1. REVIEW
TMR | January 2020 | vol. 5 | no. 1 | 34
doi: 10.12032/TMR20191228152
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Traditional Chinese Medicine
Highlights
The present review discusses the application of nanoparticles in the early diagnosis and treatment of tumors,
through Western and traditional Chinese medicine, indicating the potential enhancement of biological
effectiveness and target-specificity of the combination of nanoparticles and Western or Chinese medicine.
Traditionality
In the classical ancient Chinese medicine book of Huang Di Nei Jing (Yellow Emperor's Classic of
Medicine) (221 B.C.E.–220 C.E.), the earliest known documents on traditional Chinese medicine (TCM), a
set of theories has already been established on the diagnosis and treatment of tumors. However, the
traditional formulations of TCM, including decoctions, pills, and powders are associated with various
shortcomings, including poor water solubility, low bioavailability, and short half-life, which limit their
effectiveness in the treatment of tumors. Early research efforts in this area were dedicated to improving the
targeted delivery of the active components of TCM monomers. By combining the active TCM monomers
with nanomaterials, the bioavailability and targeted specificity of TCMs can be effectively increased.

2. REVIEW
TMR | January 2020 | vol. 5 | no. 1 | 35
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doi: 10.12032/TMR20191228152
Abstract
Objective: Malignant tumors pose a serious threat to human life and health. Despite recent developments in
modern medical techniques, the early diagnosis and treatment of tumors remain difficult due to their asymptomatic
nature in the early stages of disease and the limitations in current clinical diagnostic methods. Advancements in
nanotechnology, particularly in the area of multi-functional diagnostic nanomaterials, can help effectively resolve
present inadequacies via concurrently achieving early diagnosis, image-guided intervention, and real-time
monitoring and treatment of tumors. The development of nanomaterials and nanotechnology may also aid in the
area of anti-cancer drug development by improving the safety and side-effect profile, as well as by enhancing the
targeted specificity of the drugs, which are two of the long-standing challenges in Western medicine. The progress
in the field of nanomaterials has also uncovered novel approaches for the clinical application of traditional Chinese
medicine because the combination of traditional Chinese medicine components with nanoparticles overcomes
various drawbacks, including poor water solubility, low bioavailability, and short half-life, of the former. Moreover,
nanoparticles also enhance the biological effectiveness and targeted specificity of these medicines. In this review,
we discuss the application of nanoparticles in the early diagnosis and treatment of tumors, through modern and
traditional medicine.
Key words: Tumors, Nanomaterials, Chinese medicine, Diagnosis, Treatment
Acknowledgments:
This study was supported by grants from the National Natural Science Foundation of China (Grant No.
81801175), the Fundamental Research Funds for the Central Universities (Grant No. WK9110000044), the
China Postdoctoral Science Foundation (Grant No. 2019M662179), and the Anhui Province Postdoctoral
Science Foundation (Grant No. 2019B324).
Abbreviations:
TCM, traditional Chinese medicine; QDs, quantum dots; NIR, near-infrared; MRI, magnetic resonance imaging;
SPIO, superparamagnetic iron oxide; Gd, gadolinium; PET, positron emission tomography; RGD, Arg-Gly-Asp;
PLGA, poly (lactic-co-glycolic acid); SLNs, Solid lipid nanoparticles; TET, tetrandrine; ZTO, zedoary turmeric
oil; CYP, Chinese yam polysaccharide; APN, Andrographis paniculata (Burm. f.) Nees; mPEG-PLA, methoxy
poly(ethylene glycol)-poly(D.L-lactic acid); Lu, luteolin; Cur, curcumin; DOX, doxorubicin; MPEG-PCL,
monomethoxy poly(ethylene glycol)-poly(e-caprolactone); AuNPs, gold nanoparticles.
Competing interests:
The authors declare that they have no conflict of interest. The authors alone are responsible for the content of the
paper.
Citation:
Chaoliang Tang, Heng Li, Junmou Hong, et al. Application of nanoparticles in the early diagnosis and treatment
of tumors: current status and progress. Traditional Medicine Research 2020, 5 (1): 34–43.
Executive Editor: Nuo-Xi Pi.
Submitted: 4 December 2019, Accepted: 26 December 2019, Online: 30 December 2019

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TMR | January 2020 | vol. 5 | no. 1 | 36
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Background
Over the past few decades, a significant progress has
been made in the diagnosis and treatment of tumors.
