Immunomodulation of Chinese Herbal Medicines on NK cell populations for cancer therapy: A systematic review.

ETHNOPHARMACOLOGICAL RELEVANCE: Immunomodulation has become a crucial modality for cancer treatment. Chinese Herbal Medicines (CHMs) are expected as adjuvant therapy for immunomodulation against cancer, but face the key challenge of poor scientific evidence. Changes of natural killer (NK) cells on numbers and/or cytotoxicity are a novel respect to evaluate the immunomodulation of CHMs. AIM OF THE STUDY: The purpose of this review is to investigate the immunomodulation of Chinese Herbal Medicines (CHMs) on NK cell populations for cancer therapy. MATERIALS AND METHODS: A systematic review was conducted and outside mainstream electronic databases were screened for potential reference articles. This review tried to report and critically analyzed all the correlative studies, especially these clinical trials (3 CHM extracts and 11 CHM formulas). RESULTS: Evidence-based functions of CHMs against cancer could be summarized as: (1) enhancement of NK cells activity or relative percentage; (2) prevention of tumor growth and metastasis; (3) relief on side-effects or complications of therapeutic strategies (i.e. chemotherapy, radiotherapy and resection). Briefly, most of cellular studies and two thirds animal studies were based on the extract or components of single herbs, whilst most of clinical trials were keen on formula or prescription of CHMs. The main components of CHMs were demonstrated active on promoting the cytotoxicity of NK cells, including Angelica sinensis, Ganoderma lucidum, Panax ginseng, Radix Astragali, Lentinus edodes, etc. CONCLUSIONS: This comprehensive review demonstrated NK cells activity was positively associated with quality of life but not survival benefit of cancer patients. Thus exploring the roles of NK cells in adjuvant therapy against cancer is confirmed to be beneficial to explore the underlying relationship between immunomodulation and quality of life.

What Are the Primary Limitations in B-Cell Affinity Maturation, and How Much Affinity Maturation Can We Drive with Vaccination? A Role for Antibody Feedback.

We discuss the impact of antibody feedback on affinity maturation of B cells. Competition from epitope-specific antibodies produced earlier during the immune response leads to immune complex formation, which is essential for transport and deposition of antigen onto follicular dendritic cells (FDCs). It also reduces the concentration of free epitopes into the µm to nm range, which is essential for B-cell receptors (BCRs) to sense affinity-dependent changes in binding capacity. Antibody feedback may also induce epitope spreading, leading to a broader selection of epitopes recognized by newly emerging B-cell clones. This may be exploitable, providing ways to manipulate epitope usage induced by vaccination.

Anthropometric profile of Hong Kong children and adolescents: the Wellness Population of Youth Study.

Childhood obesity has been a public health concern increasingly. We investigated the age- and sex-specific body mass index (BMI), blood pressure level, and other obesity measures in Hong Kong children and adolescents. We used the data from Wellness Population of Youth Study, a health examination for anthropometric measurements among children and adolescents (aged 9-15 years) in Hong Kong, conducted in Oct 2012-Jun 2013 (n = 4410). Anthropometric measures including weight, height, pulse, systolic and diastolic blood pressures, triceps and scapula skinfold thickness, and waist circumference were measured following universal standard protocol. Overweight and obesity were classified using the 2000 International Obesity Task Force, 2007 World Health Organization, and 2000 Centers of Disease Control and Prevention age- and sex-specific growth charts. Hypertension was categorized using Centers of Disease Control and Prevention and Chinese standards. The prevalence of obesity, overweight, and hypertension of Hong Kong adolescents according to the above definitions were 5.4%-15.1%, 20.8%-25.9%, and 12.0%-13.8%, respectively. Boys had higher systolic blood pressure, waist, BMI, and waist-to-height ratio (all P < .001). Systolic and diastolic blood pressures, scapula skinfold, waist, and BMI increased with age, while pulse and waist-to-height ratio decreased with age. To conclude, compared with worldwide data, the situations of obesity and overweight among Hong Kong children and adolescents were more severe.

An Ensemble Approach for Record Matching in Data Linkage.

