Chuanxiong preparations for preventing stroke

Ligusticum chuanxiong promotes the angiogenesis of preovulatory follicles (F1-F3) in late-phase laying hens

Ligusticum chuanxiong (CX) is a traditional Chinese medicine that is widely planted throughout the world. CX is one of the most important and commonly used drugs to enhance blood circulation. The preovulatory follicles in laying hens have a large number of blood arteries and meridians that feed the follicles' growth and maturation with nutrients, hormones, and cytokines. With the extension of laying time, preovulatory follicles angiogenesis decreased gradually. In this study, we studied the mechanism of CX on preovulatory follicles angiogenesis in late-phase laying hens. The results show that CX extract can increase the angiogenesis of preovulatory follicles (F1-F3) of late-phase laying hens. CX extract can promote vascular endothelial growth factor receptor 2 (VEGFR2) phosphorylation in preovulatory follicles theca layers, promote the proliferation, invasion and migration through PI3K/AKT and RAS/ERK signaling pathways in primary follicle microvascular endothelial-like cells (FMECs). In addition, CX extract can up-regulate the expression of hypoxia inducible factor α (HIF1α) in granulosa cells (GCs) and granulosa layers through PI3K/AKT and RAS/ERK signaling pathways, thereby promoting the secretion of vascular endothelial growth factor A (VEGFA). In conclusion, the current study confirmed the promoting effect of CX extract on the preovulatory follicles angiogenesis, which sets the stage for the design of functional animal feed for late-phase laying hens.

A systematic review and meta-analysis for the primary prevention of high risk of stroke by Nao-an capsules

BACKGROUND

To date, Nao-an capsules are the only Chinese patent medicine primarily prescribed for the primary prevention of stroke.

PURPOSE

To evaluate the efficacy and safety of Nao-an capsules in the primary prevention of stroke in high-risk patients.

STUDY DESIGN

A systematic review and meta-analysis of randomized controlled trials.

METHODS

We searched 7 electronic databases and 2 registries from inception to January 13, 2022 for relevant randomized controlled trials. Two independent investigators selected trials, collected data, and judged the risk of bias. We performed a meta-analysis using the Review Manager software.

RESULTS

Nine randomized controlled trials involving 14 744 patients at high risk of stroke were included. Nao-an capsules reduced the risk of first stroke compared with no intervention (risk ratio [RR] = 0.49, 95 % confidence interval [CI] 0.29 to 0.82, p = 0.006) or aspirin (RR_{50 mg qd} = 0.47, 95 % CI 0.25 to 0.91, p = 0.03; RR_{100 mg qd} = 0.46, 95 % CI 0.22 to 0.99, p = 0.05), without increased bleeding risks. The certainty of evidence was evaluated as moderate to very low.

CONCLUSION

In addition to controlling specific risk factors, Nao-an capsules might provide additional preventive effects on first stroke with an acceptable safety profile for populations at high risk of stroke. However, as current evidence is too weak, a firm recommendation depends on further confirmation from more studies with more rigorous methodology.

The Effectiveness of Intermittent Theta Burst Stimulation for Stroke Patients With Upper Limb Impairments: A Systematic Review and Meta-Analysis

Background

Upper limb impairments are one of the most common health problems of stroke, affecting both motor function and independence in daily life. It has been demonstrated that intermittent theta burst stimulation (iTBS) increases brain excitability and improves upper limb function. Our study sought to determine the role of iTBS in stroke recovery.

Objective

The purpose of this study was to determine the efficacy of iTBS in individuals with upper limb impairments following stroke.

Methods

The databases used included Cumulative Index to PubMed, EMBASE, ESCBOhost, The Cochrane Library, Chinese Biomedical Database, Web of Science, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Technology Periodical Database (VIP), and WanFang Database. Studies published before November 2021 were included. Each participant received an iTBS-based intervention aimed at improving activity levels or impairment, which was compared to usual care, a sham intervention, or another intervention. The primary outcome measure was a change in upper limb function assessment. Secondary outcomes included impairment, participation, and quality of life measures.

Result

A total of 18 studies (n = 401 participants) that met the inclusion criteria were included in this study. There was a slight change in the upper limb function of the iTBS group compared with the control group, as measured by the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score (mean difference 2.70, 95% CI −0.02 to 5.42, p = 0.05). Significant improvement in resting motor threshold (RMT) and motor-evoked potential (MEP) was also observed in the meta-analysis of iTBS (MD 3.46, 95% CI 2.63 to 4.28, p < 0.00001); (MD 1.34, 95% CI 1.17 to 1.51, P < 0.00001). In addition, we got similar results when the studies were using the Modified Barthel Index (MBI) assessment (mean difference of 7.34, 95% CI 0.47 to 14.21, p = 0.04).

