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Li J, Sun Y, Qiu W, Zhou Y, Zhou D, Zhao Y, Liu A, Yuan Y, Guo W. Liangxue Tongyu prescription attenuates neuroinflammation by increasing cholecystokinin octapeptide in acute intracerebral hemorrhage rats. Neuropeptides 2024; 107:102452. [PMID: 38941823 DOI: 10.1016/j.npep.2024.102452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/21/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
Inflammatory reactions after acute intracerebral hemorrhage (AICH) contribute significantly to a poor prognosis. Liangxue Tongyu Prescription (LTP) has been proven to be clinically effective in treating AICH. Numerous studies have shown that LTP suppresses brain inflammatory damage in AICH, while the internal mechanisms underlying its action remain unclear. The aim of this study was to verify the anti-inflammatory effects of LTP on an AICH rat model and investigate the potential mechanisms. The AICH rat models were created by injecting autologous blood into the right caudate nucleus. LTP markedly decreased cerebral hematoma and brain water content and recovered from neurological deficits. Meanwhile, LTP prevented microglial activation and reduced the inflammatory reaction caused by pro-inflammatory cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6). Notably, the expression of cholecystokinin octapeptide (CCK-8) in the brain and intestine was increased by LTP or CCK-8 treatment. LTP further suppressed nuclear factor kappa B (NF-κB) in the brains of rats with AICH. Moreover, LTP increased the protein and mRNA expression of Occludin and Claudin-1 in the intestine and decreased the levels of lipopolysaccharide (LPS) and diamine oxidase (DAO) in serum. Furthermore, the results showed that LTP increased the protein and mRNA expression of Claudin-5 and zonula occludens-1 (ZO-1) in the brain. CCK-8 receptor antagonists increased the expression of NF-κB and the concentration of pro-inflammatory cytokines. These findings suggested that LTP attenuated neuroinflammation by increasing CCK-8 in the brain and intestine, and its mechanism might be related to alterations in the gut-brain axis (GBA).
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Affiliation(s)
- Jianxiang Li
- School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China; Department of Neurology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210022, China
| | - Yingying Sun
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Wenzhe Qiu
- School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yu Zhou
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Dandan Zhou
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yang Zhao
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Anlan Liu
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yuan Yuan
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China.
| | - Weifeng Guo
- First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China.
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Li C, Zhang K, Jin X, Gao X, Lv J, Shen J, Gao X, Zhang H, Sun J. A transcriptomics and network pharmacology approach to elucidate the mechanism of action of geniposide on carbon tetrachloride-induced liver injury in rats. Int Immunopharmacol 2023; 120:110391. [PMID: 37262958 DOI: 10.1016/j.intimp.2023.110391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
Geniposide, the main active component of Fructus Gardeniae (FG), is known to confer protection against liver diseases. Herein we explored the hepatoprotective effects of geniposide and elucidated its molecular mechanism by transcriptome RNA-seq and network pharmacology. Liver injury was modeled by intraperitoneally injecting CCl4 (0.15% prepared with refined peanut oil) at a dose of 1.5 mL/kg thrice a week; from the second week, rats were administered geniposide (20 mg/kg or 40 mg/kg) by gavage for 6 weeks. Serum and liver samples were then collected to assess liver function indicators and inflammatory factors and to observe pathological changes in the liver. The Illumina HiSeq 4000 platform was used to obtain transcriptome data from the liver tissue of rats after geniposide administration. Core targets and pathways related to the liver protection mechanism of geniposide were further analyzed by integrating transcriptomics and network pharmacology. Differentially expressed genes (DEGs), core targets, and signaling pathways were identified by methods such as q-PCR, molecular docking, and Western blotting. We found that after geniposide administration, the levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and inflammatory factors decreased in the model group, and liver injury cells be effectively repaired. RNA-seq data analysis showed that compared to control group, the model group reversed 1,451 DEGs; further, compared to model group, geniposide reversed 511 DEGs. Eight key targets, including PIK3R1, ACOX3, and EGF, were found through further analyses. Geniposide was determined to mainly regulate the PPAR signaling pathway, apoptosis signaling pathway, and MAPK signaling pathway in liver tissues. To summarize, the protective and restorative effects of geniposide on rat liver may seem to be related to its efficacy in inhibiting the activation of inflammatory pathways, thereby reducing cell apoptosis. Our findings should serve as the basis for the development of functional foods or drugs to prevent and treat liver diseases.
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Affiliation(s)
- Chunnan Li
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Kaiyue Zhang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Xin Jin
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Xiaochen Gao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Jingwei Lv
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Jiaming Shen
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Xu Gao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Hui Zhang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
| | - Jiaming Sun
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun, China.
