Botanicals used in complementary and alternative medicine treatment of cancer: clinical science and future perspectives

Prospects and potentials of underutilized leafy Amaranths as vegetable use for health-promotion

Climate change causes environmental variation worldwide, which is one of the most serious threats to global food security. In addition, more than 2 billion people in the world are reported to suffer from serious malnutrition, referred to as 'hidden hunger.' Dependence on only a few crops could lead to the loss of genetic diversity and high fragility of crop breeding in systems adapting to global scale climate change. The exploitation of underutilized species and genetic resources, referred to as orphan crops, could be a useful approach for resolving the issue of adaptability to environmental alteration, biodiversity preservation, and improvement of nutrient quality and quantity to ensure food security. Moreover, the use of these alternative crops will help to increase the human health benefits and the income of farmers in developing countries. In this review, we highlight the potential of orphan crops, especially amaranths, for use as vegetables and health-promoting nutritional components. This review highlights promising diversified sources of amaranth germplasms, their tolerance to abiotic stresses, and their nutritional, phytochemical, and antioxidant values for vegetable purposes. Betalains (betacyanins and betaxanthins), unique antioxidant components in amaranth vegetables, are also highlighted regarding their chemodiversity across amaranth germplasms and their stability and degradation. In addition, we discuss the physiological functions, antioxidant, antilipidemic, anticancer, and antimicrobial activities, as well as the biosynthesis pathway, molecular, biochemical, genetics, and genomic mechanisms of betalains in detail.

Cellular senescence and cancer: Focusing on traditional Chinese medicine and natural products

Cancer is the principal cause of death and a dominant public health problem which seriously threatening human life. Among various ways to treat cancer, traditional Chinese medicine (TCM) and natural products have outstanding anti‐cancer effects with their unique advantages of high efficiency and minimal side effects. Cell senescence is a physiological process of cell growth stagnation triggered by stress, which is an important line of defence against tumour development. In recent years, active ingredients of TCM and natural products, as an interesting research hotspot, can induce cell senescence to suppress the occurrence and development of tumours, by inhibiting telomerase activity, triggering DNA damage, inducing SASP, and activating or inactivating oncogenes. In this paper, the recent research progress on the main compounds derived from TCM and natural products that play anti‐cancer roles by inducing cell senescence is systematically reviewed, aiming to provide a reference for the clinical treatment of pro‐senescent cancer.

Synthesis of TPGS/Curcumin Nanoparticles by Thin-Film Hydration and Evaluation of Their Anti-Colon Cancer Efficacy In Vitro and In Vivo

Curcumin (CCM) has many potential uses in anticancer chemotherapy, but its low water solubility poses a major problem, preventing its translation into clinical use. TPGS is a water-soluble derivative of vitamin E that acts as a surfactant with the ability to form micellar nanoparticles in water. More importantly, TPGS acts as a potent antioxidant that can neutralize intracellular reactive oxygen species (ROS). In this study, we solubilized CCM with TPGS using thin-film rehydration to prepare aqueous formulations containing CCM at clinically relevant concentrations. We found that the minimal TPGS:CCM ratio for producing nanoparticles was 5:1 (w/w): at or above this ratio, stable nanoparticles formed with an average particle diameter of 12 nm. CCM was released from TPGS/CCM micelles in simulated colonic and gastric fluids. These TPGS/CCM nanoparticles were shown to decrease intracellular ROS levels and apoptosis and inhibited migration of HT-29 human colon cancer cells more potently than free CCM. Pharmacokinetic analysis showed TPGS/CCM to be more bioavailable than free CCM after oral administration to rats. Our results suggest that TPGS/CCM may increase therapeutic efficacy of CCM against colon cancer and merits further investigation in a clinical setting.

