Xiaoaiping injection affects the invasionand metastasis of hepatocellular carcinomaby controlling AFP expression

Objective Xiaoaiping (XAP) is a traditional Chinese medicine that is a commonly used as an anticancerdrug in clinical practice owing to its high efficiency and low toxicity. Specifically, XAP can effectively inhibitthe growth of hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is a key HCC diagnostic marker andis closely related to certain malignant cytological behaviors of HCC. However, whether AFP expression andXAP treatment are related to the invasion and metastasis of HCC remains unclear. In the present study, weaimed to evaluate the effects and underlying mechanism of XAP on the invasion and metastasis of HCC..Methods Using a cell scratch assay, Transwell technology, and western blotting we detected the differentinvasion and metastatic abilities of Hep3B cells in XAP treatment and blank control groups. This allowedcomparison of the invasion and metastatic abilities of Hep3B cells with differing levels of AFP expression.AFP mRNA sequencing technology was used to analyze the mechanism of tumor invasion and metastasisassociated with AFP and XAP treatment.Results Cell invasion and metastasis abilities in the XAP group were significantly lower than those in thecontrol group (P < 0.05). Additionally, compared to the control group, the expression of AFP significantlydecreased after XAP treatment (P < 0.05). The ability of Hep3B cells to invade and metastasize waspromoted when AFP expression was up-regulated, whereas it was inhibited when AFP was silenced. XAPinjection and AFP regulate the invasion and metastatic ability of HCC by affecting matrix metalloproteinases(MMPs).Conclusion XAP injection inhibits the invasion and metastatic ability of HCC by influencing the expressionof AFP;additionally, this inhibition of AFP is achieved by affecting MMPs.

Xiaoaiping injection combined with cisplatin and gemcitabine for non-small cell lung cancer:a meta-analysis

Objective:To evaluate the clinical efficacy of Xiaoaiping injection(XAPI)combined with cisplatin plus gemcitabine(regimen of GP)for patients with non-small cell lung cancer(NSCLC).Methods:A literature search was conducted for collecting the randomized controlled trials(RCTs)on NSCLC treated by Xiaoaiping injection and GP in the Cochrane Library,PubMed,Embase,Chinese National Knowledge Infrastructure(CNKI),China Biology Medicine(CBM),China Science and Technology Journal Database(VIP)and the Wanfang Database from inception to December,2018.The quality of the RCTs was evaluated by the Cochrane risk of bias assessment tool,and data analysis were performed with Review Manager 5.3.Results:A total of 7 randomized controlled trials with 534 patients were incorporated.The results showed that there is no statistical significance in total effective rate[OR=1.39,95%CI(0.97,1.98),P=0.07]and gastrointestinal reactions rate[OR=0.44,95%CI(0.16,1.23),P=0.12]between GP alone and XAPI combined with GP.In comparison with GP alone,the XAPI combined with GP was associated with the lower effects on the decrease rate of hemoglobin[OR=0.49,95%CI(0.26,0.92),P=0.03],leukocyte[OR=0.40,95%CI(0.21,0.74),P=0.004]and platelet[OR=0.43,95%CI(0.22,0.87),P=0.02].However,performance status[OR=3.78,95%CI(2.24,6.38),P<0.0001]of patients in XAPI plus GP group is better than GP alone group.Conclusion:The combination of XAPI and GP has certain curative effect for patients with NSCLC compared with only receiving GP.However,more well-designedand multicenter RCTs should be performed to verify this result because of the quality of enrolled RCTs.

Chemical constituents from Xiaoaiping injection

Xiaoaiping injection is a single-prescription of Marsdenia tenacissima. One new compound, tenacigenoside L （1）, along with ten known compounds were isolated from the CHCl3-soluble fraction of Xiaoaiping injection extract by silica gel, ODS, Sephadex LH-20 and semi-preparative HPLC chromatography. The new compound was characterized as 3-O-β-D-oleandropyranosyl- 17β-tenacigenin B. The ten known compounds were identified as tenacigenin B （2）, 17β-tenacigenin B （3）, marsdenoside F （4）, tenacissoside G （5）, tenacissoside I （6）, tenacissoside H （7）, marsdenoside D （8）, tenacigenin A （9）, marsdenoside I （10）, and tenacigenin C （11）. The structures of 11 compounds were elucidated on the basis of extensive analyses of spectroscopic data including MS, 1D NMR and 2D NMR, and comparison of their spectroscopic data with those reported in the literatures.

Clinical value of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small cell lung cancer： a Meta-analysis

OBJECTIVE: To investigate the clinical efficacy and safety of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy in the treatment of advanced non-small celllung cancer(NCSLC) compared with chemotherapy alone.METHODS: Databases including Chinese National Knowledge Infrastructure, China Biology Medicine Disc, Wanfang, and MEDLINE were searched until April 1, 2014. Two assessors independently reviewed each trial. The primary outcome was the effective rate(ER) of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy. The secondary outcomes included quality of life improvement rate(QOLIR) and adverse reactions. Statistical calculations were performed by using Cochrane Collaboration Review Manager 5.2.RESULTS: A total of 888 patients from 15 studies,13 randomized controlled trials(RCT) and two controlled clinical trials, were included. Compared with chemotherapy alone, Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly improved ER [Risk ratio(RR) =1.32, 95% CI,(1.14, 1.54)](based on 15 studies) and QOLIR [RR = 2.04, 95% CI,(1.69, 2.47)](based on 13studies). Compared with chemotherapy alone,Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract plus chemotherapy significantly inhibited chemotherapy-induced white blood cell decline [RR = 0.79, 95% CI,(0.70, 0.90)(based on 10 studies), chemotherapy-induced platelet decline[RR = 0.77, 95% CI,(0.60, 0.98)](based on 8 studies),and significantly alleviated nausea and vomiting(NV) [RR = 0.83, 95% CI,(0.71, 0.97)](based on 7studies). There was no significant difference in hemoglobin decline between the two therapies [RR =0.88, 95% CI,(0.70, 1.09)](based on 6 studies).CONCLUSION: This Meta-analysis suggests that Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract combined with chemotherapy may be more efficacious in the treatment of advanced NSCLC than chemotherapy alone. This effect includes enhancing ER and QOLIR, and weakening chemotherapy toxicity. However, large-scale RCTs are required to further investigate the short- and long-term effects of Tongguanteng(Radix seu Herba Marsdeniae Tenacissimae) extract.