>
<td rowspan="2" align="left">
<italic>Juglans regia</italic> L.</td>
<td rowspan="2" align="left">Leaf</td>
<td rowspan="2" align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Not investigated.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B157">Li et&#x20;al. (2015b)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Ammonia dichloromethane extract</td>
<td rowspan="2" align="left">
<italic>Berberis libanotica</italic>
</td>
<td rowspan="2" align="left">Root</td>
<td rowspan="2" align="left">DU145 PC3 22Rv1</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G0/G1 cell cycle arrest; eradication of self-renewal ability of highly resistant prostate cancer stem cells.</td>
<td rowspan="2" align="left"/>
</tr>
<tr>
<td align="left">Inhibition of metastasis</td>
</tr>
<tr>
<td rowspan="2" align="left">Supercritical extract</td>
<td rowspan="2" align="left">
<italic>Azadirachta indica</italic> A.Juss<italic>.</italic>
</td>
<td rowspan="2" align="left">Leaf</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Inhibition of calreticulin, integrin b1, and focal adhesion kinase activation; increase of the AKR1C2 level.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B280">Wu et&#x20;al. (2014)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis Inhibition of tumor growth</td>
</tr>
<tr>
<td align="left">Acetone extract</td>
<td align="left">
<italic>Chaenomeles japonica</italic> (Thunb.) Lindl. ex Spach</td>
<td align="left">Fruit</td>
<td align="left">PNT1A PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Increase of Bax/Bcl-2 ration.</td>
<td align="left">
<xref ref-type="bibr" rid="B150">Lewandowska et&#x20;al. (2013)</xref>
</td>
</tr>
<tr>
<td align="left">Hexanic lipidosterolic extract</td>
<td align="left">
<italic>Serenoa repens</italic> (W.Bartram) Small</td>
<td align="left">Whole plant</td>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Increase of caspase 9 activation and poly (ADP-ribose) polymerase 1 cleavage, and mitochondrial PTP activation.</td>
<td align="left">
<xref ref-type="bibr" rid="B22">Baron et&#x20;al. (2009)</xref>
</td>
</tr>
<tr>
<td align="left">Aqueous extract</td>
<td align="left">
<italic>Taraxacum officinale</italic> F.H.Wigg.</td>
<td align="left">Root</td>
<td align="left">C4-2B LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of metastasis</td>
<td align="left">Decrease of phosphorylation levels of FAK and SRC, and activities of matrix metalloproteinases (MMP-2 and MMP-9).</td>
<td align="left">
<xref ref-type="bibr" rid="B232">Sigstedt et&#x20;al. (2008)</xref>
</td>
</tr>
<tr>
<td align="left">Ethyl acetate extract</td>
<td align="left">
<italic>Commiphora mukul</italic> (Hook. ex Stocks) Engl.</td>
<td align="left">Bark</td>
<td align="left">LNCaP PrEC</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Decrease of Bax expression; suppression of JNK activation.</td>
<td align="left">
<xref ref-type="bibr" rid="B282">Xiao et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td align="left">Aqueous extract</td>
<td align="left">
<italic>Cistus creticus</italic> L. &#xff1b; <italic>Cistus monspeliensis</italic> L.</td>
<td align="left">Whole plant</td>
<td align="left">PZ-HPV-7 PNT1A</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated.</td>
<td align="left">
<xref ref-type="bibr" rid="B263">Vitali et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Acidified dimethyl sulfoxide extract</td>
<td rowspan="2" align="left">
<italic>Morus nigra</italic> L.</td>
<td rowspan="2" align="left">Fruit</td>
<td rowspan="2" align="left">PC3 CRL1435</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Induction of G1 cell cycle arrest; decrease mitochondrial membrane potential.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B257">Turan et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td align="left">Dichloromethane extract</td>
<td align="left">
<italic>Strobilanthes crispa</italic> (L.) Blume</td>
<td align="left">Leaf</td>
<td align="left">DU145 PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Increase of caspase 3 and/or 7 activity.</td>
<td align="left">
<xref ref-type="bibr" rid="B287">Visweswaran et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">Punica granatum exeract</td>
<td align="left">