However, diagnosis and treatment still mainly rely on
the use of invasive procedures (e.g., biopsy and
surgical treatment), which are inconvenient, and
noninvasive methods (e.g., radiotherapy and
chemotherapy), which have poor specificity. Therefore,
these methods lead to unsatisfactory treatment
outcomes [1, 2]. In recent years, scientists have been
actively engaged in the quest for a noninvasive,
high-specificity tumor diagnosis methods to improve
the survival rate and quality of life of tumor-affected
patients, and nanotechnology has provided a
breakthrough in this arduous task.
Nanotechnology refers to a multidisciplinary field of
applied science and technology that involves the study
of material characteristics and interactions (including
molecular and atomic manipulation) at the nanometer
scale (1–100 nm), and the utilization of these
characteristics for practical applications.
Nanomedicine, an emerging interdisciplinary field, is
the application of the principles and methods of
nanotechnology in medical research and clinical
treatment, to enable accurate diagnosis and treatment
of diseases with complex pathogenic mechanisms at
the molecular level [3]. Nanomaterials can be broadly
defined as materials with at least one dimension in the
nanoscale regime, or materials obtained through the
arrangement of the basic units in the nanoscale regime
in a certain pattern [4, 5]. In particular, the use of
nanoparticles as nanoprobes in early tumor detection
and early tumor-tissue imaging has received increasing
attention from researchers. Nanoparticles can serve as
good drug delivery platforms because of their surface
modifiability. The synthesis of aqueous injectable
solutions and the development of passive or active
targeted drug-delivery systems has allowed
nanoparticles to become an accurate means of early
tumor diagnosis and imaging [6]. The improvement in
the side-effect profile and targeted specificity of
antitumor drugs has always been a key aim in modern
medical research. Rapid developments in the area of
nanomaterials and nanotechnology have uncovered
novel research approaches for the targeted delivery of
antitumor drugs, enabling substantial progress in basic
research and clinical applications. In the classical
ancient Chinese medicine book of Huang Di Nei Jing
(Yellow Emperor's Classic of Medicine) (221
B.C.E.–220 C.E.), the earliest known documents on
traditional Chinese medicine (TCM), a set of theories
has already been established on the symptoms,
diagnosis, treatment, and prognosis of tumors.
However, the traditional formulations of TCM,
including decoctions, pills, and powders are associated
with various shortcomings, such as those of poor water
solubility, low bioavailability, and short half-life,
which limit their effectiveness in the treatment of
tumors. Early research efforts in this area were
dedicated to improving the targeted delivery of the
active components of TCM monomers. By combining
the active TCM monomers with nanomaterials, the
bioavailability and targeted specificity of TCMs can be
effectively increased.
This review discusses the applications of
nanoparticles in the early diagnosis and treatment of
tumors in modern and traditional medicine.
Nanoparticles and early tumor diagnosis
Application of quantum dots for early tumor
diagnosis
Quantum dots (QDs) are semiconductor nanocrystals
with a diameter of 2–10 nm. The size-dependent
optical properties, superior photostability, and
modifiable surface properties of QDs enable the use of
these nanoparticles as unique probes in optical imaging,
highlighting the potential application of QDs in early
tumor diagnosis [7, 8]. Inorganic-organic hybrid
nanomaterials composed of QDs are capable of
unobstructed entry into the circulatory system, as well
as navigation to specific sites for interaction between
targeted molecules and tumor markers [9]. In 2004,
Gao et al. first reported the use of QDs in cancer
targeting and imaging analysis in living animals [10].
The application of QDs in near-infrared (NIR) imaging
was described by Gao et al. in 2010 [11]. Because NIR
QDs effectively increase the tissue-penetration depth,
photon detection can be achieved with a higher
accuracy and sensitivity. Allen et al. also demonstrated
that the use of QDs resulted in greater clarity and
penetration depth in tumor vasculature imaging [12].
In general, good photostability, high surface
modifiability, and strong tissue penetration ability of
QDs enable their binding with specific tumor markers
and facilitate signal transmission to detection devices,
demonstrating the great potential of QDs in early
tumor diagnosis.
