Geven Otu (Astragalus)
Synopsis
Kanser dünya çapında ölümün önde gelen nedenlerinden biridir. Astragalus membranaceus, soğuk algınlığı, ishal, yorgunluk, anoreksi ve kalp hastalıklarının tedavisinde kullanılan geleneksel bir Çin bitkisel ilacıdır. Astragalus membranaceus'un aktif bileşenlerinden biri olan Astragalus polisakkaridi (APS), özellikle tümör öldürücü etkisi olmak üzere geniş spektrumlu biyolojik aktiviteye sahip olduğu in vivo çalışmalarda gösterilmiştir. Bağışıklık baskılaması, kemoterapi ilaçlarının ana yan etkilerinden biri gibi görünmektedir. Bunun yerine, polisakkaritler, immunostimulator aktivitelerine dayanarak in vivo tümör büyümesini baskıladığı çalışmalarda gösterilmiştir. Yapılan in vivo ve düşük vaka sayısı ile çalışmalar ile Astragalus polisakkaritlerinin, kanser hastalarında miyelosupresyon derecesinde bir azalmaya neden olduğunu gösterse de faz 3 klinik çalışmaların yetersizliği nedeniyle ileri çalışmalara ihtiyaç duyulmaktadır. Astragalus'un anti-kanser potansiyeli ile ilgili araştırmalar halen devam etmektedir ve Astragalus'un kanser tedavisinde etkili bir adjuvan olarak rutin pratiğe girmesi için kapsamlı çalışmalara ihtiyaç vardır.
Cancer is one of the leading causes of death worldwide. Astragalus membranaceus is a traditional Chinese herbal medicine used to treat colds, diarrhea, fatigue, anorexia, and heart disease. Astragalus polysaccharides (APS), one of the active components of Astragalus membranaceus, have been shown to have a broad spectrum of biological activity in in vivo studies, particularly in tumoricidal effects. Immunosuppression appears to be one of the main side effects of chemotherapy drugs. On the other hand, polysaccharides have been shown to suppress in vivo tumor growth based on their immunostimulatory activities. Although in vivo and low-case studies have shown that Astragalus polysaccharides can cause a decrease in the degree of myelosuppression in cancer patients, further studies are needed due to the lack of phase 3 clinical trials. Research on the anti-cancer potential of Astragalus is ongoing, and comprehensive studies are needed for Astragalus to enter routine practice as an effective adjuvant in cancer treatment.
References
Qin, S.-Y., et al., Combinational strategy for high-performance cancer chemotherapy. Biomaterials, 2018. 171: p. 178-197.
Patel, M.K., et al., Physicochemical, scavenging and anti-proliferative analyses of polysaccharides extracted from psyllium (Plantago ovata Forssk) husk and seeds. International journal of biological macromolecules, 2019. 133: p. 190-201.
Khan, T., A. Date, H. Chawda, and K. Patel, Polysaccharides as potential anticancer agents—A review of their progress. Carbohydrate polymers, 2019. 210: p. 412-428.
Na, D., et al., Astragalus extract inhibits destruction of gastric cancer cells to mesothelial cells by anti-apoptosis. World journal of gastroenterology: WJG, 2009. 15(5): p. 570.
Zee-Cheng, R., 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 and findings in experimental and clinical pharmacology, 1992. 14(9): p. 725-736.
Liu, J., et al., Astragalus polysaccharide stimulates glucose uptake in L6 myotubes through AMPK activation and AS160/TBC1D4 phosphorylation. Acta Pharmacologica Sinica, 2013. 34(1): p. 137-145.
Yu, J., et al., Apoptosis of human gastric carcinoma MGC-803 cells induced by a novel Astragalus membranaceus polysaccharide via intrinsic mitochondrial pathways. International journal of biological macromolecules, 2019. 126: p. 811-819.
Yang, B., B. Xiao, and T. Sun, Antitumor and immunomodulatory activity of Astragalus membranaceus polysaccharides in H22 tumor-bearing mice. International Journal of Biological Macromolecules, 2013. 62: p. 287-290.
Guo, L., S.-P. Bai, L. Zhao, and X.-H. Wang, Astragalus polysaccharide injection integrated with vinorelbine and cisplatin for patients with advanced non-small cell lung cancer: effects on quality of life and survival. Medical Oncology, 2012. 29: p. 1656-1662.
