Astragalus extract attenuates allergic airway inflammation and inhibits nuclear factor κB expression in asthmatic mice

Clinical Efficacy of Sanfeng Tongqiao Diwan in the Treatment of Allergic Rhinitis: A Randomized Controlled Trial

Objective. To explore the clinical effect of Sanfeng Tongqiao Diwan in the treatment of allergic rhinitis. Methods. Allergic rhinitis patients included in this study were randomly divided into control group and study group for 7 days of treatment. The control group was treated with Tongqiao Biyan Pian, while the study group was treated with Sanfeng Tongqiao Diwan. Results. After 7 days of treatment, the total effective rate of Sanfeng Tongqiao Diwan was 75.76%, which was higher than that of Tongqiao Biyan Pian (65.62%). The scores of visual analogue scale (VAS), symptom relief, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Epworth sleepiness scale (ESS) in both groups were significantly improved before and after treatment ( $P<0.05$ ), and the improvement was most significant 24 hours after treatment. The adverse reactions in both groups were low. Conclusion. Sanfeng Tongqiao Diwan can significantly alleviate the symptoms and improve the quality of life of patients with allergic rhinitis, with less adverse reactions.

The treatment of asthma using the Chinese Materia Medica

ETHNOPHARMACOLOGICAL RELEVANCE

Asthma is a costly global health problem that negatively influences the quality of life of patients. The Chinese Materia Medica (CMM) contains remedies that have been used for the treatment of asthma for millennia. This article strives to systematically summarize the current research progress so that more comprehensive examinations of various databases related to CMM anti-asthma drugs, can be performed, so as to sequentially provide effective basic data for development and application of anti-asthma drugs based on the CMM.

MATERIALS AND METHODS

The research data published over the past 20 years for asthma treatment based on traditional CMM remedies were retrieved and collected from libraries and online databases (PubMed, ScienceDirect, Elsevier, Spring Link, Web of Science, PubChem Compound, Wan Fang, CNKI, Baidu, and Google Scholar). Information was also added from classic CMM, literature, conference papers on classic herbal formulae, and dissertations (PhD or Masters) based on traditional Chinese medicine.

RESULTS

This review systematically summarizes the experimental studies on the treatment of asthma with CMM, covering the effective chemical components, typical asthma models, important mechanisms and traditional anti-asthma CMM formulae. The therapy value of the CMM for anti-asthma is clarified, and the original data and theoretical research foundation are provided for the development of new anti-asthmatic data and research for the CMM.

CONCLUSIONS

Substantial progress against asthma has been made through relevant experimental research based on the CMM. These advances improved the theoretical basis of anti-asthma drugs for CMM and provided a theoretical basis for the application of a asthma treatment that is unique. By compiling these data, it is expected that the CMM will now contain a clearer mechanism of action and a greater amount of practical data that can be used for future anti-asthma drug research.

Astragali Radix (Huangqi): A promising edible immunomodulatory herbal medicine

ETHNOPHARMACOLOGICAL RELEVANCE

Astragali Radix (AR, Huangqi in Chinese), the dried root of Astragalus membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao or A. membranaceus (Fisch.) Bge., possesses diverse therapeutic effects against fatigue, dyspepsia, diarrhea, heart diseases, hepatitis, and anemia. In recent years, increasing evidence has indicated the multiple immunomodulatory activities of AR in preclinical and clinical studies.

AIM OF THE REVIEW

This review attempts to elaborate the immunomodulatory effects of AR and its potential application in the treatment of immune related diseases.

MATERIALS AND METHODS

A comprehensive literature search AR was carried out using multiple internationally recognized databases (including Web of Science, Google Scholar, PubMed, ScienceDirect, Wiley, ACS, Springer, Taylor & Francis, and CNKI).

RESULTS

The immunomodulatory effects of AR are closely attributed to its active constituents such as polysaccharides, saponins, and flavonoids. We also demonstrate that AR can be used as a potential therapeutic intervention for immune related diseases through regulating immune organs, mucosal immune, and immune system (innate immunity and acquired immunity).

CONCLUSION

AR promotes the development of immune organs, enhances mucosal immune function, increases the quantity and phagocytic capacity of innate immunity, promotes the maturation and differentiation of acquired immunity cells, and improves the expression of antibodies in acquired immunity. We believe that AR has a broad research space in the adjuvant treatment of immune related diseases, which could be a breakthrough point to improve the application value of AR.

YiQi GuBen Formula Inhibits PDGF-BB-Induced Proliferation and Migration of Airway Smooth Muscle Cells

OBJECTIVE

Increased proliferation and migration of airway smooth muscle cells (ASMCs) are key events in the development of asthma. YiQi GuBen is a traditional Chinese medicinal formula shown to effectively reduce the recurrence rate of asthma and induce anti-asthma effects through multiple pathways; however, its potential role in regulating ASMC proliferation and preventing bronchial asthma remains unexplored.

METHODS

This study investigated the effects of YiQi GuBen formula on platelet-derived growth factor (PDGF)-BB-induced ASMC proliferation and migration by methylthiazolyldiphenyl-tetrazolium bromide, wound healing, transwell, and cell cycle assays. The influence of YiQi GuBen formula on nuclear factor-κB (NF-κB) signaling-relevant proteins was measured by Western blotting, real-time quantitative PCR (RT-qPCR) assay, and ELISA.

