Astragalus
Astragalus membranaceous (huang qi)
Antineoplastic properties/amelioration of chemotherapy side effects: There is in vitro evidence that astragalus can potentiate the efficacy and reduce the adverse effects of chemotherapy via stimulation of the immune system. (1-3) Wei et al. reported that astragalus extract significantly increased in vitro cytokine secretion and gene expression in blood mononuclear cells of lung cancer patients. (4) Astragalus extracts have been shown to induce LAK cell activity in the lymphocytes of cancer and HIV patients and stimulate the blastogenic response of lymphocytes to mutagens in patients with various cancers. (5-10) Lau et al. reported that an astragalus-containing herbal combination inhibited tumor growth in vivo while augmenting macrophage and lymphokine-activated killer cell activities. (11) Treatment with astragalus-containing herbal remedies also inhibited tumor growth and prolonged survival in rats compared to rats treated with conventional chemotherapy. Other authors have reported the potentiation of interleukin-2 (IL-2)-generated cytotoxicity in animal models (5,12) and reduction of mutagenesis (13).
Astragalosides appear to exert their immunomodulatory actions via direct interaction with cellular membrane receptors. Shao et al. reported that astragalus root polysaccharide fractions activated mouse B cells and stimulated macrophage production via direct interaction between the polysaccharide fractions and TLR4 on cell surfaces. (14) Hao et al. demonstrated in rat endothelial cells that astragalus root polysaccharide fractions stimulated the adhesion between neutrophils and endothelial cells by promoting the expression of superficial I-1 on the cell surface. (15) This action would hypothetically facilitate the inflammatory response in wound healing and possibly underlie the detoxification and cellular protective actions of astragalus polysaccharides observed in several tissues. Astragalus polysaccharides also are known to increase RNA activity and protein synthesis in various tissues and increase the activity of enzymes that regulate specific cellular metabolic functions. (1) Astragalus has been shown to modulate ornithine decarboxylase activity and increase insulin-induced protein tyrosine phosphorylase activity in the livers and skeletal muscles of animal models of type 2 diabetes.
1. Zee-Cheng RK. Shi-quan-da-bu-tang (ten significant tonic decoction), SQT. A potent Chinese biological response modifier in cancer immunotherapy, potentiation and detoxification of anticancer drugs. Methods Find Exp Clin Pharmacol 1992;14(9):725-736.
2. Xu, C. J., Jian, X. C., and Cheng, H. Q. [Influence of astragalus membranaceus injection on the proliferation of rabbit bone marrow stromal cells and differentiation to osteoblast]. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2004;29(4):489-491. 16134616
3. Li, N. Q. [Clinical and experimental study on shen-qo injection with chemotherapy in the treatment of malignant tumor of digestive tract]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992;12(10):579, 588-592.
4. Wei, H., Sun, R., Xiao, W., Feng, J., Zhen, C., Xu, X., and Tian, Z. Traditional Chinese medicine Astragalus reverses predominance of Th2 cytokines and their up-stream transcript factors in lung cancer patients. Oncol Rep 2003;10(5):1507-1512.
5. Chu, D. T., Lepe-Zuniga, J., Wong, W. L., LaPushin, R., and Mavligit, G. M. Fractionated extract of Astragalus membranaceus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2. J Clin Lab Immunol 1988;26(4):183-187. 3264344
6. Chu, D., Sun, Y., Lin, J., Wong, W., and Mavligit, G. [F3, a fractionated extract of Astragalus membranaceus, potentiates lymphokine-activated killer cell cytotoxicity generated by low-dose recombinant interleukin-2]. Zhong Xi Yi Jie He Za Zhi 1990;10(1):34-6, 5. 2350835
7. Chu, D. T., Lin, J. R., and Wong, W. [The in vitro potentiation of LAK cell cytotoxicity in cancer and aids patients induced by F3--a fractionated extract of Astragalus membranaceus]. Zhonghua Zhong Liu Za Zhi 1994;16(3):167-171. 7956691
8. Jin, R., Wan, L. L., Mitsuishi, T., Kodama, K., and Kurashige, S. [Immunomodulative effects of Chinese herbs in mice treated with anti- tumor agent cyclophosphamide]. Yakugaku Zasshi 1994;114(7):533-538. 7932098
9. Sun Y, Hersh EM, Talpax M, and et al. Immune restoration and/or augmentation of local graft versus host reaction by traditional Chinese medicinal herbs. Cancer 7-1-1983;52(1):70-73. 6336578
10. Sun Y, Hersh EM, Lee S, and et al. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. Journal of Biological Response Modifiers 1983;2(3):227-237.
