1
|
Guo R, Liu H, Su R, Mao Q, Zhao M, Zhang H, Mu J, Zhao N, Wang Y, Hao Y. Tanreqing injection inhibits influenza virus replication by promoting the fusion of autophagosomes with lysosomes: An integrated pharmacological study. JOURNAL OF ETHNOPHARMACOLOGY 2024; 331:118159. [PMID: 38677572 DOI: 10.1016/j.jep.2024.118159] [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: 02/07/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tanreqing injection (TRQ) is widely used, traditional Chinese medicine (TCM) injection used in China to treat respiratory infections. Modern pharmacological studies have confirmed that TRQ can protect against influenza viruses. However, the mechanism by which TRQ inhibits influenza viruses remains unclear. AIM OF THE STUDY To explore the therapeutic effects and possible mechanisms of TRQ inhibition by the influenza virus. MATERIALS AND METHODS Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC/Q-TOF MS) was used to determine the chemical composition of TRQ. Isobaric tags for relative and absolute quantification (iTRAQ) were used to define differential proteins related to TRQ inhibition of viruses. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed for functional annotation. For experimental validation, we established an in vitro model of the influenza virus infection by infecting A549 cells with the virus. The detection of the signaling pathway was carried out through qPCR, western blotting,and immunofluorescence. RESULTS Fifty one components were identified using UPLC/Q-TOF MS. We confirmed the inhibitory effect of TRQ on influenza virus replication in vitro. Ninety nine differentially expressed proteins related to the inhibitory effect of TRQ were identified using iTRAQ. KEGG functional enrichment analysis showed that the TRQ may inhibit influenza virus replication by affecting autophagy. Through network analysis, 29 targets were selected as major targets, and three key targets, HSPA5, PARP1, and GAPDH, may be the TRQ targets affecting autophagy. In vitro experiments showed that TRQ inhibits influenza virus replication by interfering with the expression and localization of STX17 and VAMP8 proteins, thereby promoting the fusion of autophagosomes with lysosomes. CONCLUSION TRQ inhibits influenza virus replication by promoting the fusion of autophagosomes with lysosomes. We additionally established potential gene and protein targets which are affected by TRQ. Therefore, our findings provide new therapeutic targets and a foundation further studies on influenza treatment with TRQ.
Collapse
Affiliation(s)
- Rui Guo
- Beijing University of Chinese Medicine, Beijing, PR China; Union Stem Cell & Gene Engineering Co., Ltd, Tianjin, PR China
| | - Hui Liu
- Beijing University of Chinese Medicine, Beijing, PR China
| | - Rina Su
- Beijing University of Chinese Medicine, Beijing, PR China
| | - Qin Mao
- Beijing University of Chinese Medicine, Beijing, PR China
| | - Mengfan Zhao
- Beijing University of Chinese Medicine, Beijing, PR China
| | - Haili Zhang
- Beijing University of Chinese Medicine, Beijing, PR China
| | - Jingwei Mu
- Shanghai Kaibao Pharmaceutical CO., LTD, Shanghai, PR China
| | - Ningbo Zhao
- Shanghai Kaibao Pharmaceutical CO., LTD, Shanghai, PR China
| | - Yi Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, PR China.
| | - Yu Hao
- Beijing University of Chinese Medicine, Beijing, PR China.
| |
Collapse
|
2
|
Liu TY, Hao Y, Mao Q, Zhou N, Liu MH, Wu J, Wang Y, Yang MR. Tanreqing Injection Inhibits Activation of NLRP3 Inflammasome in Macrophages Infected with Influenza A Virus by Promoting Mitophagy. Chin J Integr Med 2024:10.1007/s11655-024-3905-3. [PMID: 38910190 DOI: 10.1007/s11655-024-3905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To investigate the inhibitory effect of Tanreqing Injection (TRQ) on the activation of nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome in macrophages infected with influenza A virus and the underlying mechanism based on mitophagy pathway. METHODS The inflammatory model of murine macrophage J774A.1 induced by influenza A virus [strain A/Puerto Rico/8/1934 (H1N1), PR8] was constructed and treated by TRQ, while the mitochondria-targeted antioxidant Mito-TEMPO and autophagy specific inhibitor 3-methyladenine (3-MA) were used as controls to intensively study the anti-inflammatory mechanism of TRQ based on mitophagy-mitochondrial reactive oxygen species (mtROS)-NLRP3 inflammasome pathway. The levels of NLRP3, Caspase-1 p20, microtubule-associated protein 1 light chain 3 II (LC3II) and P62 proteins were measured by Western blot. The release of interleukin-1β (IL-1β) was tested by enzyme linked immunosorbent assay, the mtROS level was detected by flow cytometry, and the immunofluorescence and co-localization of LC3 and mitochondria were observed under confocal laser scanning microscopy. RESULTS Similar to the effect of Mito-TEMPO and contrary to the results of 3-MA treatment, TRQ could significantly reduce the expressions of NLRP3, Caspase-1 p20, and autophagy adaptor P62, promote the expression of autophagy marker LC3II, enhance the mitochondrial fluorescence intensity, and inhibit the release of mtROS and IL-1β (all P<0.01). Moreover, LC3 was co-localized with mitochondria, confirming the type of mitophagy. CONCLUSION TRQ could reduce the level of mtROS by promoting mitophagy in macrophages infected with influenza A virus, thus inhibiting the activation of NLRP3 inflammasome and the release of IL-1β, and attenuating the inflammatory response.
Collapse
Affiliation(s)
- Tian-Yi Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Yu Hao
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Qin Mao
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Na Zhou
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Meng-Hua Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Jun Wu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Yi Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Ming-Rui Yang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 102488, China.
| |
Collapse
|
3
|
Cheng L, Tian HL, Lei HY, Wang YZ, Jiao MJ, Liang YH, Wu ZZ, Deng XK, Ren YS. Bear Bile Powder Ameliorates LPS-Induced Acute Lung Injury by Inhibiting CD14 Pathway and Improving Intestinal Flora: Exploration of "Fei (Lung)-Dachang (Large Intestine) Interaction". Chin J Integr Med 2024:10.1007/s11655-024-3556-4. [PMID: 38816635 DOI: 10.1007/s11655-024-3556-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To explore the effect of bear bile powder (BBP) on acute lung injury (ALI) and the underlying mechanism. METHODS The chemical constituents of BBP were analyzed by ultra-high-pressure liquid chromatography-mass spectrometry (UPLC-MS). After 7 days of adaptive feeding, 50 mice were randomly divided into 5 groups by a random number table (n=10): normal control (NC), lipopolysaccharide (LPS), dexamethasone (Dex), low-, and high-dose BBP groups. The dosing cycle was 9 days. On the 12th and 14th days, 20 µL of Staphylococcus aureus solution (bacterial concentration of 1 × 10-7 CFU/mL) was given by nasal drip after 1 h of intragastric administration, and the mice in the NC group was given the same dose of phosphated buffered saline (PBS) solution. On the 16th day, after 1 h intragastric administration, 100 µL of LPS solution (1 mg/mL) was given by tracheal intubation, and the same dose of PBS solution was given to the NC group. Lung tissue was obtained to measure the myeloperoxidase (MPO) activity, the lung wet/dry weight ratio and expressions of CD14 and other related proteins. The lower lobe of the right lung was obtained for pathological examination. The concentrations of inflammatory cytokines including interleukin (IL)-6, tumour necrosis factor α (TNF-α ) and IL-1β in the bronchoalveolar lavage fluid (BALF) were detected by enzyme linked immunosorbent assay, and the number of neutrophils was counted. The colonic contents of the mice were analyzed by 16 sRNA technique and the contents of short-chain fatty acids (SCFAs) were measured by gas chromatograph-mass spectrometer (GC-MS). RESULTS UPLC-MS revealed that the chemical components of BBP samples were mainly tauroursodeoxycholic acid and taurochenodeoxycholic acid sodium salt. BBP reduced the activity of MPO, concentrations of inflammatory cytokines, and inhibited the expression of CD14 protein, thus suppressing the activation of NF-κB pathway (P<0.05). The lung histopathological results indicated that BBP significantly reduced the degree of neutrophil infiltration, cell shedding, necrosis, and alveolar cavity depression. Moreover, BBP effectively regulated the composition of the intestinal microflora and increased the production of SCFAs, which contributed to its treatment effect (P<0.05). CONCLUSIONS BBP alleviates lung injury in ALI mouse through inhibiting activation of NF-κB pathway and decreasing expression of CD14 protein. BBP may promote recovery of ALI by improving the structure of intestinal flora and enhancing metabolic function of intestinal flora.
