Chinese herbal medicine for incomplete immune reconstruction in patients with AIDS undergoing antiretroviral treatment: A systematic review of randomized trials

Objective:To evaluate the effectiveness and safety of Chinese herbal medicines(CHMs)for incomplete immune reconstruction in patients with HIV/AIDS.Methods:Eight electronic databases were searched for randomized controlled trials(RCTs)on the use of CHM for patients with HIV/AIDS with incomplete immune reconstruction.Outcomes included CD4þcell count,quality of life,and adverse events/effects.The Cochrane Risk of Bias was employed to evaluate the methodological quality of the included RCTs.Results:We identified 13 eligible RCTs,with an overall high risk of bias,on 10 different CHMs.There was a significant increase in CD4þcell count after the use of Jianpi Yiqi medicinal paste for 3 months;tripterygium glycosides tablets(TGTs)for 3 months(mean difference[MD]52.63 cells/mL,95%confidence interval[CI,46.98,58.28]),6,9,and 12 months;Wenshen Jianpi granules for 6 months;Shenling Fuzheng capsules for 6 months(MD 49.53 cells/mL,95%CI[8.45,90.61])and 12 months;Aikeqing granules for 9 months(MD 61.51 cells/mL,95%CI[16.25,106.77])and 12 months;Guipi decoction for 12 months;Mianyi No.2 granules(JT)for 12 and 18 months;and Chinese medicine granules for 18 months.The increase in the mean difference of CD4þcell count from 6 to 18 months was larger in Chinese medicine granules and Mianyi No.2 granules(JT).Guipi decoction and Jianpi Qushi decoction improved the Karnofsky score.Four RCTs reported the outcome of adverse events/effects,while four cases of minor adverse effects were reported in the TGTs group.Conclusion:Jianpi Yiqi medicinal paste,Wenshen Jianpi granules,Shenling Fuzheng capsules,Aikeqing granules,Guipi decoction,and TGTs may be effective in increasing CD4þwithin 12 months,and Mianyi No.2 granules(JT)and Chinese medicine granules may show long-term effects.High-quality large RCTs on the effectiveness and safety of CHMs are still warranted.

Wenshen Jianpi recipe(温肾健脾方) induced immune reconstruction and redistribution of natural killer cell subsets in immunological non-responders of human immunodeficiency virus/acquired immune deficiency syndrome:a randomized controlled trial

OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.

T－LYMPHOCYTE MEDIATED TUMOR CELL DESTRUCTIONIN VIVO ASSOCIATING WITH A SPECIFICFEATURE OF APOPTOSIS

The immunological responsiveness of the T-cell immunodificient NC nude mice tumor models was reconstructed by thymic transplantation of the semidominance NC mice. After immune reconstruction(IR) the tumor continued to grow until 2 to 3 weeks, then the volume of the tumor reduced gradually and disappeared at the 9th week in both H901 and SW1116 solid tumor nodules was found by light microscopic study(IM), after IR. tumor cells gradually replaced by lymphocytes and fibroblasts, shrinked till only isolated cell groups, then totally disappeared. The whole processes like that the tumor cells were nibbled. It was found that the main tumor cell death related with a specific feature of apoptosis, which had typical dense chromatin distributed along the inner surface of the nuclear membrane by transmission electron microscopic study(TEM). The IR model could be useful for further mechanical research of immune system.

Effects of dendritic cell vaccines on hematogenous micrometastasis of bladder cancer carrying for PBL-SCID mice

Objective： To study the effect of dendritic cells loaded with whole tumor antigen on hematogenous micrometastasis of bladder cancer model in hu-PBL-SCID mice. Methods： T24-3 ceil subset was selected from human bladder transitional cell carcinoma T24 cell line by Boyden chamber system. The SCID mice intraperitoneally injected with 4 × 10^7 hu-PBL and subcutaneously injected with 3 × 10^6 T24-3 cells were named hu-PBL-T24-3-SCID model. Human IgG level in the blood plasma of mice was detected by ELISA, and human CD3^＋, CD4^＋, CD8^＋ T cells in blood and spleen cells of mice were detected by FCM analysis for human immune reconstruction study. Human CK20 mRNA expression in mice peripheral blood was detected by RT-PCR to investigate metastasis of tumor cells. The PBMCs were isolated from human peripheral blood, and were induced into DCs by co-culture with rhGM-CSF and rhlL-4 in vitro. The DC vaccines were produced by co-culturing with whole tumor antigen which was purified through freezing and melting T24-3 cell subset. After T24-3 cells injected into SCID mice for 5 weeks, the mice were treated with DC vaccines. Results： All mice were initially treated at 5th week. The expression of CK20 mRNA in peripheral blood of DC vaccines treated mice was the lowest. There was 2 mice showing CK20 mRNA expression and 3 mice with metastasis tumor in PBS group. MMP-7 mRNA expression in tumor tissues of DC vaccines treated mice was statistically lower than that of PBS group （P 〈 0.01）. Conclusion： DC vaccines have a good effect on hu-PBL-SCID mice bladder cancer model by reducing hematogenous micrometastasis.

Cancer Rehabilitation,A New Discipline Based upon Multidisciplinary Collaboration

Cancer Rehabilitation is a new discipline,a combination of tumor medication,immunology,psychology,nutritional science and exercise physiology etc..The core of cancer rehabilitation is the therapy of natural immunology,which aims at activating T-cells,and restoring the bone marrow function impaired during chemo-radiation therapy.Cancer rehabilitation seeks to achieve the gradual recovery of the immune system,which in turn hinders recurrence and metastasis.In addition,with the help of psychological consultation,nutritional and physical exercise guidance,cancer patients may have a better chance at managing the risk of recurrence and metastasis,extending life expectancy with an improved quality of life.