Antitumor effects of Chinese herbal medicine compounds and their nano-formulations on regulating the immune system microenvironment

Modulating the tumor microenvironment: The role of traditional Chinese medicine in improving lung cancer treatment

The holistic approach of traditional Chinese medicine (TCM) has been increasingly being focused on as a potential adjuvant to conventional lung cancer therapies in an attempt at modulating the tumor microenvironment (TME). Covering a diverse range of herbal medicine, acupuncture, and dietary therapy, TCM brings a unique perspective to influencing the TME. Importantly, the study has found the effects of specific TCM compounds, such as cantharidin, boehmenan, shikonin, and salidroside, on lung cancer in the TME. These compounds interact intricately with key apoptotic regulators, oxidative stress pathways, and inflammation-related mechanisms, suggesting their potential role in enhancing conventional therapies. TCM compounds could modulate a variety of cellular and molecular pathways, potentially inhibiting tumor proliferation, invasion, and metastasis. Besides, the practices of TCM alleviate the side effects of conventional treatments and enhance immune function, hence promoting the quality of life among lung cancer patients. In this regard, this review gives a contemporary account of the state of affairs on the part of TCM within the framework of the treatment of lung cancer with reference to its recent developments, and diverse roles.

Integration of active ingredients from traditional Chinese medicine with nano-delivery systems for tumor immunotherapy

Tumor immune escape presents a significant challenge in cancer treatment, characterized by the upregulation of immune inhibitory molecules and dysfunction of immune cells. Tumor immunotherapy seeks to restore normal anti-tumor immune responses to control and eliminate tumors effectively. The active ingredients of traditional Chinese medicine (TCM) demonstrate a variety of anti-tumor activities and mechanisms, including the modulation of immune cell functions and inhibiting tumor-related suppressive factors, thereby potentially enhancing anti-tumor immune responses. Furthermore, nano-delivery systems function as efficient carriers to enhance the bioavailability and targeted delivery of TCM active ingredients, augmenting therapeutic efficacy. This review comprehensively analyzes the impact of TCM active ingredients on the immune system and explores the synergistic application of nano-delivery systems in combination with TCM active ingredients for enhancing tumor immunotherapy.

Bibliometric analysis of traditional Chinese medicine in cancer treatment via immune system modulation (2015-2025)

Objective

The application of Traditional Chinese Medicine (TCM) in treating cancer by regulating the immune system has garnered significant attention in the academic community. However, comprehensive quantitative analyses in this field remain limited. This study aims to assess the research progress and key trends over the past decade, providing a framework for future studies.

Methods

A comprehensive literature search was conducted on the application of TCM in treating cancer by regulating the immune system from 2015 to 2025 using the Web of Science database. The search terms mainly included cancer, Traditional Chinese Medicine, immunity and so on. Data were analyzed and visualized using Origin, R software, VOSviewer, and CiteSpace.

Results

A total of 2,459 articles were included in the analysis. The number of related publications has steadily increased since 2015. China leads in publication volume and plays a crucial role in international collaboration. The Journal of Ethnopharmacology is the leading journal in this field, publishing a substantial number of highly cited studies. Key research areas include keywords such as "apoptosis," "expression," "inflammation," "extract," "in vitro," "activation," "antioxidant," and "NF-kappa B," focusing on exploring the role, mechanisms, and efficacy of TCM in modulating immune responses.

Conclusion

Research interest in TCM's role in treating cancer through immune system regulation continues to grow, underscoring its potential in cancer therapy. Current research primarily focuses on the mechanisms by which TCM treats cancer through the modulation of immune cell functions, inhibition of tumor immune evasion, and regulation of immune-related signaling pathways. It also explores its clinical applications and the potential for enhancing the efficacy of immunotherapy.

Impact of materia medica in combination with transarterial chemoembolization on inflammatory markers in patients with hepatocellular carcinoma: A systematic review and meta-analysis

OBJECTIVES

Chinese materia medica (CMM) demonstrates promise in suppressing cancer cell proliferation and metastasis. Cytokines facilitate cellular communication within the tumor microenvironment (TME). This study aimed to examine the influence of integrating CMM with transarterial chemoembolization (TACE) on inflammatory markers and enhancing the TME in hepatocellular carcinoma (HCC) patients.

