Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Radix Stephaniae Tetrandrine: An Emerging Role for Management of Breast Cancer

Author(s): Yubo Guo, Beibei Chen, Xiaohua Pei* and Dongwei Zhang*

Volume 26, Issue 1, 2020

Page: [25 - 36] Pages: 12

DOI: 10.2174/1381612826666200110143706

Price: $65

Abstract

Background: Radix Stephaniae Tetrandrine (RST), known as FangJi (Pinyin name) in Chinese, is the dried root of Stephania tetrandra S.Moore, and has been prescribed in combination with other herbs to treat cardiovascular diseases and breast cancer in traditional Chinese medicine (TCM) clinical trials.

Objective: The aim of the review is to provide a comprehensive evaluation about the application of RST in breast cancer management in TCM clinical trials, its ingredients, and its action on preventing the development of breast cancer in vitro and in vivo studies.

Methods: Literature sources used were Pubmed, CNKI.net, Cqvip.com, and the Web of Science. For the inquiry, keywords such as Fangji, breast cancer, clinical trials, Radix Stephaniae Tetrandrine, tetrandrine, and fangchinoline were used in various combinations. About 150 research papers and reviews were consulted.

Results: In TCM, RST exhibited the anti-tumor ability through its action on the bladder and lungs through dispersing phlegm and blood stasis. 10 clinical trials were identified which used RST in combination with other herbs to treat breast cancer. On average, the trials were characterized by high efficacy (>85%) and low toxicity. However, most of the clinical trials are characterized as small patient samples, poor design, and different combinations of herbs in prescriptions. To date, more and more compounds have been isolated from this plant. RST exhibited anti-tumor activities by targeting reversing multidrug resistance, inhibiting cell proliferation, inducing apoptosis, preventing tumor angiogenesis, anti-oxidation, anti-inflammation, and enhancing the sensitization and attenuating the toxicity of radiotherapy.

Conclusion: The successful applications of RST in TCM clinical trials and preclinical experiments to beating breast cancer will provide potent lead compounds in the identification of novel anti-cancer drugs, which further contributes to the scientific exploration of functions of RST in TCM.

Keywords: Radix Stephaniae Tetrandrine, breast cancer, pharmacology, phytochemistry, TCM clinical trials, preclinical experiments.