Collapse
Affiliation(s)
- Long Cheng
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Hui-Ling Tian
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Hong-Yuan Lei
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Ying-Zhou Wang
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Ma-Jing Jiao
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Yun-Hui Liang
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Zhi-Zheng Wu
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Xu-Kun Deng
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China
| | - Yong-Shen Ren
- School of Pharmacy, South-Central Minzu University, Wuhan, 430074, China.
| |
Collapse
|
4
|
Li D, Li Y, Wang J, Yang W, Cui K, Su R, Li L, Ren X, Li X, Wang Y. In-depth analysis of the treatment effect and synergistic mechanism of TanReQing injection on clinical multi-drug resistant Pseudomonas aeruginosa. Microbiol Spectr 2024; 12:e0272623. [PMID: 38415603 PMCID: PMC10986576 DOI: 10.1128/spectrum.02726-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/17/2023] [Indexed: 02/29/2024] Open
Abstract
Antibiotic resistance is a recognized and concerning public health issue. Gram-negative bacilli, such as Pseudomonas aeruginosa (P. aeruginosa), are notorious for their rapid development of drug resistance, leading to treatment failures. TanReQing injection (TRQ) was chosen to explore its pharmacological mechanisms against clinical multidrug-resistant P. aeruginosa (MDR-PA), given its antibacterial and anti-inflammatory properties. We revealed the expression of proteins and genes in P. aeruginosa after co-culture with TRQ. This study developed an assessment method to evaluate clinical resistance of P. aeruginosa using MALDI-TOF MS identification and Biotyper database searching techniques. Additionally, it combined MIC determination to investigate changes in MDR-PA treated by TRQ. TRQ effectively reduced the MICs of ceftazidime and cefoperazone and enhanced the confidence scores of MDR-PA as identified by mass spectrometry. Using this evaluation method, the fingerprints of standard P. aeruginosa and MDR-PA were compared, and the characteristic peptide sequence (Seq-PA No. 1) associated with flagellum was found. The phenotypic experiments were conducted to confirm the effect of TRQ on the motility and adhesion of P. aeruginosa. A combination of co-immunoprecipitation and proteome analysis was employed, and 16 proteins were significantly differentially expressed and identified as potential candidates for investigating the mechanism of inhibiting resistance in P. aeruginosa treated by TRQ. The candidates were verified by quantitative real-time PCR analysis, and TRQ may affect these core proteins (MexA, MexB, OprM, OprF, OTCase, IDH, and ASL) that influence resistance of P. aeruginosa. The combination of multiple methods helps elucidate the synergistic mechanism of TRQ in overcoming resistance of P. aeruginosa.IMPORTANCEPseudomonas aeruginosa is an opportunistic pathogen closely associated with various life-threatening acute and chronic infections. The presence of antimicrobial resistance and multidrug resistance in P. aeruginosa infections significantly complicates antibiotic treatment. The expression of β-lactamase, efflux systems such as MexAB-OprM, and outer membrane permeability are considered to have the greatest impact on the sensitivity of P. aeruginosa. The study used a method to assess the clinical resistance of P. aeruginosa using matrix-assisted laser desorption ionization time of flight mass spectrometry identification and Biotyper database search techniques. TanReQing injection (TRQ) effectively reduced the MICs of ceftazidime and cefoperazone in multidrug-resistant P. aeruginosa (MDR-PA) and improved the confidence scores for co-cultured MDR-PA. The study found a characteristic peptide sequence for distinguishing whether P. aeruginosa is resistant. Through co-immunoprecipitation and proteome analysis, we explored the mechanism of TRQ overcoming resistance of P. aeruginosa.
Collapse
Affiliation(s)
- Dongying Li
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yueyi Li
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingyi Wang
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weifeng Yang
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kaiyu Cui
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Renjing Su
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu Li
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xing Ren
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xianyu Li
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Wang
- Beijing Key Laboratory of Traditional Chinese Medicine Basic Research on Prevention and Treatment for Major Diseases, Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
5
|
Ma N, Pan B, Ge L, Li M, Zhu H, Deng X, Li D, Wang X, Wu L, Xiao J, Lai H, Tian J, Niu J, Yang K. Efficacy and safety of Tanreqing injection for cough caused by acute trachea-bronchitis disease: A systematic review and meta-analysis of randomized controlled trials. JOURNAL OF ETHNOPHARMACOLOGY 2024; 321:117429. [PMID: 38007165 DOI: 10.1016/j.jep.2023.117429] [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: 06/05/2023] [Revised: 09/01/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tanreqing injection (TRQI) is an intravenous herbal preparation derived from 5 types of traditional Chinese medicines including Scutellariae Radix, Lonicerae Japonicae Flos, Forsythiae Fructus, bear bile powder and goral horn, incorporating baicalin, chlorogenic acid, ursodeoxycholic acid, and goose deoxycholic acid and other compounds known for anti-inflammatory properties, is widely used in China to treat cough caused by acute trachea-bronchitis disease (ATB). AIM OF THE STUDY To investigate the clinical efficacy and safety of Tanreqing injection (TRQI) with and without Western medicine (WM) for cough caused by acute trachea-bronchitis (ATB). MATERIALS AND METHODS We systematically searched eight databases, including CENTRAL, Embase, PubMed, Science Direct, Wiley, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang, from inception to August 2023 for randomized clinical trials (RCTs) on TRQI for cough caused by ATB. The critical outcomes of interest were time to symptom disappearance, including time for cough symptom to disappear and time to improve cough and sputum production. Important outcomes included symptom disappearance rate, adverse events (AEs) and lung function. We carried out random-effects meta-analysis using Review Manager 5.4 and assessed the certainty of evidence utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS A total of 2872 citations were identified by our search, of which 26 eligible RCTs enrolled 2731 participants. Low to moderate certainty evidence showed that when compared with WM, TRQI plus WM treatment was associated with a favorable effect on the time for cough symptom to disappear (MD -2.21 d, 95% CI -2.64 to -1.78), time to improve cough and sputum production (MD -0.68 d, 95% CI -0.83 to -0.53), symptom disappearance rate (RR 1.37, 95% CI 1.20 to 1.55), forced vital capacity, and forced expiratory volume in 1 s (MD 0.38 L, 95% CI 0.26 to 0.50; MD 2.92%, 95% CI 1.29 to 4.56, respectively). In terms of AEs, there was no association between TRQI plus WM and WM (RR 0.55, 95% CI 0.14 to 2.21; low-certainty evidence). Very low certainty evidence showed that TRQI alone was associated with reduced time to improve cough and sputum (MD -0.14 d, 95% CI -0.26 to -0.02) and increased symptom disappearance rate (RR 1.89, 95% CI 1.24 to 2.88; low certainty evidence) compared to WM. CONCLUSIONS The overall efficacy of TRQI or WM for ATB cough is better than that of WM, and TRQI also effectively improve symptoms in patients with similar adverse events. However, due to the lack of methodological rigor of included studies, the present findings should be interpreted with caution. We advocate better high-quality and convincing clinical studies to be performed to prove the effectiveness and safety of TRQIs.
Collapse
Affiliation(s)
- Ning Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Bei Pan
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Long Ge
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Mengting Li
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Hongfei Zhu
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiyuan Deng
- Department of Prenatal Diagnosis Center, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, 730000, China
| | - Dan Li
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoman Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Lei Wu
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jingmin Xiao
- Traditional Chinese Medicine Hospital of Guangdong Provincial, Guangzhou, 510120, China
| | - Honghao Lai
- Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Junqiang Niu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; The First Hospital of Lanzhou University, Lanzhou, 730000, China.
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| |
Collapse
|
6
|
Gasmi A, Tippairote T, Mujawdiya PK, Menzel A, Lysiuk R, Shanaida M, Lenchyk L, Peana M, Bjørklund G. Traditional Chinese Medicine as the Preventive and Therapeutic Remedy for COVID-19. Curr Med Chem 2024; 31:3118-3131. [PMID: 36999715 DOI: 10.2174/0929867330666230331084126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 01/24/2023] [Accepted: 02/03/2023] [Indexed: 04/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic still has tremendous impacts on the global socio-economy and quality of living. The traditional Chinese Medicines (TCM) approach showed encouraging results during previous outbreaks of Severe Acute Respiratory Syndrome-related Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). With limited treatment availability, TCM herbs and formulations could be useful to reduce COVID-19 symptoms and potential sources for discovering novel therapeutic targets. We reviewed 12 TCM herbs and formulations recommended for COVID-19 management by the National Health Commission and as National Administration of Traditional Chinese Medicine of the People's Republic of China. This article explored the Chinese national authorities' guidelines from 2003 to 2020, the scientific data in public databases for the recommended TCM remedies, and their potential mechanistic actions in COVID-19 management. Several TCM herbs and formulations could potentially benefit COVID-19 management. The recommended TCM oral preparations list includes Huoxiang zhengqi, Jinhua Qinggan, Lianhua Qingwen, and Shufeng jiedu; the recommended injection preparations comprise Xiyanping Xuebijing, Re-Du-Ning, Tanreqing, Xingnaojing, Shenfu, Shengmai, and Shenmai. TCM remedies are viable options for symptom alleviation and management of COVID-19. The current SARS-CoV-2 pandemic presents an opportunity to find novel therapeutic targets from TCM-active ingredients. Despite the recommendations in Chinese National guidelines, these remedies warrant further assessments in well-designed clinical trials to ascertain their efficacy in the treatment of COVID-19.
