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Wang X, Chen W, Yuan P, Xu H. RAGE acted as a new anti-inflammatory target for Icariin's treatment against vascular dementia based on network pharmacology-directed verification. J Biomol Struct Dyn 2023:1-21. [PMID: 37768122 DOI: 10.1080/07391102.2023.2256409] [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: 06/26/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
Vascular dementia (VaD) ranks as the second most prevalent form of dementia and poses a considerable global health challenge. Icariin has been recognized for its robust neuroprotective effects in combating VaD. Nonetheless, the underlying mechanisms have not been fully elucidated. An integrated approach involving network pharmacology, molecular docking, and molecular dynamics simulations (MDS) was employed to systematically investigate the potential pharmacological actions of Icariin in counteracting VaD. The AGE/RAGE pathway was identified as a promising anti-inflammatory pathway. A chronic cerebral hypoperfusion mouse model was utilized to establish VaD. Both Icariin and FP S-ZM1 (a RAGE inhibitor) were administered through oral gavage and intraperitoneal injection, respectively. The Morris water maze (MWZ) was used to evaluate cognitive functions. Moreover, immunofluorescence, RT-qP CR, and Western blot analyses were carried out to evaluate the effects of FP S-ZM1 on neuroinflammation. Network analysis identified 14 crucial targets and highlighted the AGE-RAGE signaling cascade in diabetic complications as the foremost KEGG pathway with potential anti-neuroinflammatory property. MDS results suggested a stable binding of the RAGE-Icariin complex. Remarkably, Icariin was found to effectively mitigate cognitive deficits in VaD mice, which was correlated with the upregulation of the P I3K/AKT pathway and downregulation of the JNK/cJUN signaling cascade. Critically, co-administration of FP S-ZM1 enhanced Icariin's ameliorative effects on cognitive deficits, owing to bolstered anti-neuroinflammatory action. This study unveils the potential of Icariin in alleviating cognitive dysfunction and neuroinflammation in VaD, which may be attributed to the modulation of the AGE/RAGE pathway.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Xiaohu Wang
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Wei Chen
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Ping Yuan
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Hongbei Xu
- Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
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Sawangjit R, Chuenchom C, Sanverm T, Chaiyakunapruk N, Jiranukool J, Nithipaijit R, Sadoyu S, Phianchana C, Jinatongthai P. Efficacy and safety of herbal medicine on dementia and cognitive function: An umbrella review of systematic reviews and meta-analysis. Phytother Res 2023. [PMID: 36728740 DOI: 10.1002/ptr.7759] [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: 08/26/2022] [Revised: 12/09/2022] [Accepted: 01/22/2023] [Indexed: 02/03/2023]
Abstract
This study aims to summarize the effects of herbs on dementia and assess the strength of evidence. Six international and local databases were searched from inception to October 2021 for systematic reviews and meta-analyses of clinical trials investigated the effects of herbal medicine on dementia or cognitive function. Two researchers independently extracted data, assessed the methodological quality, and rated the credibility of evidence according to established criteria. Thirty-seven articles evaluating 13 herbal medicines were included. Of these, 65% were rated critically low using AMSTAR2. Of 90 unique outcomes, 41 (45.6%) were statistically significant based on random effects model (p ≤ .05). Only 3 herbs were supported by suggestive evidence whereas the others were supported by weak evidence. The suggestive evidence supported benefits of Chinese herbal medicine (CHM) plus pharmacotherapy (WMD:1.84; 95% CI: 1.34, 2.35) and Vinpocetine (WMD: -0.94; 95%CI: -1.50, -0.38) on improving cognitive function assessing by Montreal Cognitive Assessment and Syndrom-Kurz-Test, respectively. Moreover, suggestive evidence supported benefit of Huperzia serrata on improving Activities of Daily Living (WMD:-7.18; 95%CI: -9.12, -5.23). No SAE was reported. In conclusion, several herbs were used for improving dementia and cognitive function but recent evidence were limited by the small sample size and poor methodological quality. Therefore, further large and well-designed studies are needed to support the evidence.
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Affiliation(s)
- Ratree Sawangjit
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.,Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Mahasarakham University, Mahasarakham, Thailand
| | - Chorthip Chuenchom
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Thanchanok Sanverm
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Jariya Jiranukool
- Department of Psychiatry, Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand
| | - Rodchares Nithipaijit
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand.,Clinical Trials and Evidence-Based Syntheses Research Unit (CTEBs RU), Mahasarakham University, Mahasarakham, Thailand
| | | | - Chankiat Phianchana
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand
| | - Peerawat Jinatongthai
- Pharmacy Practice Division, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand
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Ablat N, Ablimit M, Abudoukadier A, Kadeer B, Maihemuti A, Bakewaiyi A, Tuerxun A, Aihemaiti A. Liver protection and hemostatic effects of medicinal plant Arnebia euchroma (Royle) I.M.Johnst extract in a rat model. JOURNAL OF ETHNOPHARMACOLOGY 2023; 300:115739. [PMID: 36126784 DOI: 10.1016/j.jep.2022.115739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Arnebia euchroma (Royle) I.M.Johnst. (AE) is a Chinese medicinal herb that is traditionally used to treat various circulatory diseases. It exhibits certain effects, such as the promotion of blood circulation and cooling, rash clearance, and detoxification. AIM OF THE STUDY This study was designed to explore the hepatoprotective and hemostatic effects of the ethyl acetate extract of AE in rats with carbon tetrachloride (CCl4)-induced liver injury. MATERIALS AND METHODS Wistar rats were treated via oral gavage with different doses of the ethyl acetate extract of AE (3.5, 7, or 14 g kg-1·day-1) for 14 consecutive days, following which hemostatic and liver function tests were conducted. For the hemostatic tests, the platelet count, blood platelet aggregation, blood platelet adhesion to fibrinogen, platelet factor 4 (PF-4) secretion from blood platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), and fibrinogen levels were measured at the end of the treatment period. For the liver function tests, 0.25 mL/200 g (1.25 mL kg-1·day-1) of olive oil was injected into the abdominal cavity of the control rats, whereas 15% CCl4 plus olive oil (prescription: 7.5 mL CCl4 + 42.5 olive oil) was injected into that of the treated rats at 1 h after extract administration on day 6, 13, and 20. Additionally, food and water were withheld from all the animals. On the following day, the rats were anesthetized and their albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), gamma-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), reactive oxygen species (ROS), methane dicarboxylic aldehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels were measured. Glutathione S-transferase (GST), glutathione reductase (GR), and glutathione peroxidase (GPx) levels among the groups were determined using a one-way analysis of variance. RESULTS The platelet count and blood platelet aggregation, blood platelet adhesion to fibrinogen and PF-4 secretion levels were significantly increased in the (3.5 g kg-1 day-1) AE group as compared to those in the control group (all p < 0.001; for the 7 and 14 g kg-1 day-1 AE groups, all p > 0.05, respectively). Although the PT and aPTT were not affected by the AE extract (all p > 0.05), the TT was reduced and the FIB levels were significantly increased in all AE groups (p < 0.05). Liver function tests showed that CCl4 caused significant liver damage, thereby decreasing the albumin, SOD, CAT, GSH, GST, GR, and GPx levels, while increasing the AST, ALT, ALP, SGOT, SGPT, GGT, LDH, ROS, and MDA levels (all p < 0.001). By contrast, treatment with the different doses of AE extract reversed the CCl4 effects on all these parameters. Compared with the levels in the CCl4 group, the GSH and GR levels in the three AE groups (3.5, 7, and 14 g kg-1·day-1) were significantly higher (p < 0.05, p < 0.01, and p < 0.001, respectively), whereas the differences in the other parameters for these three groups were all at the significance levels of p < 0.05, p < 0.05, and p < 0.01, respectively. CONCLUSIONS AE extracts administered orally exhibited hepatoprotective activity by affecting platelet production and blood coagulation and ameliorating liver function-damaging modifications. Specifically, a dosage of 3.5 g kg-1·day-1 resulted in the most optimal effects.
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Affiliation(s)
- Nuramatjan Ablat
- School of Mental Health, Bengbu Medical College, Bengbu, 233030, China.
| | - Mihray Ablimit
- Xinjiang Uygur Autonomous Region Shache County Dunbag Township Health Center, 844700, China.
| | - Abudoureheman Abudoukadier
- Department of Cardiology, Urumqi City Friendship Hospital, Xinjiang Uygur Autonomous Region, Urumqi, 830049, China.
| | - Buhaiqiemu Kadeer
- Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi, 830054, China.
| | - Abulaitijiang Maihemuti
- Department of Laboratory, Uyghur Medicine Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, 830000, China.
| | - Alibati Bakewaiyi
- Department of Laboratory, Uyghur Medicine Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, 830000, China.
| | - Atike Tuerxun
- Department of Pharmacy, Uyghur Medicine Hospital of Hetian Region, Hetian, 848000, China.
| | - Adilijiang Aihemaiti
- Department of Laboratory, Uyghur Medicine Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, 830000, China.
