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Ni B, Xue K, Wang J, Zhou J, Wang L, Wang X, Liu T, Ye N, Jiang J. Integrating Chinese medicine into mainstream cancer therapies: a promising future. Front Oncol 2024; 14:1412370. [PMID: 38957318 PMCID: PMC11217489 DOI: 10.3389/fonc.2024.1412370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
Malignant tumors are complex systemic chronic diseases and one of the major causes of human mortality. Targeted therapy, chemotherapy, immunotherapy, and radiotherapy are examples of mainstream allopathic medicine treatments that effective for intermediate and advanced malignant tumors. The ongoing use of conventional allopathic medicine has resulted in adverse responses and drug resistance, which have hampered its efficacy. As an important component of complementary and alternative medicine, Chinese medicine has been found to have antitumor effects and has played an important role in enhancing the therapeutic sensitivity of mainstream allopathic medicine, reducing the incidence of adverse events and improving immune-related functions. The combined application of adjuvant Chinese medicine and mainstream allopathic medicine has begun to gain acceptance and is gradually used in the field of antitumor therapy. Traditional natural medicines and their active ingredients, as well as Chinese patent medicines, have been proven to have excellent therapeutic efficacy and good safety in the treatment of various malignant tumors. This paper focuses on the mechanism of action and research progress of combining the above drugs with mainstream allopathic medicine to increase therapeutic sensitivity, alleviate drug resistance, reduce adverse reactions, and improve the body's immune function. To encourage the clinical development and use of Chinese herb adjuvant therapy as well as to provide ideas and information for creating safer and more effective anticancer medication combinations, the significant functions of Chinese herb therapies as adjuvant therapies for cancer treatment are described in detail.
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Affiliation(s)
- Baoyi Ni
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Kaiyuan Xue
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jia Wang
- Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, China
| | - Jilai Zhou
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lankang Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xinmiao Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ting Liu
- Heilongjiang University of Chinese Medicine, Harbin, China
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Naijing Ye
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiakang Jiang
- The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
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2
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Hu YT, Kao YS. Methods, Complications, and Outcomes in a Randomized Clinical Trial of Electroacupuncture After Colorectal Cancer Surgery. JAMA Surg 2023; 158:981. [PMID: 37133852 DOI: 10.1001/jamasurg.2023.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Ya-Ting Hu
- School of Post-baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Yung-Shuo Kao
- Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
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Li Y, Hong E, Ye W, You J. Moxibustion as an Adjuvant Therapy for Cancer Pain: A Systematic Review and Meta-Analysis. J Pain Res 2023; 16:515-525. [PMID: 36824500 PMCID: PMC9942498 DOI: 10.2147/jpr.s396696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/28/2023] [Indexed: 02/19/2023] Open
Abstract
Purpose Pain is one of the most common and feared symptoms among cancer patients. Unrelieved pain denies patients comfort and greatly affects their overall quality of life. Moxibustion is commonly used to manage chronic pain. However, its efficacy on cancer pain remains inconclusive. This study aimed to evaluate the efficacy of moxibustion for cancer pain. Methods We searched seven databases to obtain articles about moxibustion combined with pharmacotherapy for cancer pain published before November 2022. All data extraction was carried out independently by two investigators. RevMan 5.4 software was used for data analysis. Results A total of ten trials involving 999 cases were included. The results of the meta-analysis revealed that moxibustion combined with pharmacotherapy was significantly better than drug therapy alone in improving pain relief rate (RR =1.16, 95% CI = [1.04, 1.30], P = 0.01), reducing pain scores (SMD = -1.43, 95% CI = [-2.09, -0.77], P < 0.0001), Shortening the onset of analgesia (MD = -12.07, 95% CI = [-12.91, -11.22], P < 0.00001), prolonging the duration of analgesia (MD = 3.69, 95% CI = [3.21, 4.18], P < 0.00001), and improving quality of life (SMD = 2.48, 95% CI = [0.67, 4.29], P = 0.007). In addition, moxibustion combined with pharmacotherapy can effectively reduce adverse reactions of drugs (RR =0.35, 95% CI = [0.21, 0.57], P < 0.0001). Conclusion The evidence in this review supports moxibustion as an effective adjuvant therapy for cancer pain management. However, high-quality RCTs are needed to further confirm these findings. Registration Number PROSPERO CRD42022370942.