11. Lau, B. H., Ruckle, H. C., Botolazzo, T., and Lui, P. D. Chinese medicinal herbs inhibit growth of murine renal cell carcinoma. Cancer Biother 1994;9(2):153-161. 7812364
12. Wang, Q. [Inotropic action of Astragalus membranaceus Bge. saponins and its possible mechanism]. Zhongguo Zhong Yao Za Zhi 1992;17(9):557-559 (inside backcover). 1292500
13. Wong, B. Y., Lau, B. H., Tadi, P. P., and Teel, R. W. Chinese medicinal herbs modulate mutagenesis, DNA binding and metabolism of aflatoxin B1. Mutat Res 6-1-1992;279(3):209-216.
14. Shao, B. M., Xu, W., Dai, H., Tu, P., Li, Z., and Gao, X. M. A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochem Biophys Res Commun 8-6-2004;320(4):1103-1111.
15. Hao, Y., Qiu, Q. Y., and Wu, J. [Effect of Astragalus polysaccharides in promoting neutrophil-vascular endothelial cell adhesion and expression of related adhesive molecules]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2004;24(5):427-430.
Cancer
Breast cancer. There is preliminary evidence that adjunctive use of astragalus in combination with glossy privet (Ligustrum lucidum) might increase survival rates in patients being treated conventionally for breast cancer (1). The applicable part of astragalus is the root. Astragalus contains a variety of active constituents including more than 40 saponins such as astragaloside, several flavonoids including isoflavones, pterocarpans, and isoflavans, polysaccharides, multiple trace minerals, amino acids, and coumarins (1,2). Astragalus seems to restore in vitro T-cell function which is suppressed in cancer patients (3,4).
1. Upton R, ed. Astragalus Root: Analytical, quality control, and therapeutic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia. 1999:1-25.
2. McCulloch M, See C, Shu XJ, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials. J Clin Oncol 2006;24:419-30.
3. Sun Y, Hersh EM, Talpaz M, et al. Immune restoration and/or augmentation of local graft versus host reaction by traditional Chinese medicinal herbs. Cancer 1983;52:70-3.
4. Chu DT, Wong WL, Mavligit GM. Immunotherapy with Chinese medicinal herbs. I. Immune restoration of local xenogeneic graft-versus-host reaction in cancer patients by fractionated Astragalus membranaceus in vitro. J Clin Lab Immunol 1988;25:119-23.
Ai Di injection (mainly Radix Ginseng, Radix Astragali, Radix Acanthopanacis senticosi, Mylabris)
W.C.S. Cho (ed.), Supportive Cancer Care with Chinese Medicine, 271. DOI 10.1007/978-90-481-3555-4_11
Aidi Injection on the Impact of Immunity and Quality of Life in Patients with Malignant Tumor (http://www.tumorres.com/tumor-marker/17045.htm)
Objective:
Immunology research has shown that the generate, development and prognosis of tumor are related closely to immunity. In this study, peripheral blood of patients is measured to understand T cell subsets, B lymphocytes and NK cell levels of tumor patients. And to study the Aidi injection on the impact of T lymphocyte subsets, B lymphocytes and NK cell levels in peripheral blood of tumor patients.At the same time, Aidi injection were observed the effect on the quality of life, bone marrow suppression and gastrointestinal reaction of cancer patients.
Methods:
60 tumor patients who are confirmed by cytology and histopathology, exclude people with autoimmune diseases, immune deficiency, hypersensitivity disease or recent patients receiving immunosuppressive therapy and all the patients were selected from Tianjin Nankai Hospital during May 2009 to February 2010. Selecting 30 healthy subjects as control group were measured in peripheral blood T lymphocyte subsets, B lymphocytes and NK cell level for statistical comparison; 46 tumor patients who received surgery treatment were randomly divided into two groups, one group received chemotherapy alone,another group of chemotherapy based on Aidi injection treatment.Collecting to determine T lymphocyte subsets, B lymphocytes and NK cell levels for statistical comparisons after two courses of peripheral blood. We also observe the effect of Aidi injection on quality of life of patients and bone marrow suppression and gastrointestinal.
