Andrographis paniculata nanosized and applied externally for the treatment of tumor rupture

Patients with malignant tumors often have ulcerated pus and broken skin, which not only increase the pain of patients, but also increase the difficulty of treatment. Tumor rupture is also one of the complications of malignant tumors, especially common in the late stage, and it can be one of the causes of tumor rupture after a long-term treatment process down the road. The reason of tumor rupture is due to the rapid growth of malignant tumors, and because the immune system of tumor patients is mostly suppressed, coupled with the application of chemotherapy, radiotherapy, laser, cryotherapy and other methods, which makes the tumor locally necrotic and infected, and leads to the appearance of rupture, ulcerated pus, with a great malodorous smell. For example, malignant tumors in nasopharynx, oral cavity, rectum, vagina, penis, skin and other parts of the body are susceptible to various kinds of stray bacteria and microorganisms because of their necrotic tissues are connected with the outside world. These microorganisms multiply and decompose necrotic tissues, and then a large amount of gases with a putrid smell will be produced. Tumors with rich blood vessels will lead to tumor rupture and bleeding. The treatment and care of ruptured surfaces of tumors has become a thorny clinical problem, and there is a lack of effective therapeutic means. In recent years, the incidence of malignant tumors has increased to varying degrees, and tumor rupture wounds are not uncommon in the clinic. Such wounds are difficult to treat, mainly because of the involvement of tumor, infection, poor blood supply, fibroblast proliferation and many other factors, which make the wound difficult to heal. Treatment cannot be solved simply by radiotherapy, chemotherapy and surgery, but local control and care also play a decisive role. Domestic literature reports that local application of glycopyrrolate mustard, urea and other treatments have general efficacy and obvious toxic effects. In recent years, there are very few reports on the treatment of tumor broken wounds, so it is necessary to find new efficient and low-toxicity therapeutic methods. Xionghuang is a traditional Chinese medicine with a long history of application, and as a kind of arsenic agent, its main component is As2S2 or As4S4 with a small amount of As2O3 and other heavy metal salts. Chinese medicine believes that Xionghuang is pungent, warm and poisonous, belongs to the heart, liver and stomach meridians, has the effect of detoxifying and killing insects, drying dampness and expelling phlegm, resolving blood stasis and eliminating stagnation, etc. Over the past thousands of years, it has been used as a component in a drug or a prescription for the treatment of a variety of diseases. Modern medical research shows that andrographis has anti-tumor effects. Many scholars in China have used the compound preparation containing andrographis or single andrographis for the treatment of hematologic tumors and some solid tumors, especially in the treatment of intractable or recurrent acute promyelocytic leukemia and chronic myelogenous leukemia, which have achieved promising results. Domestically and externally, As2O3 injection is mainly applied to treat acute promyelocytic leukemia; however, there are already many scholars who are expanding the test for malignant hematological diseases such as malignant lymphoma, myelodysplastic syndromes (MDS), multiple myeloma and other malignant hematological diseases, as well as solid tumors such as hepatocellular carcinoma, skin cancer, etc., which shows an attractive application prospect. The toxic side effects of andrographis used in the treatment of tumors are much smaller than those of As2O3. Clinically, andrographis has been used to treat many cases, such as eczema, scabies, dengue, impetigo, viral skin infections, carbuncle boils and gangrene, etc., but it has not been seen to be used in the treatment of tumor-broken wounds. At present, there are more and more literatures about the clinical application and mechanism of action of anti-tumor effect of andrographis, especially in recent years, nanotechnology has been gradually applied to the field of medicine, giving birth to the new concept of nano-medicine, which opens up a new way for modernization of traditional Chinese medicine. Studies have shown that the nanosizing of traditional Chinese medicines has greatly improved their efficacy and greatly reduced the equivalent dose, showing full superiority in anti-tumor studies. The pharmacological effects of drugs are not only attributed to the unique chemical composition of the drug, but also closely related to its physical state. It has been shown that altering the physical state of a drug so that the particle size of the drug reaches the nanometer scale, due to the quantum size effect and the surface effect, the nanodrugs present novel physical, chemical and biological properties, which may lead to changes in the absorption, distribution and metabolism of the drug in biological organisms, i.e., the pharmacokinetic process. Several studies have concluded that the altered particle size of nanoandrography can indeed lead to changes in pharmacokinetic parameters, and these changes, which are significantly better than those of common andrography, are the basis for nanoandrography to become a highly efficient, low-toxic, and high-quality pharmaceutical agent. Nano Andrographis presents more efficient and low toxicity anti-tumor effects than common Andrographis due to its particle size effect and targeting. Modern research has shown that its anti-tumor mechanism is similar to that of common andrographis, which is achieved by inducing apoptosis of tumor cells, inhibiting proliferation of tumor cells, promoting differentiation of tumor cells and anti-tumor angiogenesis. There are various preparation methods to obtain nano andrographis, such as high-energy ball mill grinding method, air flow pulverization method, micro-jet method, solvent grafting method, chemical precipitation method, and thin film dispersion-high pressure homogenization method. The topical application of nanoandrographis for the treatment of malignant tumor ulcerated wounds fills the gap of the treatment method in this field, which is close to the clinic, simple and easy to implement, has broad application prospects, has important practical value and social significance, and provides a new method for the treatment of malignant tumors.