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Adhikari P. Fatal aconite poisoning in a rural Nepali traditional healer: clinical challenges and management strategies. Ann Med Surg (Lond) 2024; 86:6289-6292. [PMID: 39359847 PMCID: PMC11444581 DOI: 10.1097/ms9.0000000000002543] [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: 07/05/2024] [Accepted: 08/25/2024] [Indexed: 10/04/2024] Open
Abstract
Introduction and importance Aconite, also known as Aconitum spp., is a group of highly toxic flowering plants used historically in traditional medicine despite their potent neurotoxic and cardiotoxic effects. In rural Nepal, where traditional healing practices are prevalent, accidental ingestion of Aconite remains a significant public health concern due to its resemblance to medicinal herbs. Case presentation The authors present a case of severe Aconite poisoning in a 45-year-old male traditional healer from rural Nepal. Following ingestion of a homemade herbal tea containing Aconitum species, the patient developed rapid-onset symptoms, including paresthesia around the mouth, severe abdominal pain, and progressive weakness. Upon admission, he exhibited signs of cardiovascular compromise and metabolic acidosis. Despite aggressive management, including gastric lavage, fluid resuscitation, and symptomatic treatment, the patient succumbed to cardiovascular collapse within 12 h of admission. Clinical discussion Aconite poisoning manifests with early neurological symptoms and progresses to severe gastrointestinal and cardiovascular complications. Its toxicity is attributed to aconitine, which disrupts cellular function by binding to voltage-gated sodium channels. Management focuses on supportive care and symptomatic treatment, given the absence of a specific antidote and challenges in rural healthcare settings. Conclusion This case underscores the critical need for awareness among healthcare providers and the public regarding the dangers of Aconite. Improved education, healthcare infrastructure, and early intervention are essential in mitigating the morbidity and mortality associated with Aconite poisoning in resource-limited settings.
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Affiliation(s)
- Pratik Adhikari
- Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Park M, Seo EH, Yi JM, Cha S. Discovery and Prediction Study of the Dominant Pharmacological Action Organ of Aconitum carmichaeli Debeaux Using Multiple Bioinformatic Analyses. Int J Mol Sci 2024; 25:10219. [PMID: 39337710 PMCID: PMC11432385 DOI: 10.3390/ijms251810219] [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: 08/08/2024] [Revised: 09/12/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
Herbs, such as Aconitum carmichaeli Debeaux (ACD), have long been used as therapies, but it is difficult to identify which organs of the human body are affected by the various compounds. In this study, we predicted the organ where the drug predominantly acts using bioinformatics and verified it using transcriptomics. We constructed a computer-aided brain system network (BSN) and intestinal system network (ISN). We predicted the action points of ACD using network pharmacology (NP) analysis and predicted the dockable proteins acting in the BSN and ISN using statistical-based docking analysis. The predicted results were verified using ACD-induced transcriptome analysis. The predicted results showed that both the NP and docking analyses predominantly acted on the BSN and showed better hit rates in the hub nodes. In addition, we confirmed through verification experiments that the SW1783 cell line had more than 10 times more differentially expressed genes than the HT29 cell line and that the dominant acting organ is the brain, using network dimension spanning analysis. In conclusion, we found that ACD preferentially acts in the brain rather than in the intestine, and this multi-bioinformatics-based approach is expected to be used in future studies of drug efficacy and side effects.
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Affiliation(s)
- Musun Park
- Korean Medicine (KM) Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; (E.-H.S.); (S.C.)
| | - Eun-Hye Seo
- Korean Medicine (KM) Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; (E.-H.S.); (S.C.)
| | - Jin-Mu Yi
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea;
| | - Seongwon Cha
- Korean Medicine (KM) Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; (E.-H.S.); (S.C.)
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Huang R, Pang Q, Zheng L, Duan R, Wang Y, Wang Z, Wang T. Acute aconitine poisoning resulting from the ingestion of medicinal liquor. J Forensic Sci 2024. [PMID: 39233350 DOI: 10.1111/1556-4029.15621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 08/08/2024] [Accepted: 08/12/2024] [Indexed: 09/06/2024]
Abstract
Diester diterpenoid alkaloids (DDAs) are the main active ingredients of herbaceous perennial plants Aconitum. DDAs possess cardiotoxic and neurotoxic properties. Although most deaths caused by DDA poisoning are accidental, a few instances of suicide and homicide have been reported. Presented is a case of an acute aconitine (AC) poisoning following the ingestion of approximately 50 mL of homemade medicinal liquor. We described the clinical manifestations after poisoning and detailed postmortem changes, and detected the concentrations of AC and hypaconitine (HA) by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The decedent experienced a burning sensation in the gastrointestinal tract after poisoning, followed by flushing and paralysis of the face and limbs, and severe cardiac arrhythmia. An autopsy revealed cyanosis of the lips and nail beds; conjunctival hemorrhage in both eyes; pulmonary edema; tissue hemorrhage and congestion in multiple organs; and inflammatory cell infiltration in the stomach, duodenum, pancreas, and cardiac muscle. The concentrations of AC and HA were as follows: cardiac blood, 38.4 ng/mL and 7.1 ng/mL; pericardial fluid, 7.3 ng/mL and 41 ng/mL; urine, 28.1 ng/mL and 574 ng/mL; bile, 38.5 ng/mL and 108 ng/mL; gastric contents, 0.06 mg and 0.56 mg; liver tissue, 10.7 ng/g and 109.6 ng/g; and medicinal liquor, 0.568 mg/mL and 0.664 mg/mL, respectively. The clinical manifestations, anatomy findings, and quantitative data on the concentrations of AC and HA in body fluids and tissues will aid forensic investigations of deaths caused by acute AC poisoning.
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Affiliation(s)
- Ruoyu Huang
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Qiuyu Pang
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Lexin Zheng
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Rui Duan
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Ying Wang
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Zhiyong Wang
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
| | - Tao Wang
- Department of Forensic Medicine and Judicial Appraisal Center, School of Basic Medicine and Biological Sciences, Suzhou Medicine College of Soochow University, Suzhou, China
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Xue R, Zhang Q, Mei X, Wang B, Su L, Mao C, Guo ZJ, Gao B, Ji D, Lu T. Research on quality marker based on the processing from Aconiti lateralis radix praeparata to Heishunpian. PHYTOCHEMICAL ANALYSIS : PCA 2024; 35:1443-1456. [PMID: 38797531 DOI: 10.1002/pca.3376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Aconiti lateralis radix praeparata (ALRP), the sub root of Aconitum carmichaelii Debx., is a traditional Chinese medicine with good pharmacological effects. Heishunpian (HSP), prepared through the process of brine immersing, boiling, rinsing, dyeing, and steaming ALRP is one of the most widely used forms of decoction pieces in clinical practice. OBJECTIVES This study aims to investigate the mechanisms of component changes and transformations during the processing from ALRP to HSP, and to screen for their quality markers through UHPLC-QTOF-MS analysis. METHODS Samples from ALRP to HSP during processing were prepared and analyzed by UHPLC-QTOF-MS. By comparing the differences between before and after each processing step, the purpose of processing and the transformation of components during processing were studied. In addition, multiple batches of ALRP and HSP were determined, and potential quality markers were screened. RESULTS Through the analysis of ALRP and five key processing samples, 55 components were identified. Immersing in brine, rinsing, and dyeing were the main factors of component loss, and boiling caused a slight loss of components. Some components were enhanced during the steaming process. Combining the screened differences components between multiple ALRP and HSP, 10 components were considered as potential quality biomarkers. CONCLUSION This study found that the adjacent hydroxyl groups of the ester group may have a positive impact on the hydrolysis of the ester group, and 10 quality markers were preliminarily screened. It provides a reference for quality control and clinical application of ALRP and HSP.
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Affiliation(s)
- Rong Xue
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Zhang
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xi Mei
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Bin Wang
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Lianlin Su
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Chunqin Mao
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhi Jun Guo
- Nanjing University of Chinese Medicine and China Resources Sanjiu Medical & Pharmaceutical Co. Ltd., Shenzhen Longhua, China
| | - Bo Gao
- Nanjing University of Chinese Medicine and China Resources Sanjiu Medical & Pharmaceutical Co. Ltd., Shenzhen Longhua, China
| | - De Ji
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tulin Lu
- College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
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Oshima Y, Tanaka A, Fukuki M, Otsuki A, Hisatome I. A Case of High-Dose Intravenous MgSO 4 and Hemoperfusion for Aconite Poisoning with Chronic Kidney Disease. Yonago Acta Med 2024; 67:270-279. [PMID: 39176192 PMCID: PMC11335928 DOI: 10.33160/yam.2024.08.012] [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: 07/03/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
Aconite contains four highly toxic diester-diterpene alkaloids, including aconitine, mesaconitine, hypaconitine, and jesaconitine, in all plant parts. Aconite has been used as for suicide, murder, and as an arrow poison since ancient Greek and Roman times. Ventricular tachyarrhythmias are the most common cause of death in aconite poisoning, and antiarrhythmic drugs and cardioversion are ineffective. A 61-year-old woman ingested the crushed raw roots of a single aconite plant. An ambulance brought her to the Tottori University Hospital 30 min after ingestion. She had a history of chronic stage 5 kidney disease but was not on dialysis. Her heart rate (HR) was 120 bpm upon arrival. The patient developed sustained supraventricular tachycardia (SVT) at an HR of 165 bpm with frequent premature ventricular contractions (PVCs) 15 min after arrival. She then developed sustained monomorphic ventricular tachycardia (VT) at an HR of 200 bpm 20 min after arrival, which progressed to pulseless polymorphic VT. Cardioversion was unsuccessful. External cardiac massage restored spontaneous circulation; however, her underlying rhythm remained sustained SVT with frequent PVCs. These arrhythmias repeatedly led to circulatory arrest. She was administered six intravenous boluses of 2 g of MgSO4 in the emergency department, which prevented her from going into sustained pulseless VT. Hemoperfusion (HP) with activated charcoal was performed 1.5 h after arrival. The aconitine, mesaconitine, and hypaconitine plasma concentrations were high at 8.9, 23.5, and 5.5 ng/mL, respectively, before the start of HP but decreased to 1.7, 4.0, and 2.7 ng/mL, respectively, after 7 h of HP. She returned to sinus rhythm on the second day of hospitalization; however, the patient required maintenance hemodialysis. We concluded that high-dose IV MgSO4 is an effective treatment for fatal tachyarrhythmias due to aconite poisoning, and that in cases of renal failure, HP may be required to remove aconite toxins from the body.
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Affiliation(s)
- Yoshiaki Oshima
- Division of Anesthesiology and Critical Care Medicine, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
- Department of Anesthesiology, Yonago Medical Center, Yonago 683-0006, Japan
| | - Akira Tanaka
- Division of Anesthesiology and Critical Care Medicine, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Masaharu Fukuki
- Department of Cardiology, Yonago Medical Center, Yonago 683-0006, Japan
| | - Akihiro Otsuki
- Division of Anesthesiology and Critical Care Medicine, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Ichiro Hisatome
- Department of Cardiology, Yonago Medical Center, Yonago 683-0006, Japan
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Bian YY, Hou J, Khakurel S. Treatment of a patient with aconitine poisoning using veno-arterial membrane oxygenation: A case report. World J Clin Cases 2024; 12:4842-4852. [PMID: 39070832 PMCID: PMC11235513 DOI: 10.12998/wjcc.v12.i21.4842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/23/2024] [Accepted: 06/12/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias. The elimination of aconitine from the body takes a considerable amount of time, and during this period, patients are at a significant risk of death due to malignant arrhythmias associated with aconitine poisoning. CASE SUMMARY A 30-year-old male patient was admitted due to accidental ingestion of aconitine-containing drugs. Upon arrival at the emergency department, the patient intermittently experienced malignant arrhythmias including ventricular tachycardia, ventricular fibrillation, ventricular premature beats, and cardiac arrest. Emergency interventions such as cardiopulmonary resuscitation and defibrillation were promptly administered. Additionally, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) therapy was initiated. Successful resuscitation was achieved before ECMO placement, but upon initiation of ECMO, the patient experienced recurrent malignant arrhythmias. ECMO was utilized to maintain hemodynamics and respiration, while continuous blood purification therapy for toxin clearance, mechanical ventilation, and hypothermic brain protection therapy were concurrently administered. On the third day of VA-ECMO support, the patient's respiratory and hemodynamic status stabilized, with only frequent ventricular premature beats observed on electrocardiographic monitoring, and echocardiography indicated recovery of cardiac contractile function. On the fourth day, a significant reduction in toxin levels was observed, along with stable hemodynamic and respiratory functions. Following a successful pump-controlled retrograde trial occlusion test, ECMO assistance was terminated. The patient gradually improved postoperatively and achieved recovery. He was discharged 11 days later. CONCLUSION VA-ECMO can serve as a bridging resuscitation technique for patients with reversible malignant arrhythmias.
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Affiliation(s)
- Yu-Yao Bian
- Department of Emergency Medicine, Hebei Petro China Central Hospital, Langfang 065000, Hebei Province, China
| | - Jin Hou
- Department of Internal Medicine, Langfang Health Vocational College, Langfang 065000, Hebei Province, China
| | - Sudha Khakurel
- Dallas Campus, UT Health Houston School of Public Health, Dallas, TX 75201, United States
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Kanungo J, Sorkin BC, Krzykwa J, Mitchell CA, Embry M, Spencer P, Harry GJ, Cannon J, Liu F, McPherson CA, Gafner S, Westerink RHS. Screening tools to evaluate the neurotoxic potential of botanicals: building a strategy to assess safety. Expert Opin Drug Metab Toxicol 2024; 20:629-646. [PMID: 38984683 DOI: 10.1080/17425255.2024.2378895] [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: 04/18/2024] [Accepted: 07/08/2024] [Indexed: 07/11/2024]
Abstract
AREAS COVERED This paper outlines the selection of NAMs, including in vitro assays using primary rat cortical neurons, zebrafish embryos, and Caenorhabditis elegans. These assays aim to assess neurotoxic endpoints such as neuronal activity and behavioral responses. Microelectrode array recordings of rat cortical neurons provide insights into the impact of botanical extracts on neuronal function, while the zebrafish embryos and C. elegans assays evaluate neurobehavioral responses. The paper also provides an account of the selection of botanical case studies based on expert judgment and existing neuroactivity/toxicity information. The proposed battery of assays will be tested with these case studies to evaluate their utility for neurotoxicity screening. EXPERT OPINION The complexity of botanicals necessitates the use of multiple NAMs for effective neurotoxicity screening. This paper discusses the evaluation of methodologies to develop a robust framework for evaluating botanical safety, including complex neuronal models and key neurodevelopmental process assays. It aims to establish a comprehensive screening framework.
