The Science Behind Elian Granules
A traditional Chinese medicine formula is gaining scientific validation for its ability to reverse precancerous stomach conditions.
Explore the ScienceFor millions suffering from chronic stomach inflammation that can progress to cancer, medical options have been limited. But emerging research on Elian Granules (ELG), a Traditional Chinese Medicine formula, demonstrates remarkable potential to not just manage symptoms but actually reverse the pathological changes of chronic atrophic gastritis with intestinal metaplasia—a known precursor to gastric cancer.
This article explores the fascinating science behind how this multi-herb formulation works at the molecular level to restore stomach health.
Gastric cancer doesn't suddenly appear—it follows a predictable stepwise progression known as Correa's cascade.
Healthy stomach lining with normal glandular structure and function.
Inflammation limited to the surface layer of the stomach lining.
Critical turning point where stomach's glandular structures begin to disappear.
Gastric cells are replaced by intestinal-type cells.
Abnormal cell growth with potential to become cancerous.
Malignant tumor formation in the stomach lining.
Chronic atrophic gastritis (CAG) represents a critical turning point where the stomach's glandular structures begin to disappear, potentially replaced by intestinal-type cells (intestinal metaplasia). This condition is classified as a precancerous lesion, with studies showing patients with concurrent intestinal metaplasia and dysplasia demonstrate a 6% incidence of gastric cancer1 .
The alarming statistics highlight why CAG management is crucial—global cancer data reveals gastric cancer ranks as the third most prevalent cancer worldwide, with particularly high incidence and mortality rates in China1 .
Elian Granules represent a formulation developed by Professor Gan Cai, a renowned TCM digestive specialist.
The formula comprises 12 traditional herbs that work synergistically to strengthen spleen function, activate blood circulation, clear heat-toxin, and eliminate dampness-phlegm1 .
| Latin Name | Chinese Name | Medicinal Part | Dosage (g) |
|---|---|---|---|
| Curcuma phaeocaulis Val. | Ezhu | Rhizoma | 15 |
| Coptis chinensis Franch. | Huanglian | Rhizoma | 3 |
| Salvia miltiorrhiza Bge. | Danshen | Radix et Rhizoma | 10 |
| Hedyotis diffusa Willd. | Baihuasheshecao | All | 30 |
| Angelica sinensis (Oliv.) Diels | Danggui | Radix | 10 |
| Codonopsis pilosula (Franch.) Nannf. | Dangshen | Radix | 10 |
| Glycyrrhiza uralensis Fisch. | Gancao | Radix et Rhizoma | 6 |
| Atractylodes macrocephala Koidz. | Baizhu | Rhizoma | 10 |
| Pinellia ternata (Thunb.) Breit. | Banxia | Rhizoma | 10 |
| Poria cocos (Schw.) Wolf | Fuling | Sclerotia | 12 |
| Taraxacum mongolicum Hand.-Mazz. | Pugongying | All | 30 |
| Citrus reticulata Blanco | Chenpi | Peel | 6 |
From Curcuma phaeocaulis
From Coptis chinensis
From Angelica sinensis
A recent multi-center, randomized, double-blind, placebo-controlled study evaluated Elian Granules in 240 CAG patients over 24 weeks.
| Outcome Measure | Elian Granules Group | Placebo Group | P-value |
|---|---|---|---|
| Improvement in Gastric Mucosal Atrophy | 76.29% | 48.96% | < 0.001 |
| Improvement in Intestinal Metaplasia | 62.89% | 34.38% | < 0.001 |
| Total Effective Rate for Symptom Relief | 85.57% | 47.92% | < 0.001 |
| Epigastric Pain Improvement (24 weeks) | Significant | Not Significant | < 0.05-0.001 |
| Quality of Life (Physical Health) | Significant Improvement | Minimal Change | < 0.05-0.01 |
| Quality of Life (Mental Health) | Significant Improvement | Minimal Change | < 0.05-0.01 |
The Elian Granule group showed significant improvement in multiple dyspepsia symptoms including epigastric pain, distension, discomfort, early satiety, heartburn, belching, and acid reflux. Importantly, the treatment demonstrated a favorable safety profile with no adverse impact observed through comprehensive monitoring including physical examinations, laboratory tests, and electrocardiograms1 .
How does this traditional formula actually reverse precancerous changes at the cellular level?
In the tumor microenvironment, tumor-associated macrophages (TAMs), particularly the M2-type, play a detrimental role by inhibiting anti-cancer immune responses and promoting tissue changes that accelerate cancer progression6 .
A 2023 animal study revealed that Elian Granules significantly decrease the percentage of M2-type TAMs in gastric antral tissue of rats with precancerous lesions6 8 .
The NF-κB signaling pathway is a critical regulator of inflammation and cell survival. Continuously abnormal upregulation of this pathway is common in precancerous gastric lesions6 .
Elian Granules effectively down-regulate the protein and mRNA expression of key NF-κB pathway components (p-p65, p65, and p-IκBα) while up-regulating IκBα expression6 8 .
| Research Tool | Specific Application | Function in ELG Research |
|---|---|---|
| UPLC-MS | Chemical ingredient analysis | Identified 5 bioactive components in ELG formulation |
| MNNG-induced PLGC rat model | Animal model development | Created precancerous lesions mimicking human disease progression |
| Immunofluorescence | Protein detection in tissue | Measured CD68/CD206 expression to identify M2-type macrophages |
| Western Blot | Protein expression analysis | Quantified NF-κB pathway proteins (p65, p-p65, IκBα, p-IκBα) |
| RT-qPCR | Gene expression analysis | Measured mRNA levels of pathway components in gastric tissue |
| HE Staining | Histopathological examination | Assessed gastric mucosal architecture and pathological changes |
Beyond laboratory experiments, computational approaches using GEO (Gene Expression Omnibus) datasets have provided additional insights into CAG mechanisms and potential therapeutic targets.
One bioinformatics study analyzed the GSE11632 dataset and identified 42 differentially expressed genes in CAG patients compared to healthy controls. Through protein-protein interaction network analysis, researchers pinpointed ATP4A, CFTR, and EPCAM as potential diagnostic biomarkers for CAG3 .
Additionally, artificial intelligence-guided analysis of gastric cancer continuum using Boolean implication networks has helped map the progression from healthy mucosa to gastric cancer, identifying key gene clusters and pathways involved in this transition9 .
The research on Elian Granules represents a fascinating convergence of traditional medicine and modern scientific validation. By demonstrating both clinical efficacy and mechanistic plausibility, this research provides a template for how traditional formulations can be systematically evaluated using contemporary scientific methods.
As Professor Gan Cai's academic legacy continues through rigorous clinical and experimental studies, Elian Granules offer hope for patients with precancerous gastric conditions—not merely for symptom management but for potentially reversing the pathological progression toward gastric cancer.
The integration of sophisticated methodologies—from randomized controlled trials to molecular pathway analysis and bioinformatics—creates a compelling evidence base that bridges the gap between traditional wisdom and modern scientific validation.