Chinese herbal medicine-derived compounds for cancer therapy: a focus on hepatocellular carcinoma

ETHNOPHARMACOLOGICAL RELEVANCE

Hepatocellular carcinoma (HCC) as the major histological subtype of primary liver cancer remains one of the most common malignancies worldwide. Due to the complicated molecular pathogenesis of HCC, the option for effective systemic treatment is quite limited. There exists a critical need to explore and evaluate possible alternative strategies for effective control of HCC. With a long history of clinical use, Chinese herbal medicine (CHM) is emerging as a noticeable choice for its multi-level, multi-target and coordinated intervention effects against HCC. With the aids of phytochemistry and molecular biological approaches, in the past decades many CHM-derived compounds have been carefully studied through both preclinical and clinical researches and have shown great potential in novel anti-HCC natural product development. The present review aimed at providing the most recent developments on anti-HCC compounds derived from CHM, especially their underlying pharmacological mechanisms.

MATERIALS AND METHODS

A systematic search of anti-HCC compounds from CHM was carried out focusing on literatures published both in English (PubMed, Scopus, Web of Science and Medline) and in Chinese academic databases (Wanfang and CNKI database).

RESULTS

In this review, we tried to give a timely and comprehensive update about the anti-HCC effects and targets of several representative CHM-derived compounds, namely curcumin, resveratrol, silibinin, berberine, quercetin, tanshinone II-A and celastrol. Their mechanisms of anti-HCC behaviors, potential side effects or toxicity and future research directions were discussed.

CONCLUSION

Herbal compounds derived from CHM are of much significance in devising new drugs and providing unique ideas for the war against HCC. We propose that these breakthrough findings may have important implications for targeted-HCC therapy and modernization of CHM.

Sivelestat attenuates lung injury in surgery for congenital heart disease with pulmonary hypertension

BACKGROUND

Pulmonary hypertension associated with congenital heart disease increases the risk of surgery using cardiopulmonary bypass. Sivelestat is a neutrophil elastase inhibitor thought to have a prophylactic effect against lung injury after surgery using bypass. We elucidated that Sivelestat had the protective effect on lung in patients with congenital heart disease and pulmonary hypertension who underwent surgery using bypass.

METHODS

This study was a controlled prospective randomized trial and enrolled 13 neonates or infants with ventricular septal defect and pulmonary hypertension. The patients were assigned to either sivelestat with the dose of 0.2 mg/kg per hour (sivelestat group, n = 7) or saline (placebo group, n = 6) from the start of bypass until 6 hours after bypass. Proinflammatory cytokines and adhesion molecules on leukocytes were measured at 10 time points during the above period. Pulmonary function was assessed perioperatively.

RESULTS

Compared with the placebo group, the sivelestat group had significantly lower values of alveolar-arterial oxygen tension gradient at 24 hours (p = 0.038) and at 48 hours (p = 0.028) after bypass, and significantly better balance of hydration at 48 hours after bypass (p = 0.012). The sivelestat group also showed significantly lower plasma levels of interleukin-8 immediately after bypass (p = 0.041) and interleukin-10 at 15 minutes after removal of the aortic cross-clamp (p = 0.048), and immediately after bypass (p = 0.037).

CONCLUSIONS

Administration of sivelestat during bypass prevented pulmonary damage and activities of proinflammatory cytokines at the cardiac operation in neonates or infants. Our results show that sivelestat may be considered to protect pulmonary function against the injury by bypass.

Soluble E-selectin correlates with disease activity in cyclosporin A-treated patients with atopic dermatitis

BACKGROUND

The expression of adhesion molecules on endothelial cells regulates leukocyte migration. The level of soluble adhesion molecules which are shed into the circulation is known to reflect the degree of inflammation, and this level can therefore be used as an indicator of disease activity. The objective of this study was first to investigate the relationship between sE-selectin levels and disease activity parameters (scores of extent, severity, itch, and sleep) in atopic dermatitis (AD) patients, and second to determine the effect of therapy with an immunosuppressive drug (cyclosporin A) on sE-selectin levels.

METHODS

Fourteen patients with severe AD and 41 healthy controls were studied. sE-selectin was measured by ELISA both 2 weeks before therapy with cyclosporin A and after 16 weeks of treatment.

RESULTS

At baseline, the level of sE-selectin was significantly higher in patients with AD than in healthy control subjects (P<0.0001). After treatment of AD with cyclosporin A, there was a significant reduction of the sE-selectin levels (P<0.0001). In addition, changes in sE-selectin levels significantly correlated with changes in disease activity parameters such as severity (P<0.002) and extent of disease (P<0.049).

CONCLUSIONS

Soluble E-selectin is a new serologic marker in AD which reflects disease activity. Therefore, soluble E-selectin may be a useful parameter in the monitoring of this disease.