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Wang R, Ren J, Li S, Bai X, Guo W, Yang S, Wu Q, Zhang W. Efficacy evaluation of Buyang Huanwu Decoction in the treatment of ischemic stroke in the recovery period: A systematic review of randomized controlled trials. Front Pharmacol 2022; 13:975816. [PMID: 36313307 PMCID: PMC9613954 DOI: 10.3389/fphar.2022.975816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background and purpose: Buyang Huanwu decoction (BYHWD) is widely used in the treatment of ischemic stroke in the recovery period, and many clinical trials have been reported, but its clinical efficacy and safety have not been fully evaluated. In this study, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy and safety of BYHWD in the recovery period. Materials and methods: Eight databases, including CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Cochrane Library, EMBASE, and Web of Science, were searched from the establishment of the database to 13 April 2022. We selected all eligible randomized controlled trials of BYHWD in the treatment of ischemic stroke during the recovery period. Systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The National Institutes of Health Stroke Score (NIHSS) was the primary outcome, and the Chinese Stroke Scale (CSS), activities of daily living (ADL), and adverse drug reaction (ADR) were the secondary outcomes. Results: A total of 39 randomized controlled trials were included, and 3,683 patients in the recovery period of ischemic stroke were recruited. Compared with conventional treatment alone, BYHWD combined with conventional treatment significantly decreased the NIHSS score (MD = -1.44, 95% CI: 1.75, -1.12, p < 0.00001), the CSS score (MD = -1.18, 95% CI: 2.02, -0.34, p = 0.006), improved the ADL (MD = 4.33, 95% CI: 3.06, 5.61, p < 0.00001), and did not increase the adverse reactions of patients (OR = 0.88, 95% CI: 0.48, 1.61, p = 0.67). Conclusion: BYHWD is an effective and safe therapy for the recovery of ischemic stroke. To further determine the efficacy and safety of BYHWD in the treatment of ischemic stroke in the recovery period, more high-quality, multicenter, and prospective RCTs are needed.
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Affiliation(s)
- Raoqiong Wang
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
- National Traditional Chinese Medicine Clinical Research Base of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Junhao Ren
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Shuangyang Li
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Xue Bai
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Wubin Guo
- The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
| | - Sijin Yang
- National Traditional Chinese Medicine Clinical Research Base of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Sijin Yang, ; Qibiao Wu, ; Wei Zhang,
| | - Qibiao Wu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
- Zhuhai MUST Science and Technology Research Institute, Zhuhai, China
- *Correspondence: Sijin Yang, ; Qibiao Wu, ; Wei Zhang,
| | - Wei Zhang
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
- *Correspondence: Sijin Yang, ; Qibiao Wu, ; Wei Zhang,
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Zhang N, Lu F, Li Z, Zhao H, Pang M, Ye T, Wang X, Liu S. Effects of Radix Scrophulariae on Hyperthyroidism Assessed by Metabonomics and Network Pharmacology. Front Pharmacol 2021; 12:727735. [PMID: 34650432 PMCID: PMC8505528 DOI: 10.3389/fphar.2021.727735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Radix Scrophulariae (Chinese name: Xuanshen), a traditional Chinese herb, is used for the treatment of hyperthyroidism, and in this study, its mechanisms were evaluated by metabonomics and system pharmacology. To study the anti-hyperthyroidism effects of R. Scrophulariae, a male SD rat (180–220 g) model of hyperthyroidism induced by Euthyrox was used. Thirty rats were randomly distributed into three groups: the Model group, the R. Scrophulariae treatment group (RS group) and the healthy Control group. Using the UHPLC/Q-TOF-MS metabolomics approach, 44 metabolites were found to be profoundly altered in the model group, and the levels of these biomarkers were significantly decreased after treatment with R. Scrophulariae. Forty-four metabolites and 13 signaling pathways related to R. Scrophulariae, including the biosynthesis of unsaturated fatty acids, primary bile acid biosynthesis and sphingolipid metabolism, were explored, and linoleic acid metabolism and sphingolipid metabolism were identified as the most relevant metabolic pathways. In addition, the system pharmacology paradigm revealed that R. Scrophulariae contains 83 active ingredients and is related to 795 genes, and 804 disease genes are related to hyperthyroidism. The construction of the R. Scrophulariaceae-chemical composition-target-hyperthyroidism network identified a total of 112 intersection genes. The enriched gene targets were analyzed, and five pathways were found to be enriched. Among them pathways, the HIF signaling pathway had the highest enrichment score, which indicated that this pathway might be the main signaling pathway related to the treatment of hyperthyroidism by R. Scrophulariae.The integrated approach involving metabolomics and network pharmacology revealed that R. Scrophulariae might play a role in the treatment of hyperthyroidism by regulating the “IL6-APOA1-cholesterol” pathway and disturbing the HIF signaling pathway. The results demonstrate that the combination of metabolomics and network pharmacology could be used to reflect the effects of R. Scrophulariae on the biological network and metabolic state of hyperthyroidism and to evaluate the drug efficacy of R. Scrophulariaceae and its related mechanisms.