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Nie CC, Su KQ, Gao J, Song XL, Lv Z, Yuan J, Luo M, Ruan XD, Fan YF, Yu MY, Qi SK, Feng XD. Bibliometric analysis: Research trends of acupuncture treatment to cognitive impairment in recent 15 years. Front Psychol 2022; 13:935053. [PMID: 36312172 PMCID: PMC9606323 DOI: 10.3389/fpsyg.2022.935053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/02/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives Acupuncture therapy has been used for cognitive impairment-related diseases, however, there are still few studies on the overall trend of acupuncture therapy on cognitive impairment based on bibliometric analysis. The purpose of this study was to explore the research trend of the impact of acupuncture on cognitive impairment in the past 15 years, analyze the research trends and hotspots, and provide new ideas and theoretical basis for future research directions. Methods From the Web of Science Core Collection (WoSCC), the relevant literature on the treatment of cognitive impairment with acupuncture from 2007 to 2022 was retrieved. Then, based on the CiteSpace and VOSviewer software of the Java platform, the cooperation between countries and institutions in this field, the co-citation of journals and documents, and the cooperation between authors and authors, etc. were analyzed. In addition, the co-occurrence and burst analysis of keywords are also carried out, and a visual knowledge map is drawn. Results As of August 08, 2022, a total of 394 records related to the treatment of cognitive impairment with acupuncture were identified. The analysis results show: The number and rate of annual publications have steadily increased, with some fluctuations from year to year. The countries that contribute the most to this field are China and the USA. Among them, Beijing University of Chinese Medicine and Capital Medical University are tied for first place in terms of the number of published papers. Tao Jing is the most prolific author and the number one cited author. Conclusions The number of publications on acupuncture for cognitive impairment is expected to increase rapidly in future research, suggesting a bright future for the field. Future research hotspots will focus on pain, injury, protocol, diagnosis, guidelines, etc. It is also necessary to strengthen cross-regional and cross-country cooperation among various academic groups.
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Affiliation(s)
- Chen-Chen Nie
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Kai-Qi Su
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Jing Gao
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiao-Lei Song
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Zhuan Lv
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Jie Yuan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Meng Luo
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiao-Di Ruan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Yong-Fu Fan
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Ming-Yue Yu
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Shi-Kui Qi
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
| | - Xiao-Dong Feng
- Department of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China
- Rehabilitation Center, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
- *Correspondence: Xiao-Dong Feng
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Wei C, Zhu Z, Zheng JN, Lu Y, Cao C, Qu S, Liu M, Meng XE, Lou Q, Wang Q, Duan JA, Shang EX, Han Z, Zhu Y. Chinese Medicine, Succinum, Ameliorates Cognitive Impairment of Carotid Artery Ligation Rats and Inhibits Apoptosis of HT22 Hippocampal Cells via Regulation of the GSK3β/β-Catenin Pathway. Front Pharmacol 2022; 13:867477. [PMID: 35784758 PMCID: PMC9240707 DOI: 10.3389/fphar.2022.867477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/06/2022] [Indexed: 12/23/2022] Open
Abstract
Succinum is an organic mineral formed from the resin of ancient coniferous and leguminous plants, which is applied for tranquilizing mood, promoting blood circulation, and removing blood stasis in Chinese medicine. For quite a long time, the modern research of succinum mainly focuses on the study of physical and chemical properties and authenticity identification while few reports on its medicinal mechanism. In current study, we evaluated different solvent extracts of succinum on carotid artery ligation rats mimicking vascular dementia. It was found that ethyl acetate extracts of succinum significantly improved the learning and memory abilities of model rats and inhibited neuronal apoptosis in the hippocampus. On a mice hippocampal neuronal cell line (HT22), ethyl acetate extracts of succinum also exerted better action trend in inhibiting cell apoptosis induced by oxygen glucose deprivation (OGD). By using XAV-939 on both in vivo and in vitro studies, it was found that ethyl acetate extracts of succinum might exert these functions by regulating the GSK3β/β-catenin pathway. These studies revealed the neuronal function of succinum, which explained the traditional effects of succinum and provided more modern scientific basis for its clinical application.
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Affiliation(s)
- Chongqi Wei
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Ziqiang Zhu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Jia-ni Zheng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Yunqing Lu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Cheng Cao
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Suchen Qu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Mengqiu Liu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Xue-er Meng
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Qianyin Lou
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Qingqing Wang
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Jin-ao Duan
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
| | - Er-xin Shang
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
| | - Zhenxiang Han
- Department of Neurology and Rehabilitation, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
| | - Yue Zhu
- Jiangsu Key Laboratory for High Technology Research of TCM Formulae and Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nan Jing, China
- *Correspondence: Yue Zhu, ; Zhenxiang Han, ; Er-xin Shang,
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Kim DW, Kim SH, Kook HJ, Jung IC. Efficacy and safety of Buyang-Huanwu-Tang (Boyang-Hwano-Tang) in patients with vascular dementia: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 47:101547. [PMID: 35168040 DOI: 10.1016/j.ctcp.2022.101547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/04/2022] [Accepted: 02/03/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Buyang-Huanwu-Tang (Boyang-Hwano-Tang, BHT) is a widely used traditional Chinese herbal medicine for treating ischemic stroke in South Korea and China. Its efficacy in vascular dementia has been reported. There has been no comprehensive systematic review of BHT for vascular dementia. METHODS We searched 15 electronic databases from inception to November 25, 2021. We included only randomised controlled clinical trials. Studies that used BHT alone or with Western medicine were included. Two independent reviewers conducted the screening, data extraction, and the Cochrane risk of bias and quality of evidence assessment. A meta-analysis was performed. RESULTS A total of 18 eligible trials with 1254 participants were included. Of these, 15 were included in the meta-analysis. The pooled results suggested that BHT alone (mean difference [MD] 1.31; 95% confidence interval [CI] -2.94 to 5.56; P = 0.55) was similar to Western medicine alone in terms of the Mini-Mental State Examination(MMSE). Additive BHT therapy showed a significant improvement in the MMSE (MD 1.42; 95% CI 0.28 to 2.56; P = 0.01), Hasegawa Dementia Scale score (MD 3.91; 95% CI 2.87 to 4.94; P < 0.001) and total effective rate (risk ratio 1.35; 95% CI 1.20 to 1.52; P < 0.001). The overall risk of bias was unclear or high. The quality of evidence was very low to moderate. Only four studies reported minor or no adverse events. CONCLUSIONS The results support the clinical use of BHT for the improvement of cognitive function in patients with vascular dementia. The methodological quality of the included studies was relatively poor. Therefore, further rigorously designed trials are required.
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Affiliation(s)
- Da Woon Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, 411 Saecheonnyeon-daero, Nam-gu, Pohang-si, Gyeongsangbuk-do, Republic of Korea.
| | - Sang Ho Kim
- Department of Neuropsychiatry of Korean Medicine, Pohang Korean Medicine Hospital Affiliated to Daegu Haany University, 411 Saecheonnyeon-daero, Nam-gu, Pohang-si, Gyeongsangbuk-do, Republic of Korea.
| | - Hye Jeong Kook
- Department of Korean Medicine, Korean Medical College of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon, 34520, South Korea.
| | - In Chul Jung
- Department of Neuropsychiatry of Korean Medicine, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea.