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Affiliation(s)
- Yan Li
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China
| | - Ensi Hong
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China
| | - Wenguo Ye
- The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,Correspondence: Wenguo Ye, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi Province, People’s Republic of China, Email
| | - Jianyu You
- Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of China,Jianyu You, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi Province, People’s Republic of China, Email
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Wu T, Fu C, Deng Y, Huang W, Wang J, Jiao Y. Acupuncture therapy for radiotherapy-induced adverse effect: A systematic review and network meta-analysis. Front Public Health 2022; 10:1026971. [PMID: 36590000 PMCID: PMC9797977 DOI: 10.3389/fpubh.2022.1026971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022] Open
Abstract
Objective To evaluate the efficacy of different acupuncture therapies for radiotherapy-induced adverse effects (RIAEs) and find out the optimal scheme. Methods Eligible randomized controlled trials (RCTs) were collected from inception to June 2020 from 9 bibliographic databases. The risk of bias evaluation of the analyzed literature was carried out using the Cochrane risk-of-bias tool. Network meta-analysis was mainly performed using STATA 14.2 and OpenBUGS 3.2.3 by figuring out the network diagrams, league figures, and SUCRA values. Results A total of 41 studies with 3,011 participants reported data suitable for network meta-analysis. There was a low to moderate risk of bias in twenty of the articles. ST36 was the most widely prescribed acupoint. Based on network meta-analysis, four outcome indicators were described, namely, acupuncture + medication ranked first in treating radiation enteritis, moxibustion + medication ranked first in preventing radiotherapy-induced leukopenia, acupuncture + medication ranked first in preventing radioactive oral mucositis, and acupuncture ranked first in improving the stimulated salivary flow rate of radioactive xerostomia. Conclusion The findings of the network meta-analysis manifested that acupuncture therapy combined with medication has superiority in most RIAEs, both reducing incidence and relieving symptoms. However, high-quality studies are still needed to provide conclusive evidence. Systematic review registration https://inplasy.com/inplasy-2020-7-0054/, identifier: INPLASY202070054.
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Affiliation(s)
- Tong Wu
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China,Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan, China,Institute of Science, Technology and Humanities, Shanghai University of Chinese Medicine, Shanghai, China
| | - Chengwei Fu
- The Second Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yiran Deng
- Xiangyang Hospital of Traditional Chinese Medicine, Xiangyang, China
| | - Wanping Huang
- General Hospital of The Yangtze River Shipping, Wuhan, China
| | - Jieyu Wang
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China,Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan, China,Jieyu Wang
| | - Yang Jiao
- Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China,Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan, China,*Correspondence: Yang Jiao
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Grain-Sized Moxibustion Heightens the AntiTumor Effect of Cyclophosphamide in Hepa1-6 Bearing Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3684899. [PMID: 35978996 PMCID: PMC9377901 DOI: 10.1155/2022/3684899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
Objective The side effects of chemotherapy as a treatment of liver cancer cannot be ignored. Grain-sized moxibustion, a characteristic external therapy, has been shown to reduce the toxic and side effects of chemotherapy and regulate the immune function. The purpose of this study was to explore the synergistic antitumor activity of grain-sized moxibustion combined with cyclophosphamide (CTX). Methods A hepatoma 1–6 (Hepa1-6)-bearing mouse model was established by injecting mice with Hepa1-6 cancer cells. CTX and grain-sized moxibustion on Dazhui (DU14), Zusanli (ST36), and Sanyinjiao (SP6) were used for treatment, and mouse survival status, body weight, and tumor growth, weight, and volume were measured. White blood cells (WBCs) and bone marrow nucleated cells (BMNCs) were quantified. The spleens and livers of Hepa1-6-bearing mice were pathologically examined and scored. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured with enzyme-linked immunosorbent assay (ELISA) kits, and protein and mRNA expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) in tumor tissues were measured with immunohistochemistry and real-time quantitative polymerase chain reaction (RT-qPCR) techniques. Results Both grain-sized moxibustion and CTX could restrain the growth of Hepa1-6 tumors, reducing both tumor volume and weight; the combined treatment had a greater effect. Grain-sized moxibustion down-regulated the expression of proliferation genes Ki67 and PCNA, weakened the proliferation ability of Hepa1-6 tumor cells, inhibited tumor growth, and enhanced the antitumor effect of CTX. In addition, grain-sized moxibustion significantly improved the signs of CTX-induced toxicity (including weight loss, leukopenia, bone marrow suppression, and hepatotoxicity), down-regulated serum AST and ALT levels, reduced spleen and liver inflammation, and improved liver and spleen indices. Conclusion Grain-sized moxibustion can synergize with CTX to enhance the antitumor effect of CTX and alleviate its toxic and side effects. It may be a promising adjuvant therapy to chemotherapy.
