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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 3
Mar.  2022
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Article Contents

Mechanism of action of Huaier granules in treatment of hepatocellular carcinoma and advances in its clinical application

DOI: 10.3969/j.issn.1001-5256.2022.03.038
Research funding:

Natural Science Foundation of Liaoning Province (20180551193);

Natural Science Foundation of Liaoning Province (2020-MS-181);

345 Talent Project of Shengjing Hospital (40B)

More Information
  • Corresponding author: XU Feng, xufengsjh@126.com(ORCID: 0000-0001-9985-6527)
  • Received Date: 2021-07-30
  • Accepted Date: 2021-10-08
  • Published Date: 2022-03-20
  • Hepatocellular carcinoma (HCC) is the second leading cause of disease-related death in China and greatly threatens the health of residents. Recent studies have shown that traditional Chinese medicine plays an important role in the comprehensive treatment of HCC. Huaier granules have been recommended for the treatment of HCC, and its mechanism of action includes inhibiting angiogenesis, inhibiting the proliferation of HCC cells, inhibiting invasion and metastasis, inducing cell apoptosis, and regulating immune function. This article summarizes the research advances in the anti-HCC mechanism of Huaier granules and its application in clinical practice, in order to provide a reference for subsequent research and clinical treatment.

     

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  • [1]
    ZHOU M, WANG H, ZENG X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. DOI: 10.1016/S0140-6736(19)30427-1.
    [2]
    ZENG H, CHEN W, ZHENG R, et al. Changing cancer survival in China during 2003-15: A pooled analysis of 17 population-based cancer registries[J]. Lancet Glob Health, 2018, 6(5): e555-e567. DOI:10.1016/S2214-109X (18)30127-X.
    [3]
    WANG Z, YU XL, ZHANG J, et al. Huaier granule prevents the recurrence of early-stage hepatocellular carcinoma after thermal ablation: A cohort study[J]. J Ethnopharmacol, 2021, 281: 114539. DOI: 10.1016/j.jep.2021.114539.
    [4]
    ZHAO GS, LIU Y, ZHANG Q, et al. Transarterial chemoembolization combined with Huaier granule for the treatment of primary hepatic carcinoma: Safety and efficacy[J]. Medicine (Baltimore), 2017, 96(29): e7589. DOI: 10.1097/MD.0000000000007589.
    [5]
    XIA NX, QIU BA, WANG JH, et al. Chemotherapy combined with Huaier granule in the prognosis of patients with recurrent/metastatic after primary hepatocellular carcinoma[J]. Clin J Med Offic, 2017, 45(9): 887-890. DOI: 10.16680/j.1671-3826.2017.09.03.

    夏念信, 邱宝安, 王敬晗, 等. 化疗联合槐耳颗粒对原发性肝癌术后复发/转移患者预后影响研究[J]. 临床军医杂志, 2017, 45(9): 887-890. DOI: 10.16680/j.1671-3826.2017.09.03.
    [6]
    ZHANG C, ZHANG J, LI X, et al. Huaier aqueous extract induces hepatocellular carcinoma cells arrest in S phase via JNK signaling pathway[J]. Evid Based Complement Alternat Med, 2015, 2015: 171356. DOI: 10.1155/2015/171356.
    [7]
    XU DQ, YUAN XJ, HIRAYAMA M, et al. Huaier extract induces apoptosis in hepatoblastoma cells via the MEK/ERK signaling pathway[J]. In Vivo, 2020, 34(5): 2381-2388. DOI: 10.21873/invivo.12051.
    [8]
    BAO H, LIU P, JIANG K, et al. Huaier polysaccharide induces apoptosis in hepatocellular carcinoma cells through p38 MAPK[J]. Oncol Lett, 2016, 12(2): 1058-1066. DOI: 10.3892/ol.2016.4686.
    [9]
    NIU Y, SHAN L, GAO H, et al. Huaier suppresses the hepatocellular carcinoma cell cycle by regulating minichromosome maintenance proteins[J]. Onco Targets Ther, 2020, 13: 12015-12025. DOI: 10.2147/OTT.S279723.
    [10]
    HU Z, YANG A, SU G, et al. Huaier restrains proliferative and invasive potential of human hepatoma SKHEP-1 cells partially through decreased Lamin B1 and elevated NOV[J]. Sci Rep, 2016, 6: 31298. DOI: 10.1038/srep31298.
    [11]
    ZHONG LH, ZHU LY, ZHAO YY, et al. Apoptosis of hepatocarcinoma cells Hepg2 induced by Huaier extract through regulation of HBx and CEACAM1 gene expression[J]. J Biol Regul Homeost Agents, 2018, 32(6): 1389-1398.
    [12]
    SHAN L, LI Y, JIANG H, et al. Huaier restrains proliferative and migratory potential of hepatocellular carcinoma cells partially through decreased yes-associated protein 1[J]. J Cancer, 2017, 8(19): 4087-4097. DOI: 10.7150/jca.21018.
    [13]
    YANG AL, XIA TJ, ZHAO YN, et al. Huaier aqueous extract inhibits proliferation of human hepatoma SK-HEP-1 cells through up-regulation of autophagy[J]. China J Chin Mater Med, 2018, 43(3): 591-595. DOI: 10.19540/j.cnki.cjcmm.20171113.012.

