Portulaca oleracea L. is a kind of natural medicine commonly used in Chinese medicine, considered to have the effect of clearing heat and poisoning. According to reports, the water-soluble polysaccharide POL-P3b extracted from Portulaca oleracea L. is evaluated with antioxidant and immune regulatory activity and can enhance immune function by removing free radicals accumulated by the body (Manzo, 1988). Tumor cells evade immune recognition and attack by modifying their surface antigens, changing the local microenvironment, and then suppressing the function of immune cells (Rabinovich et al., 2007). Zhao et al. (2019) discovered that the intestinal DCs carrying the U14 mouse and intestinal DCs will have increased apoptosis, and Pol-P3b can effectively protect the intestinal DCs from apoptosis. The protection method of Pol-P3b anti-cervical cancer has dosage dependence. The specific mechanism is related to the stimulation of TLR4/PI3K/AKT-NF-κB signal pathway stimulation to the protection of the apoptosis of intestinal DCs. Another polysaccharide, PSP, composed of glucose and galactose, is also found in gynecological cancer treatment. YouGuo et al. (2009) have confirmed that PSP has a strong oxidation damage protection effect, can inhibit H₂O₂ -induced red blood cell hemolysis phenomenon, protect red blood cell function, and enhance thymic cell proliferation in concentration dependence.

Solanum nigrum L. has been clinically applied for several centuries. It has previously been proven to have extensive biological activity and has the unique effects of antitumor, anti-inflammatory, and diuretic (Jain et al., 2011). To evaluate the antitumor effect of Solanum nigrum L. polysaccharides, Li et al. (2007), Li et al. (2010a) separated the crude polysaccharides from the Solanum nigrum L. The study found that SNL-P had a significant growth inhibitory effect on the U14 cells. Over the years, eliminating cancer cells around apoptosis and effectively eliminating cancer cells has always been an essential window for clinical cancer treatment (Carneiro and El-Deiry, 2020). Wong (2011) found that SNL-P could reduce the serum TNF-α level in U14 cervical cancer tumor-bearing mice. Many tumor cells in the SNL-P intervention group showed different degrees of nuclear chromatin clumping and cell contour convolution, which indicated that the tumor cells had undergone apoptosis. At the same time, the study also found that apoptosis is closely related to the expression of SNL-P participation, raising the Bax gene and lowering the Bcl-2 gene and mutation P53 gene expression. In addition, in vivo experiments showed that SNL-P had no obvious pathological effects on the kidney and liver, and was a safe and effective natural adjuvant for the treatment of cervical cancer.

Patricia heterophylla Bunge (PHB) is a valuable and popular natural drug. PHB-P1 is a kind of natural polysaccharide extracted from the lost sauce, and Lu et al. (2010) reported that PHB-P1 has a good body anti-cervical cancer effect. Through the weight of a mouse tumor body that was treated with different concentrations of PHB-P1, the author observed that as the PHB-P1 treatment concentration increased, the number of apoptosis cervical cancer cells in mice increased significantly. At the same time, more cells remained in the G2/M phase, and the proportion of cells in the S phase decreased, which has been proven to be closely related to the expression of BCL-2 in tumor tissue and improving the level of serum alkaline phosphatase (Lu et al., 2009). Many studies have shown that serum lactate dehydrogenase participates in the growth of tumors in tumors (Kviecinski et al., 2008). It is worth noting that PHB-P1 can reduce serum lactic acid dehydrogenase activity, indicating that the anti-cervical cancer mechanism may be more complicated and still needs to be explored in the future.

ACPS-1 is a new type of polysaccharide with a molecular weight of 11.2 KDa from Atractylodes lancea (Thunb.) DC., which contains (2→1)-linked-d-Fruf residues linear backbone structure. It has been proven to suppress the proliferation of HeLa cells in vitro. ACPS-1 can significantly block the cell cycle while promoting the apoptosis of HeLa cells (Chow et al., 2003; Xu et al., 2016). The surprising discovery of this experiment was that the researchers found that ACPS-1 also had an inhibitory effect on SK-OV-3 cells, and the impact of promoting the apoptosis of tumors was very significant, indicating that ACPS-1 may be a potential candidate for various gynecological cancers treatment essence.

