대한한방내과학회지 (The Journal of Internal Korean Medicine)

대한한방내과학회 (The Society of Internal Korean Medicine)
권호 표지
DOI QR코드

DOI QR Code

한약의 암 환자에 대한 면역기능 개선 효과 : 체계적 문헌고찰과 메타분석 프로토콜

Herbal Medicines for the Improvement of Immune Function in Patients with Cancer: A Protocol for Systematic Review and Meta-Analysis

  • 조영민 (대전대학교 대전한방병원 동서암센터) ;
  • 장수빈 (대구한의대학교 예방의학교실) ;
  • 고미미 (한국한의학연구원 한의과학연구부) ;
  • 주한음 (대전대학교 대전한방병원 동서암센터) ;
  • 유화승 (대전대학교 대전한방병원 동서암센터) ;
  • 정미경 (한국한의학연구원 한의약융합연구부)
  • Young-Min Cho (East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Soobin Jang (Dept. of Preventive Medicine, College of Korean Medicine, Daegu Haany University) ;
  • Mi Mi Ko (KM Science Research Division, Korea Institute of Oriental Medicine) ;
  • Han-eum Joo (East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Hwa-Seung Yoo (East West Cancer Center, Daejeon Korean Medicine Hospital of Daejeon University) ;
  • Mi-Kyung Jeong (KM Convergence Research Division, Korea Institute of Oriental Medicine)
  • 투고 : 2024.04.19
  • 심사 : 2024.06.25
  • 발행 : 2024.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 암 환자 치료에 대한 반응률은 종양 세포가 면역 회피 반응을 일으키면서 떨어지게 된다. 방사선 치료나 항암 치료 같은 표준 치료들은 병을 고치거나 환자들의 생명을 연장하는 목적으로 쓰이나 그 독성이나 부작용으로 인해 효과가 제한되고 있다. 한약은 아시아 지역에서 활용되고 있는 대표적인 보완 의학이며 면역 작용을 증강시키기 위해 널리 사용되고 있다. 이 프로토콜은 향후 암 환자들의 면역 기능을 개선시키는 데 있어서 한약의 객관적인 유효성을 체계적 문헌 고찰로 평가하고자 한다. 방법: 검색할 데이터베이스는 다음과 같다: MEDLINE via PubMed, EMBASE via Elsevier, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure(CNKI), Korean databases including Regional Information Sharing Systems(RISS), National Digital Science Library(NDSL), Oriental Medicine Advanced Searching Integrated System(OASIS). 한약을 이용해 암 환자들의 면역 기능 개선을 다룬 전향적 무작위 대조 연구들을 포함시키고, 면역 기능과 관련된 모든 지표들(CD3, CD4, CD8, CD4/CD8 비율, CD19(B세포), CD11(수지상세포), CD56(NK세포), 대식세포 등)을 분석한다. 결과: 암 환자의 면역 기능과 관련된 지표들을 포함시켜 체계적 문헌 고찰과 메타 분석을 수행할 예정이다. 결론: 한약의 암 환자 면역 기능 개선 유효성을 객관적으로 알리고, 본 연구를 통해 환자와 의료진에게 암 치료에 있어서 새로운 선택지를 넓힐 수 있도록 방향을 제시하고자 한다.

Objectives: Patients with cancer eventually fail to respond to therapy when malignant cells develop effective ways to evade immunosurveillance. Conventional cancer treatments, such as radiation therapy and chemotherapy, aim to cure the disease or prolong the patient's life. However, the toxicity and side effects of conventional treatments limit their efficacy. Herbal medicine is a typical complementary and integrative form of medicine for cancer treatment in Asia. This protocol evaluates the effectiveness of herbal medicines in improving the immune function of patients with cancer. Methods: The following electronic databases will be searched: MEDLINE via PubMed, EMBASE via Elsevier, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), and Korean databases including Regional Information Sharing Systems (RISS), National Digital Science Library (NDSL), and Oriental Medicine Advanced Searching Integrated System (OASIS). Additionally, prospective randomized controlled trials that evaluate the effectiveness of herbal medicines on immune function in patients with cancer will be included in this review. All outcomes related to the immune function of patients with cancer (e.g., CD3, CD4, CD8, CD4/CD8 ratio, CD19 (B cells), dendritic cells (CD11), CD56 (NK cells), and macrophages) will be included in this review. Results: This review is expected to provide data on the effectiveness of herbal medicines on improving immune functions in patients with cancers. Conclusion: This systematic review will help patients and clinicians establish new management options for cancer treatment.

