Background: Because Traditional Chinese Medicine (TCM) preparations are often combinations of multiple herbs containing hundreds of compounds, they have been di cult to study. Compound Kushen Injection (CKI) is a complex mixture cancer treatment used in Chinese hospitals for over twenty years.Purpose: To demonstrate that a systematic analysis of molecular changes resulting from complex mixtures of bioactives from TCM can identify a core set of di↵erentially expressed (DE) genes and a reproducible set of candidate pathways.
Study Design:We used a cancer cell culture model to measure the e↵ect of CKI on cell cycle phases, apoptosis and correlate those phenotypes with CKI induced changes in gene expression.
Methods:We treated cancer cells with CKI in order to generate and analyse high-throughput transcriptome data from two cancer cell lines. We integrated these di↵erential gene expression results with previously reported results.Results: CKI induced cell-cycle arrest and apoptosis and altered the expression of 363 core candidate genes associated with cell cycle, apoptosis, DNA replication/repair and various cancer pathways. Of these, 7 are clinically relevant to cancer diagnosis or therapy and 14 are cell cycle regulators, and most of these 21 candidates are downregulated by CKI. Comparison of our core candidate genes to a database of plant medicinal compounds and their e↵ects on gene expression identified one-to-one, one-to-many and many-to-many regulatory relationships between compounds in CKI and DE genes.Conclusions: By identifying promising candidate pathways and genes associated with CKI based on our transcriptome-based analysis, we have shown this approach is useful for the systematic analysis of molecular changes resulting from complex mixtures of bioactives.The treatments of choice for cancer are often radiotherapy and/or chemotherapy, and while 2 these can be e↵ective, they can cause quite serious side-e↵ects, including death. These side-e↵ects 3 have driven the search for adjuvant therapies to both mitigate side-e↵ects and/or potentiate the 4 e↵ectiveness of existing therapies. Traditional Chinese Medicine (TCM) is one of the options for 5 adjuvant therapies, particularly in China, but increasingly so in the West. While clinical trial data 6 on the e↵ectiveness of TCM is currently limited, it remains an attractive option because of its long 7 history and because its potential e↵ectiveness is believed to result from the cumulative e↵ects of 8 multiple compounds on multiple targets [13]. Because TCM often has not been subjected to 9 rigorous evidence-based assessment and because it is based on an alternative theoretical system 10 compared to Western medicine, adoption of its plant derived therapeutics has been slow.
11In this report, we continue to characterize the molecular e↵ects of Compound Kushen Injection 12 3 (CKI) on cancer cells. CKI has been approved by the State Food and Drug Administration 13 (SFDA) of China for clinical use since 1995 [31] (State medical license no. Z14021231). CKI is an 14 herb...