Elemene Injection Research Articles

Elemene Injection Overcomes Paclitaxel Resistance in Breast Cancer through AR/RUNX1 Signal: Network Pharmacology and Experimental Validation.

Paclitaxel (PTX) is a cornerstone chemotherapy for Breast Cancer (BC), yet its impact is limited by emerging resistance. Elemene Injection (EI) has shown potential in overcoming chemotherapy resistance. However, the efficacy by which EI restores PTX sensitivity in BC and the implicated molecular mechanism remain uncharted. Network pharmacology and bioinformatic analysis were conducted to investigate the targets and mechanisms of EI in overcoming PTX resistance. A paclitaxel-resistant MCF-7 cell line (MCF-7PR) was established. The efficacy of EI and/or PTX in inhibiting cell viability was evaluated using sulforhodamine B assay, while cell proliferation was assessed using EdU staining. Furthermore, protein and gene expression analysis was performed through Western blotting and qPCR. The EI containing three active components exhibited a multifaceted impact by targeting an extensive repertoire of 122 potential molecular targets. By intersecting with 761 differentially expressed genes, we successfully identified 9 genes that displayed a direct association with resistance to PTX in BC, presenting promising potential as therapeutic targets for the EI to effectively counteract PTX resistance. Enrichment analysis indicated a significant correlation between these identified targets and critical biological processes, particularly DNA damage response and cell cycle regulation. This correlation was further substantiated through meticulous analysis of single-cell datasets. Molecular docking analysis revealed robust binding affinities between the active components of the EI and the identified molecular targets. Subsequently, in vitro experiments unequivocally demonstrated the dose- and time-dependent inhibitory effects of the EI on both PTX-resistant and sensitive BC cell lines, effectively mitigating the resistance phenotype associated with PTX administration. Furthermore, our findings have indicated EI to effectively suppress the protein expression levels of AR and RUNX1 in MCF-7 and MCF-7PR cells under PTX treatment, as well as downregulate the mRNA expression levels of stem-like properties' markers, KLF4 and OCT4, in these cell lines. Elemene Injection (EI) application has exhibited a significant capability to mitigate PTX resistance in BC, which has been achieved through targeted suppression of the AR/RUNX1 axis, revealing a key strategy to overcome chemotherapeutic resistance.

Prevalence of inappropriateness of elemene injection for hospitalized cancer patients: a multicenter retrospective study.

Background: Elemene injection could provide clinical benefit for the treatment of various cancers, but the clinical evidence is weak. Thus, its wide use in China has raised concerns about the appropriateness of its use. Methods: This was a multicenter retrospective study to evaluate the prevalence of inappropriateness of elemene injection for hospitalized cancer patients. Patients who met the inclusion criteria were retrospectively included, and demographic characteristics were extracted from the hospital information systems. The inappropriateness of elemene injection use was assessed using the preset criteria, and the prevalence was calculated. Multivariate logistic analysis was applied to identify any factors associated with inappropriate use. Results: A total of 275 patients were included in the analysis. The median age was 62years, and 30.9% were females. The most common cancer was lung cancer (24.0%), and 68.2% of the patients were receiving chemotherapy. The overall prevalence of inappropriateness was 61.8%. The most common reason for inappropriateness was inappropriate indications, and the second was inappropriate doses. Age and oncological department were significant risk factors associated with inappropriate use, while lung cancer, liver cancer and admission to cardiothoracic surgery were associated with a low risk of inappropriate use. Conclusion: The prevalence of inappropriateness among hospitalized elemene injection users was high. More efforts, especially those to improve the appropriateness of indications, should be made to improve the rational use of elemene, as well as other complementary medicines. Physicians should take caution to avoid inappropriate use when prescribing drugs with limited clinical evidence.

