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Mitsumoto H, Cheung K, Oskarsson B, Andrews HF, Jang GE, Andrews JA, Shah JS, Fernandes JA, McElhiney M, Santella RM. Randomized double-blind personalized N-of-1 clinical trial to test the safety and potential efficacy of TJ-68 for treating muscle cramps in amyotrophic lateral sclerosis (ALS): study protocol for a TJ-68 trial. Trials 2023; 24:449. [PMID: 37430314 DOI: 10.1186/s13063-023-07424-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/31/2023] [Indexed: 07/12/2023] Open
Abstract
INTRODUCTION/AIMS Muscle cramps are a common and often disabling symptom in amyotrophic lateral sclerosis (ALS), a devastating and incurable neurodegenerative disorder. To date, there are no medications specifically approved for the treatment of muscle cramps. Ameliorating muscle cramps in ALS may improve and sustain quality of life. A widely prescribed traditional Japanese (Kampo) medicine against muscle cramps, shakuyakukanzoto (TJ-68), has been studied in advanced liver disease, spinal stenosis, kidney failure, and diabetic neuropathy. The Japanese ALS Management Guideline mentions TJ-68 for difficult muscle cramps in ALS. Therefore, the rationale of our trial is to investigate the safety and effectiveness of TJ-68 in treating painful and disabling muscle cramps in people with ALS outside of Japan. Accordingly, we are conducting a randomized clinical trial to test the safety and efficacy of TJ-68 in participants with ALS reporting frequent muscle cramps using an innovative, personalized N-of-1 design. If successful, TJ-68 may be used for muscle cramps in a broader population of people with ALS. METHODS This is a two-site, double-blind, randomized personalized N-of-1 early clinical trial with TJ-68. At least 22 participants with ALS and daily muscle cramps will receive drug or placebo for 2 weeks (one treatment period) followed by a 1-week washout in a four-period cross-over design. While the primary objective is to evaluate the safety of TJ-68, the study has 85% power to detect a one-point shift on the Visual Analog Scale for Muscle Cramps Affecting Overall Daily Activity of the Columbia Muscle Cramp Scale (MCS). Secondary outcomes include the full MCS score, a Cramp Diary, Clinical Global Impression of Changes, Goal Attainment Scale, quality of life scale and ALS functional rating scale-revised (ALSFRS-R). DISCUSSION The study is underway. A personalized N-of-1 trial design is an efficient approach to testing medications that alleviate muscle cramps in rare disorders. If TJ-68 proves safe and efficacious then it may be used to treat cramps in ALS, and help to improve and sustain quality of life. TRIAL REGISTRATION This clinical trial has been registered with ClinicalTrials.gov (NCT04998305), 8/9/2021.
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Affiliation(s)
- Hiroshi Mitsumoto
- Department of Neurology, Columbia University Irving Medical Center, 710 West 186 St, New York, NY, 10032, USA.
| | - Ken Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA
| | - Björn Oskarsson
- Department of Neurology, Mayo Clinic Jacksonville, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Howard F Andrews
- Data Coordinating Center (DCC) at New York State Psychiatric Institute and Columbia University, 722 W 168Th St, New York, NY, 10032, USA
| | - Grace E Jang
- Department of Neurology, Columbia University Irving Medical Center, 710 West 186 St, New York, NY, 10032, USA
| | - Jinsy A Andrews
- Department of Neurology, Columbia University Irving Medical Center, 710 West 186 St, New York, NY, 10032, USA
| | - Jaimin S Shah
- Department of Neurology, Mayo Clinic Jacksonville, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Joseph Americo Fernandes
- Department of Neurology, University of Nebraska, 4242 Farnam Street, Suite 650, Omaha, NE, 68198, USA
| | - Martin McElhiney
- Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 722 W 168Th St, New York, NY, 10032, USA
| | - Regina M Santella
- Department of Environmental Science, Mailman School of Public Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA
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Tang Y, Ou S, Ye L, Wang S. Pharmacological Activities and Pharmacokinetics of Glycycoumarin. REVISTA BRASILEIRA DE FARMACOGNOSIA : ORGAO OFICIAL DA SOCIEDADE BRASILEIRA DE FARMACOGNOSIA 2022; 33:471-483. [PMID: 36567915 PMCID: PMC9757630 DOI: 10.1007/s43450-022-00342-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
Glycycoumarin is a representative coumarin compound with significant pharmacological activities isolated from Glycyrrhiza uralensis Fisch., Fabaceae. Studies have shown that glycycoumarin has many biological activities, such as anti-tumor, liver protection, antispasmodic, antibacterial, and antivirus. However, the poor solubility of glycycoumarin in water and the accompanying reactions of the phase I (hydroxylation) and II (glucuronidation) metabolism limit its druggability, which manifests as low absorption in the body after oral administration and low free drug concentration, ultimately leading to low bioavailability. Therefore, a comprehensive review of the pharmacological effects and pharmacokinetics of glycycoumarin is presented to provide a reference for further research and application as a therapeutic agent. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s43450-022-00342-x.
