BACKGROUND: Breast cancer is the most frequent cancer in women. Green tea has been studied for breast cancer chemopreventive and possibly chemotherapeutic effects due to its high content in polyphenolic compounds, including epigallocatechin-3-gallate (EGCG). METHOD: This review is based on a literature research that included papers registered on the Medline database. The research was conducted through PubMed, with the application of the following query: "EGCG"AND 'breast cancer". The result was a total of 88 articles in which this review stands on. RESULTS: In vitro, EGCG shows antioxidant or pro-oxidant properties, depending on the concentration and exposure time. EGCG blocks cell cycle progression and modulates signaling pathways that affects cell proliferation and differentiation. EGCG also induces apoptosis, negatively modulates different steps involved in metastasis and targets angiogenesis by inhibiting VEGF transcription. In vivo, investigations have shown that oral administration of EGCG results in reduction of tumor growth and in antimetastatic and antiangiogenic effects in animal xenograft and allograft models. DISCUSSION: Much remains unknown about the molecular mechanisms involved in the protective effects of EGCG on mammary carcinogenesis. In addition, more studies in vivo are necessary to determine the potential toxicity of EGCG at higher doses and to elucidate its interactions with other drugs. CONCLUSION: A protective effect of EGCG has been shown in different experimental models and under different experimental conditions, suggesting clinical implications of EGCG for breast cancer prevention and therapy. The data presented in this review support the importance of further investigations.

ETHNOPHARMACOLOGICAL RELEVANCE: The compound epigallocatechin-3-gallate (EGCG), the major polyphenolic compound present in green tea [Camellia sinensis L. (Theaceae], has shown numerous cardiovascular health promoting activity through modulating various pathways. However, molecular understanding of the cardiovascular protective role of EGCG has not been reported. AIM OF THE REVIEW: This review aims to compile the preclinical and clinical studies that had been done on EGCG to investigate its protective effect on cardiovascular and metabolic diseases in order to provide a systematic guidance for future research. MATERIALS AND METHODS: Research papers related to EGCG were obtained from the major scientific databases, for example, Science direct, PubMed, NCBI, Springer and Google scholar, from 1995 to 2017. RESULTS: EGCG was found to exhibit a wide range of therapeutic properties including anti-atherosclerosis, anti-cardiac hypertrophy, anti-myocardial infarction, anti-diabetes, anti-inflammatory and antioxidant. These therapeutic effects are mainly associated with the inhibition of LDL cholesterol (anti-atherosclerosis), inhibition of NF-κB (anti-cardiac hypertrophy), inhibition of MPO activity (anti-myocardial infarction), reduction in plasma glucose and glycated hemoglobin level (anti-diabetes), reduction of inflammatory markers (anti-inflammatory) and the inhibition of ROS generation (antioxidant). CONCLUSION: EGCG shows different biological activities and in this review, a compilation of how this bioactive molecule plays its role in treating cardiovascular and metabolic diseases was discussed.

