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Lai H, Yang P, Wang XS, Lim D, Lam A, Shi Y, Huang Y, Zhu X. Are Published Cancer Care Trial Protocols With Traditional Chinese Medicine Interventions Concordant With SPIRIT-TCM Extension 2018? A Scoping Review on Published Trial Protocols Between 2019 and 2022. Integr Cancer Ther 2024; 23:15347354231223966. [PMID: 38291957 PMCID: PMC10832418 DOI: 10.1177/15347354231223966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/31/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The SPIRIT-TCM Extension 2018 was created to guide the design and reporting of Traditional Chinese Medicine (TCM) clinical trial protocols. This study aims to investigate the extent of concordance with this guideline in the relevant field of cancer care research. METHODS A scoping review of TCM cancer trial protocols published in English and Chinese since January 2019 was conducted. Five major academic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, and China National Knowledge Infrastructure) were searched. Concordance with the SPIRIT-TCM Extension 2018 was assessed by descriptive analysis. RESULTS Fifty-three TCM cancer care trial protocols were identified, comprising 23 acupuncture, 26 Chinese herbal medicine (CHM), and 4 Tai Chi/Qigong (TCQ) interventions. The majority of the checklist items had a low rate of concordance, especially in the reporting of quality control and safety, dosage, TCM diagnostic patterns, possible interactions between Western Medicine and TCM interventions, and TCM-related outcome assessments. CONCLUSIONS Although the SPIRIT-TCM Extension 2018 guideline was established through extensive Delphi consultation, there are low rates of concordance between published TCM cancer care clinical trial protocols with the guideline. Further research is necessary to understand the low rate of concordance and how scientific rigors of reporting can be improved in TCM cancer care research.
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Affiliation(s)
- Hezheng Lai
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, Campbelltown, NSW, Australia
| | - Peiying Yang
- University of Texas, MD Anderson Cancer Centre, Houston, Houston, TX, USA
| | - Xin Shelley Wang
- University of Texas, MD Anderson Cancer Centre, Houston, Houston, TX, USA
| | - David Lim
- University of Technology Sydney, Ultimo, NSW, Australia
- Mparntwe Center for Evidence in Health: A JBI Center of Excellence, Alice Spring, NT, Australia
| | - Anderson Lam
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, Campbelltown, NSW, Australia
| | - Yucong Shi
- Jinan University, Guangzhou, Guangdong, China
| | - Yishi Huang
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, Campbelltown, NSW, Australia
- The University of Melbourne, Parkville, VIC, Australia
| | - Xiaoshu Zhu
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, Campbelltown, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
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Chen Z, Dong Y, Yan Q, Li Q, Yu C, Lai Y, Tan J, Fan M, Xu C, Li L, Shen W, Gu J, Cheng H, Sun D. Liquid chromatography-tandem mass spectrometry analysis of a ratio-optimized drug pair of Sophora flavescens Aiton and Coptis chinensis Franch and study on the mechanism of anti-colorectal cancer effect of two alkaloids thereof. Front Oncol 2023; 13:1198467. [PMID: 37404762 PMCID: PMC10316516 DOI: 10.3389/fonc.2023.1198467] [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: 04/01/2023] [Accepted: 05/15/2023] [Indexed: 07/06/2023] Open
Abstract
The drug pair consisting of Sophora flavescens Aiton (Sophorae flavescentis radix, Kushen) and Coptis chinensis Franch. (Coptidis rhizoma, Huanglian), as described in Prescriptions for Universal Relief (Pujifang), is widely used to treat laxation. Matrine and berberine are the major active components of Kushen and Huanglian, respectively. These agents have shown remarkable anti-cancer and anti-inflammatory effects. A mouse model of colorectal cancer was used to determine the most effective combination of Kushen and Huanglian against anti-colorectal cancer. The results showed that the combination of Kushen and Huanglian at a 1:1 ratio exerted the best anti-colorectal cancer effect versus other ratios. Moreover, the anti-colorectal cancer effect and potential mechanism underlying the effects of matrine and berberine were evaluated by the analysis of combination treatment or monotherapy. In addition, the chemical constituents of Kushen and Huanglian were identified and quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of 67 chemical components were identified from the Kushen-Huanglian drug pair (water extraction), and the levels of matrine and berberine were 129 and 232 µg/g, respectively. Matrine and berberine reduced the growth of colorectal cancer and relieved the pathological conditions in mice. In addition, the combination of matrine and berberine displayed better anti-colorectal cancer efficacy than monotherapy. Moreover, matrine and berberine reduced the relative abundance of Bacteroidota and Campilobacterota at phylum level and that of Helicobacter, Lachnospiraceae_NK4A136_group, Candidatus_Arthromitus, norank_f_Lachnospiraceae, Rikenella, Odoribacter, Streptococcus, norank_f_Ruminococcaceae, and Anaerotruncus at the genus level. Western blotting results demonstrated that treatment with matrine and berberine decreased the protein expressions of c-MYC and RAS, whereas it increased that of sirtuin 3 (Sirt3). The findings indicated that the combination of matrine and berberine was more effective in inhibiting colorectal cancer than monotherapy. This beneficial effect might depend on the improvement of intestinal microbiota structure and regulation of the RAS/MEK/ERK-c-MYC-Sirt3 signaling axis.
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Affiliation(s)
- Zihan Chen
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yingying Dong
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Qiuying Yan
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Qin Li
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chengtao Yu
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Yueyang Lai
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Jiani Tan
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Minmin Fan
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Changliang Xu
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Liu Li
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Weixing Shen
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Junfei Gu
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haibo Cheng
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
| | - Dongdong Sun
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Collaborative Innovation Center of Traditional Chinese Prevention and Treatment of Tumor Research Center for Theory and Application of Cancer Toxin Pathogenesis, Nanjing, China
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