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Yang K, Zeng L, Ge A, Cao C, Zhang H, Bao T, Yi Y, Ge J. Systems Biology and Chemoinformatics-Based Strategies to Explore the Biological Mechanism of Fugui Wenyang Decoction in Treating Vascular Dementia Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6693955. [PMID: 34659639 PMCID: PMC8517630 DOI: 10.1155/2021/6693955] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/24/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To explore the biological mechanism of Fugui Wenyang Decoction (FGWYD) in treating vascular dementia (VD) rats based on systems pharmacology, proteomics, and a multidirectional pharmacology integration strategy. METHODS Chemoinformatics was utilized to construct and analyze the FGWYD-VD protein-protein interaction (PPI) network. Then, the total protein in the brain tissue of the infarcted side of the rat was extracted for protein identification, pattern identification, and protein quantitative analysis. The differentially expressed proteins are analyzed by bioinformatics. Finally, the important proteins in the oxidative stress-related biological process proteins and indicators were detected through experimental pharmacology to verify the findings of systems biology and chemoinformatics. RESULTS There were a total of 73 FGWYD components with 245 FGWYD and 145 VD genes. The results of GO enrichment analysis and pathway enrichment analysis showed that MBHD may regulate the inflammation module, oxidative stress, the synaptic plasticity regulation module, and the neuronal apoptosis section module. Compared with the sham operation group, there were 23 upregulated proteins and 17 downregulated proteins in the model group (P < 0.05). Compared with the model group, there were 16 upregulated proteins and 10 downregulated proteins in the FGWYD group (P < 0.05). Bioinformatics analysis shows that those proteins were closely related to processes such as inflammation, oxidative stress, neuronal apoptosis, neuronal growth and differentiation, signaling pathways, and transcriptional regulation. Multidirectional pharmacology further verified the neuroprotective mechanism of the Nrf2/HO-1 pathway in FGWYD treatment of VD. CONCLUSION The mechanism of FGWYD in the treatment of VD may be related to inflammation, oxidative stress, angiogenesis, and neuronal apoptosis.
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Affiliation(s)
- Kailin Yang
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Liuting Zeng
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Anqi Ge
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Chuandong Cao
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Haiyan Zhang
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Tingting Bao
- Beijing University of Chinese Medicine, Beijing, China
| | - Yaqiao Yi
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
| | - Jinwen Ge
- Hunan University of Chinese Medicine, Changsha, Hunan Province, China
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Shi C, Chen S, Salcher-Konrad M, Choy JCP, Luo H, Leung DKY, Cai X, Zeng Y, Dai R, Comas-Herrera A, McDaid D, Knapp M, Wong G. Effectiveness of interventions for people living with dementia and their carers in Chinese communities: protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2021; 11:e047560. [PMID: 34404702 PMCID: PMC8372806 DOI: 10.1136/bmjopen-2020-047560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION As the largest and most rapidly ageing population, Chinese people are now the major driver of the continued growth in dementia prevalence globally. The need for evidence-based interventions in Chinese communities is urgent. Although a wide range of pharmacological and non-pharmacological interventions for dementia have been trialled in Chinese populations, the evidence has not been systematically synthesised. This systematic review and meta-analysis aims to map out the interventions for people living with dementia and their carers in Chinese communities worldwide and compare the effectiveness of these interventions. METHODS AND ANALYSIS This protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. We will search Chinese (China National Knowledge Infrastructure, WanFang DATA) and English bibliographical databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODelling Outcome and cost impacts of interventions for DEMentia (MODEM) Toolkit, Cochrane Database of Systematic Reviews), complemented by hand searching of reference lists. We will include studies evaluating the effectiveness of interventions for dementia or mild cognitive impairment in Chinese populations, using a randomised controlled trial design, and published between January 2008 and June 2020. We will use a standardised form to extract data and Version 2 of the Cochrane risk-of-bias tool for randomised trials to assess the risk of bias of the included studies. Collected data will be fully interpreted with narrative synthesis and analysed using pairwise and network meta-analyses to pool intervention effects where sufficient information is available. We will perform subgroup analysis and meta-regression to explore potential reasons for heterogeneity. ETHICS AND DISSEMINATION No formal ethics approval is required for this protocol. The findings will facilitate the development of studies on interventions for dementia and timely inform dementia policymaking and practice. Planned dissemination channels include peer-reviewed publications, conference presentations, public events and websites. PROSPERO REGISTRATION NUMBER CRD42019134135.
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Affiliation(s)
- Cheng Shi
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Center for Social Welfare Studies, Beijing Normal University, Beijing, China
| | - Shuangzhou Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Maximilian Salcher-Konrad
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK
| | - Jacky C P Choy
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Dara Kiu Yi Leung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Xinxin Cai
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yue Zeng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Ruizhi Dai
- Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK
| | - David McDaid
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Care Policy and Evaluation Centre (CPEC), London School of Economics and Political Science, London, UK
| | - Gloria Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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9
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Kowalska M, Wize K, Prendecki M, Lianeri M, Kozubski W, Dorszewska J. Genetic Variants and Oxidative Stress in Alzheimer's Disease. Curr Alzheimer Res 2021; 17:208-223. [PMID: 32091332 DOI: 10.2174/1567205017666200224121447] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/08/2020] [Accepted: 02/12/2020] [Indexed: 12/26/2022]
Abstract
In an aging society, the number of people suffering from Alzheimer's Disease (AD) is still growing. Currently, intensive research is being carried out on the pathogenesis of AD. The results of these studies indicated that oxidative stress plays an important role in the onset and development of this disease. Moreover, in AD oxidative stress is generated by both genetic and biochemical factors as well as the functioning of the systems responsible for their formation and removal. The genetic factors associated with the regulation of the redox system include TOMM40, APOE, LPR, MAPT, APP, PSEN1 and PSEN2 genes. The most important biochemical parameters related to the formation of oxidative species in AD are p53, Homocysteine (Hcy) and a number of others. The formation of Reactive Oxygen Species (ROS) is also related to the efficiency of the DNA repair system, the effectiveness of the apoptosis, autophagy and mitophagy processes as well as the antioxidant potential. However, these factors are responsible for the development of many disorders, often with similar clinical symptoms, especially in the early stages of the disease. The discovery of markers of the early diagnosis of AD may contribute to the introduction of pharmacotherapy and slow down the progression of this disease.
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Affiliation(s)
- Marta Kowalska
- Laboratory of Neurobiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Wize
- Laboratory of Neurobiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Prendecki
- Laboratory of Neurobiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Margarita Lianeri
- Laboratory of Neurobiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Kozubski
- Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jolanta Dorszewska
- Laboratory of Neurobiology, Poznan University of Medical Sciences, Poznan, Poland
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10
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Liu H, Zhang Z, Zang C, Wang L, Yang H, Sheng C, Shang J, Zhao Z, Yuan F, Yu Y, Yao X, Bao X, Zhang D. GJ-4 ameliorates memory impairment in focal cerebral ischemia/reperfusion of rats via inhibiting JAK2/STAT1-mediated neuroinflammation. JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113491. [PMID: 33091490 DOI: 10.1016/j.jep.2020.113491] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/30/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Gardenia jasminoides J. Ellis (Fructus Gardenia) is a traditional Chinese medicine with diverse pharmacological functions, such as anti-inflammation, anti-depression, as well as improvement of cognition and ischemia brain injury. GJ-4 is a natural extract from Gardenia jasminoides J. Ellis (Fructus Gardenia) and has been proved to improve memory impairment in Alzheimer's disease (AD) mouse model in our previous studies. AIM OF THE STUDY This study aimed to evaluate the therapeutic effects of GJ-4 on vascular dementia (VD) and explore the potential mechanisms. MATERIAL AND METHODS In our experiment, a focal cerebral ischemia and reperfusion rat model was successfully developed by the middle cerebral artery occlusion and reperfusion (MCAO/R). GJ-4 (10 mg/kg, 25 mg/kg, 50 mg/kg) and nimodipine (10 mg/kg) were orally administered to rats once a day for consecutive 12 days. Learning and memory behavioral performance was assayed by step-down test and Morris water maze test. The neurological scoring test was performed to evaluate the neurological function of rats. 2,3,5-Triphenyltetrazolium chloride (TTC) staining and Nissl staining were respectively employed to determine the infarct condition and neuronal injury of the brain. Iba1 immunohistochemistry was used to show the activation of microglia. Moreover, the synaptic damage and inflammatory level were detected by Western blot. RESULTS GJ-4 could significantly improve memory impairment, cerebral infraction, as well as neurological deficits of VD rats induced by MCAO/R. Further research indicated VD-induced neuronal injury was alleviated by GJ-4. In addition, GJ-4 could protect synapse of VD rats by upregulating synaptophysin (SYP) expression, post synaptic density 95 protein (PSD95) expression, and downregulating N-Methyl-D-Aspartate receptor 1 (NMDAR1) expression. Subsequent investigation of the underlying mechanisms identified that GJ-4 could suppress neuroinflammatory responses, supported by inhibited activation of microglia and reduced expression of inflammatory proteins, which ultimately exerted neuroprotective effects on VD. Further mechanistic study indicated that janus kinase 2 (JAK2)/signal transducer and activator of transcription 1 (STAT1) pathway was inhibited by GJ-4 treatment. CONCLUSION These results suggested that GJ-4 might serve as a potential drug to improve VD. In addition, our study indicated that inhibition of neuroinflammation might be a promising target to treat VD.
