■人参多糖注射液是一种众所周知的中药,通常用作癌症的辅助治疗。这种治疗不仅可以减轻肿瘤放疗和化疗引起的不良反应,而且可以增强诊断为肺癌的个体的免疫系统。承认人参多糖注射液在非小细胞肺癌(NSCLC)治疗中的疗效很重要。然而,这些小样本研究可能有某些偏见,人参多糖治疗非小细胞肺癌的潜在机制尚不清楚。
■本研究涉及对随机对照试验(RCTs)文献的系统回顾,重点是使用人参多糖注射液作为非小细胞肺癌的治疗方法。搜索了7个数据库,以查找2023年4月之前发表的合格研究。两名研究人员独立管理数据提取,偏见风险评估,并使用RevMan5.3软件进行数据分析。在网络药理学中,我们彻底搜索了有关人参多糖(GPs)和PubChem数据库的相关文献。这项搜索旨在确定与人参多糖相关的主要活性成分和靶标。随后,我们将这些靶标与NSCLC的靶标进行了比较,并利用生物信息学技术分析和探索了它们的潜在相互作用.
■共有11项RCTs纳入荟萃分析,涉及845例NSCLC患者。荟萃分析显示,人参多糖注射液联合显著提高了客观缓解率[RR=1.45,95%CI(1.26,1.67),P<0.00001]。此外,观察到人参多糖注射液增加了CD4+T淋巴细胞(CD4+T)的血清水平[MD=8.98,95%CI(5.18,12.78),P<0.00001],并降低CD8+T淋巴细胞(CD8+T)的血清水平[MD=-2.68,95%CI(-4.66,-0.70),P=0.008]。通过网络药理学分析,共鉴定了211个GP靶基因和81个常见靶标.GAPDH,EGFR,VEGFA,JUN,SRC,CASS3、STAT3、CCND1、HSP90AA1和MMP9被鉴定为核心靶蛋白。此外,KEGG富集分析揭示了122条相关信号通路,包括癌症的途径,PD-L1表达和PD-1检查点途径在癌症中,和蛋白聚糖在癌症中。
■人参多糖注射液可改善NSCLC患者的ORR,增加CD4+T的血清水平,其潜在机制可能与PD-1/PD-L1信号通路有关。
UNASSIGNED: The ginseng polysaccharide injection is a well-known traditional Chinese medicine often employed as a supplementary treatment for cancer. This treatment can not only alleviate the adverse effects caused by tumor radiotherapy and chemotherapy but also enhance the immune system of individuals diagnosed with lung cancer. It is important to acknowledge the efficacy of ginseng polysaccharide injection in the treatment of non-small cell lung cancer (NSCLC). However, these small-sample studies may have certain biases, and the underlying mechanisms of ginseng polysaccharides therapy for NSCLC are still unclear.
UNASSIGNED: The present study involved a systematic review of the literature on randomized controlled trials (RCTs) focusing on using ginseng polysaccharide injection as a therapeutic approach for NSCLC. Seven databases were searched for eligible studies published before April 2023. Two researchers independently managed data extraction, risk of bias assessment, and data analyses using RevMan 5.3 software. In network pharmacology, we thoroughly searched the relevant literature on ginseng polysaccharides (GPs) and the PubChem database. This search aimed to identify the main active ingredients and targets associated with ginseng polysaccharides. Subsequently, we compared these targets with those of NSCLC and utilized bioinformatics techniques to analyze and explore their potential interactions.
UNASSIGNED: A total of 11 RCTs involving 845 patients with NSCLC were included in the meta-analysis. The meta-analysis revealed that ginseng polysaccharide injection combined significantly improved the objective response rate [RR = 1.45, 95% CI (1.26, 1.67), P < 0.00001]. Furthermore, it was observed that ginseng polysaccharide injection increased the serum levels of CD4+ T-lymphocytes (CD4+ T) [MD = 8.98, 95% CI (5.18, 12.78), P < 0.00001], and decreased the serum levels of CD8+ T-lymphocytes (CD8+ T) [MD = -2.68, 95% CI (-4.66, -0.70), P = 0.008]. Through network pharmacology analysis, a total of 211 target genes of GPs and 81 common targets were identified. GAPDH, EGFR, VEGFA, JUN, SRC, CASP3, STAT3, CCND1, HSP90AA1, and MMP9 were identified as the core target proteins. Additionally, KEGG enrichment analysis revealed 122 relevant signaling pathways, including Pathways in cancer, PD-L1 expression and PD-1 checkpoint pathway in cancer, and Proteoglycans in cancer.
UNASSIGNED: Ginseng polysaccharide injection can improve the ORR of patients with NSCLC, increase the serum levels of CD4+ T, and decrease the serum levels of CD8+ T. The potential mechanism may be associated with the PD-1/PD-L1 signaling pathway.