METHODS

Articles published between 2006 and 2023 were comprehensively searched from eight databases. The selected studies met the PICOS criteria and primarily consisted of randomized controlled trials (RCTs) that examined the treatment of primary HCC patients with TACE as a standalone therapy or combined with CMM. The outcome measures included inflammatory markers, objective response rate (ORR), alpha-fetoprotein (AFP) levels, and survival rates.

RESULTS

The meta-analysis included nine RCTs involving 696 HCC patients: 349 in the TACE + CMM group and 347 in the TACE-only group. The TACE + CMM group demonstrated significantly higher levels of IL-2 (P < 0.00001), IL-12 (P < 0.00001), and IFN-γ (P < 0.00001) and significantly lower levels of IL-6 (P = 0.0007), IL-8 (P < 0.00001), TNF-α (P = 0.01), and AFP (P = 0.0002) compared to the TACE-only group. No significant difference in the C-reactive protein level (P = 0.12) was observed between the two groups. The TACE + CMM group showed a higher ORR (P < 0.0001) than the TACE-only group.

CONCLUSIONS

Compared to using TACE alone, the integration of CMM with TACE enhanced the modulation of inflammatory markers and the clinical outcomes in patients with HCC.

Application and Development of Nanotechnology in Traditional Chinese Acupuncture in Recent 20 Years: A Comprehensive Review

Acupuncture, rooted in Traditional Chinese Medicine (TCM), serves as a complementary and alternative therapeutic modality that involves the insertion of needles into specific body points to stimulate and treat a variety of conditions. Over time, acupuncture has garnered global acceptance, progressively addressing an increasing spectrum of medical disorders. The integration of nanotechnology holds considerable potential to improve drug delivery efficacy and broaden the scope of acupuncture's applications, providing novel opportunities for investigating the underlying principles of meridians and acupoints. A bibliometric analysis of the application of nanotechnology in acupuncture over the past two decades (2004-2024) highlights emerging research trends and focal points in the field. This article provides an overview of the history, biological mechanisms, preparation methods, and clinical research status of nanoacupuncture, with a focus on analyzing the applications of nanoacupuncture technology. Nanotechnology enables the visualization and imaging of meridians and acupoints, facilitating a deeper understanding of the physiological mechanisms behind acupuncture's therapeutic effects. Modified acupuncture needles incorporating nanotechnology can serve dual purposes: functioning as sensors for real-time monitoring of various physiological parameters, thereby supporting disease diagnosis and enhancing therapeutic efficacy through specialized interventions. Furthermore, nanotechnology-enhanced acupuncture needles can act as platforms for targeted drug delivery working in tandem with responsive nanoparticles for disease treatment. Despite its promising potential and clinical applicability, nanoacupuncture faces inherent limitations and challenges that must be addressed.

Harnessing the Power of Traditional Chinese Medicine in Cancer Treatment: The Role of Nanocarriers

For centuries, traditional Chinese medicine (TCM) has had certain advantages in the treatment of tumors. However, due to their poor water solubility, low bioavailability and potential toxicity, their effective delivery to target sites can be a major challenge. Nanocarriers based on the active ingredients of TCM, such as liposomes, polymer nanoparticles, inorganic nanoparticles, and organic/inorganic nanohybrids, are a promising strategy to improve the delivery of TCM, resulting in higher therapeutic outcomes and fewer side effects. Therefore, this article intends to review the application of Chinese medicine nano preparation in tumor. Firstly, we introduce the classification and synthesis of nanometer preparations of Chinese medicine. The second part mainly introduces the different responses of TCM nano-preparations in the course of treatment to introduce how TCM nano-preparations play a role in anti-tumor therapy. The third part focuses on Different response modes of Chinese medicine nano preparations in tumor therapy. The fourth part elucidates the application of Chinese medicine nano preparations in the treatment of cancer. Finally, the research direction to be explored in related fields is put forward.

WNT/β-catenin-M2 macrophage interplay as a target for therapy against hepatocellular carcinoma: Role of Calculus bovis

Liver cancer, and in particular hepatocellular carcinoma (HCC) is a disease of rising prevalence and incidence. To date, definitive treatment options include either surgical excision or ablation of the affected area. With increasing research on several pathways that could be involved in the progression of HCC, new elements within these pathways emerge as potential targets for novel therapies. The WNT/β-catenin pathway favors the presence of M2 tumor-associated macrophages which in turn promote tumor growth and metastasis. The inhibition of this pathway is considered a good candidate for such targeted therapeutic interventions. Interestingly, as Huang et al show in their recently published article, Calculus bovis which is used in traditional Chinese medicine can exert an inhibitory effect on the β-catenin pathway and become a potential candidate for targeted pharmacotherapy against liver cancer.