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MESH Headings
- Animals
- Behavior, Animal/drug effects
- Brain/drug effects
- Brain/enzymology
- Brain/pathology
- Brain/physiopathology
- Dementia, Vascular/enzymology
- Dementia, Vascular/etiology
- Dementia, Vascular/prevention & control
- Dementia, Vascular/psychology
- Disease Models, Animal
- Drugs, Chinese Herbal/pharmacology
- Gardenia
- Infarction, Middle Cerebral Artery/complications
- Infarction, Middle Cerebral Artery/drug therapy
- Infarction, Middle Cerebral Artery/enzymology
- Infarction, Middle Cerebral Artery/physiopathology
- Inflammation Mediators/metabolism
- Janus Kinase 2/metabolism
- Male
- Memory/drug effects
- Memory Disorders/enzymology
- Memory Disorders/etiology
- Memory Disorders/prevention & control
- Memory Disorders/psychology
- Microglia/drug effects
- Microglia/metabolism
- Microglia/pathology
- Neuroprotective Agents/pharmacology
- Nootropic Agents/pharmacology
- Plant Extracts/pharmacology
- Rats, Sprague-Dawley
- Reperfusion Injury/enzymology
- Reperfusion Injury/etiology
- Reperfusion Injury/physiopathology
- Reperfusion Injury/prevention & control
- STAT1 Transcription Factor/metabolism
- Signal Transduction
- Synapses/drug effects
- Synapses/metabolism
- Synapses/pathology
- Rats
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Affiliation(s)
- Hui Liu
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Zihong Zhang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Caixia Zang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Lu Wang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Hanyu Yang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Chanjuan Sheng
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Junmei Shang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Zhe Zhao
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Fangyu Yuan
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China
| | - Yang Yu
- Institute of TCM, Natural Products College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Xinsheng Yao
- Institute of TCM, Natural Products College of Pharmacy, Jinan University, Guangzhou, 510632, China
| | - Xiuqi Bao
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China.
| | - Dan Zhang
- State Key Laboratory of Bioactive Substrate and Function of Natural Medicine, Institute of Materia Medica, Chinese Academy of Medical Sciences, Peking Union Medical College, 1 Xian Nong Tan Street, Beijing, 100050, China.
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Zhang X, Liu X, Xia R, Li N, Liao X, Chen Z. Chinese herbal medicine for vascular cognitive impairment in cerebral small vessel disease: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99:e22455. [PMID: 33019432 PMCID: PMC7535689 DOI: 10.1097/md.0000000000022455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cerebral small vessel disease (CSVD) is the most common etiology of vascular cognitive impairment (VCI). VCI in CSVD (CSVD-VCI) shows a progressive course with multiple stages and is also associated with dysfunctions such as gait, emotional and behavioral, and urinary disturbances, which seriously affect the life quality of elderly people. In mainland China, Chinese herbal medicine (CHM) is clinically used for CSVD-VCI and presenting positive efficacy, but the evidence revealed in relevant clinical trials has not been systematically evaluated. The purpose of this study is to assess the current evidence available for the clinical efficacy and safety of CHM for CSVD-VCI. METHODS A literature search of published RCTs up to April 30, 2020, has been conducted in the following 7 electronic databases: PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and Technology Journals Database (VIP), Wanfang Database, and Chinese Biomedical Literature Service System (SinoMed). For unpublished studies, 2 clinical trial online registration websites will be searched: ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR). Only randomized controlled trials (RCTs) using CHM in the treatment of patients with CSVD-VCI, which compares CHM with no treatment, placebo, or other conventional treatments, will be included in this systematic review. Primary outcomes will be set as acknowledged scales measuring cognitive function. Secondary outcomes will involve activities of daily living, behavioral, and psychological symptoms, global performance of dementia, neurological function, biological markers of endothelial dysfunction, the clinical effective rate, and adverse events. After screening studies and extracting data, the Cochrane Collaborations tool for assessing risk of bias will be applied to assess the methodological quality of included RCTs. Review Manager Version 5.3 software will be used for data synthesis and statistical analysis. Subgroup analyses, sensitivity analyses, and meta-regression will be conducted to detect potential sources of heterogeneity. The funnel plot and Eggers test will be developed to evaluate publication bias, if available. We will perform the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to appraise the quality of evidence. RESULTS Evidence exhibited in this systematic review will provide practical references in the field of CHM treating CSVD-VCI. Moreover, our detailed appraisals of methodological deficiencies of relevant RCTs will offer helpful advice for researchers who are designing trials of CHMs in the treatment of CSVD-VCI. CONCLUSION The conclusion about the clinical efficacy and safety of CHM for CSVD-VCI will be provided for clinical plans, decisions, and policy developments in the full version of this systematic review. SYSTEMATIC REVIEW REGISTRATION INPLASY202080120.
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Affiliation(s)
| | | | - Ruyu Xia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine
| | | | - Xing Liao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
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12
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The Utilization of Complementary and Alternative Medicine among Saudi Older Adults: A Population-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4357194. [PMID: 32831865 PMCID: PMC7428939 DOI: 10.1155/2020/4357194] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/03/2020] [Accepted: 06/22/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is an integral part of patients' therapeutic experience worldwide. Among Saudi older adults, less is known about CAM utilization. OBJECTIVES To determine the prevalence, patterns, and factors associated with CAM utilization among SOA. METHODS In the Saudi National Survey for Elderly Health (SNSEH), subjects were asked about CAM use during the last twelve months before the interview. CAM use was defined as any use of herbal products, acupuncture, bloodletting, cauterization, medical massage, bones manual manipulation, honey, or religious rituals. Demographic characteristics included gender, age, marital status, region, educational level, and residence area. In addition, multiple comorbidities were included as possible factors that may be associated with CAM use. Multivariable logistic regression was used to explore factors associated with CAM utilization. All statistical analyses were done using STATA v.14. RESULTS Out of 2946 respondents, 50.4% were males, the mean age was 70.3 ± 8.3 years, and 70% were illiterate. CAM use was prevalent (62.5%). The most common CAM types were herbal products (25.4%), acupuncture (21.2%), bloodletting (12%), honey (9.5%), cauterization (7.4%), medical massage and bones manual manipulation (4%), and traditional bone setting (2.1%). In the multivariable regression, age, gender, and marital status did not have an impact on the odds of using CAM. Subjects from rural areas were 2.92 times more likely to use CAM compared with subjects in urban areas (OR = 2.92; 95%CI: 2.28-3.75). Subjects with metabolic disorders (OR = 0.50; 95% CI: 0.42-0.60) or kidney disease were less likely to use CAM (OR = 0.30; 95%CI: 0.14-0.64). About pain, CAM is used more in neck pain (OR = 1.69; 95%CI: 1.30-2.21) and also used in back pain (OR = 1.22; 95%CI: 1.03-1.46). CONCLUSIONS CAM use was very prevalent among SOA. Clinicians and pharmacists must ask about CAM use among older adults as many of CAM may interact with patients medications.
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Abstract
BACKGROUND Although memory loss and other symptoms of dementia pose tremendous burdens on patients and societies, there is currently no cure for dementia. METHODS We conducted a systematic review and meta-analysis of the anti-dementia effects of Danggui-Shaoyao-San (DSS), which is derived from natural resources. We searched for randomized controlled trials (RCTs) from inception to June 2019. We searched PubMed, Embase, Korean databases (Research Information Service System and Oriental Medicine Advanced Searching Integrated System), Chinese databases (China Knowledge Resource Integrated Database and Wanfang Database), and Japanese databases (CiNii and J-STAGE). Studies were included if they were a RCT, investigated the efficacy of DSS or its modified form, and included participants with dementia. Use of DSS with other treatment (eg, acupuncture, anti-dementia drugs, etc) was included. Items of each trial were evaluated by 2 independent reviewers. Data were pooled by using random-effect models. RESULTS A total of 482 studies were identified, and 5 eligible studies for Alzheimer disease (AD) and 4 studies for vascular dementia (VD) were included in the final analysis, representing a total of 567 participants. As for AD, pooled results of the Mini-Mental State Examination (MMSE) (mean differences [MD] 4.60; 95% confidence interval [CI] 4.29, 4.91) and activities of daily living (MD 11.40; 95% CI 10.94, 11.86) favored DSS. DSS had synergistic effect with acupuncture over acupuncture alone in MMSE (MD 1.69; 95% CI 1.05, 2.34), Hasegawa Dementia Scale (MD.62; 95% CI -0.20, 1.44), and activities of daily living (MD 2.38; 95% CI 1.92, 2.85). In VD, pooled results showed a significant difference in the score of dementia scales such as MMSE and Hasegawa Dementia Scale compared with nootropic drugs. DSS significantly reduced symptoms (odds ratio 5.02, 95%, CI 2.76-9.11) in patients with VD. The respective size of each RCTs was small and some included studies were of low quality due to their limited description on methodological issues. CONCLUSION These estimates suggest that DSS provides clinically important reductions in symptoms of AD and VD and can be a promising anti-dementia drug candidate.
