Abstract

Plengsuriyakarn T, Thitapakorn V, Na-Bangchang K and Karbwang J

Cholangiocarcinoma (CCA), the bile duct cancer, is a major public health problem in several parts of the world particularly in Southeast Asia. The incidence of CCA in northeastern Thailand is high. The most effective treatment is surgical removal in early stage patients. However most patients present to the hospital in advanced stage, which is inoperable. There is no standard chemotherapy regimen for advanced stage. The life expectancy after being diagnosed is 12 weeks. The existing chemotherapeutics are not effective. There is an urgent need to explore other effective agents to combat with this devastating disease. Several medicinal plants used in traditional medicine have been demonstrated to exhibit promising antiCCA activities either in in vitro and/or in vivo models. These include triptolide from Tripterygium wilfordii, the ubiquitous tannic acid, Atractylodes lancea (Thunb) DC., Zingiber officinale Roscoe, Prasa-Prao-Yhai formulation, and curcumin, the pure compound isolated from Curcuma longa Linn.Their mechanisms of anti-CCA activities are either through direct activities on cancer cells (induction of apoptosis, stimulation of cell cycle arrest, and cytotoxicity, etc.) or through indirect activities through promotion of host immune system (inhibition of inflammation caused by liver fluke infection, inhibition of NF-B-regulated gene products expression involved in DNA damage, etc.). The candidate leads from these plants for CCA treatment are awaited. Their potential roles in CCA either when using alone or as adjunct therapy should be further investigated.