Tianshengyuan-1 (TSY-1) regulates cellular Telomerase activity by methylation of TERT promoter

Telomere and Telomerase have recently been explored as anti-aging and anti-cancer drug targets with only limited success. Previously we showed that the Chinese herbal medicine Tianshengyuan-1 (TSY-1), an agent used to treat bone marrow deficiency, has a profound effect on stimulating Telomerase activity in hematopoietic cells. Here, the mechanism of TSY-1 on cellular Telomerase activity was further investigated using HL60, a promyelocytic leukemia cell line, normal peripheral blood mononuclear cells, and CD34+ hematopoietic stem cells derived from umbilical cord blood. TSY-1 increases Telomerase activity in normal peripheral blood mononuclear cells and CD34+ hematopoietic stem cells with innately low Telomerase activity but decreases Telomerase activity in HL60 cells with high intrinsic Telomerase activity, both in a dose-response manner. Gene profiling analysis identified Telomerase reverse transcriptase (TERT) as the potential target gene associated with the TSY-1 effect, which was verified by both RT-PCR and western blot analysis. The β-galactosidase reporter staining assay showed that the effect of TSY-1 on Telomerase activity correlates with cell senescence. TSY-1 induced hypomethylation within TERT core promoter in HL60 cells but induced hypermethylation within TERT core promoter in normal peripheral blood mononuclear cells and CD34+ hematopoietic stem cells. TSY-1 appears to affect the Telomerase activity in different cell lines differently and the effect is associated with TERT expression, possibly via the methylation of TERT promoter.

Targeting FASN in Breast Cancer and the Discovery of Promising Inhibitors from Natural Products Derived from Traditional Chinese Medicine

Molecular targeted therapy has been developed for cancer chemoprevention and treatment. Cancer cells process a fundamental change in its bioenergetic metabolism from normal cells on an altered lipid metabolism, also known as the de novo fatty acid synthesis, for sustaining their high proliferation rates. Fatty acid synthesis is now associated with clinically aggressive tumor behavior and tumor cell growth and has become a novel target pathway for chemotherapy development. Although the underlying mechanisms of the altered de novo fatty acid synthesis still remains unclear, recent progress has shown that by targeting Fatty acid synthase (FASN), a key enzyme that catalyzes the synthesis of endogenous long chain fatty acid could be a critical target for drug discovery. However, relatively few FASN inhibitors have been discovered. With the long history of clinical practices and numerous histological case study reports, traditional Chinese medicine enjoys an important role in seeking bioactive anticancer natural compounds. Herein, we will give an overall picture of the current progress of molecular targeted therapy in cancer fatty acid synthesis, describe the advances in the research on natural products-derived FASN inhibitors and their potential for enhancing our understanding of fatty acids in tumor biology, and may provide new therapeutic moieties for breast cancer patient care.

Ganoderma lucidum spore induced CA72-4 elevation in gastrointestinal cancer: a five-case report

GANODERMA LUCIDU

spore (GLS), an over-the-counter herbal supplement, is widely used by cancer patients in China. Although preclinical studies have shown it to be safe, complete safety data on GLS is still lacking. In this article, we report 5 cases of gastrointestinal cancer that were treated with GLS plus multiple strategies between 2010 and 2011. These patients presented with increased levels of the serum tumor marker CA72-4, one of the most valuable markers for monitoring therapeutic response in patients receiving gastrointestinal cancer treatment, after oral ingestion of GLS twice a day for 1 or 2 months. Interestingly, CA72-4 rapidly returned to normal levels when the patients discontinued the supplement and no change in clinical symptoms accompanied the CA72-4 surge. Taking into consideration that the underlying mechanism of this reaction is obscure, we suggest that additional studies are urgently needed and GLS be used with caution in cancer patients.

Use of complementary and alternative medicine by patients with cancer in Saudi Arabia

BACKGROUND

The use of complementary and alternative medicine (CAM) is common among patients with cancer. However, the issue is not well-studied among the Saudi patient population. Our study aimed at determining the patterns of CAM use among patients with cancer in Saudi Arabia.