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Affiliation(s)
- Yunna Kim
- Department of Clinical Korean Medicine, Graduate School
- College of Korean Medicine
- Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, South Korea
| | - Seung-Hun Cho
- College of Korean Medicine
- Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, South Korea
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14
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Kim TH, Kang JW. Herbal Medicine for Vascular Dementia: An Overview of Systematic Reviews. Curr Vasc Pharmacol 2019; 18:394-409. [PMID: 31258089 DOI: 10.2174/1570161117666190618164443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/22/2019] [Accepted: 06/19/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Vascular dementia (VaD), a severe neurologic condition related to aging of the cerebrovascular structure, has been treated with herbal medications and products. In this overview of systematic reviews (SRs) on the effects of herbal medications, we aimed to summarize the current clinical evidence on the benefits of herbal drugs and to propose an evidence map outlining their effects on VaD. METHODS SRs assessing their effects on cognitive function or performance and the associated safety, published until December 2018, were located from PubMed, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, China National Knowledge Infrastructure, and Oriental Medicine Advanced Searching Integrated System. A Measurement Tool to Assess systematic Reviews 2 was used to assess their overall confidence. A bubble plot was proposed to present the depth and width of the current status of the evidence supporting the use of individual herbal drugs. RESULTS Ten SRs (4 on individual herbal medications and 6 on various herbal drugs) were included. The overall evidence on herbal medicines suggests that they are effective in improving cognitive function and performance. Individual herbal medications including FuFangHaiShe, NaoXinTong, YinDanXing- NaoTong, NaoMaiTai, ShenFuTang, and TongXinLuo showed favourable effects when assessed via a minimal mental state examination score but have limited evidence supporting their effectiveness due to the scarcity of randomized controlled trials. Concerning safety, most SRs did not outline the estimated risk ratio of adverse events. CONCLUSION Herbal medications might have benefits for VaD patients but they need to be evaluated further.
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Affiliation(s)
- Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, South Korea
| | - Jung Won Kang
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, South Korea
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15
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Efferth T, Banerjee M, Abu-Darwish MS, Abdelfatah S, Böckers M, Bhakta-Guha D, Bolzani V, Daak S, Demirezer ÖL, Dawood M, Efferth M, El-Seedi HR, Fischer N, Greten HJ, Hamdoun S, Hong C, Horneber M, Kadioglu O, Khalid HE, Khalid SA, Kuete V, Mahmoud N, Marin J, Mbaveng A, Midiwo J, Nakagawa H, Naß J, Ngassapa O, Ochwang'i D, Omosa LK, Ooko EA, Özenver N, Poornima P, Romero MR, Saeed MEM, Salgueiro L, Seo EJ, Yan G, Yasin Z, Saeed EM, Paul NW. Biopiracy versus One-World Medicine-From colonial relicts to global collaborative concepts. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 53:319-331. [PMID: 30190231 DOI: 10.1016/j.phymed.2018.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/10/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism. HYPOTHESIS The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe. STUDY DESIGN Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine. CONCLUSION To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients.
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Affiliation(s)
- Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany.
| | - Mita Banerjee
- Department of English and Linguistics, American Studies, Center for Comparative Native and Indigenous Studies, Johannes Gutenberg University, Mainz, Germany
| | - Mohammad Sanad Abu-Darwish
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Shoubak University College, Al-Balqa Applied University, Jordan
| | - Sara Abdelfatah
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Madeleine Böckers
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Dipita Bhakta-Guha
- School of Chemical and Biotechnology, SASTRA University, Thanjavur 613401, TN, India
| | - Vanderlan Bolzani
- Department of Organic Chemistry, Institute of Chemistry, São Paulo State University, Araraquara, Brazil
| | - Salah Daak
- Dr. Salah Wanesi Foundation for Cancer Research and Control, Khartoum, Sudan
| | | | - Mona Dawood
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Monika Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Hesham R El-Seedi
- Chemistry Department, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia; Division of Pharmacognosy, Department of Medicinal Chemistry, Uppsala University, Biomedical Center, Uppsala, Sweden
| | - Nicolas Fischer
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Henry J Greten
- Biomedical Sciences Institute Abel Salazar, University of Porto, Porto, Portugal; Heidelberg School of Chinese Medicine, Heidelberg, Germany
| | - Sami Hamdoun
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Chunlan Hong
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Markus Horneber
- Department of Internal Medicine, Division of Oncology and Hematology, Paracelsus Medical University, Klinikum Nürnberg, Germany
| | - Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Hassan E Khalid
- Department of Pharmacognosy, University of Khartoum, Khartoum, Sudan
| | - Sami A Khalid
- Faculty of Pharmacy, University of Science and Technology, Omdurman, Sudan; Faculty of Pharmacy, University of Khartoum, Karthoum, Sudan
| | - Victor Kuete
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Nuha Mahmoud
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - José Marin
- Department of Biochemistry and Molecular Biology, Experimental Hepatology and Drug Targeting (HEVEFARM), CIBERehd, IBSAL, University of Salamanca Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Armelle Mbaveng
- Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Jacob Midiwo
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | - Hiroshi Nakagawa
- Department of Applied Biological Chemistry, Graduate School of Bioscience and Biotechnology, Chubu University, Kasugai, Aichi, Japan
| | - Janine Naß
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Olipa Ngassapa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Dominic Ochwang'i
- Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Leonida K Omosa
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | - Edna A Ooko
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Nadire Özenver
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany; Hacettepe University, Faculty of Pharmacy, Department of Pharmacognosy, Ankara, Turkey
| | - Paramasivan Poornima
- Molecular and Cellular Pharmacology Laboratory, School of Science, Engineering and Technology, University of Abertay, Dundee, Scotland, United Kingdom
| | - Marta Rodriguez Romero
- Department of Biochemistry and Molecular Biology, Experimental Hepatology and Drug Targeting (HEVEFARM), CIBERehd, IBSAL, University of Salamanca Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ligia Salgueiro
- Center of Neurosciences and Cell Biology and Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Ean-Jeong Seo
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Ge Yan
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | | | | | - Norbert W Paul
- Institute for the History, Philosophy, and Ethics of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany
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Chan ESY, Bautista DT, Zhu Y, You Y, Long JT, Li W, Chen C. Traditional Chinese herbal medicine for vascular dementia. Cochrane Database Syst Rev 2018; 12:CD010284. [PMID: 30520514 PMCID: PMC6516869 DOI: 10.1002/14651858.cd010284.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Traditional Chinese herbal medicine (TCHM) is widely used for treating vascular dementia (VaD) in China. Recent studies of a number of TCHMs have demonstrated in vitro biological activity and therapeutic effects in animals, but the published clinical evidence has not been systematically appraised. OBJECTIVES To evaluate the efficacy and safety of TCHMs listed in either the Chinese Pharmacopoeia (CP) or the Chinese National Essential Drug List (NEDL) that are used to treat VaD. A secondary aim was to identify promising TCHMs for further clinical research. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's Specialised Register (on 14 March 2018) and also several Chinese biomedical databases: the Chinese Biological Medicine Database (January 1979 to May 2015), Wanfang database (January 1998 to May 2015), Chongqing VIP Information Co. Ltd or Weipu (January 1998 to May 2015) and the Chinese National Knowledge Infrastructure (January 1979 to May 2015). SELECTION CRITERIA We included randomised controlled trials (RCTs) of TCHMs compared to placebo, to Western medicine (WM) or to routine therapy for VaD risk factors. Eligible participants were men and women aged 18 years and above, diagnosed with VaD by any of the following four criteria: (1) Diagnostic and Statistical Manual of Mental Disorders (DSM) versions III, III-R, IV, IV-TR; (2) National Institute of Neurological Disorders and Stroke (NINDS-AIREN); (3) International Classification of Diseases 9 or 10; (4) the Hachinski or the Modified Hachinski Ischaemic Score. We required the use of an imaging technique to differentiate VaD from other dementias. We excluded (1) trials with participants diagnosed with mixed dementia or those that did not use an imaging technique to ascertain VaD; (2) trials of NEDL-listed Gingko biloba or Huperzine A as experimental interventions, to avoid duplication of existing Cochrane Reviews; (3) trials using acupuncture alone as the experimental intervention; (4) trials using another CP- or NEDL-listed TCHM (except for Huperzine A and Gingko which are popular in Western practice) as the control intervention; and (5) trials using purely non-pharmacological interventions as the control intervention unless explicitly described as 'routine therapy for VaD risk factors'. DATA COLLECTION AND ANALYSIS We assessed the risks of bias using the Cochrane 'Risk of bias' tool and adapted the Outcome Reporting Bias in Trials (ORBIT) classification system for outcome reporting bias. We assessed TCHM effects on five clinically important outcomes: cognition, global performance, safety, activities of daily living and behaviour and summarised the effects using mean differences for continuous outcomes and risk ratios or risk differences for binary outcomes. We stratified the studies into those that estimated the TCHM versus 'no treatment' effect and those that estimated the TCHM versus the WM effect, with further stratification by the specific TCHM tested or by one of the four modes of action. We pooled using a random-effects model. Due to substantial clinical and design heterogeneity, we did not estimate an 'overall TCHM effect'. MAIN RESULTS We only found studies (47 studies, 3581 participants) for 18 of the 29 eligible TCHMs as defined by our inclusion criteria. All were superiority trials conducted in China between 1997 and 2013, with most employing a two-arm parallel design with sample sizes ranging from 26 to 240 and a median treatment duration of 12 weeks (range: 2 to 24 weeks).We found that reporting and trial methodology were generally poor; in particular, there was a lack of information on randomisation, an absence of blinding of participants and outcome assessors and incomplete reporting of adverse events (AEs). None of the 30 trials published from 2007 onwards adopted the CONSORT recommendations for reporting RCTs of herbal interventions.We found seven TCHMs which each had potentially large benefits in studies estimating the TCHM versus 'no treatment' effect and in studies estimating the TCHM versus the WM effect. Two TCHMs (NaoXinTong and TongXinLuo) were common to both groups. Three of these TCHMs - Nao XinTong, NaoMaiTai and TongXinLuo - had the strongest evidence to justify further research. Two TCHMs (NaoMaiTai and TongXinLuo) had a 5% or more increased risk of AEs compared to the 'no Treatment' control, but the quality of this evidence was poor. AUTHORS' CONCLUSIONS We found moderate- to very low-quality evidence of benefit and harm of TCHMs for VaD. Methodological inadequacies need to be addressed by better conducted and reported trials. We identified NaoMaiTai, NaoXinTong and TongXinLuo as warranting special research priority.