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Affiliation(s)
- Jyotshna Kanungo
- Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Barbara C Sorkin
- Office of Dietary Supplements, Division of Program Coordination, Planning, and Strategic Initiatives, U.S. National Institutes of Health, Bethesda, MD, USA
| | - Julie Krzykwa
- Health and Environmental Sciences Institute, Washington, DC, USA
| | | | - Michelle Embry
- Health and Environmental Sciences Institute, Washington, DC, USA
| | - Peter Spencer
- Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - G Jean Harry
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Jason Cannon
- Purdue Institute for Integrative Neuroscience, Purdue University, West Lafayette, IN, USA
| | - Fang Liu
- Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, USA
| | - Christopher A McPherson
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | | | - Remco H S Westerink
- Division of Toxicology, Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Jin J, Xu X, Li F, Weng F, Zou B, Li Y, Zhao J, Zhang S, Yan D, Qiu F. Physiologically based pharmacokinetic modeling for confirming the role of CYP3A1/2 and P-glycoprotein in detoxification mechanism between glycyrrhizic acid and aconitine in rats. J Appl Toxicol 2024; 44:978-989. [PMID: 38448046 DOI: 10.1002/jat.4595] [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: 01/07/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
Fuzi, an effective common herb, is often combined with Gancao to treat disease in clinical practice with enhancing its efficacy and alleviating its toxicity. The major toxic and bioactive compounds in Fuzi and Gancao are aconitine (AC) and glycyrrhizic acid (GL), respectively. This study aims to elucidate detoxification mechanism between AC and GL from pharmacokinetic perspective using physiologically based pharmacokinetic (PBPK) model. In vitro experiments exhibited that AC was mainly metabolized by CYP3A1/2 in rat liver microsomes and transported by P-glycoprotein (P-gp) in Caco-2 cells. Kinetics assays showed that the Km and Vmax of AC towards CYP3A1/2 were 2.38 μM and 57.3 pmol/min/mg, respectively, whereas that of AC towards P-gp was 11.26 μM and 147.1 pmol/min/mg, respectively. GL markedly induced the mRNA expressions of CYP3A1/2 and MDR1a/b in rat primary hepatocytes. In vivo studies suggested that the intragastric and intravenous administration of GL significantly reduced systemic exposure of AC by 27% and 33%, respectively. Drug-drug interaction (DDI) model of PBPK predicted that co-administration of GL would decrease the exposure of AC by 39% and 45% in intragastric and intravenous dosing group, respectively. The consistency between predicted data and observed data confirmed that the upregulation of CYP3A1/2 and P-gp was the crucial detoxification mechanism between AC and GL. Thus, this study provides a demonstration for elucidating the compatibility mechanisms of herbal formula using PBPK modeling and gives support for the clinical co-medication of Fuzi and Gancao.
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Affiliation(s)
- Jingyi Jin
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoqing Xu
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengling Li
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fengyi Weng
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bin Zou
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Li
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Zhao
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuang Zhang
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dongming Yan
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Furong Qiu
- Laboratory of Clinical Pharmacokinetics, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Rui Y, Zhang X, Min X, Xie H, Ma X, Geng F, Liu R. Unlocking renal Restoration: Mesaconine from Aconitum plants restore mitochondrial function to halt cell apoptosis in acute kidney injury. Int Immunopharmacol 2024; 133:112170. [PMID: 38691919 DOI: 10.1016/j.intimp.2024.112170] [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: 02/11/2024] [Revised: 04/09/2024] [Accepted: 04/27/2024] [Indexed: 05/03/2024]
Abstract
Acute kidney injury (AKI) is characterized by a sudden decline in renal function. Traditional Chinese medicine has employed Fuzi for kidney diseases; however, concerns about neurotoxicity and cardiotoxicity have constrained its clinical use. This study explored mesaconine, derived from processed Fuzi, as a promising low-toxicity alternative for AKI treatment. In this study, we assessed the protective effects of mesaconine in gentamicin (GM)-induced NRK-52E cells and AKI rat models in vitro and in vivo, respectively. Mesaconine promotes the proliferation of damaged NRK-52E cells and down-regulates intracellular transforming growth factor β1 (TGF-β1) and kidney injury molecule 1 (KIM-1) to promote renal cell repair. Concurrently, mesaconine restored mitochondrial morphology and permeability transition pores, reversed the decrease in mitochondrial membrane potential, mitigated mitochondrial dysfunction, decreased ATP production, inhibited inflammatory factor release, and reduced early apoptosis rates. In vivo, GM-induced AKI rat models exhibited elevated AKI biomarkers, in which mesaconine was effectively reduced, indicating improved renal function. Mesaconine enhanced superoxide dismutase activity, reduced malondialdehyde content, alleviated inflammatory infiltrate, mitigated tubular and glomerular lesions, and downregulated NF-κB (nuclear factor-κb) p65 expression, leading to decreased tumor necrosis factor-α (TNF-α) and IL-1β (interleukin-1β) levels in GM-induced AKI animals. Furthermore, mesaconine inhibited the expression of renal pro-apoptotic proteins (Bax, cytochrome c, cleaved-caspase 9, and cleaved-caspase 3) and induced the release of the anti-apoptotic protein bcl-2, further suppressing apoptosis. This study highlighted the therapeutic potential of mesaconine in GM-induced AKI. Its multifaceted mechanisms, including the restoration of mitochondrial dysfunction, anti-inflammatory and antioxidant effects, and apoptosis mitigation, make mesaconine a promising candidate for further exploration in AKI management.
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Affiliation(s)
- Yixin Rui
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China; Department of Pharmacology, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China
| | - Xiumeng Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China; Department of Pharmacology, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China
| | - Xinran Min
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China; Department of Pharmacology, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China
| | - Hongxiao Xie
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China; Department of Pharmacology, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China
| | - Xiuying Ma
- Sichuan Engineering Research Center for Medicinal Animals, Sichuan 611137, China
| | - Funeng Geng
- Sichuan Engineering Research Center for Medicinal Animals, Sichuan 611137, China; Guizhou Yunfeng Pharmaceutical, Guizhou 510000, China.
| | - Rong Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China; Department of Pharmacology, College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611137, China.
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10
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Bouvette S, Butt AL, Harville LE, Tanaka KA. From Ancient Arsenal to an Anesthetic: Historical Roles of Hyoscyamine and Aconitine in Anesthesia. Anesthesiology 2024:141508. [PMID: 38810018 DOI: 10.1097/aln.0000000000005009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Affiliation(s)
- Sharon Bouvette
- University of Oklahoma College of Medicine, Oklahoma City, Oklahoma
| | - Amir L Butt
- Department of Anesthesiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Lacy E Harville
- Department of Surgery, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Kenichi A Tanaka
- Department of Anesthesiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
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Xu T, Wu Z, Yao H, Zhang Y, Chen S, Li Y, Meng XL, Zhang Y, Lin JM. Evaluation of aconitine cardiotoxicity with a heart-on-a-particle prepared by a microfluidic device. Chem Commun (Camb) 2024; 60:4898-4901. [PMID: 38629248 DOI: 10.1039/d4cc00396a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
A heart-on-a-particle model based on multicompartmental microgel is proposed to simulate the heart microenvironment and study the cardiotoxicity of drugs. The relevant microgel was fabricated by a biocompatible microfluidic-based approach, where heart function-related HL-1 and HUVEC cells were arranged in separate compartments. Finally, the mechanism of aconitine-induced heart toxicity was elucidated using mass spectrometry and molecular biotechnology.
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Affiliation(s)
- Tong Xu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Zengnan Wu
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Hongren Yao
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Yingrui Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Shiyu Chen
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Yuxuan Li
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
| | - Xian-Li Meng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yi Zhang
- Ethnic Medicine Academic Heritage Innovation Research Center, School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Jin-Ming Lin
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.
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12
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Lawson C, McCabe DJ, Feldman R. A Narrative Review of Aconite Poisoning and Management. J Intensive Care Med 2024:8850666241245703. [PMID: 38613376 DOI: 10.1177/08850666241245703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Aconite poisoning refers to toxicity resulting from plants belonging to the Aconitum genus, which comprises over 350 different species of perennial flowering plants that grow in temperate mountainous areas of the northern hemisphere (North America, Europe, Asia). These plants contain a group of toxins known as aconite alkaloids, which encompass numerous closely related toxic compounds. Conventional teaching from toxicology textbooks has broadly classified these alkaloids based on their mechanism of action, often simplifying them as substances that prevent sodium channel inactivation. However, this is an oversimplified and sometimes inaccurate description, as some aconite alkaloids can act as sodium channel blockers. Aconite alkaloids have a long history of use as poisonous substances and have been historically employed for hunting, assassinations, traditional medicine, and self-inflicted harm. Toxicity can occur due to the consumption of traditional medicines derived from aconitum plants or the ingestion of aconite plants and their derivatives. The clinical manifestations of aconite poisoning may encompass gastrointestinal symptoms, sensory alterations, seizures, and life-threatening dysrhythmias that may not respond to standard treatments. Treatment is primarily supportive however evaluation and management of these patients should be personalized and carried out in collaboration with a toxicologist.
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Affiliation(s)
- Christine Lawson
- Department of Pharmacy, Rhode Island Hospital, Providence, RI, USA
| | - Daniel J McCabe
- Division of Medical Toxicology, Department of Emergency Medicine, University of Iowa, Iowa City, IA, USA
- Iowa Poison Control Center, Sioux City, IA, USA
| | - Ryan Feldman
- Department of Pharmacy, Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, School of Pharmacy, Milwaukee, WI, USA
- Department of Emergency Medicine Division of Medical Toxicology, Medical College of Wisconsin, Milwaukee, WI, USA
- Wisconsin Poison Center, Milwaukee, WI, USA
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13
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Armstrong L, Machado CD, Dell'Avanzi GG, Spindola T, Raman V, Busch J, Maier J, da Silva NCB, Holandino C, Oliveira AP, Manfron J. Investigations on the morpho-anatomy and histochemistry of Aconitum napellus L. Microsc Res Tech 2024; 87:534-545. [PMID: 37950576 DOI: 10.1002/jemt.24455] [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: 05/05/2023] [Revised: 09/29/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
Aconitum napellus L. is a popular medicinal plant extensively used in homeopathy. This article provides detailed morphology and microscopy, including the anatomical and histochemical features of the herb, to aid authentication and quality control. In cross-section, the root in secondary growth shows the phloem surrounded by pericyclic fibers and a well-developed xylem. The stem is irregular in outline, displaying unicellular trichomes and many free collateral vascular bundles encircling the pith. The leaf is dorsiventral, hypostomatic with anomocytic and anisocytic stomata, and shows non-glandular trichomes. The floral parts are characterized by uniseriate epidermises, homogeneous mesophyll, anomocytic stomata on the abaxial surface, trichomes, and oval pollen grains. The tissue fragments in powdered herbs show these characteristics and have numerous starch grains with thimble-shaped, linear or star-shaped hilum. The detailed macroscopic and microscopic analysis provided in this study can help in the authentication and quality control of A. napellus raw materials. RESEARCH HIGHLIGHTS: Key anatomical, micromorphological, and microchemical features of Aconitum napellus are described. The results of the study can support the taxonomy of the genus Aconitum. Morphological standardization of the species reported here is helpful in the quality control of this herb.
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Affiliation(s)
- Lorene Armstrong
- Departamento de Ciências Farmacêuticas, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Camila Dias Machado
- Departamento de Ciências Farmacêuticas, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | - Thais Spindola
- Laboratório Multidisciplinar em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Avenue Carlos Chagas Filho, Ilha do Fundão, Rio de Janeiro, RJ, Brazil
| | - Vijayasankar Raman
- National Identification Services, USDA-APHIS-PPQ, Beltsville, Maryland, USA
| | | | - Jakob Maier
- Hiscia Institute, Society for Cancer Research, Arlesheim, Switzerland
| | - Nina Cláudia Barboza da Silva
- Laboratório de Botânica Aplicada, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carla Holandino
- Laboratório Multidisciplinar em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Avenue Carlos Chagas Filho, Ilha do Fundão, Rio de Janeiro, RJ, Brazil
| | - Adriana Passos Oliveira
- Laboratório Multidisciplinar em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Avenue Carlos Chagas Filho, Ilha do Fundão, Rio de Janeiro, RJ, Brazil
| | - Jane Manfron
- Departamento de Ciências Farmacêuticas, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
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14
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Klokman VW, Tempelaar S, Kuipers BCW, van Dijk IAG, Moviat MAM. Intentional intoxication with monkshood plant leading to atrioventricular dissociation and ventricular ectopy in a 17-year-old female: a case report. Int J Emerg Med 2024; 17:19. [PMID: 38331724 PMCID: PMC10851478 DOI: 10.1186/s12245-024-00588-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Monkshood, a toxic plant containing a potent cardio- and neurotoxin called aconitine, can lead to a range of symptoms, including nausea, vomiting, dizziness, seizures, and cardiac arrhythmias. Mortality associated with this intoxication are due to ventricular tachyarrhythmias which are difficult to treat and often refractory in nature. CASE PRESENTATION We present a case of a 17-year-old female patient who presented to the emergency department after intentionally ingesting a monkshood plant and developed atrioventricular dissociation and frequent ventricular ectopy. The patient was successfully treated with activated charcoal, supportive care, and cardiac monitoring. CONCLUSION This case highlights the importance of early recognition of aconitine poisoning and the need for prompt supportive care, cardiac rhythm monitoring, and preemptive antiarrhythmic treatment planning.
