Intervention of Inflammation and Cancer by Active Ingredients of Traditional Chinese Medicine

There has been a large amount of evidence showing that inflammation and cancer are strongly related. As a result, anti-inflammatory agents have been investigated for cancer prevention and treatment, including non-steroidal anti-inflammatory drugs (NSAIDs) and traditional Chinese medicine. Traditional Chinese medicine contains a wide range of biologically active substances, such as alkaloid, polysaccharides, quinones, and more. Several active ingredients in this medicine have been reported to inhibit inflammation, activate inflammatory immune response, and/or inhibit cancer cell proliferation and tumor growth.

Researchers from the College of Pharmacy in Ji Nan University examined the main components of traditional Chinese medicine. Multiple mechanisms of pathways of active ingredients in Chinese medicine were studied. The researchers reported thirteen active ingredients that showed anti-inflammatory and anti-tumor effects, and identified seven classes of ingredients that possibly have anti-inflammatory and anticancer mechanisms. Many ingredients have exhibited effects in suppressing inflammation, preventing tumorigenesis, and controlling tumor growth. However, the target inflammatory factors and the appropriate dosing for control inflammation and strengthen immune surveillance are still unclear.

The research on anti-inflammatory and anti-tumor functions of traditional Chinese medicine compounds is limited to only individual chemical constituents. However, traditional medicine has a combination of many active ingredients that can have synergistic effects. Therefore, researchers believe that future studies should examine whether and how synergistic, additive, and antagonistic effects of multiple ingredients of traditional medicine contribute to the anti-inflammatory and anti-tumor functions.

Since I have limited knowledge about traditional Chinese medicine, I find it fascinating that there are multiple active ingredients that can have anti-inflammatory and anti-tumor functions. I have personally used traditional Chinese medication when I was experiencing a common cold, and it helped relieve my symptoms. Thus, I think it is a great idea to study how these traditional medications work, because there are many benefits associated with these medicines. Many Chinese people rely on these traditional medicines, but in the United States it is uncommon to see traditional Chinese medicine sold.

Do you think it is important to research natural medications? Why or why not? Also, if the use of traditional Chinese medicines became more well-known, do you think this treatment will have a large impact in the United States?

Huang YH, Cai TG, Xia X et al. Research Advances in the Intervention of Inflammation and Cancer by Active Ingredients of Traditional Chinese Medicine. J Pharm Pharm Sci. 2016;19(1):114 – 126

A Mind-Body Program for Older Adults With Chronic Low Back Pain

Approximately 100 million individuals in the United States suffer from chronic pain. Pain is prevalent in 52.9% of the older adult population ages 65 and older. Of the 52.9% experiencing pain, 30.3% were experiencing chronic back pain. Analgesics commonly cause severe adverse effects in older adults. Because of this prevalent drug therapy problem, nonpharmacologic treatments must often be utilized for effective management of chronic low back pain.

An experimental study was conducted among 282 patients with low chronic back pain 65 years or older. The goal of this study was to assess the effectiveness of a mind-body program at increasing function and reducing pain. The patients received an 8-week group program followed by 6 monthly sessions. The program was modeled on the Mindfulness-Based Stress Reduction program. This program took regular activities such as sitting, walking, and lying down and transformed then into meditation through breathing exercises and mindful awareness of thoughts and sensations. Compared with the control group, those receiving this mind-body treatment improved short-term function and long-term current and most severe pain.

The trial did not yield sustained results in treatment of lower chronic back pain, suggesting that future development of this intervention should focus on durability. This article was particularly of interest to me because it combined two of my interest in medicine with my interest in meditation. I often use meditation as a form of stress relief, and it is intriguing to see that meditation could also be used in pain management. Prescription pain medication is not the answer  for every patient and it is very often over-prescribed. I believe that is important for pharmacists to be aware of other pain management methods and share these methods with their patients. Although I do not believe that meditation alone is the answer, I think that a combination of medication therapy and meditation could be a very effective treatment for a lot of patients suffering from chronic pain.

