Thiamine mimetics sulbutiamine and benfotiamine as a nutraceutical approach to anticancer therapy

Biomed Pharmacother. 2020 Jan:121:109648. doi: 10.1016/j.biopha.2019.109648. Epub 2019 Nov 25.


Malignant cells frequently demonstrate an oncogenic-driven reliance on glycolytic metabolism to support their highly proliferative nature. Overexpression of pyruvate dehydrogenase kinase (PDK) may promote this unique metabolic signature of tumor cells by inhibiting mitochondrial function. PDKs function to phosphorylate and inhibit pyruvate dehydrogenase (PDH) activity. Silencing of PDK expression has previously been shown to restore mitochondrial function and reduce tumor cell proliferation. High dose Vitamin B1, or thiamine, possesses antitumor properties related to its capacity to reduce PDH phosphorylation and promote its enzymatic activity, presumably through PDK inhibition. Though a promising nutraceutical approach for cancer therapy, thiamine's low bioavailability may limit clinical effectiveness. Here, we have demonstrated exploiting the commercially available lipophilic thiamine analogs sulbutiamine and benfotiamine increases thiamine's anti-cancer effect in vitro. Determined by crystal violet proliferation assays, both sulbutiamine and benfotiamine reduced thiamine's millimolar IC50 value to micromolar equivalents. HPLC analysis revealed that sulbutiamine and benfotiamine significantly increased intracellular thiamine and TPP concentrations in vitro, corresponding with reduced levels of PDH phosphorylation. Through an ex vitro kinase screen, thiamine's activated cofactor form thiamine pyrophosphate (TPP) was found to inhibit the function of multiple PDK isoforms. Attempts to maximize intracellular TPP by exploiting thiamine homeostasis gene expression resulted in enhanced apoptosis in tumor cells. Based on our in vitro evaluations, we conclude that TPP serves as the active species mediating thiamine's inhibitory effect on tumor cell proliferation. Pharmacologic administration of benfotiamine, but not sulbutiamine, reduced tumor growth in a subcutaneous xenograft mouse model. It remains unclear if benfotiamine's effects in vivo are associated with PDK inhibition or through an alternative mechanism of action. Future work will aim to define the action of lipophilic thiamine mimetics in vivo in order to translate their clinical usefulness as anticancer strategies.

Keywords: Cancer; Metabolism; Pyruvate dehydrogenase; Pyruvate dehydrogenase kinase; Thiamine.

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology*
  • Apoptosis / drug effects
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Confidence Intervals
  • Dietary Supplements*
  • Female
  • Humans
  • Inhibitory Concentration 50
  • Intracellular Space / metabolism
  • Mice, Nude
  • Pyruvate Dehydrogenase Acetyl-Transferring Kinase / metabolism
  • Pyruvate Dehydrogenase Complex / metabolism
  • Thiamine / analogs & derivatives*
  • Thiamine / chemistry
  • Thiamine / pharmacology*
  • Thiamine Pyrophosphate / metabolism


  • Antineoplastic Agents
  • Pyruvate Dehydrogenase Acetyl-Transferring Kinase
  • Pyruvate Dehydrogenase Complex
  • sulbutiamine
  • Thiamine Pyrophosphate
  • Thiamine
  • benphothiamine