Green tea is a functional food whose consumption is associated with improved cardiovascular morbidity and mortality in several large epidemiological studies. One third of the solids in green tea are composed of the bioactive polyphenol epigallocatechin 3-gallate (EGCG). Studies in both cell- and animal-based models (from our lab and elsewhere) suggest that EGCG may mimic and/or augment beneficial metabolic, vascular, and anti-inflammatory actions of insulin. Indeed, we have recently shown that 3-week EGCG therapy of SHR rats (genetic model of hypertension with features of human metabolic syndrome including insulin resistance, hyperinsulinemia, endothelial dysfunction, and overweight) lowers blood pressure, improves endothelial dysfunction, increases insulin sensitivity, and raises adiponectin levels nearly as effectively as treatment with the conventional ACE-inhibitor enalapril. Obesity, type 2 diabetes, and hypertension are all important interrelated public health problems that are characterized by reciprocal relationships between insulin resistance and endothelial dysfunction. Thus, therapies for these diseases that improve insulin resistance often simultaneously improve endothelial function and vice versa. Based on results from cellular, physiological, and epidemiological studies, we hypothesize that oral EGCG administration will simultaneously ameliorate insulin resistance and lower blood pressure in human subjects with obesity. To test these hypotheses, we will conduct a randomized, placebo-controlled, double-blind, cross-over study to evaluate potential beneficial effects of EGCG to modulate insulin sensitivity, blood pressure, vascular function, and inflammatory markers in two groups of subjects (lean healthy controls, obesity). After a 2-week EGCG-free run-in period, each subject will be randomized to receive EGCG or placebo capsules (400 mg p.o. B.I.D.) for 4 weeks. This will be followed by a 2-week EGCG-free washout period after which subjects will cross-over to the other treatment arm. At baseline, and after each 4-week treatment period, we will assess insulin sensitivity (hyperinsulinemic isoglycemic glucose clamp technique) and vascular function. Regarding vascular function, we will measure basal and insulin-stimulated brachial artery blood flow (large conduit artery assessed by Doppler ultrasound) as well as capillary recruitment in forearm skeletal muscle (small nutritive arterioles assessed by ultrasound with microbubble contrast). Blood pressure will be measured weekly in the UMB GCRC throughout the duration of the study. EGCG pharmacokinetics will be measured at the beginning of each glucose clamp study day after oral administration of a single dose of EGCG or placebo. Finally, various plasma markers of inflammation will be measured at baseline and at the end of each treatment arm to evaluate potential changes that may be related to improvements in metabolic and/or vascular function. This study will explore whether EGCG, a single compound thought to be a major bioactive component of green tea, is effective at improving insulin resistance and lowering blood pressure in subjects with obesity. Results from this study may have important implications for understanding potential health benefits of functional foods that contain bioactive polyphenols including green tea, dark chocolate, and red wine.

Green tea is reported to have wide ranging beneficial health outcomes across epidemiological studies, which have been attributed to its flavonoid content. We investigated whether the flavonoid epigallocatechin gallate (EGCG) modulates brain activity and self-reported mood in a double-blind, placebo controlled crossover study. Participants completed baseline assessments of cognitive and cardiovascular functioning, mood and a resting state electroencephalogram (EEG) before and then 120 min following administration of 300 mg EGCG or matched placebo. EGCG administration was associated with a significant overall increase in alpha, beta and theta activity, also reflected in overall EEG activity, more dominant in midline frontal and central regions, specifically in the frontal gyrus and medial frontal gyrus. In comparison to placebo the EGCG treatment also increased self-rated calmness and reduced self rated stress. This pattern of results suggests that participants in the EGCG condition may have been in a more relaxed and attentive state after consuming EGCG. This is in keeping with the widespread consumption of green tea for its purported relaxing/refreshing properties. The modulation of brain function due to EGCG is deserving of further controlled human studies.

PURPOSE: To test the influence of 1000 mg of quercetin (Q) with or without 120 mg of epigallocatechin 3-gallate (EGCG), 400 mg of isoquercetin, and 400 mg of eicosapentaenoic acid and docosahexaenoic acid (Q-EGCG) on exercise performance, muscle mitochondrial biogenesis, and changes in measures of immunity and inflammation before and after a 3-d period of heavy exertion. METHODS: Trained cyclists (N = 39) were randomized to placebo (P), Q, or Q-EGCG and ingested supplements in a double-blinded fashion for 2 wk before, during, and 1 wk after a 3-d period in which subjects cycled for 3 h x d(-1) at approximately 57% Wmax. Blood, saliva, and muscle biopsy samples were collected before and after 2 wk of supplementation and immediately after the exercise bout on the third day. Blood and saliva samples were also collected 14 h after exercise. RESULTS: Two-week supplementation resulted in a significant increase in plasma quercetin for Q and Q-EGCG and granulocyte oxidative burst activity (GOBA) in Q-EGCG. Immediately after the third exercise bout, significant decreases for C-reactive protein (CRP), and plasma interleukin 6 (IL-6) and interleukin 10 (IL-10) were measured in Q-EGCG compared with P. Granulocyte colony-stimulating factor and CRP were reduced in Q-EGCG 14 h after exercise. No group differences were measured in muscle messenger RNA expression for peroxisome proliferator-activated receptor gamma coactivator alpha, citrate synthase, or cytochrome c. CONCLUSIONS: Two-week supplementation with Q-EGCG was effective in augmenting GOBA andin countering inflammation after 3 d of heavy exertion in trained cyclists.