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Affiliation(s)
- Yumei Tang
- grid.417409.f0000 0001 0240 6969College of Pharmacy, Zunyi Medical University, Zunyi, Guizhou China
| | - Shuiping Ou
- grid.413390.c0000 0004 1757 6938Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou China
| | - Linhu Ye
- grid.417409.f0000 0001 0240 6969College of Pharmacy, Zunyi Medical University, Zunyi, Guizhou China
| | - Sen Wang
- grid.417409.f0000 0001 0240 6969College of Pharmacy, Zunyi Medical University, Zunyi, Guizhou China
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Morita A, Omoya Y, Ito R, Ishibashi Y, Hiramoto K, Ohnishi S, Yoshikawa N, Kawanishi S. Glycyrrhizin and its derivatives promote hepatic differentiation via sweet receptor, Wnt, and Notch signaling. Biochem Biophys Rep 2021; 28:101181. [PMID: 34934826 PMCID: PMC8654616 DOI: 10.1016/j.bbrep.2021.101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
The acute liver disease is involved in aberrant release of high-mobility group box 1 (HMGB1). Glycyrrhizin (GL), a traditional Chinese medicine for liver disease, binds to HMGB1, thereby inhibits tissue injury. However the mode of action of GL for chronic liver disease remains unclear. We investigated the effects of glycyrrhizin (GL) and its derivatives on liver differentiation using human iPS cells by using a flow cytometric analysis. GL promoted hepatic differentiation at the hepatoblast formation stage. The GL derivatives, 3-O-mono-glucuronyl 18β-glycyrrhetinic acid (Mono) and 3-O-[glucosyl (1 → 2)-glucuronyl] 18β-glycyrrhetinic acid increased AFP+ cell counts and albumin+ cell counts. Glucuronate conjugation seemed to be a requirement for hepatic differentiation. Mono exhibited the most significant hepatic differentiation effect. We evaluated the effects of (±)-2-(2,4-dichlorophenoxy) propionic acid (DP), a T1R3 antagonist, and sucralose, a T1R3 agonist, on hepatic differentiation, and found that DP suppressed Mono-induced hepatic differentiation, while sucralose promoted hepatic differentiation. Thus, GL promoted hepatic differentiation via T1R3 signaling. In addition, Mono increased β-catenin+ cell count and decreased Hes5+ cell count suggesting the involvement of Wnt and Notch signaling in GL-induced hepatic differentiation. In conclusion, GL exerted a hepatic differentiation effect via sweet receptor (T1R3), canonical Wnt, and Notch signaling.
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Key Words
- AFP, α-fetoprotein
- Api, 3-O-[apiosyl (1 → 2)-glucuronyl] βGA
- CBX, carbenoxolone, 3-O-hemisuccinyl βGA
- CK-19, cytokeratin 19
- DMSO, dimethyl sulfoxide
- DP, (±)-2-(2,4-dichlorophenoxy) propionic acid
- GL, glycyrrhizin
- Glc, 3-O-[glucosyl (1 → 2)-glucuronyl] βGA
- Glycyrrhizin
- HMGB1, high-mobility group box1
- HNF-4α, hepatocyte nuclear factor 4α
- Hepatic differentiation
- Hes, hairy and enhancer of split
- LSG, licorice saponin G
- LSH, licorice saponin H
- Liver regeneration
- Mono, 3-O-mono-glucuronyl βGA
- Sweet receptor
- T1R3
- αGA, 18α-glycyrrhetinic acid
- βGA, 18β-glycyrrhetinic acid
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Affiliation(s)
- Akihiro Morita
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Yuta Omoya
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Rie Ito
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Yuya Ishibashi
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Keiichi Hiramoto
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Shiho Ohnishi
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
| | - Nobuji Yoshikawa
- Matsusaka R&D Center, Cokey Co., Ltd., Matsusaka, Mie, 515-0041, Japan
| | - Shosuke Kawanishi
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka, Mie, 513-8670, Japan
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Yoshino T, Shimada S, Homma M, Makino T, Mimura M, Watanabe K. Clinical Risk Factors of Licorice-Induced Pseudoaldosteronism Based on Glycyrrhizin-Metabolite Concentrations: A Narrative Review. Front Nutr 2021; 8:719197. [PMID: 34604277 PMCID: PMC8484325 DOI: 10.3389/fnut.2021.719197] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Licorice, the dried root or stolon of Glycyrrhiza glabra or G. ularensis, is commonly used worldwide as a food sweetener or crude drug. Its major ingredient is glycyrrhizin. Hypokalemia or pseudoaldosteronism (PsA) is one of the most frequent side effects of licorice intake. Glycyrrhizin metabolites inhibit type 2 11β-hydroxysteroid dehydrogenase (11βHSD2), which decomposes cortisol into inactive