Application of nanoparticles in magnetic resonance
imaging for early tumor diagnosis
Decades of clinical trials have proven that magnetic
resonance imaging (MRI) is a highly effective
noninvasive imaging tool for disease diagnosis and
monitoring. With significant progress achieved in MRI
techniques over recent years, many researchers are
now dedicating their efforts to the application of
nanoparticles to enhance the tumor-diagnostic
capabilities of MRI. In particular, ultrasmall
superparamagnetic iron oxide nanoparticles have
demonstrated the widest applications among magnetic
nanoparticles. Besides serving as contrast agents for
MRI, iron oxide nanoparticles have also been utilized
by researchers as carriers for targeted drug delivery of

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chemotherapeutic agents [13, 14]. Superparamagnetic
iron oxide (SPIO) nanoparticles were the first to be
applied in clinical tumor imaging [15]. Previous
studies have shown that SPIO nanoparticles are readily
taken up by Kupffer cells—specialized macrophages
located in the hepatic parenchyma. Because most
hepatic tumors lack macrophages, the specific uptake
of SPIO nanoparticles by macrophages increases the
contrast between healthy and diseased tissue, enabling
the detection of primary or metastatic hepatic lesions
as small as 2–3 mm [16, 17]. To increase the
specificity of magnetic nanoparticles, researchers have
conjugated chlorotoxin (a small peptide present in
scorpion venom and a highly specific marker for
glioma cells) with magnetic nanoparticles to guide the
targeting of tumors in animals [18]. Meng et al.
conjugated SPIO nanoparticles with chlorotoxin and
fluorescein isothiocyanate, which provided both MRI
and optical imaging abilities and enabled fluorescence
emission [19]. Gadolinium (Gd)-based complexes are
the most commonly used MRI contrast agents used in
clinical settings. However, the applications of these
complexes are limited due to their relatively low
sensitivity. With nanotechnology, major progress has
been made in overcoming the low sensitivity of
Gd-based complexes [20, 21]. Researchers have also
found that chitosan-loaded nanoparticles have a longer
residence time in tumor tissues [22]. Xu et al.
synthesized a Gd(III)-1B4M-DTPA chelated G2
PAMAM dendrimer, labeled with rhodamine green,
which could be used for targeted detection of ovarian
cancer through MRI and fluorescence. Validation in
mice bearing ovarian cancer xenografts demonstrated
that the dendrimer bound effectively and specifically to
the tumor tissue, and delivered sufficient amounts of
chelated Gd(III) and fluorophores to the ovarian tumor
to produce visible changes detectable by both, MRI
and optical imaging [23].
Application of nanoparticles in positron emission
tomography for early tumor diagnosis
The use of positron emission tomography (PET) for
disease diagnosis has become increasingly common in
clinical settings due to its noninvasive nature, high
patient compliance, and high diagnostic accuracy. PET
imaging provides effective diagnosis of tumors and
cardiovascular diseases. Previous research has
indicated that the sensitivity of PET imaging in tumor
diagnosis can be further enhanced using a radioactive
nucleotide-labeled nanoparticle carrier system [24].
The use of nanoparticles allows for the development of
multimodal imaging probes for image-guided targeting.
Different types of imaging probes may be combined
with a single nanoparticle for the evaluation of its
effectiveness in tumor targeting [25, 26]. Cai et al.
recently developed a multifunctional probe for PET
and NIR fluorescence imaging. A QD with an
amine-functionalized surface was modified with
Arg-Gly-Asp (RGD) peptides and 1, 4, 7,
10-tetraazacyclodocecane-N, N’, N”, N”’-tetraacetic
acid chelators and subsequently labeled with 64Cu for
PET imaging. Such nanoparticle agents (RGD
peptide-conjugated QDs) were applied to mice bearing
U87MG human glioblastoma cells (integrin
αvβ3-positive). Results indicated that the dual-function
probe enabled the imaging of tiny tumor tissue in the
mice, thus demonstrating the promising prospects of
the application of such probes in early tumor diagnosis
[27, 28]. The combination of different imaging
modalities (e.g., PET and optical imaging), through the
application of nanoparticles, offers great potential in
effective clinical diagnosis [29]. For example, while
PET imaging provides useful high-level information
on the full-body macroenvironment, optical imaging
provides valuable molecular-grade information on the
tumor microenvironment. By incorporating
tumor-specific targeting agents with the help of
nanotechnology, the sensitivity and diagnostic ability
of these imaging methods can be combined and
enhanced further [30].