METHODS

A cross-sectional study using interview-administered questionnaire was conducted in patients with cancer in the Oncology Department of King Abdulaziz Medical City for National Guards, Riyadh, Kingdom of Saudi Arabia. Patients were asked about CAM use including dietary supplement (DS) and non-DS remedies. Univariate and multivariate analyses were conducted to identify predicting factors for CAM use.

RESULTS

A total of 453 adult patients were enrolled in the study, with a median age of 53.5 years (14.7-94.6), and the ratio of females to males was 271/182 (59.8%/40.2%). Of those, 410 patients (90.5%) used some type of CAM remedy. Non-DS remedies were used by 399 patients (88%) and were mainly of a religious nature including reciting the Quran (74.8%), prayer (16%), supplication (13%), and others (3.7%). However, 386 patients (85.2%) used DS including: Zamzam water (59.8%), honey (54.3%), black seed (35.1%), water with the Quran recited over it (29.8%), and other remedies. The majority of patients (90%) used CAM as a cancer treatment and the rest used it for various reasons, such as symptom control or supportive treatment. Only 18% of the patients discussed CAM use with their physicians, compared to 68% discussing it with religious clergypeople (Sheikhs).The univariate analysis revealed that only female gender is a predictor of CAM use, which remained significant in a multivariate analysis, in addition to current employment.

CONCLUSIONS

The use of complementary therapies among Saudi patients with cancer is highly prevalent, with a predominance of interventions of religious background, indicating the strong influence of religion on peoples' lives, especially when people are faced with life-threatening illnesses.

Emerging glycolysis targeting and drug discovery from chinese medicine in cancer therapy

Molecular-targeted therapy has been developed for cancer chemoprevention and treatment. Cancer cells have different metabolic properties from normal cells. Normal cells mostly rely upon the process of mitochondrial oxidative phosphorylation to produce energy whereas cancer cells have developed an altered metabolism that allows them to sustain higher proliferation rates. Cancer cells could predominantly produce energy by glycolysis even in the presence of oxygen. This alternative metabolic characteristic is known as the “Warburg Effect.” Although the exact mechanisms underlying the Warburg effect are unclear, recent progress indicates that glycolytic pathway of cancer cells could be a critical target for drug discovery. With a long history in cancer treatment, traditional Chinese medicine (TCM) is recognized as a valuable source for seeking bioactive anticancer compounds. A great progress has been made to identify active compounds from herbal medicine targeting on glycolysis for cancer treatment. Herein, we provide an overall picture of the current understanding of the molecular targets in the cancer glycolytic pathway and reviewed active compounds from Chinese herbal medicine with the potentials to inhibit the metabolic targets for cancer treatment. Combination of TCM with conventional therapies will provide an attractive strategy for improving clinical outcome in cancer treatment.

Transcatheter arterial chemoembolization combined with or without Chinese herbal therapy for hepatocellular carcinoma: meta-analysis

OBJECTIVE

Chinese herbal therapy is sometimes used in conjunction with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) in Asian countries. This study aims to systemically review the efficacy of Chinese herbal therapy in HCC patients receiving TACE.

METHODS

Meta-analysis was performed for clinical trials comparing Chinese herbal therapy versus no Chinese herbal therapy given to HCC patients receiving TACE. Publications in 10 electronic databases were extensively searched.

RESULTS/CONCLUSION

Chinese herbal therapy was associated with a significant rise in the number of patients with survival > 1-year, 2-year and 3-year, as well as a significant rise in the number of patients who reported complete or partial response and non-deterioration performance status. Chinese herbal therapy also showed significant efficacies in the increase of T cells and natural killer cells, whereas a significant lower blood alpha-fetoprotein concentration was reported. There were a significant increase in white blood cell count, a significant lower risk in patients with nausea and vomiting, and a significant rise in patients with increased body weight when Chinese herbal therapy was given. The evidence from this review supports the use of Chinese herbal therapy to enhance the efficacy of TACE in HCC patients. However, owing to limited data and heterogeneity of the included studies, further trials are required.