Corn silk decoction for blood lipid in patients with angina pectoris: A systematic review and meta-analysis

Efficacy and safety of Shexiang Baoxin Pill for stable coronary artery disease: A systematic review and meta-analysis of 42 randomized controlled trials

Objective: Patients with stable coronary artery disease (SCAD) still have a higher risk of adverse cardiovascular events. Shexiang Baoxin Pill (SBP) is widely used as a complementary and alternative treatment for SCAD. This study aimed to further verify the therapeutic effect and safety of SBP on SCAD. Methods: Seven databases were involved in this meta-analysis as of 1 June 2022. Data was collected from all the randomized controlled trials (RCTs) of the combination of SBP and conventional western medicine (CWM) in treating SCAD which was conducted by two independent authors. Risk of bias was assessed using the Cochrane risk-of-bias 2.0 (RoB2.0) tool, and the meta-analysis was accomplished with Review Manager 5.3. Furthermore, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) profiler 3.2.2 software was selected to grade the current evidence in our findings. Results: 42 articles, involving 6,694 patients were screened among all the 1,374 records in the analysis. The results demonstrated that the combination therapy was more efficient than CWM alone in lowering the incidence of major adverse cardiovascular events (MACE, RR = 0.50, 95% CI: 0.37 to 0.68, p < 0.00001) and ameliorating the total effective rate of angina symptom improvement (RR = 1.23, 95% CI: 1.19 to 1.28, p < 0.00001), the effective rate of electrocardiogram improvement (RR = 1.34, 95% CI: 1.26 to 1.43, p < 0.00001), the frequency of angina pectoris (MD = -2.83, 95% CI: -3.62 to -2.05, p < 0.00001), and the duration of angina pectoris (MD = -1.32, 95% CI: -2.04 to -0.61, p = 0.0003). We also found that, after SBP treatment, a more positive blood lipid level and left ventricular ejection fraction without the increase in adverse cases were calculated in our meta-analysis. What's more, Subgroup analysis indicated that treatment duration may be the source of heterogeneity. The certainty of the evidence for MACE, and electrocardiogram improvement exhibited moderate certainty, and the certainty of the evidence for the remaining outcomes was judged as low certainty. The trial sequential analysis further affirmed the clinical efficacy of SBP. Conclusion: The available evidence indicates that SBP may be an effective therapeutic option in patients with SCAD. However, considering the inferior quality and inconsistent results in the included trials, further rigorous RCTs are required. Systematic Review Registration: https://www.crd.york.ac.uk/prospero, identifier [CRD42022334529].

Modulation of gut microbiota and fecal metabolites by corn silk among high-fat diet-induced hypercholesterolemia mice

Corn silk (CS) is known to reduce cholesterol levels, but its underlying mechanisms remain elusive concerning the gut microbiota and metabolites. The aim of our work was to explore how altered gut microbiota composition and metabolite profile are influenced by CS intervention in mice using integrated 16S ribosomal RNA (rRNA) sequencing and an untargeted metabolomics methodology. The C57BL/6J mice were fed a normal control diet, a high-fat diet (HFD), and HFD supplemented with the aqueous extract of CS (80 mg/mL) for 8 weeks. HFD-induced chronic inflammation damage is alleviated by CS extract intervention and also resulted in a reduction in body weight, daily energy intake as well as serum and hepatic total cholesterol (TC) levels. In addition, CS extract altered gut microbial composition and regulated specific genera viz. Allobaculum, Turicibacter, Romboutsia, Streptococcus, Sporobacter, Christensenella, ClostridiumXVIII, and Rikenella. Using Spearman’s correlation analysis, we determined that Turicibacter and Rikenella were negatively correlated with hypercholesterolemia-related parameters. Fecal metabolomics analysis revealed that CS extract influences multiple metabolic pathways like histidine metabolism-related metabolites (urocanic acid, methylimidazole acetaldehyde, and methiodimethylimidazoleacetic acid), sphingolipid metabolism-related metabolites (sphinganine, 3-dehydrosphinganine, sphingosine), and some bile acids biosynthesis-related metabolites including chenodeoxycholic acid (CDCA), lithocholic acid (LCA), ursodeoxycholic acid (UDCA), and glycoursodeoxycholic acid (GUDCA). As a whole, the present study indicates that the modifications in the gut microbiota and subsequent host bile acid metabolism may be a potential mechanism for the antihypercholesterolemic effects of CS extract.

Protection against Neurological Symptoms by Consuming Corn Silk Water Extract in Artery-Occluded Gerbils with Reducing Oxidative Stress, Inflammation, and Post-Stroke Hyperglycemia through the Gut-Brain Axis

Corn silk (Stigma maydis), rich in flavonoids, is traditionally used to treat edema, depression, and hyperglycemia and may alleviate ischemic stroke symptoms in Chinese medicine. This study examined whether corn silk water extract (CSW) could alleviate ischemic stroke symptoms and post-stroke hyperglycemia in Mongolian gerbils with transient cerebral ischemia and reperfusion (I/R). After being given 0.05% (I/R-LCSW) and 0.2% (I/R-HCSW), 0.02% aspirin (I/R-aspirin), and cellulose (I/R-control) in their 40 energy% fat diets for three weeks, the gerbils underwent an artery occlusion for eight minutes and reperfusion. They took the assigned diet for an additional three weeks. Sham-operated gerbils without artery occlusion had the same diet as Sham-control. CSW intake reduced neuronal cell death in gerbils with I/R and dose-dependently improved the neurological symptoms, including drooped eyes, crouched posture, flexor reflex, and walking patterns. CSW intake also alleviated the short-term memory and spontaneous alteration and grip strength compared to the I/R-control group. The protection against ischemic stroke symptoms was associated with the reduced tumor necrosis factor-α, interleukin-1β, superoxide, and lipid peroxide levels, promoting superoxide dismutase activity in the hippocampus in the CSW groups, compared to the I/R-control. The blood flow measured by Doppler was improved with CSW compared to the I/R-control. Furthermore, CSW intake prevented the post-stroke hyperglycemia related to decreasing pancreatic β-cell mass as much as the Sham-control, and it was related to protection against β-cell apoptosis, restoring the β-cell mass similar to the Sham-control. CSW intake elevated the relative abundance of Lactobacillus, Bifidobacterium, Allobaculum, and Akkermansia compared to the I/R-control. Picrust2 analysis showed that CSW increased the propionate and butyrate metabolism and the starch and glucose metabolism but reduced lipopolysaccharide biosynthesis compared to the I/R-control. In conclusion, CSW intake protects against neuronal cell death and post-hyperglycemia by reducing oxidative stress and inflammation and increasing blood flow and the β-cell mass. The alleviation was associated with promoting the gut-brain axis by changing the gut microbiome community.