OBJECTIVES: To develop and test an optimal ensemble configuration of two complementary probabilistic data matching techniques namely Fellegi-Sunter (FS) and Jaro-Wrinkler (JW) with the goal of improving record matching accuracy. METHODS: Experiments and comparative analyses were carried out to compare matching performance amongst the ensemble configurations combining FS and JW against the two techniques independently. RESULTS: Our results show that an improvement can be achieved when FS technique is applied to the remaining unsure and unmatched records after the JW technique has been applied. DISCUSSION: Whilst all data matching techniques rely on the quality of a diverse set of demographic data, FS technique focuses on the aggregating matching accuracy from a number of useful variables and JW looks closer into matching the data content (spelling in this case) of each field. Hence, these two techniques are shown to be complementary. In addition, the sequence of applying these two techniques is critical. CONCLUSION: We have demonstrated a useful ensemble approach that has potential to improve data matching accuracy, particularly when the number of demographic variables is limited. This ensemble technique is particularly useful when there are multiple acceptable spellings in the fields, such as names and addresses.

Mining Symptom-Herb Patterns from Patient Records Using Tripartite Graph.

Unlike the western medical approach where a drug is prescribed against specific symptoms of patients, traditional Chinese medicine (TCM) treatment has a unique step, which is called syndrome differentiation (SD). It is argued that SD is considered as patient classification because prior to the selection of the most appropriate formula from a set of relevant formulae for personalization, a practitioner has to label a patient belonging to a particular class (syndrome) first. Hence, to detect the patterns between herbs and symptoms via syndrome is a challenging problem; finding these patterns can help prepare a prescription that contributes to the efficacy of a treatment. In order to highlight this unique triangular relationship of symptom, syndrome, and herb, we propose a novel three-step mining approach. It first starts with the construction of a heterogeneous tripartite information network, which carries richer information. The second step is to systematically extract path-based topological features from this tripartite network. Finally, an unsupervised method is used to learn the best parameters associated with different features in deciding the symptom-herb relationships. Experiments have been carried out on four real-world patient records (Insomnia, Diabetes, Infertility, and Tourette syndrome) with comprehensive measurements. Interesting and insightful experimental results are noted and discussed.

An ethnopharmacological approach to the preliminary screening of native Australian herbal medicines for anticancer activity.

BACKGROUND: Five plants used traditionally by Australian Aboriginals and two edible native Australian fruits have been investigated for anticancer activity. The aim was to identify native Australian herbal medicines which displayed anticancer activity, with cytotoxicity to cancer cells but sparing or even proliferating normal immunological cells, and subsequently provide potentially new anticancer drug leads. METHODS: Extracts and derived fractions were assayed for cell viability against a multiple myeloma cell line, RPMI-8226, in comparison to the peripheral blood mononuclear cells (PBMC) representing normal human immunological cells. RESULTS: None of the crude extracts exhibited the desirable differential activity; however, following further fractionation of the Eremophila duttonii F. Muell. (Myoporaceae) extract, one fraction (termed F01) exhibited a greater cytotoxicity to the cancer cell line than to the normal cells. CONCLUSIONS: One fraction may potentially contain valuable compounds which may be useful for further investigation. This may focus on the identification of the bioavailable purified compounds present within these fractions or by detailed delineation of the related mechanisms of action.

Immunomodulatory activities of Ganoderma sinense polysaccharides in human immune cells.

Medicinal mushrooms have been traditionally used as food nutrient supplements in China for thousands of years. The present study aimed to evaluate the immunomodulatory activities of Ganoderma sinense (GS), an allied species of G. lucidum, using human peripheral blood mononuclear cells (PBMC). Our results showed that the polysaccharide-enriched fraction of GS hot water extract (400 µg/ml) exhibited significant stimulatory effects on PBMC proliferation. When the fruiting bodies of GS were divided into pileus and stipe parts and were separately extracted, the GS stipe polysaccharide-enriched fraction (50-400 µg/ml) showed concentration-dependent immunostimulating effects in PBMC. The productions of tumor necrosis factor-α, interleukin (IL)-10, and transforming growth factor -ß were significantly enhanced by this fraction. In addition, the proportion of CD14(+) monocyte subpopulation within the PBMC was specifically increased. The IL-10 and IL-12 productions in monocyte-derived dendritic cells were significantly enhanced by GS stipe fraction. The composition of monosaccharides of this fraction was determined by ultra performance liquid chromatography and ion exchange chromatography. Our study demonstrated for the first time the immunostimulatory effects of GS stipe polysaccharide-enriched fraction on PBMC and dendritic cells. The findings revealed the potential use of GS (especially including the stipes of fruiting bodies) as adjuvant nutrient supplements for patients, who are receiving immunosuppressive chemotherapies.