Effect of Network-Based Positive Psychological Nursing Model Combined With Elemene Injection on Negative Emotions, Immune Function and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy in the Era of Big Data

BackgroundWith the development of big data, big data interpenetrate in every person's life. Health care is no exception to this trend, especially in regard to nursing analytics. The data that is analyzed and leveraged in this field is gathered from a variety of sources, including electronic health records (EHRs), medical histories, provider notes and mobile applications, creating an accumulation of personalized health information around each individual.ObjectiveTo explore the effect of the network-based positive psychological nursing model combined with elemene injection on negative emotions, immune function and quality of life (QOL) in patients with lung cancer (LC) undergoing chemotherapy.MethodsThe clinical data of 90 LC patients who underwent chemotherapy in our hospital from December 2020 to December 2021 were retrospectively analyzed, and the patients were equally split into experimental group (EG) and control group (CG) according to the order of enrollment. The patients in CG received routine nursing intervention during chemotherapy, while those in EG received the network-based positive psychological nursing model combined with elemene injection to compare negative emotions, immune function and quality of life (QOL) between the two groups.ResultsCompared with CG, EG had notably higher immune function indexes (P < 0.001), lower serum VEGF and MMP-2 levels (P < 0.001), lower HAMA and HAMD scores (P < 0.05), and higher scores of PTGI, physiological function, psychological function, social function and physical function (P < 0.001).ConclusionThe network-based positive psychological nursing model combined with elemene injection is a reliable method to enhance the immune function and QOL of LC patients undergoing chemotherapy and alleviate their negative emotions, which has a high clinical application value.

Chemical composition, anticancer activities and related mechanisms of the essential oil from Alpinia coriandriodora rhizome

Alpinia coriandriodora is widely cultivated as a medicinal and edible Zingiberaceae plant in Guangxi, China. Since essential oils from Zingiberaceae plants can be used as a potential source of anticancer drugs, this study was designed to identify the chemical composition of A. coriandriodora rhizome essential oil (EO) and firstly elucidate its anticancer activities and related mechanisms. The GC-FID/MS results indicated that the most predominant component of EO was (E)-2-decenal (56.3%). Based on the MTT results, EO exhibited comparable cytotoxicity to A549 cells and lower cytotoxicity to non-cancerous cells compared with the positive control (elemene injection). For related mechanism studies, EO inhibited the A549 cells proliferation, resulting from inducing cell cycle arrest at G1 phase via downregulation of cyclin E2-CDK2 and cyclin D3-CDK4/CDK6 complexes and upregulation of p21. Meanwhile, it induced the apoptosis through mitochondrial pathway with the successive enhancement in the Bax/Bcl-2 ratio, Δψm decline, cyt c release, activation of caspase-9 and caspase-3, and PARP cleavage. Moreover, it inhibited the migration and invasion ability of A549 cells via downregulation of MMP-2 and N-cadherin, as well as upregulation of E-cadherin. Hence, EO has outstanding anticancer properties in vitro, and this fact encourages further studies using in vivo models.

Investigation on the Efficiency of Chinese Herbal Injections combined with Concurrent Chemoradiotherapy for Treating Nasopharyngeal Carcinoma based on Multidimensional Bayesian Network Meta-analysis.

Introduction: Given the wide utilization of Chinese herbal injections in the treatment of nasopharyngeal carcinoma (NPC), this network meta-analysis (NMA) was devised to compare the clinical efficacy and safety of different Chinese herbal injections combined with concurrent chemoradiotherapy (CCRT) against NPC. Methods: Randomized controlled trials (RCTs) were retrieved from seven electronic databases from the date of database establishment to October 5, 2020. Study selection and data extraction conformed to a priori criteria. Focusing on clinical effective rate, performance status, grade ≥3 oral mucositis, nausea and vomiting, leukopenia, and thrombopenia, this NMA was performed with Review Manager 5.3.5, Stata 13.1, WinBUGS 1.4.3, and R 4.0.3 software. Results: Ten inventions from 37 RCTs involving 2,581 participants with NPC that evaluated the clinical effective rate, nausea and vomiting, leukopenia, thrombopenia, and grade ≥3 oral mucositis were included. Compared with CCRT alone, Elemene injection and Compound Kushen injection were associated with significantly improved clinical effective rates, and Elemene injection plus CCRT had the highest probability in terms of clinical effective rate (78.07%) compared with the other interventions. Shenqifuzheng injection, Xiaoaiping injection, and Shenmai injection ranked the best in terms of performance status (79.02%), nausea and vomiting (86.35%), and grade ≥3 oral mucositis (78.14%) when combined with CCRT. Kangai injection combined with CCRT ranked ahead of the other injections in terms of leukopenia (90.80%) and thrombopenia (91.04%), and had a better impact on improving performance status and reducing leukopenia, thrombopenia, grade ≥3 oral mucositis, and nausea and vomiting in the multidimensional cluster analysis. Conclusion: Current clinical evidence indicates that Elemene injection combined with CCRT has the best clinical effective rate and that Kangai injection might have a comprehensively better impact on improving performance status and reducing adverse reactions against NPC. Additionally, due to the limitations of this NMA, more multicenter, high-quality, and head-to-head RCTs are needed to properly support our findings.

