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Lao Q, Wang X, Zhu G, Yuan H, Ma T, Wang N. A Chinese classical prescription Maimendong decoction in treatment of pulmonary fibrosis: an overview. Front Pharmacol 2024; 15:1329743. [PMID: 38783956 PMCID: PMC11112100 DOI: 10.3389/fphar.2024.1329743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
Pulmonary fibrosis (PF) is a chronic and progressive disease characterized by fibrosis and interstitial pneumonia. It has similar clinical symptoms to "Fei Bi" and "Fei Wei" as described in the traditional Chinese medicine (TCM) classic Jingui Yaolue written by Zhang Zhongjing in the Han Dynasty. This study explored the potential of Maimendong Decoction (MMDD). MMDD consists of Ophiopogon japonicus (L.f) (ophiopogonis), Pinellia ternata (Thunb.) Breit. (pinellia), Panax ginseng C. A. Mey. (ginseng), Glycyrrhiza uralensis Fisch. (glycyrrhiza), Zizi phus jujuba Mill. (jujuba), and Oryza sativa L. (oryza sativa), with the function of nourishing the lung and stomach, and reducing the effect of reverse qi. It has been used clinically for over two thousand years to treat conditions like "Fei Bi" and "Fei Wei". Previous research suggests that MMDD and its individual herbal extracts have anti-fibrotic effects. The main focus of MMDD in treating PF is to reduce inflammatory cytokines, inhibit pro-fibrotic factors and oxidative stress, promote differentiation and homing of bone marrow mesenchymal stem cells, and enhance cell autophagy activity. This review summarized the clinical applications, mechanisms, and pharmacological effects of MMDD in treating PF based on existing clinical applications and experimental research. It also discussed current issues and prospects, aiming to provide a reference for further research on the mechanism of PF, drug development, and clinical trials.
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Affiliation(s)
- Qiurong Lao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xianbin Wang
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guangqing Zhu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haochen Yuan
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ting Ma
- College of Rehabilitation Medical, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ning Wang
- Research Department of Shandong University of Traditional Chinese Medicine, Jinan, China
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Ofori M, Danquah CA, Asante J, Ativui S, Doe P, Abdul-Nasir Taribabu A, Nugbemado IN, Mensah AN. Betulin and Crinum asiaticum L. bulbs extract attenuate pulmonary fibrosis by down regulating pro-fibrotic and pro-inflammatory cytokines in bleomycin-induced fibrosis mice model. Heliyon 2023; 9:e16914. [PMID: 37346329 PMCID: PMC10279834 DOI: 10.1016/j.heliyon.2023.e16914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023] Open
Abstract
Background Pulmonary fibrosis (PF) is a lung disease characterized by scaring of lung tissue that impairs lung functions. The estimated survival time of patients with pulmonary fibrosis is 3-5 years. Bleomycin (BLM) is used clinically in the treatment of Hodgkin lymphoma and testicular germ-cell tumors. Bleomycin's mechanism of action is the inhibition of DNA and protein synthesis. This happens when leukocytes induce the release of cytokines and chemokines which increase the pro-fibrotic and pro-inflammatory cytokines such as IL-6, TNF-alpha, IL-13, IL-1β and transforming growth factor-beta 1 (TGF-β). Crinum asiaticum L. bulbs (CAE) are widely found in parts of Africa, Asia and Indian Ocean Island. It is also prevalent in southern part of Ghana and traditionally used by the indigenes to treat upper respiratory tract infections, and for wound healing. Betulin (BET) is found in the bulbs of Crinum asiaticum L. but widely isolated from the external bark of birches and sycamore trees. Betulin as a lupine type triterpenes has been researched for their pharmacological and biological activities including anticancer, anti-inflammatory, antimicrobial activities and anti-liver fibrosis effects.Aim of the study: The aim was to study the anti-pulmonary fibrosis effect of Crinum asiaticum L. bulbs extract and betulin in bleomycin-induced pulmonary fibrosis in mice. Materials and method There was a single oropharyngeal administration of bleomycin (80 mg/kg) in mice followed by the treatment of CAE and BET after 48 h of exposure to BLM. Results There was increased survival rate in CAE and BET treatment groups compared to the BLM induced group. There was a marked decreased in the levels of hydroxyproline, collagen I and III in the CAE and BET treatment groups compared to BLM-treated group. The treatment groups of CAE and BET significantly down regulated the levels of pro-fibrotic and pro-inflammatory cytokines concentrations such as TGF-β1, MMP9, IL-6, IL-1β and TNF-alpha compared to an increased in the BLM treated groups. The histological findings of the lungs suggested the curative effects of CAE and BET following BLM induced pulmonary fibrosis in mice, the study showed improved lung functions with wide focal area of viable alveolar spaces and few collagen fibers deposition on lungs of treatment groups. Conclusion CAE and BET attenuated pulmonary fibrosis by down regulating pro-fibrotic and pro-inflammatory cytokines as well as improving lung function. This could be a lead in drug discovery where compounds with anti-fibrotic effects could be developed for the treatment of lung injury.
