Chinese Herbal Medicine as an Adjunctive Therapy for Breast Cancer: A Systematic Review and Meta-Analysis

Chinese herbal medicine (CHM) has been widely used as an adjunctive therapy for breast cancer, while its efficacy remains unexplored. The purpose of this study is to evaluate the efficacy of CHM combined with chemotherapy for breast cancer. The study results showed that CHM combined with chemotherapy significantly increased tumor response and KPS as compared to using chemotherapy alone (RR = 1.36; 95% CI = 1.24–1.48; P<0.00001; RR = 1.38; 95% CI = 1.26–1.52; P<0.00001, resp.). Besides, CHM as an adjunctive therapy significantly reduced the nausea and vomiting at toxicity grade of III–IV (RR = 0.37; 95% CI = 0.27–0.52; P<0.00001). Moreover, the combined therapy significantly prevented the decline of WBC in patients under chemotherapy at toxicity grade of III–IV (RR = 0.49; 95% CI = 0.34–0.69; P<0.00001) and prevented the decline of platelet at toxicity grade of III–IV or I–IV (RR = 0.29; 95% CI = 0.12–0.73; P=0.008; RR = 0.77; 95% CI = 0.63–0.94; P=0.009, resp.). This study suggests that CHM combined with chemotherapy in comparison with chemotherapy alone can significantly enhance tumor response, improve KPS, and alleviate toxicity induced by chemotherapy in breast cancer patients. However, a firm conclusion could not be reached due to the lack of high quality trials and large-scale RCTs, so further trials with higher quality and larger scale are needed

Bibliometric analysis of research on the role of intestinal microbiota in obesity

Background Obesity is a key public health problem. The advancement of gut microbiota research sheds new light on this field. This article aims to present the research trends in global intestinal microbiota studies within the domain of obesity research. Methods Bibliographic information of the publications on intestinal microbiota and obesity was retrieved from the Scopus database, and then analyzed by using bibliometric approaches. Results A total of 3,446 references were retrieved; the data indicated a steady growth and an exponential increase in publication numbers. The references were written in 23 different languages (93.8% in English). A number of 3,056 English journal papers were included in the further analyses. Among the 940 journals, the most prolific ones were PLOS ONE, Scientific Reports, and British Journal of Nutrition. North America and Europe were the highest publication output areas. The US (995 publications) ranked first in the number of publications, followed by the China (243 publications) and France (242 publications). The publication numbers were significantly correlated with gross domestic product (GDP), human development index (HDI), and population number (PN). International collaboration analysis also shows that most of the collaborations are among developed countries. Discussion This comprehensive bibliometric study indicates that gut microbiota is a significant topic in the obesity research. The structured information may be helpful in understanding research trends, and locating research hot spots and gaps in this domain

miRNA Expression Profile of Saliva in Subjects of Yang Deficiency Constitution and Yin Deficiency Constitution

Background/Aims: Based on the theory of constitution in Traditional Chinese Medicine (TCM), the Chinese Han population has been classified into nine constitutions. Of these, Yang deficiency constitution mainly exhibit cold intolerance while Yin deficiency constitution mainly exhibit heat intolerance. Some studies have been carried out to explore the modern genetic and biological basis of such constitution classification, but more remains to be done. MicroRNA (miRNA) serves as post-transcriptional regulators of gene expression and may play a role in the classification process. Here, we examined miRNA expression profile of saliva to further improve the comprehensiveness of constitution classification. Methods: Saliva was collected from Chinese Han individuals with Yang deficiency, Yin deficiency and Balanced constitutions (n=5 each), and miRNA expression profile was determined using the Human miRNA OneArray®v7. Based on 1.5 Fold change, means log2|Ratio|≥0.585 and P-value&#x3c; 0.05, differentially expressed miRNA was screened. Target genes were predicted using DIANA-TarBasev7.0 and analysis of KEGG pathway was carried out using DIANA-mirPathv.3. Results: We found that 81 and 98 differentially expressed miRNAs were screened in Yang deficiency and Yin deficiency constitution, respectively. Among them, 16 miRNAs were identical and the others were unique. In addition, the target genes that are regulated by the unique miRNAs were significantly enriched in 27 and 20 signaling pathways in Yang deficiency and Yin deficiency constitution, respectively. Thyroid hormone signaling pathway is present in both constitutions. These unique miRNAs that regulated target genes of thyroid hormone signaling pathway may be associated with cold intolerance or heat intolerance. Conclusion: The results of our study show that Yang deficiency and Yin deficiency constitutions exhibit systematic differences in miRNA expression profile. Moreover, the distinct characteristics of TCM constitution may be explained, in part, by differentially expressed miRNAs

Unveiling the structural features that determine the dual methyltransferase activities of Streptococcus pneumoniae RlmCD.