Physiological markers for immunotherapeutics: a review

Immunotherapy has been advanced through multiple approaches, including immunogenic cytokines, monoclonal antibodies, therapeutic vaccinations, adoptive cell transfer, stem cell transplantation, and oncolytic viruses. This review analyses various strategies in genomics, transcriptomics, single-cell techniques, computational analysis, big data, and imaging technologies for the identification of tumour microbiota and microenvironments. Immunotherapy is becoming acknowledged as a feasible cancer treatment method, facilitating innovative cancer medicines and personalized medicine techniques.

Nanodelivery system of traditional Chinese medicine bioactive compounds: Application in the treatment of prostate cancer

BACKGROUND

The long history of clinical experience in China have confirmed the effectiveness of traditional Chinese medicine (TCM) in treating prostate cancer (PCa). Until now, several bioactive compounds with anti-PCa potential, such as curcumin, gallic acid, and quercetin, have been extracted from TCM. Recent studies have shown that encapsulating these TCM bioactive compounds into nano-delivery system enhanced their bioavailability and improved their ability to target PCa tumors.

PURPOSE

This review aims to summarize the anti-PCa effects and molecular mechanisms of TCM bioactive compounds and discuss the clinical application prospects and future research trends of nano-delivery system based on these compounds.

METHODS

Literatures focusing on the treatment of PCa using traditional Chinese medicine compounds via nano-drug delivery system were searched from Electronic databases, including PubMed, Web of Science, and Scopus until December 2023.

RESULTS

Polyphenols, alkaloids, terpenes, and quinones exhibit anti-PCa effects through various pathways. Notably, compounds like curcumin, gallic acid, quercetin, and tanshinone have been extensively studied in nano-delivery systems for anti-PCa purpose. Nano-delivery systems enhance the biological activity of free compounds and reduce toxic side effects, as well. Commonly used nanomaterials for delivering TCM compounds include polymer nanomaterials, liposomes, solid lipid nanoparticles, nanostructured lipid carriers, and niosomes.

CONCLUSION

Research on nano-delivery systems for TCM bioactive compounds holds promising prospects for anti-PCa therapy. However, extensive clinical trials are necessary to evaluate the effectiveness and safety of these nanodrugs.

Aloe-emodin alleviates inflammatory bowel disease in mice by modulating intestinal microbiome homeostasis via the IL-4/IL-13 axis

Introduction

Inflammatory bowel disease (IBD) is a global health concern. Aloe-emodin (AE) has diverse pharmacological benefits, including anti-inflammatory effects. However, its role in IBD remains unclear, prompting our investigation of its regulatory effects and mechanisms in an IBD mouse model.

Methods

We studied the therapeutic efficacy of AE in alleviating symptoms and modulating cytokine secretion in a murine model of dextran sulfate sodium (DSS)-induced colitis. BALB/c mice were administered DSS to induce colitis and were subsequently treated with varying doses of AE. Changes in body weight, fecal lipocalin-2 (LCN2) levels, colon tissue histology, and serum cytokine concentrations were evaluated to assess the effects of AE treatment. Additionally, 16 S rRNA sequencing was used to analyze alterations in the composition of the gut microbiota following AE intervention. Finally, the database was used to analyze the signaling pathways associated with IBD in AE and to detect the expression levels of interleukin (IL)-4 pathway using real-time quantitative reverse transcription PCR. Exogenous IL-4 was used in rescue experiments to observe its effects on the disease process of IBD under AE regulation.

Results

AE treatment resulted in a dose-dependent mitigation of weight loss, reduction in fecal LCN2 levels, and amelioration of histological damage in DSS-induced colitis in mice. The levels of superoxide dismutase and catalase increased, whereas malondialdehyde decreased following AE treatment, indicating a dose-dependent alleviation of colitis symptoms. Furthermore, AE administration attenuated the secretion of pro-inflammatory cytokines, including IL-17, tumor necrosis factor-alpha (TNF-α), and chemokine ligand 1, while promoting the expression of anti-inflammatory cytokines IL-4 and IL-13. Analysis of the gut microbiota revealed that AE effectively suppressed the overgrowth of colitis-associated bacterial species and restored microbial homeostasis. Finally, we found that overexpression of IL-4 was able to reverse the therapeutic effect of AE for DSS-induced IBD.