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Efficacy and Safety of Moxibustion for Menopausal Obesity: A Multicentre, Randomized, Controlled Trial Protocol. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9255017. [PMID: 35966744 PMCID: PMC9371829 DOI: 10.1155/2022/9255017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 06/06/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Background. In the past, moxibustion has been widely used to treat endocrine system disorders, but evidence of its effectiveness is scarce at this point. The aim of this multicenter, randomized, controlled trial is to evaluate the efficacy and safety of treating menopausal obesity with moxibustion. Methods/Design. There are six centers taking part in this randomized, controlled, parallel trial. A total of 216 patients with menopausal obesity will be randomly divided into two equal groups: the “moxibustion for harmonization of Yin and Yang” group and the gentle moxibustion group. A 12-week study period with moxibustion will be preceded by a 1-week baseline, followed by a 12-week follow-up. We will conduct an interim analysis to determine whether or not the treatment is efficacious and safe after 216 participants have completed a 12-week treatment period. Evaluations will be conducted at weeks 0, 4, 8, 12, 18, and 24. The main outcome is waist circumference (WC), and the rate of WC reduction will be compared to the baseline. An intention-to-treat analysis will be performed with a two-sided P value of <0.05 considered significant. Participants who withdraw from the trial will be analyzed according to the intention-to-treat formula (ITT). Discussion. These results will be used to support selecting the right moxibustion prescription and guiding the improvement of clinical efficacy. This trial will provide convincing evidence of moxibustion's effectiveness and safety in the treatment of obesity by “moxibustion for harmonization of Yin and Yang,” which will be conducive to the promotion and clinical application of the theory of “moxibustion for harmonization of Yin and Yang.” Trial Registration. This trial is registered with Clinical Trials.gov: NCT04943705 (registered on June 27, 2021).
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Dai Z, Liao X, Wieland LS, Hu J, Wang Y, Kim TH, Liu JP, Zhan S, Robinson N. Cochrane systematic reviews on traditional Chinese medicine: What matters-the quantity or quality of evidence? PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 98:153921. [PMID: 35104758 PMCID: PMC9741948 DOI: 10.1016/j.phymed.2021.153921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/22/2021] [Accepted: 12/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Systematic reviews on traditional Chinese medicine (TCM) are constantly increasing. However, if these reviews are to be of practical value, the evidence needs to be relevant, valid, and adequately reported. Cochrane Systematic Reviews (CSRs) are considered as high-quality systematic reviews that can inform health care decision making. Our aim was to provide an overview of the scope, findings, quality and impact of CSRs on the benefits and harms associated with TCM interventions for the treatment and prevention of disease to provide new information for clinical practice and future research. METHODS The Cochrane Database of Systematic Reviews was searched up to May 2021, and descriptive characteristics were extracted. The correspondence between the questions asked in the CSRs and the available evidence, conclusions and certainty of findings (according to GRADE assessment), methodological quality (AMSTAR 2), and impact (Altmetric Attention Score [AAS], total citations by guideline, and total citations in Web of Science [WoS]) of CSRs were extracted. Tabular and graphical summaries of these descriptive characteristics were constructed. RESULTS Of 104 CSRs on TCM identified, 70 diseases belonged to 16 disease systems and contained 1642 primary studies with 157,943 participants. Interventions included Chinese herbal medicine (n = 70), acupuncture (n = 28), TCM exercises (n = 4), and moxibustion (n = 2). Among 1642 primary studies, 662 studies included an intervention group treated with at least one TCM therapy and 980 studies included a combination of therapies. Promising outcomes from the 104 CSRs were divided into endpoint outcomes (34 diseases), doctor- or patient-reported outcomes (27 diseases), and surrogate outcomes (37 diseases). Despite the presence of promising outcomes, only 5/104 CSRs drew overall positive conclusions, 42 CSRs concluded the evidence was insufficient, and 54 failed to draw firm conclusions. GRADE assessments were reported in 41.3% of the CSRs, and the ratings were mostly low or very low. Comparing the questions asked and results obtained, there was frequently a lack of information about specific outcomes. Only 16 CSRs obtained results for all outcomes listed in the methods section. According to AMSTAR 2, 51 CSRs (49.0%) were of low quality. The total number of citations in the WoS was 2135 (mean ± SD: 20.8 ± 21.2), and 38.5% of the CSRs had been cited in guidelines 95 times. CONCLUSION Although TCM is commonly used, evidence of its effectiveness remains largely inconclusive. Rigorous high-quality trials are needed to support the performance of high-quality reviews and to increase the evidence base. It is critical to emphasize quality over quantity in future TCM research.
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Affiliation(s)
- Zeqi Dai
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China; China Center for Evidence Based Traditional Chinese Medicine, Beijing 100700, China
| | - Xing Liao
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore MD 21201, USA
| | - Jing Hu
- Evidence-based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China
| | - Yongyan Wang
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, #23 Kyungheedae-ro, Dondaemun-gu, Seoul 02447, South Korea
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China.
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.5 Yiheyuan Road, Haidian District, Beijing 100191, China.
| | - Nicola Robinson
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, China; Institute of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK.
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Abuzenadah AM, Al-Sayes F, Mahafujul Alam SS, Hoque M, Karim S, Hussain IMR, Tabrez S. Elucidating Antiangiogenic Potential of Rauwolfia serpentina: VEGFR-2 Targeting-Based Molecular Docking Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:6224666. [PMID: 35198035 PMCID: PMC8860507 DOI: 10.1155/2022/6224666] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022]
Abstract
Angiogenesis plays a critical role in tumorigenesis as it provides the necessary blood supply to the newly grown solid tumor. It helps maintain the tumor microenvironment, promotes tumor development, progression, and metastasis. The vascular epithelial growth factor (VEGF), interacting with the tyrosine kinase receptor VEGFR-2 on endothelial cells, exerts its proangiogenic activity. Hence, targeting the VEGFR-2 signaling is considered a promising strategy to inhibit angiogenesis and thus cancer treatment. This study aims to identify the bioactive compounds derived from the medicinal herb Rauwolfia serpentina that effectively binds with VEGFR-2. The bioactive compounds of R. serpentina were first screened for their physicochemical properties using the DataWarrior program (version 5.5.0). Finally, 17 compounds that obeyed Lipinski's rule of five and showed good drug-likeness were selected for molecular docking studies. Molecular docking results showed that the ligands ajmalicidine, 1, 2-dihydrovomilenine, rauwolscine, yohimbine, ajmaline, and papaverine interact strongly with the target VEGFR-2 receptor. Hydrogen bonds and hydrophobic interactions stabilized the interactions of these compounds with VEGFR-2. These compounds showed favourable drug-like properties and possess no significant toxicity. Therefore, the findings of this study indicate that the compounds derived from R. serpentina can be considered for the development of antiangiogenic drug candidates by targeting VEGFR-2.