    杨爱琳, 夏天吉, 赵亚楠, 等. 槐耳清膏通过激活自噬抑制人肝癌细胞SK-HEP-1增殖[J]. 中国中药杂志, 2018, 43(3): 591-595. DOI: 10.19540/j.cnki.cjcmm.20171113.012.
    [14]
    LI WX, WANG XC, XIANG MH, et al. Huaier inhibits proliferation and metastasis of liver cancer cells by inducing autophagy[J/CD]. Chin J Hepat Surg: Electronic Edition, 2019, 8(2): 169-174. DOI: 10.3877/cma.j.issn.2095-3232.2019.02.019.

    黎文信, 王喜城, 向美焕, 等. 槐耳通过诱导自噬抑制肝癌细胞增殖与迁移[J/CD]. 中华肝脏外科手术学电子杂志, 2019, 8(2): 169-174. DOI: 10.3877/cma.j.issn.2095-3232.2019.02.019.
    [15]
    ZHENG J, LI C, WU X, et al. Astrocyte elevated gene-1(AEG-1) shRNA sensitizes Huaier polysaccharide (HP)-induced anti-metastatic potency via inactivating downstream P13K/Akt pathway as well as augmenting cell-mediated immune response[J]. Tumour Biol, 2014, 35(5): 4219-4224. DOI: 10.1007/s13277-013-1552-y.
    [16]
    ZHENG J, LI C, WU X, et al. Huaier polysaccharides suppresses hepatocarcinoma MHCC97-H cell metastasis via inactivation of EMT and AEG-1 pathway[J]. Int J Biol Macromol, 2014, 64: 106-110. DOI: 10.1016/j.ijbiomac.2013.11.034.
    [17]
    LI C, WU X, ZHANG H, et al. A Huaier polysaccharide reduced metastasis of human hepatocellular carcinoma SMMC-7721 cells via modulating AUF-1 signaling pathway[J]. Tumour Biol, 2015, 36(8): 6285-6293. DOI: 10.1007/s13277-015-3314-5.
    [18]
    LI C, WU X, ZHANG H, et al. A Huaier polysaccharide restrains hepatocellular carcinoma growth and metastasis by suppression angiogenesis[J]. Int J Biol Macromol, 2015, 75: 115-120. DOI: 10.1016/j.ijbiomac.2015.01.016.
    [19]
    ZOU Y, XIONG H, XIONG H, et al. A polysaccharide from mushroom Huaier retards human hepatocellular carcinoma growth, angiogenesis, and metastasis in nude mice[J]. Tumour Biol, 2015, 36(4): 2929-2936. DOI: 10.1007/s13277-014-2923-8.
    [20]
    LI Y, QI W, SONG X, et al. Huaier extract suppresses breast cancer via regulating tumor-associated macrophages[J]. Sci Rep, 2016, 6: 20049. DOI: 10.1038/srep20049.
    [21]
    SUN Y, SUN T, WANG F, et al. A polysaccharide from the fungi of Huaier exhibits anti-tumor potential and immunomodulatory effects[J]. Carbohydr Polym, 2013, 92(1): 577-582. DOI: 10.1016/j.carbpol.2012.09.006.
    [22]
    YANG A, FAN H, ZHAO Y, et al. An immune-stimulating proteoglycan from the medicinal mushroom Huaier up-regulates NF-κB and MAPK signaling via Toll-like receptor 4[J]. J Biol Chem, 2019, 294(8): 2628-2641. DOI: 10.1074/jbc.RA118.005477.
    [23]
    DURGEAU A, VIRK Y, CORGNAC S, et al. Recent advances in targeting CD8 T-cell immunity for more effective cancer immunotherapy[J]. Front Immunol, 2018, 9: 14. DOI: 10.3389/fimmu.2018.00014.
    [24]
    LI C, WU X, ZHANG H, et al. A Huaier polysaccharide inhibits hepatocellular carcinoma growth and metastasis[J]. Tumour Biol, 2015, 36(3): 1739-1745. DOI: 10.1007/s13277-014-2775-2.
    [25]
    ZHOU L, SUO LL, SONG JY, et al. Influence of sirolimus based triple anti-tumor therapy on T lymphocyte of rat model with liver cancer recurrence after transplantation[J]. Ogran Transplantation, 2014, 5(6): 368-373. DOI: 10.3969/j.issn.1674-7445.2014.06.009.