<italic>Punica granatum</italic> L.</td>
<td align="left">Seed</td>
<td align="left">LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis Inbition of metastasis</td>
<td align="left">Upregulation of p21 and p27; increase of JNK phosphorylation; suppression of AKT/mTOR signaling; modulation of the IGF-IGFBP axis.</td>
<td align="left">
<xref ref-type="bibr" rid="B62">Deng et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Hydroalcoholic extract</td>
<td rowspan="2" align="left">
<italic>Justicia spicigera</italic> Schltdl.</td>
<td align="left">stems;</td>
<td rowspan="2" align="left">LNCaP</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="2" align="left">cytostatic mechanism</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B74">Fern&#xe1;ndez-Pomares et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">leaves</td>
</tr>
<tr>
<td align="left">Ethyl acetate fraction</td>
<td align="left">
<italic>Phoenix dactylifera</italic> L. (Ajwa dates)</td>
<td align="left">Fruit</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Arrest of the cell cycle in S phase</td>
<td align="left">
<xref ref-type="bibr" rid="B190">Mirza et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td rowspan="3" align="left">Ethyl acetate extract</td>
<td rowspan="3" align="left">
<italic>Kalanchoe flammea</italic> Stapf (Crassulaceae)</td>
<td rowspan="3" align="left">Leaves</td>
<td align="left">PC-3;</td>
<td align="left">
<italic>In vitro</italic>;</td>
<td rowspan="3" align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Phosphatidylserine translocation; overproduction of reactive oxygen species;release of Cytochrome C at mitochondrial level; activation of caspase-3 and -9;downregulation of apoptosis-related proteins Bcl-2, XIAP, and PKC&#x3b5; and DNA fragmentation and cell cycle arrest</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B10">Arias-Gonz&#xe1;lez et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP;</td>
<td align="left"/>
</tr>
<tr>
<td align="left">PrEC</td>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Hydroalcoholic extracts</td>
<td align="left">
<italic>Euphorbia szovitsii</italic> Fisch. &#x26; C.A.Mey., U. dioica and <italic>Medicago sativa</italic> L.</td>
<td align="left">aerial parts</td>
<td align="left">PC-3, DU145 &#xff1b; HDF</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B14">Asadi-Samani et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanol extract</td>
<td align="left">
<italic>Moringa oleifera flower</italic>
</td>
<td align="left">flower</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of Apoptosis</td>
<td align="left">Downregulation of AKT Pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B13">Ju et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">methanolic extract</td>
<td align="left">
<italic>Paederia foetida</italic> L.</td>
<td align="left">leaves</td>
<td align="left">PC-3, DU-145,HaCaT</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Inhibition of cell growth, migration; induction of apoptosis</td>
<td align="left">Modulating chromatin modification enzymes and altering pro-inflammatory cytokine gene expression</td>
<td align="left">
<xref ref-type="bibr" rid="B205">Pradhan et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanolic extract</td>
<td align="left">
<italic>Moringa peregrina</italic> (Forssk.) Fiori</td>
<td align="left">seed</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Cell cycle arrest at sub-G0 phase and DNA fragmentation.</td>
<td align="left">
<xref ref-type="bibr" rid="B3">Abou-Hashem et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanolic extract</td>
<td align="left">
<italic>dandelion</italic> (Taraxacum officinale) <italic>root</italic> and <italic>lemongrass</italic> (Cymbopogon citratus)</td>
<td align="left">Root</td>
<td align="left"/>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Not investigated</td>
<td align="left">
<xref ref-type="bibr" rid="B200">Nguyen et&#x20;al. (2019)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanolic extract</td>
<td align="left">
<italic>Glycyrrhiza glabra</italic> (Fabaceae family)</td>
<td align="left">roots</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Both apoptosis and autophagy mechanisms</td>
<td align="left">