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Affiliation(s)
- V W Klokman
- Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands.
- Department of Emergency Medicine, Jeroen Bosch Hospital, 'S-Hertogenbosch, The Netherlands.
| | - S Tempelaar
- Department of Pediatrics, Jeroen Bosch Hospital, 'S-Hertogenbosch, The Netherlands
| | - B C W Kuipers
- Department of Pediatrics, Jeroen Bosch Hospital, 'S-Hertogenbosch, The Netherlands
| | - I A G van Dijk
- Department of Pediatrics, Jeroen Bosch Hospital, 'S-Hertogenbosch, The Netherlands
| | - M A M Moviat
- Department of Intensive Care Medicine, Jeroen Bosch Hospital, 'S-Hertogenbosch, The Netherlands
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15
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Zhao P, Tian Y, Geng Y, Zeng C, Ma X, Kang J, Lu L, Zhang X, Tang B, Geng F. Aconitine and its derivatives: bioactivities, structure-activity relationships and preliminary molecular mechanisms. Front Chem 2024; 12:1339364. [PMID: 38318112 PMCID: PMC10839071 DOI: 10.3389/fchem.2024.1339364] [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: 11/16/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024] Open
Abstract
Aconitine (AC), which is the primary bioactive diterpene alkaloid derived from Aconitum L plants, have attracted considerable interest due to its unique structural feature. Additionally, AC demonstrates a range of biological activities, such as its ability to enhance cardiac function, inhibit tumor growth, reduce inflammation, and provide analgesic effects. However, the structure-activity relationships of AC are remain unclear. A clear understanding of these relationships is indeed critical in developing effective biomedical applications with AC. In line with these challenges, this paper summarized the structural characteristics of AC and relevant functional and bioactive properties and the structure-activity relationships presented in biomedical applications. The primary temporal scope of this review was established as the period spanning from 2010 to 2023. Subsequently, the objective of this review was to provide a comprehensive understanding of the specific action mechanism of AC, while also exploring potential novel applications of AC derivatives in the biomedical field, drawing upon their structural characteristics. In conclusion, this review has provided a comprehensive analysis of the challenges and prospects associated with AC in the elucidation of structure-bioactivity relationships. Furthermore, the importance of exploring modern biotechnology approaches to enhance the potential biomedical applications of AC has been emphasized.
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Affiliation(s)
- Pengyu Zhao
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ye Tian
- Guizhou Yunfeng Pharmaceutical Co., Ltd., Qianxinan Buyi and Miao Autonomous Prefecture, China
| | - Yuefei Geng
- Sichuan Key Laboratory of Medical American Cockroach, Chengdu, China
| | - Chenjuan Zeng
- Guizhou Yunfeng Pharmaceutical Co., Ltd., Qianxinan Buyi and Miao Autonomous Prefecture, China
| | - Xiuying Ma
- Sichuan Key Laboratory of Medical American Cockroach, Chengdu, China
| | - Jie Kang
- Guizhou Yunfeng Pharmaceutical Co., Ltd., Qianxinan Buyi and Miao Autonomous Prefecture, China
| | - Lin Lu
- Sichuan Engineering Research Center for Medicinal Animals, Chengdu, China
| | - Xin Zhang
- Sichuan Good Doctor Pharmaceutical Group, Chengdu, China
| | - Bo Tang
- Sichuan Engineering Research Center for Medicinal Animals, Chengdu, China
| | - Funeng Geng
- Sichuan Key Laboratory of Medical American Cockroach, Chengdu, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
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16
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Kohara S, Kamijo Y, Kyan R, Okada I, Hasegawa E, Yamada S, Imai K, Kaizaki-Mitsumoto A, Numazawa S. Severe aconite poisoning successfully treated with veno-arterial extracorporeal membrane oxygenation: A case report. World J Clin Cases 2024; 12:399-404. [PMID: 38313648 PMCID: PMC10835702 DOI: 10.12998/wjcc.v12.i2.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/21/2023] [Accepted: 12/25/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Most species of aconite contain highly toxic aconitines, the oral ingestion of which can be fatal, primarily because they cause ventricular arrhythmias. We describe a case of severe aconite poisoning that was successfully treated through veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and in which detailed toxicological analyses of the aconite roots and biological samples were performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). CASE SUMMARY A 23-year-old male presented to the emergency room with circulatory collapse and ventricular arrhythmia after ingesting approximately half of a root labeled, "Aconitum japonicum Thunb". Two hours after arrival, VA-ECMO was initiated as circulatory collapse became refractory to antiarrhythmics and vasopressors. Nine hours after arrival, an electrocardiogram revealed a return to sinus rhythm. The patient was weaned off VA-ECMO and the ventilator on hospital days 3 and 5, respectively. On hospital day 15, he was transferred to a psychiatric hospital. The other half of the root and his biological samples were toxicologically analyzed using LC-MS/MS, revealing 244.3 mg/kg of aconitine and 24.7 mg/kg of mesaconitine in the root. Serum on admission contained 1.50 ng/mL of aconitine. Beyond hospital day 2, neither were detected. Urine on admission showed 149.09 ng/mL of aconitine and 3.59 ng/mL of mesaconitine, but these rapidly decreased after hospital day 3. CONCLUSION The key to saving the life of a patient with severe aconite poisoning is to introduce VA-ECMO as soon as possible.
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Affiliation(s)
- Saeko Kohara
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Tokyo 1900014, Japan
- Department of Clinical Toxicology, Saitama Medical University, Saitama 3500495, Japan
| | - Yoshito Kamijo
- Department of Clinical Toxicology, Saitama Medical University, Saitama 3500495, Japan
| | - Ryoko Kyan
- Department of Clinical Toxicology, Saitama Medical University, Saitama 3500495, Japan
| | - Ichiro Okada
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Tokyo 1900014, Japan
| | - Eiju Hasegawa
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, Tokyo 1900014, Japan
| | - Soichiro Yamada
- Saitama Prefectural Institute of Public Health, Saitama Prefectural Institute of Public Health, Saitama 3550133, Japan
| | - Koichi Imai
- Saitama Prefectural Institute of Public Health, Saitama Prefectural Institute of Public Health, Saitama 3550133, Japan
| | - Asuka Kaizaki-Mitsumoto
- Division of Toxicology, Department of Pharmacology, Toxicology and Therapeutics, Showa University School of Pharmacy, Tokyo 1428555, Japan
| | - Satoshi Numazawa
- Division of Toxicology, Department of Pharmacology, Toxicology and Therapeutics, Showa University School of Pharmacy, Tokyo 1428555, Japan
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17
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Fatima N, Ashique S, Upadhyay A, Kumar S, Kumar H, Kumar N, Kumar P. Current Landscape of Therapeutics for the Management of Hypertension - A Review. Curr Drug Deliv 2024; 21:662-682. [PMID: 37357524 DOI: 10.2174/1567201820666230623121433] [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: 09/11/2022] [Revised: 03/16/2023] [Accepted: 03/22/2023] [Indexed: 06/27/2023]
Abstract
Hypertension is a critical health problem. It is also the primary reason for coronary heart disease, stroke, and renal vascular disease. The use of herbal drugs in the management of any disease is increasing. They are considered the best immune booster to fight against several types of diseases. To date, the demand for herbal drugs has been increasing because of their excellent properties. This review highlights antihypertensive drugs, polyphenols, and synbiotics for managing hypertension. Evidence is mounting in favour of more aggressive blood pressure control with reduced adverse effects, especially for specific patient populations. This review aimed to present contemporary viewpoints and novel treatment options, including cutting-edge technological applications and emerging interventional and pharmaceutical therapies, as well as key concerns arising from several years of research and epidemiological observations related to the management of hypertension.
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Affiliation(s)
- Neda Fatima
- Department of Pharmacology, Amity University, Lucknow Campus, Lucknow, Uttar Pradesh 226010, India
| | - Sumel Ashique
- Department of Pharmaceutics, Pandaveswar School of Pharmacy, Pandaveswar, West Bengal 713378, India
| | - Aakash Upadhyay
- Department of Pharmaceutics, Bharat Institute of Technology (BIT), School of Pharmacy, Meerut, Uttar Pradesh, 250103, India
| | - Shubneesh Kumar
- Department of Pharmaceutics, Bharat Institute of Technology (BIT), School of Pharmacy, Meerut, Uttar Pradesh, 250103, India
| | - Himanshu Kumar
- Department of Pharmaceutics, Bharat Institute of Technology (BIT), School of Pharmacy, Meerut, Uttar Pradesh, 250103, India
| | - Nitish Kumar
- SRM Modinagar College of Pharmacy, SRM Institute of Science and Technology (Deemed to be University), Delhi-NCR Campus, Modinagar, Ghaziabad, Uttar Pradesh, 201204, India
| | - Prashant Kumar
- College of Pharmacy, Teerthanker Mahaveer University, Moradabad-244001, UP, India
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18
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Mjølstad OC, Radtke M, Brodtkorb E, Edvardsen F, Brede WR, Aamo TO, Jacobsen D, Stokke MK, Helland A. Recurrent malignant ventricular arrhythmias and paresthesia-a mystery revealed as aconitine poisoning: a case report. J Med Case Rep 2023; 17:554. [PMID: 38129927 PMCID: PMC10740282 DOI: 10.1186/s13256-023-04304-2] [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: 03/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND We report a case of a clinical challenge lasting for 12 months, with severe and unresolved clinical features involving several medical disciplines. CASE PRESENTATION A 53-year-old Caucasian male, who had been previously healthy apart from a moderate renal impairment, was hospitalized 12 times during a 1-year period for a recurrent complex of neurological, cardiovascular, and gastrointestinal symptoms and signs, without any apparent etiology. On two occasions, he suffered a cardiac arrest and was successfully resuscitated. Following the first cardiac arrest, a cardiac defibrillator was inserted. During the 12th admission to our hospital, aconitine poisoning was suspected after a comprehensive multidisciplinary evaluation and confirmed by serum and urine analyses. Later, aconitine was also detected in a hair segment, indicating exposure within the symptomatic period. After the diagnosis was made, no further episodes occurred. His cardiac defibrillator was later removed, and he returned to work. A former diagnosis of epilepsy was also abandoned. Criminal intent was suspected, and his wife was sentenced to 11 years in prison for attempted murder. To make standardized assessments of the probability for aconitine poisoning as the cause of the eleven prior admissions, an "aconitine score" was established. The score is based on neurological, cardiovascular, gastrointestinal, and other clinical features reported in the literature. We also make a case for the use of hair analysis to confirm suspected poisoning cases evaluated after the resolution of clinical features. CONCLUSION This report illustrates the medical challenge raised by cases of covert poisoning. In patients presenting with symptoms and signs from several organ systems without apparent cause, poisoning should always be suspected. To solve such cases, insight into the effects of specific toxic agents is needed. We present an "aconitine score" that may be useful in cases of suspected aconitine poisoning.
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Affiliation(s)
- Ole Christian Mjølstad
- Clinic of Cardiology, St. Olav-Trondheim University Hospital, Torgarden, P.O box 3250, 7006, Trondheim, Norway.
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Maria Radtke
- Department of Nephrology, St. Olav-Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eylert Brodtkorb
- Department of Neurology and Clinical Neurophysiology, St. Olav-Trondheim University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frode Edvardsen
- Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway
| | - Wenche Rødseth Brede
- Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway
| | - Trond Oskar Aamo
- Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway
| | - Dag Jacobsen
- Department of Acute Medicine, Oslo University Hospital Ulleval, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- National Poisons Information Centre, Oslo, Norway
| | - Mathis Korseberg Stokke
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Centre for Cardiac Research, University of Oslo, Oslo, Norway
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Arne Helland
- Department of Clinical Pharmacology, St. Olav-Trondheim University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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19
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Goumeniouk NL, Maclean DN, Howie JS, Waechter JE, Couillard P, Shaw JA, Lucyk SN. Stir Fry with a Side of Extracorporeal Membrane Oxygen: Management of Cardiogenic Shock Secondary to Unintentional Aconitine Ingestion. Wilderness Environ Med 2023; 34:567-570. [PMID: 37923684 DOI: 10.1016/j.wem.2023.09.006] [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: 05/07/2023] [Revised: 08/08/2023] [Accepted: 09/12/2023] [Indexed: 11/07/2023]
Abstract
Plant exposures leading to systemic or topical toxicity are common presentations seen in the emergency department. While often nonfatal, certain highly toxic plants result in cardiovascular or respiratory failure requiring invasive management. We describe a 65-y-old patient who presented with a refractory ventricular dysrhythmia secondary to an unintentional ingestion of an aconitine-containing plant after incorrect identification. Despite aggressive treatment with vasopressors, intravenous fluids, antiarrhythmics, as well as electrolyte correction and multiple attempted synchronized cardioversions, the patient remained in a refractory dysrhythmia with cardiogenic shock. Venoarterial extracorporeal membrane oxygen (ECMO) therapy was initiated successfully and resulted in rapid resolution of the unstable dysrhythmia. The patient was weaned from ECMO in under 48 h and was discharged without neurological or cardiovascular sequelae. This case highlights management options available to clinicians who encounter toxicity associated with aconitine ingestion. Fatal consequences were averted, and caution is required with the use of plant-identifying applications and resources.