Nanoparticles as drug carriers for early
tumor treatment
The improvement of the safety and tolerability profile
and target-selectivity of antitumor agents has always
been a key aim of researchers. Recent developments in
nanotechnology have uncovered novel research
approaches for the targeted delivery of antitumor drugs,
enabling substantial progress in basic and applied
research in this area. Gold nanoparticles (AuNPs),
inorganic nanomaterials, can have different functions
and morphologies conferred to them by their unique
biochemical characteristics. AuNPs can be classified
into Au nanospheres, Au nanorods, and Au
nanocrystals, based on the morphology, and were
mainly used for the photothermal ablation of tumors in
the early years [31]. Subsequent research revealed that
various drugs and targeted molecules can readily bind
to the AuNPs, upon appropriate surface modifications
of the latter. Exploiting the unique properties of the
nanoparticles, Khutale and Casey developed a
multifunctional AuNP-based drug delivery system
(Au-PEG-PAMAM-DOX) for the delivery of
doxorubicin (DOX). Results of the study indicated that
the drug-delivery system efficiently achieved the
targeted delivery of the antitumor drug DOX to tumor
sites, enabling the targeted killing and growth
inhibition of tumor cells [32]. To improve the accuracy
of targeted antitumor-drug delivery, Ren designed a
coordinated release system based on the photothermal
and infrared-response characteristics of AuNPs [33]. In
another study, Yang et al. reported the development of
a novel nanomaterial for tumor diagnosis and treatment
by wrapping a bovine-serum-albumin-based Gd/Au
complex on the surface of biodegradable mesoporous

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silica nanoparticles. Biodegradable mesoporous silica
nanoparticles have previously been successfully used
as nanoscale drug carriers for tumor treatment, through
disulfide linkages. This was followed by the addition
of folate as the targeting ligand. Researchers found that
the degradation rate of bMSN-ss-COOH was
significantly higher under acidic conditions than that
under normal conditions, which prevented the rapid
excretion from the body and favored the swift release
of the antitumor drug after entering the tumor cells. In
addition, the target-specificity of bMSN-ss-GABA
towards the tumor demonstrated that the folate
modification enhanced the endocytosis of the
nanoparticles and further promoted the anti-tumor
activity of the drug [34].
The combination of various types of
chemotherapeutic agents with functional nanoscale
radiosensitizers to attain synergy between
chemotherapy and radiotherapy also serves as an
effective means of killing tumor cells. Werner et al.
found that Genexol-PM, a polymeric nanoparticle
micelle formulation of paclitaxel, achieved sensitivity
enhancement ratios of 1.12 and 1.23, in H460 cells and
A549 cells, respectively, which was indicative of better
radiosensitivity compared with Taxol [35]. Shi et al.
found that tocopheryl polyethylene glycol 1000
succinate-emulsified docetaxel-loaded poly
(lactic-co-glycolic acid) (PLGA) nanoparticles had a
significantly higher radiosensitization effect on
radioresistant tumor cells, A549 and CNE-1, compared
with docetaxel alone. The improved radiosensitization
effect was associated with the enhancement of
cell-cycle arrest in the G2/M phase and promotion of
apoptosis by the nanoparticles. This also led to the
improvement of cell uptake and inhibition of multiple
drug resistance by tocopheryl polyethylene glycol
1000 succinate [36]. Certain polymers, block
copolymers, liposomes, organic silanes, hydrogels, and
mesoporous or easily modifiable nanomaterials are
commonly used as carriers for chemotherapeutic drugs
and radiosensitizers. Examples include polydopamine
loaded with the radioactive nuclide 131I and the
chemotherapeutic drug DOX [37], block copolymers
loaded with docetaxel [38], organic silanes loaded with
a cisplatin prodrug [39], mesoporous silicon dioxide
loaded with mitomycin C [40], topotecan [41] or
selenocysteine [42], and carbon nanotubes loaded with
catechin [43]. Such methods not only improve the
biocompatibility of nanomaterials and their
target-specificity towards tumor cells, overcoming the
multidrug resistance associated with chemotherapeutic
drugs, but also enhance the synergistic treatment
effects of chemotherapy and radiotherapy. Chang et al.
showed that RGD- and adrenocortico
polypeptide-modified Au@Se-R/A nanocomposites
could be used for synergistic radiochemotherapy [44].
