The Current Application and Future Prospects of Astragalus Polysaccharide Combined With Cancer Immunotherapy: A Review.

Fanming Kong,Yingjie Jia,Tianqi Chen,Xiaojiang Li

doi:10.3389/fphar.2021.737674

Abstract

So far, immunotherapy has been shown to have impressive effects on different cancers in clinical trials. All those immunotherapies are generally derived from three main therapeutic approaches: immune checkpoint inhibitors, immune cell vaccination, and adoptive cellular immunotherapy. Our research systematically reviewed a wide range of clinical trials and laboratory studies of astragalus polysaccharide (APS) and elucidated the potential feasibility of using APS in activating adoptive immunotherapy. Apart from being effective in adaptive “passive” immunotherapy such as lymphokine-activated killer treatment and dendritic cell (DC)–cytokine–induced killer treatment, APS could also regulate the anti-programmed cell death protein 1 (PD-1)/PD-L1 on the surface of the immune cells, as a part in the immune checkpoint inhibitory signaling pathway by activating the immune-suppressed microenvironment by regulating cytokines, toll-like receptor 4 (TLR4), nuclear factor kappa B (NF-κB), and mitogen-activated protein kinase (MAPK) pathways, and immune cells, such as DCs, macrophages, NK cells, and so on. In view of the multiple functions of APS in immunotherapy and tumor microenvironment, a combination of APS and immunotherapy in cancer treatment has a promising prospect.

Highlights

Immunotherapy has been shown to have impressive effects on different cancers in clinical trials (Hodi et al, 2010; Kazandjian et al, 2016; Necchi et al, 2017)
We found astragalus polysaccharide (APS) could significantly suppress the levels of tumor growth factor (TGF)-β and IL-10 in vivo and in vitro while increasing the levels of IFN-γ, tumor necrosis factors (TNFs)-α, IL-2, and IL-1β, regulating the growth factor vascular endothelial growth factor (VEGF), and reverting the immune-suppressed tumor microenvironment (TME), hopefully to be an adjuvant drug in immunotherapy (Table 2)
Our research systematically reviewed a wide range of clinical trials and laboratory studies, elucidating the potential plausibility of using APS in activating adoptive immunotherapy, as an immunological adjuvant in the future

Summary

Introduction

Immunotherapy has been shown to have impressive effects on different cancers in clinical trials (Hodi et al, 2010; Kazandjian et al, 2016; Necchi et al, 2017). It involves 1) enhancement of antigen uptake, APS Combined With Cancer Immunotherapy processing, and presentation to T cells by antigen-presenting cells (APCs), such as DC vaccines, with its extension of using agents such as interferons and cytokines to increase APC function; 2) the activation and expansion of naive T cells with DC vaccines, CTLA-4, or PD-1/PD-L1 inhibitor; and 3) enhancement of the effect of the immune response.

Results

Conclusion