Progress of “Yiqi and Spleen Enhancement Method” in the Treatment of Colorectal Cancer based on Intestinal Flora

Authors

  • Han Qiao Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China
  • Haijuan Xiao Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China; Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi, China

DOI:

https://doi.org/10.53469/jcmp.2024.06(09).25

Keywords:

Intestinal flora, Colorectal cancer, Yi qi, Spleen strengthening

Abstract

The intestinal microbiota is located close to the colorectal epithelium and consists of a large microbiota that interacts with host cells to regulate many physiological processes such as energy harvesting, metabolism and immune responses [1]. It corresponds to the functions of the “spleen” in Chinese medicine, which is responsible for the transportation of water and grains and the resistance to evil. The balance of intestinal flora directly reflects the functional status of the “spleen” in TCM. Sequencing studies have revealed the microbial composition and ecological changes in colorectal cancer (CRC) patients, and functional animal model studies have clarified the role of several bacteria in colorectal carcinogenesis, including Clostridium nucleatum, Escherichia coli, and Pseudomonas fragilis strains, which are closely related to CRC [2]. Based on this, this paper reviews the research progress on the mechanism of intestinal flora affecting CRC and the intervention of intestinal flora against CRC by Yiqi and Spleen Method, which provides ideas and references for the prevention of colorectal cancer by traditional Chinese medicine.

References

Ki X, Renyuan G, Lin L, et al. Transformation of colitis and colorectal cancer: a tale of gut microbiota. [J]. Critical Reviews in Microbiology, 2023, 11-10.

Tito Y R, Verbandt S, Vazquez A M, et al. Microbiome confounders and quantitative profiling challenge predicted microbial targets in colorectal cancer development. [J]. Nature Medicine, 2024, 30(5): 1339-1348.

Yuan C, Steer J C, Subramanian S. Host–MicroRNA–Microbiota Interactions in Colorectal Cancer[J]. Genes, 2019, 10(4):270-.

Martel D C, Georges D, Bray F, et al. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis[J]. The Lancet Global Health, 2020, 8(2):e180-e190.

PENG Mei, HUANG Ye, ZHENG Li, et al. Causal relationship between gut microbiota and 17 types of cancer based on mendelian randomization analysis [J]. Military Medical Sciences, 2024, 48(07):530-536.

LinYong Z, JiaXin M, Gang Y, et al. Role of the gut microbiota in anticancer therapy: from molecular mechanisms to clinical applications. [J]. Signal Transduction and Targeted Therapy, 2023, 8(1):201-201.

Junjie Q, Ruiqiang L, Jeroen R, et al. A human gut microbial gene catalogue established by metagenomic sequencing [J]. Nature, 2010, 464(7285):59-65.

Dai Z, Coker O O, Nakatsu G, et al. Tu1885 - Multi-Cohort Analysis of Colorectal Cancer Metagenome Identified Altered Bacteria Across Populations and Universal Bacterial Markers[J]. Gastroenterology, 2018, 154(6S1): S-1047-S-1048.

Hiromi S, Masaaki S, Tadao M, et al. Prevention of antibiotic-associated diarrhea in children by Clostridium butyricum MIYAIRI [J]. Pediatrics international: official journal of the Japan Pediatric Society, 2003, 45(1):86-90.

O B N C, A L F P, J F P, et al. A randomized formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic-associated diarrhea in infants [J]. Journal of clinical gastroenterology, 2005, 39(5):385-9.

Shi N, Li N, Duan X, et al. Interaction between the gut microbiome and mucosal immune system[J]. Military Medical Research, 2017, 4(03):170-177.

Bopanna S, Ananthakrishnan N A, Kedia S, et al. Risk of colorectal cancer in Asian patients with ulcerative colitis: a systematic review and meta-analysis[J]. The Lancet Gastroenterology & Hepatology, 2017, 2(4):269-276.

Selinger P C, Andrews M J, Titman A, et al. Long-term Follow-up Reveals Low Incidence of Colorectal Cancer, but Frequent Need for Resection, Among Australian Patients with Inflammatory Bowel Disease[J]. Clinical Gastroenterology and Hepatology, 2014, 12(4):644-650.

Wong SH, Zhao L, Zhang X, et al. Gavage of Fecal Samples from Patients with Colorectal Cancer Promotes Intestinal Carcinogenesis in Germ-Free and Conventional Mice. Gastroenterology. 2017; 153(6): 1621-1633.e6.

Eleonora C, Valeria G, Glaus F J G, et al. Gut microbiota modulate T cell trafficking into human colorectal cancer. [J]. Gut, 2018, 67(11):1984-1994.

