Page 51 - Genomic Medicine in Emerging Economies

40 CHAPTER 3: Genomics and Public Health: China’s Perspective

interaction research should gradually illuminate such interactions and how
they may be influenced by multiple environmental and/or genetic factors.
Tian Xian is a traditional Chinese herbal anticancer remedy that activates
human pregnane X receptor (PXR) in cell-based reporter gene assays. Tian Xian
products are herbal dietary supplements manufactured in China that are dis-
tributed worldwide and aggressively marketed as anticancer herbal therapies.
These products are also marketed as herbal therapies that alleviate the unpleas-
ant side effects associated with the anticancer treatments of Western medicine.
Activation of PXR in liver regulates the expression of genes encoding proteins
that are intimately involved in the hepatic uptake, metabolism, and elimina-
tion of toxic compounds from the body. PXR-mediated herb–drug interactions
can have undesirable effects in patients receiving combination therapy. Tian
Xian can alter the strength of interaction between the human PXR protein
and transcriptional cofactor proteins. It can increase expression of Cyp3a11
in primary cultures of rodent hepatocytes and induce expression of CYP3a4
in primary cultures of human hepatocytes. These data indicate that coadmin-
istration of Tian Xian is probably contraindicated in patients undergoing anti-
cancer therapy with conventional chemotherapeutic agents (Lichti-Kaiser and
Staudinger, 2008).
Another example is the recent report on the interaction of PHY906, a TCM for
chemotherapy-associated side effects relief, with Irinotecan (CPT-11), a drug
used for the treatment of cancer using a systems biology approach. A study
demonstrated that PHY906 significantly amplifies the effects of CPT-11 in
tumor tissues. Furthermore, administration of PHY906 together with CPT-11
could trigger unique changes that are not triggered by either alone, suggesting
the enhanced antitumor activity of the combination (Wang et al., 2011). Thus
genomic medicine may provide a crucial link in our understanding of the com-
plicated interactive relationships between TCM and Western drugs.

TRADITIONAL CHINESE MEDICINE AND NEW
CONCEPTS OF PREDICTIVE, PREVENTIVE AND
PERSONALIZED MEDICINE IN DIAGNOSIS AND
TREATMENT OF SUBOPTIMAL HEALTH
Suboptimal health status (SHS) is a physical state between health and disease,
characterized by the perception of health complaints, general weakness, chronic
fatigue, and low energy levels (Yan et al., 2009). SHS is foreshadowed by the an
ancient concept in TCM similar to the perspective of predictive, preventive, and
personalized (precision) medicine (PPPM) (Wang et al., 2016a,b,c). It is also
found that SHS is associated with cardiovascular risk factors and may contrib-
ute to the development of cardiovascular disease. SHS has also been reported