Collapse
Affiliation(s)
- Amin Gasmi
- Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
| | - Torsak Tippairote
- Nutritional and Environmental Section, Thailand Initiatives for Functional Medicine, Bangkok, Thailand
- Nutritional and Environmental Medicine, Healing Passion Medical Center, Bangkok, Thailand
| | | | - Alain Menzel
- Laboratoires Réunis, Junglinster, Luxembourg, UK
| | - Roman Lysiuk
- Department of Pharmacognosy and Botany, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
- CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Mariia Shanaida
- Department of Pharmacognosy and Medical Botany, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Larysa Lenchyk
- Department of Quality, Standardization and Certification of Medicines of IATPS, National University of Pharmacy, Kharkiv, Ukraine
- CONEM Ukraine Pharmacognosy and Natural Product Chemistry Research Group, National University of Pharmacy, Kharkiv, Ukraine
| | - Massimiliano Peana
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, Sassari, Italy
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Mo i Rana, Norway
| |
Collapse
|
7
|
Wu Y, He L, Guo Y, Wang N. Risk Factors and Drug Efficacy for Severe Illness in Hemodialysis Patients Infected with the Omicron Variant of COVID-19. Kidney Blood Press Res 2023; 48:642-651. [PMID: 37751729 PMCID: PMC10614566 DOI: 10.1159/000534192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION The Omicron variant of the novel coronavirus (COVID-19) has been spreading more rapidly and is more infectious, posing a higher risk of death and treatment difficulty for patients undergoing hemodialysis. This study aims to explore the severity rate and risk factors for hemodialysis patients infected with the Omicron variant and to conduct a preliminary analysis of the clinical efficacy of drugs. METHODS Clinical and biochemical indicators of 219 hemodialysis patients infected with the Omicron variant were statistically analyzed. The patients were divided into two groups based on whether they were severely ill or not, and multiple regression analysis was conducted to determine the risk factors for severe illness. The severely ill patients were then grouped based on discharge or death, and the treatment drugs were included as influencing factors for multiple regression analysis to determine the risk factors and protective factors for death of severely ill patients, and drug efficacy analysis was conducted. RESULTS Analysis showed that diabetes, low oxygen saturation, and high C-reactive protein (CRP) were independent risk factors for severe illness in hemodialysis patients infected with the Omicron variant. A history of diabetes and high C-reactive significantly increased the risk of severe illness in patients (aOR: 1.450; aOR: 1.011), while a high oxygen saturation level can reduce this risk (aOR: 0.871). In addition, respiratory distress was an independent risk factor for death in severely patients, significantly reducing the probability of discharge for patients (aOR: 0.152). The drugs thymalfasin and Tanreqing significantly increased the probability of discharge for patients (aOR: 1.472; aOR: 3.104), with the latter having a higher correlation, but with a relatively longer effective course. CONCLUSION Hemodialysis patients infected with the Omicron variant of COVID-19 should pay special attention to their history of diabetes, CRP, and oxygen saturation levels, as well as respiratory distress symptoms, to reduce the risk of severe illness and death. In addition, thymalfasin and Tanreqing may be considered in treatment.
Collapse
Affiliation(s)
- Yan Wu
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Lingling He
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongping Guo
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Niansong Wang
- Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
8
|
Wang W, He Q, Wang MQ, Xu JY, Ji P, Zhang R, Zou K, Sun X. Effects of Tanreqing Injection on ICU Mortality among ICU Patients Receiving Mechanical Ventilation: Time-Dependent Cox Regression Analysis of A Large Registry. Chin J Integr Med 2023; 29:782-790. [PMID: 36973530 DOI: 10.1007/s11655-023-3634-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To assess whether the use of Tanreqing (TRQ) Injection could show improvements in time to extubation, intensive care unit (ICU) mortality, ventilator-associated events (VAEs) and infection-related ventilator associated complication (IVAC) among patients receiving mechanical ventilation (MV). METHODS A time-dependent cox-regression analysis was conducted using data from a well-established registry of healthcare-associated infections at ICUs in China. Patients receiving continuous MV for 3 days or more were included. A time-varying exposure definition was used for TRQ Injection, which were recorded on daily basis. The outcomes included time to extubation, ICU mortality, VAEs and IVAC. Time-dependent Cox models were used to compare the clinical outcomes between TRQ Injection and non-use, after controlling for the influence of comorbidities/conditions and other medications with both fixed and time-varying covariates. For the analyses of time to extubation and ICU mortality, Fine-Gray competing risk models were also used to measure competing risks and outcomes of interest. RESULTS Overall, 7,685 patients were included for the analyses of MV duration, and 7,273 patients for the analysis of ICU mortality. Compared to non-use, patients with TRQ Injection had a lower risk of ICU mortality (Hazards ratios (HR) 0.761, 95% CI, 0.581-0.997), and was associated with a higher hazard for time to extubation (HR 1.105, 95% CI, 1.005-1.216), suggesting a beneficial effect on shortened time to extubation. No significant differences were observed between TRQ Injection and non-use regarding VAEs (HR 1.057, 95% CI, 0.912-1.225) and IVAC (HR 1.177, 95% CI, 0.929-1.491). The effect estimates were robust when using alternative statistic models, applying alternative inclusion and exclusion criteria, and handling missing data by alternative approaches. CONCLUSION Our findings suggested that the use of TRQ Injection might lower mortality and improve time to extubation among patients receiving MV, even after controlling for the factor that the use of TRQ changed over time.
Collapse
Affiliation(s)
- Wen Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China
| | - Qiao He
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China
| | - Ming-Qi Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China
| | - Jia-Yue Xu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China
| | - Peng Ji
- Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Rui Zhang
- Information Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Kang Zou
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
- NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China.
- Sichuan Center of Technology Innovation for Real World Data, Chengdu, 610041, China.
| |
Collapse
|
9
|
Huang Q, Wang M, Wang M, Lu Y, Wang X, Chen X, Yang X, Guo H, He R, Luo Z. Scutellaria baicalensis: a promising natural source of antiviral compounds for the treatment of viral diseases. Chin J Nat Med 2023; 21:563-575. [PMID: 37611975 DOI: 10.1016/s1875-5364(23)60401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Indexed: 08/25/2023]
Abstract
Viruses, the smallest microorganisms, continue to present an escalating threat to human health, being the leading cause of mortality worldwide. Over the decades, although significant progress has been made in the development of therapies and vaccines against viral diseases, the need for effective antiviral interventions remains urgent. This urgency stems from the lack of effective vaccines, the severe side effects associated with current drugs, and the emergence of drug-resistant viral strains. Natural plants, particularly traditionally-used herbs, are often considered an excellent source of medicinal drugs with potent antiviral efficacy, as well as a substantial safety profile. Scutellaria baicalensis, a traditional Chinese medicine, has garnered considerable attention due to its extensive investigation across diverse therapeutic areas and its demonstrated efficacy in both preclinical and clinical trials. In this review, we mainly focused on the potential antiviral activities of ingredients in Scutellaria baicalensis, shedding light on their underlying mechanisms of action and therapeutic applications in the treatment of viral infections.
Collapse
Affiliation(s)
- Qiuju Huang
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China
| | - Muyang Wang
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, Nanning 530021, China
| | - Min Wang
- Hainan Affiliated Hospital of Hainan Medical University, Department of Pharmacy, Haikou 570311, China
| | - Yuhui Lu
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China
| | - Xiaohua Wang
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, College of Pharmacy, Jinan University, Guangzhou 612505, China
| | - Xin Chen
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, Nanning 530021, China
| | - Xin Yang
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China
| | - Hongwei Guo
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, Nanning 530021, China.
| | - Rongrong He
- Guangdong Engineering Research Center of Chinese Medicine & Disease Susceptibility, College of Pharmacy, Jinan University, Guangzhou 612505, China.
| | - Zhuo Luo
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning 530021, China.
