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eCAM Advance Access originally published online on May 17, 2007
eCAM 2008 5(3):337-344; doi:10.1093/ecam/nem031
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© 2007 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

A Randomized Pilot Study of Atractylenolide I on Gastric Cancer Cachexia Patients

Yi Liu1, Zhongwu Jia2, Lei Dong3, Rui Wang1 and Genquan Qiu1

1Department of Traditional Chinese Medicine, the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, 2State Administration of Traditional Chinese Medicine of People's Republic of China, Beijing and 3Department of Digestion, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China

We determined the therapeutic efficacy of atractylenolide I (ATR), extracted from largehead atractylodes rhizome, in managing gastric cancer cachexia (GCC), and interpreted its probable pharmacological mechanism via investigating tumor necrosis factor alpha (TNF-{alpha}), interleukin-1 (IL-1), interleukin-6 (IL-6) and proteolysis-inducing factor (PIF). This was a randomized but not-blinded pilot. The study group (n = 11) received 1.32 g per day of atractylenolide I (ATR) and the control group (n = 11) received 3.6 g per day of fish-oil-enriched nutritional supplementation (FOE) for 7 weeks. Conservative therapy was similar in both groups. Clinical [appetite, body weight, mid-arm muscle circumference (MAMC), Karnofsky performance status (KPS) status], biomarker (TNF-{alpha}, IL-1, IL-6 and PIF) were evaluated in the basal state, at the third and seventh weeks. To analyze changes of cytokines, an immumohistochemistry technique was adopted. Base line characteristics were similar in both groups. Effects on MAMC and body weight increase, TNF-{alpha} increase and IL-1 decreases of serum level were significant in both groups (P < 0.05). ATR was significantly more effective than FOE in improving appetite and KPS status, and decreasing PIF positive rate (P < 0.05). Slight nausea (3/11) and dry mouth (1/11) were shown in intervention groups but did not interrupt treatment. These preliminary findings suggest that ATR might be beneficial in alleviating symptoms, in modulating cytokine and in inhibiting PIF proteolysis of gastric cancer cachexia. Further research using a randomized controlled design is necessary to confirm these pilot study findings.

Keywords: cytokine – largehead atractylodes rhizome – proteolysis-inducing factor

For reprints and all correspondence: Yi Liu, Department of Traditional Chinese Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Jiankang Road #1, Xi’an 710061, Shannxi Province, China. Tel: +86-29-81987592; E-mail: liuyi.jiaotong{at}163.com

Received July 3, 2006; accepted February 13, 2007


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