Li, W., et al., Anti-tumor potential of astragalus polysaccharides on breast cancer cell line mediated by macrophage activation. Materials Science and Engineering: C, 2019. 98: p. 685-695.
Ma, X.Q., et al., Chemical analysis of Radix Astragali (Huangqi) in China: a comparison with its adulterants and seasonal variations. Journal of agricultural and food chemistry, 2002. 50(17): p. 4861-4866.
Mills, S. and K. Bone, Principles and practice of phytotherapy. Modern herbal medicine. 2000: Churchill Livingstone.
Auyeung, K.K., Q.-B. Han, and J.K. Ko, Astragalus membranaceus: a review of its protection against inflammation and gastrointestinal cancers. The American journal of Chinese medicine, 2016. 44(01): p. 1-22.
Chattopadhyay, N., et al., Polysaccharides from Turbinaria conoides: Structural features and antioxidant capacity. Food Chemistry, 2010. 118(3): p. 823-829.
Borazjani, N.J., M. Tabarsa, S. You, and M. Rezaei, Purification, molecular properties, structural characterization, and immunomodulatory activities of water soluble polysaccharides from Sargassum angustifolium. International journal of biological macromolecules, 2018. 109: p. 793-802.
Wang, Q., et al., β-Glucans: Relationships between modification, conformation and functional activities. Molecules, 2017. 22(2): p. 257.
c Ooi, V.E. and F. Liu, Immunomodulation and anti-cancer activity of polysaccharide-protein complexes. Current medicinal chemistry, 2000. 7(7): p. 715-729.
Zee-Cheng, R., A potent Chinese biological response modifier in cancer immunotherapy, potetiation and detoxification of anticancer drugs. Methods Find Exp Clin Phamacol, 1992. 14: p. 725-736.
Yoshida, Y., et al., Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. International Journal of Immunopharmacology, 1997. 19(7): p. 359-370.
Chu, D.-T., W. Wong, and G. Mavligit, Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. Journal of clinical & laboratory immunology, 1988. 25(3): p. 125-129.
Jiao, Y., J. Wen, and X. Yu, Influence of flavonoid of Astragalus membranaceus's stem and leaves on the function of cell mediated immunity in mice. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi= Chinese journal of integrated traditional and Western medicine, 1999. 19(6): p. 356-358.
Shimizu, N., M. Tomoda, M. Kanari, and R. GONDA, An acidic polysaccharide having activity on the reticuloendothelial system from the root of Astragalus mongholicus. Chemical and pharmaceutical bulletin, 1991. 39(11): p. 2969-2972.
Shao, B.-M., et al., A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochemical and biophysical research communications, 2004. 320(4): p. 1103-1111.
Lee, K.Y. and Y.J. Jeon, Macrophage activation by polysaccharide isolated from Astragalus membranaceus. International immunopharmacology, 2005. 5(7-8): p. 1225-1233.
Yin, X., et al., Protective effects of Astragalus saponin I on early stage of diabetic nephropathy in rats. Journal of pharmacological sciences, 2004. 95(2): p. 256-266.
Kiyohara, H., et al., Different contributions of side-chains in β-D-(1→ 3, 6)-galactans on intestinal Peyer’s patch-immunomodulation by polysaccharides from Astragalus mongholics Bunge. Phytochemistry, 2010. 71(2-3): p. 280-293.
Wu, J., et al., Astragalus polysaccharide enhanced antitumor effects of Apatinib in gastric cancer AGS cells by inhibiting AKT signalling pathway. Biomedicine & Pharmacotherapy, 2018. 100: p. 176-183.
Ferreira, S.S., et al., Structure–function relationships of immunostimulatory polysaccharides: A review. Carbohydrate polymers, 2015. 132: p. 378-396.
Pang, G., F. Wang, and L.W. Zhang, Dose matters: Direct killing or immunoregulatory effects of natural polysaccharides in cancer treatment. Carbohydrate polymers, 2018. 195: p. 243-256.
Li, W., et al., Characterization and anti-tumor bioactivity of astragalus polysaccharides by immunomodulation. International Journal of Biological Macromolecules, 2020. 145: p. 985-997.
