ASTRAGALUS INJECTION:
Contemporary research has proven that many herbal extracts and isolated compounds possess anti-tumor activities. Clinical trials on the use of herbal medicinal agents have been conducted in order to establish novel chemotherapeutic avenues. The dried root of Astragalus membranaceus (Huangqi) has a long history of medicinal use in traditional Chinese medicine. It is now commonly used as an immunomodulating agent in mixed herbal decoctions to treat common cold, diarrhea, fatigue and anorexia, and being prescribed to patients with cardiac diseases. In recent years, Astragalus membranaceus injections for i.v. and i.m. administration have been developed and are now commonly used to ameliorate the side effects of cytotoxic anti-neoplastic drugs. The active pharmacological constituents of Radix Astragalus membranaceus include various polysaccharides, saponins and flavonoids. Among these, Astragalus polysaccharides have been most widely studied, mainly on their immunopotentiating properties like stimulation of murine B-cell proliferation and cytokine production. Apart from these, clinical studies also showed that Astragalus polysaccharides could counteract the side effects of chemotherapeutic drugs, such as a significant reduction in the degree of myelosuppression in cancer patients. Recently, there are growing evidences that Astragalus extract may be a potential anti-tumorigenic agent. For instance, hepatocarcinogenesis could be prevented in rats fed with the aqueous extract of Astragalus, which is mainly composed of Astragalus polysaccharides. There are also reports that describe the potentiating effect of Astragalus extract in recombinant interleukin-2-generated lymphokine-activated cells upon the anti-tumorigenic action of drugs against murine renal carcinoma.

Saponins isolated from radix Astragalus membranaceus consist of astragalosides (I–VIII) and some of their isomer isoastragalosides (I, II and IV). Similar to the polysaccharides obtained from the same herb, astragalus saponins have been found to possess immunomodulating effects. The pure isolated saponin astragaloside IV could increase murine B and T cell proliferation and possess cardioprotective properties. Alternatively, many saponins derived from other natural sources have also been reported to effectively suppress cancer cell growth. Among these, ginsenosides are pharmacologically active saponins obtained from ginseng that could inhibit the growth of many different types of cancer in vitro. Ginsenosides such as Rh2 and Rg5 have been shown to induce G1 phase arrest in human MCF-7 breast cancer cells . Apoptosis can also be induced in human SK-HEP-1 hepatoma cells by Rh2 through activation of cyclin A/cyclin-dependent kinase cdk 2 activity and caspase 3-mediated p21 cleavage. 

A few medicines and herbal products are claimed to be good for supporting the immune function of cancer patients undergoing chemotherapy. But for that purpose, I have never seen one, conventional or non-conventional, more effective than Huang Qi (Astragalus membranaceous) injection. 

Huang Qi (astragalus membranaceus) for intramuscular injection are more suitable for use at home or at an outpatient clinic. Commonly used in Asia, Huang Qi intravenous administration requires 0.9% sodium chloride for i.v. infusion and is usually administered in the hospitals. Intramuscular or intravenous administration are preferred for intestinal absorption bypass and assured hemo-availability. Huang Qi 5:1 concentrated extract powder is also available for oral administration.

Huang Qi (astragalus membranaceus) is available at our clinic. 

Be aware that Huang Qi (astragalus membranaceus) for professional therapeutical use is pharmaceutically graded, which is many times stronger than its simple natural form often found on the stores and sold to treat common cold and minor infections. The professional use and administration of some herbal medicines may require the prescription of a licensed health care practitioner authorized to use these products for therapeutical purpose.  

Clinical Summary:
The root of Huang Qi (Astragalus membranaceus) is primarily used for its immune stimulating properties. In vitro, animal, and human data show a marked increase of NK cells and lymphocytic phagocytosis, which are essential, both, to fight conformed tumor cells as well as to prevent recurrence.  Significant reduction of immune suppression following chemotherapy with Cyclophosphamide has also been demonstrated when Huang Qi (Astragalus membranaceus) is administered. 

Besides powerful immune stimulating action, Chinese studies suggest that Huang Qi has renal protective effects. Huang Qi has also been shown to reduce fatigue in athletes. Some animal studies demonstrate the following: Huang Qi (Astragalus membranaceus) increases M-cholinergic receptor density in senile rats. This suggests that Huang Qi may have a role in deterring brain senility. Huang Qi (Astragalus membranaceus) can delay chemical induced hepatocarcinogenesis in rats.