키워드

과제정보

This study was supported by the Korea Institute of Oriental Medicine, Republic of Korea (KSN2022240), and the Korea Health Industry Development Institute (KHIDI), Republic of Korea (HF20C0038). The funding source will have no input for interpretation or publication of the study results.

참고문헌

  1. GLOBOCAN 2020: New Global Cancer Data l UICC. https://www.uicc.org/news/globocan-2020-new-global-cancer-data. Accessed September 13 2022; 2020. UICC.
  2. World Cancer Day 2022 - IARC. https://www.iarc.who.int/featured-news/world-cancer-day-2022/. Accessed September 13 2022; 2022. IARC.
  3. Bray F, Soerjomataram I. The changing global burden of cancer: transitions in human development and implications for cancer prevention and control. International Bank for Reconstruction and Development. World Bank; 2015. doi:10.1596/978-1-4648-0349-9_ch2.
  4. Guoyan Y, Xun L, Xiaoli L, Lu W, Jia L, Xue S, et al. Traditional Chinese medicine in cancer care: a review of case series published in the Chinese literature. https://www.hindawi.com/journals /ecam/2012/751046/. Accessed September 13 2022.
  5. Crawford J, Dale DC, Lyman GH. Chemotherapy -induced neutropenia: risks, consequences, and new directions for its management. Cancer 2004; 100(2):228-37.
  6. D'Errico G, Machado HL, Sainz B. A current perspective on cancer immune therapy: step-by-step approach to constructing the magic bullet. Clin Transl Med 2017;6(1):3. doi:10.1186/s40169-016-0130-5.
  7. Bagchi S, Yuan R, Engleman EG. Immune checkpoint inhibitors for the treatment of cancer: clinical impact and mechanisms of response and resistance. Annu Rev Pathol 2021;16:223-49. doi:10.1146/annurev-pathol-042020-042741.
  8. Qi F, Li A, Inagaki Y, Gao J, Li J, Kokudo N, et al. Chinese herbal medicines as adjuvant treatment during chemo- or radio-therapy for cancer. BioSci Trends 2010;4(6):297-307.
  9. Wang Y, Zhang Q, Chen Y, Liang CL, Liu H, Qiu F, et al. Antitumor effects of immunityenhancing traditional Chinese medicine. Biomed Pharmacother 2020;121:109570.
  10. Jung SJ, Jung ES, Choi EK, Sin HS, Ha KC, Chae SW. Immunomodulatory effects of a mycelium extract of Cordyceps (Paecilomyces hepiali; CBG-CS-2): a randomized and doubleblind clinical trial. BMC Complement Altern Med 2019;19(1):77. doi:10.1186/s12906-019-2483-y.
  11. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015;350:g7647.
  12. Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev 2019;10(10):ED000142. doi: 10.1002/14651858.ED000142.
  13. Li S, So TH, Tang G, Tan HY, Wang N, Ng BFL, et al. Chinese herbal medicine for reducing chemotherapy-associated side-effects in breast cancer patients: a systematic review and metaanalysis. Front Oncol 2020;10:599073.
  14. Lee JY, Kim EH, Yoon JH, Eo W, Yoon SW. Traditional herbal medicine, Sipjeondaebo-Tang, for cancer-related fatigue: a randomized, placebocontrolled, preliminary study. Integr Cancer Ther 2021;20:15347354211040830.
  15. Luo H, Vong CT, Chen H, Yan G, Peng L, Ling Q. Naturally occurring anti-cancer compounds: shining from Chinese herbal medicine l EndNote Click. https://click.endnote.com/viewer?doi=10.1186%2Fs13020-019-0270-9&token=WzM3Njc4MjMsIjEwLjExODYvczEzMDIwLTAxOS0wMjcwLTkiXQ.8rI9Yb-aI2XHNlpJ4Yq7xegRzKs. AccessedSeptember 20 2022.
  16. Chen Z, Liu L, Gao C, Chen W, Vong CT, Yao P, et al. Astragali Radix (Huangqi): A promising edible immunomodulatory herbal medicine. J Ethnopharmacol 2020;258:112895.
  17. Tang H, Qiao J, Fu YX. Immunotherapy and tumor microenvironment. Cancer Lett 2016;370(1):85-90. doi:10.1016/j.canlet.2015.10.009.
  18. Zhang Y, Lou Y, Wang J, Yu C, Shen W. Research status and molecular mechanism of the traditional chinese medicine and antitumor therapy combined strategy based on tumor microenvironment. Front Immunol 2021;11:609705. https://www.frontiersin.org/articles/10.3389/fimmu.2020.609705. Accessed September 8 2022:609705.