INTERVENTION: Product Name: Sunphenon EGCG Product Code: Sunphenon EGCG Pharmaceutical Form: Capsule, hard Current Sponsor code: Sunphenon EGCG Other descriptive name: Sunphenon EGCG Concentration unit: mg milligram(s) Concentration type: equal Concentration number: 200‐ Pharmaceutical form of the placebo: Capsule, hard Route of administration of the placebo: Oral use CONDITION: Huntington´s Disease Therapeutic area: Diseases [C] ‐ Nervous System Diseases [C10] PRIMARY OUTCOME: Main Objective: To assess efficacy of Sunphenon EGCG in patients with Huntington´s Disease Primary end point(s): Difference in the sum score of: Stroop colour‐word interference test, word fluency, and symbol digit modalities test (SDMT) after 12 months of treatment (verum vs placebo) Secondary Objective: To compare secondary clinical endpoints (scores) between the verum and the placebo group; To assess safety of Sunphenon EGCG in patients with Huntington´s Disease Timepoint(s) of evaluation of this end point: after 12 months of treatment (12 months after baseline) SECONDARY OUTCOME: Secondary end point(s): ‐ Huntington specific motoric function: UHDRS Motor Score ; ‐ Huntington specific behavioral function: UHDRS Behavioral Score ; ‐ Huntington specific funtioning of daily living: UHDRS Functional Assessement ; ‐ Huntington specific indepedance: UHDRS Indepedance ; ‐ Huntington specific performance: UHDRS Total ; ‐ safatey and tolerability Timepoint(s) of evaluation of this end point: after 12 months of treatment (12 months after baseline) INCLUSION CRITERIA: • Chorea Huntington (CAG repeats > 39) • UHDRS TFC > 5 • = 18 years • Stable medication 4 weeks before baseline • no further participation in other interventional trials during and 3 months before/after ETON trial Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18‐64 years) yes F.1.2.1 Number of subjects for this age range F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 54

BACKGROUND & AIMS: Green tea catechins, especially epigallocatechin-3-gallate (EGCG), have been associated with cancer prevention and treatment. This has resulted in an increased number of studies evaluating the effects derived from the use of this compound in combination with chemo/radiotherapy. This review aims at compiling latest literature on this subject. METHODS: Keywords including EGCG, cancer, chemotherapy, radiotherapy and side effects, were searched using PubMed and ScienceDirect databases to identify, analyze, and summarize the research literature on this topic. Most of the studies on this subject up to date are preclinical. Relevance of the findings, impact factor, and date of publication were critical parameters for the studies to be included in the review. RESULTS: Additive and synergistic effects of EGCG when combined with conventional cancer therapies have been proposed, and its anti-inflammatory and antioxidant activities have been related to amelioration of cancer therapy side effects. However, antagonistic interactions with certain anticancer drugs might limit its clinical use. CONCLUSIONS: The use of EGCG could enhance the effect of conventional cancer therapies through additive or synergistic effects as well as through amelioration of deleterious side effects. Further research, especially at the clinical level, is needed to ascertain the potential role of EGCG as adjuvant in cancer therapy.