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Affiliation(s)
- Adel M. Abuzenadah
- Department of Medical Laboratory Science, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fatin Al-Sayes
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mehboob Hoque
- Applied Bio-Chemistry Lab, Department of Biological Sciences, Aliah University, Kolkata, India
| | - Sajjad Karim
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibtessam M. R. Hussain
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shams Tabrez
- Department of Medical Laboratory Science, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Tian JS, Zhao HL, Gao Y, Wang Q, Xiang H, Xu XP, Huang S, Yan DL, Qin XM. Branched-Chain Amino Acids Catabolism Pathway Regulation Plays a Critical Role in the Improvement of Leukopenia Induced by Cyclophosphamide in 4T1 Tumor-Bearing Mice Treated With Lvjiaobuxue Granule. Front Pharmacol 2021; 12:657047. [PMID: 34759816 PMCID: PMC8573099 DOI: 10.3389/fphar.2021.657047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 08/02/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Cyclophosphamide is a common tumor chemotherapy drug used to treat various cancers. However, the resulting immunosuppression leads to leukopenia, which is a serious limiting factor in clinical application. Therefore, the introduction of immunomodulators as adjuvant therapy may help to reduce the hematological side effects of cyclophosphamide. Lvjiaobuxue granule has been widely used in the clinical treatment of gynecological diseases such as anemia and irregular menstruation. Recently, it has been found to increase the function of white blood cells, but its mechanism of action is still unclear. We aimed to reveal the mechanisms of Lvjiaobuxue granule against acute leukopenia by an integrated strategy combining metabolomics with network pharmacology. Methods: Subcutaneously inoculated 4T1 breast cancer cells to prepare tumor-bearing mice, intraperitoneal injection of cyclophosphamide to establish a 4T1 tumor-bearing mice leukopenia animal model, using pharmacodynamic indicators, metabolomics, network pharmacology and molecular biology and other technical methods. To comprehensively and systematically elucidate the effect and mechanism of Lvjiaobuxue granule in improving cyclophosphamide-induced leukopenia in 4T1 tumor-bearing mice. Results: Lvjiaobuxue granule can improve the blood routine parameters and organ index levels of the leukopenia model of 4T1 tumor-bearing mice. Metabolomics studies revealed that 15 endogenous metabolites in the spleen of mice were considered as potential biomarkers of Lvjiaobuxue granule for their protective effect. Metabonomics and network pharmacology integrated analysis indicated that Lvjiaobuxue granule exerted the leukocyte elevation activity by inhibiting the branched-chain amino acids (BCAAs) degradation pathway and increasing the levels of valine, leucine and isoleucine. The results of molecular biology also showed that Lvjiaobuxue granule can significantly regulate the key enzymes in the catabolism of BCAAs, which further illustrates the importance of BCAAs in improving leukopenia. Conclusion: Lvjiaobuxue granule exerts obvious pharmacological effects on the leukopenia model of 4T1 tumor-bearing mice induced by cyclophosphamide, which could be mediated by regulating the branched-chain amino acid degradation pathway and the levels of valine, leucine and isoleucine.
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Affiliation(s)
- Jun-sheng Tian
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
- Jiuzhitang Co. Ltd., Changsha, China
| | - Hui-liang Zhao
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Yao Gao
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Qi Wang
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
| | - Huan Xiang
- School of Physical Education, Shanxi University, Taiyuan, China
| | | | - Sheng Huang
- Jiuzhitang Co. Ltd., Changsha, China
- School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | | | - Xue-mei Qin
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China
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Tao D, Xu J, Zou S, Tan Y, Ai S. Effect of moxibustion on quality of life after chemotherapy in patients with the malignant tumor: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e23471. [PMID: 33545928 PMCID: PMC7837930 DOI: 10.1097/md.0000000000023471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The quality of life of patients with malignant tumor can be affected by the severity and treatment of the disease. After chemotherapy, the main symptoms are gastrointestinal reactions, including nausea, vomiting, loss of appetite, and so on, and hematologic response including leukopenia, anemia, and bleeding in severe cases. Currently, moxibustion is conducted to improve the living life of patients after chemotherapy. This article will make a comprehensive and objective discussion in terms of the effect of moxibustion on quality of life after chemotherapy in patients with malignant tumors. METHODS After searching the Chinese database (CNKI, VIP, Wanfang Database, and Chinese Biomedical Database) and English database (PubMed, Embase, the Cochrane Library Web of Science), Meta-analysis was performed according to the randomized controlled trial of moxibustion after chemotherapy in patients with malignant tumors. The retrieval time was limited from the time of building the repository to October 2020. Two researchers independently conducted data extraction and quality evaluation of literature on the included studies, and RevMan5.3 was used for Meta-analysis on the included literature. RESULTS After analyzing the included literature, this study suggested that by combining chemotherapy with moxibustion, the adverse reactions such as nausea, vomiting, appetite, and insomnia can be relieved. Meanwhile, the psychological burden of patients can be alleviated to a certain extent. Therefore, moxibustion can improve the overall health level and quality of life of patients with malignant tumors. CONCLUSION This study will provide evidence-based medical evidence that moxibustion can improve the quality of life after chemotherapy and reduce chemotherapy's adverse reactions in patients with malignant tumors. ETHICS AND DISSEMINATION Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/Q5NYM.