Results:
Healthy subjects CD3+, CD4+T lymphocyte levels and CD4+/CD8+ significantly higher than the tumor group (P<0.01); B lymphocytes and NK cells was higher than tumor group, the difference was statistically significant (P< 0.05); healthy subjects peripheral blood CD8+ cells was significantly lower than the tumor group (P<0.05).2 After two cycles of chemotherapy, chemotherapy combined with Aidi group after treatment was higher than in peripheral blood CD3+ chemotherapy group, the difference was statistically significant (P<0.05); peripheral blood CD4+T lymphocyte levels and CD4+/CD8+ significantly higher than the chemotherapy alone group (P<0.01); CD8+T lymphocyte levels of the two groups after treatment, no significant statistical difference (P>0.05); B lymphocytes and NK cell levels in Aidi group was slightly higher than the chemotherapy group, however, no statistically significant difference (P>0.05). Eddie was the treatment group after two courses3 Aidi group patients who were treated after two courses, KPS increased in 17 cases, no change in 3 cases, the deterioration in 3 cases. Patients treatment KPS increased in 10 cases, no change in 8 cases, the general deterioration in 5 patients after chemotherapy. The statistics revealed that the two groups KPS showed significant difference(χ2=4.39, P<0.05); Aidi group and the chemotherapy group was no significant difference in body weight (χ2=0.35, P>0.05)4 Aidi group leukopenia rate was 43.48%,Ⅲ,Ⅳdegree of inhibition rate was 8.70%, and leukopenia in chemotherapy group rate was 73.91%,Ⅲ,Ⅳdegree of bone marrow inhibition rate was 21.73%, leukopenia rate between the two groups was significant difference (χ2=4.39, P<0.05), while the two groupsⅢ,Ⅳdegree of bone marrow suppression was no significant difference in the incidence of significant (χ2=0.67, P>0.05). Aidi group and the chemotherapy group of hemoglobin, the incidence of thrombocytopenia andⅢ,Ⅳdegree of bone marrow suppression was no significant difference in the incidence of significant (P>0.05).5 Aidi group the incidence of gastrointestinal symptoms compared with the chemotherapy alone group had no significant statistical difference (χ2= 0.89, P> 0.05), but Aidi groupⅢ,Ⅳdegree of gastrointestinal tract were significantly lower than the chemotherapy alone group difference between two groups was statistically significant (χ2=3.60, P<0.05).Conclusion:1 Immune function in patients with malignant tumors was significantly lower than healthy people.
Aidi injection can improve immune function in patients with malignant tumors. Aidi injection can improve the quality of life of cancer patients. Aidi injection can significantly reduce the side effects produced by chemotherapy, systemic chemotherapy in patients w ith increased tolerance.
Ma WH, Duan KN, Feng M, She B, Chen Y, Zhang RM. Aidi Injection as an adjunct therapy for non-small cell lung cancer: a systematic review. J Chin Integr Med / Zhong Xi Yi Jie He Xue Bao. 2009; 7(4): 315-324. DOI: 10.3736/jcim20090404
Abstract
OBJECTIVE:
To assess methodological quality of clinical studies using Aidi Injection as an adjunct therapy for non-small cell lung cancer (NSCLC) and to evaluate the effects of Aidi Injection.
METHODS:
PubMed (1980-2008), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), EMBASE (1984-2008), CancerLit (1996-2003), CBMdisc (1980-2008), CNKI database (1980-2008), Wanfang database (1980-2008), and Chongqing VIP database (1980-2008) were searched. The authors also hand-searched Chinese periodicals potentially related to the question. All randomized controlled trials comparing Aidi Injection with other treatment methods of NSCLC were included. Two reviewers selected studies, assessed the quality of studies, and extracted the data independently. The included studies were appraised and analyzed by Cochrane Collaboration Review Manager 5.0.
RESULTS:
Fourteen randomized controlled trials were included in the meta-analysis, but the quality of reports of the 14 included studies was poor. Aidi Injection combined with cobalt-60 or navelbine and platinol (NP) showed statistically significant differences in improving the response rate as compared with single use of cobalt-60 (P=0.000 2) or NP (P=0.04), and the relative risk (RR) and 95% confidence interval (CI) were 1.93 [1.36, 2.72] and 1.18 [1.00, 1.38], respectively. However, Aidi Injection combined with etoposide and platinol (EP), taxinol and platinol (TP) or gamma knife showed no significant differences as compared with single use of EP (P=0.60), TP (P=0.16) or gamma knife (P=0.34), respectively. The RR and 95% CI of EP, TP and gamma knife were 1.17 [0.65, 2.09], 1.27 [0.91, 1.78] and 1.08 [0.92, 1.26] respectively. Six studies indicated that Aidi Injection combined with NP or gamma knife could improve the quality of life.Six studies showed that Aidi Injection combined with NP or TP could improve the bone marrow hematopoietic function.Three studies indicated that Aidi Injection combined with NP could improve the immune function. Three studies showed that the combined therapy could not improve 1-, 2-, and 3-year survival rates.