MicroRNAs Involved in Anti-Tumour Immunity.

MicroRNAs (miRNAs) are a category of small RNAs that constitute a new layer of complexity to gene regulation within the cell, which has provided new perspectives in understanding cancer biology. The deregulation of miRNAs contributes critically to the development and pathophysiology of a number of cancers. miRNAs have been found to participate in cell transformation and multiplication by acting as tumour oncogenes or suppressors; therefore, harnessing miRNAs may provide promising cancer therapeutics. Another major function of miRNAs is their activity as critical regulatory vehicles eliciting important regulatory processes in anti-tumour immunity through their influence on the development, differentiation and activation of various immune cells of both innate and adaptive immunity. This review aims to summarise recent findings focusing on the regulatory mechanisms of the development, differentiation, and proliferative aspects of the major immune populations by a diverse profile of miRNAs and may enrich our current understanding of the involvement of miRNAs in anti-tumour immunity.

Potential antioxidant, antiinflammatory, and proapoptotic anticancer activities of Kakadu plum and Illawarra plum polyphenolic fractions.

Kakadu plum (Terminalia ferdinandiana Exell, Combretaceae) and Illawarra plum (Podocarpus elatus Endl., Podocarpaceae) extracts were fractionated, using a bioassay-guided approach and screened for antioxidant activity [oxygen radical absorbance capacity (ORAC) and cellular antioxidant activity (CAA) assays] and antiinflammatory activity (nitrite concentration and prostaglandin E(2) release in lipopolysaccharide (LPS)-activated murine macrophages). Among 8 fractions obtained from KP and 5 fractions obtained from IP, fraction KPF5 from KP exhibited superior activity in all assays, with an ORAC value of 3,776 ± 603 µmol Trolox/g DW and a CAA value of 52.2 ± 8.6 µmol quercetin equivalents/g DW. In addition, KPF5 further demonstrated an upregulation of the Nrf2/Keap1 ratio in Hep G2 cells. KPF5 also inhibited the expression of COX-2 and iNOS in LPS-activated murine macrophages, potentially through the NF-κB, p44/42 mitogen activated protein kinase and Akt pathways. KPF5 also induced apoptosis and DNA damage in HT-29 cells, as determined by the cytokinesis block micronucleus cytome assay.

Molecular pathways for cancer chemoprevention by dietary phytochemicals.

Interest in dietary phytochemicals for potential cancer chemoprevention has increased substantially. Screening dietary compounds for chemopreventive activity however, requires a systematic and wide-ranging approach to encompass the complexity of carcinogenesis. We present some of the molecular pathways that underpin the broad biological processes involved in carcinogenesis. Oxidative stress, inflammation, and the evasion of apoptosis are important biological mechanisms by which carcinogenesis occurs. Subsequently, antioxidant, anti-inflammatory, and pro-apoptotic activity represent important activities for preventing, suppressing, or reversing the development of carcinogenesis. Ultimately, these mechanisms of action may provide a useful basis for screening novel phytochemicals for chemopreventive activity. In this review, we identify the important molecular processes that may be targeted in routine screenings of dietary phytochemicals to ultimately select the most effective potential candidates for cancer chemoprevention.

Native Australian fruit polyphenols inhibit cell viability and induce apoptosis in human cancer cell lines.