Kostic D A, Chun E, Robertson L, et al. Fusobacterium nucleatum Potentiates Intestinal Tumorigenesis and Modulates the Tumor-Immune Microenvironment [J]. Cell Host & Microbe, 2013, 14(2):207-215.

Tomkovich S, Yang Y, Winglee K, et al. Locoregional Effects of Microbiota in a Preclinical Model of Colon Carcinogenesis. Cancer Res. 2017;77(10):2620-2632.

Annemarie B, M E H, C A G, et al. The Bacteroides fragilis toxin gene is prevalent in the colon mucosa of colorectal cancer patients [J]. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 2015, 60(2):208-15.

Shaoguang W, Ki-Jong R, Emilia A, et al. A human colonic commensal promotes colon tumorigenesis via activation of T helper type 17 T cell responses [J]. Nature medicine, 2009, 15(9):1016-22.

Chung L, Orberg T E, Geis L A, et al. Bacteroides fragilis Toxin Coordinates a Pro-carcinogenic Inflammatory Cascade via Targeting of Colonic Epithelial Cells[J]. Cell Host & Microbe, 2018, 23(2): 203-214.e5.

Kesselring R, Glaesner J, Hiergeist A, et al. IRAK-M Expression in Tumor Cells Supports Colorectal Cancer Progression through Reduction of Antimicrobial Defense and Stabilization of STAT3[J]. Cancer Cell, 2016, 29(5):684-696.

Aurélie C, Thomas S, Ateequr R, et al. NOD2-mediated dysbiosis predisposes mice to transmissible colitis and colorectal cancer. [J].The Journal of clinical investigation, 2013, 123(2):700-11.

Houbao Z, Wang-Yang X, Zhiqiang H, et al. RNA virus receptor Rig-I monitors gut microbiota and inhibits colitis-associated colorectal cancer. [J]. Journal of experimental & clinical cancer research: CR, 2017, 36(1):2.

Man M S, Zhu Q, Zhu L, et al. Critical Role for the DNA Sensor AIM2 in Stem Cell Proliferation and Cancer[J]. Cell, 2015, 162(1):45-58.

Yang Y, Weng W, Peng J, et al. Fusobacterium nucleatum Increases Proliferation of Colorectal Cancer Cells and Tumor Development in Mice by Activating Toll-Like Receptor 4 Signaling to Nuclear Factor−κB, and Up-regulating Expression of MicroRNA-21[J]. Gastroenterology, 2017, 152(4):851-866.e24.

Yaxin W, Jiao W, Ting C, et al. Fusobacterium nucleatum Potentiates Intestinal Tumorigenesis in Mice via a Toll-Like Receptor 4/p21-Activated Kinase 1 Cascade[J]. Digestive diseases and sciences, 2018, 63(5):1210-1218.

Ho T, Chu S E, Zhang X, et al. Peptostreptococcus Anaerobius Induces Intracellular Cholesterol Biosynthesis in Colon Cells to Induce Proliferation and Causes Dysplasia in Mice[J]. Gastroenterology, 2017, 152(5S1):S1010-S1010.

Gabriel C, R C P, Ingrid M, et al. Escherichia coli induces DNA damage in vivo and triggers genomic instability in mammalian cells [J]. Proceedings of the National Academy of Sciences of the United States of America, 2010, 107(25):11537-42.

Zhen H, Z R G, C R N, et al. Campylobacter jejuni promotes colorectal tumorigenesis through the action of cytolethal distending toxin. [J]. Gut, 2018, 68(2):289-300.

Z S, Y F, B A R, et al. Cytolethal distending toxin promotes Helicobacter cinaedi-associated typhlocolitis in interleukin-10-deficient mice. [J]. Infection and immunity, 2009, 77(6):2508-16.

Emmanuel B, Damien D, Pierre S, et al. High prevalence of mucosa-associated E. coli producing cyclomodulin and genotoxin in colon cancer [J]. PloS one, 2013, 8(2):e56964.

C A G, E C S D, Shaoguang W, et al. Polyamine catabolism contributes to enterotoxigenic Bacteroides fragilis-induced colon tumorigenesis [J]. Proceedings of the National Academy of Sciences of the United States of America, 2011, 108(37):15354-9.

M M H, Victoria A, R D M. Enterococcus faecalis produces extracellular superoxide and hydrogen peroxide that damages colonic epithelial cell DNA. [J]. Carcinogenesis, 2002, 23(3):529-36.