CONCLUSION:
The results of meta-analysis indicate that Aidi Injection may have adjuvant therapeutic effects in treatment of NSCLC patients, but the sample size is too small and with poor quality, and the existence of publication bias is found.The effects of Aidi Injection need to be confirmed by large multicenter randomized controlled trials.
Li HJ, Dong L, Fu SY. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007 Dec;27(12):1086-9. Comparative study on treatment of advanced colorectal cancer by Aidi injection combined with FOLFOX4 regimen and by FOLFOX4 regimen alone
OBJECTIVE:
To evaluate the therapeutic efficacy and adverse reaction of Aidi Injection (ADI) combined with FOLFOX4 regimen for treatment of patients with advanced colorectal cancer, and controlled with those of FOLFOX4 regimen alone.
METHODS:
One hundred and seventeen patients were randomized into two groups. All received FOLFOX4 regimen, i.e. Oxaliplatin 85 mg/m2 intravenous dripping in 2 h on day 1, leucovorin CF 200 mg/m2 intravenous dripping and 5-FU 400 mg/m2 intravenous injection followed with 600 mg/m2 continuous infusion by micro-pump in 22 h on day 1 and 2, 14 days as one cycle. Besides, to the treatment group (65 patients), ADI was administered additionally by adding 60 mL ADI in 250 mL 5% glucose for intravenous dripping every day for 10 successive days, while to the control group (52 patients), no additional medication was given.
RESULTS:
The response rate in the treatment group was 44.62%, and in the control group 30.77% (P = 0.126), the KPS score improving rate in the two groups was 66.15% and 40.38% respectively (P = 0.005), the 1-year survival rate was 53.85% and 40.38% respectively (P = 0.148), and the adverse reaction presented in the treatment group was greatly less than that in the control group (P < 0.05).
CONCLUSION:
ADI in combining with FOLFOX4 regimen can enhance the efficacy, reduce the adverse reaction of chemotherapy in treating advanced colorectal cancer, and could also improve the quality of life and prolong the survival time of patients.
Zhang H, Zhou QM, Lu YY, Du J, Su SB. Aidi injection alters the expression profiles of microRNAs in human breast cancer cells. J Tradit Chin Med. 2011 Mar;31(1):10-6.
OBJECTIVE:
To investigate the effects of Aidi Injection on the MicroRNAs (miRNA) expression profiles in human breast cancer cells and explore the potential targets of the cancer treatment.
METHODS:
MCF-7 breast cancer cells were grown in RPMI 1640 medium supplemented with different concentrations of ADI. The inhibition of cell proliferation was measured by MTT assay. MCF-7 cells were treated by ADI with above 50% inhibiting concentration (IC50) for 48 h. The expression profiles of miRNA in ADI-treated and ADI-untreated MCF-7 cells were detected with miRNA microarray chips and the array data were verified by quantitative RT-PCR. MCF-7 cells were transiently transfected with miRNA mimics by liposome method. Potential mRNA targets were predicted by informatics analysis with TargetScan and PicTar software.
RESULTS:
ADI significantly inhibited the proliferation of MCF-7 cells in a dose-dependent manner. The IC50 of ADI was 55.71 mg/mL after treatment for 48 h. The 60 mg/mL ADI was used as the therapeutic drug concentration. Microarray analysis identified 45 miRNAs that were up-regulated and 55 miRNAs that were down-regulated in response to ADI treatment. Many ADI-induced miRNAs were related to breast cancers. The microarray data were validated by qRT-PCR. Ectopic expression of 100 nmol/L mir-126 mimics significantly inhibited the proliferation of MCF-7 cells. The 12 potential target genes of mir-126 were predicted by both TargetScan and PicTar software.
CONCLUSIONS:
The miRNA may serve as therapeutic targets, and the modulation of miRNA expression is an important mechanism of ADI inhibiting breast cancer cell growth.