Apoptosis is one of the most critical forms of defense against cancer, and the induction of apoptosis by dietary polyphenols represents significant potential for cancer preventive activity. The present study examined polyphenols extracted from selected native Australian fruits--Illawarra plum (Podocarpus elatus Endl., Podocarpaceae), Kakadu plum (Terminalia ferdinandiana Exell, Combretaceae), muntries (Kunzea pomifera F. Muell., Myrtaceae), and native currant (Acrotriche depressa R.Br., Epacridaceae)--for antiproliferative activity against a panel of cancer and normal cell lines. Each fruit selectively inhibited the growth of cancer cell lines in a dose-dependent manner. The mechanism of growth inhibition of the human promyelocytic leukaemia cells (HL-60) was determined to be apoptosis by morphological assessment, DNA fragmentation, flow cytometry, and caspase-3 induction. Furthermore, Kakadu plum was found to activate caspase-7, -9, and poly (ADP-ribose) polymerase (PARP), suggesting it acts via the intrinsic apoptosis pathway. The same fruit also caused direct DNA damage in colon adenocarcinoma cells (HT-29) as detected using the cytokinesis-block micronucleus cytome (CBMN Cyt) assay.

Towards the discovery of novel phytochemicals for disease prevention from native Australian plants: an ethnobotanical approach.

Investigation into phytochemicals from foods for disease prevention has increased substantially in the last few decades. However, a clear strategy on the selection of the most promising foods for research has been lacking. An ethnobotanical approach represents an effective method which may improve the outcomes of phytochemical research. Research on the health properties of native Australian plants is limited. The vast number of edible plants used as foods and medicines by the Australian Aboriginal population creates opportunities for the discovery of novel physiologically active compounds. Within this review, we propose an ethnobotanical approach to accelerate research towards the utilisation of native Australian plants for foods with health-enhancing properties.

Clonal expansions of cytotoxic T cells exist in the blood of patients with Waldenstrom macroglobulinemia but exhibit anergic properties and are eliminated by nucleoside analogue therapy.

T cells contribute to host-tumor interactions in patients with monoclonal gammopathies. Expansions of CD8(+)CD57(+) T-cell receptor Vbeta-positive (TCRVbeta(+))-restricted cytotoxic T-cell (CTL) clones are found in 48% of patients with multiple myeloma and confer a favorable prognosis. We now report that CTL clones with varying TCRVbeta repertoire are present in 70% of patients with Waldenström macroglobulinemia (WM; n = 20). Previous nucleoside analog (NA) therapy, associated with increased incidence of transformation to aggressive lymphoma, significantly influenced the presence of TCRVbeta expansions (chi(2) = 11.6; P < .001), as 83% of patients without (n = 6) and only 7% with (n = 14) TCRVbeta expansions had received NA. Clonality of CD3(+)CD8(+)CD57(+)TCRVbeta(+)-restricted CTLs was confirmed by TCRVbeta CDR3 size analysis and direct sequencing. The differential expression of CD3(+)CD8(+)CD57(+)TCRVbeta(+) cells was profiled using DNA microarrays and validated at mRNA and protein level. By gene set enrichment analysis, CTL clones expressed not only genes from cytotoxic pathways (GZMB, PRF1, FGFBP2) but also genes that suppress apoptosis, inhibit proliferation, arrest cell-cycle G1/S transition, and activate T cells (RAS, CSK, and TOB pathways). Proliferation tracking after stimulation confirmed their anergic state. Our studies demonstrate the incidence, NA sensitivity, and nature of clonal CTLs in WM and highlight mechanisms that cause anergy in these cells.

Development of Taxol and other endophyte produced anti-cancer agents.

Taxol is a powerful and complex anti-cancer compound that was first isolated from the bark of the Pacific yew Taxus brevifolia. Although it offered huge potential as an anti-cancer agent, it experienced a long development period, attributed to by its low availability from its traditional source. Research into alternate sources and methods of production for Taxol have been crucial in meeting with demand for the drug. Three main avenues of research have resulted. Firstly, chemical syntheses of this complex diterpene consist of multiple steps and are not economically feasible due to their low yield. Developments have therefore concentrated on enhancing production in vivo. Efforts have been made to understand the enzymatic steps involved in the synthesis within the yew and innovations to produce Taxol and Taxol-like substances in high yield from cell cultures of Taxus species. An alternative stream of research focuses on endophytes as the producer of Taxol. Endophytes can be isolated from the yew tree and produce Taxol in culture. Encouraging findings with endophytes resulted in much interest in the prospect of using endophytes as the producer of Taxol and Taxol-like substances. This review also discusses patents and the future prospects of each of the main streams of production.