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Affiliation(s)
- Edwin SY Chan
- Singapore Clinical Research InstituteCochrane SingaporeNanos Building #02‐0131 Biopolis WaySingaporeSingapore138669
| | - Dianne T Bautista
- Singapore Clinical Research InsituteDepartment of Biostatistics31 Biopolis Way, Nanos #02‐01SingaporeSingapore138669
| | - Yanan Zhu
- A*STARSingapore Institute of Clinical Sciences61 Compassvale Bow, #08‐21SingaporeSingapore544989
| | - Yong You
- First Affiliated Hospital of Nanhua UniversityNeurology69 Chan Shuan RoadHengyangHunanChina421001
| | - Jian Ting Long
- First Affiliated Hospital of Nanhua UniversityNeurology69 Chan Shuan RoadHengyangHunanChina421001
| | - Wenyun Li
- Jinan UniversityDepartment of Public Health and Preventive Medicine, School of Medicine601 Huangpudadao Street WestGuangzhouGuangdongChina510632
| | - Christopher Chen
- Yong Loo Lin School of Medicine, National University of SingaporeDepartment of PharmacologyClinical Research Center Bldng MD11, Level 510 Medical DriveSingaporeSingapore117597
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17
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Ghorani-Azam A, Sepahi S, Khodaverdi E, Mohajeri SA. Herbal medicine as a promising therapeutic approach for the management of vascular dementia: A systematic literature review. Phytother Res 2018; 32:1720-1728. [DOI: 10.1002/ptr.6120] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Adel Ghorani-Azam
- Medical Toxicology Research Center; Mashhad University of Medical Sciences; Mashhad Iran
| | - Samaneh Sepahi
- Targeted Drug Delivery Research Center; Pharmaceutical Technology Institute, Mashhad University of Medical Sciences; Mashhad Iran
- Student Research Committee; Mashhad University of Medical Sciences; Mashhad Iran
| | - Elham Khodaverdi
- Targeted Drug Delivery Research Center; Pharmaceutical Technology Institute, Mashhad University of Medical Sciences; Mashhad Iran
- Department of pharmaceutics, School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
| | - Seyed Ahmad Mohajeri
- Pharmaceutical Research Center; Pharmaceutical Technology Institute, Mashhad University of Medical Sciences; Mashhad Iran
- Department of pharmacodynamics and Toxicology, School of Pharmacy; Mashhad University of Medical Sciences; Mashhad Iran
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18
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Perng CH, Chang YC, Tzang RF. The treatment of cognitive dysfunction in dementia: a multiple treatments meta-analysis. Psychopharmacology (Berl) 2018; 235:1571-1580. [PMID: 29502274 DOI: 10.1007/s00213-018-4867-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/20/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE No cure is currently available for dementia; however, various treatments and interventions have been reported to be effective. The factors influencing the efficacy of dementia treatment have not been comprehensively evaluated. This study evaluated the factors influencing treatment effects on cognitive dysfunction in dementia by comparing the results obtained from a meta-analysis based on meta-regression. METHODS We searched for articles, clinical trials, and meta-analyses on the efficacy of pharmacotherapy or psychosocial treatment for dementia published between 2000 and 2016 in the MEDLINE/PubMed, Cochrane Library, SCOPUS, and Airiti Library databases. RESULTS The 235 selected studies involved 44,854 patients with dementia (mainly vascular dementia, Alzheimer disease, and mild cognitive impairment). A preliminary random effects meta-analysis yielded a positive overall effect. The pooled standardized mean difference of the treatment effects on cognitive dysfunction was 0.439 (95% confidence interval 0.374, 0.504). The results of meta-regression showed that in young patients (β = - 0.036, p value < 0.001) with vascular dementia (β = 0.603, p value < 0.001), the efficacies of treatment 2 (symptomatic treatment for vascular dementia with piracetam, nimodipine, aniracetam, flunarizine, vinpocetine, hyperbaric oxygen, oxiracetam, or EGB761) and treatment 5 (treatment with other alternative therapies including acupuncture, premarin, statin, butylphthalide soft capsules, donepezil, huperzine A, and lithium treatment) were higher than those of other existing treatments for cognitive dysfunction (β = 0.308 and 0.321, p values = 0.010 and < 0.001, respectively). CONCLUSION The most effective intervention for dementia available is symptomatic treatment for vascular dementia. Antipsychotic treatment for dementia alleviates cognitive dysfunction less effectively than does symptomatic treatment. Alternative therapies are also effective at present. Further research on causes and very early diagnosis of Alzheimer disease is warranted.
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Affiliation(s)
- Cheng-Hwang Perng
- Department of Statistics and Actuarial Science, Aletheia University, New Taipei City, Taiwan, Republic of China
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei City, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Number 92, Sec. 2, Zhong Shan N Road, Taipei, 104, Taiwan. .,Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan. .,Mackay Medical College, New Taipei City, Taiwan.
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19
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Xu QQ, Shan CS, Wang Y, Shi YH, Zhang QH, Zheng GQ. Chinese Herbal Medicine for Vascular Dementia: A Systematic Review and Meta-Analysis of High-Quality Randomized Controlled Trials. J Alzheimers Dis 2018; 62:429-456. [PMID: 29439346 DOI: 10.3233/jad-170856] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Qing-qing Xu
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chun-shuo Shan
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yong Wang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-hua Shi
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qi-hao Zhang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
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20
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Lee YS, Kwon S, Chae Y, Jang BH, Ko SG. A retrospective cohort study on the outcomes of ischemic stroke patients with adjuvant Korean Medicine treatment. Sci Rep 2018; 8:1656. [PMID: 29374270 PMCID: PMC5786017 DOI: 10.1038/s41598-018-19841-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/08/2018] [Indexed: 12/14/2022] Open
Abstract
This study aims to examine the long-term effect of adjuvant treatment in Korean Medicine (KM) clinics in ischemic stroke patients, using a national sample cohort from the National Health Insurance Service in Korea between 2010 and 2013. The National Health Insurance Service - National Sample Cohort database from 2002 to 2013 was used in this study. Ischemic stroke patients were defined and covariates were included to account for socioeconomic variables, comorbidities and disease severity. Propensity score matching was applied. Cox proportional hazards modeling and Kaplan-Meier analysis were applied to determine the differences between KM and non-KM treated groups. The results shows that KM-treated group had a higher probability of survival than non-KM group patients. No significant difference was observed between the risk of readmission between the treated and non-treated patients. Kaplan-Meier analysis showed a weak effect of KM treatments in the patients with 8 to 28 days of hospital stay for a lower risk of recurrence than in non-treated patients. In conclusion, KM treatment of mild to moderate ischemic stroke patients has a mild effect on the survival probability of stroke. Its effect for improving long-term recurrence need to be explored in the future studies.