Auyeung, K.K., C.H. Cho, and J.K. Ko, A novel anticancer effect of Astragalus saponins: Transcriptional activation of NSAID‐activated gene. International journal of cancer, 2009. 125(5): p. 1082-1091.
Tin, M.M., et al., Astragalus saponins induce growth inhibition and apoptosis in human colon cancer cells and tumor xenograft. Carcinogenesis, 2007. 28(6): p. 1347-1355.
Cassileth, B.R., et al., Safety and pharmacokinetic trial of docetaxel plus an Astragalus-based herbal formula for non-small cell lung cancer patients. Cancer chemotherapy and pharmacology, 2009. 65: p. 67-71.
Song, J., et al., Astragalus polysaccharide promotes adriamycin-induced apoptosis in gastric cancer cells. Cancer management and research, 2020: p. 2405-2414.
Wu, J., et al., Traditional Chinese medicine Astragalus polysaccharide enhanced antitumor effects of the angiogenesis inhibitor apatinib in pancreatic cancer cells on proliferation, invasiveness, and apoptosis. OncoTargets and therapy, 2018: p. 2685-2698.
Li, X., et al., Preventing effect of astragalus polysaccharide on cardiotoxicity induced by chemotherapy of epirubicin: A pilot study. Medicine, 2022. 101(32).
Duan, P. and Z. Wang, Clinical study on effect of Astragalus in efficacy enhancing and toxicity reducing of chemotherapy in patients of malignant tumor. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi Jiehe Zazhi= Chinese Journal of Integrated Traditional and Western Medicine, 2002. 22(7): p. 515-517.
Rittenhouse, J.R., P.D. Lui, and B.H. Lau, Chinese medicinal herbs reverse macrophage suppression induced by urological tumors. The Journal of urology, 1991. 146(2): p. 486-490.
Jia, R., et al., In vitro and in vivo hepatoprotective and antioxidant effects of Astragalus polysaccharides against carbon tetrachloride-induced hepatocyte damage in common carp (Cyprinus carpio). Fish physiology and biochemistry, 2012. 38: p. 871-881.
Tang, L., Y. Liu, Y. Wang, and C. Long, Phytochemical analysis of an antiviral fraction of Radix astragali using HPLC–DAD–ESI–MS/MS. Journal of natural medicines, 2010. 64: p. 182-186.
Karimi, P., et al., The effects of excess copper on antioxidative enzymes, lipid peroxidation, proline, chlorophyll, and concentration of Mn, Fe, and Cu in Astragalus neo-mobayenii. The Scientific World Journal, 2012. 2012.
Cui, R., et al., Suppressive effect of Astragalus membranaceus Bunge on chemical hepatocarcinogenesis in rats. Cancer chemotherapy and pharmacology, 2003. 51: p. 75-80.
Kim, W., S.H. Kim, S.K. Park, and M.S. Chang, Astragalus membranaceus ameliorates reproductive toxicity induced by cyclophosphamide in male mice. Phytotherapy Research, 2012. 26(9): p. 1418-1421.
Patel, M.K., et al., Physicochemical, scavenging and anti-proliferative analyses of polysaccharides extracted from psyllium (Plantago ovata Forssk) husk and seeds. International journal of biological macromolecules, 2019. 133: p. 190-201.
Khan, T., A. Date, H. Chawda, and K. Patel, Polysaccharides as potential anticancer agents—A review of their progress. Carbohydrate polymers, 2019. 210: p. 412-428.
Na, D., et al., Astragalus extract inhibits destruction of gastric cancer cells to mesothelial cells by anti-apoptosis. World journal of gastroenterology: WJG, 2009. 15(5): p. 570.
Zee-Cheng, R., 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 and findings in experimental and clinical pharmacology, 1992. 14(9): p. 725-736.
Liu, J., et al., Astragalus polysaccharide stimulates glucose uptake in L6 myotubes through AMPK activation and AS160/TBC1D4 phosphorylation. Acta Pharmacologica Sinica, 2013. 34(1): p. 137-145.