Lepidium Sativum L., also known as Garden Cress (GC), is a cross-flower plant native to West Asia and Egypt. It is not only used in cooking but also in traditional folk medicine worldwide. The plant chemical analysis of GC shows that it contains many natural ingredients such as flavonoids, alkaloids, phenols, and polysaccharides, which can be used as an anti-inflammatory analgesic, antitumor, and antioxidants (Painuli et al., 2022). Garden Cress polysaccharide (GCP) has the potential to inhibit the growth of HeLa cells in vitro. When the dosage of GCP is 500 μg/ml, GCP shows higher anti-tumor activity, and its potential anti-mutagenic effect is achieved by its antioxidant activity and then reducing the production of free radicals (Alkahtani et al., 2020). Unfortunately, in the published original research, the study of antitumor internal antitumor of GCP was ignored. Therefore, while having the potential to be a natural alternative to chemical anticancer drugs, it is worth emphasizing that the clinical study of GCP is still immature and great caution must be taken from the laboratory to any clinical application.

As a common natural polysaccharide, acanthopanax senticosus polysaccharides (ASPS) are a dietary supplement widely used to treat diseases such as tumors, diabetes, gout, and hepatitis, rarely reported adverse reactions after ASPS intake (Park et al., 2006; Chen et al., 2011; Fu et al., 2012). Tumor cells secrete immunosuppressive factors, induce immune disorders and immune effects cell abnormalities, and inhibit the host’s immune function in the micro-ring (Ahn et al., 2015). ASPS can improve the thymus and spleen index of U14 solid tumor mice, which is the standard solution in cancer therapy of immunity and reverse immune cell apoptosis (Meng et al., 2018). In addition, ASPS can also increase the contents of IL-2 and IL-12 in the mice group. As a multi-effect immune factor resisting cervical cancer, IL-2 is secreted by innate killing cells, macrophages, and auxiliary T lymphocytes (Valle-Mendiola et al., 2016). Macrophages and dendritic cells secrete IL-12, recognized as an antitumor and multi-functional cytokine that causes metastasis (Lasek et al., 1997). This study shows that ASPS is a potential biological reaction regulator for the clinical treatment of cervical cancer.

Angelica sinensis (Oliv.) Diels is an umbrella-shaped plant. It was an essential Chinese medicine for gynecological diseases as early as thousands of years ago. The polysaccharides in angelica are abundant, and they are considered the main contributor to the role of angelica. Studies have found that angelic pose polysaccharides can activate congenital and acquired immune systems, enhance the body’s immune function, and control tumor growth and metastasis (Kim et al., 2018). APS-1d is a new type of polysaccharide, that is, separated from Angelica sinensis (Oliv.) Diels that are separated from (1,4)-a-D-glucopyranosyl (Glip), which can inhibit the proliferation of cervical cancer cells in vitro concentration and dependence (Cao et al., 2010). Specifically, the antitumor effects involved in APS-1d are related to regulating the Bcl-2 family protein, increasing the cell soluble cell pigment c level, regulating mitochondria potential, and blocking the cell cycle. The researchers confirmed that the APS-1d had a good anti-cervical cancer effect in this study. The antitumor effect result was confirmed and established in HeLa cells’ internal and in vitro experiments.

Humans have used mushrooms as food and drugs for thousands of years. Natural biological active substances in mushrooms are a reliable nutrition and drug source that benefits human health (Wasser, 2002). It is estimated that the number of mushrooms on the Earth is more than 1,500, of which about 10% are well known (Panda et al., 2022), but less than 1% are used for drug use. Mushroom contains a large number of polysaccharides with antitumor and immune stimulus characteristics. It is a natural treasure trove developed by new antitumor new pharmaceutical products. In Asian countries such as China, South Korea, and Japan, more and more mushroom derivatives are reported to be applied to the clinic (Wasser, 2014).