<xref ref-type="bibr" rid="B82">Gioti et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Dimethyl sulfoxide extract</td>
<td align="left">
<italic>Ganoderma lucidum</italic>
</td>
<td align="left">whole plant</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Inhibition of Jak-1/STAT-3 activity</td>
<td align="left">
<xref ref-type="bibr" rid="B274">Wang et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Methanolic extract</td>
<td align="left">
<italic>Moringa oleifera</italic> Lam.</td>
<td align="left">leaf</td>
<td align="left">DU145;PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation; induction of apoptosis;G0/G1 cell cycle arrest</td>
<td align="left">Downregulation of Notch signaling&#xff1b;downregulation of Hedgehog Signaling Pathway</td>
<td align="left">(<xref ref-type="bibr" rid="B128">Khan et&#x20;al., 2020a</xref>; <xref ref-type="bibr" rid="B129">Khan et&#x20;al., 2020b</xref>)</td>
</tr>
<tr>
<td align="left">Dichloromethane and methanol extract</td>
<td align="left">
<italic>Cecropia pachystachya</italic> Tr&#xe9;cul</td>
<td align="left">leaves</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Senescence induction</td>
<td align="left">&#x3b2;-galactosidase overexpression</td>
<td align="left">
<xref ref-type="bibr" rid="B211">Rosa et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Methanolic extract</td>
<td align="left">
<italic>Dracocephalum palmatum</italic> Stephan</td>
<td align="left">leaves</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Via the caspase-8-mediated extrinsic pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B145">Lee et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">Extract of multi-solvent systems(Cyclohexane, Hexane, Diethyl Ether, Ethyl Acetate, Methanol, Water)</td>
<td align="left">
<italic>Hippophae rhamnoides</italic> L. and <italic>Hippophae tibetana</italic> Schltdl.</td>
<td align="left">leaves</td>
<td align="left">LNCaP;C4-2</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td align="left">Downregulation of androgen responsive genes, PSA, ELL2, EAF2 and CALR</td>
<td align="left">
<xref ref-type="bibr" rid="B181">Masoodi et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Ethanolic extract</td>
<td rowspan="2" align="left">
<italic>Salvia miltiorrhiza</italic> Bunge.</td>
<td rowspan="2" align="left">roots</td>
<td rowspan="2" align="left">DU-145</td>
<td align="left">
<italic>In vitro</italic>;</td>
<td rowspan="2" align="left">Antiproliferation;induction of apoptosis;</td>
<td rowspan="2" align="left">Increase of the expression of p53 and reducion of the expression of Bcl-2 proteins</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B19">Bae et&#x20;al. (2020)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td align="left">Ethanolic extract</td>
<td align="left">
<italic>Spirogyra neglecta</italic> (Hassall) Kutzing</td>
<td align="left">whole plant</td>
<td align="left">PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antimetastasis activity</td>
<td align="left">Inhibiting the Akt signaling pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B11">Arjsri et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">Methanolic extract</td>
<td align="left">
<italic>Artemisia kruhsiana</italic> subsp. alaskana (Rydb.) D.F.Murray &#x26; Elven</td>
<td align="left">stems and leaves</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of autophagy;</td>
<td align="left">Inhibitions of phosphor (p)-AKT, p-mTOR, Bcl-2, and Bax, activating beclin 1 and LC3 ratio in PC-3 cells</td>
<td align="left">
<xref ref-type="bibr" rid="B144">Lee et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanolic extracts</td>
<td align="left">
<italic>Treculia africana</italic> Decne. (Moraceae) and <italic>Entandrophragma angolense</italic> Welw (Meliaceae)</td>
<td align="left">whole plants</td>
<td align="left">LNCaP, DU145 and PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation;induction of apoptosis; anti-metastatic effects</td>
<td align="left">Overexpression of caspase-3; low expression of Akt, pAkt and Bcl-2 proteins;a decrease of chemotaxis and cell migration</td>
<td align="left">
<xref ref-type="bibr" rid="B318">Zingue et&#x20;al. (2021)</xref>
</td>
</tr>
<tr>
<td align="left">Ethanolic extracts</td>
<td align="left">
