{"id":"338b03ad-b42c-539f-b225-71d62d5a703d","stable_key":"182336c6-ed36-5ec6-8a09-25c31096262e:dim-4oh-tam-lower","predicate":"lowers_trial","statement":"BR-DIM reduced plasma 4-hydroxytamoxifen compared with placebo.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"ab93b65f-0422-5fbc-a810-2c904e8dd86a","mechanism_event_label":"A second active metabolite also fell.","subject":{"id":"6009bdd4-f1b5-5867-b5c3-cdf7c9645cd0","slug":"dim","display_name":"3,3'-Diindolylmethane / DIM","entity_type_key":"small_molecule"},"object":{"id":"6daad032-f8dd-586a-b091-bcc227e22b69","slug":"4-hydroxytamoxifen-plasma-concentration","display_name":"Plasma 4-hydroxytamoxifen concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"ab93b65f-0422-5fbc-a810-2c904e8dd86a","stable_key":"182336c6-ed36-5ec6-8a09-25c31096262e:dim-4oh-tam-lower-event","event_type":"observed_intervention","label":"A second active metabolite also fell.","description":"BR-DIM reduced plasma 4-hydroxytamoxifen compared with placebo.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"53989c4c-d006-5dfc-a11b-8ac4ba48161c","slug":"tamoxifen","display_name":"Tamoxifen","entity_type_key":"small_molecule"},"role":"concurrent_treatment","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"acac079b-66bd-5db4-a827-39092d9c9dfe","slug":"4-hydroxytamoxifen","display_name":"4-Hydroxytamoxifen","entity_type_key":"small_molecule"},"role":"measured_metabolite","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"6009bdd4-f1b5-5867-b5c3-cdf7c9645cd0","slug":"dim","display_name":"3,3'-Diindolylmethane / DIM","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"6daad032-f8dd-586a-b091-bcc227e22b69","slug":"4-hydroxytamoxifen-plasma-concentration","display_name":"Plasma 4-hydroxytamoxifen concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""}]},"contexts":[{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/dim-research/28560655.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"f4d3745a4c2211551e755b314eced209ac88e072b9e02cd97cbaa5eed8303f28\", \"start_char\": 0, \"end_char\": 1823, \"text_sha256\": \"f4d3745a4c2211551e755b314eced209ac88e072b9e02cd97cbaa5eed8303f28\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Randomized double-blind placebo-controlled trial","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"BR-DIM 150 mg twice daily for 12 months","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Biomarker and pharmacokinetic endpoints, not recurrence or survival. The causal enzyme mechanism and effect on tamoxifen clinical benefit were not determined.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Diindolylmethane (DIM) research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"dim","display_name":"3,3'-Diindolylmethane / DIM","entity_type_key":"small_molecule"}},{"dimension":"organism","value_text":"130 women prescribed tamoxifen; 98 completed","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"A second active metabolite also fell.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[dim-p28560655] A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. (2017). https://pubmed.ncbi.nlm.nih.gov/28560655/ DOI: 10.1007/s10549-017-4292-7","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Estrogen biomarkers and tamoxifen metabolites","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"e4d2a874-d8ae-54f5-9cc4-9531909b43b7","evidence_kind":"source_excerpt","locator":"Lines 1065-1076","start_line":1065,"end_line":1076,"excerpt":"### dim-4oh-tam-lower\nBR-DIM reduced plasma 4-hydroxytamoxifen compared with placebo.\nCondition category: normal\nnutrient_topic: Diindolylmethane (DIM) research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A second active metabolite also fell.\norganism: 130 women prescribed tamoxifen; 98 completed\ntissue_or_cell_type: Estrogen biomarkers and tamoxifen metabolites\nexperimental_model: Randomized double-blind placebo-controlled trial\nlimitations: Biomarker and pharmacokinetic endpoints, not recurrence or survival. The causal enzyme mechanism and effect on tamoxifen clinical benefit were not determined.\nexposure: BR-DIM 150 mg twice daily for 12 months\nevidence_span: {\"source_cache\": \"artifacts/dim-research/28560655.abstract.txt\", \"locator\": \"Primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"f4d3745a4c2211551e755b314eced209ac88e072b9e02cd97cbaa5eed8303f28\", \"start_char\": 0, \"end_char\": 1823, \"text_sha256\": \"f4d3745a4c2211551e755b314eced209ac88e072b9e02cd97cbaa5eed8303f28\"}\n[dim-p28560655] A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. (2017). https://pubmed.ncbi.nlm.nih.gov/28560655/ DOI: 10.1007/s10549-017-4292-7","model_system":"Randomized double-blind placebo-controlled trial","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [dim-p28560655] A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. (2017). https://pubmed.ncbi.nlm.nih.gov/28560655/ DOI: 10.1007/s10549-017-4292-7","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"b6d70682-97f9-5893-a03c-f9f88836033c","stable_key":"import-182336c6-ed36-5ec6-8a09-25c31096262e","title":"Diindolylmethane (DIM): formation, receptor signaling, metabolism and drug interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"31e14060de904976d2f5d439f2bc9c8a99a72d34626c562c78429025e050d404","revision_id":"611094c1-a9cf-5b9b-b255-ac70b571696a","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}