Wild Russula griseocarnosa is an edible mushroom native to southeast China. Residents call it ‘Dahongjun,’ from which PRG is a kind of crude polysaccharide extracted. Yuan et al. (2017) reported the activity of HeLa and Siha cells in vitro-human cervical cancer cells. Unfortunately, the study did not clarify the detailed mechanism of the in vitro-body anti-human cervical cancer cells. With the deepening of research, Liu et al. (2018) isolated and purified PRG1-1 from crude polysaccharide of Wild Russula griseocarnosa, and reported the cytotoxic effect of PRG1-1 on the cytotoxicity of cervical cancer in vitro. The study found that PRG1-1 can reduce the vitality of HeLa cells and SiHa cells by increasing the content of lactate dehydrogenase and active oxygen and promoting its apoptosis. As an enzyme that repairs DNA, PARP is a crucial regulator for DNA damage reactions and maintaining replication stability binding to damaged DNA in DNA fracture sites (Kang et al., 2020; Slade, 2020). Studies have shown that PRG1-1 can improve the level of cracking PARP through dose dependence, thereby preventing tumor cell DNA repair and exacerbating cumulative damage. LEP1 is a natural polysaccharide extracted from the precious edible bacteria Lentinus edodes. It can inhibit the value-added of cervical cancer cells by increasing the Bax/Bcl-2 ratio and interference mitochular membrane potential (Ya, 2017). Among the mice carrying HeLa cells, LEP1 can induce apoptosis by cracking PARP in HeLa cells, basically the same as the anti-cervical cancer mechanism of PRG1-1.

Ganoderma lucidum is native to eastern Asia and is a well-known medicinal fungus. Today, researchers have separated and identified a variety of biologically active substances, such as polysaccharides, alkaloids (Xu et al., 2011), and gradually developed them for the clinical treatment of diseases. Ganoderma lucidum polysaccharide (GLP) is a natural product of Ganoderma lucidum and has been proven effective in various tumor treatments. Researchers such as Kong et al. (2019) compared the effects of GLP and enzymatic hydrolysis of Ganoderma lucidum polysaccharide (EGLP). They found that both polysaccharides can increase the expression of Bax and cleaved caspase-3, and reduce the expression of BCL-2 and Cox-2 to inhibit the growth of tumors. Compared with cyclopensions, GLP and EGLP can improve oxidation stimulation, protect immune organs, and have better antitumor and lower side effects. The thymus produces T cells to participate in the host’s adaptive immunity, and the spleen maintains immune stability. Both are essential immune organs of the body. It is worth noticing that EGLP can improve the spleen and thymus index of ruminoma mice, enhance the activity of antioxidant enzymes, and inhibit the progress of cervical cancer. In addition, EGLP has a better role in accelerating U14 cell apoptosis and inhibiting tumor growth than GLP, which shows that after enzymatic disintegration, GLP anti-cervical cancer has a more substantial effect. Another interesting study is that Zhu et al. (2019) combined cisplatin therapy for clinical cervical cancer, which results in show that GLP can reduce the nephrotoxicity and neurotoxicity of cisplatin and accelerate the apoptosis of tumor cells. Qiu et al. (2018a) confirmed that the folic acid conjugated-Auricularia auricular polysaccharide-cisplatin complex could better act on cervical cancer, reduce cisplatin damage to the kidneys, and provide new directions for the study of folic acid-targeted polysaccharides. These results can help us understand the mechanism of polysaccharide antitumor and their effects and accelerate the development of new cervical cancer treatment drugs.

Ocean fungi and bacteria have formed unique metabolites in adapting to the adaptation of marine salinity, temperature, and pressure. Recently many natural metabolites separated from marine fungi and bacteria have shown antitumor, antiviral, and immune regulatory activity in in vitro experiments (Mayer and Gustafson, 2006; Lee et al., 2013). HPA is an extracellular polysaccharide extracted from the marine fungus Hansfordia sinuosae. Gao et al. (2018) used HeLa and MCF-7 cells to prove that HPA uses cytotoxicity in dose dependence. The fluorescence test shows that tumor cells after HPA treatment have cell contraction and fracture, showing typical cell forms. Studies have shown that HPA induces the apoptosis of cervical cancer cells by increasing caspase-3 expression in HeLa cells to reduce mitochondrial membrane potential. Extracellular polymeric substances (EPS) is an extracellular polysaccharide separated from the thraustochytrium Striatum. The experiments by Xiao et al. (2018) showed that EPS could produce strong cytotoxic effects on HeLa cells, relieve oxidative stress and reduce the inflammatory response, and is a promising bioactive compound for the treatment of cervical cancer. Although the experimental results of marine microorganisms showed that HPA and EPS had the potential anti-cervical cancer significance, it should be emphasized that the lack of in vivo experiments makes their safety not well poorly evaluated. Their antitumor mechanisms still need to be further studied in detail, and any extrapolation to the clinical application must be cautious.

