Ignite Creation Date:
2024-05-06 @ 2:50 PM
Last Modification Date:
2024-10-26 @ 1:38 PM
Study NCT ID:
NCT04438564
Status:
RECRUITING
Last Update Posted:
2023-02-08
First Post:
2020-06-14
Brief Title:
Immunoassay and Regulation of Traditional Chinese Medicine on Cancer Patients
Sponsor:
China Medical University Hospital
Organization:
China Medical University Hospital
Study Overview
Official Title:
Immunoassay and Regulation of Traditional Chinese Medicine on Cancer Patients
Status:
RECRUITING
Status Verified Date:
2023-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The immune system is our bodys defense mechanism which helps us to resist foreign pathogens and cancer cells in the body However if the immune system is too weak too strong or unbalanced it will be susceptible to get bacterial and viral infections unable to fight cancer or cause allergies autoimmune and rheumatic diseases At present there is no good western medicine to strengthen immunity when the body is insufficient immunity However strong immunity causes autoimmune diseases and need to be treated by steroids and immunosuppressive agents These drugs have limited efficacy and often have many side effects In the clinical practice of traditional Chinese medicine tonify qi supplement blood and nourish yin are often used to enhance immunity However there is no clinical test to demonstrate the modulation of immune response after traditional Chinese medicine treatment
In our preliminary study the investigators identified that the basic immune response of cancer patients is weaker than healthy people by testing the level of IFN-r promoting T cell activity anti-tumor anti-viral TNF-a promoting B cell proliferation producing antibodies anti-tumor anti-viral and IL-2 regulate the proliferation and differentiation Besides some Chinese herbal extracts can significantly stimulate the immune response higher than the general average basic immunity of cancer patients Further we will use the stimulatory Chinese medicine extract to administer to cancer patients and examine the immune response of cancer patients after taking them Therefore this test can provide actual data on the basic immunity of healthy people or cancer patients and the modulation of immune response by traditional Chinese medicine treatment This analysis platform provides patients to select the medicines that can enhance the immune response for individuals and analyze the changes of the immune response after conditioning with the candidate Chinese medicines Therefore this test could be applied clinically to validate the immunological regulation of Chinese herbal medicine as well as analyze the immunological modulation against different cancer by various Chinese herbal medicine
In our preliminary study the investigators identified that the basic immune response of cancer patients is weaker than healthy people by testing the level of IFN-r promoting T cell activity anti-tumor anti-viral TNF-a promoting B cell proliferation producing antibodies anti-tumor anti-viral and IL-2 regulate the proliferation and differentiation Besides some Chinese herbal extracts can significantly stimulate the immune response higher than the general average basic immunity of cancer patients Further we will use the stimulatory Chinese medicine extract to administer to cancer patients and examine the immune response of cancer patients after taking them Therefore this test can provide actual data on the basic immunity of healthy people or cancer patients and the modulation of immune response by traditional Chinese medicine treatment This analysis platform provides patients to select the medicines that can enhance the immune response for individuals and analyze the changes of the immune response after conditioning with the candidate Chinese medicines Therefore this test could be applied clinically to validate the immunological regulation of Chinese herbal medicine as well as analyze the immunological modulation against different cancer by various Chinese herbal medicine
Detailed Description:
Traditional Chinese medicine TCM and dendritic cells DCs activationmaturation One of the important approaches to successful cancer immunotherapy is generation of specific T cell responses by dendritic cells DCs DCs are the most potent antigen-presenting cells for naive T cells because their high expression of MHC and co-stimulatory molecules DCs comprise several subsets and their roles in the presentation of antigens derived from pathogens vaccines and self tissues are now beginning to be elucidated Immature DCs iDCs resided in periphery have a high ability to endocytose antigens and become to mature DCs mDCs upon a variety of stimuli through Toll-like receptors TLRs However iDCs facilitate immune tolerance and fully mDCs can promote immune responses Until now there are some studies have demonstrated that TCM could promote the activation status of DC to enhance immune responses through TLR which are characterized by increased expression of co-stimulatory moleculars MHC class II and several cytokines Ganoderma lucidum and Cordyceps sinensis have been widely used in Asian countries to have beneficial effects on human health Ganoderma lucidum polysaccharides have been reported to induce DCs maturation and promote the cytotoxicity of specific CTL Moreover Ganoderma lucidum polysaccharides were able to induce DC activation markers production and cytokines expression through TLR-4 signaling pathway However this character about TCM acted as TLR agonists could apply to develop safe and effective adjuvant in vaccine generation
