Gastrointestinal tumors have a major impact on human life expectancy and quality of life and are a major cause of personal and social hygiene stress. Gastrointestinal tumors are the main cause of cancer-related death, and the main treatment methods are surgery, radiotherapy, and chemotherapy. However, they also cause great damage to the body and have a poor prognosis after surgery. Therefore, we urgently need safe and effective drugs to intervene in gastrointestinal tumors. In recent years, Traditional Chinese Medicine has been widely used in tumor treatment as a complementary and alternative therapy. Astragalus membranaceus is one of the main herbal medicines with tonic effect and one of the important components of many antitumor herbal compounds. Astragalus polysaccharides, saponins, and flavonoids are the main active components of Astragalus, all of which have antitumor effects. In this article, we studied the mechanism of action of Astragalus and its active ingredients in the intervention of gastrointestinal tumors in recent years and suggested a new approach for the study of Astragalus intervention in gastrointestinal tumors from the perspective of the homology of medicine and food.
Get full access to this article
View all access options for this article.
References
1.
LechG, SłotwińskiR, SłodkowskiM, et al.Colorectal cancer tumour markers and biomarkers: Recent therapeutic advances. World J Gastroenterol, 2016; 22(5):1745–1755; doi: 10.3748/wjg.v22.i5.1745
2.
CaoW, ChenHD, YuYW, et al.Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020. Chin Med J (Engl), 2021; 134(7):783–791; doi: 10.1097/CM9.0000000000001474
3.
SunY, LiB, CaoQ, et al.Targeting cancer stem cells with polymer nanoparticles for gastrointestinal cancer treatment. Stem Cell Res Ther, 2022; 13(1):489; doi: 10.1186/s13287-022-03180-9
4.
XiangY, GuoZ, ZhuP, et al.Traditional Chinese medicine as a cancer treatment: Modern perspectives of ancient but advanced science. Cancer Med, 2019; 8(5):1958–1975; doi: 10.1002/cam4.2108
5.
National Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China. Beijing:China Medical Science Press, 2015:302–303.
6.
ZhangJ, WuC, GaoL, et al.Astragaloside IV derived from Astragalus membranaceus: A research review on the pharmacological effects. Adv Pharmacol, 2020; 87:89–112; doi: 10.1016/bs.apha.2019.08.002
7.
ZhangCH, YangX, WeiJRJr, et al.Ethnopharmacology, Phytochemistry, Pharmacology, Toxicology and Clinical Applications of Radix Astragali. Chin J Integr Med, 2021; 27(3):229–240; doi: 10.1007/s11655-019-3032-8
8.
WangW, NingJ, HeY, et al.Unveiling the mechanism of Astragalus membranaceus in the treatment of gastrointestinal cancers based on network pharmacology. European Journal of Integrative Medicine, 2020; 40:101249; doi: 10.1016/j.eujim.2020.101249
9.
FuJ, WangZ, HuangL, et al.Review of the botanical characteristics, phytochemistry, and pharmacology of Astragalus membranaceus (Huangqi). Phytother Res, 2014; 28(9):1275–1283; doi: 10.1002/ptr.5188
10.
ZhengY, RenW, ZhangL, et al.A Review of the Pharmacological Action of Astragalus Polysaccharide. Front Pharmacol, 2020; 11:349; doi: 10.3389/fphar.2020.00349
11.
LiuG, ZhangC, LiuX, et al.Study on the antir proliferation effect of Astragalus polysaccharides on the human GastricCancer cell line SGC-7901 in vitro. China Practical Medicine, 2007; 13:8–9; doi: 10.3969/j.issn.1673-7555.2007.13.003
12.
GrazianiV, ScognamiglioM, EspositoA, et al.Chemical diversity and biological activities of the saponins isolated from Astragalus genus: Focus on Astragaloside IV. Phytochem Rev, 2019; 18(4):1133–1166; doi: 10.1007/s11101-019-09626-y
13.