Clinical Study on TACE Combined with Elemene Injection and Cinobufagin Injection Respectively for Middle and Advanced Primary Hepatic Carcinoma

Objective. To observe and compare the differences in the clinical effect and the incidences of adverse reactions of transcatheter arterial chemoembolization(TACE) combined with elemene injection and cinobufagin injection respectively for middle and advanced primary hepatic carcinoma. Methods . A total of 104 cases of patients with middle and advanced primary hepatic carcinoma who were treated in the oncology department from August 2018 to January 2020 were included as the study objects, and were randomly divided into two groups according to different treatment regimens, 52 cases in each group. Both groups were treated with TACE once; the cinobufagin injection group was given intravenous infusion with 500 mL of 5% glucose injection and 10 mL of cinobufagin injection once a day. The elemene injection group was given intravenous infusion with elemene injection of 0.4 g each time and once a day. Both groups were treated for two courses, 15 days of continuous treatment with a rest of 15 days being one course. The clinical effect, the changes in the indexes of liver function including alanine amino transferase(ALT), aspartate transaminase(AST) and total bilirubin(TBil), the scores of alpha-fetoprotein(AFP) and Karnofsky (KPS) and tumor volumes as well as the difference in the incidences of adverse reactions between the two groups were observed and compared. Results . The total clinical effective rate was 88.46% in the elemene injection group and 71.15% in the cinobufagin injection group, and the difference was significant(P 0.05). After treatment, the decrease of AFP, tumor volume and the increase of KPS scores in the elemene injection group were significantly more than those in the cinobufagin injection group, differences being significant (P 0.05). The adverse reactions in the cinobufagin injection group were mainly nausea and vomiting, with higher incidence than that in the elemene injection group, the difference being significant (P<0.05). The adverse reactions in the elemene injection group were mainly pain at the injection site, with higher incidence than that in the cinobufagin injection group, the difference being significant (P<0.05). Conclusion . The therapy of elemene injection combined with TACE for middle and advanced primary hepatic carcinoma has better clinical effect than that of cinobufagin injection, but the occurrence of adverse reactions should still be paid attention to during the treatment with the two Chinese herbal medicines.

Anti-Tumor Drug Discovery Based on Natural Product β-Elemene: Anti-Tumor Mechanisms and Structural Modification.

Natural products are important sources for drug discovery, especially anti-tumor drugs. β-Elemene, the prominent active ingredient extract from the rhizome of Curcuma wenyujin, is a representative natural product with broad anti-tumor activities. The main molecular mechanism of β-elemene is to inhibit tumor growth and proliferation, induce apoptosis, inhibit tumor cell invasion and metastasis, enhance the sensitivity of chemoradiotherapy, regulate the immune system, and reverse multidrug resistance (MDR). Elemene oral emulsion and elemene injection were approved by the China Food and Drug Administration (CFDA) for the treatment of various cancers and bone metastasis in 1994. However, the lipophilicity and low bioavailability limit its application. To discover better β-elemene-derived anti-tumor drugs with satisfying drug-like properties, researchers have modified its structure under the premise of not damaging the basic scaffold structure. In this review, we comprehensively discuss and summarize the potential anti-tumor mechanisms and the progress of structural modifications of β-elemene.

Preparation, characterization, pharmacokinetics and anticancer effects of PEGylated β-elemene liposomes.