<italic>Moringa oleifera</italic> Lam.</td>
<td align="left">Flower</td>
<td align="left">PC-3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Downregulation of AKT Pathway</td>
<td align="left">
<xref ref-type="bibr" rid="B13">Ju et&#x20;al. (2018)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s4-2">
<title>Chinese Herbal Compound Preparations</title>
<p>There are four traditional Chinese medical formulations reported to display significant anti-prostate cancer properties, that is, Zyflamend, PC-SPES and LCS101, which are composed of different medicinal plants (<xref ref-type="table" rid="T9">Table&#x20;9</xref>; <xref ref-type="bibr" rid="B25">Bemis et&#x20;al., 2005</xref>; <xref ref-type="bibr" rid="B103">Hsieh et&#x20;al., 1997</xref>; <xref ref-type="bibr" rid="B50">Cohen et&#x20;al., 2015</xref>). Especially, PC-SPES significantly inhibited prostate tumor growth in tumor-bearing mouse model, mainly through cell cycle arrest and apoptosis induction, which is already clinically utilized for the treatment of clincal patients with prostate cancer (<xref ref-type="bibr" rid="B103">Hsieh et&#x20;al., 1997</xref>).</p>
<table-wrap id="T9" position="float">
<label>TABLE 9</label>
<caption>
<p>Chinese herbal compound preparations obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Medical formulation</th>
<th align="center">Composition</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="3" align="left">Zyflamend</td>
<td align="left">Rosemary; Ginger; Turmeric; Green tea; Holy basil; Hu zhang; Chinese goldthread;</td>
<td rowspan="3" align="left">LNCaP</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Antiproliferation</td>
<td rowspan="3" align="left">Inhibition of COX-1 and COX-2 enzyme activities; upregulation of p21 expression; downregulation of AR expression; induction of phosphorylation of Stat3 and PKC&#x3b1;/&#x3b2;.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B25">Bemis et&#x20;al. (2005)</xref>
</td>
</tr>
<tr>
<td align="left">Oregano; Barberry;</td>
</tr>
<tr>
<td align="left">
<italic>Scutellaria baicalensis.</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="3" align="left">PC-SPES</td>
<td align="left">
<italic>Ganoderma lucidium;</italic>
</td>
<td align="left">DU145</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td rowspan="3" align="left">Induction of G0/G1 and G2/M cell cycle arrest; upregulation of p21waf1 expression and downregulation of Bcl-2 expression.</td>
<td rowspan="3" align="left">
<xref ref-type="bibr" rid="B103">Hsieh et&#x20;al. (1997)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>Dendranthema morifolium; Isatis indigotica; Glycyrrhiza glabra; Rabdosia rubescens; Panax pseudoginseng; Serenoa repens; Scutellaria baicalensis;.</italic>
</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td align="left"/>
<td align="left">PC3</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td rowspan="2" align="left">LCS101</td>
<td rowspan="2" align="left">
<italic>Atractylodes macrocephala; Astragalus membranaceus; Glehnia littoralis; Citrus reticulate; Lycium chinense; Ligustrum lucidum; Oldenlandia diffusa; Milletia reticulata; Ophiopogon japonicus; Paeonia obovata; Paeonia lactiflora; Prunella vulgaris; Poriae cocos; Scutellaria barbata.</italic>
</td>
<td align="left">DU145</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Not investigated</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B50">Cohen et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s4-3">
<title>Nutraceuticals and Extracts Derived From Edible Sources</title>
<p>Nowadays, dietary factors play an increasingly important role in the chemopreventive and/or therapeutic management of cancer (<xref ref-type="table" rid="T10">Table&#x20;10</xref>). The study of dietary agents (nutraceuticals or extracts derived from edible sources) in prostate cancer prevention is an important area of research since about 43&#x2013;80% patients with prostate cancer are on alternative therapy based on dietary modification (<xref ref-type="bibr" rid="B166">Lippert et&#x20;al., 1999</xref>; <xref ref-type="bibr" rid="B197">Nam et&#x20;al., 1999</xref>). There are strong evidences that nutraceuticals and extracts derived from edible spices, vegetables or fruits such as vitamin D, pomegranate