cortisone in the distal nephron, thereby inducing mineralocorticoid receptor activity. Among the several reported glycyrrhizin-metabolites, 18β-glycyrrhetyl-3-O-sulfate is the major compound found in humans after licorice consumption, followed by glycyrrhetinic acid. These metabolites are highly bound to albumin in blood circulation and are predominantly excreted into bile via multidrug resistance-associated protein 2 (Mrp2). High dosage and long-term use of licorice are constitutional risk factors for PsA. Orally administered glycyrrhizin is effectively hydrolyzed to glycyrrhetinic acid by the intestinal bacteria in constipated patients, which enhances the bioavailability of glycyrrhizin metabolites. Under hypoalbuminemic conditions, the unbound metabolite fractions can reach 11βHSD2 at the distal nephron. Hyper direct-bilirubin could be a surrogate marker of Mrp2 dysfunction, which results in metabolite accumulation. Older age is associated with reduced 11βHSD2 function, and several concomitant medications, such as diuretics, have been reported to affect the phenotype. This review summarizes several factors related to licorice-induced PsA, including daily dosage, long-term use, constipation, hypoalbuminemia, hyper direct-bilirubin, older age, and concomitant medications.
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Affiliation(s)
- Tetsuhiro Yoshino
- Center for Kampo Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Saori Shimada
- Department of Pharmaceutical Sciences, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masato Homma
- Department of Pharmaceutical Sciences, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toshiaki Makino
- Department of Pharmacognosy, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Masaru Mimura
- Center for Kampo Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Psychiatry and Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Watanabe
- Center for Kampo Medicine, Keio University School of Medicine, Tokyo, Japan
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Qian Y, Markowitz JS. Natural Products as Modulators of CES1 Activity. Drug Metab Dispos 2020; 48:993-1007. [PMID: 32591414 DOI: 10.1124/dmd.120.000065] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/12/2020] [Indexed: 12/30/2022] Open
Abstract
Carboxylesterase (CES) 1 is the predominant esterase expressed in the human liver and is capable of catalyzing the hydrolysis of a wide range of therapeutic agents, toxins, and endogenous compounds. Accumulating studies have demonstrated associations between the expression and activity of CES1 and the pharmacokinetics and/or pharmacodynamics of CES1 substrate medications (e.g., methylphenidate, clopidogrel, oseltamivir). Therefore, any perturbation of CES1 by coingested xenobiotics could potentially compromise treatment. Natural products are known to alter drug disposition by modulating cytochrome P450 and UDP-glucuronosyltransferase enzymes, but this issue is less thoroughly explored with CES1. We report the results of a systematic literature search and discuss natural products as potential modulators of CES1 activity. The majority of research reports reviewed were in vitro investigations that require further confirmation through clinical study. Cannabis products (Δ 9-tetrahydrocannabinol, cannabidiol, cannabinol); supplements from various plant sources containing naringenin, quercetin, luteolin, oleanolic acid, and asiatic acid; and certain traditional medicines (danshen and zhizhuwan) appear to pose the highest inhibition potential. In addition, ursolic acid, gambogic acid, and glycyrrhetic acid, if delivered intravenously, may attain high enough systemic concentrations to significantly inhibit CES1. The provision of a translational interpretation of in vitro assessments of natural product actions and interactions is limited by the dearth of basic pharmacokinetic data of the natural compounds exhibiting potent in vitro influences on CES1 activity. This is a major impediment to assigning even potential clinical significance. The modulatory effects on CES1 expression after chronic exposure to natural products warrants further investigation. SIGNIFICANCE STATEMENT: Modulation of CES1 activity by natural products may alter the course of treatment and clinical outcome. In this review, we have summarized the natural products that can potentially interact with CES1 substrate medications. We have also noted the limitations of existing reports and outlined challenges and future directions in this field.