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Affiliation(s)
- Ye-Seul Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Seungwon Kwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
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21
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Colalto C. What phytotherapy needs: Evidence-based guidelines for better clinical practice. Phytother Res 2017; 32:413-425. [DOI: 10.1002/ptr.5977] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/12/2017] [Accepted: 10/14/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Cristiano Colalto
- Farmacia San Paolo Dr. Colalto; P.zza De L'Osto 37 37035 San Giovanni Ilarione Verona Italy
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22
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Liu W, Zhao Y, Zhang X, Ji J. Simvastatin ameliorates cognitive impairments via inhibition of oxidative stress‑induced apoptosis of hippocampal cells through the ERK/AKT signaling pathway in a rat model of senile dementia. Mol Med Rep 2017; 17:1885-1892. [PMID: 29257256 DOI: 10.3892/mmr.2017.8098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 10/06/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Wenting Liu
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Yan Zhao
- Department of Neurology, The Affiliated Qingdao Hiser Hospital of Qingdao University, Qingdao, Shandong 266033, P.R. China
| | - Xinyu Zhang
- Department of Neurology, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China
| | - Jiangang Ji
- Department of Encephalopathy, Traditional Chinese Medicine Hospital of Weifang, Weifang, Shandong 261041, P.R. China
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23
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Using Complementary and Alternative Medicine to Treat Pain and Agitation in Dementia: A Review of Randomized Controlled Trials from Long-Term Care with Potential Use in Critical Care. Crit Care Nurs Clin North Am 2017; 29:519-537. [PMID: 29107312 DOI: 10.1016/j.cnc.2017.08.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The risk of pain in adults with dementia worsens with advancing age. Painful comorbidities may be underassessed and inadequately treated. Receiving treatment in critical care settings may indicate greater occurrences of pain and complications. Pain may exacerbate behavioral and psychological symptoms of dementia (BPSD), such as agitation. Complementary and alternative medicine (CAM) therapies may alleviate pain and BPSD, and continuity of therapy may bolster these therapeutic effects. This review did not reveal an apparent benefit of aromatherapy; however, improvements in BPSD have been shown previously. Massage and human interaction did demonstrate efficacy in reducing BPSD and pain.
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24
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Liu CT, Wu BY, Hung YC, Wang LY, Lee YY, Lin TK, Lin PY, Chen WF, Chiang JH, Hsu SF, Hu WL. Decreased risk of dementia in migraine patients with traditional Chinese medicine use: a population-based cohort study. Oncotarget 2017; 8:79680-79692. [PMID: 29108348 PMCID: PMC5668081 DOI: 10.18632/oncotarget.19094] [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: 02/27/2017] [Accepted: 06/28/2017] [Indexed: 01/08/2023] Open
Abstract
Patients with migraine are reportedly at increased risk of developing dementia. We aimed to investigate the association between traditional Chinese medicine (TCM) use and dementia risk in migraine patients. This longitudinal cohort study used the Taiwanese National Health Insurance Research Database to identify 32,386 diagnosed migraine patients aged 20 years and above who received treatment from 1997 to 2010. To balance comparability between TCM users and non-TCM users, we randomly selected equal numbers from each group, and compared subgroups compiled based on combinations of age, sex, index year, and year of migraine diagnosis. All enrollees received follow-up until the end of 2013 to measure dementia incidence. We identified 1,402 TCM users and non-TCM users after frequency matching. A total of 134 subjects were newly diagnosed with dementia during the follow-up period. TCM users were significantly less likely to develop dementia than non-TCM users. The most frequently prescribed formulae and single Chinese herbal products were Jia-Wei-Xiao-Yao-San and Yan-Hu-Suo, respectively. This population-based study revealed a decreased dementia risk in migraine patients with TCM use. These findings may provide a reference for dementia prevention strategies, and help integrate TCM into clinical intervention programs that provide a favorable prognosis for migraine patients.
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Affiliation(s)
- Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Bei-Yu Wu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Lin-Yi Wang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yan-Yuh Lee
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsu-Kung Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wu-Fu Chen
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Sheng-Feng Hsu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taipei Branch, Taipei, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan.,Fooyin University College of Nursing, Kaohsiung, Taiwan
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25
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Bordet R, Ihl R, Korczyn AD, Lanza G, Jansa J, Hoerr R, Guekht A. Towards the concept of disease-modifier in post-stroke or vascular cognitive impairment: a consensus report. BMC Med 2017; 15:107. [PMID: 28539119 PMCID: PMC5444106 DOI: 10.1186/s12916-017-0869-6] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 05/06/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vascular cognitive impairment (VCI) is a complex spectrum encompassing post-stroke cognitive impairment (PSCI) and small vessel disease-related cognitive impairment. Despite the growing health, social, and economic burden of VCI, to date, no specific treatment is available, prompting the introduction of the concept of a disease modifier. CONSENSUS AND SUGGESTIONS Within this clinical spectrum, VCI and PSCI remain advancing conditions as neurodegenerative diseases with progression of both vascular and degenerative lesions accounting for cognitive decline. Disease-modifying strategies should integrate both pharmacological and non-pharmacological multimodal approaches, with pleiotropic effects targeting (1) endothelial and brain-blood barrier dysfunction; (2) neuronal death and axonal loss; (3) cerebral plasticity and compensatory mechanisms; and (4) degenerative-related protein misfolding. Moreover, pharmacological and non-pharmacological treatment in PSCI or VCI requires valid study designs clearly stating the definition of basic methodological issues, such as the instruments that should be used to measure eventual changes, the biomarker-based stratification of participants to be investigated, and statistical tests, as well as the inclusion and exclusion criteria that should be applied. CONCLUSION A consensus emerged to propose the development of a disease-modifying strategy in VCI and PSCI based on pleiotropic pharmacological and non-pharmacological approaches.
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Affiliation(s)
- Régis Bordet
- University of Lille, Inserm, CHU, U1171 'Degenerative and vascular cognitive disorders', Lille, France.
- Département de Pharmacologie Médicale, Faculté de Médecine, 1 place Verdun, 59045, Lille Cedex, France.