Jun Y, Qiang F, Hei S W, et al. Metagenomic analysis of faecal microbiome as a tool towards targeted non-invasive biomarkers for colorectal cancer. [J]. Gut, 2017, 66(1):70-78.

Antony C, Julien D, Lucie G, et al. Small-molecule inhibitors prevent the genotoxic and protumoural effects induced by colibactin-producing bacteria. [J]. Gut, 2016, 65(2):278-85.

ZHANG Mei-yu; WU Yong-xi; WANG Yi-zhu, et al. Research progress on qi-tonifying traditional Chinese medicines in treatment of spleen deficiency syndrome by regulating intestinal flora[J]. Chinese Traditional and Herbal Drugs, 2021, 52(17):5430-5436.

ZHANG Shengsheng, HU Ling, LI Ruliu. Expert consensus opinion on Chinese medicine diagnosis and treatment of spleen deficiency (2017)[J]. Journal of Traditional Chinese Medicine, 2017, 58(17):1525-1530.

Si H, Yang Q, Hu H, et al. Colorectal cancer occurrence and treatment based on changes in intestinal flora [J]. Seminars in Cancer Biology, 2020, 7013-10.

ZHANG Kunli; LYU Mi; HU Jiayan, et al. Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology [J]. Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology, 2024, 26(03):628-633.

Li FT, Yang D, Song FY, et al. In Vitro Effects of Ginseng and the Seed of Zizyphus jujuba var. spinosa on Gut Microbiota of Rats with Spleen Deficiency[J]. Chem Biodivers, 2020;17(9):e2000199.

Zhao Xingbing, Wu Weijia, Li Dandan, et al. The effect of modeling spleen-deficiency constipation on the intestinal microbiota and enzyme activities in mice[J]. Chinese Journal of Microecology, 2013, 25(9): 993-996.

Cao Wuqun, He Mengchu, Shu Yingshang, et al. Effects of Canine-Derived Compound Probiotics on Cecal Microflora in Splenic Qi Asthenia Canines[J]. Chinese Journal of Animal Nutrition, 2019, 31(8): 3810-3820.

ZHENG Haolong, CHEN Si, SONG Nannan, et al. Distribution and timeliness of intestinal flora in rats with spleen deficiency model [J]. Journal of Traditional Chinese Medicine, 2020, 61(14): 1262-1267.

LI Qiuming, ZHANG Yajie, ZHANG Dafang, et al. Microecological regulation effect of spleen-enhancing and anti-diarrhea granules on mice with spleen deficiency and antibiotic intestinal flora dysbiosis model[J]. China Journal of Basic Chinese Medicine, 2010, 16(12):1119-1120.

YANG M D, CHEN X L, HU X Q, et al. Traditional Chinese medicine syndromes distribution in colorectal cancer and its association with western medicine treatment and clinical laboratory indicators[J]. World J Tradit Chin Med, 2019, 5 (2): 81-87.

YUAN Chenyue, JIAO Wen, LIU Xiangjun, et al. Study on tongue characteristic parameters and distribution of Chinese medicine patterns in postoperative colorectal cancer patients[J]. Chinese Journal of Traditional Chinese Medicine, 2024, 39(08):4443-4449.

LU Wenjie, CAO Jianchun, LI Huiping, et al. Study on the distribution pattern of early colorectal cancer and precancerous lesions in Chinese medicine[J]. Zhejiang Journal of Traditional Chinese Medicine, 2019, 54(07): 488-489.

LIN Shengyou, SHEN Minhe, LAN Ji, et al. Correlation analysis between Chinese medicine evidence and survival in 780 cases of colorectal cancer[J]. Journal of Traditional Chinese Medicine, 2012, 53(05):410-412.

HE Wenting, ZHANG Tong, YANG Yufei, et al. Meta-analysis of Clinical Efficacy of Traditional Chinese Medicine in Treating Colorectal Cancer and Syndrome Analysis[J]. Journal of Traditional Chinese Medicine, 2018, 59(22):1929-1936.

CHEN Yeqing, LI Xiaolin, CHEN Zirui. Literature study on the dosing pattern of modern Chinese medicine in the treatment of colorectal cancer[J]. Central South Pharmacy, 2022, 20(01):193-196.

HAN Ming-Xin, LI Fang-Tong, ZHANG Yan, et al. Biotransformation of Rare Protopanaxadiol Saponin by Human Intestinal Microflora[J]. Chemical Journal of Chinese Universities, 2019, 40(07):1390-1396.