| |
Collapse
|
10
|
Chen TF, Song L, Gao YH, Li H, Li JL, Hou HP, Peng B, Wang HY, Cheng WH, Ye ZG, Li YF, Zhang GP. Pharmacokinetics of baicalin and oroxyloside in plasma and different tissues of rats after transnasal aerosol inhalation and intravenous injection of Tanreqing. Front Pharmacol 2022; 13:951613. [PMID: 36071852 PMCID: PMC9442038 DOI: 10.3389/fphar.2022.951613] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
To avoid adverse drug reactions associated with injection, off-label nebulization of Tanreqing (TRQ) injection is often used in China to treat respiratory diseases. However, the aerodynamic properties and lung availability of TRQ aerosols remain largely uninvestigated. This study aimed to investigate the size distribution of TRQ aerosols and to compare the pharmacokinetics and tissue distribution of two compounds from TRQ (baicalin and oroxyloside) after transnasal aerosol inhalation and intravenous administration. Furthermore, this study aimed to evaluate the efficacy of TRQ against lipopolysaccharide-induced lung inflammation. The Dv(50) and transmission of TRQ aerosols were 2.512 μm and 74.867%, respectively. The Cmax of baicalin and oroxyloside in rat plasma after inhalation was lower than that after intravenous injection. After inhalation, the area under the curve (AUC) of baicalin and oroxyloside in tissues (lung, bronchoalveolar lavage fluid, and trachea) was 7.9–115.3 and 9.5–16.0 times that observed after intravenous administration, respectively. Baicalin and oroxyloside maintained high concentrations 4 h after inhalation, but only 1 h after intravenous injection. The mean lung-to-plasma concentration ratios of baicalin and oroxyloside were 287.6 and 49.9 times higher than with intravenous administration. Inhaled TRQ achieved the same effect against lipopolysaccharide-induced lung inflammation in mice at doses of only 1/16–1/8 of those administered intravenously. The results indicate that TRQ inhalation is a promising alternative to intravenous injections for the treatment of respiratory infection.
Collapse
Affiliation(s)
- Teng-Fei Chen
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Ling Song
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Yun-Hang Gao
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Han Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Jian-Liang Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Hong-Ping Hou
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Bo Peng
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Hui-Ying Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
| | - Wen-Hao Cheng
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, China
| | - Zu-Guang Ye
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Guang-Ping Zhang, ; Ying-Fei Li, ; Zu-Guang Ye,
| | - Ying-Fei Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Guang-Ping Zhang, ; Ying-Fei Li, ; Zu-Guang Ye,
| | - Guang-Ping Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, China
- *Correspondence: Guang-Ping Zhang, ; Ying-Fei Li, ; Zu-Guang Ye,
| |
Collapse
|
11
|
Cheng G, She B, Mao B, Jiang H. Efficacy and safety of Tanreqing oral liquid in treatment of acute bronchitis: study protocol for a randomized controlled trial. Trials 2022; 23:373. [PMID: 35526026 PMCID: PMC9077961 DOI: 10.1186/s13063-022-06318-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/19/2022] [Indexed: 02/08/2023] Open
Abstract
Background Approximately 5% of adults have an episode of acute bronchitis each year, accounting for more than 10 million medical visits yearly. The primary goal of treatment is reduction of symptoms. Currently, available medications are questionable in effectiveness and safety and are not recommended for routine use in clinical practice. Although Chinese herbal medicine has been widely used in the management of acute bronchitis in China, evidence-based data is lacking. This trial aims to evaluate the efficacy and safety of Tanreqing oral liquid in the treatment of acute bronchitis with phlegm-heat obstructing lungs syndrome. Methods/design This study is a prospective, multi-center, randomized, double-blinded, parallel-group, placebo-controlled trial. A total of 270 acute bronchitis adult patients with phlegm-heat obstructing lungs syndrome will be enrolled from outpatients and emergency departments at nine study centers across China. All included patients will be randomly allocated to receive Tanreqing oral liquid or placebo oral liquid, 20 mL three times daily for seven consecutive days. The primary outcome will be cough resolution rate. Secondary outcomes will include change of bronchitis symptoms scores from baseline to post-treatment, cough relief rate, time to cough resolution, time to cough relief, resolution rate of a single symptom, combination medicine use, change of traditional Chinese medicine syndrome score from baseline to post-treatment, and adverse events. Discussion This trial may provide an alternative treatment option for acute bronchitis patients, especially those in outpatients and emergency departments. It may also add evidence to Chinese herbal medicine for treating acute bronchitis. Trial registration Chinese Clinical Trial Registry ChiCTR2000040264. Registered on 26 November 2020 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06318-5.
Collapse
Affiliation(s)
- Guilan Cheng
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Bin She
- Department of Integrated Traditional Chinese and Western Medicine, Division of Respiratory Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Bing Mao
- Department of Integrated Traditional Chinese and Western Medicine, Division of Respiratory Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, People's Republic of China.
| | - Hongli Jiang
- Department of Integrated Traditional Chinese and Western Medicine, Division of Respiratory Medicine, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, Sichuan Province, People's Republic of China.
| |
Collapse
|
12
|
Li J, Chen Y, Yu X, Xie Y, Li X. Diagnosis and treatment guideline for Chinese medicine on acute trachea-bronchitis. J Evid Based Med 2021; 14:333-345. [PMID: 34936217 PMCID: PMC9306795 DOI: 10.1111/jebm.12460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/15/2021] [Indexed: 01/11/2023]
Abstract
Chinese medicine (CM) has significant clinical effects in the treatment of trachea-bronchitis. It is of important clinical significance to formulate guidelines for the diagnosis and treatment of tracheal-bronchitis based on the characteristics of TCM syndrome differentiation. The Respiratory Disease Branch of China Association of Chinese Medicine and Respiratory Disease Branch of China Medical Association of Minorities have organized and established a multidisciplinary working group, based on the World Health Organization Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine to develop this guideline. It has been developed through technical links such as clinical problem investigation, evidence collection and evaluation, Delphi method, and expert consensus meetings. Based on the current best evidence, CM intervention costs and expert experience, 25 recommendations were established to standardize the etiology and pathogenesis of tracheal-bronchitis, syndrome differentiation and treatment, prevention, and care, etc., which can be used by respiratory physicians at all levels of TCM medical institutions.
Collapse
Affiliation(s)
- Jiansheng Li
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Henan Key Laboratory of Chinese Medicine for Respiratory DiseaseHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Department of respiratory diseasesthe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouP.R. China
| | - Yaolong Chen
- Evidence‐Based Medicine Centre, School of Basic Medical SciencesLanzhou UniversityLanzhouP.R. China
- Chinese GRADE CentreLanzhou UniversityLanzhouP.R. China
- WHO Collaborating Centre for Guideline Implementation and Knowledge TranslationLanzhouP.R. China
| | - Xueqing Yu
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Henan Key Laboratory of Chinese Medicine for Respiratory DiseaseHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Department of respiratory diseasesthe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouP.R. China
| | - Yang Xie
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Henan Key Laboratory of Chinese Medicine for Respiratory DiseaseHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
- Department of respiratory diseasesthe First Affiliated Hospital of Henan University of Chinese MedicineZhengzhouP.R. China
| | - Xuanlin Li
- Co‐Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. ChinaHenan University of Chinese MedicineZhengzhouHenan ProvinceP.R. China
| | | |
Collapse
|
13
|
Zhao D, Liu XF, Tian YG, Dong HR, Feng SX, Li JS. The pharmacokinetic study of Tanreqing and the interaction with cefixime in rat model of pneumonia by validated UPLC-MS/MS. J Pharm Biomed Anal 2021; 209:114484. [PMID: 34891004 DOI: 10.1016/j.jpba.2021.114484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/09/2021] [Accepted: 11/14/2021] [Indexed: 11/27/2022]
Abstract
Combining traditional Chinese medicine and chemical drugs with antimicrobial activities has become more popular, but there is insufficient relevant research on such combinations. The Tanreqing injection (TRQI), a Chinese compound medicine, exhibits therapeutic effects in treating upper respiratory tract infections, severe influenza, and pneumonia. This research investigates the pharmacokinetics of TRQI in pneumonia model rats and explores the effect of the antibiotic cefixime on its metabolism. The pneumonia model rats were randomly divided into six groups: low, medium, and high (3, 6, and 12 mL kg-1) dose TRQI group, and a medium dose TRQI combined with cefixime (14.4 mg kg-1) group, with the remainder two groups were control group. Blood samples were collected from the tail vein at different time points between 0 and 24 h after injection. A sensitive and quick method based on ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established for the simultaneous determination of the 13 TRQI components in the blood samples. The analytes were separated on an XBridge™C18 column (2.1 mm × 150 mm, 5 µm), with the flow phase consisting of methanol and 0.1% formic acid water at a flow rate of 0.3 mL/min. The assay method met the biological sample determination requirements, demonstrating good adaptability and practicability for application in the pharmacokinetic study of TRQI in pneumonia model rats. Moreover, the method was used successfully in the interaction study of TRQI with cefixime. The results indicated that co-administration results in a significant change in the pharmacokinetic parameters of the main TRQI components. However, the changes in the pharmacokinetic characteristics of multiple TRQI components were inconsistent. Thus, the results of this drug combination under different pathological conditions in clinical applications were unpredictable. Therefore, more attention should be paid to the combined use of cefixime and TRQI in clinical applications to avoid the risk of adverse drug reactions in future studies.