TinMMY, ChoCH, ChanK, et al.Astragalus saponins induce growth inhibition and apoptosis in human colon cancer cells and tumor xenograft. Carcinogenesis, 2007; 28(6):1347–1355; doi: 10.1093/carcin/bgl238
14.
AuyeungKK, WooPK, LawPC, et al.Astragalus saponins modulate cell invasiveness and angiogenesis in human gastric adenocarcinoma cells. J Ethnopharmacol, 2012; 141(2):635–641; doi: 10.1016/j.jep.2011.08.010
15.
IonkovaI, ShkondrovA, KrastevaI, et al.Recent progress in phytochemistry, pharmacology and biotechnology of Astragalus saponins. Phytochem Rev, 2014; 13(2):343–374; doi: 10.1007/s11101-014-9347-3
16.
BratkovVM, ShkondrovAM, ZdravevaPK, et al.Flavonoids from the Genus Astragalus: Phytochemistry and Biological Activity. Pharmacogn Rev, 2016; 10(19):11–32; doi: 10.4103/0973-7847.176550
17.
WenzelU, KuntzS, BrendelMD, et al.Dietary flavone is a potent apoptosis inducer in human colon carcinoma cells. Cancer Res, 2000; 60(14):3823–3831; doi: 10.1016/S0165-4608(00)00214-4
18.
LiuS, LuoX, LiD, et al.Tumor inhibition and improved immunity in mice treated with flavone from Cirsium japonicum DC. Int Immunopharmacol, 2006; 6(9):1387–1393; doi: 10.1016/j.intimp.2006.02.002
19.
LiuY, LiCL, XuQQ, et al.Quercetin inhibits invasion and angiogenesis of esophageal cancer cells. Pathol Res Pract, 2021; 222:153455; doi: 10.1016/j.prp.2021.153455
20.
ChenL, XingD, GuoLR, et al.Formononetin, an Active Component of Astragalus Membranaceus, Inhibits the Pathogenesis and Progression of Esophageal Cancer Through the COX-2/Cyclin D1 Axis. Clin Lab, 2023; 69(3); doi: 10.7754/Clin.Lab.2022.220403
21.
ChangM, ZhangS, HaoY, et al.Astragalus polysaccharide inhibits the proliferation of esophageal cancer EC109 cells by inducing cell autophagy. Medicine and Health, 2022; 20(4):856–862; doi: 10.7539/j.issn.1672-2981.2022.04.021
22.
SunX, WangL, LiuC, et al.Therapeutic effects and mechanism of ginseng polysaccharide on colon carcinoma and inflammatory factors via p － PKA － PKA － VEGF signaling pathwayGuangdong. Medical Journal, 2020; 41(21):2187–2191; doi: 10.1382/0/j.cnki.gdyx.20194330
23.
HuJ, ZhangC, LiQ.*, et al.Effects of Astragaloside IV on apoptosis, stem cell -like characteristics and PI3K/AKT pathway of esophageal carcinoma cells. J Dig Oncol (Electronic Version), 2022; 14(2):135–140; doi: 10.3969/j.issn.1674-7402.2022.02.006
24.
YuJ, JiH, DongX, et al.Apoptosis of human gastric carcinoma MGC-803 cells induced by a novel Astragalus membranaceus polysaccharide via intrinsic mitochondrial pathways. Int J Biol Macromol, 2019; 126:811–819; doi: 10.1016/j.ijbiomac.2018.12.268
25.
WuJ, YuJ, WangJ, et al.Astragalus polysaccharide enhanced antitumor effects of Apatinib in gastric cancer AGS cells by inhibiting AKT signalling pathway. Biomed Pharmacother, 2018; 100:176–183; doi: 10.1016/j.biopha.2018.01.140
26.
LiuW, ChenH, WangD. Protective role of astragaloside IV in gastric cancer through regulation of microRNA-195-5p-mediated PD-L1. Immunopharmacol Immunotoxicol, 2021; 43(4):443–451; doi: 10.1080/08923973.2021.1936013
27.
