S-adenosylmethionine and its clinical applications

Zhang Jingtao; Zhang Yao; Yang Yanling

doi:10.16689/j.cnki.cn11-9349/r.2026.03.004

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (3) : 354-359. DOI: 10.16689/j.cnki.cn11-9349/r.2026.03.004

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S-adenosylmethionine and its clinical applications

¹Zhang Jingtao, ¹Zhang Yao, ¹Yang Yanling

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Abstract

S-adenosylmethionine (SAM), a natural endogenous compound discovered in 1953, is the principal methyl donor in mammalian cells. It is synthesized most abundantly in the liver. SAM plays a central role in maintaining cell growth, differentiation, and functional homeostasis by participating in the methylation of DNA, RNA, and proteins, polyamine synthesis, and the provision of glutathione precursors. Its metabolism involves a complex regulatory network encompassing the methionine cycle, folate cycle, and methionine salvage pathway. In clinical applications, the effect of SAM in treating liver diseases such as intrahepatic cholestasis and alcoholic liver disease is well-established. In oncology, dysregulation of SAM homeostasis has been proposed as a diagnostic or prognostic biomarker for malignancies including liver and lung cancer. Experimental studies indicate that SAM showed anti-cancer effects in various models, such as gastric cancer, breast cancer, glioblastoma, and melanoma, by reversing the aberrant methylation of oncogenes and intervening in multiple signaling pathways. It can also produce synergistic effects when combined with chemotherapy or immunotherapy. SAM has been shown to alleviate chemotherapy-induced liver injury. In inherited metabolic disorders, SAM has been confirmed to improve neurological symptoms in patients with methionine adenosyltransferase deficiency. It also serves as an effective adjunctive treatment strategy for refractory depression. Although SAM holds broad application prospects in multiple diseases, current clinical evidence remains insufficient, necessitating more comprehensive studies to fill mechanistic gaps and provide high-level clinical evidence.

Key words

S-adenosylmethionine / Metabolism / Methyl donor / Methylation / Hepatoprotection / Antitumor / Liver disease / Methionine adenosyltransferase Ⅰ/Ⅲ deficiency

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Zhang Jingtao, Zhang Yao, Yang Yanling. S-adenosylmethionine and its clinical applications[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(3): 354-359 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.03.004

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