Collapse
Affiliation(s)
- Di Zhao
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China
| | - Xue-Fang Liu
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China
| | - Yan-Ge Tian
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China
| | - Hao-Ran Dong
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China
| | - Su-Xiang Feng
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China; Zhengzhou Key Laboratory of Chinese Medicine Quality Control and Evaluation, Zhengzhou 450046, China.
| | - Jian-Sheng Li
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of P.R. China, 450046, China; Zhengzhou Key Laboratory of Chinese Medicine Quality Control and Evaluation, Zhengzhou 450046, China.
| |
Collapse
|
14
|
Zhu XB, Guo M, Zhang ZH, Sun LH, Liu L, Zhou LJ, Shan CL, Yang Y, Kan LD, Li LC. Chinese herbal injections for coronavirus disease 2019 (COVID-19): A narrative review. Integr Med Res 2021; 10:100778. [PMID: 34608432 PMCID: PMC8481649 DOI: 10.1016/j.imr.2021.100778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/16/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background The outbreak of Coronavirus disease 2019 (COVID-19) has caused more than 180 million infections and 3.9 million deaths. To date, emerging clinical evidence has shown the synergetic benefits of Chinese herbal injections in treating this contagious respiratory disease. This review aims to summarize and analyze the efficacy and safety of Chinese herbal injections in the therapy of COVID-19. Methods The literature from 3 electronic databases, PubMed, CNKI, and Web of Science, were searched using the search terms “COVID-19”, “SARS-CoV-2”, “traditional Chinese medicine”, “herb”, “herbal”, and “injection”. Then the identified articles were comprehensively evaluated. Results Limited data demonstrated that Chinese herbal injections could significantly improve the clinical outcomes of COVID-19 patients, especially in combination with conventional treatment strategies. The benefits of which were mainly associated with the relief of symptoms, prevention of secondary infection, regulation of inflammation and immune function. There was also evidence showing the inhibitory effects on SARS-CoV-2 replication in vitro. Nevertheless, available real-world data suggested the increased risk of adverse event. Furthermore, the defects of existing researches and the insights for discovering novel antiviral drugs were prospectively discussed. Conclusion Evidence-based advances revealed that Chinese herbal injections such as XueBiJing injection and ShenMai injection, exerted potent effects against COVID-19. Further laboratory researches and clinical evaluation are needed to gather scientific evidence on the efficacy and safety.
Collapse
Affiliation(s)
- Xiao-Bin Zhu
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meng Guo
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhi-Hui Zhang
- Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai TCM-Integrated Institute of Vascular Anomalies, Shanghai, China
| | - Li-Hua Sun
- Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Liu
- Department of Orthopaedics, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, China
| | - Li-Juan Zhou
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chun-Lei Shan
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Yang
- Department of Pharmacy, Xiasha Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lian-Di Kan
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Liu-Cheng Li
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
15
|
Wang L, Ma Y, He Y, Deng J, Huang D, Zhang X, Chen K, Qiu S, Chen W. Systematic investigation of the pharmacological mechanism of Tanreqing injection in treating respiratory diseases by UHPLC/Q-TOF-MS/MS based on multiple in-house chemical libraries coupled with network pharmacology. J Pharm Biomed Anal 2021; 202:114141. [PMID: 34015594 DOI: 10.1016/j.jpba.2021.114141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/19/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023]
Abstract
Tanreqing injection (TRQI), a drug approved by the National Drug Regulatory Authority of China (China SFDA, number: Z20030045), is widely used clinically to treat respiratory diseases. However, as a complex system, the pharmacological mechanism of TRQI for the treatment of respiratory diseases is still unclear. TRQI contains three Chinese medicines that make up the classic Chinese compound formulas Shuang-Huang-Lian (SHL). Moreover, it is known that SHL components are beneficial for characterizing the chemical compounds of TRQI. Therefore, in this study, we applied UHPLC/Q-TOF-MS/MS analysis based on multiple chemical compound libraries to identify the chemical profiles of TRQI and used network pharmacology to predict the potential targets of TRQI active compounds. First, three chemical libraries related to TRQI were created, including the TRQI in-house library, SHL in-house library, and targeted Metlin library. An integrated TRQI library was established by combining three chemical libraries for the identification and characterization of the chemical profiles of TRQI. Second, the potential targets of TRQI active compounds were predicted with the Swiss Target Prediction and TCMSP databases, and targets of respiratory disease were collected from the GeneCards database. Then, the network between the active compounds and common targets was established by Cytoscape 3.7.1. The common targets were imported into the STRING database to construct protein-protein interaction (PPI) networks and select core targets of TRQI against respiratory diseases. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analyses of the core targets were performed by the Omicsbean analytic system and DAVID database, respectively. As a result, a total of 126 compounds were identified, and network pharmacological analysis showed that luteolin, wogonin, baicalein, chenodeoxycholic acid, l-serine, aspartic acid, oroxylin A, syringin, phenylalanine, and glutamic acid could be the active compounds of TRQI; GABBR1, MAPK3, GRM5, FOS, DRD2, GRM1, VEGFA, GRM3 and 92 other potential core targets for the treatment of respiratory diseases by modulating pathways in cancer, the calcium signaling pathway, cAMP signaling pathway, estrogen signaling pathway and TNF-α signaling pathway.
Collapse
Affiliation(s)
- Liang Wang
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Ying Ma
- Chemistry and Biological Engineering College, Yichun University, Yichun, 336000, China; Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
| | - Yuqiong He
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jiuling Deng
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Doudou Huang
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
| | - Xiaoli Zhang
- Shanghai Kaibao Pharmaceutical Co., Ltd., Shanghai, 201401, China
| | - Kaixian Chen
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Shi Qiu
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Wansheng Chen
- Institute of Chinese Materia Madica, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China; Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.
| |
Collapse
|
16
|
Zhou D, Xie L, Shi X, Liu F, Wu S, Zhang S, Liu R, Chang J, Zhu L. A meta-analysis of the clinical efficacy of Tanreqing injection combined with antibiotics vs antibiotics alone for treating pulmonary infection secondary to intracerebral hemorrhage. Medicine (Baltimore) 2021; 100:e24905. [PMID: 33725962 PMCID: PMC7982207 DOI: 10.1097/md.0000000000024905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/15/2020] [Accepted: 01/31/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Pulmonary infection is the most common complication to develop after intracerebral hemorrhage (ICH). Antibiotics have certain limitations when used to treat pulmonary infection, while Tanreqing injection (TRQI) is extensively used to treat pulmonary infection as an adjuvant to antibiotics. The aim of this meta-analysis was to investigate the clinical efficacy of TRQI for the treatment of lung infection secondary to ICH. METHODS Randomized controlled trials (RCTs) assessing the combination of TRQI and antibiotics compared to antibiotics alone for pulmonary infection after ICH were comprehensively searched for in 7 electronic databases from their establishment to August 2020. Two independent researchers conducted the literature retrieval, screening, and data extraction. The assessment tool of Cochrane risk of bias and Review Manager 5.3 software were applied to assess the methodological quality and analyze the data, respectively. RESULTS Seventeen RCTs involving 1122 patients with pulmonary infection after ICH were included. Compared to antibiotics alone, the combination treatment enhanced the clinical effective rate, shortened the hospital stay, reduced the white blood cell, procalcitonin, and C-reactive protein levels, ameliorated the times to the resolution of fever, cough, and lung rales, and increased the oxygenation index. The evidence indicated that TRQI combined with antibiotics caused no adverse reactions. CONCLUSIONS Our study showed that the combination of TRQI and antibiotics was effective for treating pulmonary infection after ICH. However, high-quality multicenter RCTs are needed to further verify the clinical efficacy of TRQI due to the publication bias and the low methodological quality of the included RCTs.