Traditional Chinese medicine TCM and T cell activation T cells are the master regulators of adaptive immune responses Proper T cell responses are essential for the hosts to orchestrate sufficient adaptive immunity Classically the TH1TH2 hypothesis has served the immunology community well particularly in understanding infectious and allergic diseases Regulatory T cells Treg are suppressive T cells that regulate effector T cell immunity Nevertheless this model dose not fit all systems when it comes to the study of organ-specific autoimmune diseases It has also become more and more clear however that many complicated pathological situations cannot be simply explained by the TH1 cell and TH2 cell paradigm Efforts to resolve these issues in recent years have resulted in the discovery of TH17 cells
T cell immunity is crucial for anti-tumor immunity Given their importance in immune responses and diseases it is important to understand the regulation of T cell immunity In immune system different lineages of immune cells were conventionally distinguished by the morphology and expression of a cluster of differentiation markers on the cell surface TH1 cells that make IL-2 and IFN-r are important for delayed-type hypersensitivity reactions whereas TH2 cells that make IL-4 promote IgE production and allergic reaction The differentiation of TH1 and TH2 cells mainly through the induction of distinct transcriptional programs Activation of Signal Transducers and Activators of Transcription 1 STAT1 by IFN-r and STAT4 by IL-12 drives expression of T-bet for TH1 programming On the other hand activation of STAT6 by IL-4 promotes GATA3 expression in TH2 cells A revise of the TH1TH2 hypothesis was proposed until the discovery and IL-23 and IL-17 TH17 cell is a distinct T helper cell population that plays a crucial role in CD4 T cell-mediated adaptive immunity Commitment to the TH17 pathway requires the presence of both IL-6 and TGF-a during in vitro culture These cells different from the classical TH1 and TH2 cells do not produce IFN-r or IL-4 but on the other hand express the IL-23 receptor and IL-21 IL-22 and IL-17F ROR-rt ROR-rt are also highly expressed in TH17cells and can be induced by TGF-a and IL-6 Our previous studies showed for the first time an in vivo requirement for STAT3 in TH17 mediated autoimmunity In addition the investigators found that STAT3 is required for the maintenance of endogenous TH17 cells In a more recent report the investigators also found that CD8 T cells like their CD4 counterparts TH17 can be skewed toward IL-17 production in vitro and in vitro
Manipulating T cell immunity by Chinese herbs is a promising field to explore Many herbs were reported to regulate the T cell activation Tanshinlactone A from Salvia miltiorrhiza Bunge significantly decreased the IL-2 and IFN-γ gene expression through reduction of MAPK activation in phytohemagglutinin-activated peripheral blood mononuclear cells Periplocoside E PSE was shown to dose-dependently inhibit anti-CD3 induced primary T cell proliferation activation for IL-2R CD25 expression and IFN-γ and IL-2 production at the transcriptional level by inhibited the activation of ERK and JNK Furthermore kurarinol was reported to increase level of HBV specific CTL by down-regulating peripheral blood HBV specific CTL surface PD-1 expression of CHB patients
All of these will support investigators hypothesis that modulation of dendritic cell and T cell immunity by Chinese herbs or cytokines may be an applicable intervention to modulate immunity for example to promote anti-tumor immunity against cancer The successful completion of the proposed studies will provide a strong support for future development of anti-cancer immunotherapy by Chinese herbs
Traditional Chinese herbs as a pharmacologic approach to modulate immunity Cancer immunotherapy allergy and autoimmune diseases are among the chronic illness that accounts for the death and economic burdens in Taiwan and other modern countries Diseases such of Rheumatoid arthritis RA SLE multiple sclerosis ankylosing spondylitis vasculitis psoriasis and Sjogrens syndrome are common autoimmune diseases that cause not only life-long discomfort but also disabilities of the patients Cancer immunotherapy is promising Many of autoimmune disease and difficult-to-treat allergies are now found to be associated with IL-17 mediated pathology However the current treatment is limited Recently targeted therapy such as Etanercept trade name Enbrel a biopharmaceutical that interferes with tumor necrosis factor TNF a soluble inflammatory cytokine has been developed to treat some of the autoimmune diseases However nhibition of TNF has substantially advanced the treatment of inflammatory diseases Because TNF and IL-17 have shared functions the rationale for testing IL-17 inhibitors in the clinic is often based on the concept that patients who do not respond to TNF inhibitors may have an IL-17-driven disease Autoimmune diseases such of rheumatoid arthritis and multiple sclerosis are common autoimmune diseases that cause not only life-long discomfort but also disabilities of the patients The current treatment for these autoimmune diseases is limited to analgesia anti-inflammatory drugs steroids disease-modifying antirheumatic drugs DMARDs and immunosuppressants Recent studies in mouse models and in humans have identified a key role of IL-17 and TH17 cells in the pathogenesis of inflammation and autoimmunity as well as in host defense against certain pathogens