| | - Ralf Ihl
- University of Duesseldorf, Alexian Research Center, Krefeld, Germany
| | - Amos D Korczyn
- Department of Neurology, Tel Aviv University, Ramat Aviv, Israel
| | - Giuseppe Lanza
- Department of Neurology IC, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
| | - Jelka Jansa
- University Medical Centre Ljubljana, Neurologic Hospital, Neurorehabilitation Unit, Ljubljana, Slovenia
| | - Robert Hoerr
- Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
| | - Alla Guekht
- Department of Neurology, Neurosurgery and Genetics, Russian National Research Medical University, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
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26
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Ikram MA, Bersano A, Manso-Calderón R, Jia JP, Schmidt H, Middleton L, Nacmias B, Siddiqi S, Adams HHH. Genetics of vascular dementia - review from the ICVD working group. BMC Med 2017; 15:48. [PMID: 28260527 PMCID: PMC5338082 DOI: 10.1186/s12916-017-0813-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vascular dementia is a common disorder resulting in considerable morbidity and mortality. Determining the extent to which genes play a role in disease susceptibility and their pathophysiological mechanisms could improve our understanding of vascular dementia, leading to a potential translation of this knowledge to clinical practice. DISCUSSION In this review, we discuss what is currently known about the genetics of vascular dementia. The identification of causal genes remains limited to monogenic forms of the disease, with findings for sporadic vascular dementia being less robust. However, progress in genetic research on associated phenotypes, such as cerebral small vessel disease, Alzheimer's disease, and stroke, have the potential to inform on the genetics of vascular dementia. We conclude by providing an overview of future developments in the field and how such work could impact patients and clinicians. CONCLUSION The genetic background of vascular dementia is well established for monogenic disorders, but remains relatively obscure for the sporadic form. More work is needed for providing robust findings that might eventually lead to clinical translation.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands. .,Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands. .,Department of Neurology, Erasmus MC, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
| | - Anna Bersano
- Cerebrovascular Unit IRCCS Foundation Neurological Institute C. Besta, Milan, Italy
| | - Raquel Manso-Calderón
- Department of Neurology, University Hospital of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), University of Salamanca-CSIC-SACYL, Salamanca, Spain
| | - Jian-Ping Jia
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Helena Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Lefkos Middleton
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Hieab H H Adams
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
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27
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Matsumoto-Miyazaki J, Ushikoshi H, Miyata S, Miyazaki N, Nawa T, Okada H, Ojio S, Ogura S, Minatoguchi S. Acupuncture and Traditional Herbal Medicine Therapy Prevent Deliriumin Patients with Cardiovascular Disease in Intensive Care Units. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:255-268. [PMID: 28231740 DOI: 10.1142/s0192415x17500161] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the effect of combination therapy consisting of acupuncture and traditional herbal medicine (Kampo medicine) for reducing the incidence rate of delirium in patients with cardiovascular (CV) disease in ICUs. Twenty-nine patients who had been urgently admitted to the ICU in the control period were treated with conventional intensive care. Thirty patients in the treatment period received conventional therapy plus a combination therapy consisting of acupuncture and herbal medicine. Acupuncture treatment was performed once a day, and the herbal formula was administered orally three times a day during the first week of the ICU stay. The standard acupuncture points were GV20, Ex-HN3, HT7, LI4, Liv3, and KI3, and the main herbal preparation was Kamikihito. The incident rates of delirium, assessed using the confusion assessment method for ICU, in the treatment and control period were compared. The incidence rate of delirium was significantly lower in the treatment group than in the control group (6.6% vs. 37.9%, [Formula: see text]). Moreover, sedative drugs and non-pharmacological approaches against aggressive behavior of patients who were delirious were used less in the treatment group than in the control group. No serious adverse events were observed in the treatment group. Combination therapy consisting of acupuncture and herbal medicine was found to be effective in lowering the incidence of delirium in patients with CV disease in ICUs. Further studies with a large sample size and parallel randomized controlled design would be required to establish the effects of this therapy.
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Affiliation(s)
| | - Hiroaki Ushikoshi
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.,‡ Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Shusaku Miyata
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.,‡ Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan.,§ Department of Cardiology, Gifu Municipal Hospital, Gifu, Japan
| | - Nagisa Miyazaki
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.,¶ Department of Internal Medicine, Asahi University, Gifu, Japan
| | - Takahide Nawa
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hideshi Okada
- † Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,‡ Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Shinsuke Ojio
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan.,‡ Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan.,§ Department of Cardiology, Gifu Municipal Hospital, Gifu, Japan
| | - Shinji Ogura
- † Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.,‡ Advanced Critical Care Center, Gifu University Hospital, Gifu, Japan
| | - Shinya Minatoguchi
- * Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
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Hyde AJ, May BH, Dong L, Feng M, Liu S, Guo X, Zhang AL, Lu C, Xue CC. Herbal medicine for management of the behavioural and psychological symptoms of dementia (BPSD): A systematic review and meta-analysis. J Psychopharmacol 2017; 31:169-183. [PMID: 27899689 DOI: 10.1177/0269881116675515] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Management of the behavioural and psychological symptoms of dementia remains a challenge worldwide. Herbal medicines may play a role in the development of new interventions. To determine effects of herbal medicines for management of the behavioural and psychological symptoms of dementia, meta-analysis was conducted of 31 controlled trials (3613 participants). Frequently tested herbal medicines were the Ginkgo biloba leaf extract EGb 761 (seven studies) and the multi-ingredient formula Yokukansan (eight studies). Sixteen studies tested other herbal medicines. Improvements were detected in Neuropsychiatric Inventory scores in EGb 761 groups compared to placebo (MD -3.46 [-5.94, -0.98]; I2 = 93%; n = 1757) and Yokukansan groups compared to no treatment (SMD -0.53 [-0.86, -0.21]; I2 = 0%; n = 150). Cognitive scores were improved in EGb 761 groups while Yokukansan did not appear to affect cognitive function. Of the other herbal medicines, there were improvements in the behavioural and psychological symptoms of dementia and cognitive outcomes in two of four placebo-controlled studies. EGb 761 and Yokukansan appeared safe and well tolerated. Adverse effects and dropouts were not reported consistently for the other herbal medicines. Weaknesses of these included short durations, small sample sizes, lack of blinding and other risks of bias. Well-designed studies are needed to further investigate the reported effects of these interventions on the behavioural and psychological symptoms of dementia.
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Affiliation(s)
- Anna J Hyde
- 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Brian H May
- 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Lin Dong
- 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Mei Feng
- 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Shaonan Liu
- 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Xinfeng Guo
- 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Anthony Lin Zhang
- 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Chuanjian Lu
- 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.,2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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Dong L, May BH, Feng M, Hyde AJ, Tan HY, Guo X, Zhang AL, Lu C, Xue CC. Chinese Herbal Medicine for Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Cognitive Outcomes. Phytother Res 2016; 30:1592-1604. [PMID: 27416935 DOI: 10.1002/ptr.5679] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 06/02/2016] [Accepted: 06/17/2016] [Indexed: 11/09/2022]
Abstract
Mild cognitive impairment (MCI) is a condition that may be prodromal to the development of dementia. There remain, as yet, no approved pharmaceutical interventions for MCI. Chinese herbal medicines (CHMs) have a long history of use for cognitive impairments and some plant ingredients have shown neuroprotective actions in experimental studies. This review assesses the current clinical evidence from controlled clinical trials for the effects of CHMs on cognitive outcomes as measured by Mini-mental state examination (MMSE) or Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog). Fifty one studies (4026 participants) were included. These compared CHM with placebo, supportive care, pharmaceutical treatment or combined CHM with a pharmaceutical in an integrative setting. For the eight randomised controlled trials (RCTs) of comparisons with placebo, MMSE was significantly higher in the CHM groups (MD 1.56 [0.78, 2.34] I2 = 85%, n = 503), similarly for eight RCTs of comparisons with supportive care (MD 1.77 [1.33, 2.21] I2 = 0%, n = 555). Benefits were also evident in comparisons with some pharmaceuticals and with integrative treatment. The small size of most studies and methodological weaknesses mean that these results should be interpreted with caution. Further studies employing rigorous methods are required to investigate the potential benefits of these CHMs for MCI. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Lin Dong
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Brian H May
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Mei Feng
- Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Anna J Hyde
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Hsiewe Ying Tan
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Xinfeng Guo
- Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Anthony Lin Zhang
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.
| | - Chuanjian Lu
- Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Charlie Changli Xue
- The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia.,Guangdong Provincial Academy of Chinese Medical Sciences and Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
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El Haouari M, Rosado JA. Medicinal Plants with Antiplatelet Activity. Phytother Res 2016; 30:1059-71. [PMID: 27062716 DOI: 10.1002/ptr.5619] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/29/2016] [Accepted: 03/12/2016] [Indexed: 12/25/2022]
Abstract
Blood platelets play an essential role in the hemostasis and wound-healing processes. However, platelet hyperactivity is associated to the development and the complications of several cardiovascular diseases. In this sense, the search for potent and safer antiplatelet agents is of great interest. This article provides an overview of experimental studies performed on medicinal plants with antiplatelet activity available through literature with particular emphasis on the bioactive constituents, the parts used, and the various platelet signaling pathways modulated by medicinal plants. From this review, it was suggested that medicinal plants with antiplatelet activity mainly belong to the family of Asteraceae, Rutaceae, Fabaceae, Lamiaceae, Zygophyllaceae, Rhamnaceae, Liliaceae, and Zingiberaceae. The antiplatelet effect is attributed to the presence of bioactive compounds such as polyphenols, flavonoids, coumarins, terpenoids, and other substances which correct platelet abnormalities by interfering with different platelet signalization pathways including inhibition of the ADP pathway, suppression of TXA2 formation, reduction of intracellular Ca(2+) mobilization, and phosphoinositide breakdown, among others. The identification and/or structure modification of the plant constituents and the understanding of their action mechanisms will be helpful in the development of new antiplatelet agents based on medicinal plants which could contribute to the prevention of thromboembolic-related disorders by inhibiting platelet aggregation. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Mohammed El Haouari
- Centre Régional des Métiers de l'Education et de la Formation de Taza (CRMEF - Taza), B.P. 1178, Taza Gare, Morocco.,Faculté Polydisciplinaire de Taza, Laboratoire des Matériaux, Substances Naturelles, Environnement et Modélisation (LMSNEM), Université Sidi Mohamed Ben Abdellah, B.P. 1223, Taza Gare, Morocco
| | - Juan A Rosado
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003, Cáceres, Spain
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