OuYangY, HuangJ, OuYangZ, et al.Enrichment and purification process of astragalosides and their anti-human gastric cancer MKN-74 cell proliferation effect. Afr Health Sci, 2014; 14(1):22–27; doi: 10.4314/ahs.v14i1.5
28.
LiF, CaoK, WangM, et al.Astragaloside IV exhibits anti-tumor function in gastric cancer via targeting circRNA dihydrolipoamide S-succinyltransferase (circDLST)/miR-489-3p/eukaryotic translation initiation factor 4A1(EIF4A1) pathway. Bioengineered, 2022; 13(4):10111–10122; doi: 10.1080/21655979.2022.2063664
29.
NaD, LiuFN, MiaoZF, et al.Astragalus extract inhibits destruction of gastric cancer cells to mesothelial cells by anti-apoptosis. World J Gastroenterol, 2009; 15(5):570–577; doi: 10.3748/wjg.15.570
30.
WangZ, LvJ, LiX, et al.The flavonoid Astragalin shows anti-tumor activity and inhibits PI3K/AKT signaling in gastric cancer. Chem Biol Drug Des, 2021; 98(5):779–786; doi: 10.1111/cbdd.13933
31.
DingL, DangS, SunM, et al.Quercetin induces ferroptosis in gastric cancer cells by targeting SLC1A5 and regulating the p-Camk2/p-DRP1 and NRF2/GPX4 Axes. Free Radic Biol Med, 2024; 213:150–163; doi: 10.1016/j.freeradbiomed.2024.01.002
32.
MaM, WEiX. Effectiveness of Astragalus granules combined with FOLFOX chemotherapy regimen in the treatment of elderly gastric cancer and its effect on immune function. Chinese Journal of Gerontology, 2022; 42(21):5209–5212; doi: 10.3969/j.issn.1005-9202.2022.21.016
33.
HuangW, LiaoW, SunR. Astragalus polysaccharide induces the apoptosis of human hepatocellular carcinoma cells by decreasing the expression of Notch1. Int J Mol Med, 2016; 38(2):551–557; doi: 10.3892/ijmm.2016.2632
34.
TianQE, LiHD, YanM, et al.Astragalus polysaccharides can regulate cytokine and P-glycoprotein expression in H22 tumor-bearing mice. World J Gastroenterol, 2012; 18(47):7079–7086; doi: 10.3748/wjg.v18.i47.7079
35.
LaiX, XiaW, WeiJ, et al.Therapeutic effect of astragalus polysaccharides on hepatocellular carcinoma H22-Bearing mice. Dose Response, 2017; 15(1):1559325816685182; doi: 10.1177/1559325816685182
36.
LiM, DuanF, PanZ, et al.Astragalus polysaccharide promotes doxorubicin-induced apoptosis by reducing O-GlcNAcylation in hepatocellular carcinoma. Cells., 2023; 12(6):866; doi: 10.3390/cells12060866
37.
MinL, WangH, QiH. Astragaloside IV inhibits the progression of liver cancer by modulating macrophage polarization through the TLR4/NF-κB/STAT3 signaling pathway. Am J Transl Res, 2022; 14(3):1551–1566; doi: 35422920
38.
QuX, GaoH, ZhaiJ, et al.Astragaloside IV enhances cisplatin chemosensitivity in hepatocellular carcinoma by suppressing MRP2. Eur J Pharm Sci, 2020; 148:105325; doi: 10.1016/j.ejps.2020.105325
39.
SuCM, WangHC, HsuFT, et al.Astragaloside IV induces apoptosis, G1-Phase Arrest and inhibits anti-apoptotic signaling in hepatocellular carcinoma. In Vivo, 2020; 34(2):631–638; doi: 10.2187/3/invivo.11817
40.