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Affiliation(s)
| | - Davis N Maclean
- University of Calgary, Cumming School of Medicine, Calgary, Alberta
| | - Joshua S Howie
- University of Saskatchewan, Department of Psychiatry, Regina, Saskatchewan
| | - Jason E Waechter
- University of Calgary, Department of Critical Care Medicine, Calgary, Alberta
| | - Philippe Couillard
- University of Calgary, Department of Critical Care Medicine, Calgary, Alberta
| | - Jeffrey A Shaw
- University of Calgary, Department of Cardiology, Calgary, Alberta
| | - Scott N Lucyk
- Department of Emergency Medicine, University of Calgary, Calgary, Alberta; Poison and Drug Information Service (PADIS), Alberta Health Services, Calgary, Alberta
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20
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Xue C, Luo H, Wang L, Deng Q, Kui W, Da W, Chen L, Liu S, Xue Y, Yang J, Li L, Du W, Shi Q, Li X. Aconine attenuates osteoclast-mediated bone resorption and ferroptosis to improve osteoporosis via inhibiting NF-κB signaling. Front Endocrinol (Lausanne) 2023; 14:1234563. [PMID: 38034017 PMCID: PMC10682992 DOI: 10.3389/fendo.2023.1234563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Osteoporosis (OP), a prevalent public health concern primarily caused by osteoclast-induced bone resorption, requires potential therapeutic interventions. Natural compounds show potential as therapeutics for postmenopausal OP. Emerging evidence from in vitro osteoclastogenesis assay suggests that aconine (AC) serves as an osteoclast differentiation regulator without causing cytotoxicity. However, the in vivo functions of AC in various OP models need clarification. To address this, we administered intraperitoneal injections of AC to ovariectomy (OVX)-induced OP mice for 8 weeks and found that AC effectively reversed the OP phenotype of OVX mice, leading to a reduction in vertebral bone loss and restoration of high bone turnover markers. Specifically, AC significantly suppressed osteoclastogenesis in vivo and in vitro by decreasing the expression of osteoclast-specific genes such as NFATc1, c-Fos, Cathepsin K, and Mmp9. Importantly, AC can regulate osteoclast ferroptosis by suppressing Gpx4 and upregulating Acsl4, which is achieved through inhibition of the phosphorylation of I-κB and p65 in the NF-κB signaling pathway. These findings suggest that AC is a potential therapeutic option for managing OP by suppressing NF-κB signaling-mediated osteoclast ferroptosis and formation.
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Affiliation(s)
- Chunchun Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huan Luo
- Department of Pharmacy, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Libo Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Deng
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenyun Kui
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weiwei Da
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Chen
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shuang Liu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yongpeng Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiafan Yang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingxing Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenlan Du
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qi Shi
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaofeng Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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21
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Yoda S, Onimaru H, Izumizaki M. Effects of aconitine on the respiratory activity of brainstem-spinal cord preparations isolated from newborn rats. Pflugers Arch 2023; 475:1301-1314. [PMID: 37707585 DOI: 10.1007/s00424-023-02857-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
Aconitine is a sodium channel opener, but its effects on the respiratory center are not well understood. We investigated the dose-dependent effects of aconitine on central respiratory activity in brainstem-spinal cord preparations isolated from newborn rats. Bath application of 0.5-5 μM aconitine caused an increase in respiratory rhythm and decrease in the inspiratory burst amplitude of the fourth cervical ventral root (C4). Separate application of aconitine revealed that medullary neurons were responsible for the respiratory rhythm increase, and neurons in both the medulla and spinal cord were involved in the decrease of C4 amplitude by aconitine. A local anesthetic, lidocaine (100 μM), or a voltage-dependent sodium channel blocker, tetrodotoxin (0.1 μM), partially antagonized the C4 amplitude decrease by aconitine. Tetrodotoxin treatment tentatively decreased the respiratory rhythm, but lidocaine tended to further increase the rhythm. Treatment with 100 μM riluzole or 100 μM flufenamic acid, which are known to inhibit respiratory pacemaker activity, did not reduce the respiratory rhythm enhanced by aconitine + lidocaine. The application of 1 μM aconitine depolarized the preinspiratory, expiratory, and inspiratory motor neurons. The facilitated burst rhythm of inspiratory neurons after aconitine disappeared in a low Ca2+/high Mg2+ synaptic blockade solution. We showed the dose-dependent effects of aconitine on respiratory activity. The antagonists reversed the depressive effects of aconitine in different manners, possibly due to their actions on different sites of sodium channels. The burst-generating pacemaker properties of neurons may not be involved in the generation of the facilitated rhythm after aconitine treatment.
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Affiliation(s)
- Shunya Yoda
- Department of Physiology, Showa University School of Medicine, Tokyo, 142-8555, Japan
| | - Hiroshi Onimaru
- Department of Physiology, Showa University School of Medicine, Tokyo, 142-8555, Japan.
| | - Masahiko Izumizaki
- Department of Physiology, Showa University School of Medicine, Tokyo, 142-8555, Japan
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22
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Li Y, Deng X, Xiong H, Hu Q, Chen Y, Zhang W, Ma X, Zhao Y. Deciphering the toxicity-effect relationship and action patterns of traditional Chinese medicines from a smart data perspective: a comprehensive review. Front Pharmacol 2023; 14:1278014. [PMID: 37915415 PMCID: PMC10617680 DOI: 10.3389/fphar.2023.1278014] [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: 08/15/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023] Open
Abstract
In Chinese medicine, the primary considerations revolve around toxicity and effect. The clinical goal is to achieve maximize effect while minimizing toxicity. Nevertheless, both clinical and experimental research has revealed a distinct relationship between these two patterns of action in toxic Traditional Chinese Medicines (TCM). These TCM often exhibit characteristic "double-sided" or "multi-faceted" features under varying pathological conditions, transitioning between effective and toxic roles. This complexity adds a layer of challenge to unraveling the ultimate objectives of Traditional Chinese medicine. To address this complexity, various hypotheses have been proposed to explain the toxicity and effect of Traditional Chinese Medicines. These hypotheses encompass the magic shrapnel theory for effect, the adverse outcome pathway framework, and the indirect toxic theory for toxicity. This review primarily focuses on high-, medium-, and low-toxicity Traditional Chinese Medicines as listed in Chinese Pharmacopoeia. It aims to elucidate the essential intrinsic mechanisms and elements contributing to their toxicity and effectiveness. The critical factors influencing the mechanisms of toxicity and effect are the optimal dosage and duration of TCM administration. However, unraveling the toxic-effect relationships in TCM presents a formidable challenge due to its multi-target and multi-pathway mechanisms of action. We propose the integration of multi-omics technology to comprehensively analyze the fundamental metabolites, mechanisms of action, and toxic effects of TCM. This comprehensive approach can provide valuable insights into the intricate relationship between the effect and toxicity of these TCM.
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Affiliation(s)
- Yubing Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyu Deng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huiling Xiong
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qichao Hu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuan Chen
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenwen Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiao Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanling Zhao
- Department of Pharmacy, The Fifth Medical Center of the PLA General Hospital, Beijing, China
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23
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Weisheng H, Shuquan Z, Weiwei Z, Meichen P, Huine L, Hongmei D. Fatal poisoning due to aconite: Autopsy findings and postmortem quantitative analysis. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00728-w. [PMID: 37783875 DOI: 10.1007/s12024-023-00728-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
Aconitum species are commonly used in traditional Chinese medicine, and they have a narrow therapy window due to the possibility of aconitine poisoning. Aconitine poisoning deaths appear infrequently in forensic practice. It is important to collect valuable body samples in time due to the rapid absorption and excretion of aconitine. However, it is unknown whether postmortem samples have value for toxicological analysis if the deceased has experienced long-term treatment before death. Herein, we present a case of a woman who died after 12 days of failed active treatment for aconitine poisoning. Aconitine was detected in the liver tissue. To our knowledge, this is the first case report describing the detection of aconitine in a decedent after long-term active treatment. The findings indicated that the aconitine concentration in liver tissue can be maintained after long-term treatment; this information may therefore serve as a reference in forensic practice.
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Affiliation(s)
- Huang Weisheng
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, College of Basic Medical Sciences, China Three Gorges University, Yichang, China
| | - Zhao Shuquan
- Department of Forensic Pathology, Zhongshan School of Medicine Sun Yat-sen University, Guangzhou, China
| | - Zhu Weiwei
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pan Meichen
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Huine
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dong Hongmei
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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24
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Zhao D, Zhang Y, Ren H, Shi Y, Dong D, Li Z, Cui G, Shen Y, Mou Z, Kennelly EJ, Huang L, Ruan J, Chen S, Yu D, Cun Y. Multi-omics analysis reveals the evolutionary origin of diterpenoid alkaloid biosynthesis pathways in Aconitum. JOURNAL OF INTEGRATIVE PLANT BIOLOGY 2023; 65:2320-2335. [PMID: 37688324 DOI: 10.1111/jipb.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/27/2023] [Accepted: 09/07/2023] [Indexed: 09/10/2023]
Abstract
Diterpenoid alkaloids (DAs) have been often utilized in clinical practice due to their analgesic and anti-inflammatory properties. Natural DAs are prevalent in the family Ranunculaceae, notably in the Aconitum genus. Nevertheless, the evolutionary origin of the biosynthesis pathway responsible for DA production remains unknown. In this study, we successfully assembled a high-quality, pseudochromosome-level genome of the DA-rich species Aconitum vilmorinianum (A. vilmorinianum) (5.76 Gb). An A. vilmorinianum-specific whole-genome duplication event was discovered using comparative genomic analysis, which may aid in the evolution of the DA biosynthesis pathway. We identified several genes involved in DA biosynthesis via integrated genomic, transcriptomic, and metabolomic analyses. These genes included enzymes encoding target ent-kaurene oxidases and aminotransferases, which facilitated the activation of diterpenes and insertion of nitrogen atoms into diterpene skeletons, thereby mediating the transformation of diterpenes into DAs. The divergence periods of these genes in A. vilmorinianum were further assessed, and it was shown that two major types of genes were involved in the establishment of the DA biosynthesis pathway. Our integrated analysis offers fresh insights into the evolutionary origin of DAs in A. vilmorinianum as well as suggestions for engineering the biosynthetic pathways to obtain desired DAs.
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Affiliation(s)
- Dake Zhao
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650500, China
| | - Ya Zhang
- Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, 518000, China
| | - Huanxing Ren
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Germplasm Bank of Wild Species, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, China
| | - Yana Shi
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
| | - Ding Dong
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650500, China
| | - Zonghang Li
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650500, China
| | - Guanghong Cui
- National Resource Center for Chinese Materia Medica, Chinese Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Yong Shen
- College of Agriculture and Biotechnology, Yunnan Agricultural University, Kunming, 650201, China
| | - Zongmin Mou
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650500, China
| | - Edward J Kennelly
- Department of Biological Sciences, Lehman College, City University of New York, Bronx, 10468, New York, USA
- Graduate Center, City University of New York, Bronx, 10468, New York, USA
| | - Luqi Huang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, 650500, China
- National Resource Center for Chinese Materia Medica, Chinese Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Jue Ruan
- Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, 518000, China
| | - Suiyun Chen
- School of Ecology and Environmental Science, Yunnan University, Kunming, 650500, China
| | - Diqiu Yu
- State Key Laboratory for Conservation and Utilization of Bio-resources in Yunnan, Yunnan University, Kunming, 650500, China
| | - Yupeng Cun
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Germplasm Bank of Wild Species, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, 650201, China
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25
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Majumder MI, Mahadi AR, Rahman OU, Roy BK, Shihab HM. Accidental poisoning with aconite overdose: A case report and resuscitative emergency management in a tertiary level hospital of Bangladesh. Clin Case Rep 2023; 11:e7845. [PMID: 37636875 PMCID: PMC10448233 DOI: 10.1002/ccr3.7845] [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: 06/21/2023] [Revised: 08/09/2023] [Accepted: 08/12/2023] [Indexed: 08/29/2023] Open
Abstract
Intoxication with aconite, a common over-the-counter herbal medicine in Asia, can result in ventricular tachycardia and cardiac arrest and requires heart rate monitoring in a critical care setting and aggressive use of antiarrhythmica. Educational efforts in the appropriate use of alternative medicine may help prevent intoxication.
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Affiliation(s)
| | | | - Obayed Ur Rahman
- Department of AnesthesiologyCumilla Medical CollegeCumillaBangladesh
| | - Biplob Kumar Roy
- Department of AnesthesiologyCumilla Medical CollegeCumillaBangladesh
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26
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Matsuo C, Yamamoto K, Fukushima H, Yajima D, Inoue H. Recurrent ventricular arrhythmia due to aconite intoxication successfully treated with landiolol: A case report. World J Clin Cases 2023; 11:5297-5302. [DOI: 10.12998/wjcc.v11.i22.5297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Ventricular arrhythmias, such as ventricular tachycardia and fibrillation, are the main causes of death in patients with aconite poisoning.
CASE SUMMARY A 51-year-old man presented to our emergency department because he was vomiting after ingesting aconite root to attempt suicide. On arrival, the patient was hemodynamically unstable, and his electrocardiogram revealed polymorphic ventricular extrasystoles and non-sustained ventricular tachycardia. Amiodarone was immediately administered for ventricular arrhythmia. However, the patient remained unresponsive. We administered continuous intravenous landiolol as the ventricular arrhythmia worsened, gradually suppressing it. The patient returned to sinus rhythm 16 h after arriving at the hospital. Some aconitum alkaloids act on voltage-gated Na+- channels and induce ventricular or supraventricular tachyarrhythmias. Landiolol suppresses sympathetic nerve activity through its blocking effect, preventing arrhythmia.
CONCLUSION Landiolol can be a therapeutic option for amiodarone-refractory ventricular arrhythmias caused by aconite intoxication.
