Physiological Relevance of the Antiproliferative and Estrogenic Effects of Dietary Polyphenol Aglycones versus Their Phase-II Metabolites on Breast Cancer Cells: A Call of Caution.

While preclinical studies suggest the breast cancer (BC) chemopreventive effects of dietary polyphenols, the human evidence is still very weak. The huge existing in vitro-in vivo gap is mainly due to the plethora of potential effects reported by in vitro studies that usually assay polyphenols as occurring in the food (beverages, extracts, foods) and/or derived aglycone metabolites with doubtful physiological relevance. Since phase-II metabolites can reach systemic tissues such as malignant breast tumors, we aimed here to compare for the first time the antiproliferative and estrogenic/antiestrogenic effects of dietary polyphenols and microbiota-derived metabolites (i.e., resveratrol, dihydroresveratrol, urolithins (A, B, and Isourolithin A), and the flavanone hesperetin), with those effects exerted by their physiologically relevant glucuronides and sulfates on human BC cell lines (MDA-MB-231 and MCF-7). Results showed that aglycones exerted dose-dependent antiproliferative and estrogenic/antiestrogenic activities, but both their glucuronide and sulfate conjugates lacked these activities. In addition, aglycones underwent phase-II metabolism in BC cells, mainly via sulfation, which determined the cell-dependent differences in the effects observed. Therefore, phase-II metabolism limits the antiproliferative, estrogenic, and antiestrogenic activities of dietary polyphenols on BC cells. Likewise, as a call of caution, enthusiasm should be limited for publishing effects that are not physiologically relevant.