In a study by Song et al., hollow tantalum oxide
nanoshells were used as radiosensitizers, and cell-cycle
arrest into radiation-sensitive phases was induced
through the loading of the chemotherapeutic agent
SN-38 [45]. Another study by Liu et al. demonstrated
the effective inhibition of hypoxic tumor-cell growth
through the utilization of upconversion nanoparticles
as radiosensitizers, and loading of the nanoparticles
with the chemotherapeutic agent tirapazamine [46].
Novel inorganic nanomaterials such as selenium
nanoparticles [47] are capable of achieving synergy
between chemotherapy and radiotherapy. Researchers
have also found that cysteine-modified Fe Pt
nanoparticles can serve the dual function of
chemotherapeutic agents and radiosensitizers, wherein
Pt ions can provide chemotherapeutic effects by
reacting with DNA, while the strong radioactive decay
of Pt, a heavy metal, promotes the generation of
reactive oxygen species, making the nanoparticles
suitable for use as radiosensitizers. This results in the
realization of synergistic chemoradiotherapy [48].
Nanomaterials are of great significance to tumor
treatment, and substantial progress has been attained in
basic research on the use of nanomaterials in tumor
treatment. However, there are relatively few reports on
the application of nanomaterials in the clinical
treatment of tumors. Further research in the form of
meticulously conducted large-scale clinical trials is
needed to validate the clinical safety and efficacy of
nanomaterials in the treatment of tumors.
Nanoparticles as drug carriers for
application in tumor treatment with TCM
monomers
Relevant studies have shown that TCM monomers play
an active role in the treatment of tumors. With the
increasing application of nanomaterials in the field of
tumor research, many attempts have been made to
combine the TCM monomers with nanomaterials for
tumor treatment. Early research efforts in this area had
been dedicated to enhancing the targeted delivery of
the active components of TCM monomers. Solid lipid
nanoparticles (SLNs) are nanomaterials comprised of
solid lipids, with have diameters ranging between 50
and 1000 nm [49]. To enhance the effects of
tetrandrine (TET), which is extracted from Han Fang Ji
(Stephania tetrandra S. Moore), in the treatment of
arthritis, silicosis, hypertension, and fibrosis, Li et al.
extracted the lipophilic active components of TET and
utilized SLNs as a carrier, which increased the
bioavailability and targeted-specificity of TET [50].
Chen et al. found that zedoary turmeric oil (ZTO), a
volatile oil extracted from the dry rhizome of E Zhu
(Curcuma phaeocaulis Val.), possessed antitumor
activity and provided protection against liver injury
[51]. However, ZTO has low bioavailability and
limited clinical applications, as it causes irritation of
the upper gastrointestinal tract and has poor water
solubility. Zhao et al. found that the loading of ZTO

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onto SLNs prepared by a melt-emulsification
technique significantly alleviated the side effects and
improved the targeted-specificity of ZTO in the
treatment of diseases [52].
The polysaccharides found in TCM play a crucial
role in the regulation of many physiological processes
in the human body, and possess antitumor,
anti-inflammatory, and antioxidant properties. Chinese
yam polysaccharide (CYP) which is extracted from
Shan Yao (Dioscorea opposita Thunb.), the major
constituent of Chinese yam, has been proven to have
antitumor activity, by Kim et al. However, the
shortcomings of CYP, including strong dose
dependence and short half-life, limit its applications in
the clinical treatment of tumors [53]. To overcome this,
Li et al. selected PLGA nanoparticles, believed to
possess high biocompatibility and biodegradability
characteristics, to encapsulate CYP and increase its
biological activity [24]. PLGA mainly comprises lactic
acid and glycolic acid, and is ultimately metabolized to
carbon dioxide and water in the human body. When
used as a drug carrier, PLGA’s biocompatibility and
biodegradability favors a sustained and effective
release of drugs in the body [54]. Therefore,
PLGA-based nanomaterials can potentially serve as
suitable carriers for enhancement of the bioavailability
of active TCM components.
Chuan Xin Lian (Andrographis paniculata (Burm. f.)
Nees, APN) is an important medicinal plant in TCM.
Studies have indicated that the monomer
andrographolide of APN possesses a wide spectrum of
anticancer activities; however, the agent has a low
bioavailability due to its poor water solubility [55, 56].