Conclusion

AE shows promise in alleviating colitis severity, influencing inflammatory cytokines, and modulating the gut microbiota in an IBD mouse model via the IL-4/IL-13 pathway, suggesting its potential as a natural IBD remedy.

Anticancer Mechanism of Astragalus Polysaccharide and Its Application in Cancer Immunotherapy

Astragalus polysaccharide (APS) derived from A. membranaceus plays a crucial role in traditional Chinese medicine. These polysaccharides have shown antitumor effects and are considered safe. Thus, they have become increasingly important in cancer immunotherapy. APS can limit the spread of cancer by influencing immune cells, promoting cell death, triggering cancer cell autophagy, and impacting the tumor microenvironment. When used in combination with other therapies, APS can enhance treatment outcomes and reduce toxicity and side effects. APS combined with immune checkpoint inhibitors, relay cellular immunotherapy, and cancer vaccines have broadened the application of cancer immunotherapy and enhanced treatment effectiveness. By summarizing the research on APS in cancer immunotherapy over the past two decades, this review elaborates on the anticancer mechanism of APS and its use in cancer immunotherapy and clinical trials. Considering the multiple roles of APS, this review emphasizes the importance of using APS as an adjunct to cancer immunotherapy and compares other polysaccharides with APS. This discussion provides insights into the specific mechanism of action of APS, reveals the molecular targets of APS for developing effective clinical strategies, and highlights the wide application of APS in clinical cancer therapy in the future.

Azoximer bromide and hydroxyapatite: promising immune adjuvants in cancer

Immune adjuvants are immune modulators that have been developed in the context of infectious vaccinations. There is currently a growing interest in immune adjuvants due to the development of immunotherapy against cancers. Immune adjuvant mechanisms of action are focused on the initiation and amplification of the inflammatory response leading to the innate immune response, followed by the adaptive immune response. The main activity lies in the support of antigen presentation and the maturation and functions of dendritic cells. Most immune adjuvants are associated with a vaccine or incorporated into the new generation of mRNA vaccines. Few immune adjuvants are used as drugs. Hydroxyapatite (HA) ceramics and azoximer bromide (AZB) are overlooked molecules that were used in early clinical trials, which demonstrated clinical efficacy and excellent tolerance profiles. HA combined in an autologous vaccine was previously developed in the veterinary field for use in canine spontaneous lymphomas. AZB, an original immune modulator derived from a class of heterochain aliphatic polyamines that is licensed in Russia, the Commonwealth of Independent States, and Slovakia for infectious and inflammatory diseases, is and now being developed for use in cancer with promising results. These two immune adjuvants can be combined in various immunotherapy strategies.

Global trends in bufalin application research for cancer from 2003 to 2022: A bibliometric and visualised analysis

Background

Bufalin, the main active ingredient of the traditional Chinese medicine huachansu, is used in the clinical treatment of colorectal cancer and has multiple effects, including the inhibition of migratory invasion, reversal of multi-drug resistance, induction of apoptosis and differentiation, and inhibition of angiogenesis.

Methods

We collected relevant articles on bufalin from 2003 to 2022 using the Web Science platform, and analysed the information using VOSviewer, CiteSpace, and Microsoft Excel to categorise and summarise the publications over the past 20 years.

Results

We collected 371 papers, with a steady increase in the number of articles published globally. China has the highest number of published articles, whereas Japan has the highest number of citations. Currently, there is considerable enthusiasm for investigating the anti-tumour mechanism of bufalin and optimising drug delivery systems for its administration.

Conclusion

For the first time, we present a comprehensive overview of papers published worldwide on bufalin over the past two decades and the progress of its application in tumour therapy. We summarised the key authors, institutions, and countries that have contributed to the field and the potential of bufalin for the treatment of cancer. This will help other researchers obtain an overview of progress in the field, enhance collaboration and knowledge sharing, and promote future research on bufalin.