and tea polyphenols have demonstrated significant anti-prostate cancer activity when tested either <italic>in&#x20;vitro</italic> and/or <italic>in vivo</italic> (<xref ref-type="bibr" rid="B126">Kasimsetty et&#x20;al., 2009</xref>; <xref ref-type="bibr" rid="B85">Gregory et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B137">Koyama et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B192">Mordanmccombs et&#x20;al., 2010</xref>; <xref ref-type="bibr" rid="B107">Hsu et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B282">Xiao et&#x20;al., 2011</xref>; <xref ref-type="bibr" rid="B257">Turan et&#x20;al., 2017</xref>). Especially, dietary phytochemicals that can selectively interfere cellular pathways involved in prostate cancer cells have attracted research interest of scientists in prostate cancer therapies in recent&#x20;years.</p>
<table-wrap id="T10" position="float">
<label>TABLE 10</label>
<caption>
<p>Nutraceuticals and extracts obtained from plants with anti-prostate cancer activities.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left">Dietary agents</th>
<th align="center">Cell type</th>
<th align="center">Observation</th>
<th align="center">Activity</th>
<th align="center">Mechanism of action</th>
<th align="center">Refs</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td rowspan="2" align="left">Epigallocatechin-3-Gallate (Green Tea)</td>
<td align="left">Du145</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of ID2; increase of Bax/Bcl-2; inducing cell death via an ID2-related mechanism; Antiproliferation by increasing the activity of ERK 1/2 through a MEK-independent and PI3K-dependent mechanism.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B282">Xiao et&#x20;al. (2011)</xref>, <xref ref-type="bibr" rid="B257">Turan et&#x20;al. (2017)</xref>
</td>
</tr>
<tr>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Grape skin</td>
<td rowspan="2" align="left">C4-2B LNCaP ARCaP-E</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis Inhibition of metastasis</td>
<td rowspan="2" align="left">Decrease of nail and pSTAT3 expression; inhibition of Snail-mediated CatL activity.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B33">Burton et&#x20;al. (2015)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">Modified Citrus Pectin</td>
<td rowspan="2" align="left">LNCaP PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td rowspan="2" align="left">Induction of apoptosis</td>
<td rowspan="2" align="left">Cell growth inhibition and apoptosis induction via inhibiting MAPK/ERK signaling pathway and activating caspase 3.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B18">Az&#xe9;mar et&#x20;al. (2007)</xref>, <xref ref-type="bibr" rid="B288">Yan and Katz (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vitro</italic>
</td>
</tr>
<tr>
<td rowspan="2" align="left">ProstaCaid</td>
<td rowspan="2" align="left">PC3</td>
<td rowspan="2" align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Downregulation of expression CCND1, CDK4, E2F1and MAPK6; upregulation of CDKN1A expression; downregulation of CAV1, IGF2, NR2F1, and PLAU genes expression; suppression of the urokinase plasminogen activator (uPA) secretion.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B120">Jiang et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td align="left">Inhibition of and migration invasion</td>
</tr>
<tr>
<td rowspan="6" align="left">Pomegranate</td>
<td align="left">C4-2B</td>
<td rowspan="3" align="left">
<italic>In vitro</italic>
</td>
<td rowspan="3" align="left">Antiproliferation</td>
<td rowspan="6" align="left">Inhibition of enzyme (cytochrome P450) expression and activity; inhibition of mTOR phosphorylation at Ser2448 and Ser2481 and IGF1 expression.</td>
<td rowspan="6" align="left">
<xref ref-type="bibr" rid="B177">Malik et&#x20;al. (2005)</xref>, <xref ref-type="bibr" rid="B101">Hong et&#x20;al. (2008)</xref>, <xref ref-type="bibr" rid="B126">Kasimsetty et&#x20;al., (2009)</xref>, <xref ref-type="bibr" rid="B137">Koyama et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">DU145</td>
</tr>
<tr>
<td align="left">LNCaP</td>
</tr>
<tr>
<td align="left">LNCaP-AR</td>
<td rowspan="3" align="left">In vivo</td>
<td rowspan="3" align="left">Induction of apoptosis Inhibition of metastasis</td>