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Affiliation(s)
- Ning Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China.,The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Fang Lu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zihui Li
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hongwei Zhao
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mu Pang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Tao Ye
- The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Xijun Wang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shumin Liu
- Heilongjiang University of Chinese Medicine, Harbin, China
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Liu M, Pu Y, Gu J, He Q, Liu Y, Zeng Y, Li J, Long X, Yang S, Wu Q, Zhou H. Evaluation of Zhilong Huoxue Tongyu capsule in the treatment of acute cerebral infarction: A systematic review and meta-analysis of randomized controlled trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 86:153566. [PMID: 33940333 DOI: 10.1016/j.phymed.2021.153566] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/24/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Zhilong Huoxue Tongyu capsule (ZL) is a Chinese patent medicine and used for the treatment of acute cerebral infarction (ACI) and its clinical application has gradually been widely recognized in China. However, the effects of ZL for patients with ACI have never been systematically evaluated. PURPOSE A systematic review and meta-analysis was performed to evaluate the efficacy of ZL in ACI. STUDY DESIGN A systematic review and meta-analysis of randomized clinical trials (RCTs). MATERIALS AND METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The comprehensive literature search was accomplished in 6 electronic databases to find relevant randomized controlled trials from their inception until October 31, 2020. The Cochrane Handbook for Systematic Reviews of Interventions was used for methodological quality and independent evaluation. Review Manager 5.3 was used to analyze all the data obtained. The Clinical Effective Rate (CER) was the primary outcome, and the National Institutes of Health Stroke Score (NIHSS), Barthel Index (BI), and Modified Rankin Scale (MRS) were the secondary outcomes. RESULTS Seven clinical studies recruiting 571 eligible patients were included in this meta-analysis. The results of meta-analysis suggested that compared with conventional treatment alone, ZL combined with conventional treatment significantly improved CER (RR = 1.20, 95% CI: 1.12-1.29, p < 0.00001), decrease National Institutes of Health Stroke Scale Score (NIHSS) (MD = -2.60, 95% CI: -3.41-1.79, p < 0.00001), Barthel Index (BI) (MD = -9.75, 95% CI: 7.15-12.36, p < 0.00001) and Modified Rankin Scale (MRS) (MD = -0.57, 95% CI: -0.84-0.30, p < 0.00001). There were no reported adverse events in the studies. Most results were robust and the quality of evidence was from moderate to low. CONCLUSION ZL combined with conventional treatment can improve the short-term outcomes of ACI patients, indicating ZL is a promising treatment choice for ACI and may be used as adjunctive treatment to the conventional treatment of ACI. However, due to the limitations of included clinical trials, high-quality clinical trials with longer follow-ups are still needed to further assess the effectiveness and safety of ZL for ACI patients.
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Affiliation(s)
- Mengnan Liu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China; National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, China
| | - Yuting Pu
- Department of Neurology, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, China
| | - Juan Gu
- Department of Neurology, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, China
| | - Qida He
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China
| | - Yan Liu
- National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, China
| | - Yiwei Zeng
- Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingchi Li
- Department of Spine Surgery, Affiliated Hospital of Integrated Traditional Chinese, and Western Medicine for Nanjing University of Chinese Medicine, Nanjing, China
| | - Xingru Long
- Medical Imaging Department, Southwest Medical University, Luzhou, Sichuan, China
| | - Sijin Yang
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China; National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, China.
| | - Qibiao Wu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China.
| | - Hua Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macau, China.
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Synergistic Network Pharmacology for Traditional Chinese Medicine Liangxue Tongyu Formula in Acute Intracerebral Hemorrhagic Stroke. Neural Plast 2021; 2021:8874296. [PMID: 33727915 PMCID: PMC7936909 DOI: 10.1155/2021/8874296] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/22/2020] [Accepted: 02/05/2021] [Indexed: 02/07/2023] Open
Abstract
Background Nowadays, acute intracerebral hemorrhage stroke (AICH) still causes higher mortality. Liangxue Tongyu Formula (LXTYF), originating from a traditional Chinese medicine (TCM) prescription, is widely used as auxiliary treatment for AICH. Objective To dig into the multicomponent, multitarget, and multipathway mechanism of LXTYF on treating AICH via network pharmacology and RNA-seq. Methods Network pharmacology analysis was used by ingredient collection, target exploration and prediction, network construction, and Gene Ontology (GO) and KEGG analysis, with the Cytoscape software and ClusterProfiler package in R. The RNA-seq data of the AICH-rats were analyzed for differential expression and functional enrichments. Herb-Compound-Target-Pathway (H-C-T-P) network was shown to clarify the mechanism of LXTYF for AICH. Results 76 active ingredients (quercetin, Alanine, kaempferol, etc.) of LXTYF and 376 putative targets to alleviate AICH (PTGS2, PTGS1, ESR1, etc.) were successfully identified. The protein-protein interaction (PPI) network indicated the important role of STAT3. The functional enrichment of GO and KEGG pathway showed that LXTYF is most likely to influence MAPK and PI3K-Akt signaling pathways for AICH treatment. From the RNA-seq of AICH-rats, 583 differential mRNAs were identified and 14 of them were consistent with the putative targets of LXTYF for AICH treatment. The KEGG pathway enrichment also implied that the MAPK signaling pathway was the most correlated one among all the related signaling pathways. Many important targets with expression changes of LXTYF for AICH treatment and their related pathways are great markers of antioxidation, anti-inflammatory, antiapoptosis, and lowering blood pressure, which indicated that LXTYF may play mutiroles in the mechanisms for AICH treatment. Conclusion The LXTYF attenuates AICH partially by antioxidation, anti-inflammatory, and antiapoptosis and lowers blood pressure roles through regulating the targets involved MAPK, calcium, apoptosis, and TNF signaling pathway, which provide notable clues for further experimental validation.