In the past 10 years, people have maintained a great interest in the research on the antitumor of seaweed. In Asian countries, seaweed has been considered an essential food and drug source (Yang et al., 2010). The content of polysaccharides in seaweed is wealthy, accounting for about 50% of the dry weight, which is the storage library of natural polysaccharides (Jiao et al., 2011). LJSP is the first time that Zhai et al. (2014) isolated a sulfated polysaccharide from Laminaria japonica, an edible brown seaweed, which was confirmed to have anti-cervical cancer effects in vitro and in vivo . The internal results show that LJSP has almost no liver and kidney toxicity. It can induce the apoptosis of transplantation tumor tissue by increasing the BAX/BCL-2 to inhibit the growth of cervical cancer. LJSP improves the immune function of mice by enhancing the spleen and thymus index of the U14 cells. Ulvan is an acidized polysaccharide separated from the green seaweed Ulva Lactuca. Thanh et al. (2016) confirmed that has significant cytotoxicity to HeLa cells. Unfortunately, although the researchers have verified Ulvan’s antitumor results, the original research does not provide complete details of the Ulvan anti-cervicalvical cancer mechanism, which makes its clinical application prospects unclear.

Pyracantha fortuneana (Maxim.) Li, a plant species of Maloideae, is widely used in the biomedical field and has been used as an excellent TCM for the treatment of abdominal distension (Peng et al., 2016). Pyracantha fortune can play antioxidant and immune protection in animal experiments (Yuan et al., 2015). Yuan et al. (2015) used response surface methodology to prove the antitumor effect of polysaccharides from Pyracantha fortune (PSPF).In this study, researchers used a fluorescent probe DCFH-DA to detect the ROS levels in SK-OV-3 cells, they found that the fluorescence intensity of DCF in the PSPF treatment group was significantly higher than that in the control group, suggesting that PSPF can induce the increased of ROS levels in SK-OV-3 cells, leading to mitochondrial destruction and DNA damage. And then play a cytotoxic effect. In terms of cell morphology, the shape of the SK-OV-3 cells in the treatment group is transformed from the previous slender spindle-shaped body to a circular shape after 200 μg/ml PSPF treatment, which also indicates that PSPF promotes the apoptosis of tumor cells. Another new type of selenium-rich polysaccharide, Se-PFPs, discovered in recent years from Pyracantha fortune, has also been confirmed to suppress the β-catenin signal pathway and epithelial-mesenchymal transition through in vitro and in vivo experiments (Liu et al., 2014; Sun et al., 2016). Therefore, PSPF and Se-PFPs can be used as functional dietary additives to become clinical treatment agents for ovarian cancer patients (Sanmartin et al., 2012).

Astragalus polysaccharide (APS) is a naturally new type of antitumor polysaccharide. Previous studies have confirmed that it can induce the apoptosis of nasopharyngeal carcinoma cells and osteosarcoma cells (Zhou et al., 2017; Chu et al., 2018) and shows the role of inhibiting tumor growth in an animal experiment (Zhou et al., 2018). Guo et al. (2020) reported the part and mechanism of APS inhibiting ovarian cancer cell growth. Microarray assay. It was found that APS could reduce the proliferation of ovarian cancer cells and induce them to apoptosis. The specific mechanism of invasion and migration is achieved by reducing the expression of the MIR-27A and raising the tumor inhibitory gene FBXW7. The BAX and BCL-2 genes are currently crucial in controlling apoptosis in the BCL-2 family (Garrido et al., 2006). While Li et al. (2018b) found that ASP weakened the survival of SK-OV-3 cells, it can increase the expression of BAX and caspase-3 and activate the JNK1/2 signaling pathway by lowering the expression of BCL2, thereby increasing the sensitivity of ovarian cancer to cisplatin treatment. Therefore, APS has the potential to develop a new sensitive agent for ovarian cancer.