OBJECTIVE: To evaluate metabolic effects of epigallocatechin gallate (EGCG) supplementation when combined with a program of regular aerobic exercise in overweight/obese post-menopausal women. METHODS: Thirty-eight overweight or obese postmenopausal women exercised at moderate intensity, viz. walking three times per week for 45 min at 75% of age-predicted maximum heart rate (HR), and took a 150 mg capsule of EGCG (Teavigo) or placebo (lactose) twice daily for 12 weeks. Blood parameters (lipids, glucose and insulin), blood pressure, heart rate, arterial function and anthropometry were assessed at 0, 6 and 12 wk. At wk 0 and 12, body composition was assessed by dual energy X-ray absorptiometry (DXA) and abdominal fat was assessed by DXA and computed tomography (CT). RESULTS: Waist circumference (p < 0.01), total body fat (p < 0.02), abdominal fat (by DXA) (p < 0.01) and intra abdominal adipose tissue (by CT) (p < 0.01) were reduced in both treatment groups, with no difference between placebo and Teavigo. Teavigo significantly decreased resting HR (p < 0.01) and reduced plasma glucose in subjects with impaired glucose tolerance (p < 0.05). CONCLUSIONS: Moderate consumption of EGCG can improve the health status of overweight individuals undergoing regular exercise by reducing HR and plasma glucose concentrations. Loss of body fat, however, may require a higher intake of EGCG, other catechins or addition of metabolic stimulants.

Duchenne muscular dystrophy (DMD) is the most frequent neuromuscular condition to occur in childhood and youth. The course of the disease is progressive, and life expectancy is severely curtailed by the participation of the respiratory muscles and/or by progressive cardiomyopathy. DMD derives from mutations in the DMD gene which leads to a loss of the protein dystrophin. Secondary inflammatory/immunological reactions contribute to the progressive course of the disease (1,2). No curative therapy yet exists. Administration of steroids is the only established medical treatment. Symptomatic measures are also available, such as orthopaedic operations, the treatment of cardiomyopathy or, in advanced stages, home mechanical ventilation. In studies involving experiments on cells and animals, Epigallocatechin-Gallate (EGCG, the major polyphenol in green tea) has shown a neuroprotective effect. The neuroprotective mechanism of action is probably based on several factors, including EGCG\'s modulation of several signal transduction pathways, its influence on the expression of genes regulating cell survival or programmed cell death, as well as its modulation of mitochondrial function. The mdx mouse is the best-investigated animal model of a dystrophin-negative muscular dystrophy. Administration of EGCG in the mdx mouse led to both a reduction in the proportion of fibre necroses as well as to a less pronounced proliferation of connective tissue in the muscle (3,4), and also to an improvement in clinical symptoms (5,6). Therefore, the investigators want to investigate safety and tolerance of EGCG in a dosage of up to 10mg/kg in patients with muscular dystrophy of the Duchenne type in this multicentre, prospective, double blind, placebo controlled, randomized pilot study.

Epigallocatechin gallate (EGCG) is the most abundant catechin (sometimes referred to as tea flavonoids) in green tea extract. A review by Nagle et al (2006) identifies that a large amount of research indicates EGCG (amongst other catechins) is responsible for most of the potential health benefits associated with green tea. EGCG is brain permeable (Nakagawa \& Miyazawa, 1997), and it is considered to have neuroprotective and neurorescue effects including modulation of cell survival and cell cycle genes (Levites et al 2002). Although there have been several human studies looking at the bioavailability of EGCG when administered in varying doses, there have been no studies that have specifically investigated the cognitive effects of this catechin in humans. Therefore, the purpose of this study is to assess the cerebral blood flow (using Near Infrared Spectroscopy), cerebro-electrical activity (EEG) and behavioural effects of EGCG. A randomised, double-blind, placebo-controlled, balanced crossover study will assess the effects of 135 mg and 270 mg pure EGCG in 24 healthy, young adults (18-35). Prior to the first active study day participants will attend a screening/training visit where relevant exclusion criteria will be assessed including any food sensitivities. They will also complete a caffeine consumption questionnaire in order to control for potential caffeine withdrawal effects as a result of restrictions of the study.