Lactic acid bacteria are able to produce a number of important metabolites, including bacteriocins. Bacteriocins are peptides with antimicrobial activity that have long been used in food production, but their use has recently expanded into the pharmaceutical and medical field, either as alternatives to antibacterial agents or as adjuvants in cancer treatment. As cancer is one of the most difficult and widespread diseases and modern therapies stil have too many side effects, there is a need for treatment options with new approaches. Bacteriocins from lactic acid bacteria such as nisin, enterocin and plantaricin have emerged as potential candidates to help treat various cancers, as they inhibit the growth of cancer cells and induce apoptosis in them, while having no cytotoxic effect on healthy cells. Possible modes of action include increasing the fluidity of cell membranes and the formation of ion channels on cancer cell membranes, which increases the release of lactate dehydrogenase. At the same time bacteriocins can promote the accumulation of reactive oxygen radicals and increase the apoptotic index. In addition, they can inhibit mitochondrial energy metabolism and glycolysis, as well as cancer cell migration and proliferation. Studies on bacteriocins are currently limited to in vitro and mouse studies, so well-controlled clinical studies will be needed in the future. There are also possibilities to improve the properties of naturally ocurring bacteriocins through bioengineering or synergistic combinations of bacteriocins with other active ingredients to improve the stability and efficacy od bacteriocins.
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