BAX and breast carcinoma: Additional mechanisms involved in the pro-apoptotic effect of DHA in breast cancer cells include, but are not limited to, decreased Erk activity [28,29], increased Bax pro-apoptotic enzyme levels or activity and decreased Bcl-XL, increased death receptors (DR-4, TRAIL, and Fas) expression and mitochondrial release of the caspase activator SMAC/Diablo in the MCF-7 cell line [30], PPAR-α overexpression in breast cancer tissue or cells [31,32], increased expression of the stress-induced growth inhibitor 1 (OSGIN1) and transcription factor NFE2L2 in MCF-7 and Hs578T breast cancer cells [33].