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Affiliation(s)
- Michael Ofori
- Department of Pharmaceutical Science, Dr Hilla Limann Technical University, Wa, Ghana
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Joshua Asante
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Ghana
- Department of Medical Laboratory, Diamed Diagnostic Center, Kumasi, Ghana
| | - Selase Ativui
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Ghana
| | - Peace Doe
- Department of Pharmaceutical Science, School of Pharmacy, Central University, Accra, Ghana
| | | | | | - Adwoa Nkrumah Mensah
- Department of Pharmacology, Kwame Nkrumah University of Science and Technology, Ghana
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Feng C, Wenlin Y, Qiangyong K, Li L, Jingjing Q. Clinical efficacy of combination therapy of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs in the treatment of novel coronavirus pneumonia: A prospective interventional study. J Herb Med 2023; 38:100627. [PMID: 36644210 PMCID: PMC9831664 DOI: 10.1016/j.hermed.2023.100627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/13/2021] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
Introduction The National Administration of Traditional Chinese Medicine of the People's Republic of China (NATCM) and the State Administration of Traditional Chinese medicine (TCM) advocated a combination therapy of TCM and anti-viral drugs for novel coronavirus pneumonia (NCP) to improve the efficacy of clinical treatment. Methods Forty-six patients diagnosed with NCP were sequentially divided into intent-to-treat population: the experimental group (combination of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs; n = 23) and the control group (anti-viral drugs only) (n = 23). The two groups were compared in terms of duration of fever, cough symptom score, fatigue, appetite, dyspnea, out-of-bed activities, chest computer tomography (CT) recovery, virological clearance, average length of hospital stay, and clinical effective rate of drug. After 6 days of observation, patients from the control group were divided into as-treated population: experimental subgroup (n = 14) to obtain clinical benefit and control subgroup (n = 9). Results There was a significant improvement in the duration of fever (1.087 ± 0.288 vs 4.304 ± 2.490), cough (0.437 ± 0.589 vs 2.435 ± 0.662; P < 0.05), chest CT evaluation (82.6% vs 43.4%; P < 0.05), and virological clearance (60.8% vs 8.7%; P < 0.05) in patients of the experimental group compared with patients in the control group. Further observation in as-treated population reported that cough (0.742 ± 0.463 vs 1.862 ± 0.347; P < 0.05) and fatigue (78.5% vs 33.3%; P < 0.05) were significantly relieved after adding FuXi-Tiandi-Wuxing Decoction to the existing treatment. Conclusion An early treatment with combination therapy of FuXi-Tiandi-Wuxing Decoction and anti-viral drugs significantly relieves the clinical symptoms of NCP, shows improvement in chest CT scan, improves virological clearance, shortens average length of hospital stay, and reduces the risk of severe illness. The effect of FuXi-Tiandi-Wuxing Decoction in NCP may be clinically important and require further consideration.