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Affiliation(s)
- Yuli Qian
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida
| | - John S Markowitz
- Department of Pharmacotherapy and Translational Research, University of Florida, Gainesville, Florida
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6
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Chen YS, Hong ZX, Lin SZ, Harn HJ. Identifying Therapeutic Targets for Spinocerebellar Ataxia Type 3/Machado-Joseph Disease through Integration of Pathological Biomarkers and Therapeutic Strategies. Int J Mol Sci 2020; 21:ijms21093063. [PMID: 32357546 PMCID: PMC7246822 DOI: 10.3390/ijms21093063] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/13/2022] Open
Abstract
Spinocerebellar ataxia type 3/Machado-Joseph disease (SCA3/MJD) is a progressive motor disease with no broadly effective treatment. However, most current therapies are based on symptoms rather than the underlying disease mechanisms. In this review, we describe potential therapeutic strategies based on known pathological biomarkers and related pathogenic processes. The three major conclusions from the current studies are summarized as follows: (i) for the drugs currently being tested in clinical trials; a weak connection was observed between drugs and SCA3/MJD biomarkers. The only two exceptions are the drugs suppressing glutamate-induced calcium influx and chemical chaperon. (ii) For most of the drugs that have been tested in animal studies, there is a direct association with pathological biomarkers. We further found that many drugs are associated with inducing autophagy, which is supported by the evidence of deficient autophagy biomarkers in SCA3/MJD, and that there may be more promising therapeutics. (iii) Some reported biomarkers lack relatively targeted drugs. Low glucose utilization, altered amino acid metabolism, and deficient insulin signaling are all implicated in SCA3/MJD, but there have been few studies on treatment strategies targeting these abnormalities. Therapeutic strategies targeting multiple pathological SCA3/MJD biomarkers may effectively block disease progression and preserve neurological function.
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Affiliation(s)
- Yu-Shuan Chen
- Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- Correspondence: (Y.-S.C.); (H.-J.H.); Tel.: +886-3-856-1825 (Y.-S.C. & H.-J.H.); Fax: +886-3-856-0977 (H.-J.H.)
| | - Zhen-Xiang Hong
- Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Shinn-Zong Lin
- Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
| | - Horng-Jyh Harn
- Bioinnovation Center, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- Department of Pathology, Hualien Tzu Chi Hospital, Tzu Chi University, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
- Correspondence: (Y.-S.C.); (H.-J.H.); Tel.: +886-3-856-1825 (Y.-S.C. & H.-J.H.); Fax: +886-3-856-0977 (H.-J.H.)
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Han K, Kwon O, Jung SY, Park IH, Hwang MS, Park SY, Hwang EH, Lee JH. Jakyakgamcho-tang in the relief of delayed-onset muscle soreness in healthy adults: study protocol for a randomized, double-blind, placebo-controlled, crossover design clinical trial. Trials 2020; 21:211. [PMID: 32085792 PMCID: PMC7035661 DOI: 10.1186/s13063-020-4119-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background Muscle soreness after exercise, called delayed-onset muscle soreness (DOMS), may cause significant changes in muscle function and may increase the risk of sports injuries. Therefore, various therapeutic strategies have been studied to help recovery after exercise. Jakyakgamcho-tang (JGT) is a widely prescribed herbal medicine to treat muscle pain and cramps in traditional Eastern medicine. The aim of this study is to evaluate the effect of JGT for reducing pain and improving muscle damage after exercise. Methods This study is a randomized, double-blind, placebo-controlled, crossover design clinical trial. A total of 30 healthy male adults will be recruited. Subjects who voluntarily wish to participate in this study will be hospitalized for 4 days. On the first day, the subjects will perform a standardized treadmill exercise for 1 h to induce DOMS. After the exercise, the subjects will take either JGT or a placebo for 3 days. After a more than 1 week wash-out period, the subjects will repeat the same process with the other drug. Pain intensity, calf circumference, and pain threshold will be measured as outcome measures. Blood tests and blood pressure will be measured as safety assessments. In addition, blood tests for muscle damage and inflammation markers, such as creatine kinase, interleukin-6, and C-reactive protein, will be analyzed. Discussion This will be the first trial to assess the effect of JGT on exercise-induced muscle soreness. Our findings will provide valuable data to determine the clinical effects of JGT on DOMS. Trial registration Clinical Research Information Sevice, KCT0003457. Registered on 29 January 2019.
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Affiliation(s)
- Kyungsun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - So-Young Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - In-Hwa Park
- Department of Rehabilitation Medicine of Korean Medicine, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, 50612, Republic of Korea
| | - Man-Suk Hwang
- Department of Rehabilitation Medicine of Korean Medicine, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, 50612, Republic of Korea.,Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Sun-Young Park
- Department of Rehabilitation Medicine of Korean Medicine, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, 50612, Republic of Korea
| | - Eui-Hyoung Hwang
- Department of Rehabilitation Medicine of Korean Medicine, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, 50612, Republic of Korea. .,Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daro, Yuseong-gu, Daejeon, 34054, Republic of Korea. .,Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, 34113, Republic of Korea.