MDP-A1 and MDP-A2 are two kinds of natural polysaccharides extracted from the rhizomes of Menispermumum dauricum. Unlike previously studied antitumor polysaccharides, MDP-A1 and MDP-A2 are acidic, filling the blank of natural acidic polysaccharides in ovarian cancer research. Lin et al. (2013) discovered that MDP-A1 and MDP-A2 can not only significantly inhibit the proliferation of SK-OV-3 cells in vitro, but the effect of antitumor is also confirmed in the BALB/c nude body of the injection of SK-OV-3 cells. MDP-A1 and MDP-A2 can reduce the expression of caspase-3 and caspase-8 and induce the apoptosis of ovarian cancer cells. Interestingly, MDP-A1 and MDP-A2 have the same sugar composition both of which are composed of glucose, mannose, galactose, arabic sugar, glucosol acid, and lactic acid. There are certain differences in molar ratio, and such a slight gap also makes the two slightly different in anti-tumor activity. MDP-A2 shows a better antitumor effect than MDP-A1, but the detailed mechanism of the difference in effects does not explicitly clarify and still needs to be discussed.

Polygala tenuifolia polysaccharide (PTP) is a novel natural water-soluble natural polysaccharide separated from Chinese medicine Polygala tenuifolia L., which has been reported to suppress the growth of ovarian cancer in vitro and body effectively. Yao et al. (2018) tested different doses of PTP’s ovarian tumor volume changes in BALB/c nude mice. The results showed that the tumor volume of the mouse model was dropped from 868.78 mm³ of the unbearable group to 40 mg/kg of the dose of 40 mg/kg. At the time of 214.45 mm³, this inhibitory phenomenon is concentrated dependence (Xin et al., 2012). The study also confirmed that PTP was to lower the vascular endothelial growth factor (VEGF), the epidermal growth factor receptor (EGFR), and the protein and mRNA levels of CD34, inhibiting the formation of tumor new vascular formation. In addition, studies have found that PTP can interfere with the NF-κB pathway in SK-OV-3 cells and reduce Bmi-1 and telomerase activity (Zhang et al., 2015a; Zhang et al., 2015b). These studies show that PTP’s mechanism for inhibiting ovarian cancer is complicated and has massive potential in regulating immunity and controlling inflammation reactions.

BPP is a kind of natural polysaccharide obtained from Balanophora polyandra Griff. Qu et al. (2020) discovered BPP to inhibit the proliferation of ovarian cancer cells in time and dose-dependent ways. This mechanism is related to the induction of cycle arrest in A2780 and OVSAHO cells by reducing the expression of cyclin-dependent kinase 2 (CDK2). P53, as a carcinogenic suppression gene to control the integrity of the genome, plays a vital role in cell damage repair (Goodheart et al., 2005). In this study, the researchers also found that the BPP could inhibit the proliferation of ovarian cancer by affecting the P53 signaling pathway. The manuscript does not detail the relationship between the BPP and the P53 signaling pathway. However, this study still shows that BPP can be a potential therapeutic agent for ovarian cancer therapy.

Ocimum Basilicum L. is native to Southeast Asia and parts of the Americas. It has good antitumor, antioxidant, immune regulation, blood sugar, and antibacterial effects (Uma Devi, 2001). BPS is a naturally active polysaccharide extracted from Lawler. Studies have found that it has an excellent dynamic cancer effect. Lv et al. (2013) treated SK-OV-3 cells and DCS with 100 μg/ml BPS and found that BPS can reduce the invasion of SK-OV-3 cells and the MMP-9 expression of mRNA and protein in SK-OV-3 cells. This study supports BPS as an effective supplementary therapy for ovarian cancer.

