Abstract
The tumor microenvironment (TME) plays a key role in promoting the initiation and progression of tumors, leading to chemoradiotherapy resistance and immunotherapy failure. Targeting of the TME is a novel anti-tumor therapeutic approach and is currently a focus of anti-tumor research. Panax ginseng C. A. Meyer (ginseng), an ingredient of well-known traditional Asia medicines, exerts beneficial anti-tumor effects and can regulate the TME. Here, we present a systematic review that describes the current status of research efforts to elucidate the functions and mechanisms of ginseng active components (including ginsenosides and ginseng polysaccharides) for achieving TME regulation. Ginsenosides have variety effects on TME, such as Rg3, Rd and Rk3 can inhibit tumor angiogenesis; Rg3, Rh2 and M4 can regulate the function of immune cells; Rg3, Rd and Rg5 can restrain the stemness of cancer stem cells. Ginseng polysaccharides (such as red ginseng acidic polysaccharides and polysaccharides extracted from ginseng berry and ginseng leaves) can regulate TME mainly by stimulating immune cells. In addition, we propose a potential mechanistic link between ginseng-associated restoration of gut microbiota and the tumor immune microenvironment. Finally, we describe recent advances for improving ginseng efficacy, including the development of a nano-drug delivery system. Taken together, this review provides novel perspectives on potential applications for ginseng active ingredients as anti-cancer adjuvants that achieve anti-cancer effects by reshaping the tumor microenvironment.
Highlights
Efforts to develop anti-cancer therapies no longer focus on targeting tumor cells themselves, since cancer progression is regulated by the interaction between tumor cells and the tumor-site environment
Could decrease the number of vessels oriented toward the tumor lesions, and reduce vascular endothelial cell proliferation and migration Could inhibit VEGF-dependent migration, vascularization and viability and angiogenesis activity of human umbilical vascular endothelial cells (HUVECs), and prevent tumor angiogenesis Could decrease the expression of endothelial cell marker CD34 in tumor tissues and inhibit angiogenetic activity in chorioallantoic membrane (CAM) model Could induce endoplasmic reticulum stress and apoptosis of HUVECs Could suppressing the formation of endothelial tube-like structures Could inhibit tube formation of HUVECs
A synergistic effect on tumor-associated macrophages (TAMs) repolarization with PTX; decreasing the numbers of granulocyte-like myeloid derived suppressor cells in tumor microenvironment Inducing repolarization of TAM to M1-like phenotype; downregulating M2 macrophages-induced secretion and expression of VEGF-C, MMP2, and MMP9 in non-small cell lung cancer (NSCLC) cells; decreasing the VEGF-C and marker of M2-like phenotype expression Inhibiting ionizing radiation enhanced LPS-stimulated NO synthesis and IL-1β production in macrophages; radioprotective effects on J774A.1 via inhibiting MAPK and Akt pathways Increasing production of IL-1, IL-6, TNFα and NO via activating NF-κB pathway when combine with IFN-γ treatment Augmenting macrophage phagocytosis and stimulating production of TNF-α and NO Increasing cytokine production and MHC expression in macrophage cells and activating MAPKs and NF-κB pathways
Summary
Efforts to develop anti-cancer therapies no longer focus on targeting tumor cells themselves, since cancer progression is regulated by the interaction between tumor cells and the tumor-site environment. The tumor microenvironment (TME) is a complex tumor ecosystem that are dominated by tumor and consists of tumor cells, stromal cells, immune cells, and the extracellular
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