Objective: This study aimed to develop a new polyethylene glycol (PEG)ylated β-elemene liposome (PEG-Lipo-β-E) and evaluate its characterization, pharmacokinetics, antitumor effects and safety in vitro and in vivo.Methods: The liposomes were prepared by ethanol injection and high-pressure micro-jet homogenization. Characterization of the liposomes was conducted, and drug content, entrapment efficiency (EE), in vitro release and stability were studied by ultra-fast liquid chromatography (UFLC) and a liquid surface method. Blood was drawn from rats to establish the pharmacokinetic parameters. The anticancer effect was evaluated in a KU-19-19 bladder cancer xenograft model. Histological analyses were performed to evaluate safety.Results: The PEG-Lipo-β-E showed good stability and was characterized as 83.31 ± 0.181 nm in size, 0.279 ± 0.004 in polydispersity index (PDI), −21.4 ± 1.06 mV in zeta potential, 6.65 ± 0.02 in pH, 5.024 ± 0.107 mg/mL in β-elemene (β-E) content, and 95.53 ± 1.712% in average EE. The Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) indicated the formation of PEG-Lipo-β-E. Compared to elemene injection, PEG-Lipo-β-E demonstrated a 1.75-fold decrease in clearance, a 1.62-fold increase in half-life, and a 1.76-fold increase in area under the concentration-time curves (AUCs) from 0 hour to 1.5 hours (P < 0.05). PEG-Lipo-β-E also showed an enhanced anticancer effect in vivo. Histological analyses showed that there was no evidence of toxicity to the heart, kidney, liver, lung or spleen.Conclusions: The present study demonstrates PEG-Lipo-β-E as a new formulation with ease of preparation, high EE, good stability, improved bioavailability and antitumor effects.

A case of anaphylactic shock caused by elemene injection

A case of anaphylactic shock caused by elemene injection

The effect of elemene in combination with vascular endothelial growth factor polyclonal antibody on the expression of proliferating cell nuclear antigen and tissue inhibitor of metalloproteinase-1 in brain glioma tissue of rats

Objective To investigate the effect of elemene in combination with vascular endothelial growth factor (VEGF) polyclonal antibody on the expression of proliferating cell nuclear antigen (PCNA) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in brain glioma tissue of rats. Methods The rat glioma models were built by intracerebral injection of C6 glioma cells. Forty-eight successful rat models were selected and randomly divided into model group, elemene group, VEGF polyclonal antibody group and elemene in combination with VEGF polyclonal antibody group, with 12 rats in each group. Rats in model group were performed intraperitoneal injection of 0.5 ml normal saline, rats in elemene group were performed intraperitoneal injection of 0.5 ml elemene injection, rats in VEGF polyclonal antibody group were performed intraperitoneal injection of 0.5 ml VEGF polyclonal antibody, and rats in elemene in combination with VEGF polyclonal antibody group were performed intraperitoneal injection of 0.5 ml elemene injection and 0.5 ml VEGF polyclonal antibody. The drug was administered on alternate days for 7 consecutive times. The tumour volume, tumor inhibition rate and the expression of PCNA and TIMP-1 in brain tissue of the rats between the groups were compared. Statistics with SPSS 21.0 software, measurement data for Mean±SD indicated that one factor variance analysis was used for the comparison between the two groups, and t test was used for the comparison between the two groups. Results (1) Tumor volume and tumor inhibition rate: The tumor volumes in model group, elemene group, polyclonal group, VEGF polyclonal antibody group and elemene in combination with VEGF polyclonal antibody group were (68.54±8.12), (37.65±6.24), (39.12±6.41), (30.12±5.24) mm3, respectively; the tumor inhibition rates in elemene group, VEGF polyclonal antibody group and elemene in combination with VEGF polyclonal antibody group were (445.07±6.45)%, (42.92±6.52)%, (56.05±7.21)%, respectively. The tumor volume in elemene in combination with VEGF polyclonal antibody group was significantly smaller than that in control group (t=10.449, 9.851, 13.772, P<0.01); the tumor volume in elemene in combination with VEGF polyclonal antibody group was significantly smaller than that in elemene group and VEGF polyclonal antibody group (t=3.201, 3.766, P<0.05), and the tumor inhibition rate was significantly higher than that in elemene group and VEGF polyclonal antibody group (t=3.932, 4.679, P<0.05). (2) As to the expression of PCNA and TIMP-1 in brain tissue: the PCNA indexes of tumors in model group, elemene group, VEGF polyclonal antibody group and elemene in combination with VEGF polyclonal antibody group were (73.12±10.21, 44.24±6.42, 47.36±7.12, 37.45±5.24), respectively, and the TIMP-1 indexes were (45.24±6.45, 62.45±8.15, 59.45±7.32, 78.65±11.24), respectively. The PCNA indexes of tumors in elemene group, VEGF polyclonal antibody group and elemene in combination with VEGF polyclonal antibody group were significantly lower than that in model group (t=8.295, 7.447, 10.767, P<0.05, P<0.01), the TIMP-1 indexes were significantly higher than that in model group (t=5.736, 5.401, 8.931, P<0.05, P<0.01); the PCNA index of tumor in elemene in combination with VEGF polyclonal antibody group was significantly lower than that in elemene group and VEGF polyclonal antibody group (t=2.838, 3.491, P<0.05), and the TIMP-1 index was significantly higher than that in elemene group and VEGF polyclonal antibody group (t=4.042, 4.700, P<0.05). Conclusion Elemene in combination with VEGF polyclonal antibody can help to inhibit the growth of brain glioma tissue, which may be related to the regulation of PCNA and the expression of TIMP-1 in brain tissue. Key words: Brain glioma; Elemene; Vascular endothelial growth factor polyclonal antibody; Proliferating cell nuclear antigen; Tissue inhibitor of metalloproteinase-1