HuYW, LiuCY, DuCM, et al.Induction of apoptosis in human hepatocarcinoma SMMC-7721 cells in vitro by flavonoids from Astragalus complanatus. J Ethnopharmacol, 2009; 123(2):293–301; doi: 10.1016/j.jep.2009.03.016
41.
LawPC, AuyeungKK, ChanLY, et al.Astragalus saponins downregulate vascular endothelial growth factor under cobalt chloride-stimulated hypoxia in colon cancer cells. BMC Complement Altern Med, 2012; 12:160; doi: 10.1186/1472-6882-12-160
42.
AuyeungKKW, MokNL, WongCM, et al.Astragalus saponins modulate mTOR and ERK signaling to promote apoptosis through the extrinsic pathway in HT-29 colon cancer cells. Int J Mol Med, 2010; 26(3):341–349; doi: 10.3892/ijmm_00000471
43.
AuyeungKKW, LawPC, KoJKS. Novel anti-angiogenic effects of formononetin in human colon cancer cells and tumor xenograft. Oncol Rep, 2012; 28(6):2188–2194; doi: 10.3892/or.2012.2056
44.
AuyeungKKW, KoJKS. Novel herbal flavonoids promote apoptosis but differentially induce cell cycle arrest in human colon cancer cell. Invest New Drugs, 2010; 28(1):1–13; doi: 10.1007/s10637-008-9207-3
45.
GuJ, SunR, TangD, et al.Astragalus mongholicus Bunge-Curcuma aromatica Salisb. suppresses growth and metastasis of colorectal cancer cells by inhibiting M2 macrophage polarization via a Sp1/ZFAS1/miR-153-3p/CCR5 regulatory axis. Cell Biol Toxicol, 2022; 38(4):679–697; doi: 10.1007/s10565-021-09679-w
46.
ZhaoZ, QiuZ, ZhaoY. Astragalus polysaccharides suppressed cisplatin-resistance of colorectal cancer TH-29/DDP cells via regulating miR-20a/TGFBR2 axis. Chin J Cancer Biother, 2019; 26(4):417–425; doi: 10.3872/j.issn.1007-385x.2019.04.008
47.
LiQ, ZhangC, XuG, et al.Astragalus polysaccharide ameliorates CD8+ T cell dysfunction through STAT3/Gal-3/LAG3 pathway in inflammation-induced colorectal cancer. Biomed Pharmacother, 2024; 171:116172; doi: 10.1016/j.biopha.2024.116172
48.
ZhangZ, FeiM, SunM. Effect of Astragalus granules combined with bevacizumab on serum TIMP-1, MMP-7 and P53 levels in elderly patients with metastatic colorectal cancer. Chinese Journal of Gerontology, 2021; 41(21):4654–4657; doi: 10.3969/j.issn.1005-9202.2021.21.017
49.
WuJ, WangJ, SuQ, et al.Traditional Chinese medicine Astragalus polysaccharide enhanced antitumor effects of the angiogenesis inhibitor apatinib in pancreatic cancer cells on proliferation, invasiveness, and apoptosis. Onco Targets Ther, 2018; 11:2685–2698; doi: 10.2147/OTT.S157129
50.
WangZ, DesmoulinS, BanerjeeS, et al.Synergistic effects of multiple natural products in pancreatic cancer cells. Life Sci, 2008; 83(7–8):293–300; doi: 10.1016/j.lfs.2008.06.017
51.
DingC, KhanM, ZhengB, et al.Casticin induces apoptosis and mitotic arrest in pancreatic carcinoma PANC-1 cells. Afr. J. Pharm. Pharmacol, 2012; 6(6):412–418; doi: 10.5897/AJPP11.830
52.
BianY, WangG, ZhouJ, et al.Astragalus membranaceus (Huangqi) and Rhizoma curcumae (Ezhu) decoction suppresses colorectal cancer via downregulation of Wnt5/β-Catenin signal. Chin Med, 2022; 17(1):11; doi: 10.1186/s13020-021-00564-6