Huang Qi Astragalus membranaceus) is usually an important ingredient in herbal formulas used in Traditional Chinese Medicine (TCM) to help the body fight cancer cells. Huang Qi is also indicated in cases of:

• Chemotherapy side effects
• Viral Hepatitis
• Cardiovascular diseases
• Common cold
• Diabetes
• HIV and AIDS
• Immunodeficiency (compromised immunity).
• Microbial infections 
• Renal function support (astragalus along agelica sinensis and/or rehmannia glutinosa can improve kidney function). 

Constituents:
Triperpenoid saponins (cycloastragenol, astragaloside I to VIII, and cyclocanthoside), Cycloartane, triterpene, Polysaccharide, Isoflavonoids, Amino acids. 

Mechanism of Action:
Astragalus works by stimulating several factors of the immune system. The polysaccharides potentiate in vitro the immune-mediated antitumor activity of interleukin-2 ,improve the responses of lymphocytes from normal subjects and cancer patients, and enhance the natural killer cell activity of normal subjects and potentiate activity of monocytes. The saponins potentiate natural killer cell (NKc) activity and restore steroid-inhibited NKc activity in vitro. They also increase phagocytosis and demonstrate hepatoprotective effects on chemically induced liver injury in vitro and in vivo. Chinese studies suggest that astragalus, when used with angelica, has renal protective effects by mediating gene expression. Astragalus increases M-cholinergic receptor density in senile rats. This suggests that astragalus may have a role in combating brain senility. Herbal formula containing astragalus can reduce fatigue in athletes by increasing uptake and utility of oxygen. 

Adverse Reactions:
No adverse events have been reported. As with any herbal medicine, Huang Qi should be properly indicated and administered.   

Positive Drug Interaction:
Concomitant treatment with Huang Qi (Astragalus membranaceus) and Aldesleukin (a conventional drug used for renal cancer and other forms of malignancy) has resulted in a 10-fold potentiation of tumor-cidal activity when compared to only Aldesleukin, and Aldesleukin side effects also decreased.  Huang Qi also decreased immunosuppression following chemotherapy treatment with Cyclophosphamide. 

Notice: This page is for educational purpose only. The U.S. law requires the following statement for natural health products sold in the United States:  This information has not been evaluated by the FDA, and is not intended to diagnose, treat, cure, or prevent any illness. Decisions to use herbs or natural health supplements should be carefully considered. Individuals should consult a licensed health care practitioner with knowledge of herbal medicine, before undergoing any herbal treatment.

Reference:
(1) Tang W, et al. Chinese Drugs of Plant Origin. Berlin: Springer-Verlag; 1992.

(2) Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland (Australia): Phytotherapy Press; 1996.

(3) Yao X, et al. Mechanism of inhibition of HIV-1 infection in vitro by purified extract of Prunella vulgaris. Virology 1992;187:56-62.

(4) Upton, R. Astragalus root: analytical, quality control and therapeutic monograph. American Herbal Pharmacopoeia 1999;1:1-25.

(5) Chu DT, et al. Fractionated extract of Astragalus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2. J Clin Lab Immunol 1988;26:183-7.

(6) Chu DT, Wong WL, Mavligit GM.Immunotherapy with Chinese medicinal herbs. II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo. J Clin Lab Immunol 1988;25:125-9.

(7) Shi R, et al. The regulatory action of radix astragali on M-cholinergic receptor of the brain of senile rats. J Tradit Chin Med 2001;21:232-5.

(8) Yu L, et al. Identification of a gene associated with astragalus and angelica's renal protective effects by silver staining mRNA differential display. Chin Med J (Engl) 2002;115:923-7.

(9) Chen K, et al.Reducing fatigue of athletes following oral administration of huangqi jianzhong tang. Acta Pharmacol Sin. 2002 Aug;23(8):757-61.

(10) Cui R, et al. Suppressive effect of Astragalus membranaceus Bunge on chemical hepatocarcinogenesis in rats.Cancer Chemother Pharmacol. 2003 Jan;51(1):75-80.

(11) Qun L, et al. Effects of astragalus on IL-2/IL-2R system in patients with maintained hemodialysis. Clin Nephrol. 1999 Nov;52(5):333-4.

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