Angelicae Sinensis
Also known as: Dong quai, Chinese angelica, Dang-qui, Angelica sinensis (Oliv.) Diels, Angelica sinensis
Overview
Angelica sinensis, commonly known as Dong quai or Chinese angelica, is a perennial herb native to China and a cornerstone of Traditional Chinese Medicine (TCM). It is primarily utilized for its purported benefits in women's health, blood circulation, and as a general tonic. The herb contains several bioactive compounds, notably Z-ligustilide and N-Butylidenephthalide, which contribute to its therapeutic effects. Recent research has expanded its potential applications to include anti-cancer properties and as an adjunctive treatment for chronic conditions such as idiopathic pulmonary fibrosis (IPF). The scientific understanding of Angelica sinensis is evolving, with an increasing number of randomized controlled trials and meta-analyses providing evidence for its efficacy and safety, particularly in oncology and pulmonary health.
Benefits
Angelica sinensis offers several evidence-based benefits, particularly as an adjunctive therapy. It demonstrates anti-cancer effects, with constituents like Z-ligustilide sensitizing tamoxifen-resistant breast cancer cells to apoptosis and acting as epigenetic modulators in vitro. Clinical data suggests it does not increase breast cancer risk and may offer positive effects when combined with conventional treatments. For Idiopathic Pulmonary Fibrosis (IPF), a systematic review and meta-analysis of 17 RCTs found that Radix Angelicae Sinensis, when combined with Radix Astragali, significantly improved pulmonary function, exercise tolerance (measured by six-minute walk distance), and reduced adverse reactions compared to controls, indicating both efficacy and safety. Furthermore, Angelica sinensis-containing TCM compounds are being investigated in systematic reviews for their potential to improve quality of life, immune function, and reduce recurrence rates when combined with chemotherapy for endometrial cancer, highlighting its role in supportive cancer care.
How it works
Angelica sinensis exerts its therapeutic effects through a multi-component, multi-target mechanism. Its anti-tumor actions involve inducing apoptosis, epigenetic modulation, and enhancing the sensitivity of cancer cells to chemotherapy. Network pharmacology analyses have identified numerous molecular targets and pathways, including those critical for cancer progression and microRNA regulation. The herb's compounds, such as Z-ligustilide, are absorbed and interact with cellular processes, leading to effects like caspase-mediated apoptosis in cancer cells. Additionally, Angelica sinensis possesses immune-modulating and anti-inflammatory properties, which contribute to its beneficial outcomes in fibrotic diseases like IPF and its potential role in mitigating inflammation associated with various conditions.
Side effects
Angelica sinensis is generally considered safe when used within traditional dosage guidelines. Clinical trials, particularly in IPF patients, have reported fewer adverse reactions in treatment groups compared to controls. Mild gastrointestinal symptoms and allergic reactions are possible but uncommon. A significant consideration is its potential estrogenic activity; however, recent evidence suggests it does not increase breast cancer risk or interfere with tamoxifen therapy, alleviating some prior concerns. Despite this, individuals with hormone-sensitive conditions should exercise caution and consult a healthcare provider. Angelica sinensis is generally contraindicated during pregnancy due to potential uterotonic effects. While long-term safety data are somewhat limited, no major safety concerns have been reported in clinical trials lasting several months. Breast cancer patients should always consult their healthcare providers before use, though current evidence does not contraindicate its use.
Dosage
The optimal dosage of Angelica sinensis is not definitively established due to variations in formulations and indications. Traditional formulations vary widely, and clinical trials often utilize standardized extracts within multi-herb TCM compounds. For specific conditions like Idiopathic Pulmonary Fibrosis (IPF), dosages should align with those proven effective in clinical trials, typically as part of a combined herbal formula. Angelica sinensis is commonly administered orally. The timing of administration, especially in conjunction with conventional treatments like chemotherapy, may be important but requires further research to optimize. The bioavailability of active compounds, such as Z-ligustilide, can be influenced by the specific formulation and the presence of other herbs in a compound, which can affect its absorption and overall efficacy.
FAQs
Does Angelica sinensis increase breast cancer risk?
Current systematic reviews and clinical data suggest Angelica sinensis does not increase breast cancer risk. Some studies even indicate potential benefits or neutral effects in breast cancer patients, particularly in sensitizing resistant cells.
Can it be used with chemotherapy?
Evidence supports its use as an adjunct to chemotherapy. It may improve quality of life and treatment efficacy in cancers like endometrial carcinoma and potentially breast cancer, but always consult your oncologist.
How soon do benefits appear?
Clinical improvements, such as enhanced pulmonary function and symptom relief in IPF, have been observed within weeks to months in randomized controlled trials, though individual responses may vary.
Is it safe long-term?
Long-term safety data are limited, but clinical trials lasting several months have not reported major safety concerns. Continuous use should be discussed with a healthcare professional.
Research Sources
- https://www.xiahepublishing.com/2835-6357/FIM-2023-00002 – This systematic review and meta-analysis of 17 RCTs found that Radix Angelicae Sinensis combined with Radix Astragali significantly improved pulmonary function, exercise tolerance, and reduced adverse reactions in patients with idiopathic pulmonary fibrosis (IPF) compared to controls. The study suggests efficacy and safety for this herbal combination in IPF treatment, despite some heterogeneity in herbal formulations and moderate risk of bias in a few included RCTs.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12103411/ – This systematic review protocol outlines the methodology for evaluating the efficacy of Angelica sinensis-containing Traditional Chinese Medicine (TCM) compounds combined with chemotherapy for endometrial carcinoma. It aims to assess outcomes such as quality of life, immune function, pain, and recurrence rates, highlighting growing interest in Angelica sinensis as an adjunct in cancer treatment, with results pending.
- https://pubmed.ncbi.nlm.nih.gov/32425767/ – This systematic review and in vitro study investigated Angelica sinensis's role in breast cancer. It concluded that Angelica sinensis does not increase breast cancer risk and may even sensitize tamoxifen-resistant breast cancer cells to apoptosis. The review also reported positive clinical effects, though it noted that most anti-cancer mechanistic studies are in vitro and clinical data is still somewhat limited.
- https://journals.sagepub.com/doi/10.1177/1934578X241309226 – This network pharmacology and literature review explored the multi-target anti-tumor mechanisms of Angelica sinensis across various cancer types. It identified 53 potential molecular targets and 88 related pathways, including cancer-related signaling and microRNA regulation, suggesting that active compounds modulate cancer pathways. The study provides a comprehensive preclinical understanding but emphasizes the need for clinical validation.