Shengmai San for Treatment of Cardiotoxicity from Anthracyclines: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically evaluate the efficacy of Shengmai San in patients with cardiotoxicity of anthracyclines. METHODS: Randomized controlled trials (RCTs) were identified by searching China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), PubMed, Cochrane Library, and Embase Databases from the inceptions until December 2020. The Cochrane Handbook was used to evaluate the risk of bias in the included studies. Data analysis was conducted using RevMan 5.3 software. RESULTS: Totally 19 RCTs with 2,331 participants were included in this review. Results showed that in improving arrhythmia (13 RCTs, n=1,877, RR=0.37, 95%CI 0.25 to 0.52, P<0.00001), the treatment group was superior to the control group. In terms of reducing left ventricular end-diastolic diameter (LVEDD, 2 RCTs, n=128, MD=-0.79, 95%CI -0.93 to -0.65, P<0.00001) and left ventricular end systolic diameter (LVESD, 2 RCTs, n=128, MD=-0.58, 95%CI -0.82 to -0.35, P<0.00001), the treatment group was also better than the control group. In reducing myocardial enzymes such as creatine kinase (CK) [(3 RCTs, n=256, SMD=-0.80, 95%CI -1.16 to -0.44, P<0.0001), (2 RCTs, n=126, SMD=-0.62, 95%CI -0.98 to -0.26, P=0.0007)], the treatment group was superior to the control group. CONCLUSION: Shengmai San has a positive effect on the treatment of cardiotoxicity from anthracyclines. However, in the future, it is still necessary to conduct high-quality RCTs to verify its efficacy.

Cytotoxic genes from traditional Chinese medicine inhibit tumor growth both in vitro and in vivo.

OBJECTIVE: Little effort has been made to study the protein-encoding genes isolated from traditional Chinese medicine (TCM) drugs, and the delivery of these genes into malignant cells through recombinant adeno-associated virus (rAAV) vectors has not been attempted. METHODS: We synthesized the cDNAs of five known cytotoxic proteins isolated from TCM drugs and the FLAG epitope-tagged cDNAs were subcloned into a rAAV plasmid vector. The protein expression was confirmed by Western blot assay. Various cancer cell lines were transfected with the above plasmids and cell growth was monitored both in vitro and in vivo. The best cytotoxic gene was further packaged into rAAV vectors, under the control of a liver cancer-specific promoter. The liver tumor growth was then monitored following intratumor administration of the rAAV vectors. RESULTS: The expression plasmids, encoding individual potential cytotoxic genes tagged with FLAG epitope, were successfully generated and sequenced. Among these genes, trichosanthin (TCS) gene yielded the most promising results for the inhibition of cancer cell growth in vitro. The over-expressed TCS functioned as a type I ribosome-inactivating protein, followed by inducing apoptosis that is associated with the Bcl-PARP signaling pathway. Furthermore, intratumor injection of rAAV vectors containing the TCS gene significantly inhibited the growth of human hepatocellular carcinoma tumors in a murine xenograft model. CONCLUSION: Our studies suggest that the use of TCM cytotoxic genes is a useful therapeutic strategy for treating human cancers in general, and liver tumors in particular.

The roles of traditional Chinese medicine in gene therapy.

The field of gene therapy has been increasingly studied in the last four decades, and its clinical application has become a reality in the last 15 years. Traditional Chinese medicine (TCM), an important component of complementary and alternative medicine, has evolved over thousands of years with its own unique system of theories, diagnostics and therapies. TCM is well-known for its various roles in preventing and treating infectious and chronic diseases, and its usage in other modern clinical practice. However, whether TCM can be applied alongside gene therapy is a topic that has not been systematically examined. Here we provide an overview of TCM theories in relation to gene therapy. We believe that TCM theories are congruent with some principles of gene therapy. TCM-derived drugs may also act as gene therapy vehicles, therapeutic genes, synergistic therapeutic treatments, and as co-administrated drugs to reduce side effects. We also discuss in this review some possible approaches to combine TCM and gene therapy.

Pristimerin enhances recombinant adeno-associated virus vector-mediated transgene expression in human cell lines in vitro and murine hepatocytes in vivo.

