Lee Gayoung, Joung Jin-Yong, Cho Jung-Hyo, Son Chang-Gue, Lee Namhun
Department of Clinical Oncology, Cheonan Korean Medicine Hospital of Daejeon University, 4, Notaesan-ro, Seobuk-gu, Cheonan-si, No. 31099, Republic of Korea.
Liver and Immunology Research Center, Dunsan Korean Medicine Hospital of Daejeon University, 75, Daedeok-daero 176beon-gil, Seo-gu, Daejeon-si, No. 35235, Republic of Korea.
Evid Based Complement Alternat Med. 2018 Aug 12;2018:3412074. doi: 10.1155/2018/3412074. eCollection 2018.
Multidrug resistance (MDR) is the major reason for the failure of chemotherapy in colorectal cancer (CRC), and the primary determinant of MDR in CRC patients is active drug efflux owing to overexpression of P-glycoprotein (P-gp) in cancer tissues. Despite research efforts to overcome P-gp-mediated drug efflux, the high toxicity of P-gp inhibitors has been a major obstacle for the clinical use of these agents. The aim of this study was to review the literature for potential P-gp reversal agents among traditional herbal medicines, which offer the advantages of safety and potential synergetic effects in CRC chemotherapy.
We searched ten databases including 3 English databases, 1 Chinese medical database, and 6 Korean medical databases up to July 2018 and included in vivo and in vitro studies evaluating the effects of herbal medicines as P-gp reversal agents in CRC.
A total of 28 potentially related studies were identified and 16 articles were included. Involving 3 studies about and 2 studies about , finally we found 14 kinds of traditional herbal medicines- and Lour, and -as showing efficacy as P-gp inhibitors in anticancer drug-resistant CRC cells in vitro and in vivo.
This brief account provides insight into the relationship between P-gp and CRC. Further studies on herbal medicines with demonstrated effects against P-gp overexpression will aid in improving the efficacy of chemotherapy in CRC.
多药耐药（MDR）是结直肠癌（CRC）化疗失败的主要原因，CRC患者MDR的主要决定因素是癌组织中P-糖蛋白（P-gp）过表达导致的药物主动外排。尽管人们致力于克服P-gp介导的药物外排，但P-gp抑制剂的高毒性一直是这些药物临床应用的主要障碍。本研究的目的是回顾传统草药中潜在的P-gp逆转剂的文献，这些草药在CRC化疗中具有安全性和潜在协同作用的优势。
我们检索了10个数据库，包括3个英文数据库、1个中国医学数据库和6个韩国医学数据库，检索截至2018年7月的文献，并纳入评估草药作为CRC中P-gp逆转剂作用的体内和体外研究。
共鉴定出28项潜在相关研究，纳入16篇文章。涉及3项关于[具体草药1]的研究和2项关于[具体草药2]的研究，最终我们发现14种传统草药——[草药名称1]、[草药名称2]、[草药名称3]等——在体外和体内对耐抗癌药的CRC细胞具有P-gp抑制剂的功效。
本简要报告深入探讨了P-gp与CRC之间的关系。对已证明对P-gp过表达有作用的草药进行进一步研究，将有助于提高CRC化疗的疗效。