    周林, 索龙龙, 宋继勇, 等. 以西罗莫司为基础三联抗肿瘤疗法对大鼠肝癌肝移植复发模型T淋巴细胞的影响[J]. 器官移植, 2014, 5(6): 368-373. DOI: 10.3969/j.issn.1674-7445.2014.06.009.
    [26]
    LIN SZ, CHEN KJ, XU ZY, et al. Prediction of recurrence and survival in hepatocellular carcinoma based on two Cox models mainly determined by FoxP3+regulatory T cells[J]. Cancer Prev Res (Phila), 2013, 6(6): 594-602. DOI: 10.1158/1940-6207.CAPR-12-0379.
    [27]
    ZHOU L, PAN LC, ZHENG YG, et al. Reduction of FoxP3+Tregs by an immunosuppressive protocol of rapamycin plus Thymalfasin and Huaier extract predicts positive survival benefits in a rat model of hepatocellular carcinoma[J]. Ann Transl Med, 2020, 8(7): 472. DOI: 10.21037/atm.2020.03.129.
    [28]
    LIU N, GENG XP, ZHU LX, et al. MDR-reversing effect of Extractum trametes robiniophila murr on human hepatocellular carcinoma HepG2/ADM in vitro[J]. Chin J Surg, 2007, 13(6): 385-388. DOI: 10.3760/cma.j.issn.1007-8118.2007.06.009.

    刘念, 耿小平, 朱立新, 等. 槐耳清膏体外逆转人肝癌细胞HepG2/ADM多药耐药性[J]. 中华肝胆外科杂志, 2007, 13(6): 385-388. DOI: 10.3760/cma.j.issn.1007-8118.2007.06.009.
    [29]
    TAO Y, SHAN L, XU X, et al. Huaier augmented the chemotherapeutic sensitivity of oxaliplatin via downregulation of YAP in hepatocellular carcinoma[J]. J Cancer, 2018, 9(21): 3962-3970. DOI: 10.7150/jca.25909.
    [30]
    ZHANG ZG, LIU B, LIANG WF, et al. Preliminary study on reversal of Sorafenib resistance of hepatocellular carcinoma cells by Huaier granule[J]. J Nangjing Univ Tradit Chin Med, 2020, 36(1): 83-87. DOI: 10.14148/ji.ssn.1672-0482.2020.0083.