Herbal Medicines for the Improvement of Immune Function in Patients With Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Background: Lung cancer has the highest mortality rate of all cancers worldwide. Conserving the immune system and reducing the adverse events associated with cancer treatment have become increasingly important. Our study aimed to investigate the immunological effects of herbal medicine (HM) alone, independent of conventional cancer therapies, in patients with non-small cell lung cancer (NSCLC). Methods: We searched 8 databases for articles published until March 2023. Bias risk was assessed using RevMan 5.4. Meta-analyses of CD4+ and CD8+ levels reported in the included RCTs were also performed. Results: A total of 610 patients from 5 RCTs were included in the analysis. Immune markers in the peripheral blood of patients treated with HM alone were compared with those in the control group. As a result of meta-analyses, CD4+ (three studies; mean difference(MD) = 5.21, 95 confidence interval (CI) [3.26, 7.27], I2 = 61%, n = 428) and CD4+/CD8+ (two studies; MD = 0.22, 95% CI [0.18, 0.26], I2 = 0%, n = 278) significantly increased in the treatment group, while CD8+ levels (three studies; MD = -3.04, 95% CI [-5.80, -0.29], I2 = 74%, n = 428) decreased in HM groups compared to comparison groups. In a single trial, IL-1, IL-6, tumor necrosis factor (TNF)-a levels and the number of Tregs in the treatment group significantly decreased, while Th17 levels and the Th17/Treg ratios increased. Conclusion: This study provides a comprehensive and systematic review of the immunological effects of HM in patients with NSCLC. Future studies should explore how the immunological effects of HM correlate with clinical outcomes, such as tumor response and survival rates.PROSPERO registration: CRD42023459.

Effects of Shenmai Injection on the Pharmacokinetics of Dasatinib: An In-Depth In vivo Analysis Utilizing UPLC-MS/MS Technique

BACKGROUND

Dasatinib has been widely used in the treatment of a variety of cancers, such as lung cancer and acute myeloid leukemia. Shenmai injection is a traditional Chinese medicine injection that is often used in antitumor adjuvant therapy. In recent years, dasatinib combined with Shenmai injection has been increasingly used to treat tumors clinically. However, the potential risks and benefits of co-administering Shenmai injection and dasatinib are unclear.

OBJECTIVE

The study aimed to investigate the potential influence of Shenmai injection on dasatinib pharmacokinetics.

METHODS

Twelve rats were selected and randomly divided into two groups: dasatinib alone and a combination of dasatinib and Shenmai injection. To measure the concentration of dasatinib in rat plasma, blood samples were obtained from the orbital vein. Using ultra-performance liquid chromatography-tandem mass spectrometry, the concentration of dasatinib was determined to obtain pharmacokinetic parameters.

RESULTS

Compared to the dasatinib alone administration, the maximum concentration of the dasatinib plus Shenmai injection administration was decreased (355.9 ± 194.9 vs. 199.2 ± 73.8 ng·mL-1) (P < 0.05). Moreover, the area under the moment curve (3867.0 ± 2141.9 vs. 6355.3 ± 3311.6 ng·mL-1·h2) and mean residence time (3.7 ± 1.2 vs. 6.5 ± 3.1 h) showed a statistically significant increase (P < 0.05).

CONCLUSION

The study revealed that Shenmai injection might have the capacity to slow down the absorption rate of dasatinib and could extend the retention period of dasatinib in the body, resulting in stabilized blood drug concentrations and a reduction in adverse drug reactions.

Research Progress on the Synergistic Anti-Tumor Effect of Natural Anti-Tumor Components of Chinese Herbal Medicine Combined with Chemotherapy Drugs

The application of chemotherapy drugs in tumor treatment has a long history, but the lack of selectivity of drugs often leads to serious side effects during chemotherapy. The natural anti-tumor ingredients derived from Chinese herbal medicine are attracting increased attention due to their diverse anti-tumor effects, abundant resources, and minimal side effects. An effective anti-tumor strategy may lie in the combination of these naturally derived anti-tumor ingredients with conventional chemotherapy drugs. This approach could potentially inhibit tumor growth and the development of drug resistance in tumor cells while reducing the adverse effects of chemotherapy drugs. This review provides a comprehensive overview of the combined therapy strategies integrating natural anti-tumor components from Chinese herbal medicine with chemotherapy drugs in current research. We primarily summarize various compounds in Chinese herbal medicine exhibiting natural anti-tumor activities and the relevant mechanisms in synergistic anti-tumor combination therapy. The focus of this paper is on underlining that this integrative approach, combining natural anti-tumor components of Chinese herbal medicine with chemotherapy drugs, presents a novel cancer treatment methodology, thereby providing new insights for future oncological research.