Agaricus blazei Murill is a type of Basidiomycete fungus. The β-glucan separated from the water-soluble part of its extract is a potential antitumor polysaccharide. Kobayashi et al. (2005) through internal and in vitro experiments found that β-glucan can enhance P38 MAPK activity, stimulate the optimal protein BAX to mitochondria, and then activate caspase-9 to inhibit HRA cell proliferation. The study found that in the disseminated metastatic model of nude mice ovarian cancer, a certain amount of tumor load related to the naked ovarian cancer peritoneal metastasis protected by a certain amount of β-glucan is significantly reduced daily. Interestingly, the inhibitory of β-glucan in the tumor is divided. This experiment shows that in vitro experiments, β-glucan does not have inhibitory effects on Lewis lung cancer 3LL cells. Maity et al. (2019) separated a water-insoluble β-glucan from the edible bacteria Pleurotus djamorjammer. After research, when the β-glucan concentration reaches 250 μg/ml, almost all ovarian cancer PA1 cells are destroyed, revealing its significant anti-resistance cancer effect. In addition, the natural polysaccharides in Ganoderma lucidum can also be confirmed that they can regulate the growth of OVCAR-3 cell lines and destroy the cycle process of the cell by lowering cyclin D1 (Hsieh and Wu, 2011). Overall, β-glucans isolated from different fungi have potential anticancer effects, and such polysaccharides may be more beneficial in the clinic for ovarian cancer patients with metastasis or at risk of metastasis.

Bangia fuscopurpurea polysaccharides are natural polysaccharides separated from Bangia fuscopurpurea (BFP). Wu et al. (2021) proved that the A2780 cells processed by BFP showed a dose-dependent increase in LC3 levels. At the same time, the essential protein BeClin-1 expression of the autophagy body is increased, which indicates that the accumulation of autophagosome formation increased after BFP intervention, while the number of autophagosomes did not change in untreated A2780 cells. Hseu et al. (2019), Feng et al. (2020) researchers found that the accumulation of ROS in cells can induce cells to develop in the direction of apoptosis. When using ROS inhibitors NAC and different concentrations of BFP processing A2780 cells, the formation of ROS can decrease as the BFP concentration increases, and there are calculated changes in the apoptosis rate, which indicates that the BFP can promote ROS accumulation, and then induces the apoptosis of A2780 cells. In addition, the study also found that BFP activated the mitochondrial apoptosis pathway in A2780 cells, induced the decrease of mitochondrial membrane potential in A2780 cells, and then led to the activation of caspase-9 and the release of cytochrome C (Yu et al., 2020). Another polysaccharide, Fucoidan, separated from Brown Algae, has been confirmed by researchers it also has an anti-OC role. Its mechanism to inhibit the proliferation of ES2 and OV90 cells is related to regulating ER stress and calcium level (Bae et al., 2020).

Marine microalgal exopolysaccharide (EPS) is a polysaccharide from marine microalgae Thraustochytriidae sp. It is reported that it has excellent potential in antioxidant, anti-proliferation, antiviral, and immune regulation and has attracted the attention of scientists (Xiao and Zheng, 2016). To study and verify the potential antitumor cell proliferation and immune regulation of EPS on OC, Park et al. (2017) performed in vitro experiments on BG-1 cells. They found that EPS can inhibit the protein expression of CyClin D1 and CyClin E-related genes related to cell cycles, thereby promoting the apoptosis of ovarian cancer cells. Specifically, the reduction of cyclin D1 and cyclin E directly interrupted the cell cycle process and cell division of OC cells, which prevented the transition from phase G1 to S (Baldin et al., 1993; Donnellan and Chetty, 1999). In addition, in terms of the immune response, research also revealed that this process is related to EPS increasing B cell proliferation and antibody production. These results show that marine algae have the potential for experiments, indicating that Marine algae have the potential to be developed as a functional food for ovarian cancer therapy.

CFPS-2, a polysaccharide extracted from a freshwater clam, Corbicula fluminea, can regulate the function of immune cells and lower cholesterol. Corbicula fluminea has been a dual-use medicinal herb since ancient times. It is a TCM against various diseases. In terms of tumor cell formation and malignant transformation, Devi et al. (2000) reported that free radical generation could accelerate oxidation stress damage, causing lipid peroxidation and mutations in DNA (Zhou et al., 2004). Liao et al. (2013) found that CFPS-2 could significantly inhibit the growth of SK-OV-3 cells and A2780 cells in vitro. Hydroxyl radicals and superoxide radicals contained in CFPS-2 are natural antioxidants. Their anti-ovarian cancer effect is related to the high content of sulfate radicals in CFPS-2 in the structure, limiting the damage caused by reactive oxygen species. It should be noted that animal polysaccharides are more likely to cause allergic reactions, which makes us need to be cautious when using animal polysaccharides, especially in certain conditions and particular populations (Lei and Grammer, 2019).