Elemene injection combined with transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma: A meta-analysis.

Background:To evaluate the short-term efficacy, long-term efficacy, and adverse events (AEs) of elemene plus transcatheter arterial chemoembolization (TACE) in comparison with TACE alone for the treatment of hepatocellular carcinoma (HCC).Methods:PubMed, EMBASE, the Cochrane Library, the Chinese Scientific Journal Full-text Database, Wanfang Data, CBM, and VIP were searched by 2 reviewers using the same search strategy for clinical studies on elemene plus TACE in the treatment of HCC. These articles were screened according to pre-established inclusion and exclusion criteria, and the qualities of the included studies were assessed using the Newcastle–Ottawa scale. The primary outcomes were the objective response rate (ORR), the 1-year survival rate and AEs. Review Manager 5.3 and Stata 15.0 were used for the meta-analysis.Results:A total of 10 studies involving 543 patients (TACE + elemene = 277, TACE alone = 266) were included. The results showed that the ORR was significantly improved in the combined treatment group compared to the TACE alone group (odds ratio [OR] = 2.72, 95% confidence interval [CI]: 1.84–4.00, P < .05). TACE + elemene significantly increased the 1-year survival rate (OR = 2.79, 95% CI: 1.58–4.95, P < .05). We also found no significant difference in gastrointestinal reactions (OR = 0.97, 95% CI: 0.57–1.64, P = .90), fever (OR = 0.80, 95% CI: 0.37–1.71, P = .56), or bone marrow suppression (OR = 0.73, 95% CI: 0.44–1.22, P = .23) between the 2 groups.Conclusion:Based on current findings, TACE + elemene injection may improve the ORR and the 1-year survival rate for HCC patients compared to TACE alone. Arterial perfusion may be superior to intravenous guttae.

Elemene injection as adjunctive treatment to platinum-based chemotherapy in patients with stage III/IV non-small cell lung cancer: A meta-analysis following the PRISMA guidelines