Conclusion

Our study established the efficacy of iTBS in improving motor cortical plasticity, motor function, and daily functioning in stroke patients. However, the review requires evidence from additional randomized controlled trials and high-quality research.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/

Classical prescription Dachuanxiong Formula delays nitroglycerin-induced pain response in migraine mice through reducing endothelin-1 level and regulating fatty acid biosynthesis

ETHNOPHARMACOLOGICAL RELEVANCE

Dachuanxiong Formula (DCXF) is a classical Chinese medicine prescription and is composed of dried rhizomes from Ligusticum striatum DC. (Chuanxiong Rhizoma) and Gastrodia elata Bl. (Gastrodiae Rhizoma) at the ratio of 4:1 (w/w). It has been used as Chinese medicine prescription for thousands of years. DCXF is used traditionally to treat many diseases, including migraine, atherosclerosis and ischemic stroke.

AIM OF THE STUDY

This study aimed to investigate the effects of DCXF on pain response in migraine mice, and the underlying mechanisms using proteomics and bioinformatics analyses.

MATERIALS AND METHODS

DCXF extract was prepared by mixing Chuanxiong Rhizoma and Gastrodiae Rhizoma at a mass ratio of 4:1 (w/w). After extraction, the extract was filtered prior to high performance liquid chromatography (HPLC) analysis. Nitroglycerin (NTG) was used to establish a mouse migraine model, and a behaviour study was conducted by hot plate test. In addition, proteomics and bioinformatics studies were conducted to investigate the mechanisms of DCXF-mediating anti-migraine treatment.

RESULTS

Our results showed that there were significant differences in the latencies between NTG-treated and DCXF low dose- and high doses-treated groups at 30 min after NTG injection, this suggested that DCXF could ameliorate pain response in migraine mice. Besides, the plasma levels of endothelin-1 were also measured. NTG group significantly enhanced the endothelin-1 level compared to the control group. In contrast, DCXF low dose and high dose groups significantly reduced this level compared to NTG group. In addition, the underlying mechanisms were also investigated. Our results demonstrated that the anti-migraine treatment of DCXF was highly associated with fatty acid synthesis, suggesting that DCXF ameliorated pain response through reducing endothelin-1 level and regulating fatty acid synthesis.

CONCLUSIONS

The present study revealed the anti-migraine effect of DCXF in migraine mice and provided insights into the mechanisms of DCXF-mediating anti-migraine treatment.

Locally and traditionally used Ligusticum species - A review of their phytochemistry, pharmacology and pharmacokinetics

ETHNOPHARMACOLOGICAL RELEVANCE

Ligusticum species (Umbelliferae) have been widely used in traditional Chinese medicine, Korean folk medicine and Native American medicine for their medicinal and nutritional value. Decoctions of the rhizomes are used in treatment and prophylaxis of migraine, anemia and cardiovascular conditions including stroke.

AIM OF STUDY

This review is intended to fully compile the constituents of locally and traditionally used Ligusticum species, present their bioactivities and highlight potential leads for future drug design, and thus, provide a reference for further research and application of these species. Emphasis is also placed on current trends in the pharmacokinetic studies of the major constituents.

METHODS

The literature discussed is derived from readily accessible papers spanning the early 1990s to the end of 2015. Information was collected from journals, books and online searches (Google Scholar, PubMed, ScienceDirect, SciFinder, Springerlink and CNKI).

RESULTS

The major phytoconstituents, 154 of which are presented in this review, include alkaloids, phthalides and phenolic acids. The crude extracts and isolated constituents have exhibited a wide range of in vitro and in vivo pharmacologic effects, including cardioprotective, antioxidant, anti-inflammatory and neuroprotective activities. The bioactive alkaloid tetramethylpyrazine (TMP) has attracted the most attention for its potent effect on calcium channels, anti-platelet as well as anti-inflammatory effects. Pharmacokinetic studies of major constituents have also been summarized.

CONCLUSION

The pthalides, organic acids and alkaloids of Ligusticum species have emerged as a good source of traditional medicines for the management of cardio- and cerebrovascular conditions, inflammation and neurogenerative disorders. The species discussed in this review have demonstrated wide pharmacological actions and have great potential to yield multipotent drugs if challenges such as poor bioavailability, solubility and toxicological profiles are addressed. Apart from the rhizomes, pharmacological activities of other botanical parts also need to be studied further. Expansion of research to cover other species in the Ligusticum genus would provide more opportunities for the discovery of new bioactive principles.

