Clinical efficacy of tetrandrine in artificial stone-associated silicosis: A retrospective cohort study

Abstract

BackgroundOutbreaks of silicosis have occurred among workers in the artificial stone (AS) industry, and there is currently no effective antifibrosis treatment for silicosis.DesignA retrospective cohort study.MethodsWe retrospectively analyzed the clinical data of 89 artificial stone-associated silicosis patients treated in Shanghai Pulmonary Hospital (China). Patients who agreed to be administered tetrandrine entered the observation group and those who disagreed entered the control group. Changes in chest HRCT, pulmonary function, and clinical symptoms of patients in two groups were compared pre- and post-treatment.ResultsAfter treatment for 3–12 months, 56.5%–65.4% of patients in the observation group showed improvements in HRCT imaging, while there was no improvement in the control group (p < 0.05). Disease progression occurred in 0%–17.4% of patients in the observation group after 3–12 months of treatment compared with 44.4%–92.0% of patients in the control group (p < 0.05). After 3 months of treatment, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and diffusing capacity of the lung for carbon monoxide (DLco) in the observation group increased by 136.7 ± 189.2 mL (p < 0.05), 124.2 ± 169.9 mL (p < 0.05), and 1.4 ± 2.3 mL/min/mmHg (p > 0.05), respectively, while those in the control group decreased (145.8 ± 356.5; 107.5 ± 272.1; 1.9 ± 3.8). After 6 months of treatment, FVC, FEV1, and DLco in the observation group increased by 207.8 ± 372.2 mL (p > 0.05), 107.8 ± 295.2 mL (p > 0.05) and 0.7 ± 6.0 mL/min/mmHg (p > 0.05), respectively, while those of the control group decreased (383.3 ± 536.7; 215.6 ± 228.9; 1.4 ± 1.7). The incidences of clinical symptoms such as cough, expectoration, dyspnea, chest tightness, and chest pain in the observation group were decreased-after treatment (all p < 0.05), while the incidences of these symptoms increased in the control group, although the change was not statistically significant (all p > 0.05).ConclusionTetrandrine can control and delay the progression of AS-associated silicosis fibrosis, with improved chest HRCT imaging and pulmonary function.

Tetrandrine slows the radiographic progression of progressive massive fibrosis in pneumoconiosis: a retrospective cohort study

“…From the results of this study, we found that Tet has great potential to slow the progression of PMF fibrosis as well as the aggravation of emphysema. Similar to the results of a recent study, which showed that after taking Tet for 3–12 months, 56.5 to 65.4% of silicosis patients had improved HRCT [ 9 ].…”

“…Tetrandrine (Tet) as a potent calcium channel blocker and in the treatment of different health issues has been referenced in Chinese Pharmacopoeia for its use as an anti-silicosis agent [ 7 ]. Previous studies have reported that silicotic nodules under X-ray have reduced and lung function have improved after Tet treatment [ 8 , 9 ]. However, the effect of Tet on PMF has not been reported.…”

Preliminary Study on the Effect and Molecular Mechanism of Tetrandrine in Alleviating Pulmonary Inflammation and Fibrosis Induced by Silicon Dioxide

“…Clinical studies have found that Tet can control and postpone the pathological process of pulmonary fibrosis in silicosis patients (chest HRCT imaging evidence, lung function, changes of molecular indexes related to lung inflammation and fibrosis, etc.) [ 26 , 27 , 29 ]. In this study, the results of histopathological experiments showed that Tet intervention could significantly alleviate lung inflammation and fibrosis in mice caused by SiO 2 .…”

“…It is commonly used to treat arthritis, hypertension, tumors, silicosis, liver fibrosis prevention and treatment, liver cell protection, and other conditions in clinical practice [ 23 , 24 , 25 ]. Both in vitro and in vivo studies have confirmed that Tet is effective in the treatment of silicosis [ 26 , 27 , 28 , 29 ]. Currently, tetrandrine (Tet) is the only plant-derived drug approved in China for the treatment of silicosis.…”

Natural-Product-Derived Adjunctive Treatments to Conventional Therapy and Their Immunoregulatory Activities in Triple-Negative Breast Cancer

“…The Chinese medicinal vine plant Stephania tetranda S. Moore contains a bisbenzylisoquinoline alkaloid named tetrandrine. Recent clinical studies have reported improved outcomes in patients with COVID-19 and those with silicosis when treated with tetrandrine [153,154]. Aside from its calcium-channel-blocking properties, accumulating evidence suggests that it targets cancer-associated inflammation, induces apoptosis, and reverses multidrug-resistant cancer cell lines [155].…”