BackgroundElemene injection is an anticancer Chinese patent medicine that is widely used for the treatment of advanced lung cancer. Its active ingredients are β-, γ- and δ-elemene, which are extracted from Curcuma aromatica Salisb. (Curcuma wenyujin Y.H. Chen & C. Ling). PurposeTo evaluate the effects of Elemene injection as adjunctive treatment to platinum-based chemotherapy (PBC) in patients with stage III/IV non-small cell lung cancer. Study designA systematic review and meta-analysis of randomized clinical trials (RCTs). Materials and methodsA systematic review and meta-analysis were conducted following the PRISMA (Preferred Reported Items for Systematic Review and Meta-analysis) guidelines. Analyses were performed using Review Manager 5.3, Comprehensive Meta-Analysis 3.0 and Trial Sequential Analysis software. All RCTs comparing Elemene injection combined with PBC vs. PBC alone were selected and assessed for inclusion. The disease control rate (DCR) was defined as the primary endpoint, and the objective Response rate (ORR), survival rate, quality of life (QOL), cellular immune function and toxicities were the secondary outcomes. Results15 RCTs recruiting 1,410 patients with stage III/IV NSCLC were included. The methodological quality of most included trials was low to moderate. Compared with PBC alone, Elemene injection plus PBC can improve DCR (RR = 1.23, 95% CI 1.16 to 1.31, p < 0.00001), ORR (RR = 1.62, 95% CI 1.44 to 1.82, p < 0.00001), 1- and 2-year survival rates (RR = 1.33, 95% CI 1.11 to 1.59, p = 0.002; RR = 1.73, 95% CI 1.21 to 2.46, p = 0.002, respectively), QOL (RR = 1.91, 95% CI 1.58 to 2.32, p < 0.00001), CD4+T cell counts (WMD = 10.43, 95% CI 8.25 to 12.62, p < 0.00001), and the CD4+/CD8+ratio (WMD = 0.78, 95% CI 0.42 to 1.14, p < 0.0001) and can reduce severe toxicities by 58% (RR = 0.42, 95% CI 0.34 to 0.52, p < 0.00001). ConclusionElemene injection is a safe and effective adjunctive treatment to platinum-based chemotherapy in patients with stage III/IV NSCLC. Elemene injection can improve clinical efficacy, enhance cellular immune function and alleviate the toxicity of chemotherapy. High-quality RCTs with significant survival outcomes and longer follow-ups are warranted to confirm the results further.

Drug delivery systems for elemene, its main active ingredient β-elemene, and its derivatives in cancer therapy.

β-elemene is a noncytotoxic Class II antitumor drug extracted from the traditional Chinese medicine Curcuma wenyujin Y. H. Chen et C. Ling. β-elemene exerts its effects by inhibiting cell proliferation, arresting the cell cycle, inducing cell apoptosis, exerting antiangiogenesis and antimetastasis effects, reversing multiple-drug resistance (MDR), and enhancing the immune system. Elemene injection and oral emulsion have been used to treat various tumors, including cancer of the lung, liver, brain, breast, ovary, gastric, prostate, and other tissues, for >20 years. The safety of both elemene injection and oral emulsion in the clinic has been discussed. Recently, the secondary development of β-elemene has attracted the attention of researchers and made great progress. On the one hand, studies have been carried out on liposome-based systems (including solid lipid nanoparticles [SLNs], nanostructured lipid carriers [NLCs], long-circulating liposomes, active targeting liposomes, and multidrug-loaded liposomes) and emulsion systems (including microemulsions, self-emulsion drug delivery systems [SEDDSs], and active targeting microemulsion) to solve the issues of poor solubility in water, low bioavailability, and severe phlebitis, as well as to improve antitumor efficacy. The pharmacokinetics of different drug delivery systems of β-elemene are also summarized. On the other hand, a number of highly active anticancer β-elemene derivatives have been obtained through modification of the structure of β-elemene. This review focuses on the two drug delivery systems and derivatives of β-elemene for cancer therapy.

Severe Adverse Reactions Induced by the Chest Injection of Elemene: An Analysis of 7 Cases

背景与目的恶性胸腔积液（malignant pleural effusion, MPE）指胸膜原发恶性肿瘤或其他部位恶性肿瘤转移至胸膜引起的胸腔积液。胸腔内注射榄香烯对MPE有良好的治疗效果，在临床中应用较普遍，同时存在一些不良反应，但文献缺乏对严重不良反应的报道及处理。本研究旨在观察榄香烯注射液治疗恶性胸腔积液导致不良反应发生情况，探讨严重不良反应发生原因和应对方案。方法回顾性分析14例胸腔注射榄香烯病例，对其中7例发生严重不良反应病例进行详细报道。结果榄香烯注射液胸腔注射所致严重不良反应主要表现为剧烈胸痛、呼吸困难、喘憋、意识模糊和凝血功能障碍，经临床对症治疗后均可缓解。结论胸腔注射榄香烯榄香烯对MPE有一定治疗价值，使用时应严格把握适应证、筛选患者、严密监测。