« Previous Next »
[1]
Huang HP, Peng HS, Wang DL, et al. The historical evolution of Chinese medicine radix stephaniae tetrandrae. Zhong Yao Cai 2015; 38: 1533-5.
[2]
Zhu ZW, Gu YY, Han YS, et al. Position thinking and research in treatment of cancer of traditional Chinese medicine. Liaoning J Trad Chinese Med 2018; 45: 423-5.
[3]
Q W, L Z, Y F Research on the Dosage of Fangji in Different Era. World Chinese Medicine 2015; pp. 624-7.
[4]
Wong TM, Wu S, Yu XC, Li HY. Cardiovascular actions of radix stephaniae tetrandrae: a comparison with its main component, tetrandrine. Acta Pharmacol Sin 2000; 21(12): 1083-8.
[PMID: 11603280]
[5]
Zhang JH, Yang Y, Song Q, et al. Clinical observation on the effect of fangji fuling decoction on prevention of subcutaneous hydras after modified radical mastectomy of breast cancer. Liaoning J Trad Chinese Med 2012; 39: 1109-10.
[6]
Liu H. Clinical effect of fangji fuling decoction on prevention of subcutaneous fluid accumulation after breast cancer surgery. Lishizhen Med Materia Med Res 2013; 24: 2190-1.
[7]
Tang M. Clinical value of fangji huangqi decoction in treating postoperative limb edema of breast cancer. Inner Mongolia J Trad Chinese Med 2018; 37: 3-4.
[8]
Yang Y. Fangji hsuangqi decoction for breast cancer patients with postoperative limb edema. China Cont Med Edu 2016; 8: 175-6.
[9]
Huang GX. Clinical observation of the treatment of limb edema after breast cancer operation with anti-huanghuang decoction. Chinese J Modern Drug App 2018; 12: 204-6.
[10]
He Y. Clinical observation on modified fangji huangqi decoction in the treatment of limb edema after radical resection of breast cancer. Guangming J Chinese Med 2018; 33: 504-6.
[11]
Li JJ, Xing TY. Therapeutic effect of fangji huangqi decoction on postoperative limb edema in patients with breast cancer. Shaanxi J Trad Chinese Med 2016; 37: 806-7.
[12]
Liu HL. Clinical research of fangji huangqi decoction treatment of postoperative limb edema in breast cancer. Inner Mongolia Med J 2018; 50: 1092-3.
[13]
Wang W, Kong LM, Jiang MQ. Effects of fangji huangqi decoction on edema and immunity of postoperative breast cancer. World Chinese Med 2018; 13: 1119-22.
[14]
Wang MM, Wang CZ, Liu GH, et al. Observation of curative effect of shuxue tong and huoxue lishui decoction on upper limb edema after breast cancer operation. Heilongjiang Med J 2018; 31: 75-7.
[15]
Liu B, Wang T, Qian X, Liu G, Yu L, Ding Y. Anticancer effect of tetrandrine on primary cancer cells isolated from ascites and pleural fluids. Cancer Lett 2008; 268(1): 166-75.
[http://dx.doi.org/10.1016/j.canlet.2008.03.059] [PMID: 18495333]
[16]
Zhang LZ, He HM, Li XF, et al. Relationship between effect of tetrandrine on pleurisy and cAMP of inflammatory neutrophils. Zhongguo Yaolixue Tongbao 2003; 19: 791-6.
[17]
Wang WS. Preliminary study on treatment of cancerous ascites with modified fangji huangqi decoction. J Sichuan Trad Chinese Med 2007; 25: 59.
[18]
Yang QL. Clinical observation on 40 cases of Anti-cancer lishui decoction combined western medicine in treating malignant ascites. J Prac Trad Chinese Inter Med 2015; 29: 85-7.
[19]
Wang R, Ma TM, Liu F, Gao HQ. [Research progress on pharmacological action and clinical application of stephania tetrandrae radix]. Zhongguo Zhongyao Zazhi 2017; 42(4): 634-9.
[PMID: 28959829]
[20]
Yu XC, Wu S, Chen CF, Pang KT, Wong TM. Antihypertensive and anti-arrhythmic effects of an extract of radix stephaniae tetrandrae in the rat. J Pharm Pharmacol 2004; 56(1): 115-22.
[http://dx.doi.org/10.1211/0022357022458] [PMID: 14980008]
[21]
Lee Y-S, Han S-H, Lee S-H, et al. The mechanism of antibacterial activity of tetrandrine against staphylococcus aureus. Foodborne Pathog Dis 2012; 9(8): 686-91.
[http://dx.doi.org/10.1089/fpd.2011.1119] [PMID: 22845553]
[22]