    张正光, 刘冰, 梁炜锋, 等. 槐耳颗粒逆转肝癌细胞对索拉非尼耐药的初步研究[J]. 南京中医药大学学报, 2020, 36(1): 83-87. DOI: 10.14148/ji.ssn.1672-0482.2020.0083.
    [31]
    XU X, WEI Q, WANG K, et al. Anticancer effects of Huaier are associated with down-regulation of P53[J]. Asian Pac J Cancer Prev, 2011, 12(9): 2251-2254.
    [32]
    ZHU C, ZHANG CL, YANG JY, et al. Study on the effect and mechanism of Huaier granules in relieving oxaliplatin-induced liver injury[J]. Chin Hosp Pharm J, 2021, 41(17): 1723-1729. DOI: 10.13286/j.1001-5213.2021.17.05.

    朱晨, 张程亮, 杨金玉, 等. 槐耳颗粒缓解奥沙利铂诱导肝脏损伤的作用及机制研究[J]. 中国医院药学杂志, 2021, 41(17): 1723-1729. DOI: 10.13286/j.1001-5213.2021.17.05.
    [33]
    LEVY J, TOWERS CG, THORBURN A. Targeting autophagy in cancer[J]. Nat Rev Cancer, 2017, 17(9): 528-542. DOI: 10.1038/nrc.2017.53.
    [34]
    NIETO MA, HUANG RY, JACKSON RA, et al. EMT: 2016[J]. Cell, 2016, 166(1): 21-45. DOI: 10.1016/j.cell.2016.06.028.
    [35]
    ZHANG SY, SONG XY, LI Y, et al. Tumor-associated macrophages: A promising target for a cancer immunotherapeutic strategy[J]. Pharmacol Res, 2020, 161: 105111. DOI: 10.1016/j.phrs.2020.105111.
    [36]
    ZHOU L, PAN LC, ZHENG YG, et al. Novel strategy of sirolimus plus thymalfasin and huaier granule on tumor recurrence of hepatocellular carcinoma beyond the UCSF criteria following liver transplantation: A single center experience[J]. Oncol Lett, 2018, 16(4): 4407-4417. DOI: 10.3892/ol.2018.9226.
    [37]
    CHEN Q, SHU C, LAURENCE AD, et al. Effect of Huaier granule on recurrence after curative resection of HCC: A multicentre, randomised clinical trial[J]. Gut, 2018, 67(11): 2006-2016. DOI: 10.1136/gutjnl-2018-315983.
    [38]
    Expert Group of the StateKey Project on Infectious Diseases on "Novel Strategies of Comprehensive and Individualizd Surgical Treatment of Viral Hepatitis-related Liver Cancer" from the Ministry of Science and Technology of China. Chinese expert consensus on the preventation and man-agement of recurrent hepatocellular carcinoma after hepatic resection (2020 edition)[J]. Chin J Pract Surg, 2021, 41(1): 20-30. DOI: 10.19538/j.cjps.issn1005-2208.2021.01.03.

    国家科技部传染病防治重大专项课题《病毒性肝炎相关肝癌外科综合治疗的个体化和新策略研究》专家组. 肝细胞癌肝切除术后复发预防和治疗中国专家共识(2020版)[J]. 中国实用外科杂志, 2021, 41(1): 20-30. DOI: 10.19538/j.cjps.issn1005-2208.2021.01.03.
    [39]
    LEI JY, YAN LN, ZHU JQ, et al. Hepatocellular carcinoma patients may benefit from postoperative Huaier aqueous extract after liver transplantation[J]. Transplant Proc, 2015, 47(10): 2920-2924. DOI: 10.1016/j.transproceed.2015.10.045.
    [40]
    GAO YR, CHEN SJ, HOU YW, et al. Clinical effect of Huaier Granule sequential with radiofrequency ablation and TACE in treating primary hepatic carcinoma[J]. J Changchun Univ Chin Med, 2020, 36(4): 684-687. DOI: 10.13463/j.cnki.cczyy.2020.04.021.

    高远韧, 陈思佳, 侯英文, 等. TACE联合射频消融术序贯槐耳颗粒治疗原发性肝癌[J]. 长春中医药大学学报, 2020, 36(4): 684-687. DOI: 10.13463/j.cnki.cczyy.2020.04.021.
    [41]
    ZHANG SH, TANG Y, YUE H, et al. Efficacy of Huaier granule combined with transcatheter arterial chemoembolization in treatment of primary liver cancer: A meta analysis[J]. Chin J Bases and Clin Gen Surg, 2020, 27(7): 855-860. DOI: 10.7507/1007-9424.201910035.