Clinical observation on the effect of elemene injection maintenance treatment on the recurrence time of malignant pleural effusion

Objective To observe the effect of elemene injection for the maintenance treatment of malignant pleural effusion. Methods A total of 90 patients with malignant pleural effusion from May 2014 to Apirl 2016 in First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine were collec-ted. They were divided into observation group (n=45) and control group (n=45) according to the random number table method. The patients of the two groups were treated with pleural effusion drainage through thoracocentesis, and Mannatide (Lifein) and carboplatin were poured. The observation group sequentially received maintenance treatment of elemene injection. The therapeutic effects of the two groups were compared. Results At the 12th month after treatment, the difference of relapse rate between the two groups was statistically significant(82.2% vs. 100.0%, χ2=8.780, P=0.003). The median progression-free survival (95%CI) of the observation group and the control group were 10.00 (9.15-10.85) months and 6.00(4.74-7.26) months respectively, with a significant difference (χ2=40.475, P<0.001). The improvement rates of life quality of the observation group were 82.22%, 57.78%, 54.55% respectively at one, six, twelve months after perfusion treatment, and the improvement rates of the control group were 84.44%, 23.26%, 0 respectively. The data differences between the two groups were statistically significant at six, twelve months (χ2=10.840, P=0.001; χ2=32.390, P<0.001). The one year survival rates of the observation group and the control group were 97.78% and 95.56%, and the difference was statistically significant (P=1.000). Conclusion The effect of elemene injection for the maintenance treatment of malignant pleural effusion is obvious, which can prolong the progression-free survival time and can significantly improve the quality of life. Key words: Pleural effusion, malignant; Drug therapy; Elemene

Evidence of elemene injection combined radiotherapy in lung cancer treatment among patients with brain metastases: A systematic review and meta-analysis.

Background:This review evaluates the effectiveness and safety of elemene injection combined radiotherapy in the treatment of lung cancer with brain metastases.Methods:A systematic literature research was conducted from EMBASE, Cochrane Library, PubMed, Chinese biomedical database, Chinese scientific journal database, China knowledge resource integrated database, and WanFang Database from established to July 2016 without language restriction. The Cochrane Collaboration tool was used to evaluate the risk of bias. All statistical analyses were conducted with STATA (version 14.0) and RevMan (version 5.3).Results:Eleven randomized controlled trials (765 patients) were included for determining the effectiveness and safety of elemene combined with radiotherapy in the treatment of lung cancer with brain metastases. Objective response rate (ORR) [odds ratio (OR) = 2.89, 95% confidence interval (95% CI) 2.04–4.08, P < .00001] and symptoms (OR = 4.06, 95% CI 2.00–8.25, P = .0001) improved more in the elemene-based combination treatment group than in the radiotherapy-alone control group. The Karnofsky Performance Status (KPS) score was used to measure patients’ improvement rate. The patients who were treated with elemene-based combination with radiotherapy were higher than those patients who were treated with radiotherapy alone (OR = 3.51, 95% CI 2.20–5.61, P < .00001]. The incidence of bone marrow suppression (OR = 0.27, 95% CI 0.11–0.68, P = .006) and leukopenia (OR = 0.23, 95% CI 0.12–0.46, P < .00001) decreased in the elemene-based combination treatment group by radiotherapy significantly.Conclusions:The elemene injection combined radiotherapy in the treatment of lung cancer with brain metastases appears to improve the treatment response rate and alleviated symptoms. The combined treatment has showed positive impact to reduce adverse reactions and improve quality of life.

Elemene injection induced autophagy protects human hepatoma cancer cells from starvation and undergoing apoptosis.

Elemene, a compound found in an herb used in traditional Chinese medicine, has shown promising anticancer effects against a broad spectrum of tumors. In an in vivo experiment, we found that apatinib, a tyrosine kinase inhibitor that selectively inhibits VEGFR2, combined with elemene injection (Ele) for the treatment of H22 solid tumor in mice resulted in worse effectiveness than apatinib alone. Moreover, Ele could protect HepG2 cells from death induced by serum-free starvation. Further data on the mechanism study revealed that Ele induced protective autophagy and prevented human hepatoma cancer cells from undergoing apoptosis. Proapoptosis effect of Ele was enhanced when proautophagy effect was inhibited by hydroxychloroquine. Above all, Ele has the effect of protecting cancer cells from death either in apatinib induced nutrient deficient environment or in serum-free induced starvation. A combination of elemene injection with autophagy inhibitor might thus be a useful therapeutic option for hepatocellular carcinoma.