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Rzajew J, Radzik T, Rebas E. Calcium-Involved Action of Phytochemicals: Carotenoids and Monoterpenes in the Brain. Int J Mol Sci 2020; 21:ijms21041428. [PMID: 32093213 PMCID: PMC7073062 DOI: 10.3390/ijms21041428] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Neurodegenerative and mood disorders represent growing medical and social problems, many of which are provoked by oxidative stress, disruption in the metabolism of various neurotransmitters, and disturbances in calcium homeostasis. Biologically active plant compounds have been shown to exert a positive impact on the function of calcium in the central nervous system. Methods: The present paper reviews studies of naturally occurring terpenes and derivatives and the calcium-based aspects of their mechanisms of action, as these are known to act upon a number of targets linked to neurological prophylaxis and therapy. Results: Most of the studied phytochemicals possess anticancer, antioxidative, anti-inflammatory, and neuroprotective properties, and these have been used to reduce the risk of or treat neurological diseases. Conclusion: The neuroprotective actions of some phytochemicals may employ mechanisms based on regulation of calcium homeostasis and should be considered as therapeutic agents.
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Zhang E, Yin S, Zhao S, Zhao C, Yan M, Fan L, Hu H. Protective effects of glycycoumarin on liver diseases. Phytother Res 2019; 34:1191-1197. [PMID: 31840883 DOI: 10.1002/ptr.6598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/01/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022]
Abstract
Licorice, an edible and medicinal plant, has long been used to treat various diseases, including liver diseases. Glycycoumarin (GCM) is a representative coumarin compound in licorice with favorable bioavailability feature. Recent studies by us demonstrated that GCM is highly effective against alcoholic liver disease, nonalcoholic fatty liver disease, acetaminophen-induced hepatotoxicity, and liver cancer through mechanisms involved in activation of Nrf2 antioxidant system, stimulation of AMPK-mediated energy homeostasis, induction of autophagy degradation process, and inhibiting oncogenic kinase T-lymphokine-activated killer cell-originated protein kinase activity. In this review, we summarize the findings on the hepatoprotective effect of GCM, discuss the signaling pathways underlying GCM-induced protective effect on liver diseases, and propose the issues that need to be addressed to promote further development of GCM as a clinically useful hepatoprotective agent.
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Affiliation(s)
- Enxiang Zhang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Shutao Yin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Shuang Zhao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Chong Zhao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Mingzhu Yan
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Lihong Fan
- College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Hongbo Hu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China
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Identification of glycyrrhizin metabolites in humans and of a potential biomarker of liquorice-induced pseudoaldosteronism: a multi-centre cross-sectional study. Arch Toxicol 2019; 93:3111-3119. [DOI: 10.1007/s00204-019-02588-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/01/2019] [Indexed: 02/06/2023]
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11
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Nagira K, Taniguchi F, Nakamura K, Tokita Y, Tsuchiya N, Khine YM, Harada T. Tokishakuyakusan, a Kampo medicine, attenuates endometriosis-like lesions and hyperalgesia in murine with endometriosis-like symptoms. Am J Reprod Immunol 2019; 82:e13182. [PMID: 31446641 DOI: 10.1111/aji.13182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/18/2019] [Accepted: 08/19/2019] [Indexed: 12/28/2022] Open
Abstract
PROBLEM How are the effects of Tokishakuyakusan (TSS), a traditional Japanese medicine (Kampo) on murine endometriosis model? METHODS BALB/c mice were used for making the murine endometriosis model. Homogeneous uterus was surgically implanted with lipopolysaccharide (LPS) in peritoneal cavity. We administered 2 weeks of TSS (1.0 g/kg) orally. Upon treatment completion, we performed the hot plate test for all mice and collected blood samples before sacrifice. Then, the endometriosis-like lesions and uteri in the abdominal cavity were harvested. Concentrations of several cytokines in sera and cyst fluids were measured using Bio-Plex Suspension Array System. IL-33 localization was determined by immunohistochemistry. Gene expression of inflammatory cytokines in the endometriosis-like lesions or the eutopic endometrium was evaluated by real-time RT-PCR. RESULTS After 14 days of TSS treatment, the numbers of endometriosis-like cysts and cyst weight were significantly decreased. In TSS-treated mice, the latency against heat stimuli was extended. Inflammatory cytokine concentrations in sera were not changed by TSS treatment. TSS intake decreased IL-33 mRNA expression in endometriosis-like lesions and led to the tendency of attenuation of the elevated IL-33 synthesis in the cyst fluids of lesions. CONCLUSION These results suggest the TSS ameliorated the hyperalgesia and lesion formation on the LPS-accelerated endometriosis-like model. TSS represents a possible ideal target of novel therapeutics for endometriosis patients with dysmenorrhea.