Fang L-H, Zhang Y-H, Ku B-S. Fangchinoline inhibited the antinociceptive effect of morphine in mice. Phytomedicine 2005; 12(3): 183-8.
[http://dx.doi.org/10.1016/j.phymed.2003.06.007] [PMID: 15830839]
[23]
Liu JQ, Zhang YN, Zhao W, et al. Research progress of radix stephaniae tetrandrae chemical constituents and pharmacology. Acta Chinese Med Pharmacol 2017; 45: 100-3.
[24]
Eldehna WM, El-Naggar DH, Hamed AR, Ibrahim HS, Ghabbour HA, Abdel-Aziz HA. One-pot three-component synthesis of novel spirooxindoles with potential cytotoxic activity against triple-negative breast cancer MDA-MB-231 cells. J Enzyme Inhib Med Chem 2018; 33(1): 309-18.
[http://dx.doi.org/10.1080/14756366.2017.1417276] [PMID: 29281924]
[25]
Huang CP, Lin M. Pathogenesis and postoperative health guidance of breast cancer. Sci Technol Indus Parks 2017; 10: 27.
[26]
Nagini S. Breast cancer: current molecular therapeutic targets and new players. Anticancer Agents Med Chem 2017; 17(2): 152-63.
[http://dx.doi.org/10.2174/1871520616666160502122724] [PMID: 27137076]
[27]
Yin HF, Qian XP, Liu BR. Research progress on the anti-tumor mechanism of tetrandrine. J Modern Oncol 2011; 19: 582-4.
[28]
Ma R, Zhu R, Wang L, et al. Diabetic osteoporosis: a review of its traditional Chinese medicinal use and clinical and preclinical research. Evid Based Complement Alternat Med 2016; 2016 3218313
[http://dx.doi.org/10.1155/2016/3218313] [PMID: 27698674]
[29]
Wang L, Ma R, Liu C, et al. Salvia miltiorrhiza: a potential red light to the development of cardiovascular diseases. Curr Pharm Des 2017; 23(7): 1077-97.
[http://dx.doi.org/10.2174/1381612822666161010105242] [PMID: 27748194]
[30]
Guo Y, Li Y, Xue L, et al. Salvia miltiorrhiza: an ancient Chinese herbal medicine as a source for anti-osteoporotic drugs. J Ethnopharmacol 2014; 155(3): 1401-16.
[http://dx.doi.org/10.1016/j.jep.2014.07.058] [PMID: 25109459]
[31]
Wang L, Li Y, Guo Y, et al. Herba epimedii: an ancient Chinese herbal medicine in the prevention and treatment of osteoporosis. Curr Pharm Des 2016; 22(3): 328-49.
[http://dx.doi.org/10.2174/1381612822666151112145907] [PMID: 26561074]
[32]
Liu S, Hua YQ, Sun ZP, Tan S, Lu DM. [Breast cancer pathogenesis of stagnation of phlegm, poison and blood stasis: rationale and clinical application in traditional Chinese medicine]. J Chin Integr Med 2007; 5(2): 122-5.
[http://dx.doi.org/10.3736/jcim20070203] [PMID: 17352863]
[33]
Wang XL, Liu X, Xia CY, et al. Research progress in chemical constituents in single herbs of fangji huangqi decoction and its pharmacological activities. Chin Tradit Herbal Drugs 2016; 47: 3527-34.
[34]
Xing ZB, Yao L, Zhang GQ, Zhang XY, Zhang YX, Pang D. Fangchinoline inhibits breast adenocarcinoma proliferation by inducing apoptosis. Chem Pharm Bull (Tokyo) 2011; 59(12): 1476-80.
[http://dx.doi.org/10.1248/cpb.59.1476] [PMID: 22130369]
[35]
Jin Q, Kang C, Soh Y, et al. Tetrandrine cytotoxicity and its dual effect on oxidative stress-induced apoptosis through modulating cellular redox states in Neuro 2a mouse neuroblastoma cells. Life Sci 2002; 71(17): 2053-66.
[http://dx.doi.org/10.1016/S0024-3205(02)01989-6] [PMID: 12175898]
[36]
Choi HS, Kim HS, Min KR, et al. Anti-inflammatory effects of fangchinoline and tetrandrine. J Ethnopharmacol 2000; 69(2): 173-9.
[http://dx.doi.org/10.1016/S0378-8741(99)00141-5] [PMID: 10687873]
[37]
He FQ, Qiu BY, Li TK, et al. Tetrandrine suppresses amyloid-β-induced inflammatory cytokines by inhibiting NF-κB pathway in murine BV2 microglial cells. Int Immunopharmacol 2011; 11(9): 1220-5.
[http://dx.doi.org/10.1016/j.intimp.2011.03.023] [PMID: 21496499]
[38]
Seebacher N, Lane DJ, Richardson DR, Jansson PJ. Turning the gun on cancer: utilizing lysosomal P-glycoprotein as a new strategy to overcome multi-drug resistance. Free Radic Biol Med 2016; 96: 432-45.
[http://dx.doi.org/10.1016/j.freeradbiomed.2016.04.201] [PMID: 27154979]
[39]
