Resveratrol and its analogs: defense against cancer, coronary disease and neurodegenerative maladies or just a fad?

Resveratrol (3,5,4'-trihydroxy-trans-stilbene; RV), a dietary constituent found in grapes and wine, exerts a wide variety of pharmacological activities. Because the grape skins are not fermented in the production process of white wines, only red wines contain considerable amounts of this compound. RV is metabolized into sulfated and glucuronidated forms within approximately 15min of entering the bloodstream, and moderate consumption of red wine results in serum levels of RV that barely reach the micromolar concentrations. In contrast, its metabolites, which may be the active principle, circulate in serum for up to 9h. RV has been identified as an effective candidate for cancer chemoprevention due its ability to block each step in the carcinogenesis process by inhibiting several molecular targets such as kinases, cyclooxygenases, ribonucleotide reductase, and DNA polymerases. In addition, RV protects the cardiovascular system by a large number of mechanisms, including defense against ischemic-reperfusion injury, promotion of vasorelaxation, protection and maintenance of intact endothelium, anti-atherosclerotic properties, inhibition of low-density lipoprotein oxidation, and suppression of platelet aggregation, thereby strongly supporting its role in the prevention of coronary disease. Promising data within the use of RV have also been obtained regarding progressive neurodegenerative maladies such as Alzheimer's, Huntington's, and Parkinson's diseases. Because neurotoxicity is often related to mitochondrial dysfunction and may be ameliorated through the inclusion of metabolic modifiers and/or antioxidants, RV may provide an alternative (and early) intervention approach that could prevent further damage. RV induces a multitude of effects that depend on the cell type (e.g., NF-kappaB modulation in cancer cells vs. neural cells), cellular condition (normal, stressed, or malignant), and concentration (proliferative vs. growth arrest), and it can have opposing activities. RV affects whole pathways and sets of intracellular events rather than a single enzyme and, therefore, may be an effective therapy to restore homoestasis. Nonetheless, the question of whether RV or its metabolites can accumulate to bioactive levels in target organs remains to be addressed.