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Affiliation(s)
- Kei Nagira
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Fuminori Taniguchi
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazuomi Nakamura
- Division of Laboratory Animal Science, Research Center for Bioscience and Technology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yohei Tokita
- Kampo Research and Development Division, Tsumura & Co., Tokyo, Japan
| | - Naoko Tsuchiya
- Tsumura Kampo Research Laboratories, Kampo Research and Development Division, Tsumura & Co., Ibaraki, Japan
| | - Yin Mon Khine
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology, Tottori University Faculty of Medicine, Yonago, Japan
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12
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EGHB010, a Standardized Extract of Paeoniae Radix and Glycyrrhizae Radix, Inhibits VEGF-Induced Tube Formation In Vitro and Retinal Vascular Leakage and Choroidal Neovascularization In Vivo. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:1568702. [PMID: 29234364 PMCID: PMC5646325 DOI: 10.1155/2017/1568702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/29/2017] [Indexed: 11/18/2022]
Abstract
EGHB010 is a hot water extract of the rhizome mixture of Paeonia lactiflora Pallas and Glycyrrhiza uralensis Fisch. Choroidal neovascularization (CNV) and vascular leakage are the common pathophysiologies of age-related macular degeneration. In this study, we aimed to evaluate the effect of EGHB010 on retinal vascular leakage and laser-induced CNV in a rat model. Vascular endothelial growth factor- (VEGF-) induced tube formation was assayed in human retinal microvascular endothelial cells. Intravitreal VEGF-induced blood-retinal barrier breakdown was assayed in Sprague-Dawley rats. Experimental CNV was induced by laser photocoagulation in Brown Norway rats. EGHB010 (50 and 100 mg/kg/day) was administered orally for 10 days after laser photocoagulation. Choroidal flat mounts were prepared to measure the lesion size of CNV. Incubation of retinal vascular endothelial cells with EGHB010 (12.5 and 25 μg/mL) resulted in the inhibition of VEGF-induced tube formation in a dose-dependent manner. VEGF-mediated retinal vascular leakage was blocked by the oral administration of EGHB010. The CNV area was significantly lower in EGHB010-treated rats than in vehicle-treated rats. These results suggest that EGHB010 is a potent antiangiogenic agent. Thus, the oral administration of EGHB010 may have a beneficial effect in the treatment of vascular leakage and CNV in patients with age-related macular degeneration.
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Wang Z, Tang S, Hattori M, Zhang H, Wu X. Simultaneous determination of paeonilactone A and paeonilactone B in rat plasma after oral administration of albiflorin by UPLC/TOF/MS following picolinoyl derivatization. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1061-1062:327-333. [PMID: 28783562 DOI: 10.1016/j.jchromb.2017.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
A new highly sensitive analytical method was developed to investigate the in vivo metabolism of albiflorin, one of the most principal components in traditional Chinese medicine. After hydrolyzation with sulfatase, the main metabolites paeonilactone A and paeonilactone B of paeoniflorin in rat plasma were successfully detected for the first time by liquid chromatography mass spectrometry following picolinoyl derivatization. Borneol was used as the internal standard compound to quantify paeonilactone A and paeonilactone B in rat plasma. Paeonilactone A and paeonilactone B show different pharmacokinetic behaviors. The maximum plasma concentration of paeonilactone A reached 36.4±5.6ng/mL at about 8h after oral administration of albiflorin at a dose of 5mg/kg, while the maximum plasma concentration of paeonilactone B reached 12.4±3.4ng/mL at about 2h. The total metabolic pathway of albiflorin in rats was proposed. Albiflorin was found to be metabolized to the sulfate of paeonilactone A and paeonilactone B which may be responsible for the biological effect of albiflorin. The new analytical method may help to elucidate the clinical efficacy of traditional Chinese formula containing albiflorin.
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Affiliation(s)
- Zhigang Wang
- Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China; Institute of Natural Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Shuhan Tang
- Institute of Natural Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; Harbin Children's Hospital, Youyi Road 57, Harbin, China
| | - Masao Hattori
- Institute of Natural Medicine, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan
| | - Hailong Zhang
- School of Pharmacy, Health Science Center, Xi'an Jiaotong University, Shaanxi 710061, China
| | - Xiuhong Wu
- Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China.