Stavrovskaya AA, Rybalkina EY. Recent advances in the studies of molecular mechanisms regulating multidrug resistance in cancer cells. Biochemistry (Mosc) 2018; 83(7): 779-86.
[http://dx.doi.org/10.1134/S0006297918070015] [PMID: 30200862]
[40]
Li HY, Chen Y, He QY. Mechanism of combination of matrine and tetrandrine for reversal of multidrug resistance of breast carcinoma MCF-7 cells. Zhongguo Shiyan Fangjixue Zazhi 2013; 19: 275-8.
[41]
Wang TX, Yang XH. Reversal effect of isotetrandrine, an isoquinoline alkaloid extracted from Caulis Mahoniae, on P-glycoprotein-mediated doxorubicin-resistance in human breast cancer (MCF-7/DOX) cells. Yao Xue Xue Bao 2008; 43(5): 461-6.
[PMID: 18717331]
[42]
Wang JQ, Chen BA, Cheng J, Xu WL, Sun XC. [Comparison of reversal effects of 5-bromotetrandrine and tetrandrine on P-glycoprotein-dependent Resistance to adriamycin in human lukemia cell line K562/A02]. Chin J Cancer 2008; 27(5): 491-5.
[PMID: 18479598]
[43]
Pei XH, Li TH. Antitumor effect of tetrandrine on MCF-7 in tumor bearing nude mice. China Assoc Chinese Med 2011; 6: 325-30.
[44]
Pei XH, Fan YY. Combined effect of arsenic trioxide and tetrandrine on MCF-7 cell. J Nanjing Uni Trad Chinese Med 2009; 2009(2): 13.
[45]
Wang TX, Li M, Zhang Y. Study on isotetrandrine enhancing the effect of doxorubicin-induced apoptosis on breast cancer cell lines MCF-7/DOX. Zhongguo Fuyou Baojian 2008; 23: 5052-3.
[46]
Wang JH, Ye ZG, Sun AX, et al. [Reversal of anti-apoptotic action by tetrandrine in human breast carcinoma multidrug-resistant MCF-7 cells]. Zhongguo Zhongyao Zazhi 2002; 27(1): 46-50.
[PMID: 12774357]
[47]
Ye ZG, Wang JH, Sun AX, et al. [Poteintation of vincristine-induced apoptosis by tetrandrine, neferine and dauricine in the human mammary MCF-7 multidrug-resistant cells]. Yao Xue Xue Bao 2001; 36(2): 96-9.
[PMID: 12579872]
[48]
Wang JH, Ye ZG, Sun AX, et al. Reversal of anti-apoptotic action by tetrandrine in the human breast carcinoma doxorubicin-resistant MCF-7 cells. Chinese J Histochem Cytochem 2000; 9: 438-42.
[49]
Yao M, Yuan B, Wang X, et al. Synergistic cytotoxic effects of arsenite and tetrandrine in human breast cancer cell line MCF-7. Int J Oncol 2017; 51(2): 587-98.
[http://dx.doi.org/10.3892/ijo.2017.4052] [PMID: 28656245]
[50]
Wu JY, Shen Q, Jin YJ, et al. Study on effect of tetrandrine on akt activity in MCF-7 cell line. Chinese J Pharmacovigilance 2016; 13: 257-9.
[51]
Wu JY, Shen Q, Jin YJ, et al. Influence of tetrandrine on apoptosis and AKT/NF-κB signal pathway in human MCF-7 cell line. Chinese J Oncol 2010; 17: 1524-7.
[52]
Luo SM, Ke CH, Cai JY, et al. Effects of tetrandrine combined with cisplatin on breast cancer cells in vitro. Biotechnology (Faisalabad) 2011; 21: 64-9.
[53]
He QY, Zhang HQ, Jiang B, et al. Effective reversal of adriamycin resistance in Chinese hamster ovary cell by tetrandrine. J Beijing Normal Uni (Natural Science) 1991; 27: 314-5.
[54]
Wong VKW, Zeng W, Chen J, et al. Tetrandrine, an activator of autophagy, induces autophagic cell death via PKC-α inhibition and mTOR-Dependent mechanisms. Front Pharmacol 2017; 8: 351.
[http://dx.doi.org/10.3389/fphar.2017.00351] [PMID: 28642707]
[55]
Liu BT, Zhang YH, Wang BG. Experimental study for the apoptosis of breast cancer cells induced by Fangchinoline. Chinese J Current Adv Gen Surg 2016; 19: 589-91.
[56]
Liu T, Liu X, Li W. Tetrandrine, a Chinese plant-derived alkaloid, is a potential candidate for cancer chemotherapy. Oncotarget 2016; 7(26): 40800-15.
[http://dx.doi.org/10.18632/oncotarget.8315] [PMID: 27027348]
[57]
Yan XY. New strategies for tumor neovascularization and molecular targeted therapy. Acta Biophysica Sinica 2010; 26: 180-93.
[58]
Lu MY, Zhong WL, Si CF, et al. Tumor angiogenesis and tumor vascular-targeted drug: research advances. Anhui Yiyao 2018; 22: 798-802.
[59]