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Affiliation(s)
- Chiaki Matsuo
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Koji Yamamoto
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Hidetada Fukushima
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Daisuke Yajima
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita City 286-8686, Chiba, Japan
| | - Hiroyuki Inoue
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita City 286-8686, Chiba, Japan
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27
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Matsuo C, Yamamoto K, Fukushima H, Yajima D, Inoue H. Recurrent ventricular arrhythmia due to aconite intoxication successfully treated with landiolol: A case report. World J Clin Cases 2023; 11:5303-5308. [PMID: 37621582 PMCID: PMC10445079 DOI: 10.12998/wjcc.v11.i22.5303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Ventricular arrhythmias, such as ventricular tachycardia and fibrillation, are the main causes of death in patients with aconite poisoning. CASE SUMMARY A 51-year-old man presented to our emergency department because he was vomiting after ingesting aconite root to attempt suicide. On arrival, the patient was hemodynamically unstable, and his electrocardiogram revealed polymorphic ventricular extrasystoles and non-sustained ventricular tachycardia. Amiodarone was immediately administered for ventricular arrhythmia. However, the patient remained unresponsive. We administered continuous intravenous landiolol as the ventricular arrhythmia worsened, gradually suppressing it. The patient returned to sinus rhythm 16 h after arriving at the hospital. Some aconitum alkaloids act on voltage-gated Na+- channels and induce ventricular or supraventricular tachyarrhythmias. Landiolol suppresses sympathetic nerve activity through its blocking effect, preventing arrhythmia. CONCLUSION Landiolol can be a therapeutic option for amiodarone-refractory ventricular arrhythmias caused by aconite intoxication.
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Affiliation(s)
- Chiaki Matsuo
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Koji Yamamoto
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Hidetada Fukushima
- Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara City 634-8522, Nara, Japan
| | - Daisuke Yajima
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita City 286-8686, Chiba, Japan
| | - Hiroyuki Inoue
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, Narita City 286-8686, Chiba, Japan
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28
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Pan L, Wang Y, Yue L, Wang N, Xu W, Liao X, Wang H, Xiu Y. Review on Processing Methods of Toxic Chinese Materia Medica and the Related Mechanisms of Action. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2023; 51:1385-1412. [PMID: 37545180 DOI: 10.1142/s0192415x23500635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Toxic Chinese materia medica (CMM) has both pharmacological activities and toxic effects. Based on thousands of years of experience in the application of CMMs, people have explored many practical processing methods of CMMs, also known as "Pao Zhi", to reduce/control toxicity and preserve/enhance efficacy. Toxic CMMs have been used throughout China's hospitals. Yet, the production and use of toxic CMM should be carried out in accordance with the Chinese pharmacopoeia (ChP) and the processing regulations formulated by the health administrative departments of provinces, autonomous regions, and municipalities directly under the Central Government. This paper summarizes the current understanding and awareness of toxicity and 45 toxic CMMs, the commonly used processing methods of toxic CMMs recorded in the 2020 edition of ChP, and the changes in the chemical component, toxicity, or efficacy profiles after processing. This review may provide useful information for the processing methods of toxic CMMs worldwide. We believe that with an in-depth study and understanding of toxic CMMs combined with a standardized application, the toxicity of CMMs will be predictable and controllable in the future.
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Affiliation(s)
- Lingyun Pan
- Experiment Center for Science and Technology, Shanghai 201203, P. R. China
| | - Yingshu Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Lixia Yue
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Nan Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Wen Xu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Xue Liao
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Haiying Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Yanfeng Xiu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
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29
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Jiang C, Shen J, Wang C, Huang Y, Wang L, Yang Y, Hu W, Li P, Wu H. Mechanism of aconitine mediated neuronal apoptosis induced by mitochondrial calcium overload caused by MCU. Toxicol Lett 2023; 384:86-95. [PMID: 37506855 DOI: 10.1016/j.toxlet.2023.07.014] [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: 04/10/2023] [Revised: 06/25/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023]
Abstract
Aconitine is a crucial toxic component in Chinese herbal medicines such as Aconitum, Aconitum coreanum, and Aconitum soongaricum. The poisoning symptoms of the central nervous system and cardiovascular system caused by it are relatively common in China, and there are many studies on cardiovascular system diseases caused by aconitine. However, the specific mechanism of neurotoxicity induced by aconitine is still unclear. This study explored the effect and mechanism of mitochondrial calcium uniporter on mitochondrial energy metabolism disorder in aconitine poisoning hippocampal neurons. The results showed that after treatment with 400μmol/L aconitine, mitochondrial energy metabolism was abnormal in rat hippocampal neuron cells, the expression of MCU in mitochondria was up-regulated, calcium overload in mitochondria, ATP production decreased, and mitochondrial membrane potential Changes, increased expression of the apoptosis gene Cleaved-Caspase-3. After treatment with the MCU agonist spermine, mitochondrial energy metabolism was significantly abnormal, and cell apoptosis was increased considerably. However, pretreatment with calcium ion channel inhibitor Ruthenium Red (RR) effectively promoted the generation of ATP, thereby improving mitochondrial energy metabolism disorders and reducing cell apoptosis. These results suggest that aconitine induces mitochondrial energy metabolism dysfunction in hippocampal neurons, which may be related to the increased expression of MCU.
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Affiliation(s)
- Chen Jiang
- Kunming Medical University, Kunming, China
| | - Jun Shen
- Kunming Medical University, Kunming, China
| | - Chun Wang
- Kunming Medical University, Kunming, China
| | - Yongjie Huang
- Department of Emergency and Intensive Care Unit, First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Linbo Wang
- Department of Emergency and Intensive Care Unit, First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China
| | - Yiran Yang
- Kunming Medical University, Kunming, China
| | - Wen Hu
- Kunming Medical University, Kunming, China
| | - Ping Li
- Department of Anatomy and Histology & Embryology, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan, China.
| | - Haiying Wu
- Department of Emergency and Intensive Care Unit, First Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China.
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Chen YJ, Wu LT, Li TA, Pu MQ, Sun XL, Bao H, Wan WM. Ketyl Radical Anion Mediated Radical Polymerization and Anionic Ring-Opening Polymerization to Give Polymers with Low Molecular Weight Distribution. Angew Chem Int Ed Engl 2023; 62:e202304033. [PMID: 37263979 DOI: 10.1002/anie.202304033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/03/2023]
Abstract
The development of novel polymerization capable of yielding polymers with low molecular weight distribution (Đ) is essential and significant in polymer chemistry, where monofunctional initiator contains only one initiation site in these polymerizations generally. Here, ketyl radical anion species is introduced to develop a novel Ketyl Mediated Polymerization (KMP), which enables radical polymerization at carbon radical site and anionic ring-opening polymerization at oxygen anion site, respectively. Meanwhile, polymerization and corresponding organic synthesis generally couldn't be performed simultaneously in one pot. Through KMP, organic synthesis and polymerization are achieved in one pot, where small molecules (cyclopentane derivates) and polymers with low Đ are successfully prepared under mild condition simultaneously. At the initiation step, both organic synthesis and polymerization are initiated by single electron transfer reaction with ketyl radical anion formation. Cyclopentane derivates are synthesized through 3-3 coupling reaction and cyclization. Polystyrene and polycaprolactone with low Đ and a full monomer conversion are prepared by KMP via radical polymerization and anionic ring-opening polymerization, respectively. This work therefore enables both organic synthesis and two different polymerizations from same initiation system, which saves time, labour, resource and energy and expands the reaction mode and method libraries of organic chemistry and polymer chemistry.
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Affiliation(s)
- Yu-Jiao Chen
- College of Environment and Resources, Engineering Research Center of Polymer Green Recycling of Ministry of Education, Fujian Key Laboratory of Pollution Control & Resource Reuse, Fujian Normal University, Fuzhou, 350007, P. R. China
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
| | - Liang-Tao Wu
- College of Environment and Resources, Engineering Research Center of Polymer Green Recycling of Ministry of Education, Fujian Key Laboratory of Pollution Control & Resource Reuse, Fujian Normal University, Fuzhou, 350007, P. R. China
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
| | - Tai-An Li
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou, 350007, P. R. China
| | - Meng-Qin Pu
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
- College of Chemistry and Materials Science, Fujian Normal University, Fuzhou, 350007, P. R. China
| | - Xiao-Li Sun
- College of Environment and Resources, Engineering Research Center of Polymer Green Recycling of Ministry of Education, Fujian Key Laboratory of Pollution Control & Resource Reuse, Fujian Normal University, Fuzhou, 350007, P. R. China
| | - Hongli Bao
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
| | - Wen-Ming Wan
- Key Laboratory of Coal to Ethylene Glycol and Its Related Technology, State Key Laboratory of Structural Chemistry, Center for Excellence in Molecular Synthesis, Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, 350002, P. R. China
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Cheng H, Zhao J, Zhang J, Wang Z, Liu Z, Ma X, Liang J, Li W, Fu P, Yang S, Guo Y. Attribution Analysis of Household Foodborne Disease Outbreaks in China, 2010-2020. Foodborne Pathog Dis 2023; 20:358-367. [PMID: 37506344 DOI: 10.1089/fpd.2022.0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Foodborne diseases have become a serious public health problem worldwide, and foodborne disease outbreaks have placed a heavy disease burden on China. Foodborne disease outbreaks occur most frequently among families in China. The objectives of this study were to analyze the cause of household foodborne disease outbreaks in China from 2010 to 2020 and to identify where preventive measures could be targeted. All data were obtained from the China Foodborne Disease Surveillance System Report. A total of 17,985 outbreaks, which resulted in 73,252 illnesses, 38,829 hospitalizations, and 1269 deaths, were reported in this period. Most household outbreaks of foodborne diseases occurred in May-October, and the highest number occurred in July (3620 outbreaks, 20%). The province with the highest number of outbreaks was Yunnan Province (4829 outbreaks), followed by Hunan Province (2264 outbreaks). The attribution analysis revealed that fungi (mainly poisonous mushrooms) were the most implicated food category, with 8873 (49.3%) cases. The second was poisonous plants and their products, with 1552 (8.6%) cases. Fungi were the primary etiologic agent, with 31,125 illnesses, accounting for 42.5% of the incidents. Inedibility and misuse (9423 outbreaks), unknown origin (2505 outbreaks), and improper processing (2365 outbreaks) were the main contributing factors causing outbreaks of foodborne diseases. The results show that southwest China was a high-risk area for household foodborne diseases. Therefore, public health institutions should strengthen supervision and food safety education of residents to reduce the outbreaks of household foodborne diseases.
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Affiliation(s)
- Han Cheng
- School of Public Health, Weifang Medical University, Weifang, China
| | - Jie Zhao
- School of Public Health, Weifang Medical University, Weifang, China
| | - Jing Zhang
- Weifang Center for Disease Control and Prevention, Shandong, China
| | - Zhiyuan Wang
- School of Public Health, Weifang Medical University, Weifang, China
| | - Zhitao Liu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xiaochen Ma
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Jinjun Liang
- Hunan Center for Disease Control and Prevention, Changsha, China
| | - Weiwei Li
- Division of Risk Surveillance II, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Ping Fu
- Division of Risk Surveillance II, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Shuxiang Yang
- School of Public Health, Weifang Medical University, Weifang, China
| | - Yunchang Guo
- Division of Risk Surveillance II, China National Center for Food Safety Risk Assessment, Beijing, China
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Mareş C, Udrea AM, Şuţan NA, Avram S. Bioinformatics Tools for the Analysis of Active Compounds Identified in Ranunculaceae Species. Pharmaceuticals (Basel) 2023; 16:842. [PMID: 37375790 DOI: 10.3390/ph16060842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
The chemical compounds from extracts of three Ranunculaceae species, Aconitum toxicum Rchb., Anemone nemorosa L. and Helleborus odorus Waldst. & Kit. ex Willd., respectively, were isolated using the HPLC purification technique and analyzed from a bioinformatics point of view. The classes of compounds identified based on the proportion in the rhizomes/leaves/flowers used for microwave-assisted extraction and ultrasound-assisted extraction were alkaloids and phenols. Here, the quantifying of pharmacokinetics, pharmacogenomics and pharmacodynamics helps us to identify the actual biologically active compounds. Our results showed that (i) pharmacokinetically, the compounds show good absorption at the intestinal level and high permeability at the level of the central nervous system for alkaloids; (ii) regarding pharmacogenomics, alkaloids can influence tumor sensitivity and the effectiveness of some treatments; (iii) and pharmacodynamically, the compounds of these Ranunculaceae species bind to carbonic anhydrase and aldose reductase. The results obtained showed a high affinity of the compounds in the binding solution at the level of carbonic anhydrases. Carbonic anhydrase inhibitors extracted from natural sources can represent the path to new drugs useful both in the treatment of glaucoma, but also of some renal, neurological and even neoplastic diseases. The identification of natural compounds with the role of inhibitors can have a role in different types of pathologies, both associated with studied and known receptors such as carbonic anhydrase and aldose reductase, as well as new pathologies not yet addressed.
