From traditional Chinese medicine formulations to effective anticancer agents: Insights from Calculus bovis

Abstract

This editorial examines the therapeutic potential of traditional Chinese medicine (TCM) for aggressive cancers, particularly liver cancer. It highlights the study by Huang et al, which shows how Calculus bovis, a component of the TCM Pien Tze Huang, suppresses liver cancer by inhibiting M2 macrophage polarization via the Wnt/β-catenin pathway. This research emphasizes the importance of transitioning from effective TCM formulations to isolating active components and understanding their mechanisms. While the study provides valuable insights, it primarily focuses on the Wnt/β-catenin pathway and does not delve deeply into the mechanisms of individual components. Future research should aim to comprehensively study these components, explore their interactions, and validate findings through clinical trials. This approach will integrate traditional wisdom with modern scientific validation, advancing the development of innovative cancer treatments based on TCM formulations.

Key Words: Calculus bovis; Traditional Chinese medicine; Liver cancer; Tumor microenvironment; M2 tumor-associated macrophages; Wnt/β-catenin pathway

Core Tip: This study elucidates the anticancer potential of traditional Chinese medicine (TCM), focusing on Calculus bovis (CB), a principal component in Pien Tze Huang, in treating liver cancer. It demonstrates CB’s role in suppressing liver cancer progression by inhibiting M2 macrophage polarization through the Wnt/β-catenin pathway. Key findings emphasize the transition from holistic TCM formulations to the isolation of specific active ingredients, underscoring the necessity for modern scientific methods to dissect these components further. This approach highlights a significant shift towards integrating traditional remedies with contemporary oncological research to develop novel cancer therapies.

TO THE EDITOR

Liver cancer represents one of the most aggressive malignancies and carries a high rate of mortality worldwide[1]. Traditional Chinese medicine (TCM) has emerged as a promising complementary approach in oncology, particularly in liver cancer management[2]. The recent study by Huang et al[3], published in the World Journal of Gastroenterology, exemplifies the importance of exploring TCM formulations to identify potent anticancer agents[3]. This editorial explores the study’s insights, the transition from traditional formulations to active components, and the future of integrating TCM with modern medical practices.

TCM formulations, which combine various herbs, have been refined over centuries and have shown efficacy in treating a range of diseases[4]. To modernize TCM and integrate it with contemporary medical practices, it is crucial to identify effective formulations against specific conditions. From these formulations, we can isolate active components and further pinpoint the specific compounds responsible for therapeutic benefits. The study by Huang et al[3] exemplifies this process. Their research on Calculus bovis (CB), a key component in the TCM formulation Pien Tze Huang, demonstrates its potential in inhibiting liver cancer progression.

The study demonstrates that CB can inhibit the polarization of M2 tumor-associated macrophages (M2-TAM), which support tumor growth and metastasis, by modulating the Wnt/β-catenin signaling pathway. This finding not only validates the anticancer potential of CB but also elucidates a clear mechanism of action. Using an integrated approach of network pharmacology, transcriptomics, and molecular docking, the researchers identified 22 active components in CB, with 11 detected in the bloodstream, indicating their bioavailability and potential therapeutic roles. The study confirmed that CB suppresses M2-TAM polarization, thereby altering the tumor microenvironment to inhibit cancer progression.

Although this editorial has outlined the potential of CB in the treatment of liver cancer, it is recognized that the investigation primarily focused on the Wnt/β-catenin pathway. Appreciating the intricate nature of CB, it is suggested that future research should not only continue to explore its role in modulating key pathways but also deeply investigate the specific mechanisms of each active component identified within CB. Modulation of the tumor microenvironment is complex, involving numerous pathways and interactions. Future research should employ advanced techniques such as high-throughput screening, proteomics, and metabolomics to further dissect these interactions and validate the mechanisms involved. Understanding the synergistic effects of CB with other TCM ingredients or conventional chemotherapeutic agents could lead to more effective combination therapies. Clinical trials are essential to validate these preclinical findings and to assess the safety and efficacy of CB in human patients.

The journey from discovering effective TCM formulations to isolating active components and understanding their mechanisms is a cyclical process that begins with clinical observations and returns to clinical applications. It is essential to begin with TCM formulations that have shown efficacy in clinical settings, isolate the active components, explore their mechanisms, and then apply these findings to develop new clinical therapies. This approach ensures that treatments are grounded in both traditional wisdom and modern scientific validation.

The study by Huang et al[3] represents a significant advancement in our understanding of how TCM, particularly CB, can be harnessed to combat liver cancer. By focusing on inhibiting M2-TAM polarization via the Wnt/β-catenin pathway, this research provides a robust framework for future studies aimed at uncovering the full therapeutic potential of TCM formulations. Continued efforts in this direction will enhance the integration of traditional and modern medicine, paving the way for innovative cancer treatments.