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Wu Q, Yao X, Chen H, Liu Z, Li T, Fan X, Zhang G, Yu L, Chen M, Xu C, Zhang R, Chen B, Sui X, Leung ELH. Long-term aspirin use for primary cancer prevention: An updated systematic review and subgroup meta-analysis of 29 randomized clinical trials. J Cancer 2020; 11:6460-6473. [PMID: 33033530 PMCID: PMC7532493 DOI: 10.7150/jca.49001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022] Open
Abstract
Background and objective: Long-term aspirin use for the primary prevention of cancer remains controversial, and variations in the effect of aspirin use on cancer outcomes by aspirin dose, follow-up duration, or study population have never been systematically evaluated. The objective of this study was to evaluate the effect of aspirin on primary cancer prevention and to determine whether the effect differed according to aspirin dose, follow-up duration, or study population. Materials and methods: Seven electronic databases were searched from inception to September 30, 2019. Randomized clinical trials (RCTs) that compared aspirin use versus no aspirin use in participants without pre-existing cancer and reported cancer outcomes were selected. Data were screened and extracted by different investigators. Analyses were performed using Review Manager 5.3 and Comprehensive Meta-Analysis 2.0. Total cancer incidence was defined as the primary clinical endpoint. Total cancer mortality, all-cause mortality, major bleeding, and total bleeding events were the secondary outcomes. Subgroup analyses were conducted based on aspirin dose, follow-up duration, and study populations. Results: Twenty-nine RCTs that randomized 200,679 participants were included. Compared with no aspirin, aspirin use was not associated with significant reductions in total cancer incidence (RR = 1.01, 95% CI: 0.97 to 1.04, P = 0.72), total cancer mortality (RR = 1.00, 95% CI: 0.93 to 1.07, P = 0.90), or all-cause mortality (RR = 0.98, 95% CI: 0.94 to 1.02, P =0.31); however, aspirin use was associated with a 44% increase in the risk of major bleeding (RR = 1.44, 95% CI: 1.32 to 1.57, P < 0.00001) and a 52% increase in the risk of total bleeding events (RR = 1.52, 95% CI: 1.33 to 1.74, P < 0.00001). Subgroup analyses demonstrated consistent results. Conclusions: Long-term aspirin use in individuals without pre-existing cancer was not associated with a significant reduction in total cancer incidence, cancer mortality, or all-cause mortality; however, aspirin use was associated with a significant increase in the risk of bleeding. Therefore, aspirin is not an appropriate choice for the primary cancer prevention.
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Affiliation(s)
- Qibiao Wu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Xiaojun Yao
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Hongwei Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Medicine; Macau University of Science and Technology, Macau, China
| | - Zhengtang Liu
- Department of Geriatrics, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, P.R. China
| | - Ting Li
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Xingxing Fan
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Guilin Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Lili Yu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Min Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Cong Xu
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
| | - Ruonan Zhang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China.,Holistic Integrative Pharmacy Institutes and Department of Medical Oncology, The Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.,Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province and Engineering Laboratory of Development and Application of Chinese Medicine from Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Bi Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China.,Holistic Integrative Pharmacy Institutes and Department of Medical Oncology, The Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.,Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province and Engineering Laboratory of Development and Application of Chinese Medicine from Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xinbing Sui
- Holistic Integrative Pharmacy Institutes and Department of Medical Oncology, The Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China.,Key Laboratory of Elemene Class Anti-cancer Chinese Medicine of Zhejiang Province and Engineering Laboratory of Development and Application of Chinese Medicine from Zhejiang Province, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Elaine Lai-Han Leung
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.,Faculty of Chinese Medicine; Macau University of Science and Technology, Macau, China
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