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Affiliation(s)
- Cătălina Mareş
- Department of Anatomy, Animal Physiology and Biophysics, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania
| | - Ana-Maria Udrea
- Laser Department, National Institute for Laser, Plasma and Radiation Physics, Atomistilor 409, 077125 Magurele, Romania
- Research Institute of the University of Bucharest-ICUB, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania
| | - Nicoleta Anca Şuţan
- Department of Natural Sciences, University of Piteşti, 1 Targul din Vale Str., 110040 Pitesti, Romania
| | - Speranţa Avram
- Department of Anatomy, Animal Physiology and Biophysics, University of Bucharest, 91-95 Splaiul Independentei, 050095 Bucharest, Romania
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Tiwari S, Acharya P, Solanki B, Sharma AK, Rawat S. A review on efforts for improvement in medicinally important chemical constituents in Aconitum through biotechnological interventions. 3 Biotech 2023; 13:190. [PMID: 37193333 PMCID: PMC10183062 DOI: 10.1007/s13205-023-03578-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/21/2023] [Indexed: 05/18/2023] Open
Abstract
The genus Aconitum belongs to the family Ranunculaceae, is endowed with more than 350 species on the earth. Medicinally important aconitine type of diterpenoid alkaloids are the characteristic compounds in most of the Aconitum species. The present review endeavored the major research carried out in the field of genetic resource characterization, pharmacological properties, phytochemistry, major factors influencing quantity, biosynthetic pathways and processing methods for recovery of active ingredients, variety improvement, propagation methods, and important metabolite production through cell/organ culture of various Aconitum species. More than 450 derivatives of aconitine-type C19 and C20-diterpenoid alkaloids along with a few other non-alkaloidal compounds, such as phenylpropanoids, flavonoids, terpenoids, and fatty acids, have been identified in the genus. A few Aconitum species and their common diterpenoid alkaloid compounds are also well characterized for analgesic, inflammatory and cytotoxic properties. However, the different isolated compound needs to be validated for supporting other traditional therapeutical uses of the plant species. Aconitine alkaloids shared common biosynthesis pathway, but their diversification mechanism remains unexplored in the genus. Furthermore, the process needs to be developed on secondary metabolite recovery, mass-scale propagation methods, and agro-technologies for maintaining the quality of products. Many species are losing their existence in nature due to over-exploitation or anthropogenic factors; thus, temporal monitoring of the population status in its habitat, and suitable management programs for ascertaining conservation needs to be developed.
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Affiliation(s)
- Sekhar Tiwari
- Department of Biotechnology, School of Sciences, P. P. Savani University, Surat, Gujarat India
| | - Puja Acharya
- Sikkim Regional Centre, G. B. Pant National Institute of Himalayan Environment, Pangthang, Gangtok, Sikkim India
| | - Bharat Solanki
- Department of Biochemistry, M. B. Patel Science College, Sardar Patel University, Anand, Gujarat India
| | - Anish Kumar Sharma
- Department of Biotechnology, School of Sciences, P. P. Savani University, Surat, Gujarat India
| | - Sandeep Rawat
- Sikkim Regional Centre, G. B. Pant National Institute of Himalayan Environment, Pangthang, Gangtok, Sikkim India
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Salehi A, Ghanadian M, Zolfaghari B, Jassbi AR, Fattahian M, Reisi P, Csupor D, Khan IA, Ali Z. Neuropharmacological Potential of Diterpenoid Alkaloids. Pharmaceuticals (Basel) 2023; 16:ph16050747. [PMID: 37242531 DOI: 10.3390/ph16050747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
This study provides a narrative review of diterpenoid alkaloids (DAs), a family of extremely important natural products found predominantly in some species of Aconitum and Delphinium (Ranunculaceae). DAs have long been a focus of research attention due to their numerous intricate structures and diverse biological activities, especially in the central nervous system (CNS). These alkaloids originate through the amination reaction of tetra or pentacyclic diterpenoids, which are classified into three categories and 46 types based on the number of carbon atoms in the backbone structure and structural differences. The main chemical characteristics of DAs are their heterocyclic systems containing β-aminoethanol, methylamine, or ethylamine functionality. Although the role of tertiary nitrogen in ring A and the polycyclic complex structure are of great importance in drug-receptor affinity, in silico studies have emphasized the role of certain sidechains in C13, C14, and C8. DAs showed antiepileptic effects in preclinical studies mostly through Na+ channels. Aconitine (1) and 3-acetyl aconitine (2) can desensitize Na+ channels after persistent activation. Lappaconitine (3), N-deacetyllapaconitine (4), 6-benzoylheteratisine (5), and 1-benzoylnapelline (6) deactivate these channels. Methyllycaconitine (16), mainly found in Delphinium species, possesses an extreme affinity for the binding sites of α7 nicotinic acetylcholine receptors (nAChR) and contributes to a wide range of neurologic functions and the release of neurotransmitters. Several DAs such as bulleyaconitine A (17), (3), and mesaconitine (8) from Aconitum species have a drastic analgesic effect. Among them, compound 17 has been used in China for decades. Their effect is explained by increasing the release of dynorphin A, activating the inhibitory noradrenergic neurons in the β-adrenergic system, and preventing the transmission of pain messages by inactivating the Na+ channels that have been stressed. Acetylcholinesterase inhibitory, neuroprotective, antidepressant, and anxiolytic activities are other CNS effects that have been investigated for certain DAs. However, despite various CNS effects, recent advances in developing new drugs from DAs were insignificant due to their neurotoxicity.
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Affiliation(s)
- Arash Salehi
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Mustafa Ghanadian
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
- Isfahan Pharmaceutical Sciences Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Behzad Zolfaghari
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Amir Reza Jassbi
- Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Maryam Fattahian
- Department of Pharmacognosy, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Parham Reisi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Dezső Csupor
- Institute of Clinical Pharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary
| | - Ikhlas A Khan
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, University, MS 38677, USA
| | - Zulfiqar Ali
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, University, MS 38677, USA
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Bao Y, Zhang R, Jiang X, Liu F, He Y, Hu H, Hou X, Hao L, Pei X. Detoxification mechanisms of ginseng to aconite: A review. JOURNAL OF ETHNOPHARMACOLOGY 2023; 304:116009. [PMID: 36516908 DOI: 10.1016/j.jep.2022.116009] [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: 10/18/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aconite (Fuzi, FZ), the processed root tuber of Aconitum carmichaelii Debx., is utilized as a classic medicine to treat diseases of the cardiovascular system and immune system. Resulting from the narrow margin of safety between a therapeutic dose and a toxic dose, FZ often causes cardiotoxicity including hypotension, palpitation, and bradycardia. Contributing to the detoxification effects of the other famous herbal medicine ginseng (Renshen, RS), which is the dried root and rhizome of Panax ginseng C. A. Meyer, people broadly combine FZ and RS as compatibility more than 1800 years to attenuate the toxicity of FZ. However, the systematic detoxification mechanisms of RS to FZ have not been fully revealed. AIM OF THE REVIEW Aiming to provide a comprehensive interpretation of the attenuation processes of FZ via RS, this review summarizes the up-to-date information about regulatory mechanisms of RS to FZ to shed the light on the essence of detoxification. MATERIALS AND METHODS Literature was searched in electronic databases, including PubMed, Web of Science ScienceDirect, Google Scholar, CNKI and WanFang Data. Relevant studies on detoxification mechanisms were included while irrelevant and duplicate studies were excluded. According to the study design, subject, intervention regime, outcome, first author and year of publication of included data, detoxification mechanisms of RS to FZ were summarized and visualized. RESULTS A total of 144 studies were identified through databases from their inception up to Oct. 2022. Included information indicated that diester-diterpenoid alkaloids (DDAs) were the main toxic substances of FZ. The main mechanisms that RS attenuates the toxicity of FZ were transforming toxic compounds of FZ, affecting the absorption and metabolism of FZ as well as the FZ-induced cell toxicity alleviation. CONCLUSION FZ, as a famous traditional Chinese medicine, has good prospects for utilization. The narrow margin of safety between a therapeutic dose and a toxic dose of FZ limits its clinical effect and safety while RS is always combined with FZ to alleviate its toxicity. However, mechanisms responsible for the detoxification process have not been well identified. Therefore, detoxification mechanisms of RS to FZ are reviewed to ensure the safety and effectiveness of FZ.
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Affiliation(s)
- Yiwen Bao
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China
| | - Ruiyuan Zhang
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China
| | - Xinyi Jiang
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China
| | - Fang Liu
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China.
| | - Yao He
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China.
| | - Huiling Hu
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China
| | - Xinlian Hou
- Huarun Sanjiu (Ya'an) Pharmaceutical Group Co., LTD, Ya'an, 625000, PR China
| | - Li Hao
- Huarun Sanjiu (Ya'an) Pharmaceutical Group Co., LTD, Ya'an, 625000, PR China
| | - Xu Pei
- Pharmacy College of Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China; State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, 611137, PR China
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Li X, Hou W, Lin T, Ni J, Qiu H, Fu Y, Zhao Z, Yang C, Li N, Zhou H, Zhang R, Liu Z, Fu L, Zhu L. Neoline, fuziline, songorine and 10-OH mesaconitine are potential quality markers of Fuzi: In vitro and in vivo explorations as well as pharmacokinetics, efficacy and toxicity evaluations. JOURNAL OF ETHNOPHARMACOLOGY 2023; 303:115879. [PMID: 36370966 DOI: 10.1016/j.jep.2022.115879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Fuzi, the lateral roots of Aconitum carmichaelii Debx, plays an irreplaceable role in treating Yang deficiency and cold coagulation syndromes. However, Fuzi has a narrow margin of safety since its pharmacological constituents, Aconitum alkaloids, have potential cardiotoxicity and neurotoxicity. The current quality markers (Q-markers) for the control of Fuzi's efficacy and toxicity are 3 monoester-diterpenoid alkaloids, namely, benzoylaconine (BAC), benzoylhypaconine and benzoylmesaconine (BMA) and 3 diester-diterpenoid alkaloids, namely, aconitine (AC), hypaconitine and mesaconitine (MA). However, mounting evidence indicates that the current 6 Q-markers may not be efficacy- or toxicity-specific enough for Fuzi. AIM OF THE STUDY The aim of this study was to explore and evaluate efficacy- or toxicity-specific potential quality markers (PQ-markers) of Fuzi. MATERIALS AND METHODS PQ-markers were explored by analyzing 30 medicinal samples and alkaloids exposed in mouse. Pharmacokinetics of PQ-markers on C57BL/6J mice were determined. Anti-inflammatory effects of PQ-markers were evaluated by λ-carrageenan-induced paw edema model and lipopolysaccharide-induced RAW264.7 cell inflammatory model, while analgesic effects were assessed by acetic acid-induced pain model and Hargreaves test. Cardiotoxicity and neurotoxicity of PQ-markers were assessed by histological and biochemical analyses, while acute toxicity was evaluated by modified Kirschner method. RESULTS After in vitro and in vivo explorations, 7 PQ-markers, namely, neoline (NE), fuziline (FE), songorine (SE), 10-OH mesaconitine (10-OH MA), talatizamine, isotalatizidine and 16β-OH cardiopetalline, were found. In the herbal medicines, NE, FE, SE and 10-OH MA were found in greater abundance than many other alkaloids. Specifically, the amounts of NE, FE and SE in the Fuzi samples were all far higher than that of BAC, and the contents of 10-OH MA in 56.67% of the samples were higher than that of AC. In mouse plasma and tissues, NE, FE, SE, talatizamine, isotalatizidine and 16β-OH cardiopetalline had higher contents than the other alkaloids, including the 6 current Q-markers. The pharmacokinetics, efficacy and toxicity of NE, FE, SE and 10-OH MA were further evaluated. The average oral bioavailabilities of NE (63.82%), FE (18.14%) and SE (49.51%) were higher than that of BMA (3.05%). Additionally, NE, FE and SE produced dose-dependent anti-inflammatory and analgesic effects, and their actions were greater than those of BMA. Concurrently, the toxicities of NE, FE and SE were lower than those of BMA, since no cardiotoxicity or neurotoxicity was found in mice after NE, FE and SE treatment, while BMA treatment notably increased the creatine kinase activity and matrix metalloproteinase 9 level in mice. The average oral bioavailability of 10-OH MA (7.02%) was higher than that of MA (1.88%). The median lethal dose (LD50) of 10-OH MA in mice (0.11 mg/kg) after intravenous injection was close to that of MA (0.13 mg/kg). Moreover, 10-OH MA produced significant cardiotoxicity and neurotoxicity, and notable anti-inflammatory and analgesic effects that were comparable to those of MA. CONCLUSIONS Seven PQ-markers of Fuzi were found after in vitro and in vivo explorations. Among them, NE, FE and SE were found to be more efficacy-specific than BMA, and 10-OH MA was as toxicity-specific as MA.
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Affiliation(s)
- Xiaocui Li
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Weiqing Hou
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Tingting Lin
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Jiadong Ni
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Huawei Qiu
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Yu Fu
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhongxiang Zhao
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Caihua Yang
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Na Li
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, 999078, China
| | - Hua Zhou
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510006, China
| | - Rong Zhang
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhongqiu Liu
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Ling Fu
- Huizhou Hosptial of Guangzhou University of Chinese Medicine, Huizhou, 516000, China.
| | - Lijun Zhu
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangdong Provincial Key Laboratory of Translational Cancer Research of Chinese Medicines, Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, International Institute for Translational Chinese Medicine, School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
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Jin Y, Wang W, Zhang Z, Ou Y, Quan J, Zhao X. Stepwise Frontal Analysis Coupled with Affinity Chromatography: A Fast and Reliable Method for Potential Ligand Isolation and Evaluation from Mahuang-Fuzi-Xixin Decoction. Chem Biodivers 2023; 20:e202201057. [PMID: 36756691 DOI: 10.1002/cbdv.202201057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/10/2023]
Abstract
Mahuang-Fuzi-Xixin Decoction (MFXD) is widely used in the treatment of asthma, however, the functional components in the decoction targeting beta2-adrenoceptor (β2 -AR) remain unclear. Herein, we immobilized the haloalkane dehalogenase (Halo)-tagged β2 -AR on the 6-chlorocaproic acid-modified microspheres. Using the affinity stationary phase, the interactions of four ligands with the receptor were analyzed by stepwise frontal analysis. The association constants were (4.75±0.28)×104 M-1 for salbutamol, (2.93±0.15)×104 M-1 for terbutaline, (1.23±0.03)×104 M-1 for methoxyphenamine, (5.67±0.38)×104 M-1 for clorprenaline at high-affinity binding site, and (2.73±0.05)×103 M-1 at low-affinity binding site. These association constants showed the same rank order as the radioligand binding assay, demonstrating that immobilized β2 -AR had capacity to screen bioactive compounds binding to the receptor while stepwise frontal analysis could predict their binding affinities. Application of the immobilized receptor in analysis of MFXD by chromatographic method revealed that ephedrine, aconifine, karakoline, and chasmanine were the bioactive compounds targeting β2 -AR. Among them, ephedrine and chasmanine exhibited association constants of (2.94±0.02)×104 M-1 and (4.60±0.15)×104 M-1 to the receptor by stepwise frontal analysis. Molecular docking analysis demonstrated that ephedrine, chasmanine, and the other two compounds interact with β2 -AR through the same pocket involving the key amino acids such as Asn312, Asp113, Phe289, Trp286, Tyr316, and Val114. As such, we reasoned that the four compounds dominate the therapeutic effect of MFXD against asthma through β2 -AR mediating pathway. This work shed light on the potential of immobilized β2 -AR for drug discovery and provided a valuable methodology for rapid screening.