</tr>
<tr>
<td align="left">PC3</td>
</tr>
<tr>
<td align="left">22Rv1</td>
</tr>
<tr>
<td rowspan="2" align="left">Selenium</td>
<td rowspan="2" align="left">C4-2B LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Increase of p53 expression; apoptosis induction by superoxide generation through the mitochondrial-dependent pathway</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B204">Pinto et&#x20;al. (2007)</xref>, <xref ref-type="bibr" rid="B281">Xiang et&#x20;al. (2009)</xref>, <xref ref-type="bibr" rid="B219">Sarveswaran et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Induction of apoptosis</td>
</tr>
<tr>
<td rowspan="2" align="left">Soy</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Decreased of COX-2 RNA and protein expression; inhibition of the synthesis of prostaglandins; downregulation growth factors involved in angiogenesis (EGF and IGF-1) and the IL-8 gene; inhibition of ERK-1 and ERK-2 expression.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B266">Wang et&#x20;al. (2004)</xref>, <xref ref-type="bibr" rid="B243">Swami et&#x20;al. (2009)</xref>, <xref ref-type="bibr" rid="B206">Rabiau et&#x20;al. (2010)</xref>
</td>
</tr>
<tr>
<td align="left">PC3</td>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of tumor growth</td>
</tr>
<tr>
<td rowspan="2" align="left">Vitamin D</td>
<td rowspan="2" align="left">DU145 LNCaP PC3</td>
<td align="left">
<italic>In vitro</italic>
</td>
<td align="left">Antiproliferation</td>
<td rowspan="2" align="left">Increase of E-cadherin expression; decrease of urokinase plasminogen activator receptor levels.</td>
<td rowspan="2" align="left">
<xref ref-type="bibr" rid="B85">Gregory et&#x20;al. (2010)</xref>, <xref ref-type="bibr" rid="B192">Mordanmccombs et&#x20;al. (2010)</xref>, <xref ref-type="bibr" rid="B107">Hsu et&#x20;al. (2011)</xref>
</td>
</tr>
<tr>
<td align="left">
<italic>In vivo</italic>
</td>
<td align="left">Inhibition of migration</td>
</tr>
<tr>
<td align="left">Vitamin K2</td>
<td align="left">VCaP</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Antiproliferation;Induction of apoptosis</td>
<td align="left">Downregulation of the expression of androgen receptor, BiP, survivin, while activating caspase-3 and -7, PARP-1 cleavage, p21 and DNA damage response marker, phospho-H2AX</td>
<td align="left">
<xref ref-type="bibr" rid="B59">Dasari et&#x20;al. (2018)</xref>
</td>
</tr>
<tr>
<td align="left">Algerian propolis</td>
<td align="left">LNCaP</td>
<td align="left">
<italic>in&#x20;vitro</italic>
</td>
<td align="left">Induction of apoptosis</td>
<td align="left">Blocking the cell cycle at G0/G1 phase.</td>
<td align="left">
<xref ref-type="bibr" rid="B299">Zabaiou et&#x20;al. (2019)</xref>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
</sec>
<sec id="s5">
<title>Conclusion and Perspectives</title>
<p>Prostate cancer is the second most frequently diagnosed tumor and the fifth leading cause of cancer-related deaths in men in the worldwide (<xref ref-type="bibr" rid="B182">McEleny et&#x20;al., 2002</xref>). And the mortality of prostate cancer mainly occurs as a result of the castrate resistant ones. Up to date, different kinds of drugs have been employed to improve the treatment condition, mainly including LHRH antagonists, antiandrogen (androgen receptor antagonists and androgen synthesis inhibitors), tyrosine kinase inhibitors, angiogenesis inhibitors, endothelin antagonists, matrix metalloproteinase inhibitors, antioxidants, and cell cycle inhibitors. However, as mentioned above, there is no effective therapy for CRPC at present, except for docetaxel, which is the only chemotherapeutic agent that has been proven to prolong the overall survival in CRPC patient population though with many adverse effects reported (<xref ref-type="bibr" rid="B264">Eyben et&#x20;al., 2015</xref>). Hence, it is urgent for us to explore an effective treatment for prostate cancer, especially for CRPC. In recent years, many natural products and extracts have been scientifically investigated <italic>in&#x20;vitro</italic> and/or <italic>in vivo</italic> and proved as potential anti-prostate cancer agents, which are currently scattered across various publications. So a systematic summary and knowledge of future prospects are necessary to facilitate further chemical and pharmacological studies for anti-prostate cancer agents.</p>