Meanwhile there are some studies using Chinese herbs to modulate CD4 TH17 immunity Compound extracted from Chinese herbs such as berberine exhibited potent efficacy inhibiting TH17 in the EAE model Triptolide also inhibited collagen-induced arthritis CIA a model of rheumatoid arthritis through inhibition of CD4 TH17 cells Periplocoside A was found to ameliorate EAE by suppressing IL-17 production and inhibited the differentiation of Th17 cells in vitro Eriocalyxin B was also found to be effective to inhibit TH17 and EAE through targeting Janus KinaseSignal Transducer and Activator Of Transcription and Nuclear factor-kappaB signaling pathways TCM formula such as Qingkailing injection was found to ameliorate rat experimental autoimmune uveitis EAU Qingkailing injection can alleviate autoimmune uveitis in rats inhibit the differentiation toward Th1 and Th17 effector cells and the relevant cytokines secretion Pure compound from Daphne odora var marginata D marginata was also found to inhibit TH17 and thus exhibit inhibitory effects in CIA model
One of the landmark study published in Science and Nature Chemical Biology is the example of halofuginone an active component of traditional Chinese herb hydrangea root Dichroa febrifuga used to treat malaria for thousands of years A collaborative research team led by Dr Mark Sundrud at the Department of Pathology Harvard Medical School and Immune Disease Institute Boston MA has reported that halofuginone halted the progression of experimental autoimmune encephalomyelitis EAE mice and TH17 Importantly unlike other therapies for autoimmune diseases halofuginone does not have the undesirable effect of suppressing the other immune system
The investigators have established some platforms for screening Chinese herbs not only for modulating PD-1PD-L1 IL-17 but also for detection of dendritic cell and T cell activation Immunogen Test Panel
The hypothesis is that modulation of dendritic cells and T cells by traditional Chinese medicine may be an applicable intervention to treat some of the immunologic diseases such as cancer allergy and autoimmune diseases Studies that can fit the niche understanding the function and mechanism of Chinese herbs on immune cells and its pathway will have broad clinical and immunological significance The successful completion of the proposed studies will provide a strong support for a clinical trial of traditional Chinese medicine to treat patients with immunologic diseases
Traditional Chinese medicine TCM and T cell activation T cells are the master regulators of adaptive immune responses Proper T cell responses are essential for the hosts to orchestrate sufficient adaptive immunity Classically the TH1TH2 hypothesis has served the immunology community well particularly in understanding infectious and allergic diseases Regulatory T cells Treg are suppressive T cells that regulate effector T cell immunity Nevertheless this model dose not fit all systems when it comes to the study of organ-specific autoimmune diseases It has also become more and more clear however that many complicated pathological situations cannot be simply explained by the TH1 cell and TH2 cell paradigm Efforts to resolve these issues in recent years have resulted in the discovery of TH17 cells
T cell immunity is crucial for anti-tumor immunity Given their importance in immune responses and diseases it is important to understand the regulation of T cell immunity In immune system different lineages of immune cells were conventionally distinguished by the morphology and expression of a cluster of differentiation markers on the cell surface TH1 cells that make IL-2 and IFN-r are important for delayed-type hypersensitivity reactions whereas TH2 cells that make IL-4 promote IgE production and allergic reaction The differentiation of TH1 and TH2 cells mainly through the induction of distinct transcriptional programs Activation of Signal Transducers and Activators of Transcription 1 STAT1 by IFN-r and STAT4 by IL-12 drives expression of T-bet for TH1 programming On the other hand activation of STAT6 by IL-4 promotes GATA3 expression in TH2 cells A revise of the TH1TH2 hypothesis was proposed until the discovery and IL-23 and IL-17 TH17 cell is a distinct T helper cell population that plays a crucial role in CD4 T cell-mediated adaptive immunity Commitment to the TH17 pathway requires the presence of both IL-6 and TGF-a during in vitro culture These cells different from the classical TH1 and TH2 cells do not produce IFN-r or IL-4 but on the other hand express the IL-23 receptor and IL-21 IL-22 and IL-17F ROR-rt ROR-rt are also highly expressed in TH17cells and can be induced by TGF-a and IL-6 Our previous studies showed for the first time an in vivo requirement for STAT3 in TH17 mediated autoimmunity In addition the investigators found that STAT3 is required for the maintenance of endogenous TH17 cells In a more recent report the investigators also found that CD8 T cells like their CD4 counterparts TH17 can be skewed toward IL-17 production in vitro and in vitro