OBJECTIVE: In the present study, we systemically evaluated the ability of two bioactive compounds from traditional Chinese medicine, celastrol and pristimerin, to enhance recombinant adeno-associated virus (rAAV) serotype vector-mediated transgene expression both in human cell lines in vitro, and in murine hepatocytes in vivo. METHODS: Human cell lines were infected with rAAV vectors with either mock treatment or treatment with celastrol or pristimerin. The transgene expression, percentage of nuclear translocated viral genomes and the ubiquitination of intracellular proteins were investigated post-treatment. In addition, nonobese diabetic/severe combined immunodeficient gamma (NSG) mice were tail vain-injected with rAAV vectors and co-administered with either dimethyl sulfoxide, celastrol, pristimerin or a positive control, bortezomib. The transgene expression in liver was detected and compared over time. RESULTS: We observed that treatment with pristimerin, at as low as 1 µmol/L concentration, significantly enhanced rAAV2 vector-mediated transgene expression in vitro, and intraperitoneal co-administration with pristimerin at 4 mg/(kg·d) for 3 d dramatically facilitated viral transduction in murine hepatocytes in vivo. The transduction efficiency of the tyrosine-mutant rAAV2 vectors as well as that of rAAV8 vectors carrying oversized transgene cassette was also augmented significantly by pristimerin. The underlying molecular mechanisms by which pristimerin mediated the observed increase in the transduction efficiency of rAAV vectors include both inhibition of proteasomal degradation of the intracellular proteins and enhanced nuclear translocation of the vector genomes. CONCLUSION: These studies suggest the potential beneficial use of pristimerin and pristimerin-containing herb extract in future liver-targeted gene therapy with rAAV vectors.

[Analysis of Chinese medical syndrome features of patients with primary liver cancer before and after transcatheter arterial chemoembolization].

OBJECTIVE: To observe the Chinese medical syndrome features of patients with primary liver cancer before and after transcatheter arterial chemoembolization (TACE). METHODS: Recruited were 106 primary liver cancer (PLC) patients treated with TACE at the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi Medical University from May to November 2009. Using self-control study, the distributions of 8 syndrome types were compared, such as qi stagnation syndrome, blood stasis syndrome, excess-heat syndrome, fluid and damp syndrome, qi deficiency syndrome, blood deficiency syndrome, yin deficiency syndrome, and yang deficiency syndrome. The scoring for each syndrome quantization was performed to all patients before and after TACE. RESULTS: Eight syndromes occurred in the 106 patients before treatment, amounting to 412 cases. The proportions of syndrome types in PLC patients before TACE were ranked from high to low as blood stasis syndrome [(92 cases, 86.8%)], excess-heat syndrome [(73 cases, 68.9%)], qi stagnation syndrome [(62 cases, 58.5%)], qi deficiency syndrome [(62 cases, 58.5%)], yin deficiency syndrome [(60 cases, 56.6%)], blood deficiency syndrome [(30 cases, 28.3%)], yang deficiency syndrome [(18 cases, 17.0%)], fluid and damp syndrome [(15 cases, 14.2%)]. The 8 syndromes occurred in 456 cases after TACE. The proportions of syndrome types in PLC patients after TACE were ranked from high to low as blood stasis syndrome [(89 cases, 84.0%)], qi deficiency syndrome [(87 cases, 82.1%)], excess-heat syndrome [(85 cases, 80.2%)], qi stagnation syndrome [(52 cases, 49.1%)], yin deficiency syndrome [(49 cases, 46.2%)], blood deficiency syndrome [(42 cases, 39.6%)], yang deficiency syndrome [(32 cases, 30.2%)], fluid and damp syndrome [(20 cases, 18.9%)]. After TACE the proportions of qi deficiency syndrome and yang deficiency syndrome increased with statistical difference (P<0.01, P<0.05). There were no statistical difference in terms of other syndromes between before and after TACE (P>0.05). Blood stasis syndrome and qi stagnation syndrome got the highest quantization scores before TACE. After TACE blood stasis syndrome and qi deficiency syndrome got the highest quantization scores. After TACE the score of qi stagnation syndrome decreased, while that of excess-heat syndrome, qi deficiency syndrome, blood deficiency syndrome, yang deficiency syndrome increased (all P<0.05). CONCLUSIONS: It's necessary to pay attention to regulating qi, clearing heat, replenishing qi, and removing stasis for treating liver cancer patients. Clearing heat, replenishing qi, enriching blood, and warming yang after TACE should also be paid equal attention to while using syndrome typing methods.

Total Saponin from Root of Actinidia valvata Dunn Inhibits Hepatoma 22 Growth and Metastasis In Vivo by Suppression Angiogenesis.