Collapse
Affiliation(s)
- Dongrui Zhou
- Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital
| | - Liandi Xie
- Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine
| | - Xiaowei Shi
- Department of Massage, The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Fengzhi Liu
- Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital
| | - Shuang Wu
- Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital
| | - Shuangshuang Zhang
- Department of Oncology, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine
| | - Ruijia Liu
- Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital
| | - Jingling Chang
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Lingqun Zhu
- Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital
| |
Collapse
|
17
|
Guo J, Zhu J, Wang Q, Wang J, Jia Y. Comparative Efficacy of Seven Kinds of Chinese Medicine Injections in Acute Lung Injury and Acute Respiratory Distress Syndrome: A Network Meta-analysis of Randomized Controlled Trials. Front Pharmacol 2021; 12:627751. [PMID: 33767627 PMCID: PMC7985440 DOI: 10.3389/fphar.2021.627751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Chinese medicine injection is wildly used in Acute Lung Injury and Acute respiratory distress syndrome (ALI/ARDS) treatment. However, what kinds of CMIs are more effective in the ALI/ARDS treatment is uncertain. Objectives: Compare the efficacy of different CMIs to identify the optimal one for the therapy of ALI/ARDS patients. Data sources: We searched the data up to April 30, 2020 from MEDLINE, EMBASE, The Cochrane Library, Web of Science, the China Science Journal Citation Report (VIP database), WanFang and the China National Knowledge Infrastructure Study selection: Randomized Clinical Trials assessed at least one of the following outcomes: mortality, Oxygenation Index, length of ICU stay, mechanical ventilation duration, APACHEⅡ score, SOFA score and Murray score, for adult patients of ALI/ADRS. Eligible Studies should also use CMIs as complementary therapies in addition to the standard treatment. Data extraction and synthesis: Two reviewers independently assessed the data. Then, we used a Bayesian random-effects network meta-analysis for data synthesis. Results: Twenty-six studies were selected (involved 2073 participants). Seven kinds of CMIs were evaluated. Compared with standard treatment, Xuebijing is associated with lower mortality. Tanreqing and Xuebijing have the best effect on improving the Oxygenation Index. Huangqi, Danshen, Tanreqing and Xuebijing can significantly reduce the APACHE II score (Huangqi works better than Xuebijing). Huangqi and Xuebijing have the best effect on reducing mechanical ventilation duration and Murray score, while Xuebijing has the best effect on shortening the length of ICU stay. Conclusions: As adjuvant drugs, Xuebijing, Tanreqing and Huangqi show certain effects on treating ALI/ARDS in different aspects.
Collapse
Affiliation(s)
- Jie Guo
- Department of Internal Medicine of TCM, The First Clinical Medical College, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Chinese Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Jia Zhu
- Department of Respiratory medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Wang
- Department of Respiratory medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Juan Wang
- Department of Internal Medicine of TCM, The First Clinical Medical College, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- Department of Intensive Medicine, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
| | - Yaodan Jia
- Environmental science, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
18
|
The Interrelationships between Intestinal Permeability and Phlegm Syndrome and Therapeutic Potential of Some Medicinal Herbs. Biomolecules 2021; 11:biom11020284. [PMID: 33671865 PMCID: PMC7918952 DOI: 10.3390/biom11020284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 02/06/2023] Open
Abstract
The gastrointestinal (GI) tract has an intriguing and critical role beyond digestion in both modern and complementary and alternative medicine (CAM), as demonstrated by its link with the immune system. In this review, we attempted to explore the interrelationships between increased GI permeability and phlegm, an important pathological factor in CAM, syndrome, and therapeutic herbs for two disorders. The leaky gut and phlegm syndromes look considerably similar with respect to related symptoms, diseases, and suitable herbal treatment agents, including phytochemicals even though limitations to compare exist. Phlegm may be spread throughout the body along with other pathogens via the disruption of the GI barrier to cause several diseases sharing some parts of symptoms, diseases, and mechanisms with leaky gut syndrome. Both syndromes are related to inflammation and gut microbiota compositions. Well-designed future research should be conducted to verify the interrelationships for evidence based integrative medicine to contribute to the promotion of public health. In addition, systems biology approaches should be adopted to explore the complex synergistic effects of herbal medicine and phytochemicals on conditions associated with phlegm and leaky gut syndromes.
Collapse
|
19
|
Yang M, Shang YX, Tian ZY, Xiong M, Lu CL, Jiang Y, Zhang Y, Zhang YY, Jin XY, Jin QB, Zhang Y, Willcox ML, Liu JP. Characteristics of registered studies for Coronavirus disease 2019 (COVID-19): A systematic review. Integr Med Res 2020; 9:100426. [PMID: 32483523 PMCID: PMC7239016 DOI: 10.1016/j.imr.2020.100426] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The World Health Organization characterized the Coronavirus disease 2019 (COVID-19) as a pandemic on March 11th. Many clinical trials on COVID-19 have been registered, and we aim to review the study characteristics and provide guidance for future trials to avoid duplicated effort. METHODS Studies on COVID-19 registered before March 3rd, 2020 on eight registry platforms worldwide were searched and the data of design, participants, interventions, and outcomes were extracted and analyzed. RESULTS Three hundred and ninety-three studies were identified and 380 (96.7%) were from mainland China, while 3 in Japan, 3 in France, 2 in the US, and 3 were international collaborative studies. Two hundred and sixty-six (67.7%) aimed at therapeutic effect, others were for prevention, diagnosis, prognosis, etc. Two hundred and two studies (51.4%) were randomized controlled trials. Two third of therapeutic studies tested Western medicines including antiviral drugs (17.7%), stem cell and cord blood therapy (10.2%), chloroquine and derivatives (8.3%), 16 (6.0%) on Chinese medicines, and 73 (27.4%) on integrated therapy of Western and Chinese medicines. Thirty-one studies among 266 therapeutic studies (11.7%) used mortality as primary outcome, while the most designed secondary outcomes were symptoms and signs (47.0%). Half of the studies (45.5%) had not started recruiting till March 3rd. CONCLUSION Inappropriate outcome setting, delayed recruitment and insufficient numbers of new cases in China implied many studies may fail to complete. Strategies and protocols of the studies with robust and rapid data sharing are warranted for emergency public health events, helping the timely evidence-based decision-making.
Collapse
Affiliation(s)
- Ming Yang
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ya-xi Shang
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zi-yu Tian
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Min Xiong
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chun-li Lu
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, China
| | - Yue Jiang
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yao Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ying-ying Zhang
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-yan Jin
- Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qiu-bai Jin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Zhang
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Merlin L. Willcox
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, United Kingdom
| | - Jian-ping Liu
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
20
|
Liu H, Ding XF, Guo R, Zhao MF, Deng D, Hao Y, Wang Y. Effects and safety of tanreqing injection on viral pneumonia: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21808. [PMID: 32871901 PMCID: PMC7458180 DOI: 10.1097/md.0000000000021808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Viral pneumonia is a common respiratory disease that leads to high mortality around the world. Tanreqing (TRQ) injection has been widely used to treat viral pneumonia in China. However, the efficiency and safety of TRQ injection for viral pneumonia have not been scientifically and methodically evaluated up to now. Thus, this protocol describes a plan of performing a systematic review and meta-analysis to evaluate the efficacy and safety of TRQ injection on patients with viral pneumonia. METHODS Only randomized controlled trials will be enrolled in our study, and we will search eligible studies in the following electronic databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, the Wanfang database, the Chinese Scientific Journal Database, and the Sinomed. The total effective rate of clinical efficacy will be used as primary outcome. Time to relieve symptoms, incidence of adverse reactions, and the laboratory parameters will be used as secondary outcomes. Any side effects and adverse events will be recorded and assessed as safety outcomes. Study inclusion, data extraction, and quality assessment will be performed independently by 2 reviewers, and any disagreement will be resolved by a third reviewer. After that, data synthesis and subgroup analysis will be conducted with the Review Manager V.5.3.3 software. RESULTS This review will provide a high-quality synthesis to assess the effectiveness and safety of TRQ injection for viral pneumonia patients. CONCLUSION Our study will provide comprehensive evidence to decide whether TRQ injection is effective and safe for viral pneumonia patients. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020164164.