Zhang utilized glyceryl tribehenate as a carrier material
and poloxamer as an emulsifier for the preparation of
an andrographolide derivative, ATC-II-SLNs, by
high-pressure homogenization. When a tumor
formation experiment was conducted with nude mice,
ATC-II-SLNs were found to provide stronger
inhibitory effects towards tumor growth and increase
targeted-specificity of the drug in the liver, compared
with ATC-II, indicating good prospects for the clinical
application of these nanoparticles [57]. In another
study by Yao et al., the effective components of APN
(mainly diterpene lactones) were encapsulated using
methoxy poly(ethylene glycol)-poly(D.L-lactic acid)
(mPEG-PLA) nanomaterials. Results showed that the
mPEG-PLA-APN particles were stable against salt
dissociation, protein adsorption, and anion substitution.
Cytotoxicity testing in vitro demonstrated that the
inhibitory effect of mPEG-PLA-APN on cell viability
in the mouse mammary carcinoma cell line 4T-1 was
more significant than that of free APN [58].
Luteolin (Lu), which is extracted from Mu Xi Cao
(Reseda odorata), a flavonoid, can inhibit tumor cell
proliferation, promote the activation of cell cycle
checkpoints, and induce apoptosis in early mutant cells,
thereby preventing tumor formation and development
[59]. However, the clinical applications of Lu have
been considerably limited due to its poor water
solubility. Qiu et al. used monomethoxy poly (ethylene
glycol)-poly(e-caprolactone) (MPEG-PCL) micelles to
encapsulate Lu by a self-assembly method to obtain
water-soluble Lu/MPEG-PCL micelles. This enabled
the slow release of Lu from the Lu/MPEG-PCL
micelles, leading to its sustained effects in the body.
Results of in vivo and in vitro experiments also
indicated that the inhibitory effects of Lu/MPEG-PCL
on tumor growth were more significant than those of
Lu [60].
Quercetin (2-(3, 4-dihydroxyphenyl)-3, 5,
7-trihydroxychromen-4-one), a natural flavonoid
commonly found in fruits and vegetables, such as
onions, apples and strawberries, can regulate multiple
biological pathways, including induction of apoptosis,
and inhibition of angiogenesis and cell-proliferation.
Quercetin has also been reported to protect against
oxidative stress and mutagenesis in normal cells [61,
62]. However, the poor water solubility of quercetin
necessitates the use of solvents such as dimethyl
sulfoxide or ethanol, during administration, which can
cause dose-dependent hemolysis as well as liver and
kidney impairments. Quercetin’s low bioavailability
also limits its use as a pharmaceutical agent [63]. Hu et
al. developed a quercetin prodrug through the
phosphorylation of its hydroxyl groups, which not only
increased its water solubility but also facilitated its
precipitation with calcium to form an amorphous
nanoparticle core, used in the formulation of lipid
calcium phosphate nanoparticles. The targeted lipid
calcium phosphate nanoparticle formulation was
shown to have a high loading efficiency and a particle
size of approximately 35 nm, which significantly
improved the bioavailability and metabolic stability of
quercetin. Following the systemic administration of the
quercetin phosphate nanoparticles, quercetin phosphate
was released and was found to convert back to the
quercetin under physiological conditions. In a
stroma-rich bladder carcinoma model, a significant
downregulation of Wnt16 expression and a synergistic
antitumor effect was observed with cisplatin
nanoparticles, suggesting that quercetin phosphate
alone significantly remodeled the tumor
microenvironment, thereby increasing the penetration
of the second-wave nanoparticles into the tumor nests.
Therefore, quercetin phosphate nanoparticles may be a
safe and effective alternative to improve the treatment
outcomes for desmoplastic tumors [64].