Meta-analysis on elemene injection combined with cisplatin chemotherapeutics in treatment of non-small cell lung cancer

To research databases of Cochrane library, Web of Science, PubMed, FMJS, CBM, VIP, CNKI and Wanfang Data Konwledge Service Platform by computers as at July 5, 2012, which was supplemented with other search results. The findings were included into randomized controlled trials (RCTs) of elemene injection combined with cisplatin chemotherapeuties in treating small cell lung cancer (NSCLC). Data was separately collected by two researchers for literature quality evaluation, and a Meta analysis was made with RevMan 5. 2 software, in order to assess the efficacy and safety of elemene injection combined with cisplatin chemotherapeutics in treating NSCLC. Totally 11 RCTs or 844 cases were included. Meta analysis results suggested that compared with cisplatin chemotherapy alone, the combination of elemene injection and cisplatin chemotherapeutics showed a higher clinical benefit rate ( OR = 2. 03, 95% CI:1.43-2. 88, P <0. 000 1) and a better quality of life (OR = 3.23, 95% CI:2. 20-4. 74, P <0. 000 01). Besides,the combination could also reduce leucopenia (OR =0. 50, 95% CI:0. 33-0. 76, P <0. 001) , and thrombocytopenia (OR =0. 38, 95% CI:0. 16-0. 85, P <0. 02), increase CD4 (MD = 3.32, 95% C1:2. 94-3.70, P <0. 000 01), and CD4/CD8 (MD = 0. 36, 95% CI:0. 28-0. 44, P < 0. 000 01) , and relieve gastrointestinal reactions such as nausea and vomiting (OR = 0. 37, 95% CI: 0. 19-0. 71, P = 0. 003). The analysis indicates that elemene can enhance the chemotherapeutic effect on NSCLC, improve the quality of life, and reduce adverse effect of platinum-contained chemotherapeutics, thereby being worth promoting in clinic.

Formulation design, preparation, and in vitro and in vivo characterizations of &amp;beta;-Elemene- loaded nanostructured lipid carriers

In the present study, nanostructured lipid carriers (NLCs) were prepared and optimized for the intravenous delivery of β-Elemene (β-E). Aqueous dispersions of NLCs were successfully prepared by high-pressure homogenization method using glycerol monostearate as the solid lipid and a mixture of Maisine 35-1 and Labrafil M1944 CS as the liquid lipid. The results revealed that the morphology of the NLCs was spheroidal. The particle size, zeta potential, and entrapment efficiency (EE) for the optimized formulation were observed as 138.9 nm, −20.2 mV, and 82.11%, respectively. X-ray diffraction analysis revealed the formation of less ordered structures in the inner core of the NLC particles. Moreover, the β-E-loaded NLCs were also less irritating and less toxic compared to Elemene injection. In addition, β-E-NLCs showed a significantly higher bioavailability and anti-tumor efficacy than Elemene injection. Taken together, our data indicate that the β-E-NLCs described in this study are well-suited for the intravenous delivery of β-E.

English

Some researchers suggest that many plant species or extracts have medicinal value; in particular, some have great antitumor potential. Rhizoma curcuma is the dried roots ofCurcuma phaeocaulis, C. kwangsinensis and C. wenyujing in Chinese herbal medicine and the essential oil from it has been shown to inhibit tumor cell growth mainly due to its elemene component. Elemene has marked the characteristic of wide spectrum of antineoplastic activity and low adverse toxicity, especially β-elemene. Commercialized elemene injection is produced by R. curcuma, and applied as a national second-class new drug of antitumor in China.Literature reveals that many other plant species contain β-elemene or isomers in their essential oils from plant or parts of plant, and may represent a potential alternative to R. curcuma in the elemene processing industry and for use in antineoplastic medicine. This review summarizes the list of plants studied for their constituents of essential oils, and forty-four plant species are given much attention. Key words: Elemene, plant species, medicine, Rhizoma curcuma.