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Affiliation(s)
- Dan Tao
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Jingyu Xu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion
| | - Shuyuan Zou
- Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Yanfu Tan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province
| | - Shuangchun Ai
- Mianyang Hospital of T.C.M, Mianyang, Sichuan Province, China
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The Combinatorial Effect of Cisplatin and Moxibustion on Tumor Growth Inhibition with Special Reference to Modulation of the Immune Microenvironment in Lewis Lung Cancer Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2020:3170803. [PMID: 33456484 PMCID: PMC7785363 DOI: 10.1155/2020/3170803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/08/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
Objective As a first-line treatment for non-small cell lung cancer (NSCLC), the efficacy of chemotherapy is still unsatisfactory. Moxibustion has been shown to improve the side effects of radiotherapy and chemotherapy and regulate immune function. This study aimed to explore the antitumor effects and potential mechanisms of combinatorial cisplatin and moxibustion treatment for NSCLC by targeting the tumor microenvironment. Methods Lewis lung cancer (LLC)-bearing mice were induced and treated with cisplatin or/and moxibustion at ST36 (Zusanli), and the growth, weight, and area of the tumor were evaluated. The numbers of various T cell subsets and myeloid cells in the tumor were assessed by flow cytometry, and the gene expression of related markers and cytokines was detected with real-time quantitative polymerase chain reaction (RT-qPCR). In addition, the tumor vascular structure was investigated using CD31 and α-smooth muscle actin (α-SMA) immunofluorescence staining. The expression of the vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1α (HIF-1α) was detected by immunohistochemical staining. Results Both cisplatin and moxibustion inhibited LLC tumor growth and reduced both the tumor area and weight, with the combinatorial therapy showing superior outcomes. Moxibustion upregulated the infiltration of CD4+ T cells and Th1 cells in the tumor, and the combinatorial therapy increased the proportion of CD8+ cytotoxic T cells (CTLs), CD4+T cells, Th1, Th9 cells, and M1 macrophages, as well as the expression of Cd69, Ifng, and Cd86 mRNA. The combinatorial therapy improved vascular normalization by increasing both the microvessel density (MVD) and pericyte coverage (α-SMA area density) and inhibiting the expression of the VEGF. Conclusions Combinatorial cisplatin and moxibustion treatment inhibited the LLC tumor growth by mechanisms related to the improvement of the tumor immune microenvironment and vascular normalization, providing an effective combinatorial therapy beneficial for patients with NSCLC.
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Ji Z, Zhang J, Menniti-Ippolito F, Massari M, Fauci AJ, Li N, Yang F, Zhang M. The quality of Cochrane systematic reviews of acupuncture: an overview. BMC Complement Med Ther 2020; 20:307. [PMID: 33054785 PMCID: PMC7556594 DOI: 10.1186/s12906-020-03099-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/29/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Many systematic reviews of clinical trials on acupuncture were performed within the Cochrane Collaboration, the evidence-based medicine (EBM) most recognized organization. Objective of the article was to systematically collect and identify systematic reviews of acupuncture published in the Cochrane Library and assess their quality from a methodological perspective. METHODS A comprehensive literature search was performed in the Cochrane Database of Systematic Reviews to identify the reviews of acupuncture conducted until June 2019. The methodological quality of the included reviews was assessed using the AMSTAR 2 checklist, an evaluation tool for systematic reviews. RESULTS Out of a total of 126 eligible reviews, 50 systematic reviews were included. According to the AMSTAR 2, 52% of Cochrane Systematic Reviews (CSRs) were of low quality, due to the presence of one or more weaknesses in at least one of the domains defined as critical for the methodological quality assessment. The less satisfied critical domain was inadequate investigation and discussion of publication bias. Declaration of potential sources of conflict of interest, and funding of the authors of the review and of the included studies were other important weaknesses. CONCLUSIONS The main methodological flaws in the included CSRs were related to topics of relatively new concern in the conduction of systematic reviews of the literature. However, both, lack of attention about retrieval of negative studies, and statements about conflict of interests are crucial point for the evaluation of therapeutic interventions according to EBM methodology.