Yu, J., et al., Apoptosis of human gastric carcinoma MGC-803 cells induced by a novel Astragalus membranaceus polysaccharide via intrinsic mitochondrial pathways. International journal of biological macromolecules, 2019. 126: p. 811-819.
Yang, B., B. Xiao, and T. Sun, Antitumor and immunomodulatory activity of Astragalus membranaceus polysaccharides in H22 tumor-bearing mice. International Journal of Biological Macromolecules, 2013. 62: p. 287-290.
Guo, L., S.-P. Bai, L. Zhao, and X.-H. Wang, Astragalus polysaccharide injection integrated with vinorelbine and cisplatin for patients with advanced non-small cell lung cancer: effects on quality of life and survival. Medical Oncology, 2012. 29: p. 1656-1662.
Li, W., et al., Anti-tumor potential of astragalus polysaccharides on breast cancer cell line mediated by macrophage activation. Materials Science and Engineering: C, 2019. 98: p. 685-695.
Ma, X.Q., et al., Chemical analysis of Radix Astragali (Huangqi) in China: a comparison with its adulterants and seasonal variations. Journal of agricultural and food chemistry, 2002. 50(17): p. 4861-4866.
Mills, S. and K. Bone, Principles and practice of phytotherapy. Modern herbal medicine. 2000: Churchill Livingstone.
Auyeung, K.K., Q.-B. Han, and J.K. Ko, Astragalus membranaceus: a review of its protection against inflammation and gastrointestinal cancers. The American journal of Chinese medicine, 2016. 44(01): p. 1-22.
Chattopadhyay, N., et al., Polysaccharides from Turbinaria conoides: Structural features and antioxidant capacity. Food Chemistry, 2010. 118(3): p. 823-829.
Borazjani, N.J., M. Tabarsa, S. You, and M. Rezaei, Purification, molecular properties, structural characterization, and immunomodulatory activities of water soluble polysaccharides from Sargassum angustifolium. International journal of biological macromolecules, 2018. 109: p. 793-802.
Wang, Q., et al., β-Glucans: Relationships between modification, conformation and functional activities. Molecules, 2017. 22(2): p. 257.
c Ooi, V.E. and F. Liu, Immunomodulation and anti-cancer activity of polysaccharide-protein complexes. Current medicinal chemistry, 2000. 7(7): p. 715-729.
Zee-Cheng, R., A potent Chinese biological response modifier in cancer immunotherapy, potetiation and detoxification of anticancer drugs. Methods Find Exp Clin Phamacol, 1992. 14: p. 725-736.
Yoshida, Y., et al., Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. International Journal of Immunopharmacology, 1997. 19(7): p. 359-370.
Chu, D.-T., W. Wong, and G. Mavligit, Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. Journal of clinical & laboratory immunology, 1988. 25(3): p. 125-129.
Jiao, Y., J. Wen, and X. Yu, Influence of flavonoid of Astragalus membranaceus's stem and leaves on the function of cell mediated immunity in mice. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi= Chinese journal of integrated traditional and Western medicine, 1999. 19(6): p. 356-358.
Shimizu, N., M. Tomoda, M. Kanari, and R. GONDA, An acidic polysaccharide having activity on the reticuloendothelial system from the root of Astragalus mongholicus. Chemical and pharmaceutical bulletin, 1991. 39(11): p. 2969-2972.
Shao, B.-M., et al., A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochemical and biophysical research communications, 2004. 320(4): p. 1103-1111.
Lee, K.Y. and Y.J. Jeon, Macrophage activation by polysaccharide isolated from Astragalus membranaceus. International immunopharmacology, 2005. 5(7-8): p. 1225-1233.
Yin, X., et al., Protective effects of Astragalus saponin I on early stage of diabetic nephropathy in rats. Journal of pharmacological sciences, 2004. 95(2): p. 256-266.
Kiyohara, H., et al., Different contributions of side-chains in β-D-(1→ 3, 6)-galactans on intestinal Peyer’s patch-immunomodulation by polysaccharides from Astragalus mongholics Bunge. Phytochemistry, 2010. 71(2-3): p. 280-293.
Wu, J., et al., Astragalus polysaccharide enhanced antitumor effects of Apatinib in gastric cancer AGS cells by inhibiting AKT signalling pathway. Biomedicine & Pharmacotherapy, 2018. 100: p. 176-183.
