Herbal Cascara Sagrada and non-small cell lung cancer (NSCLC)

Cascara sagrada is a species of buckthorn, genus Rhamnus, belonging to the family Rhamnaceae, native to western North America, it's bark has been used in traditional medicine for gastrointestinal support. and it is thought to have a laxative and natural cleansing, etc., effect.

Lung cancer is defined as a condition of the abnormal growth of the cells in the lung's tissue. Most common form of primary lung cancers are derived from epithelial cells. In Us, Lung cancer is the leading cause of cancer deaths, causing 158,683 people deaths, including 88,329 men and 70,354 women, according to 2007 statistic. Non-small cell lung cancer is the most common type of lung cancer. It usually grows and spreads methodically and predictably.Most common types of lung cancers include
a. Squamous-cell carcinoma often found in an outer area of the lung,
b. Large-cell carcinoma found in the center of the lung by an air tube
c. Adenocarcinoma found in any part of the lung.

The ingredients
Beside the main compound of anthraquinones, otyher compounds include anthraquinone glycosides, (emodin, frangulin, iso-emodin, aloe-emodin, and chrysophanol), rhein, aloin, malic acid, tannic acid, cascarosides A, B, C, and D, and hydroxy anthracene derivatives (HAD), etc.

The benefits
In last article, we have shown that Emodin, an anthraquinone derivative, may effectively reverse the multi-drug resistance in MCF-7/Adr cells and down-regulate ERCC1 protein expression. In the study of  the cytotoxic effect of combined emodin and cisplatin on NSCLC cell lines, emodin alone or combined with cisplatin significantly decreased expression of ERCC1 mRNA levels, may lead to novel therapy in the future for NSCLC. Other in study of the same also support the effects of emodin  suppressed by emodin to induce cytotoxicity in NSCLC cells by activation of the MKK1/2-ERK1/2 pathway.
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The Side effects
1. Cascara Sagrada can be liver toxic.
2. It may cause Postal hypertension
Cascara sagrada (CS) has been associated with the development of cholestatic hepatitis, complicated by portal hypertension.
3. Fresh cut, dried bark may cause vomiting and diarrhea.
4. It may allergic effect.
5. Etc.

References
1. Emodin enhances cisplatin-induced cytotoxicity via down-regulation of ERCC1 and inactivation of ERK1/2 by Ko JC, Su YJ, Lin ST, Jhan JY, Ciou SC, Cheng CM, Chiu YF, Kuo YH, Tsai MS, Lin YW.(PubMed)
2. Suppression of ERCC1 and Rad51 expression through ERK1/2 inactivation is essential in emodin-mediated cytotoxicity in human non-small cell lung cancer cells by Ko JC, Su YJ, Lin ST, Jhan JY, Ciou SC, Cheng CM, Lin YW.(PubMed)
3. [Toxic hepatitis following consumption of the herbal medicinal product Cascara Sagrada].[Article in Danish]" by Jacobsen C, Semb S, Kromann-Andersen H(PubMed)
4. "Cascara sagrada-induced intrahepatic cholestasis causing portal hypertension: case report and review of herbal hepatotoxicity" by Nadir A, Reddy D, Van Thiel DH.(PubMed)
5. "Occupational respiratory allergic disease induced by Passiflora alata and Rhamnus purshiana" by Giavina-Bianchi PF Jr, Castro FF, Machado ML, Duarte AJ.(PubMed)