Modern technology-based exploration of mechanism of traditional Chinese medicine in prevention and treatment of gastric cancer

Abstract

This review comments on the article “To explore the mechanism of Yigong San anti-gastric cancer and immune regulation”. We are interested that the article applied network pharmacology and bioinformatics techniques to elucidate the mechanism of action of Yigong Sang, a traditional Chinese medicine (TCM), in the treatment of gastric cancer (GC). The mechanism of action of Yigong Sang in the treatment of GC has not yet been elucidated because it is composed of multiple Chinese medicines with multiple components and multiple targets. The emergence of network pharmacology and bioinformatics analysis helps explain the mechanism of action of TCM in preventing and treating GC, and provides a possibility for TCM to transform from empirical to evidence-based medicine. This is of great significance for the application of TCM in oncology, new drug development, formula optimization, and the improvement of clinical efficacy.

Key Words: Gastric cancer; Traditional Chinese medicine; Mechanism; Network pharmacology; Bioinformatics; New technology

Core Tip: In this editorial, we explore the importance of traditional Chinese medicine (TCM) in the prevention and treatment of malignant tumors, as well as the important role played by emerging technologies such as network pharmacology and bioinformatics in understanding the mechanism of action of TCMs. These techniques have not only accelerated the research and elucidation of the mechanism of action of TCM in the prevention and treatment of malignant tumors, but they have also promoted the modernization and standardization of TCM.

INTRODUCTION

Traditional Chinese medicine (TCM) has unique advantages in the prevention and treatment of tumors, such as simplicity, convenience, efficacy, and cost-effectiveness. It has no adverse reactions and can effectively improve the quality of life of patients. But it lacks the support of modern science. Scientific validation is needed to examine and evaluate the current clinical applications of TCM and to predict its role in the process of tumor prevention and treatment. Network pharmacology is an emerging interdisciplinary field using the theory of systems biology to study the mechanism of drug action and the molecular design of multi-target drugs at the system level. Bioinformatics uses mathematical, statistical, and informatics methods and techniques to acquire, store, process, and analyze biological data, and to extract potential biological information from these data. The combination of the two has been widely used in elaborating the mechanism of action of TCM, in order to screen active ingredients, analyze the targets of the main active ingredients, and develop combination drugs.

In the article by Lu et al[1], they analyzed the mechanism of action of the traditional TCM formula Yigong San, which is effective in the treatment of malignant tumors belonging to the spleen-qi deficiency type in Chinese medicine. They utilized network pharmacology and bioinformatics to elucidate the immunomodulatory effects of Yigong San, along with the mechanism of action in the treatment of gastric cancer (GC), providing more scientific and powerful evidence for the treatment of GC with Yigong San.

CURRENT TREATMENT OF GC

GC is a malignant tumor that arises in the epithelial cells of the gastric mucosa. It is the most commonly occurring malignant tumor of the gastrointestinal tract worldwide, and its incidence, mortality, and disease burden have increased rapidly in recent years[2,3]. As an invasive disease, GC has a low 5-year survival rate, and its onset is insidious. By the time it is diagnosed, it has often already progressed to the middle and late stages, missing the best time for surgery, resulting in a poor prognosis[4]. Currently, the main treatment methods for GC in Western medicine include surgical resection, chemotherapy, targeted therapy, and immunotherapy[5,6]. However, these treatments are prone to recurrence and metastasis, side effects, and drug resistance[7]. The elucidation of the pathogenesis of GC and the search for effective preventative methods are urgently needed[8].

Before the disease progresses to GC, it typically goes through several years of gastric precancerous lesions, including chronic atrophic gastritis, intestinal metaplasia, and intraepithelial neoplasia[9]. Patients with gastric precancerous lesions have a higher risk of developing GC compared to the general population. Effective intervention when gastric precancerous lesions occur is crucial for preventing GC[10]. Western medicine primarily focuses on endoscopic mucosal resection surgery at this stage, as there are no other effective means of prevention and treatment[11].