Methyltransferase RlmCD was previously shown to be responsible for the introduction of C5 methylation at both U747 and U1939 of the 23S ribosomal RNA in Streptococcus pneumoniae. Intriguingly, its structural homologue, RumA, can only catalyze the methylation of U1939, while RlmC is the dedicated enzyme for m5U747 in Escherichia coli. In this study, we describe the structure of RlmCD in complex with its cofactor and the RNA substrate containing U747 at 2.00 Å or U1939 at 3.10 Å. We demonstrate that multiple structural features collaborate to establish the dual enzymatic activities of RlmCD. Of them, the side-chain rearrangement of F145 was observed to be an unusual mechanism through which RlmCD can discriminate between U747- and U1939-containing RNA substrate by switching the intermolecular aromatic stacking between protein and RNA on/off. An in-vitro methyltransferase assay and electrophoretic mobility shift assay were performed to validate these findings. Overall, our complex structures allow for a better understanding of the dual-functional mechanism of RlmCD, suggesting useful implications for the evolution of the RumA-type enzyme and the potential development of antibiotic drugs against S. pneumoniae

DIA-PRM Proteomic Analysis of Phlegm-Dampness Constitution with Glucolipid Metabolic Disorders by the Intervention of Hua Tan Qu Shi Recipe

Background. Phlegm-dampness constitution as one of nine constitutions in traditional Chinese medicine (TCM) has been a high risk factor for glucolipid metabolic disorders (GLMD). Based on our previous findings, Hua Tan Qu Shi recipe (HTQSR) could effectively improve metabolic indicators of GLMD by targeting on phlegm-dampness constitution. However, the proteomic mechanisms of GLMD with the treatment of HTQSR targeting on phlegm-dampness constitution remain unknown. Methods. Clinical participants from phlegm-dampness constitution with the prediabetic state (T), phlegm-dampness constitution with marginally elevated blood lipids (Z), and phlegm-dampness constitution before sickness (W) were included in this study, who orally took HTQSR for 12 weeks and, respectively, marked AT, AZ, and AW. Data-independent acquisition (DIA) and parallel reaction monitoring (PRM) were performed to identify the differential proteins; then, Venn analysis was used to investigate coexpressed and coregulated proteins. In addition, ingenuity pathway analysis (IPA) software was utilized to explore the related pathways and diseases and biofunctions. Results. LXR/RXR activation, acute phase response signaling, and production of nitric oxide and reactive oxygen species in macrophages were obviously activated between the T and AT groups, as well as the Z and AZ groups. In contrast, these three pathways were inhibited between the W and AW groups. Importantly, one coexpressed and coregulated differential protein, B2MG, was validated by PRM among all groups. Conclusions. This work firstly reported the underlying proteomic mechanisms of GLMD with the treatment of HTQSR targeting on phlegm-dampness constitution, indicating that intervention of phlegm-dampness constitution might be a novel strategy for the preventive treatment of GLMD

Composition of intestinal microflora associated with Yang-deficiency

Objective: In this study, we investigated the composition of the intestinal microflora associated with Yang-deficiency and the function-specific members of this microflora. Method: Subjects with normal and Yang-deficient constitutions were recruited in Beijing, with 30 subjects in each group. Illumina high-throughput sequencing was used to sequence the DNA of their fecal bacteria in the 16S rRNA V3–V4 region. The species abundance and distribution of the intestinal microflora in each specimen were determined with a statistical analysis of these sequences. We identified an underlying taxonomic trend with nonparametric PCoA and other statistical techniques. Results: (1) Subjects with Yang-deficiency displayed more uneven abundances of the taxa in their intestinal microflora than the subjects with normal Yang; (2) several differences were observed in the proportions of certain bacterial groups between the Yang-deficient and control groups; and (3) the following bacteria differed significantly between the two groups: (i) Brevundimonas, Leuconostoc, Turicibacter, Defluviitaleaceae incertae sedis, Rothia, and Butyricimonas were slightly higher in the Yang-deficient subjects, whereas (ii) Megasphaera, Ruminococcus, and Lachnospira were higher in the normal subjects than in the Yang-deficient subjects. Conclusions: The composition of the intestinal microflora is altered in Yang-deficient subjects

