We determined the therapeutic efficacy of
atractylenolide I (ATR), extracted from largehead atractylodes rhizome, in managing
gastric cancer cachexia (GCC), and interpreted its probable pharmacological mechanism via investigating
tumor necrosis factor alpha (
TNF-alpha),
interleukin-1 (IL-1),
interleukin-6 (IL-6) and proteolysis-inducing factor (PIF). This was a randomized but not-blinded pilot. The study group (n = 11) received 1.32 g per day of
atractylenolide I (ATR) and the control group (n = 11) received 3.6 g per day of
fish-oil-enriched nutritional supplementation (FOE) for 7 weeks.
Conservative therapy was similar in both groups. Clinical [appetite,
body weight, mid-arm muscle circumference (MAMC), Karnofsky performance status (KPS) status],
biomarker (
TNF-alpha, IL-1, IL-6 and PIF) were evaluated in the basal state, at the third and seventh weeks. To analyze changes of
cytokines, an immumohistochemistry technique was adopted. Base line characteristics were similar in both groups. Effects on MAMC and
body weight increase,
TNF-alpha increase and
IL-1 decreases of serum level were significant in both groups (P < 0.05). ATR was significantly more effective than FOE in improving appetite and KPS status, and decreasing PIF positive rate (P < 0.05). Slight
nausea (3/11) and dry mouth (1/11) were shown in intervention groups but did not interrupt treatment. These preliminary findings suggest that ATR might be beneficial in alleviating symptoms, in modulating
cytokine and in inhibiting PIF proteolysis of
gastric cancer cachexia. Further research using a randomized controlled design is necessary to confirm these pilot study findings.