Fermented Chinese Herbs Improve the Growth and Immunity of Growing Pigs through Regulating Colon Microbiota and Metabolites

(1) Background: the development of new antibiotic substitutes to promote pig growth and health has become an important way to solve the current dilemma and promote the pig industry. (2) Methods: to assess the effects of a fermented Chinese herbal (FCH) formula on the growth and immunity of growing pigs, 100 Duroc × Landrace × Yorshire three-way crossed growing pigs were randomly divided into control and treatment groups that were fed a basal diet, and a basal diet with 1% (group A), 2% (group B), and 3% (group C) FCH formulas, respectively. A sixty-day formal experiment was conducted, and their growth and serum indices, colonic microbiota, and metabolites were analyzed. (3) Results: the daily gain of growing pigs in groups A, B, and C increased by 7.93%, 17.68%, and 19.61%, respectively, and the feed-to-gain ratios decreased by 8.33%, 15.00%, and 14.58%, respectively. Serum immunity and antioxidant activities were significantly increased in all treatment groups. Particularly, adding a 2% FCH formula significantly changed the colon's microbial structure; the Proteobacteria significantly increased and Firmicutes significantly decreased, and the metabolite composition in the colon's contents significantly changed. (4) Conclusions: these results indicate that the FCH formula is a good feed additive for growing pigs, and the recommended addition ratio was 3%.

Biosynthesis of Copper Nanoparticles with Medicinal Plants Extracts: From Extraction Methods to Applications

Copper nanoparticles (CuNPs) can be synthesized by green methods using plant extracts. These methods are more environmentally friendly and offer improved properties of the synthesized NPs in terms of biocompatibility and functional capabilities. Traditional medicine has a rich history of utilization of herbs for millennia, offering a viable alternative or complementary option to conventional pharmacological medications. Plants of traditional herbal use or those with medicinal properties are candidates to be used to obtain NPs due to their high and complex content of biocompounds with different redox capacities that provide a dynamic reaction environment for NP synthesis. Other synthesis conditions, such as salt precursor concentration, temperature, time synthesis, and pH, have a significant effect on the characteristics of the NPs. This paper will review the properties of some compounds from medicinal plants, plant extract obtention methods alternatives, characteristics of plant extracts, and how they relate to the NP synthesis process. Additionally, the document includes diverse applications associated with CuNPs, starting from antibacterial properties to potential applications in metabolic disease treatment, vegetable tissue culture, therapy, and cardioprotective effect, among others.

Successful treatment of immune-related lichenoid dermatitis by Weiling decoction in a patient with non-small cell lung cancer: A case report and review of literature

BACKGROUND

Immune checkpoint inhibitors (ICIs) have emerged as a revolutionary therapy in advanced squamous non-small cell lung cancer (sqNSCLC) and ushered a new era of immunotherapy. Despite of remarkable outcomes, a wide spectrum of immune-related adverse events (irAEs) was reported, among which cutaneous reactions were the most common. Cutaneous irAEs were mainly managed by glucocorticoids, whereas prolonged use of glucocorticoids may cuase kinds of side effects, especially in elderly paitients, and diminish the anti-tumor efficacy of ICIs, thus finding a safe and effective alternative approach to managing cutaneous irAEs is imperative.

CASE SUMMARY

A 71-year-old man who was diagnosed with advanced sqNSCLC suffered from sporadic maculopapulars one week later after the fifth cycle of sintilimab treatment, and the skin lesions had been deteriorating rapidly. Skin biopsy revealed epidermal parakeratosis with a dense band-like lymphocytic infiltrate and acanthosis, indicating a diagnosis of immune-induced lichenoid dermatitis. Oral administration of traditional Chinese herbal formula modified Weiling decoction significantly alleviated the symptoms of the patient. The dosage of Weiling decoction were maintained for about three months without recurrence of cutaneous adverse reactions and any other side effects. The patient refused to receive further anti-tumor medication and stayed alive without disease progression at follow up.