CURRENT STATUS OF TCM IN PREVENTION AND TREATMENT OF GC

TCM, as a traditional medicine in China, has a long history and tradition, along with unique theories and techniques. It is characterized by its simplicity, convenience, long history of use, inexpensiveness, efficacy, and reduced side effects. TCM can effectively treat gastric precancerous lesions and inhibit the progression of the disease by various strategies, including eradicating Helicobacter pylori, regulating cell proliferation and apoptosis, regulating inflammatory cytokines, inhibiting vascularization, and regulating the microenvironment[12-14]. TCM can not only effectively treat gastric precancerous lesions and prevent the occurrence of GC, but it can also play a role in the treatment of GC by inhibiting the proliferation and metastasis of GC cells, inducing apoptosis, inhibiting angiogenesis, and regulating the immune system[15,16].

In addition to its important role in the prevention and treatment of GC, many studies have also shown that TCM can effectively improve functional recovery of patients after surgery or radiotherapy[17]. Our previous study demonstrated that TCM can enhance patients’ immune function and promote gastrointestinal function, enhancing recovery after surgery[18]. Additionally, TCM also has significant advantages in reducing postoperative complications and recurrences, improving multidrug resistance, supporting the efficacy of chemotherapy, reducing the toxicity of chemotherapy, enhancing immunity, and improving quality of life[19-21].

Recent studies have demonstrated that TCM plays an important role in the prevention, treatment, and prognosis of GC, and its clinical efficacy is significant. However, unlike studies on the active ingredients of individual Chinese medicines, TCM formulas consist of multiple Chinese medicines and do not rely on a single ingredient for therapeutic effects. Due to the complexity of their components, it is not possible to analyze them singularly. Therefore, the clinical efficacy of many formulas in the treatment of tumors is remarkable, but their mechanism of action is unknown[22-24].

APPLICATION OF MODERN TECHNOLOGY TO STUDY MECHANISM OF TCM IN PREVENTION AND TREATMENT OF GC

The mechanism of action of TCM has been studied using various modern research techniques. These include various omics technologies (genomics, transcriptomics, proteomics, and metabolomics), network pharmacology, and multi-omics linkage. Additionally, the linkage of network pharmacology and genomics technology has also been used[25,26]. The use of single-omics technology alone cannot fully explain the mechanism of action of TCM in the prevention and treatment of cancer. Multi-omics linkage and spatial multi-omics technology have become a recently advancing trend, but the integration of multi-omics data still faces many problems that need to be further improved upon in the future[27,28].

Through the construction of “drug-target-disease” networks, network pharmacology works in concert with bioinformatics analyses to describe the target and pathway of drug action in various diseases. These results coincide with the characteristics of various TCMs to prevent and treat malignant tumors[29]. It is now widely used in the study of the mechanism of action of TCMs with anti-tumor properties, and also provides the basis for clinical applications, action principles, quality evaluation, and other aspects of Chinese medicine, while also promoting the internationalization and modernization of TCM[26,30]. TCM network pharmacology combined with bioinformatics analysis technology has a broad scope of application and development space, which can provide new ideas for the study of the complex system of TCM, and provides new scientific theoretical support for the rational use of clinical medication, as well as the research and development of new medicines.

DISCUSSION

TCM has obvious advantages in the prevention and treatment of GC. Many studies have demonstrated that TCM can prevent and treat GC in various ways. However, there still exists the problem of insufficient understanding of the mechanism of action, which requires additional research. Network pharmacological analysis has been widely used in the study of the mechanisms of action of single-component Chinese medicines and compound formulas, which provide a more substantial scientific basis for the prevention and treatment of malignant tumors by TCM[31]. However, at present, the research of network pharmacology on the mechanism of action of TCM formulas against tumors is still in the initial stages, and there are still some limitations in its methodology[32]. However, it is believed that with the continuous development of modern science and the progress of artificial intelligence technology, the research on the mechanism of action of Chinese medicine will continue to develop and be improved upon[33]. This is of great significance for the scientific elaboration of the mechanism of TCM in the prevention and treatment of tumors, the guidance of clinical medication, and the promotion of TCM innovation.

CONCLUSION

In conclusion, the clinical efficacy of TCM in the prevention and treatment of GC is remarkable. TCM plays an important role in the prevention of tumor recurrence and metastasis in GC, and in the interception and reversal of precancerous lesions, but its mechanism of action needs to be further elucidated. The current application of omics technology as well as network pharmacology technology has many problems, such as insufficient research depth, and difficulty in analyzing huge data. However, we believe that newly developing artificial intelligence can be combined with omics technology and network pharmacology, in order to further explore the targets and specific mechanisms of action of TCM in the prevention and treatment of GC, so as to benefit more patients.