Ferreira, S.S., et al., Structure–function relationships of immunostimulatory polysaccharides: A review. Carbohydrate polymers, 2015. 132: p. 378-396.
Pang, G., F. Wang, and L.W. Zhang, Dose matters: Direct killing or immunoregulatory effects of natural polysaccharides in cancer treatment. Carbohydrate polymers, 2018. 195: p. 243-256.
Li, W., et al., Characterization and anti-tumor bioactivity of astragalus polysaccharides by immunomodulation. International Journal of Biological Macromolecules, 2020. 145: p. 985-997.
Auyeung, K.K., C.H. Cho, and J.K. Ko, A novel anticancer effect of Astragalus saponins: Transcriptional activation of NSAID‐activated gene. International journal of cancer, 2009. 125(5): p. 1082-1091.
Tin, M.M., et al., Astragalus saponins induce growth inhibition and apoptosis in human colon cancer cells and tumor xenograft. Carcinogenesis, 2007. 28(6): p. 1347-1355.
Cassileth, B.R., et al., Safety and pharmacokinetic trial of docetaxel plus an Astragalus-based herbal formula for non-small cell lung cancer patients. Cancer chemotherapy and pharmacology, 2009. 65: p. 67-71.
Song, J., et al., Astragalus polysaccharide promotes adriamycin-induced apoptosis in gastric cancer cells. Cancer management and research, 2020: p. 2405-2414.
Wu, J., et al., Traditional Chinese medicine Astragalus polysaccharide enhanced antitumor effects of the angiogenesis inhibitor apatinib in pancreatic cancer cells on proliferation, invasiveness, and apoptosis. OncoTargets and therapy, 2018: p. 2685-2698.
Li, X., et al., Preventing effect of astragalus polysaccharide on cardiotoxicity induced by chemotherapy of epirubicin: A pilot study. Medicine, 2022. 101(32).
Duan, P. and Z. Wang, Clinical study on effect of Astragalus in efficacy enhancing and toxicity reducing of chemotherapy in patients of malignant tumor. Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi Jiehe Zazhi= Chinese Journal of Integrated Traditional and Western Medicine, 2002. 22(7): p. 515-517.
Rittenhouse, J.R., P.D. Lui, and B.H. Lau, Chinese medicinal herbs reverse macrophage suppression induced by urological tumors. The Journal of urology, 1991. 146(2): p. 486-490.
Jia, R., et al., In vitro and in vivo hepatoprotective and antioxidant effects of Astragalus polysaccharides against carbon tetrachloride-induced hepatocyte damage in common carp (Cyprinus carpio). Fish physiology and biochemistry, 2012. 38: p. 871-881.
Tang, L., Y. Liu, Y. Wang, and C. Long, Phytochemical analysis of an antiviral fraction of Radix astragali using HPLC–DAD–ESI–MS/MS. Journal of natural medicines, 2010. 64: p. 182-186.
Karimi, P., et al., The effects of excess copper on antioxidative enzymes, lipid peroxidation, proline, chlorophyll, and concentration of Mn, Fe, and Cu in Astragalus neo-mobayenii. The Scientific World Journal, 2012. 2012.
Cui, R., et al., Suppressive effect of Astragalus membranaceus Bunge on chemical hepatocarcinogenesis in rats. Cancer chemotherapy and pharmacology, 2003. 51: p. 75-80.
Kim, W., S.H. Kim, S.K. Park, and M.S. Chang, Astragalus membranaceus ameliorates reproductive toxicity induced by cyclophosphamide in male mice. Phytotherapy Research, 2012. 26(9): p. 1418-1421.
Pages
225-232
Published
March 11, 2024
Copyright (c) 2024 Academician Publishing Book Portal
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1.
Muğlu H. Geven Otu (Astragalus). In: Sakin A, editor. Kanser Hastalarının Başvurduğu Geleneksel ve Tamamlayıcı Tedaviler - Tıbbi Onkolog Gözü ile Bakış ve Onkolojik İlaçlarla Etkileşim [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2024 [cited 2026 Jul. 13]. pp. 225-32. Available from: https://www.omp35.books.akademisyen.net/index.php/akya/catalog/book/2380/chapter/13921