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14
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Inhibition of UDP-glucuronosyltransferase (UGT)-mediated glycyrrhetinic acid 3- O -glucuronidation by polyphenols and triterpenoids. Drug Metab Pharmacokinet 2017; 32:218-223. [DOI: 10.1016/j.dmpk.2017.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/06/2017] [Accepted: 04/24/2017] [Indexed: 12/24/2022]
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15
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Hong C, Schüffler A, Kauhl U, Cao J, Wu CF, Opatz T, Thines E, Efferth T. Identification of NF-κB as Determinant of Posttraumatic Stress Disorder and Its Inhibition by the Chinese Herbal Remedy Free and Easy Wanderer. Front Pharmacol 2017; 8:181. [PMID: 28428751 PMCID: PMC5382210 DOI: 10.3389/fphar.2017.00181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/20/2017] [Indexed: 01/09/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a mental disorder developing after exposure to traumatic events. Although psychotherapy reveals some therapeutic effectiveness, clinically sustainable cure is still uncertain. Some Chinese herbal formulae are reported to work well clinically against mental diseases in Asian countries, but the safety and their mode of action are still unclear. In this study, we investigated the mechanisms of Chinese remedy free and easy wanderer (FAEW) on PTSD. We used a reverse pharmacology approach combining clinical data to search for mechanisms of PTSD with subsequent in vitro verification and bioinformatics techniques as follows: (1) by analyzing microarray-based transcriptome-wide mRNA expression profiling of PTSD patients; (2) by investigating the effect of FAEW and the antidepressant control drug fluoxetine on the transcription factor NF-κB using reporter cell assays and western blotting; (3) by performing molecular docking and literature data mining based on phytochemical constituents of FAEW. The results suggest an involvement of inflammatory processes mediated through NF-κB in the progression of PTSD. FAEW was non-cytotoxic in vitro and inhibited NF-κB activity and p65 protein expression. FAEW's anti-inflammatory compounds, i.e., paeoniflorin, isoliquiritin, isoliquiritin apioside and ononin were evaluated for binding to IκK and p65-RelA in a molecular docking approach. Paeoniflorin, albiflorin, baicalin, isoliquiritin and liquiritin have been reported to relieve depression in vivo or in clinical trials, which might be the active ingredients for FAEW against PTSD.
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Affiliation(s)
- Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Anja Schüffler
- Institut für Biotechnologie und Wirkstoff Forschung gGmbHKaiserslautern, Germany.,Institute of Molecular Physiology, Johannes Gutenberg UniversityMainz, Germany
| | - Ulrich Kauhl
- Institute of Organic Chemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Jingming Cao
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Ching-Fen Wu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Till Opatz
- Institute of Organic Chemistry, Johannes Gutenberg UniversityMainz, Germany
| | - Eckhard Thines
- Institut für Biotechnologie und Wirkstoff Forschung gGmbHKaiserslautern, Germany.,Institute of Molecular Physiology, Johannes Gutenberg UniversityMainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg UniversityMainz, Germany
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16
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Matsumoto T, Kushida H, Matsushita S, Oyama Y, Suda T, Watanabe J, Kase Y, Setou M. Distribution Analysis via Mass Spectrometry Imaging of Ephedrine in the Lungs of Rats Orally Administered the Japanese Kampo Medicine Maoto. Sci Rep 2017; 7:44098. [PMID: 28272490 PMCID: PMC5341069 DOI: 10.1038/srep44098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/02/2017] [Indexed: 01/10/2023] Open
Abstract
Maoto, a traditional Japanese Kampo medicine, has been used to treat various respiratory diseases, including respiratory infections and influenza. Ephedrine (EPD), the main ingredient in maoto, is also clinically used to treat respiratory diseases. However, the pharmacokinetics and distribution of EPD in the lungs after the administration of maoto have not been demonstrated. This study aimed to determine the concentrations, distribution, and pharmacokinetics of EPD and its precursor methylephedrine (MEPD) in the lungs of rats orally administered maoto (1 and 4 g/kg). We used liquid chromatography–electrospray ionization-tandem mass spectrometry to measure the ingredient concentrations. Both ingredients were detected in maoto-treated lung homogenates. Next, we examined the distribution of both ingredients in lung sections by using matrix-assisted laser desorption/ionization-mass spectrometry imaging, a powerful tool for the visualization of the distribution of biological molecules. The mass spectrometry imaging analysis detected only EPD and provided the first visual demonstration that EPD is distributed in the alveoli, bronchi, and bronchioles in the lungs of rats orally administered maoto (4 g/kg, three times at 2-h intervals). These results suggest that the pharmacological efficacy of maoto for the amelioration of respiratory symptoms is related to the distribution of EPD in the lung.