Collapse
Affiliation(s)
- Hui Liu
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine
| | - Xue-Fei Ding
- Department of Emergency, Beijing Shunyi Hospital of Traditional Chinese Medicine
| | - Rui Guo
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine
| | - Meng-Fan Zhao
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine
| | - Di Deng
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine
| | - Yu Hao
- Department of Immunology and Microbiology, School of Life Science, Beijing University of Chinese Medicine
| | - Yi Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
21
|
Tong Y, Wen J, Yang T, Li H, Wei S, Jing M, Wang M, Zou W, Zhao Y. Clinical efficacy and safety of Tanreqing injection combined with antibiotics versus antibiotics alone in the treatment of pulmonary infection patients after chemotherapy with lung cancer: A systematic review and meta‐analysis. Phytother Res 2020; 35:122-137. [PMID: 32780543 DOI: 10.1002/ptr.6790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/12/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Yuling Tong
- Department of Pharmacy Chinese PLA General Hospital Beijing China
- College of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China
| | - Jianxia Wen
- Department of Pharmacy Chinese PLA General Hospital Beijing China
- College of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China
| | - Tao Yang
- Department of Pharmacy Chinese PLA General Hospital Beijing China
- College of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China
| | - Haotian Li
- Department of Pharmacy Chinese PLA General Hospital Beijing China
| | - Shizhang Wei
- Department of Pharmacy Chinese PLA General Hospital Beijing China
- College of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China
| | - Manyi Jing
- Department of Pharmacy Chinese PLA General Hospital Beijing China
| | - Min Wang
- Department of Pharmacy Chinese PLA General Hospital Beijing China
| | - Wenjun Zou
- College of Pharmacy Chengdu University of Traditional Chinese Medicine Chengdu China
| | - Yanling Zhao
- Department of Pharmacy Chinese PLA General Hospital Beijing China
| |
Collapse
|
22
|
Zhuang W, Fan Z, Chu Y, Wang H, Yang Y, Wu L, Sun N, Sun G, Shen Y, Lin X, Guo G, Xi S. Chinese Patent Medicines in the Treatment of Coronavirus Disease 2019 (COVID-19) in China. Front Pharmacol 2020; 11:1066. [PMID: 32848729 PMCID: PMC7396557 DOI: 10.3389/fphar.2020.01066] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/30/2020] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus Disease 2019 (COVID-19) is an emerging and rapidly evolving disease, with no recommended effective anti-coronavirus drug treatment. Traditional Chinese Patent Medicines (CPMs) have, however, been widely used to treat COVID-19 in China, and a number of clinical practice results have shown them to have a significant role in its treatment. Consequently, numerous guidelines and expert consensus have recommended the use of CPMs to treat COVID-19. Aim of the Study The objectives of this review are to provide up-to-date information on the pharmacology and clinical research on CPMs in the treatment of COVID-19, discuss the research findings, and to better guide clinical application and scientific research on CPMs in the treatment of COVID-19. Methods The frequencies of CPM recommendations by guidelines and expert consensus for treatment of COVID-19 in China were ranked. This report identifies the top 10 CPMs, which include Huoxiang Zhengqi capsule (HXZQC), Lianhua Qingwen capsule (LHQWC), Jinhua Qinggan granule (JHQGG), Shufeng Jiedu capsule (SFJDC), Tanreqing injection (TRQI), Xiyanping injection (XYPI), Xuebijing injection (XBJI), Shenfu injection (SFI), Shengmai injection (SMI), and Angong Niuhuang pill (AGNHP). Relevant studies from 2000 to 2020 on these top 10 CPMs, covering usage, dosage, mechanism, curative effect, and precautions, were collected from pharmacopoeia, reports, and theses via library and digital databases (including PubMed, CNKI, Google Scholar, Web of Science, and Elsevier). Results The properties of the top 10 CPMs included antiviral, antibacterial, anti-inflammatory, antipyretic and analgesic, anti-acute lung injury, anti-shock, immune regulation, and enhancement of pulmonary function. In addition, clinical research results and Chinese treatment data showed that the CPMs had good therapeutic efficacy in the treatment of COVID-19, and adverse reactions were minimal. Conclusions Knowledge of the characteristics of the top 10 CPMs and precautions that should be taken may help clinicians to rationally improve therapeutic efficacy, and promote the role of Chinese Medicine in the control of the COVID-19 global epidemic.
Collapse
Affiliation(s)
- Wei Zhuang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zheng Fan
- Department of Clinical Pharmacy, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yanqi Chu
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Haizheng Wang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ying Yang
- Department of Clinical Pharmacy, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Li Wu
- Department of Pharmacy, Beijing Mentougou District Hospital of Traditional Chinese Medicine, Beijing, China
| | - Nan Sun
- Pharmacy Department, Beijing Mentougou Hospital, Beijing, China
| | - Ge Sun
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yuqiao Shen
- Pharmaceutical Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Xiaolan Lin
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Guiming Guo
- Department of Clinical Pharmacy, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Shengyan Xi
- Department of Traditional Chinese Medicine, School of Medicine, Xiamen University, Xiamen, China
| |
Collapse
|
23
|
Zhang D, Zhang B, Lv JT, Sa RN, Zhang XM, Lin ZJ. The clinical benefits of Chinese patent medicines against COVID-19 based on current evidence. Pharmacol Res 2020; 157:104882. [PMID: 32380051 PMCID: PMC7198419 DOI: 10.1016/j.phrs.2020.104882] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 02/07/2023]
Abstract
The outbreak of emerging infectious pneumonia caused by 2019 Novel Coronavirus (2019-nCoV) has posed an enormous threat to public health, and traditional Chinese medicine (TCM) have made vast contribution to the prevention, treatment and rehabilitation of coronavirus disease 19 (COVID-19) among Chinese population. As an indispensable part of TCM, Chinese patent medicines (CPMs) are highly valued and critically acclaimed in their campaign to contain and tackle the epidemic, they can achieve considerable effects for both suspected cases under medical observation period, and confirmed individuals with serious underlying diseases or critical conditions. Given this, based on the Guideline on Diagnosis and Treatment of Coronavirus Disease 2019 in China, the present review summarized the basic information, clinical evidence and published literatures of recommended CPMs against COVID-19. The details were thoroughly introduced involving compositions, therapeutic effects, clinical indications, medication history of CPMs and the profiles of corresponding research. With regard to infected patients with different stages and syndrome, the preferable potentials and therapeutic mechanism of CPMs were addressed through the comprehensive collection of relevant literatures and on-going clinical trials. This study could provide an insight into clinical application and underlying mechanism of recommended CPMs against COVID-19, with the aim to share the Chinese experience in clinical practice and facilitate scientific development of TCM, especially CPMs in the fierce battle of COVID-19.
Collapse
Affiliation(s)
- Dan Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Bing Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China; Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
| | - Jin-Tao Lv
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Ri-Na Sa
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China; Pharmacy Department, Gansu Provincial Hospital, Lanzhou, China
| | - Xiao-Meng Zhang
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Jian Lin
- Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
24
|
Feng SX, Zhang HJ, Zhao D, Li RR, Du XH, Wang PY, Shu SN, Qu LB, Li JS. Chemical profiling and quantification of Tanreqing injection, a systematic quality control strategy equipped with UPLC-Q-Orbitrap fusion MS. J LIQ CHROMATOGR R T 2020. [DOI: 10.1080/10826076.2020.1723105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Su-Xiang Feng
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Hao-Jie Zhang
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Di Zhao
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Rong-Rong Li
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Xue-Hang Du
- Shanghai Kaibao Pharmaceutical Co. Ltd, Shanghai, China
| | - Pei-Yang Wang
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Sheng-Nan Shu
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| | - Ling-Bo Qu
- College of Chemistry and Molecular Engineering, Zhengzhou University, Zhengzhou, China
| | - Jian-Sheng Li
- College of Pharmacy, Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
- Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases, by Henan and Education Ministry of P. R., Zhengzhou, Henan, China
| |
Collapse
|
25
|
Li XX, Zhuo L, Zhang Y, Yang YH, Zhang H, Zhan SY, Zhai SD. The Incidence and Risk Factors for Adverse Drug Reactions Related to Tanreqing Injection: A Large Population-Based Study in China. Front Pharmacol 2020; 10:1523. [PMID: 31998127 PMCID: PMC6962140 DOI: 10.3389/fphar.2019.01523] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/25/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Tanreqing injection (TRQ) is a traditional Chinese medicine commonly used in China to treat pulmonary diseases presenting as phlegm-heat syndrome. Robust data on the safety of TRQ from real-world observational cohorts are currently lacking. Objective: To evaluate as the incidence, type, and predictors of adverse events (AEs) and adverse drug reactions (ADRs) of TRQ in clinical practice in China. Methods: We conducted a population-based cohort, multicenter study to evaluate the incidence, manifestation, outcomes, and risk factors of AEs and ADRs following TRQ use in China. Between April 2014 and May 2015 a total of 30,322 consecutive inpatients/emergency attendance patients from 90 hospitals across China administrated TRQ were followed-up for 7 days. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression to identify predictors of ADRs. Results: The incidence of AEs and ADRs was 1.4 and 0.3%, respectively. Skin and subcutaneous tissue disorders were the most common ADRs. All ADRs were mild or moderate in severity, except for one serious case of anaphylactic reaction. The majority of ADRs (72.8%) occurred in the first 2 h after TRQ administration. Two-thirds of patients (66.1%) in the study were prescribed TRQ off-label, including infants aged ≤24 months. A history of food allergy (OR 4.50, 95% CI: 1.35–15.00), drug allergy (OR 2.77, 95% CI: 1.56–4.94), and fast infusion speed (off-label use) (OR 2.10, 95% CI: 1.27–3.50) were associated with an increased risk of ADRs. Conclusion: TRQ is well tolerated in the general population, yet off-label use is prevalent. Efforts are required to educate prescribers to adhere to the drug label in order to minimize potential patient harm.