The root of Actinidia valvata dunn has been widely used in the treatment of hepatocellular carcinoma (HCC), proved to be beneficial for a longer and better life in China. In present work, total saponin from root of Actinidia valvata Dunn (TSAVD) was extracted, and its effects on hepatoma H22-based mouse in vivo were observed. Primarily transplanted hypodermal hepatoma H22-based mice were used to observe TSAVD effect on tumor growth. The microvessel density (MVD), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) are characterized factors of angiogenesis, which were compared between TSAVD-treated and control groups. Antimetastasis effect on experimental pulmonary metastasis hepatoma mice was also observed in the study. The results demonstrated that TSAVD can effectively inhibit HCC growth and metastasis in vivo, inhibit the formation of microvessel, downregulate expressions of VEGF and bFGF, and retrain angiogenesis of hepatoma 22 which could be one of the reasons.

Mechanisms of inhibiting proliferation of vascular smooth muscle cells by serum of rats treated with Dahuang Zhechong pill.

UNLABELLED: Dahuang Zhechong pill (DHZCP), a famous and classical Chinese herbal prescription, consists of twelve traditional Chinese drugs: Eupolyphaga sinensis Walker., Rheum officinale Baill., Scutellaria baicalensis Georgi., Glycyrrhiza uralensis Fisch., Prunus persica Batsch., Prunus armeniaca L., Paeonia lactiflora Pall., Rehmannia glutinosa Libosch., Toxicodendron vernicifluum F.A. Barkl., Tabanus bivittatus Mats., Hirudo nipponica Whitman. and Holotrichia diomphalia Bates., and is clinically used to treat hepatic diseases, gynecopathy and atherosclerosis in China. Our previous studies confirm that DHZCP is able to significantly inhibit proliferation of vascular smooth muscle cells (VSMCs) in vivo and in vitro. AIM OF THE STUDY: To investigate the mechanisms of inhibition of VSMCs proliferation by DHZCP with the method of Serum Pharmacology. MATERIALS AND METHODS: VSMCs proliferation of rat was assayed by measuring the cell viability with the MTT method, and platelet-derived growth factor (PDGF) expression in VSMCs was examined by the immunocytochemical method. Cycle and apoptosis of VSMCs were evaluated with flow cytometry. RESULTS: The serum of DHZCP-treated rats not only inhibited endothelin-1 (ET-1) stimulated cell proliferation and PDGF expression in VSMCs, but also promoted apoptosis of the proliferated VSMCs. Meanwhile, the serum of rats containing DHZCP interfered with the cycle of PDGF-stimulated VSMCs, increasing proportion of the cells in G(0)/G(1) phases and decreasing proportion of the cells in S and G(2)/M phases. CONCLUSION: These suggest that the inhibitory effect of DHZCP on VSMCs proliferation is partially attributed to depressing PDGF expression in VSMCs, retarding the cell cycle and to promoting apoptosis of VSMCs.

In vitro inhibition of proliferation of vascular smooth muscle cells by serum of rats treated with Dahuang Zhechong pill.

Dahuang Zhechong pill (DHZCP) is a famous and classical Chinese herbal prescription, which is clinically used to treat hepatic, gynecological and cardiovascular diseases in China. The aim of this study was to observe the effects of the serum of rats treated with DHZCP on the proliferation of cultured rat vascular smooth muscle cells (VSMCs) stimulated by platelet-derived growth factor (PDGF), oxidized low density lipoprotein (ox-LDL) and hyperlipidemic serum (HLS), and on DNA, protein and collagen syntheses of VSMCs induced by PDGF in vitro. VSMCs proliferation was assayed by measuring the cell viability with MTT method, and syntheses of DNA, protein and collagen were evaluated by detecting [(3)H]-thymidine, [(3)H]-leucine and [(3)H]-proline incorporations, respectively. The results showed that PDGF, ox-LDL and HLS stimulated the proliferation of rat VSMCs in vitro. The serum of rats treated with DHZCP significantly inhibited the proliferation of rat VSMCs induced by the above stimulants and the incorporations of [(3)H]-thymidine, [(3)H]-leucine and [(3)H]-proline into rat VSMCs induced by PDGF in comparison with the model control group (P<0.01). The data suggest that DHZCP is able to obviously inhibit VSMCs proliferation via interfering with syntheses of DNA and protein, and to decrease production of extracellular matrix by VSMCs through antagonizing collagen synthesis.