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Affiliation(s)
- Yahui Jin
- College of Life Sciences, Northwest University, Xi'an, 710069, China
| | - Wenwen Wang
- College of Life Sciences, Northwest University, Xi'an, 710069, China
| | - Zilong Zhang
- College of Life Sciences, Northwest University, Xi'an, 710069, China
| | - Yuanyuan Ou
- College of Life Sciences, Northwest University, Xi'an, 710069, China
| | - Jia Quan
- College of Life Sciences, Northwest University, Xi'an, 710069, China
| | - Xinfeng Zhao
- College of Life Sciences, Northwest University, Xi'an, 710069, China
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Ichikawa Y, Matsumoto S, Fujinaka W, Takatori M, Nishioka K, Namera A. Left Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias With Aconitine Poisoning: A Case Report. A A Pract 2023; 17:e01666. [PMID: 36805572 DOI: 10.1213/xaa.0000000000001666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Aconitine poisoning causes refractory ventricular arrhythmias (VAs). In a 20-year-old man, VAs of unknown etiology did not respond to drugs and electrical defibrillation. However, left stellate ganglion blockade (SGB) dramatically decreased arrhythmias without complications. At a later date, we found that refractory VAs were caused by aconitine poisoning. Left SGB is effective for treating refractory VAs with aconitine poisoning and can be easily performed with few complications for VAs of unknown etiology even if patients are receiving anticoagulant therapy. Also, left SGB can be performed to diagnose refractory VAs.
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Affiliation(s)
- Yasuko Ichikawa
- From the Departments of Anesthesiology and Intensive Care Medicine
| | | | - Waso Fujinaka
- From the Departments of Anesthesiology and Intensive Care Medicine
| | - Makoto Takatori
- From the Departments of Anesthesiology and Intensive Care Medicine
| | - Kenji Nishioka
- Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Akira Namera
- Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Simultaneous determination of twenty-nine active compounds in fuzhengjiedu granules by HPLC-QQQ-MS/MS. Heliyon 2023; 9:e13675. [PMID: 36873156 PMCID: PMC9975104 DOI: 10.1016/j.heliyon.2023.e13675] [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: 11/28/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
As an empirical medicine of traditional Chinese medicine, Fuzhengjiedu Granules have shown an effect against COVID-19 in clinical and inflammatory animal models. It is formulated with eight herbs, including Aconiti Lateralis Radix Praeparata, Zingiberis Rhizoma, Glycyrrhizae Radix Et Rhizoma, Lonicerae Japonicae Flos, Gleditsiae Spina, Fici Radix, Pogostemonis Herba, and Citri Reticulatae Pericarpium. This study established a high-performance liquid chromatography-triple quadrupole mass spectrometry (HPLC-QQQ-MS/MS) method by simultaneously determining 29 active compounds in the granules with significant content differences. Separation by gradient elution using acetonitrile and water (0.1% formic acid) as mobile phases was performed on a Waters Acquilty UPLC T3 column (2.1 mm × 100 mm, 1.7 μm). A triple quadrupole mass spectrometer, operating in positive and negative ionization modes, was used for multiple reaction monitoring to detect the 29 compounds. All calibration curves showed good linear regression (r2 > 0.998). RSDs of precision, reproducibility, and stability of active compounds were all lower than 5.0%. The recovery rates were 95.4-104.9%, with RSDs< 5.0%. This method was successfully used to analyze the samples, and the results showed that 26 representative active components from 8 herbs were detected in the granules. While aconitine, mesaconitine, and hypaconitine were not detected, indicating that the existing samples were safe. The granules had the maximum and minimum content of hesperidin (27.3 ± 0.375 mg/g) and benzoylaconine (38.2 ± 0.759 ng/g). To conclude, a fast, accurate, sensitive, and reliable HPLC-QQQ-MS/MS method was established, which can simultaneously detect 29 active compounds that have a considerable difference in the content of Fuzhengjiedu Granules. This study can be used to control the quality and safety of Fuzhengjiedu Granules and provide a basis and guarantee for further experimental research and clinical application.
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Al Jumaan MA. The Role of Activated Charcoal in Prehospital Care. Med Arch 2023; 77:64-69. [PMID: 36919135 PMCID: PMC10008342 DOI: 10.5455/medarh.2023.77.64-69] [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: 01/04/2023] [Accepted: 02/12/2023] [Indexed: 02/25/2023] Open
Abstract
Background Administration of a single-dose activated charcoal (SDAC) is an effective method used for gastric decontamination and for other types of poisoning and overdose. This is only true when given within the first hour of poison ingestion as the effectivity of SDAC reduces over time. In addition, generally, not all patients are able to avail treatment within the specified period. Hence, multi-dose activated charcoal is regarded as a solution to a delayed process, although, no proof outweighs the use of SDAC. Objective This study aimed to review and assess the adequacy of the past and current use of AC. The author also aimed to offer recommendations believed to be the best method to consider for prehospital care. Methods The author conducted 6,337 online literature searches for this review, wherein seven papers met eligibility criteria for inclusion and analysis. Results In this review, routine administration of AC in poisoning was found not related to the duration of hospital stay nor any other subsequent outcomes following poison ingestion. Further, this review did not establish that administration of AC could improve patient's clinical outcome. Further research and clinical trials is required to determine the efficacy of this therapy to appropriate patients in the prehospital setting. Conclusion Activated charcoal can be used to treat highly acute to life-threatening poisoning if it is administered within the first hour of ingestion. Further studies would be necessary to investigate if this would affect clinical outcome..
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Affiliation(s)
- Mohammed Abdullah Al Jumaan
- Department of Emergency Medicine, King Fahd Hospital of the University- Imam Abdulrahman Bin Faisal University. Dammam, Kingdom of Saudi Arabia
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Tao H, Liu X, Tian R, Liu Y, Zeng Y, Meng X, Zhang Y. A review: Pharmacokinetics and pharmacology of aminoalcohol-diterpenoid alkaloids from Aconitum species. JOURNAL OF ETHNOPHARMACOLOGY 2023; 301:115726. [PMID: 36183950 DOI: 10.1016/j.jep.2022.115726] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/31/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aconitum medicinal materials, such as Aconitum carmichaelii Debeaux (Chinese: Wutou/) and Aconitum kusnezoffii Reichb. (Chinese: Caowu/), are a kind of important Traditional Chinese Medicine (TCM) with great medicinal value. Statistics show that there are over 600 efficient TCM formulations comprising Aconitum medicinal materials. But high toxicity limits their clinical application. Clinically, the Aconitum medicinal materials must undergo a complex processing process that includes soaking, steaming, and boiling with pharmaceutical excipients, which makes highly toxic ester diterpenoid alkaloids are hydrolyzed to form less toxic aminoalcohol-diterpenoid alkaloids (ADAs). AIM OF THE STUDY This review aims to summarize the pharmacokinetic and pharmacological activities of low-toxicity ADAs, providing a reference for future ADAs research and drug development. MATERIALS AND METHODS Accessible literature on ADAs published between 1984 and 2022 were screened and obtained from available electronic databases such as PubMed, Web of Science, Springer, Science Direct and Google Scholar, followed by systematic analysis. RESULTS ADAs are secondary products of plant metabolism, widely distributed in the Aconitum species and Delphinium species. The toxicity of ADAs as pharmacodynamic components of Aconitum medicinal materials is much lower than that of other diterpenoid alkaloids due to the absence of ester bonds. On the one hand, the pharmacokinetics of ADAs have received little attention compared to other toxic alkaloids. The research primarily focuses on aconine and mesaconine. According to existing studies, ADAs absorption in the gastrointestinal tract is primarily passive with a short Tmax. Simultaneously, efflux transporters have less impact on ADAs absorption than non-ADAs. After entering the body, ADAs are widely distributed in the heart, liver, lungs, and kidney, but less in the brain. Notably, aconine is not well metabolized by liver microsomes. Aconine and mesaconine are excreted in urine and feces, respectively. ADAs, on the other hand, have been shown to have a variety of pharmacological activities, including cardiac, analgesic, anti-inflammatory, anti-tumor, antioxidant, and regenerative effects via regulating multiple signaling pathways, including Nrf2/ARE, PERK/eIF2α/ATF4/Chop, ERK/CREB, NF-κB, Bcl-2/Bax, and GSK3β/β-catenin signaling pathways. CONCLUSIONS ADAs have been shown to have beneficial effects on heart disease, neurological disease, and other systemic diseases. Moreover, ADAs have low toxicity and a wide range of safe doses. All of these suggest that ADAs have great potential for drug development.
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Affiliation(s)
- Honglin Tao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Xianfeng Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Ruimin Tian
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yue Liu
- School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China
| | - Yong Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Xianli Meng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China; Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China.
| | - Yi Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China; School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China; Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 611130, China.
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Ji X, Yang M, Shen G, Or KH, Yim WS, Zuo Z. Safety evaluations of the processed lateral root of Aconitum carmichaelii Debx. And its hepatotoxicity mechanisms in rats. JOURNAL OF ETHNOPHARMACOLOGY 2023; 301:115801. [PMID: 36216199 DOI: 10.1016/j.jep.2022.115801] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The processed lateral root of Aconitum carmichaelii Debx. is known as Fuzi, an extensively used Traditional Chinese Medicine to treat cardiovascular diseases, rheumatism arthritis, bronchitis, pains, and hypothyroidism, etc. Although Chinese Pharmacopeia regulates the safe clinical dosage of Fuzi at 3-15 g/person/day, such recommendation not only lacks bench evidence but also does not differentiate Fuzi with different processing types, such as Heishunpian and Paofupian. AIM OF THE STUDY The current study aimed to 1) determine No-Observed-Adverse-Effect-Levels of Heishunpian and Paofupian in rats and 2) investigate the related toxicity mechanisms for their safe clinical use. MATERIALS AND METHODS After giving clinically relevant dosing regimen of Heishunpian/Paofupian to rats, we conducted toxicity assessments including ECG monitoring, histopathological changes and serum biomarkers to detect organ injury. Metabolomic study in the liver revealed changes in endogenous metabolite levels after two-week treatment of Fuzi preparations or its corresponding six toxic alkaloids mixtures. RESULTS The NOAEL for both bolus and two-week treatments of Heishunpian and Paofupian in rats was designated to be 7.5 g/kg and 15 g/kg, respectively. Corresponding recommended doses in humans were 7.5-25 g/person/day for Heishunpian and 15-50 g/person/day for Paofupian. Metabolic profiles revealed more significant alterations in endogenous substances from rats receiving the two Fuzi preparations than their corresponding toxic alkaloids mixtures. Upregulation of bile acid pathway could be responsible for Fuzi induced liver injury. CONCLUSIONS Compared to the current maximum recommended dose, our suggested upper limit of guided dose for Heishunpian was comparable, whereas that for Paofupian could be further elevated. Both C19-diterpenoid alkaloids and co-occurring components in Fuzi preparations contributed to their hepatotoxicity via upregulation of bile acid pathway.
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Affiliation(s)
- Xiaoyu Ji
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Mengbi Yang
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, PR China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, PR China
| | - Guolin Shen
- Institute of Chemicals Safety, Chinese Academy of Inspection and Quarantine, Beijing, PR China
| | - Ka Hang Or
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Wan Sze Yim
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, PR China
| | - Zhong Zuo
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, PR China.
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Zhang Y, Chen S, Fan F, Xu N, Meng XL, Zhang Y, Lin JM. Neurotoxicity mechanism of aconitine in HT22 cells studied by microfluidic chip-mass spectrometry. J Pharm Anal 2023; 13:88-98. [PMID: 36820076 PMCID: PMC9937797 DOI: 10.1016/j.jpha.2022.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
Aconitine, a common and main toxic component of Aconitum, is toxic to the central nervous system. However, the mechanism of aconitine neurotoxicity is not yet clear. In this work, we had the hypothesis that excitatory amino acids can trigger excitotoxicity as a pointcut to explore the mechanism of neurotoxicity induced by aconitine. HT22 cells were simulated by aconitine and the changes of target cell metabolites were real-time online investigated based on a microfluidic chip-mass spectrometry system. Meanwhile, to confirm the metabolic mechanism of aconitine toxicity on HT22 cells, the levels of lactate dehydrogenase, intracellular Ca2+, reactive oxygen species, glutathione and superoxide dismutase, and ratio of Bax/Bcl-2 protein were detected by molecular biotechnology. Integration of the detected results revealed that neurotoxicity induced by aconitine was associated with the process of excitotoxicity caused by glutamic acid and aspartic acid, which was followed by the accumulation of lactic acid and reduction of glucose. The surge of extracellular glutamic acid could further lead to a series of cascade reactions including intracellular Ca2+ overload and oxidative stress, and eventually result in cell apoptosis. In general, we illustrated a new mechanism of aconitine neurotoxicity and presented a novel analysis strategy that real-time online monitoring of cell metabolites can provide a new approach to mechanism analysis.
