Traditional Chinese Medicine, TCM, widely used in the treatment of colorectal cancer, could contribute to influencing cell proliferation, apoptosis, the cell cycle, migration, invasion, autophagy, epithelial-to-mesenchymal transition, angiogenesis, and several other factors associated with this neoplasm. These are the aspects investigated by a Chinese study, published in Chinese Medicine, which aimed to identify the key signaling pathways and the potential targets of TCM and its active constituents in colorectal cancer, thereby developing new therapeutic approaches.
Colorectal Cancer (CRC)
Colorectal cancer is a neoplasm with a complex pathogenesis, prone to metastasis, and characterized by abnormalities arising in multiple signaling pathways. Surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy remain the main treatments for CRC today, but there is an urgent need to improve overall survival rates and quality of life.
TCM, with a long history in the prevention and treatment of this oncologic condition, could influence, in addition to the aspects cited above, chemoresistance by regulating multiple signaling pathways, such as PI3K/Akt, NF-κB, MAPK, Wnt/β-catenin, epidermal growth factor receptor, p53, TGF-β, mTOR, Hedgehog, and immunomodulatory signaling pathways.
Moreover, it should be noted that the treatment options employed by Western conventional medicine are not devoid of side effects, such as surgical sequelae, chemotherapy resistance, toxicity, a high risk of metastasis development, and possibilities of recurrence. All implications that impact patients’ quality of life.
Therefore there is a demonstrated need for new complementary and integrated treatment options: TCM, a major source of natural medicines and plant-based products, could be an effective tool to leverage anti-CRC drugs. The evidence appears to suggest that the TCM approach to this neoplasm could exert a positive effect on multiple targets and pathways, for example by synergistically mitigating the toxic side effects induced by gold-standard therapies, with meaningful benefits extending to patient survival.
Among the ingredients explored by TCM that seem to be most effective in CRC prevention and/or control are Wogonin (WOG), found in Huang Qin (Scutellaria baicalensis Georgi), Coptisine (COP) which can be derived from Huang Lian (Coptis chinensis Franch.), Emodin (EMD) supplied by Da Huang (Rheum palmatum L.), Triptolide (TP), Lei Gong Teng (Tripterygium wilfordii Hook. f.), Platycodin D (PD), contained in Jie Geng (Platycodon grandiflorus (Jacq.) A. DC.), Oridonin (ORI), obtainable from Dong Ling Cao (Rabdosia rubescens( Hemsl.) Hara), Baicalein (BE), present in significant quantities in Huang Qin (Scutellaria baicalensis Georgi), Berberine (BBR) whose main sources are Huang Lian (Coptis chinensis Franch.), Huang Bai (Phellodendron chinense Schneid.), Xiao Bo (Berberis silva-taroucana Schneid.), Curcumin, contained in the extract herb Jiang Huang (Curcuma longa L.), Ginsenoside Rh1 (Rh1) found in Ren Shen (Panax ginseng C.A.Mey.), Diterpenoid C provided by Jiang Huang (Curcuma longa L.), 8-Gingerol present in Sheng Jiang (Zingiber officinale Rosc.), and several others.
Literature Evidence
Experimental studies have shown that TCM and its components can effectively inhibit the proliferation of CRC cells, and related mechanisms such as inducing apoptosis, arresting the cell cycle, promoting cellular autophagy, and inhibiting angiogenesis.
There is also evidence that TCM may play an anti-CRC role in radiotherapy and chemotherapy synergy and in regulating signaling pathways, considered one of the important mechanisms for treating CRC. It is precisely these aspects that the future direction of research will target, with the aim of better clarifying the mechanisms underlying CRC development and thus identifying potential TCM targets for disease intervention.
Source
Chen JF, Wu SW, Shi SZ et al. Traditional Chinese medicine for colorectal cancer treatment: potential targets and mechanisms of action. Chinese Medicine, 2023, 18:14. doi: 10.1186/s13020-023-00719-7
Abbonati a Karla Miller