Association between body-constitution type and vascular endothelial dysfunction: A cross-sectional study in an adult obese/overweight population

Objective: To measure vascular endothelial function (VED) in obese/overweight people grouped according to the constitutional theory of traditional Chinese medicine (TCM). We wished to predict the risk of VED and cardiovascular diseases in obese/overweight populations. Methods: This was a cross-sectional study. Eighty-six obese/overweight volunteers from Beijing Chao-Yang Hospital were enrolled and divided into four groups based on body-constitution type: phlegm dampness (PD); phlegm dampness with blood stasis (PDBS); qi-deficiency (QD); balance (BA). Height, weight, waist circumference and hip circumference were measured, and percent body fat and reactive hyperemia index (RHI) calculated. Levels of vascular endothelial growth factor (VEGF), von Willebrand factor (vWF) and plasma endothelial-1 (ET-1) were detected by immunohistochemistry. Results: The RHI and vWF levels in the PDBS group were significantly lower than those in the BA group and QD group (P  .05). These two indicators displayed no significant differences among BA, QD, and PD groups (P > .05). There was no significant difference among the four groups in level of ET-1 or VEGF (P > .05). Conclusion: Of the four indicators selected, the RHI and vWF displayed significant differences between the PDBS group and BA group, and between the PDBS group and QD group. Hence, in an obese/overweight population with different constitutional types, compared with BA and QD groups, a relatively higher risk of suffering from VED was detected in the PDBS group. Meanwhile, this study provides the experimental basis for confirming the feasibility of constitutional classification in obese/overweight population. Keywords: Obese/overweight, Constitution classification, Vascular endothelial dysfunction, Reactive hyperemia inde

Classification of traditional Chinese medicine constitution based on facial features in color images

Objective: To explore the possible correlation between traditional Chinese medicine (TCM) constitution and facial features in color images and to improve the accuracy of automated constitution classification. Methods: Color images were taken of 5150 individuals of different professions. Automated face detection and key point positioning were performed on the collected images, which were then transformed into a standard size. The relationship between facial features and TCM constitution based on the red, green, blue (RGB) pixel and the local binary pattern (LBP) texture features was explored. Results: The overall accuracy rate and robustness of TCM constitution classification based on RGB features were low. Classification results of the phlegm-dampness, damp-heat, blood stasis, and balance constitutions achieved high accuracy rates. Classification accuracy rate using the LBP texture feature was higher than that of the RGB feature, with the best accuracy observed for the balance constitution. Conclusion: Application of computer image acquisition and processing of facial features may serve as an adjunct to the TCM diagnostic method of inspection

Consistency between traditional Chinese medicine constitution-based classification and genetic classification

Background: We studied the consistency between two classification systems for categorizing patients: traditional Chinese medicine (TCM) constitution-based methods, versus genetic clustering. Genetic classification in constitutional identification was also evaluated. Methods: A TCM physician evaluated the constitution of each patient, according to four examinations (inspection, auscultation-olfaction, interrogation, and palpation). Those who met the criteria for Yang-deficient, Yin-deficient, and balanced constitutions were enrolled in the study. Peripheral blood samples were obtained from the participants, and peripheral blood mononuclear cells were separated from the samples within 2 hours. Total RNA extraction from the white blood cells was performed; and an Affymetrix HG-U133 Plus2.0 array was used to determine the peripheral blood gene expression profiles. The samples were classified using a support vector machine genetic classifier, and the “leave-one-out” method was used for validation. Results: The global gene expression profiles of 32 samples were grouped into three categories, and the samples in each of the gene categories corresponded with the three constitution categories. The three constitution types were distinguished using the genetic classifier with 165 genes. The accuracy of the prediction classification was greater than 95% using mathematical method. Conclusions: Participants with Yin-deficient, Yang-deficient, and balanced constitutions have varying physical characteristics and gene expression patterns. Additionally, the results from TCM constitution classification matched those obtained by genetic classification. Finally, our preliminary gene classifier distinguishes among Yin-deficient, Yang-deficient, and balanced constitutions, and provides a methodological basis for identifying the different constitutions