Collapse
Affiliation(s)
- Xiao-Xiao Li
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Lin Zhuo
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yan Zhang
- Technology and Development Center for TCM of China, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, China
| | - Yi-Heng Yang
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Hong Zhang
- Technology and Development Center for TCM of China, State Administration of Traditional Chinese Medicine of the People's Republic of China, Beijing, China
| | - Si-Yan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Suo-Di Zhai
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| |
Collapse
|
26
|
Li W, Yan X, Pan J, Liu S, Xue D, Qu H. Rapid analysis of the Tanreqing injection by near-infrared spectroscopy combined with least squares support vector machine and Gaussian process modeling techniques. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 218:271-280. [PMID: 31004970 DOI: 10.1016/j.saa.2019.03.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 02/17/2019] [Accepted: 03/28/2019] [Indexed: 06/09/2023]
Abstract
Near-infrared spectroscopy (NIRS) combined with chemometrics was used to analyze the main active ingredients including chlorogenic acid, caffeic acid, luteoloside, baicalin, ursodesoxycholic acid, and chenodeoxycholic acid in the Tanreqing injection. In this paper, first, two hundred samples collected in the product line were divided into the calibration set and prediction set, and the reference values were determined by the High Performance Liquid Chromatography- Diode Array Detector/Evaporative Light Scattering Detector (HPLC-DAD/ELSD) method. Partial least squares (PLS) analysis was implemented as a linear method for models calibrated with different preprocessing means. Wavelet transformation (WT) was introduced as a variable selection technique by means of multiscale decomposition, and wavelet coefficients were employed as the input for modeling. Furthermore, two nonlinear approaches, least squares support vector machine (LS-SVM) and Gaussian process (GP), were applied to exploit the complicated relationship between the spectra and active ingredients. The optimal models for each ingredient were obtained by LS-SVM and GP methods. The performance of the final models was evaluated by the root mean square error of calibration (RMSEC), root mean square error of cross-validation (RMSECV), root mean square error of prediction (RMSEP) and correlation coefficient (R). All of the models in the paper give a good calibration ability with an R value above 0.92, and the prediction ability is also satisfactory, with an R value higher than 0.85. The overall results demonstrate that nonlinear models are more stable and predictable than linear ones, and they will be more suitable for the CHM system when high accuracy analysis is required. It can be concluded that NIRS with the LS-SVM and GP modeling methods is promising for the implementation of process analytical technology (PAT) in the pharmaceutical industry of Chinese herbal injections (CHIs).
Collapse
Affiliation(s)
- Wenlong Li
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; College of Pharmaceutical Engineering of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Xu Yan
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Jianchao Pan
- Kaibao Pharmacy Co., Ltd., Shanghai 201418, China
| | - Shaoyong Liu
- Kaibao Pharmacy Co., Ltd., Shanghai 201418, China
| | | | - Haibin Qu
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.
| |
Collapse
|
27
|
The Effect of Tanreqing Injection on the Pharmacokinetics of Sirolimus in Rats. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1854323. [PMID: 30956975 PMCID: PMC6431440 DOI: 10.1155/2019/1854323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 12/30/2022]
Abstract
To evaluate the effect of Tanreqing injection on the pharmacokinetics of sirolimus in rats, a high performance liquid chromatography tandem mass spectrometry method was developed for sirolimus assay in whole blood. Calibration curve of sirolimus was acquired over a concentration ranging from 2.5 to 100 ng/mL with r2= 0.9955. The matrix effects and extraction recoveries of sirolimus ranged from 144% to 152% and from 80% to 96%, respectively. The inter- and intraday relative standard deviations were both <10%. The stability investigation showed that the blood samples were stable for 30-day-storage at −20°C, for 8 h storage at room temperature, for 24 h storage in the auto-sampler at 4°C, and for three freeze-thaw cycle process. The pharmacokinetic results demonstrated that the Cmax, AUC, and AUMC of sirolimus in rats (7.5 mg/kg, i.g.) were increased after beincoadministration with Tanreqing Injection at 2.5, 5.0, and 7.5 mL/kg (i.v.), respectively, or at 5 min, 2 h, and 4 h (5.0 mL/kg, i.v.) after SRL dosing, respectively. For the first time, the results proved the herb-drug interaction between Tanreqing Injection and sirolimus and accordingly suggested avoiding concurrent reception of those two drugs for patients.
Collapse
|
28
|
Li C, Zang C, Nie Q, Yang B, Zhang B, Duan S. Simultaneous determination of seven flavonoids, two phenolic acids and two cholesterines in Tanreqing injection by UHPLC-MS/MS. J Pharm Biomed Anal 2018; 163:105-112. [PMID: 30292136 DOI: 10.1016/j.jpba.2018.08.058] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 06/20/2018] [Accepted: 08/27/2018] [Indexed: 11/29/2022]
Abstract
A new ultra-high performance liquid chromatography combined with triple quadrupole mass spectrometry was developed to evaluate the quality of Tanreqing injection. Seven flavonoids (Rutin, Baicalin, Scutellarin, Chrysin-7-O-Beta-d-glucoronide, Oroxylin A-7-O-β-d-glucoronide, Wogonin, Luteolin-7-O-glucoside), two phenolic acids (Chlorogenic acid, Caffeic acid) and two cholesterines (Ursodeoxycholic acid, Chenodeoxycholic acid) in Tanreqing injection could be measured simultaneously. For the determination of the eleven compounds, the conditions were set as follows: The mobile phase was a gradient of 0.1% aqueous formic acid solution (A) and acetonitrile (B); the flow rate was 0.2 mL min-1, the column was Acquity UPLC HSS T3 column (2.1 mm × 100 mm, 1.8 μm); and the multiple-reaction monitoring (MRM) with a negative electro spray ionization interface (ESI-) was selected. Within the test ranges, all the standard regression curves showed excellent linear regression (r > 0.99). In terms of (relative standard deviation) RSDs, the precision, repeatability and stability of the eleven compounds were all lower than 3%. The recovery rates of Tanreqing injection and the RSD were 97.8-103.7% and 0.4%-2.0%, respectively. The RSD value was in accordance with the requirements of less than 3.0%. This method has been successfully used in the analysis of Tanreqing injection. In summary, a fast, accurate and reliable UPLC-ESI--MS/MS method was successfully developed for the simultaneous detection of the eleven major active ingredients with different chemical structures in Tanreqing injection, and can be used for the quality control of Tanreqing injection as well.
Collapse
Affiliation(s)
- Cui Li
- Institute for Innovative Drug Design and Evaluation, School of Pharmacy, Henan University, N. Jinming Ave., Kaifeng, Henan 475004, China; Institute of Chinese Material Medica, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Chen Zang
- Institute of Chinese Material Medica, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Qixia Nie
- Institute of Chinese Material Medica, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Bo Yang
- Institute for Innovative Drug Design and Evaluation, School of Pharmacy, Henan University, N. Jinming Ave., Kaifeng, Henan 475004, China
| | - Baoxian Zhang
- Institute of Chinese Material Medica, China Academy of Chinese Medical Sciences, Beijing 100102, China
| | - Shaofeng Duan
- Institute for Innovative Drug Design and Evaluation, School of Pharmacy, Henan University, N. Jinming Ave., Kaifeng, Henan 475004, China; Henan International Joint Laboratory for Nuclear Protein Regulation, School of Medical Sciences, Henan University, N. Jinming Ave., Kaifeng, Henan 475004, China.
| |
Collapse
|
29
|
Tu Z, Xue H, Chen W, Cao L, Zhang W. Changes of Treg and Th17 cells as well as cytokines in children with acute bronchitis. Exp Ther Med 2017; 14:3846-3850. [PMID: 29042990 DOI: 10.3892/etm.2017.4992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 06/06/2017] [Indexed: 01/08/2023] Open
Abstract
The present study aimed to investigate changes of T-regulatory (Treg) and T-helper (Th)17 cells as well as cytokines in peripheral blood of children with acute bronchitis, and to explore the roles of these cells in the pathogenesis of acute bronchitis. A total of 126 children who had presented at Renji Hospital (Shanghai, China) with acute bronchitis were selected as the observation group and 30 healthy children were selected as the control group. Th17/Tregs in the peripheral blood of the children of the observation group and the control group was detected by flow cytometry. The levels of cytokines interleukin (IL)-17, IL-22, IL-10 and transforming growth factor (TGF)-β in peripheral blood serum were detected by ELISA. Compared with those in the control group, Treg cells, the Treg/Th17 ratio as well as serum IL-10 and TGF-β levels were significantly decreased in the observation group (P<0.05), while Th17 cells as well as serum levels of IL-17 and IL-22 were significantly increased (P<0.05). In conclusion, Treg/Th17 and the expression of associated cytokines lost their balance in children with acute bronchitis, suggesting that Treg and Th17 cells as well as their cytokines may be involved in the pathogenesis of acute bronchitis. It may be of certain guiding significance to detect Treg/Th17 and levels of serum cytokines in peripheral blood for clinical treatment.
Collapse
Affiliation(s)
- Zhiqiang Tu
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, P.R. China
| | - Haiyan Xue
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, P.R. China
| | - Wei Chen
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, P.R. China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, P.R. China
| | - Weiqi Zhang
- Department of Pediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, P.R. China
| |
Collapse
|