Chen Li, Zhu Xiu-Ling, Lin Jie, Li Dong-Liang
Department of Hepatobiliary Disease, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
Department of Hepatobiliary Disease, 900 Hospital of the Joint Logistics Team of the Chinese PLA, Fuzhou, Fujian, China.
Front Pharmacol. 2024 Dec 6;15:1495343. doi: 10.3389/fphar.2024.1495343. eCollection 2024.
This study investigates the clinical benefits of integrating traditional Chinese medicine (TCM) with Transarterial Chemoembolization (TACE) in hepatocellular carcinoma (HCC) treatment via meta-analysis and an exploration of network pharmacology analysis (NPA).
A comprehensive search across different databases retrieved all randomized controlled trials (RCTs) evaluating TCM combined with TACE for HCC. Meta-analysis included 39 RCTs to assess the intervention effects. The bayesian network meta-analysis observed the relative efficacy and potential ranking of various interventions. Active compounds and target genes from frequently used TCM were sourced from the TCMSP database, while HCC disease targets were collected from five public disease databases. Regulatory networks connecting target genes with active components of key herbs were constructed. Following the identification of key genes, we conducted analyses of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) to enrich our understanding of their functions. NPA and molecular docking methods were refined to reveal potential interactions between TCM components and their specific targets.
The combination of TCM with TACE significantly enhances the efficacy and safety of HCC treatment, improving the overall response rate, disease control rate, and overall survival rate, while also reducing the incidence of adverse events. Among the TCM evaluated, Ganfu Formula proved to be the most effective in enhancing patient response rates. Analysis of all included medicinal herbs identified 10 pivotal TCMs and 17 core genes. GO analysis revealed their significance in protein interactions, whereas KEGG analysis highlighted their role in crucial oncological pathways. NPA and molecular docking techniques elucidate the underlying mechanisms of action of TCM components.
Adding TCM to TACE protocols significantly enhances treatment outcomes and safety in HCC patients by modulating tumor biology and systemic immune responses, highlighting its potential as an effective adjunct therapy. These findings support the inclusion of TCM in standard care regimens, offering potential for improved management of HCC.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024571280.
本研究通过荟萃分析和网络药理学分析（NPA）探索，调查中医（TCM）与经动脉化疗栓塞术（TACE）相结合在肝细胞癌（HCC）治疗中的临床益处。
在不同数据库中进行全面检索，获取所有评估中医联合TACE治疗HCC的随机对照试验（RCT）。荟萃分析纳入39项RCT以评估干预效果。贝叶斯网络荟萃分析观察了各种干预措施的相对疗效和潜在排名。常用中药的活性成分和靶基因来自TCMSP数据库，而HCC疾病靶点则从五个公共疾病数据库中收集。构建了连接靶基因与关键草药活性成分的调控网络。在确定关键基因后，我们进行了基因本体论（GO）和京都基因与基因组百科全书（KEGG）分析，以加深对其功能的理解。完善了NPA和分子对接方法，以揭示中药成分与其特定靶点之间的潜在相互作用。
中医与TACE联合使用可显著提高HCC治疗的疗效和安全性，提高总体缓解率、疾病控制率和总生存率，同时降低不良事件的发生率。在所评估的中药中，肝复方被证明在提高患者缓解率方面最有效。对所有纳入草药的分析确定了10种关键中药和17个核心基因。GO分析揭示了它们在蛋白质相互作用中的重要性，而KEGG分析突出了它们在关键肿瘤学途径中的作用。NPA和分子对接技术阐明了中药成分的潜在作用机制。
在TACE方案中加入中医可通过调节肿瘤生物学和全身免疫反应，显著提高HCC患者的治疗效果和安全性，突出了其作为有效辅助治疗的潜力。这些发现支持将中医纳入标准护理方案，为改善HCC管理提供了潜力。
