Mode of action

1. Immunmodulatory effect
   1. Enhancement of blastic transformation
   2. Restoration of damaged immune response
2. Stimulation of apoptosis (programmed cell death): Cleavage of PARP (poly-(ADP-ribose)polymerase-) induced by caspase-3 protease (nuclear enzyme)
3. Effects on glucose/nucleic acid metabolism. Avemar decreases the glucose-uptake of tumour cells in a dose-dependent manner and inhibits the production of ribose and desoxyribose. Avemar inhibits the activity of glucose-6-phosphate dehydrogenase and transketolase (i.e. the key enzymes of ribose synthesis).
4. Exerts a selective inhibition of MHC-I (main histocompatibility-I) expression on the surface of tumour cells.
5. Enhances TNFalpha (tumor necrosis factor alpha) production, thereby inhibiting tumour angiogenesis.
6. ICAM-I: the intracellular adhesion molecule (CD 45) level is increased by Avemar.
7. Inhibition of carcinogenesis/chemo-preventive effect: Avemar is capable of inhibiting the development of rat colon tumours induced with azoxymethane
8. Stimulation of haemopoesis: regeneration of thrombopoesis and erythropoesis in cyclophosphamide-induced bone marrow impairment.