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Affiliation(s)
- Zhaochen Ji
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | | | | | | | - Na Li
- School of Social and Political Sciences, Institute of health and wellbeing, University of Glasgow, Glasgow, UK
| | - Fengwen Yang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mingyan Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Effects of 10.6-μm laser moxibustion and electroacupuncture at ST36 in a 5-Fu-induced diarrhea rat model. Support Care Cancer 2020; 29:2561-2569. [PMID: 32959156 DOI: 10.1007/s00520-020-05788-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/16/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of 10.6-μm laser moxibustion and electroacupuncture in 5-fluorouracil (5-Fu)-induced diarrhea model rats. METHODS Forty-eight Sprague Dawley rats were randomly divided into 4 groups: a normal group, model group, 10.6-μm laser moxibustion (LM) group, and electroacupuncture (EA) group. Diarrhea was induced by 5-Fu (50 mg/kg) injection in 36 rats; the LM and EA groups received treatment at acupoint ST36 (Zusanli) on hind limbs once a day for 6 days. RESULTS 5-Fu injection caused body weight decline and diarrhea. From the 5th to 7th day, the LM group showed higher body weights than the model group (P < 0.05). On the 6th day, diarrhea score of the LM group was better than that of the EA group (P < 0.05). Both scores of the LM group and EA group were better than that of model group (P < 0.05). The LM group and EA group both had better intestine pathological scores and lower endotoxin (ET) and diamine oxide (DAO) activity than the model group (P < 0.01). The LM group got better pathological scores than the EA group (P < 0.01). Ultramicroscopic structures of the model group showed severe damage while the LM group and EA group remained good in their small intestines. The model group had obviously decreased occludin protein in intestine tissues than the control group (P < 0.01), while occludin expressions in the LM group and EA group were both obviously increased compared with the model group (P < 0.01). CONCLUSION LM and EA treatment on ST36 could alleviate damage to intestinal barrier function and alleviate diarrhea caused by 5-Fu.
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Xue N, Fu X, Zhu Y, Da N, Zhang J. Moxibustion Enhances Chemotherapy of Breast Cancer by Affecting Tumor Microenvironment. Cancer Manag Res 2020; 12:8015-8022. [PMID: 32943934 PMCID: PMC7481310 DOI: 10.2147/cmar.s249797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/04/2020] [Indexed: 01/09/2023] Open
Abstract
Introduction Chemotherapeutic drugs often cause obvious toxicity and side effects. Moxibustion can improve the immunity of cancer patients, enhance cellular immunity, and reduce the toxicity and adverse effects of radiotherapy and chemotherapy. In this study, the efficacy of moxibustion combined with paclitaxel on breast cancer was evaluated. Methods A breast cancer mouse model was established. Hematoxylin and eosin staining was used to analyze tumor necrosis in mouse tumors. Immunohistochemistry, Western blot, and qPCR were used to detect the expression of CD34, hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor A(VEGFA), programmed death-1 (PD-1), and programmed death-1 ligand (PD-L1) in tumor tissues. Results Moxibustion combined with paclitaxel significantly inhibited weight loss in breast cancer-burdened mice and increased the survival rate. Moxibustion combined with paclitaxel increased the number of white blood cells, thymus index, and spleen index, and enhanced immune function by upregulating interferon-gamma and interleukin-2 and downregulating interleukin-10 and transforming growth factor-β1. Notably, moxibustion combined with paclitaxel inhibited the angiogenesis of tumors through the downregulation of CD34, HIF-1α, and VEGFA, and overcame the immunosuppressive microenvironment by inhibiting the PD-1/PD-L1 signaling pathway. Conclusion Moxibustion improves the body’s immune function and enhances the efficacy of chemotherapy by overcoming the immunosuppressive microenvironment.