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Key Words
- ARDS, acute respiratory distress syndrome
- Anti-viral drug
- COVID-19
- CRS, cytokine release syndrome
- CT, computed tomography
- ELISA, enzyme-linked immunosorbent assay
- H1N1, Hemagglutinin Type 1 and Neuraminidase Type 1
- ITT, intent-to-treat
- NATCM, National Administration of Traditional Chinese Medicine of the People’s Republic of China
- NCP, novel coronavirus pneumonia
- Novel coronavirus pneumonia
- PG, Platycodon grandiflorum
- Prospective
- RT-PCR, reverse transcriptase polymerase chain reaction
- RdRp, RNA-dependent RNA polymerase
- TCM, traditional Chinese medicine
- TNF, tumor necrosis factor
- Traditional Chinese medicine
- WHO, World Health Organization
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Affiliation(s)
- Chen Feng
- People’s Hospital of Xiang Zhou District, Lanpu Rd, Xiangzhou, ICP No. 09154174, Zhuhai, Guangdong Province, China
| | - Yao Wenlin
- People’s Hospital of Xiang Zhou District, Lanpu Rd, Xiangzhou, ICP No. 09154174, Zhuhai, Guangdong Province, China
| | - Kou Qiangyong
- People’s Hospital of Xiang Zhou District, Lanpu Rd, Xiangzhou, ICP No. 09154174, Zhuhai, Guangdong Province, China
| | - Lanting Li
- Shanghai Palan DataRx Co., Ltd, Room 611, Building A, No. 3501 Hechuan Road, Minhang District, 200110 Shanghai, China
| | - Qi Jingjing
- People’s Hospital of Xiang Zhou District, Lanpu Rd, Xiangzhou, ICP No. 09154174, Zhuhai, Guangdong Province, China,Correspondence to: Department of Pneumonology, People’s Hospital of Xiang Zhou District, Lanpu Rd, Xiangzhou, ICP No. 09154174, Zhuhai, Guangdong Province, China
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Gad El-Hak HN, Mohamed OE, Nabil ZI. Evaluating the protective role of Deglycyrrhizinated licorice root supplement on bleomycin induced pulmonary oxidative damage. Toxicol Mech Methods 2021; 32:180-193. [PMID: 34488542 DOI: 10.1080/15376516.2021.1977881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The goal of this study was to investigate the protective effect of licorice supplements in a rat model of Bleomycin-induced lung oxidative damage over a duration of one month. The rats were randomly divided into six groups (n = 10 per group). Control group; Bleomycin group (B): rats were IP injected with bleomycin 5 mg/kg twice weekly. Licorice group (L): rats received orally 300 mg/kg licorice extract. Bleomycin and a low dose of Licorice group (BLLG): rats received orally 75 mg/kg licorice daily and injected as the B group. Bleomycin and a middle dose of Licorice group (BMLG): rats received orally 150 mg/kg licorice daily and injected as the Bleomycin group. Bleomycin and a high dose of Licorice group (BHLG): rats received orally 300 mg/kg licorice daily and injected as the Bleomycin group. Treatment with Bleomycin induced inflammation and oxidative damage to the lungs expressed in the disturbance of the measured parameters in the blood serum, the lung tissue, and the broncholavage fluid. In addition to the decreased expression of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), and catalase (CAT) in the lung tissues. Bleomycin caused deformative changes in the histopathological and cellular examination of the lungs especially in the alveolar cells and the interstitial space. On the other hand, treated the bleomycin group with different doses of licorice supplement activates the antioxidant defense mechanism and attenuates the oxidative damage and damage induced to the lung. In conclusion, Deglycyrrhizinated licorice root supplement provided strong antioxidant and protective effects on Bleomycin-induced lung damage.
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Affiliation(s)
- Heba N Gad El-Hak
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Osman E Mohamed
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Zohour I Nabil
- Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
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Du M, Zhang Y, Shi X, Liu M. Comparative efficacy and safety of traditional Chinese medicine for lipodermatosclerosis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e23386. [PMID: 33217882 PMCID: PMC7676565 DOI: 10.1097/md.0000000000023386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lipodermatosclerosis (LDS) is a severe skin change accompanied by the development of chronic venous disease of the lower extremities. Its main clinical manifestations are erythema, induration, hyperpigmentation, and rough and thickened skin. It may also eventually lead to refractory ulcers, skin necrosis and even cancer. Conventional treatment methods mainly include the intake of oral anabolic hormones or androgen and pressure therapy. However, patients often refuse due to their drug resistance and intolerance. As a clinical irreplaceable treatment method for LDS, traditional Chinese medicine (TCM) has not been compared of the safety and effectiveness so far. Therefore, we cannot wait to use a method to compare the efficacy of TCM for LDS systematically, such as network meta-analysis (NMA). METHODS We will retrieve the relevant Chinese and English databases comprehensively. All the randomized controlled trials of TCM for LDS from January 2015 to September 2020 will be included. Under the guidance of inclusion criteria, 2 researchers will screen the literature, then assess the risk of bias and extract data. We will use Bayesian NMA to evaluate all available evidence in STATA 14.0 and WinBUGS software. RESULTS This study will use Bayesian NMA to evaluate the efficacy and safety of TCM for LDS. CONCLUSION This study provide a reliable theoretical basis for the clinical application of TCM in the treatment of LDS, and contribute to the formulation of treatment guidelines for LDS.