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Affiliation(s)
- Yingrui Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China,Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Shiyu Chen
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China,Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Fangfang Fan
- Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Ning Xu
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Xian-Li Meng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Yi Zhang
- Ethnic Medicine Academic Heritage Innovation Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China,Corresponding author.
| | - Jin-Ming Lin
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation, Department of Chemistry, Tsinghua University, Beijing, 100084, China,Corresponding author.
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Taniguchi M, Takamura N, Watanabe T, Ishimaru R, Chinaka S, Miki A, Miyazaki H, Tsuchihashi H, Zaitsu K. Easily Operable Quantification Method of 21 Plant-Derived Alkaloids in Human Serum by Automatic Sample Preparation and Liquid Chromatography-Tandem Mass Spectrometry. Chromatographia 2022; 85:1051-1063. [PMID: 36341308 PMCID: PMC9617228 DOI: 10.1007/s10337-022-04212-5] [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: 04/21/2022] [Revised: 09/02/2022] [Accepted: 10/18/2022] [Indexed: 11/23/2022]
Abstract
In this study, we developed an easily operable quantification method for 21 plant-derived alkaloids in human serum by automatic sample preparation and liquid chromatography-tandem mass spectrometry. We designed to perform parallel sample preparation by a developed apparatus, which increased sample throughput. We conducted an automatic sample preparation through de-proteinization with 0.1% formic acid in methanol and achieved recovery rates of 89-107% (2.0-14% RSD) for all targeted analytes, demonstrating its high repeatability. The method validation results were satisfactory as follows: the linearity (r 2) of each calibration curve ranged from 0.978 to 1.000; the inter- and intra-day accuracies were 89.0-125% and 82.1-110%, respectively; the inter- and intra-day precisions were below 13% and 10%, respectively. Additionally, the lower limits of detection and quantification were 0.0044-0.047 and 0.013-0.14 ng/mL, respectively. Finally, the developed method was applied to pseudo-protoveratrine A poisoning serum and pseudo-colchicine poisoning serum, which were prepared by diluting acute-poisoning mice serum with human serum. Our method successfully quantitated protoveratrine A (0.15-0.25 ng/mL) and colchicine (4.8-6.0 ng/mL). Thus, our method is essential for prompt clinical treatment and critical care on patient in acute intoxication cases caused by plant-derived alkaloids. Supplementary Information The online version contains supplementary material available at 10.1007/s10337-022-04212-5.
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Affiliation(s)
- Masaru Taniguchi
- Nagoya City Public Health Research Institute, 2266-132 Anagahora, Shimoshidami, Moriyama-Ku, Nagoya, 463-8585 Japan
| | - Naoki Takamura
- Shimadzu Engineering Inc., 1 Nishinokyo Kuwabara-Cho, Nakagyo-Ku, Kyoto, 604-8511 Japan
| | - Tsutomu Watanabe
- Shimadzu Engineering Inc., 1 Nishinokyo Kuwabara-Cho, Nakagyo-Ku, Kyoto, 604-8511 Japan
| | - Reiko Ishimaru
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, 1-1 Kuratsuki, Kanazawa, Ishikawa 920-8553 Japan
| | - Satoshi Chinaka
- Forensic Science Laboratory, Ishikawa Prefectural Police Headquarters, 1-1 Kuratsuki, Kanazawa, Ishikawa 920-8553 Japan
| | - Akihiro Miki
- Forensic Science Laboratory, Osaka Prefectural Police Headquarters, 1-3-18 Hommachi, Chuo-Ku, Osaka, 541-0053 Japan
| | - Hitoshi Miyazaki
- Nagoya City Public Health Research Institute, 2266-132 Anagahora, Shimoshidami, Moriyama-Ku, Nagoya, 463-8585 Japan
| | - Hitoshi Tsuchihashi
- Department of Legal Medicine and Bioethics, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550 Japan
| | - Kei Zaitsu
- Multimodal Informatics and Wide-Data Analytics Laboratory, Department of Computational Systems Biology, Faculty of Biology-Oriented Science and Technology, Kindai University, 930 Nishi Mitani, Kinokawa, Wakayama, 649-6493 Japan
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Yu L, Li S, Pu L, Yang C, Shi Q, Zhao Q, Meniga S, Liu Y, Zhang Y, Lai X. Traditional Tibetan medicine: therapeutic potential in rheumatoid arthritis. Front Pharmacol 2022; 13:938915. [PMID: 36267280 PMCID: PMC9576941 DOI: 10.3389/fphar.2022.938915] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Rheumatoid arthritis (RA) is a severe inflammatory autoimmune disease characterized by the failed spontaneous resolution of inflammation. The induction of immune regulation and resolution of inflammatory pathways are effective in alleviating inflammation in RA. As the oldest medical system in the world, traditional Tibetan medicine (TTM) has a long history of preventing and treating RA. This review provides a comprehensive overview of medicinal plants with anti-RA activity in the TTM system, using classic books of Tibetan medicine, modern research literature, and drug standards. A total of 27 species have been found to be effective in treating RA, including Tinospora sinensis (Lour.) Merr., Terminalia chehula Retz., P. hookeri (C. B. Clarke) Hock.), and Aconitum pendulum Busch. Alkaloids, flavonoids, polyphenols, and terpenoids have turned out to be the major bioactive components for RA treatment. The inhibition of pro-inflammatory cytokine expression by mediating the NF-κB, MAPK, and JAK/STAT pathways is the core mechanism in RA treatment. In conclusion, this review provides key information and research perspectives for further research on the anti-RA effects of TTM.
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Affiliation(s)
- Liqiong Yu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shiling Li
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lili Pu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chunhong Yang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qian Shi
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qi Zhao
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shengbu Meniga
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Yue Liu, ; Yi Zhang, ; Xianrong Lai,
| | - Yi Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Yue Liu, ; Yi Zhang, ; Xianrong Lai,
| | - Xianrong Lai
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Ethnic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Yue Liu, ; Yi Zhang, ; Xianrong Lai,
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Liu X, Xie X, Luo M, Zhao Y, Li M, Peng F, Peng C. The synergistic compatibility mechanisms of fuzi against chronic heart failure in animals: A systematic review and meta-analysis. Front Pharmacol 2022; 13:954253. [PMID: 36188581 PMCID: PMC9515783 DOI: 10.3389/fphar.2022.954253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/05/2022] [Indexed: 12/09/2022] Open
Abstract
Background: Fuzi’s compatibilities with other medicines are effective treatments for chronic heart failure. Pre-clinical animal experiments have indicated many possible synergistic compatibility mechanisms of it, but the results were not reliable and reproducible enough. Therefore, we performed this systematic review and meta-analysis of pre-clinical animal studies to integrate evidence, conducted both qualitative and quantitative evaluations of the compatibility and summarized potential synergistic mechanisms. Method: An exhaustive search was conducted for potentially relevant studies in nine online databases. The selection criteria were based on the Participants, Interventions, Control, Outcomes, and Study designs strategy. The SYRCLE risk of bias tool for animal trials was used to perform the methodological quality assessment. RevMan V.5.3 and STATA/SE 15.1 were used to perform the meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions. Result: 24 studies were included in the systematic review and meta-analysis. 12 outcomes were evaluated in the meta-analysis, including BNP, HR, HWI, ALD, LVEDP, LVSP, EF, FS, +dP/dtmax, −dP/dtmax, TNF-α and the activity of Na + -K + -ATPase. Subgroup analyses were performed depending on the modeling methods and duration. Conclusion: The synergistic Fuzi compatibility therapeutic effects against CHF animals were superior to those of Fuzi alone, as shown by improvements in cardiac function, resistance to ventricular remodeling and cardiac damage, regulation of myocardial energy metabolism disorder and RAAS, alleviation of inflammation, the metabolic process in vivo, and inhibition of cardiomyocyte apoptosis. Variations in CHF modeling methods and medication duration brought out possible model–effect and time-effect relationships.
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Affiliation(s)
- Xingyu Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofang Xie
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiaofang Xie, ; Cheng Peng,
| | - Maozhu Luo
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuting Zhao
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mengting Li
- Personalized Drug Therapy Key Laboratory of Sichuan Province, Department of Pharmacy, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Fu Peng
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Cheng Peng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Xiaofang Xie, ; Cheng Peng,
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Natori Y, Kamioka S, Yoshimoto T, Ishii A. A Simple and Rapid Method for Quantifying Aconitines and Their Metabolites in Whole Blood by Modified QuEChERS and Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS). Forensic Sci Int 2022; 341:111475. [DOI: 10.1016/j.forsciint.2022.111475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022]
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An J, Fan H, Han M, Peng C, Xie J, Peng F. Exploring the mechanisms of neurotoxicity caused by fuzi using network pharmacology and molecular docking. Front Pharmacol 2022; 13:961012. [PMID: 36110545 PMCID: PMC9468872 DOI: 10.3389/fphar.2022.961012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/08/2022] [Indexed: 12/14/2022] Open
Abstract
Safety has always been an important issue affecting the development of traditional Chinese medicine industry, especially for toxic medicinal materials, the establishment of risk prevention and control measures for toxic herbs is of great significance to improving the use of traditional Chinese medicine in clinical. Fuzi is a kind of traditional Chinese medicine and its toxicity has become the most important obstacle of limit in clinical using. In this paper, network pharmacology and molecular docking technology were used to analyze the main toxic components of Fuzi, the key targets and the mechanism of neurotoxicity. We carried out CCK-8 and WB assays, and detected LDH release and SDH activity. It was verified that aconitine caused neurotoxicity through a variety of pathways, including MAPK signaling pathway, pathways related to Akt protein, destruction of cell membrane integrity, damage of mitochondrial function affecting energy metabolism and apoptosis. What’s more, this study confirmed that aconitine could produce neurotoxicity by promoting apoptosis of hippocampus neuron and decreasing its quantity through Nissl Staining and TUNEL assay. This paper found and confirmed multiple targets and various pathways causing neurotoxicity of Fuzi, in order to provide reference for clinical application and related research.
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Affiliation(s)
- Junsha An
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Huali Fan
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Mingyu Han
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Cheng Peng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Fu Peng, ; Cheng Peng, ; Jie Xie,
| | - Jie Xie
- College of Life Science, Sichuan Normal University, Chengdu, China
- *Correspondence: Fu Peng, ; Cheng Peng, ; Jie Xie,
| | - Fu Peng
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, China
- *Correspondence: Fu Peng, ; Cheng Peng, ; Jie Xie,
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Zhang B, Bi Q, Huang S, Lv S, Zong X, Wang M, Ji X. Baoyuan Jiedu decoction alleviating cancer cachexia–Induced muscle atrophy by regulating muscle mitochondrial function in ApcMin/+ mice. Front Pharmacol 2022; 13:914597. [PMID: 36060011 PMCID: PMC9437209 DOI: 10.3389/fphar.2022.914597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Cancer cachexia is a complex syndrome that leads to an ongoing loss of skeletal muscle mass in many malignant tumors. Our previous studies have evaluated the effectiveness of Baoyuan Jiedu decoction (BJD) in alleviating cancer-induced muscle atrophy. However, the mechanisms of BJD regulating muscle atrophy could not be fully understood. Therefore, we further investigated the mechanisms of BJD mitigating muscle atrophy both in an ApcMin/+ mouse model and the Lewis-conditioned medium–induced C2C12 myotube atrophy model. We confirmed the quality of BJD extracts by HPLC. In an In vivo study, body weight loss and muscle atrophy were alleviated with BJD treatment. GO analysis suggested that ATP metabolism and mitochondria were involved. The results of the electron microscope show that BJD treatment may have a healing effect on mitochondrial structure. Moreover, ATP content and mitochondrial numbers were improved with BJD treatment. Furthermore, both in vivo and in vitro, we demonstrated that the BJD treatment could improve mitochondrial function owing to the increased number of mitochondria, balanced dynamic, and regulation of the electron transport chain according to the protein and mRNA expressions. In addition, oxidative stress caused by mitochondrial dysfunction was ameliorated by BJD treatment in ApcMin/+ mice. Consequently, our study provides proof for BJD treatment alleviating cancer cachexia–induced muscle atrophy by modulating mitochondrial function in ApcMin/+ mice.
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Affiliation(s)
- Beiying Zhang
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qianyu Bi
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shengqi Huang
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Siyuan Lv
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Zong
- Weifang Nursing Vocational College, Weifang, China
| | - Mengran Wang
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xuming Ji
- School of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
- Academy of Chinese Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
- *Correspondence: Xuming Ji,
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Poisoning cases in the German crime series Tatort (crime scene) from 1974 to 2022. Naunyn Schmiedebergs Arch Pharmacol 2022; 395:1419-1440. [PMID: 35970967 PMCID: PMC9568490 DOI: 10.1007/s00210-022-02281-9] [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: 07/11/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022]
Abstract
Poisoning occurs frequently in TV crime series but, to the best of our knowledge, has not yet been analyzed scientifically. This study examines the plausibility of poisoning cases in Germany’s most popular crime series, Tatort (crime scene), from 1974 to 2022. In the TV series, the increasing rate of poisoning in Germany as well as the increasing variety of substances leading to poisoning over the years are depicted. Largely in line with reality, similar substance categories and routes of administration are presented. However, poisoning outcomes in Tatort differ from reality: over 50% of the victims die in Tatort, whereas in reality, more than 80% survive. In > 95% of the episodes, the mechanism of action of a poison is not explained, omitting an important opportunity for raising public awareness. The TV series also deviates from reality in terms of the etiology of poisonings: External poison delivery is largely overrepresented, while the high rate of accidental poisonings in real life is underrepresented. Almost no accidental poisonings occur in Tatort, although this is the most frequent type of poisoning in real life. In Tatort, men are overrepresented as offenders and victims of poisoning compared to reality. Thus, the crime series does not convey the message that anyone can be a potential victim of poisoning and that particularly vulnerable groups need proper education and the best possible protection. This paper discusses the conflict between detailed, plausible episodes with cases of poisoning and the potential for imitation that they may cause.
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