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Affiliation(s)
- Ning Xue
- Department of Acupuncture, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210017, People's Republic of China.,Department of Acupuncture, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang 212400, People's Republic of China
| | - Xingli Fu
- Jiangsu University Health Science Center, Zhenjiang 212001, People's Republic of China
| | - Yin Zhu
- Department of Oncology, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang 212400, People's Republic of China
| | - Nili Da
- Department of Acupuncture, Jurong Hospital Affiliated to Jiangsu University, Zhenjiang 212400, People's Republic of China
| | - Jianbin Zhang
- Department of Acupuncture, Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210017, People's Republic of China
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Mitochondrial Respiratory Chain and Its Regulatory Elements SIRT1 and SIRT3 Play Important Role in the Initial Process of Energy Conversion after Moxibustion at Local Skin. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2343817. [PMID: 32904439 PMCID: PMC7456489 DOI: 10.1155/2020/2343817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/04/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
Objectives To study how thermal energy is converted after moxibustion at local skin from the view of mitochondrial respiratory chain and its key regulatory elements of sirtuins 1 (SIRT1) and sirtuins 3 (SIRT3). Methods Two moxibustion temperatures usually used in clinical practice (38°C and 46°C) were applied to Zusanli (ST36) acupoint for 30 minutes in C57BL/6J mice. Local skin samples were harvested at 30 min and 72 h after moxibustion intervention, respectively. The activity of mitochondrial respiratory chain complexes I–V was detected by spectrophotometry. The expression of SIRT1 and SIRT3 protein was detected by immunofluorescence staining or western blot. Results Moxibustion at 38°C triggered more significant increase of mitochondrial respiratory chain complexes I–V expression. However, the protein expression of SIRT1 and SIRT3 at 46°C showed more obvious enhancement. In addition, the effect of mitochondrial respiratory chain complexes I–V activity on local skin of ST36 acupoint was more obvious at 30 min after moxibustion, while the expression of SIRT1 and SIRT3 protein was more significant at 72 h after moxibustion. Conclusion Mitochondrial respiratory chain and its key regulatory element proteins SIRT1 and SIRT3 play important role in the initial process of thermal energy conversion stimulated by different moxibustion temperatures in local skin.
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Gan QX, Wang J, Hu J, Lou GH, Xiong HJ, Peng CY, Huang QW. Modulation of Apoptosis by Plant Polysaccharides for Exerting Anti-Cancer Effects: A Review. Front Pharmacol 2020; 11:792. [PMID: 32536869 PMCID: PMC7267062 DOI: 10.3389/fphar.2020.00792] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022] Open
Abstract
Cancer has become a significant public health problem with high disease burden and mortality. At present, radiotherapy and chemotherapy are the main means of treating cancer, but they have shown serious safety problems. The severity of this problem has caused further attention and research on effective and safe cancer treatment methods. Polysaccharides are natural products with anti-cancer activity that are widely present in a lot of plants, and many studies have found that inducing apoptosis of cancer cells is one of their important mechanisms. Therefore, this article reviews the various ways in which plant polysaccharides promote apoptosis of cancer cells. The major apoptotic pathways involved include the mitochondrial pathway, the death receptor pathway, and their upstream signal transduction such as MAPK pathway, PI3K/AKT pathway, and NF-κB pathway. Moreover, the paper has also been focused on the absorption and toxicity of plant polysaccharides with reference to extant literature, making the research more scientific and comprehensive. It is hoped that this review could provide some directions for the future development of plant polysaccharides as anticancer drugs in pharmacological experiments and clinical researches.
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Affiliation(s)
- Qing-Xia Gan
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jin Wang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ju Hu
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guan-Hua Lou
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hai-Jun Xiong
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cheng-Yi Peng
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qin-Wan Huang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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