Pi (Spleen)-deficiency syndrome in tumor microenvironment is the pivotal pathogenesis of colorectal cancer immune escape

2015 ◽  
Vol 22 (10) ◽  
pp. 789-794 ◽  
Author(s):  
Xue-gang Sun ◽  
Xiao-chang Lin ◽  
Jian-xin Diao ◽  
Zhi-ling Yu ◽  
Kun Li
Keyword(s):  
Colorectal Cancer ◽  
Tumor Microenvironment ◽  
Immune Escape ◽  
Deficiency Syndrome ◽  
Spleen Deficiency ◽  
Spleen Deficiency Syndrome

scholarly journals Patient Reported Traditional Chinese Medicine Spleen Deficiency Syndrome (TCM-SDS) Scale for Colorectal Cancer: Development and Validation in China

2021 ◽  
Vol 20 ◽  
pp. 153473542110201
Author(s):  
Lingyun Sun ◽  
Jun J. Mao ◽  
Yunzi Yan ◽  
Yun Xu ◽  
Yufei Yang
Keyword(s):  
Colorectal Cancer ◽  
Reliability And Validity ◽  
Stage Iv ◽  
Deficiency Syndrome ◽  
Survey Study ◽  
Measurement Tool ◽  
Spleen Deficiency ◽  
Patient Reported ◽  
Stage Iv Disease ◽  
Spleen Deficiency Syndrome

Introduction: Spleen Deficiency Syndrome (SDS) is recognized as one of the most common Traditional Chinse Medicine (TCM) syndromes in patients with colorectal cancer (CRC). However so far there is no existing patient-reported outcome (PRO) to evaluate SDS. Our study aimed to develop and validate a PRO TCM-SDS scale for CRC in China. Methods: We developed an initial 8-item TCM-SDS scale for CRC based on literature review and consultation with experts. We then pilot tested the scale ( n = 40) and performed item revision. We conducted a survey study among CRC patients from oncology clinics at a TCM Hospital to further determine the reliability and validity of the scale. Results: Among 100 patients finally enrolled and analyzed in the survey study, 46% were female with median age of 60 years old, 77% had left side tumors and 23% had stage IV disease. Factor loading indicated that there were three domains within TCM-SDS scale. The final TCM-SDS scale involves 5 items including “I feel loss of appetite,” “I feel abdomen fullness,” “I feel my arms and legs lack strength,” “I feel short of breath when talking,” and “My stool is formless” (Cronbach’s alpha coefficient 0.76). We calculated the total score of the scale by summing the 5 individual items and normalizing them to a value maximum of 10, with higher scores indicating greater burden of spleen deficiency syndrome. The average spleen deficiency score for all patients was 3.55 ± 1.54. Among them, those who had stage IV disease had higher scores than stage I-III patients (4.30 vs 3.38, P = .015). Test-retest reliability after 2 weeks showed Pearson coefficient of 0.67 and all items were highly related ( P < .001). Compared with healthy controls, CRC patients had significantly higher spleen deficiency scores (3.55 vs 3.23, P = .045). Conclusion: The patient-reported TCM-SDS scale for CRC showed adequate initial reliability and validity. The development of the scale provided an outcome measurement tool, which could facilitate future studies to better evaluate the role of TCM in treating CRC.

scholarly journals Treatment of Spleen-Deficiency Syndrome With Atractyloside A From Bran-Processed Atractylodes lancea by Protection of the Intestinal Mucosal Barrier

2020 ◽  
Vol 11 ◽  
Author(s):  
Jiyuan Tu ◽  
Ying Xie ◽  
Kang Xu ◽  
Linghang Qu ◽  
Xiong Lin ◽  
...  
Keyword(s):  
Body Weight ◽  
Deficiency Syndrome ◽  
Mucosal Barrier ◽  
Enzyme Linked Immunosorbent Assay ◽  
Residual Rate ◽  
Intestinal Mucosal Barrier ◽  
Expression Levels ◽  
Spleen Deficiency ◽  
Atractylodes Lancea ◽  
Spleen Deficiency Syndrome