Manipulating T cell immunity by Chinese herbs is a promising field to explore Many herbs were reported to regulate the T cell activation Tanshinlactone A from Salvia miltiorrhiza Bunge significantly decreased the IL-2 and IFN-γ gene expression through reduction of MAPK activation in phytohemagglutinin-activated peripheral blood mononuclear cells Periplocoside E PSE was shown to dose-dependently inhibit anti-CD3 induced primary T cell proliferation activation for IL-2R CD25 expression and IFN-γ and IL-2 production at the transcriptional level by inhibited the activation of ERK and JNK Furthermore kurarinol was reported to increase level of HBV specific CTL by down-regulating peripheral blood HBV specific CTL surface PD-1 expression of CHB patients
All of these will support investigators hypothesis that modulation of dendritic cell and T cell immunity by Chinese herbs or cytokines may be an applicable intervention to modulate immunity for example to promote anti-tumor immunity against cancer The successful completion of the proposed studies will provide a strong support for future development of anti-cancer immunotherapy by Chinese herbs
Traditional Chinese herbs as a pharmacologic approach to modulate immunity Cancer immunotherapy allergy and autoimmune diseases are among the chronic illness that accounts for the death and economic burdens in Taiwan and other modern countries Diseases such of Rheumatoid arthritis RA SLE multiple sclerosis ankylosing spondylitis vasculitis psoriasis and Sjogrens syndrome are common autoimmune diseases that cause not only life-long discomfort but also disabilities of the patients Cancer immunotherapy is promising Many of autoimmune disease and difficult-to-treat allergies are now found to be associated with IL-17 mediated pathology However the current treatment is limited Recently targeted therapy such as Etanercept trade name Enbrel a biopharmaceutical that interferes with tumor necrosis factor TNF a soluble inflammatory cytokine has been developed to treat some of the autoimmune diseases However nhibition of TNF has substantially advanced the treatment of inflammatory diseases Because TNF and IL-17 have shared functions the rationale for testing IL-17 inhibitors in the clinic is often based on the concept that patients who do not respond to TNF inhibitors may have an IL-17-driven disease Autoimmune diseases such of rheumatoid arthritis and multiple sclerosis are common autoimmune diseases that cause not only life-long discomfort but also disabilities of the patients The current treatment for these autoimmune diseases is limited to analgesia anti-inflammatory drugs steroids disease-modifying antirheumatic drugs DMARDs and immunosuppressants Recent studies in mouse models and in humans have identified a key role of IL-17 and TH17 cells in the pathogenesis of inflammation and autoimmunity as well as in host defense against certain pathogens
Meanwhile there are some studies using Chinese herbs to modulate CD4 TH17 immunity Compound extracted from Chinese herbs such as berberine exhibited potent efficacy inhibiting TH17 in the EAE model Triptolide also inhibited collagen-induced arthritis CIA a model of rheumatoid arthritis through inhibition of CD4 TH17 cells Periplocoside A was found to ameliorate EAE by suppressing IL-17 production and inhibited the differentiation of Th17 cells in vitro Eriocalyxin B was also found to be effective to inhibit TH17 and EAE through targeting Janus KinaseSignal Transducer and Activator Of Transcription and Nuclear factor-kappaB signaling pathways TCM formula such as Qingkailing injection was found to ameliorate rat experimental autoimmune uveitis EAU Qingkailing injection can alleviate autoimmune uveitis in rats inhibit the differentiation toward Th1 and Th17 effector cells and the relevant cytokines secretion Pure compound from Daphne odora var marginata D marginata was also found to inhibit TH17 and thus exhibit inhibitory effects in CIA model
One of the landmark study published in Science and Nature Chemical Biology is the example of halofuginone an active component of traditional Chinese herb hydrangea root Dichroa febrifuga used to treat malaria for thousands of years A collaborative research team led by Dr Mark Sundrud at the Department of Pathology Harvard Medical School and Immune Disease Institute Boston MA has reported that halofuginone halted the progression of experimental autoimmune encephalomyelitis EAE mice and TH17 Importantly unlike other therapies for autoimmune diseases halofuginone does not have the undesirable effect of suppressing the other immune system
The investigators have established some platforms for screening Chinese herbs not only for modulating PD-1PD-L1 IL-17 but also for detection of dendritic cell and T cell activation Immunogen Test Panel
The hypothesis is that modulation of dendritic cells and T cells by traditional Chinese medicine may be an applicable intervention to treat some of the immunologic diseases such as cancer allergy and autoimmune diseases Studies that can fit the niche understanding the function and mechanism of Chinese herbs on immune cells and its pathway will have broad clinical and immunological significance The successful completion of the proposed studies will provide a strong support for a clinical trial of traditional Chinese medicine to treat patients with immunologic diseases
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None