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Affiliation(s)
- Mengmeng Du
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine
| | - Yudong Zhang
- Department of Peripheral Blood Vessel, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong
| | - Xiaohua Shi
- Department of Trauma Orthopaedics, Zhengzhou Orthopaedic Hospital, Zhengzhou, Henan, China
| | - Ming Liu
- Department of Peripheral Blood Vessel, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong
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Mahmoudi T, Abdolmohammadi K, Bashiri H, Mohammadi M, Rezaie MJ, Fathi F, Fakhari S, Rezaee MA, Jalili A, Rahmani MR, Tayebi L. Hydrogen Peroxide Preconditioning Promotes Protective Effects of Umbilical Cord Vein Mesenchymal Stem Cells in Experimental Pulmonary Fibrosis. Adv Pharm Bull 2020; 10:72-80. [PMID: 32002364 PMCID: PMC6983995 DOI: 10.15171/apb.2020.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 12/15/2022] Open
Abstract
Purpose: Idiopathic pulmonary fibrosis (IPF) is a progressive lung disorder with few available treatments. Mesenchymal stem cell therapy (MSCT), an innovative approach, has high therapeutic potential when used to treat IPF. According to recent data, preconditioning of MSCs can improve their therapeutic effects. Our research focuses on investigating the anti-inflammatory and antifibrotic effects of H2 O2 -preconditioned MSCs (p-MSCs) on mice with bleomycin-induced pulmonary fibrosis (PF). Methods: Eight-week-old male C57BL/6 mice were induced with PF by intratracheal (IT) instillation of bleomycin (4 U/kg). Human umbilical cord vein-derived MSCs (hUCV-MSCs) were isolated and exposed to a sub-lethal concentration (15 μM for 24 h) of H2 O2 in vitro. One week following the injection of bleomycin, 2×105 MSCs or p-MSCs were injected (IT) into the experimental PF. The survival rate and weight of mice were recorded, and 14 days after MSCs injection, all mice were sacrificed. Lung tissue was removed from these mice to examine the myeloperoxidase (MPO) activity, histopathological changes (hematoxylin-eosin and Masson's trichrome) and expression of transforming growth factor beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) through immunohistochemistry (IHC) staining. Results: Compared to the PF+MSC group, p-MSCs transplantation results in significantly decreased connective tissue (P<0.05) and collagen deposition. Additionally, it is determined that lung tissue in the PF+pMSC group has increased alveolar space (P<0.05) and diminished expression of TGF-β1 and α-SMA. Conclusion: The results demonstrate that MSCT using p-MSCs decreases inflammatory and fibrotic factors in bleomycin-induced PF, while also able to increase the therapeutic potency of MSCT in IPF.
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Affiliation(s)
- Tayebeh Mahmoudi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kamal Abdolmohammadi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Bashiri
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehdi Mohammadi
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Rezaie
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fardin Fathi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shohreh Fakhari
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Ali Rezaee
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Jalili
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Cancer and Immunology Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Reza Rahmani
- Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Zoonoses Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, 53233, USA
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Mojiri-Forushani H, Hemmati AA, Dehghani MA, Malayeri AR, Pour HH. Effects of herbal extracts and compounds and pharmacological agents on pulmonary fibrosis in animal models: a review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 15:433-441. [DOI: 10.1016/s2095-4964(17)60363-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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