Analysis of Chuanxiong Rhizoma and its active components by Fourier transform infrared spectroscopy combined with two-dimensional correlation infrared spectroscopy

As complicated mixture systems, active components of Chuanxiong Rhizoma are very difficult to identify and discriminate. In this paper, the macroscopic IR fingerprint method including Fourier transform infrared spectroscopy (FT-IR), the second derivative infrared spectroscopy (SD-IR) and two-dimensional correlation infrared spectroscopy (2DCOS-IR), was applied to study and identify Chuanxiong raw materials and its different segmented production of HPD-100 macroporous resin. Chuanxiong Rhizoma is rich in sucrose. In the FT-IR spectra, water eluate is more similar to sucrose than the powder and the decoction. Their second derivative spectra amplified the differences and revealed the potentially characteristic IR absorption bands and combined with the correlation coefficient, concluding that 50% ethanol eluate had more ligustilide than other eluates. Finally, it can be found from 2DCOS-IR spectra that proteins were extracted by ethanol from Chuanxiong decoction by HPD-100 macroporous resin. It was demonstrated that the above three-step infrared spectroscopy could be applicable for quick, non-destructive and effective analysis and identification of very complicated and similar mixture systems of traditional Chinese medicines.

Phytochemical and pharmacological review of da chuanxiong formula: a famous herb pair composed of chuanxiong rhizoma and gastrodiae rhizoma for headache

Chronic headache such as migraine and nervous headache has become one of the most common locations of pain and one of the most difficult diseases to recover due to its numerous causes and inconvenience to keep acesodyne administration for a long time. However, there are a series of treatment theories and herbal formulas for this disease in traditional Chinese medicine (TCM), in which Da Chuanxiong formula (DCXF), a herb pair composed of Chuanxiong Rhizoma (CR), Chuanxiong in Chinese, and Gastrodiae Rhizoma (GR) called as Tianma in China, is a greatly classic representative. This formula has been used for headaches via dispelling wind pathogen and dissipating blood stasis for many years in TCM. In recent years, the efficiency and representativeness of DCXF have garnered many researchers' attention. To reveal the compatibility mechanism and develop innovative Chinese herb, herein ethnopharmacological relevance, chemical characters, and pharmacological actions of DCXF are detailed. It is expected to give a comprehensive interpretation of DCXF, namely, Chuanxiong Tianma herb pair (CTHP), to inherit the essence of herb pair and innovate drug delivery system of this prescription.

Advances in the chemical analysis and biological activities of chuanxiong

Chuanxiong Rhizoma (Chuan-Xiong, CX), the dried rhizome of Ligusticum chuanxiong Hort. (Umbelliferae), is one of the most popular plant medicines in the World. Modern research indicates that organic acids, phthalides, alkaloids, polysaccharides, ceramides and cerebrosides are main components responsible for the bioactivities and properties of CX. Because of its complex constituents, multidisciplinary techniques are needed to validate the analytical methods that support CX's use worldwide. In the past two decades, rapid development of technology has advanced many aspects of CX research. The aim of this review is to illustrate the recent advances in the chemical analysis and biological activities of CX, and to highlight new applications and challenges. Emphasis is placed on recent trends and emerging techniques.

Cochrane systematic reviews of Chinese herbal medicines: an overview

OBJECTIVES

our study had two objectives: a) to systematically identify all existing systematic reviews of Chinese herbal medicines (CHM) published in Cochrane Library; b) to assess the methodological quality of included reviews.

METHODOLOGY/PRINCIPAL FINDINGS

We performed a systematic search of the Cochrane Database of Systematic Reviews (CDSR, Issue 5, 2010) to identify all reviews of CHM. A total of fifty-eight reviews were eligible for our study. Twenty-one of the included reviews had at least one Traditional Chinese Medicine (TCM) practitioner as its co-author. 7 reviews didn't include any primary study, the remaining reviews (n = 51) included a median of 9 studies and 936 participants. 50% of reviews were last assessed as up-to-date prior to 2008. The questions addressed by 39 reviews were broad in scope, in which 9 reviews combined studies with different herbal medicines. For OQAQ, the mean of overall quality score (item 10) was 5.05 (95% CI; 4.58-5.52). All reviews assessed the methodological quality of primary studies, 16% of included primary studies used adequate sequence generation and 7% used adequate allocation concealment. Of the 51 nonempty reviews, 23 reviews were reported as being inconclusive, while 27 concluded that there might be benefit of CHM, which was limited by the poor quality or inadequate quantity of included studies. 58 reviews reported searching a median of seven electronic databases, while 10 reviews did not search any Chinese database.

CONCLUSIONS

Now CDSR has included large numbers of CHM reviews, our study identified some areas which could be improved, such as almost half of included reviews did not have the participation of TCM practitioners and were not up-to-date according to Cochrane criteria, some reviews pooled the results of different herbal medicines and ignored the searching of Chinese databases.

Placebo - More hatred than love

A placebo is a sham medical intervention that can produce a placebo effect. Laboratory evidence supports the existence of several mechanisms of placebo effects in both healthy population and patients with a variety of medical conditions. The ethics of placebos have long been debated. However, accumulating ethical concern has arisen from the worldwide use of placebo in randomized control trials (RCTs), which may render their participants without early and optimal treatment. Although the pilgrimage of placebo is still on the way, refinement of controls in RCTs is worth paying new attention to.