Qian XP, Liu BR, Hu J, et al. [Inhibitory effect of tetrandrine on angiogenesis]. Chin J Cancer 2008; 27(10): 1050-5.
[PMID: 18851784]
[60]
Zhang XM, Zhang XP. Effects of tetrandrine on phenotypic modulation of vascular smooth muscle cells and expression of p38 MAPK as well as MKP-1 after intimal injury of rabbit carotid arteries. Res Explor Lab 2008; 27: 41-4.
[61]
Zhang XP, Pang YH, Feng YB, et al. Effects of tetrandrine on phenotypicmodulation of vascular smoothmuscle cells and expression of mitogen-activated protein kinase phosphotase-1 after intmial injury of rabbit carotid arteries. Chinese Heart J 2006; 18: 131-4.
[62]
Feng YP. Effects of tetrandrine on the proliferation of hypertrophic scar fibroblasts in vitro. Herald Med 2008; 27: 1455-7.
[63]
Panka DJ, Atkins MB, Mier JW. Targeting the mitogen-activated protein kinase pathway in the treatment of malignant melanoma. Clin Cancer Res 2006; 12(7 Pt. 2): S2371-5.
[http://dx.doi.org/10.1158/1078-0432.CCR-05-2539] [PMID: 16609061]
[64]
Gao JL, Ji X, He TC, et al. Tetrandrine suppresses cancer angiogenesis and metastasis in 4T1 tumor bearing mice. Evid Based Complement Alternat Med 2013; 2013 265061
[http://dx.doi.org/10.1155/2013/265061] [PMID: 23762115]
[65]
Rao MR. Effects of tetrandrine on cardiac and vascular remodeling. Acta Pharmacol Sin 2002; 23(12): 1075-85.
[PMID: 12466044]
[66]
Tobar N, Guerrero J, Smith PC, Martínez J. NOX4-dependent ROS production by stromal mammary cells modulates epithelial MCF-7 cell migration. Br J Cancer 2010; 103(7): 1040-7.
[http://dx.doi.org/10.1038/sj.bjc.6605847] [PMID: 20717118]
[67]
Graham KA, Kulawiec M, Owens KM, et al. NADPH oxidase 4 is an oncoprotein localized to mitochondria. Cancer Biol Ther 2010; 10(3): 223-31.
[http://dx.doi.org/10.4161/cbt.10.3.12207] [PMID: 20523116]
[68]
Huang Y, Jiang DH, Fan WM. Antagonistic effect of tetrandrine on multidrug resistance of breast cancer cells and the antioxidant mechanism. Zhongguo Fuyou Baojian 2017; 32: 2469-72.
[69]
Xie HH. Side effects and nursing of postoperative radiotherapy for breast cancer. Chinese J Misdiagnostics 2008; 8: 392-3.
[70]
Tian QZ, Han XL, Sun XC. Study of potentiation of radiosensitivity by tetrandrine and its mechanism. J Southeast Univ (Med Sci Ed) 2005; 24: 233-6.
[71]
Ma Y, Ren Y, Dai ZJ, Wu CJ, Ji YH, Xu J. IL-6, IL-8 and TNF-α levels correlate with disease stage in breast cancer patients. Adv Clin Exp Med 2017; 26(3): 421-6.
[http://dx.doi.org/10.17219/acem/62120] [PMID: 28791816]
[72]
Fouad TM, Kogawa T, Reuben JM, Ueno NT. The role of inflammation in inflammatory breast cancer. Adv Exp Med Biol 2014; 816: 53-73.
[http://dx.doi.org/10.1007/978-3-0348-0837-8_3] [PMID: 24818719]
[73]
Shen YC, Chou CJ, Chiou WF, Chen CF. Anti-inflammatory effects of the partially purified extract of radix stephaniae tetrandrae: comparative studies of its active principles tetrandrine and fangchinoline on human polymorphonuclear leukocyte functions. Mol Pharmacol 2001; 60(5): 1083-90.
[http://dx.doi.org/10.1124/mol.60.5.1083] [PMID: 11641437]
[74]
Muñoz-Pérez VM, Fernández-Martínez E, Ponce-Monter H, Ortiz MI. Relaxant and anti-inflammatory effect of two thalidomide analogs as PDE-4 inhibitors in pregnant rat uterus. Korean J Physiol Pharmacol 2017; 21(4): 429-37.
[http://dx.doi.org/10.4196/kjpp.2017.21.4.429] [PMID: 28706457]
[75]
Lu Y, Ge ZW, Liu JL. Expression changes and significance of BLM and RecQ4 helicases in breast cancer stem cells. Shandong Yiyao 2017; 57: 17-20.
[76]
Yan WT, Pan WD, Liu BC, et al. Effects of tetrandrine derivatrve P-42 on proliferation and apoptosis. Shandong Yiyao 2016; 56: 1-4.
[77]
Sun XC, Wang JJ, Zhen YS, et al. Potentiation of radiosensitivity by tetrandrine in human breast cancer cells and its mechanism. Chinese J Radiol Med Protec 2003; 23: 19-21.

Rights & Permissions Print Cite
Article Metrics
28
© 2024 Bentham Science Publishers | Privacy Policy