    张少华, 唐盈, 岳瀚, 等. 槐耳颗粒联合经导管肝动脉化疗栓塞治疗原发性肝癌疗效的meta分析[J]. 中国普外基础与临床杂志, 2020, 27(7): 855-860. DOI: 10.7507/1007-9424.201910035.
    [42]
    WANG HR, LIU ZY. Treatment of unresectable hepatocellular carcinoma with Huaier granule combined with TACE: Prospective cohort study[J]. J Chin Clin Med Imaging, 2020, 31(7): 490-494. DOI: 10.12117/jccmi.2020.07.009.

    王海瑞, 刘兆玉. 槐耳颗粒联合TACE治疗不可手术切除肝细胞癌的前瞻性队列研究[J]. 中国临床医学影像杂志, 2020, 31(7): 490-494. DOI: 10.12117/jccmi.2020.07.009.
    [43]
    ZHOU TY, TAO GF, CHEN SQ, et al. Complete response of hepatocellular carcinoma with macroscopic vascular invasion and pulmonary metastasis to the combination of drug-eluting beads transarterial chemoembolization and Huaier granule: A case report[J]. Onco Targets Ther, 2021, 14: 3873-3880. DOI: 10.2147/OTT.S309660.
    [44]
    ZHANG QH, LIANG YH. Clinical efficacy of Huaier granule combined with Sorafenib on patients with postoperative recurrence of primary liver cancer[J]. Pract J Cancer, 2019, 34(9): 1560-1562. DOI: 10.3969/j.issn.1001-5930.2019.09.049.

    张庆辉, 梁艳华. 槐耳颗粒联合索拉非尼对原发性肝癌术后复发患者的临床疗效研究[J]. 实用癌症杂志, 2019, 34(9): 1560-1562. DOI: 10.3969/j.issn.1001-5930.2019.09.049.
    [45]
    ZHEN ZH, SHEN CH, DU WK. Clinical effect on Apatinib combined with Huaier granule in treating advanced hepatocellular carcinoma[J]. Mod Oncol, 2019, 27(17): 3086-3089. DOI: 10.3969/j.issn.1672-4992.2019.17.024.

    甄振华, 申传厚, 杜文凯. 阿帕替尼联合槐耳颗粒治疗晚期原发性肝癌的临床疗效[J]. 现代肿瘤医学, 2019, 27(17): 3086-3089. DOI: 10.3969/j.issn.1672-4992.2019.17.024.
    [46]
    LIU X, LI M, WANG X, et al. Effects of adjuvant traditional Chinese medicine therapy on long-term survival in patients with hepatocellular carcinoma[J]. Phytomedicine, 2019, 62: 152930. DOI: 10.1016/j.phymed.2019.152930.
    [47]
    DANG ZB, YAN J, LI LR, et al. Clinical efficacy of Huaier granule in the treatment of HBV related primary liver cancer[J]. Chin J Integr Trad West Med Dig, 2020, 28(9): 681-687. DOI: 10.3969/j.issn.1671-038X.2020.09.08.

    党志博, 晏军, 李玲孺, 等. 槐耳颗粒治疗乙肝相关原发性肝癌的临床疗效分析[J]. 中国中西医结合消化杂志, 2020, 28(9): 681-687. DOI: 10.3969/j.issn.1671-038X.2020.09.08.
    [48]
    LI L, WU ZL, LIANG CJ, et al. Meta-analysis on efficacy and safety of Huaier granules assisted with western medicine in treatment of primary hepatocellular carcinoma[J]. Chin J Inf Tradit Chin Med, 2020, 27(10): 103-109. DOI: 10.19879/j.cnki.1005-5304.201909098.

    李丽, 吴驻林, 梁彩君, 等. 槐耳颗粒辅助西医疗法治疗原发性肝癌疗效及安全性Meta分析[J]. 中国中医药信息杂志, 2020, 27(10): 103-109. DOI: 10.19879/j.cnki.1005-5304.201909098.
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