Yue Hao, Zhou Dongyue, Zhang Meiyu, et al.In vitro Biotransformation of Protopanaxtriol Saponins from Red Ginseng by Intestinal Flora and Its Effect on Intestinal Flora[J]. Chinese Journal of Applied Chemistry, 2021, 38(03):323-330.

Ruijun Wang. Characterization and In vitro Metabolism of Polysaccharide from Atractylodes macrocephala Koidz and active polysaccharides fractions of Sijunzi decoction [D]. Shanghai Jiao Tong University, 2017.

GUAN Ting, HUANG Haiyang, HUANG Junmei, et al. The Effects of Spleen-meridian Chinese Herbs with Different Medical Properties on the Intestinal Microecology of Liver-stagnation and Spleen-dificiency Mice[J]. Traditional Chinese Drug Research and Clinical Pharmacology, 2021, 32(04):511-517.

Ruijun W, Guisheng Z, Mengyue W, et al. The Metabolism of Polysaccharide from Atractylodes macrocephala Koidz and Its Effect on Intestinal Microflora [J]. Evidence-based complementary and alternative medicine: eCAM, 2014, 2014(11):926381.

Shu YT, Kao KT, Weng CS. In vitro antibacterial and cytotoxic activities of plasma-modified polyethylene terephthalate nonwoven dressing with aqueous extract of Rhizome Atractylodes macrocephala[J]. Mater Sci Eng C Mater Biol Appl, 2017, 77:606-612.

YU Leimin, LIU Qingsheng, ZHAO Kejia, et al. Fecal Metabolic Profiling in a Murine Model of Irritable Bowel Syndrome and the Intervention Role of Prepared Atractylodes Macrocephala [J]. Chinese Journal of Integrated Traditional and Western Medicine, 2019, 39(06):708-715.

LIANG Xiaorui, JIA Cheng, WANG Danyang, et al. The effect of water extracts of three tonic Chinese medicine on intestinal morphological structure and immune function of chicken[J]. Heilongjiang Animal Science And veterinary Medicine, 2021, (04): 110-115+158.

ZHANG Wen-ji, LAI Xing-hai, CHEN Jia-wei, Effect of yam polysaccharides in the treatment of obese diabetic nephropathy rats and its effect on renal function and intestinal microecology[J]. Chinese Journal of Microecology, 2021, 33(01):37-42.

LIU Lu, ZHANG Yan, WEI Zhencheng, et al. Study on Production of Short Chain Fatty Acids from Yam Oligosaccharides by Intestinal Probiotics Fermentation in vitro[J]. Journal of Food Science and Technology, 2019, 37(04):49-56.

WANG Shiqi, WANG Xuemei, LI Xiaoqing, et al. Effect of Sijunzi Decoction on Intestinal Microecology Changes of Deficiency of Spleen and Stomach Peptic Ulcer Patients’and Expression of COX-1, COX-2 and PGE2[J]. Chinese Medicine Modern Distance Education of China, 2020, 18(04):67-70.

HUANG Wenwu, PENG Ying, WANG Mengyue, et al. Regulatory Effect of Sijunzi Tang and Its Single Herbs on Intestinal Flora in Rats with Spleen Deficiency[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2019, 25(11):8-15.

GUO Zhuo, MI Lifeng, GUO Qian, et al. Effects of Buzhong Yiqi Decoction on intestinal flora structure and gastrointestinal function in rats with chronic fatigue syndrome[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2024, 39(06):3084-3088.

YU Hanchuan, MENG Yangyang, WANG Enkang, et al. Buzhong Yiqi Decoction ameliorates spleen deficiency syndrome by regulating gut microbiota [J]. China Journal of Chinese Materia Medica, 2024, 49(04): 1028-1043.

LIN Xia, HUANG You, YANG Shasha, et al.Effect of Fuzi Lizhong Pill on Intestinal Flora of Spleen Yang Deficiency IBS-D Rats Based on High-Throughput Sequencing Technique[J].Journal of Nanjing University of Traditional Chinese Medicine, 2021, 37(03):388-395.

CHEN Weini, DUAN Sujing, TAN Wei, etc. Effect of Fuzi Lizhong Pills on Intestinal Flora of Type 2 Diabetic Patients with Spleen Deficiency[J]. Journal of Baotou Medical College, 2020, 36(05):64-66+70.

Downloads

Published

2024-09-26

How to Cite

Qiao, H., & Xiao, H. (2024). Progress of “Yiqi and Spleen Enhancement Method” in the Treatment of Colorectal Cancer based on Intestinal Flora. Journal of Contemporary Medical Practice, 6(9), 131–137. https://doi.org/10.53469/jcmp.2024.06(09).25