Atractylodes lancea (Thunb.) DC. (AL) is used in traditional Chinese medicine for the treatment of spleen-deficiency syndrome (SDS). Bran-processed Atractylodes lancea (BAL) has been found to be more effective than unprocessed AL. However, the compound in BAL active against SDS remains unclear. The pharmacological efficacy of BAL and its mechanism of action against SDS were investigated by HPLC-ELSD. Candidate compound AA (atractyloside A) in AL and BAL extracts was identified by HPLC-MS analysis. AA was tested in a rat model of SDS in which body weight, gastric residual rate, and intestinal propulsion were measured, and motilin (MTL), gastrin (GAS), and c-Kit were quantified by enzyme-linked immunosorbent assay. Potential targets and associated pathways were identified based on network pharmacology analysis. mRNA expression levels were measured by qRT-PCR and protein expression levels were measured by Western blot analysis and immunohistochemistry. AA increased body weight, intestinal propulsion, MTL, GAS, and c-Kit levels, while decreasing gastric residual volume and intestinal tissue damage, as same as Epidermal Growth Factor Receptor and Proliferating Cell Nuclear Antigen levels. Seventy-one potential pharmacologic targets were identified. Analysis of protein interaction, Gene Ontology (GO) functional analysis, pathway enrichment analysis, and docking and molecular interactions highlighted MAPK signaling as the potential signal transduction pathway. Validation experiments indicated that treatment with AA increased MTL, GAS, ZO-1, and OCLN levels, while reducing AQP1, AQP3, and FGF2 levels. In addition, phosphorylation of p38 and myosin light-chain kinase (MLCK) expression were inhibited. AA improved gastrointestinal function by protecting the intestinal mucosal barrier via inhibition of the p38 MAPK pathway. The results have clinical implications for the therapy of SDS.

Effects of Chai Hu (Radix Burpleuri) Containing Formulation on Plasma β-endorphin, Epinephrine and Dopamine in Patients

2005 ◽  
Vol 33 (05) ◽  
pp. 737-745 ◽  
Author(s):  
Jia-Xu Chen ◽  
Bo Ji ◽  
Zhao-Lin Lu ◽  
Li-Sheng Hu
Keyword(s):  
High Performance ◽  
Clinical Status ◽  
Immunoglobulin A ◽  
Deficiency Syndrome ◽  
Control Group ◽  
Plasma Norepinephrine ◽  
Spleen Deficiency ◽  
Before And After ◽  
Spleen Deficiency Syndrome ◽  
Experimental Group

Chai Hu (Radix Burpleuri), a major ingredient in many traditional Chinese medicine formulas, such as Xiao Yao Wan, is used in the treatment of liver stagnation and spleen deficiency syndrome (LSSDS). The objectives of this study were to examine the effects of Xiao Yao Wan containing Chai Hu on the changes of plasma indices in patients with LSSDS. Fifty-eight cases of LSSDS were randomly divided into two groups: 41 cases in the experimental group were treated with Xiao Yao Wan containing Chai Hu and 17 cases in the control group were treated with Zhi Bai Di Huang Wan for one consecutive month in a single blind design. Before and after treatment, high performance liquid chromatography (HPLC) was applied to determine the changes of plasma norepinephrine (NE), epinephrine (E) and dopamine (DA). Radioimmunoassay was performed to measure the amount of plasma β-endorphin (β-EP), adrenocorticotropin hormone (ACTH), estradiol (E2) and testosterone (T), and laser nephelometry was also conducted to measure plasma immunoglobulin A (Ig A) and G (Ig G). Compared to baseline levels, plasma β-EP was significantly increased ( p < 0.01), while E and DA were markedly decreased ( p < 0.01) after the administration of Xiao Yao Wan in the experimental group. The other indices did not change. This is the first evidence showing that the effect of Xiao Yao Wan containing Chai Hu on the treatment of patients with LSSDS may be through enhancing plasma β-EP and decreasing E and DA release. We conclude that Xiao Yao Wan containing Chai Hu regulates nervous and endocrine systems and contributes to the improvement of the clinical status of patients with LSSDS.

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