<p>In our review, we provided a comprehensive overview of the molecular basis of the incidence and development of prostate cancer, especially for castration-resistant prostate cancer (CRPC), which mainly including canonical AR signaling (AR amplification, over-expression, mutation, and unconventional activation), and non-nuclear AR signaling (PI3K/AKT, Src, MAPKs, JAK-STAT3, and Ca<sup>2&#x2b;</sup> signaling pathways). So most components involved in above-mentioned pathways represent potential targets for screening natural compounds and/or extracts with anti-prostate cancer activity. And natural compounds or extracts that could function as modulators of canonical AR or non-nuclear AR signalling pathways thus can be regarded as promising candidates for anti-prostate interventions.</p>
<p>So far, a great amount of natural products isolated from diverse sources have been found to significantly inhibit prostate cancer cell proliferation/tumor growth or affected cellular signaling pathways in prostate cancer. As shown in our paper, the majority of natural compounds with direct relevance to prostate cancer are primarily derived from plants, with comparatively few molecules from marine and microbial sources. For these reported bioactive constituents, there is still plenty of room for improvement regarding the studies focused on efficacy enhancement and side effects amelioration by semi-synthetic modifications based on quantitative structural activity relationship elucidation. Since marine and microbial organisms represent important sources for single molecules exploit, more available and improved approaches should be included in finding novel natural products with significant anti-prostate cancer activity from these resource. Especially, engineering bacteria or fungus with novel gene clusters, currently used mainly for the identification of antibiotics or anti-tumor drugs, would be another promising approach for discovering natural compounds with anti-prostate activity. Extracts are another applicable option for anti-prostate purposes, in which case the chemical profile should be further elucidated, possibly affording a pure bioactive compound with precise mechanism of action. Also clinically used Chinese herb preparations should be profiled using techniques such as HPLC&#x2013;MS to standardize the complex system to make it more controllable, stable, and reproducible in prostate cancer treatment. Furthermore, drug combination of these reported natural compounds with conventional chemotherapeutic agents may also be a promising way in finding solution for prostate cancer treatment. Finally, safty large-scale studies are needed to evaluate promising compounds or extracts and determing non-toxic doses for treating prostate cancer in mammals.</p>
<p>In conclusion, tackling prostate cancer (especially CRPC) is a much needed task that requires not only the great progress in understanding the genetic basis of prostate cancer, but also the significant technological improvements in tracking of bioactive natural compounds and structural characterization, which will facilitate the identification of novel natural compounds with significant anti-prostate cancer properties for drug development and therefore can be translated into significant health benefits for humans.</p>
</sec>
</body>
<back>
<sec id="s6">
<title>Author Contributions</title>
<p>CZ, WX, and QY conceived and designed the outline of the manuscript; BB, QC, and RJ collated and summarized the literatures; XQ, HW and YB analyzed the data; RJ, BB, and CZ wrote the manuscript, QC, WX, and QY revised the manuscript and provided technical assistance to RJ and&#x20;BB.</p>
</sec>
<sec id="s7">
<title>Funding</title>
<p>The work was supported by the National Nature Science Foundation of China (No. 82174081, 81770604), the Program of Shanghai Health System Subject Chief Scientist (2017BR004), and Shanghai Natural Science Fund (21ZR1478000).</p>
</sec>
<sec sec-type="COI-statement" id="s8">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s9">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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