The use of thalidomide in myeloma therapy as an effective anticancer drug.

Thalidomide and its immunomodulatory derivatives have provided the most significant advance in the therapy of myeloma since the introduction of high dose chemotherapy followed by stem cell transplantation nearly 20 years ago. The mechanism of action of thalidomide is complex and involves many aspects of malignant plasma cell growth and bone marrow stromal cell microenvironment interaction. Thalidomide was first used because of its anti-angiogenic properties, however it is the immunomodulatory actions that involve increasing host tumour-specific immunosurveillance by both T cell and natural killer cells which may be the most important mode of action.

Clonality detection of expanded T-cell populations in patients with multiple myeloma.

Expanded T-cell clones in the peripheral blood of patients with multiple myeloma and smoldering myeloma are usually CD8 positive and persist over long periods, suggesting that they are the result of chronic antigenic stimulation. The presence of enlarged T-cell clones can be demonstrated as bands other than the germ-line bands on Southern blots probed for the T-cell receptor beta gene (Vbeta), or defined by anti-TCRVbeta monoclonal antibody staining. However, the most sensitive way to demonstrate clonality within a population of T-cells is by analysis of the length of complementarity-determining region 3 of the rearranged TCR gene, followed by sequencing. Furthermore, my colleagues and I have previously shown that the CD57+ T-cells expressing the "expanded" TCRVbeta are monoclonal or biclonal, whereas the CD57- cells are usually polyclonal.

Clonal cytotoxic T cells in myeloma.

Multiple myeloma (MM) is a malignant disease characterized by accumulation of morphologically recognizable plasma cells producing immunoglobulin (Ig) in the bone marrow. The occurrence of clonal T cells in MM, as defined by the presence of rearrangements in the T-cell receptor (TCR)-beta chains detected on Southern blotting, is associated with an improved prognosis. This review aims to describe the various ways in which we have demonstrated the presence of such T cell clones, and to describe the phenotype of these cells. Finally, the specificities of these clinically important CD8+ T cell populations will be discussed in the context of immunotherapy.

Extrafollicular antibody responses.

In adaptive antibody responses, B cells are induced to grow either in follicles where they form germinal centers or in extrafollicular foci as plasmablasts. Extrafollicular growth typically occurs in the medullary cords of lymph nodes and in foci in the red pulp of the spleen. It is not a feature of secondary lymphoid tissue associated with the internal epithelia of the body. All types of naïve and memory B cells can be recruited into extrafollicular responses. These responses are associated with immunoglobulin class switching but, at the most, only low-level hypermutation.

Recirculating and germinal center B cells differentiate into cells responsive to polysaccharide antigens.

Antibodies against bacterial capsular polysaccharides play a critical protective role. Responses to these antigens can occur without the help or control of T cells and are associated with marginal zone (MZ) B cells. Capsular antigens are diverse and some cross-react with self-carbohydrate epitopes. This diversity may explain the recruitment of non-autoreactive recirculating B cells and memory B cells to the MZ in addition to other B cells, some of which are weakly autoreactive cells, that are recruited to the MZ without entering the recirculating pool. To test whether memory B cells respond to polysaccharide-based antigens, mice with hapten-specific memory B cells were challenged with hapten-polysaccharide. Hapten-specific plasma cells producing high affinity antibody with Ig V-region mutations were induced. To test whether naive recirculating B cells can form MZ cells that respond to polysaccharide, recirculating B cells from lymph nodes were transferred into Rag-1-deficient mice. MZ cells differentiated from the donor cells without proliferation or T cell help and responded to polysaccharide-based antigen. The differentiation of B cells both from germinal centers and the recirculating pool to the MZ phenotype is likely to make an important contribution to the repertoire of B cells that respond to polysaccharide antigens.