CONCLUSION

We present modified Weiling decoction successfully ameliorates immune-induced lichenoid dermatitis in a patient with sqNSCLC for the first time. This report indicates that Weiling decoction may be an effective and safe complementary or alternative approach for the treatment of cutaneous irAEs. Further investigation of the underling mechanism is required in the future.

Natural Shikonin Potentially Alters Intestinal Flora to Alleviate Acute Inflammation

Shikonin, derived from the herb Lithospermum erythrorhizon (Purple Cromwell), is extensively utilized in traditional Chinese medicine as an anti-inflammatory agent; however, its effect on the intestinal flora is not yet known. Herein, we demonstrate that, compared to a blank control group, the intragastric administration of shikonin suppressed the swelling rate of ears in a mouse model of acute inflammation in a dose-dependent manner via animal experiments; furthermore, the 20 mg/kg shikonin treatment exhibited the highest inhibitory effect. In formal animal experimentation, we discovered that the inhibitory effect of shikonin with 20 mg/kg on inflammation was closely linked to the intestinal flora, whereby the microbiota phylum was altered in feces through a 16S rDNA sequencing analysis, implying that shikonin improves gut microbiota structures and compositions to counteract inflammation. Notably, using a real-time quantitative polymerase chain reaction (RT-qPCR), a Western blotting assay, and an immunohistochemistry (IHC) assay, we found that inflammatory cytokines such as TNF-α, IL-6, and IL-1β reduced in both the shikonin-administration group and the positive control group than those in the blank control group, as expected. To the best of our knowledge, this is the first study to outline the underlying mechanism through which shikonin acts on gut microbes to alleviate acute inflammation, providing an alternative mechanism for shikonin to become a preventive agent in countering inflammation.

Emerging Trends in Nano-Driven Immunotherapy for Treatment of Cancer

Despite advancements in the development of anticancer medications and therapies, cancer still has the greatest fatality rate due to a dismal prognosis. Traditional cancer therapies include chemotherapy, radiotherapy, and targeted therapy. The conventional treatments have a number of shortcomings, such as a lack of selectivity, non-specific cytotoxicity, suboptimal drug delivery to tumour locations, and multi-drug resistance, which results in a less potent/ineffective therapeutic outcome. Cancer immunotherapy is an emerging and promising strategy to elicit a pronounced immune response against cancer. Immunotherapy stimulates the immune system with cancer-specific antigens or immune checkpoint inhibitors to overcome the immune suppressive tumour microenvironment and kill the cancer cells. However, delivery of the antigen or immune checkpoint inhibitors and activation of the immune response need to circumvent the issues pertaining to short lifetimes and effect times, as well as adverse effects associated with off-targeting, suboptimal, or hyperactivation of the immune system. Additional challenges posed by the tumour suppressive microenvironment are less tumour immunogenicity and the inhibition of effector T cells. The evolution of nanotechnology in recent years has paved the way for improving treatment efficacy by facilitating site-specific and sustained delivery of the therapeutic moiety to elicit a robust immune response. The amenability of nanoparticles towards surface functionalization and tuneable physicochemical properties, size, shape, and surfaces charge have been successfully harnessed for immunotherapy, as well as combination therapy, against cancer. In this review, we have summarized the recent advancements made in choosing different nanomaterial combinations and their modifications made to enable their interaction with different molecular and cellular targets for efficient immunotherapy. This review also highlights recent trends in immunotherapy strategies to be used independently, as well as in combination, for the destruction of cancer cells, as well as prevent metastasis and recurrence.

Phytochemicals as Immunomodulatory Agents in Melanoma

Cutaneous melanoma is an immunogenic highly heterogenic tumor characterized by poor outcomes when it is diagnosed late. Therefore, immunotherapy in combination with other anti-proliferative approaches is among the most effective weapons to control its growth and metastatic dissemination. Recently, a large amount of published reports indicate the interest of researchers and clinicians about plant secondary metabolites as potentially useful therapeutic tools due to their lower presence of side effects coupled with their high potency and efficacy. Published evidence was reported in most cases through in vitro studies but also, with a growing body of evidence, through in vivo investigations. Our aim was, therefore, to review the published studies focused on the most interesting phytochemicals whose immunomodulatory activities and/or mechanisms of actions were demonstrated and applied to melanoma models.