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Affiliation(s)
- Takashi Matsumoto
- Tsumura Research Laboratories, Kampo Scientific Strategies Division, Tsumura &Co., Ibaraki, Japan
| | - Hirotaka Kushida
- Tsumura Research Laboratories, Kampo Scientific Strategies Division, Tsumura &Co., Ibaraki, Japan
| | - Shoko Matsushita
- Department of Cellular &Molecular Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,International Mass Imaging Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yoshiyuki Oyama
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Junko Watanabe
- Tsumura Research Laboratories, Kampo Scientific Strategies Division, Tsumura &Co., Ibaraki, Japan
| | - Yoshio Kase
- Tsumura Research Laboratories, Kampo Scientific Strategies Division, Tsumura &Co., Ibaraki, Japan
| | - Mitsutoshi Setou
- Department of Cellular &Molecular Anatomy, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.,International Mass Imaging Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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17
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Kim J, Kim CS, Kim YS, Lee IS, Kim JS. Jakyakgamcho-tang and Its Major Component, Paeonia Lactiflora, Exhibit Potent Anti-glycation Properties. J Exerc Nutrition Biochem 2016; 20:60-64. [PMID: 28150470 PMCID: PMC5545203 DOI: 10.20463/jenb.2016.0049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
[Purpose] Advanced glycation end products (AGEs) have been implicated in the pathogenesis of diabetes and other age-related diseases. AGE inhibitors or breakers, such as aminoguanidine and alagebrium, have been proposed as therapeutic agents for AGE-related disorders. Jakyakgamcho-tang (JGT) is a well-known traditional herbal formula, which consists of the radix of Paeonia lactiflora Pallas (PR) and the radix and rhizome of Glycyrrhiza uralensis Fisch (GR). The purpose of this study was to evaluate the inhibitory and breaking activities of JGT, PR, and GR against AGEs. [Methods] JGT, PR, and GR extracts were prepared in hot water. We performed in vitro assays to evaluate their inhibitory activity against glycation of bovine serum albumin (BSA) by high glucose and their ability to break the already formed AGEs. [Results] In the in vitro AGE formation assay, JGT and PR dose-dependently inhibited AGE-BSA formation (half-maximal inhibitory concentration, IC50, = 41.41 ± 0.36 and 6.84 ± 0.09 μg/mL, respectively). In the breakdown assay of the preformed AGE-BSA-collagen complexes, JGT and PR exhibited potent breaking activities (IC50 = 6.72 ± 1.86 and 7.45 ± 0.47 μg/mL, respectively). However, GR showed a weaker inhibitory activity and no breaking activity against AGEs. [Conclusion] This study suggests that JGT and PR could be valuable drug candidates for treatment of AGE-related diseases by reducing AGE burden.
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Affiliation(s)
- Junghyun Kim
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon Republic of Korea
| | - Chan-Sik Kim
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon Republic of Korea
| | - Young Sook Kim
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon Republic of Korea
| | - Ik Soo Lee
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon Republic of Korea
| | - Jin Sook Kim
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon Republic of Korea
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18
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Pharmacokinetic evaluation of paeoniflorin after oral administration of Paeoniae Radix extract powder to healthy Korean subjects using UPLC-MS/MS. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2016. [DOI: 10.1007/s40005-016-0242-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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19
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Comparison of the Spasmolytic Effects of Jakyak-Gamcho Decoctions Derived via Different Extractants. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:270380. [PMID: 26539219 PMCID: PMC4619897 DOI: 10.1155/2015/270380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/22/2015] [Accepted: 09/02/2015] [Indexed: 01/04/2023]
Abstract
Aim. To investigate whether differences in the amounts of effective index components in Jakyak-Gamcho decoctions derived via extraction with either water or ethanol were associated with differential spasmolytic effectiveness. Methods. The amounts of effective index components (paeoniflorin, benzoic acid, glycyrrhizin, and isoliquiritin) contained in water-extracted Jakyak-Gamcho decoction and 70% ethanol-extracted Jakyak-Gamcho decoction were compared by high-performance liquid chromatography. Muscle cramp reduction rates were compared between the two decoctions by comparing the degrees of muscle contraction, measured as the tension developed during electrical stimulation, before and 1 and 2 h after injection in rats. Results. The relative amounts of effective index components were, on average, about 43% higher in the 70% ethanol-extracted decoction than in the water-extracted decoction. Two hours after injection, 0.25 g/kg of 70% ethanol-extracted decoction produced a significantly greater spasmolytic effect than 0.25 g/kg of water-extracted Jakyak-Gamcho decoction or distilled water (both p < 0.05). Conclusion. Differences in the amounts of effective index components resulting from the use of different extractants were associated with differences in spasmolytic effectiveness. Hence, it may be worthwhile to investigate alternative extraction methods in terms of extraction efficiency and in vivo effectiveness for various herbal medicines in the future.
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