JAMA Intern Med. Published online February 22, 2016.

Link to article

Concord grape juice, cognitive function, and driving performance: a 12-wk, placebo-controlled, randomized crossover trial in mothers of preteen children.

According to the article: “Daily consumption of Concord grape juice (CGJ) over 3-4 mo has been shown to improve memory function in adults with mild cognitive impairment and reduce blood pressure in hypertensive adults.” most likely due to a high concentration of polyphenyols within the grapes. The study chose mothers of pre-teens because they have more stressful lifestyles and “Increased stress can impair cognitive function and elevate blood pressure.” The study included 25 mothers of pre-teens who were also employed for 30 or more hours per week. They were given either 12 oz of the concord grape juice or an energy, taste, and appearance matched placebo daily for 12 weeks and included a 4 week washout. Seven tests were given to test for verbal memory, non verbal spacial memory, executive functioning, psychomotor skill, executive functioning, longitudinal tracking, and lateral tracking. In addition, blood pressure and mood were tested at baseline and at six and then 12 weeks. And then 17 of the 25 also performed a 25 driving test during which they were asked to match the speed and direction of another car.

The researchers discovered from the results of the test that those given concord grape juice did significantly better in verbal recall, spatial recall, psychomotor skill, executive functioning, longitudinal tracking, lateral tracking. They concluded that the juice was associated with better immediate spacial memory and the longitudinal and lateral tracking aspects of the car test. They also noted that this is the first study to test the juice on middle-aged adults whereas previous studies were on older adults with mild cognitive impairment which shows that the benefits are not exclusive to adults exhibiting cognitive decline or neurodegenerative disease. And because this study also included a washout period, it showed that the juice had enduring effects in improving verbally recall, executive functioning, and lateral tracking which mean that polyphenols cause  cause relatively stable physiologic effects that do not disappear quickly after stopping its consumption.

This article was very interesting to read as pharmacists are typically so involved with actual medicine, it almost seems strange to hear about an alternative treatment that seems to work well in improving memory. At the same time its good to keep up with literature about alternative medicine so that when there is a patient who comes in who need help and doesn’t want to take medicine we can help refer them to studies like these and suggest an alternative method to treat their symptoms. Plus unlike herbal medication or other OTCs this is a completely safe treatment since it’s just drinking concord grape juice daily.

Lamport DJ, Lawton CL, Merat NL, et al. Concord grape juice, cognitive function, and driving performance: a 12-wk, placebo-controlled, randomized crossover trial in mothers of preteen children. J Nutr. doi: 10.3945/ajcn.115.114553 (published 10 February 2016).



Comparison of dietary supplement product knowledge and confidence between pharmacists and health food store employees

A common topic discussed within the pharmaceutical world is the subject of complementary and alternative medicine (CAM). In a recent study, researchers compared knowledge about the safety and efficacy of common dietary supplements between pharmacists and health food employees. In retail settings located in central and western New York, participants were told to answer a survey about CAM safety and efficacy using the Likert scale, which ranged from scores of 0, or “very hesitant,” to 4, or “very confident.” Afterward, the participants were asked to answer a knowledge assessment portion, in which the participants were asked to answer True or False questions with the responses “true”, “false”, or “I don’t know.”

A total of 31 pharmacists and 27 health food store employees participated in this study. Results determined that pharmacists’ mean score was higher than that of the health food store employees. However, the pharmacists’ response confidence was significantly lower. Because of this, it is determined that pharmacists must improve on the subject of CAM.

This study is interesting because I had recently researched about a specific supplement in relation to depression for my drug information assignment. Prior to pharmacy school, I did not realize the amount of herbal and alternative medicines that were available on the market. It is important that current and future pharmacists improve their knowledge about this subject in order to give patients a proper recommendation.

Coon SA, Stevens VW, Brown JE, et al. Comparison of dietary supplement product knowledge and confidence between pharmacists and health food store employees: J Am Pharm Assoc. 2015;55:161-8.