Chinese medicine monomers for hepatocellular carcinoma: New ideas related to autophagy

Hepatocellular carcinoma (HCC) represents the most prevalent form of primary liver cancer, characterized by high mortality rates, frequent recurrence and metastasis, poor clinical prognosis, and a complex pathogenesis with limited therapeutic options. Autophagy plays a pivotal role in the immune response and functions as a lysosome-mediated degradation mechanism essential for recycling cellular components and eliminating aggregated proteins, damaged organelles, and invasive pathogens, thereby maintaining cellular function and dynamic homeostasis. Additionally, autophagy regulates several critical proteins and signaling pathways, including mammalian target of the rapamycin (mTOR), Beclin-1, the phosphatidylinositol 3-kinase/protein kinase B/mTOR signaling pathway, the Hippo/yes-associated protein signaling pathway, and the Janus kinase/signal transducer of activation signaling pathway. This regulatory capacity of autophagy can potentially prevent or delay the progression of HCC. Nowadays, many studies have shown that different types of herbal monomers such as the more common quercetin, baicalein, berberine and emodin can further regulate autophagy and exert preventive and therapeutic effects on HCC through the modulation of mTOR and other related signaling pathways and so on. In this paper, we examine the mechanisms of autophagy, key proteins and signaling pathways involved, and the modulation of autophagy by Chinese medicine monomers in the prevention and treatment of HCC. This review aims to provide valuable insights for the development of Chinese medicine strategies against HCC and to inform the rational use of these therapies in clinical practice.