Curcumin (Cur), a natural polyphenol derived from
Jiang Huang (Curcuma longa L.), possesses a broad
range of therapeutic properties, and can provide
antioxidant, anti-inflammatory, antitoxic, antimicrobial
and antitumor effects [65]. Besides having superior
pharmacological characteristics, Cur is also an ideal
chemosensitizer, as it downregulates multidrug-
resistance proteins and inhibits cancer cell proliferation

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through the inhibition of human epidermal growth
factor receptor 2 activity and activation of nuclear
factor kappa B [66, 67]. In addition, high doses of Cur
can provide cardiac protection without causing
systemic side effects [68]. However, the clinical utility
of Cur is low because of its insolubility in water and
poor bioavailability [69]. P-glycoprotein-mediated
drug efflux is considered to be the major obstacle
limiting the success of cancer chemotherapy. To
effectively overcome multidrug resistance, enhance the
antitumor effects, and reduce the side effects of drugs,
Wang et al. prepared DOX and Cur co-encapsulated
pegylated polymeric micelles. These micelles had a
high loading efficiency, high stability, and the ability to
simultaneously deliver a chemotherapeutic drug along
with a multidrug-resistance modulator to the tumor
sites. As a chemosensitizer, Cur enhanced the
absorption of DOX by MCF7/Adr cells, thereby
enhancing the latter’s anticancer activity. Results also
indicated that the DOX and Cur co-encapsulated
pegylated polymeric micelles significantly increased
the cellular uptake and cellular apoptosis in vitro, as
well as enhanced the antitumor activity and reduced
the systemic side effects in vivo of DOX. Therefore,
the concomitant use of anticancer agents and
chemosensitizers may be a promising approach in
tumor treatment [70].
Cornus officinalis is a widely distributed woody
plant native to China, Japan, and Korea. Its fruit,
known as Shan Zhu Yu (Corni fructus) in China, is
considered a valuable herb and tonic, mainly used by
the Chinese for the improvement of kidney function
[71]. Shan Zhu Yu (Corni fructus) extract possesses
antidiabetic, antioxidant, immunoregulatory, and
antihyperglycemic effects, and can be used for the
treatment of cancer and shock [71, 72]. Through
phytochemical research, more than 150 different
compounds with diverse structures have been isolated
from Shan Zhu Yu (Corni fructus), including iridoid
glycosides, anthocyanidin, flavonoids, saccharides, and
tannins [73]. In particular, compounds such as
anthocyanidin have attracted widespread attention, as
they possess a broad range of biological properties,
including anti-inflammatory, antioxidant, antitumor,
and antidiabetic properties [74, 75]. In consideration of
the wide range of biological activity and chemical
components of Shan Zhu Yu (Corni fructus), He et al.
prepared Ag NPs with the use of the aqueous extract of
Shan Zhu Yu (Corni fructus) and obtained uniformly
dispersed nanoparticles with an average size of 11.7
nm, with potential pharmacological effects.
Water-soluble biological molecules such as flavonoids
and/or anthocyanidin play a key role in the reduction
and stabilization of Ag NPs. The Ag NPs synthesized
using the aqueous Shan Zhu Yu (Corni fructus) extract
exhibited remarkable anticancer properties against
human prostate cancer (PC-3) and human liver cancer
(HepG2) cells. The results of this study provided a
low-cost, nontoxic, and eco-friendly method for the
synthesis of metal nanoparticles as well demonstrated
as a novel approach for future anticancer research [76].
Prospects
With the current lack of effective diagnostic and
treatment measures, tumors remain a colossal threat to
human health globally. With the help of recent
experimental research, significant progress has been
made in the application of nanomaterials in tumor
diagnosis and treatment. However, researchers still
face substantial challenges in the effective application
of these materials in clinical settings. In particular, the
biosafety of nanomaterials remains a critical challenge,
as there is a lack of clear evidence indicating that
nanomaterials can be effectively metabolized in the
body, without causing significant side effects of
toxicity through accumulation. Furthermore, the
determination of safe-dose levels of the
nanoparticle-based drugs is difficult, due to a lack of
definite evaluation criteria. However, it is an
indisputable fact that the combination of nanomaterials
and biological diagnostic techniques can effectively
assist in the diagnosis and prevention of diseases.
Nanomedical techniques can contribute positively to
the further development of clinical medicine and basic
medicine. In general, the application of TCM in the
treatment of tumors is limited by the biochemical
characteristics of the therapeutic agents. However, the
advent of nanomaterials has uncovered novel
approaches to overcome these limitations, through
combining the active TCM components with
nanomaterials, thereby effectively enhancing the
formers’ biological efficacy and target-specificity.
When used concomitantly with other chemotherapeutic
agents, nanomaterials can also help resolve the
problem of tumor drug resistance. In addition, the side
effects caused by the poor target-specificity of TCM
may also be greatly avoided with the help of
nanomaterials.
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