RESULTS

We found that pretreatment with YiQi GuBen formula had a dose-dependent inhibitory effect on PDGF-BB-stimulated ASMC proliferation. It also suppressed PDGF-BB-induced ASMC migration and arrested PDGF-BB-induced cell cycle progression. Furthermore, YiQi GuBen formula suppressed PDGF-BB-induced expression of phosphorylated p65 and the release of inflammatory factors TNF-α, IL-1β, IL-6, and IL-8 in ASMCs.

CONCLUSIONS

In summary, our study shows that YiQi GuBen formula is able to significantly inhibit PDGF-BB-induced ASMC proliferation and migration by suppressing the NF-κB signaling pathway.

Copaiba oil suppresses inflammation in asthmatic lungs of BALB/c mice induced with ovalbumin

Asthma is a chronic inflammatory disease that represents high hospitalizations and deaths in world. Copaiba oil (CO) is popularly used for relieving asthma symptoms and has already been shown to be effective in many inflammation models. This study aimed to investigate the immunomodulatory relationship of CO in ovalbumin (OVA)-induced allergic asthma. The composition of CO sample analyzed by GC and GC-MS and the toxicity test was performed in mice at doses of 50 or 100 mg/kg (by gavage). After, the experimental model of allergic asthma was induced with OVA and mice were orally treated with CO in two pre-established doses. The inflammatory infiltrate was evaluated in bronchoalveolar lavage fluid (BALF), while cytokines (IL-4, IL-5, IL-17, IFN-γ, TNF-α), IgE antibody and nitric oxide (NO) production was evaluated in BALF and lung homogenate (LH) of mice, together with the histology and histomorphometry of the lung tissue. CO significantly attenuated the number of inflammatory cells in BALF, suppressing NO production and reducing the response mediated by TH2 and TH17 (T helper) cells in both BALF and LH. Histopathological and histomorphometric analysis confirmed that CO significantly reduced the numbers of inflammatory infiltrate in the lung tissue, including in the parenchyma area. Our results indicate that CO has an effective in vivo antiasthmatic effect.

Immune Homeostasis: Effects of Chinese Herbal Formulae and Herb-Derived Compounds on Allergic Asthma in Different Experimental Models

Allergic asthma is thought to arise from an imbalance of immune regulation, which is characterized by the production of large quantities of IgE antibodies by B cells and a decrease of the interferon-γ/interleukin-4 (Th1/Th2) ratio. Certain immunomodulatory components and Chinese herbal formulae have been used in traditional herbal medicine for thousands of years. However, there are few studies performing evidence-based Chinese medicine (CM) research on the mechanisms and effificacy of these drugs in allergic asthma. This review aims to explore the roles of Chinese herbal formulae and herb-derived compounds in experimental research models of allergic asthma. We screened published modern CM research results on the experimental effects of Chinese herbal formulae and herb-derived bioactive compounds for allergic asthma and their possible underlying mechanisms in English language articles from the PubMed and the Google Scholar databases with the keywords allergic asthma, experimental model and Chinese herbal medicine. We found 22 Chinese herb species and 31 herb-derived anti-asthmatic compounds as well as 12 Chinese herbal formulae which showed a reduction of airway hyperresponsiveness, allergen-specifific immunoglobulin E, inflflammatory cell infifiltration and a regulation of Th1 and Th2 cytokines in vivo, in vitro and ex vivo, respectively. Chinese herbal formulae and herbderived bioactive compounds exhibit immunomodulatory, anti-inflflammatory and anti-asthma activities in different experimental models and their various mechanisms of action are being investigated in modern CM research with genomics, proteomics and metabolomics technologies, which will lead to a new era in the development of new drug discovery for allergic asthma in CM.

Bufalin Inhibits the Inflammatory Effects in Asthmatic Mice through the Suppression of Nuclear Factor-Kappa B Activity

Asthma is an inflammatory airway disease characterized by increased infiltration of inflammatory cells into the airways and poor respiratory function. Bufalin is one of the biological ingredients obtained from Chansu. Bufalin was found to possess various pharmacological properties including anti-inflammatory activities. However, the effect of bufalin treatment on asthma has not yet been reported. Therefore, this study aimed to investigate the inhibitory effect of bufalin on asthmatic response in a murine model. A mouse asthma model was developed by ovalbumin (OVA) sensitization and challenge in the BALB/c mice. OVA-specific serum IgE and the levels of interleukin (IL)-4, IL-5, and IL-13 in bronchoalveolar lavage fluid (BALF) were determined by an enzyme-linked immunosorbent assay. Recruitment of inflammatory cells into BALF or lung tissues, and goblet cell hyperplasia were evaluated by histological staining. The expression levels of inhibitory subunit of nuclear factor-kappa B (NF-κB) alpha (IκBα) and phosphorylated p65 protein were measured by Western blot analyses. The results demonstrated that bufalin (5 and 10 mg/kg) markedly attenuated hyperresponsiveness, and strongly suppressed the OVA-induced increases of total inflammatory cells including macrophages, eosinophils, lymphocytes, and neutrophils in BALF. The levels of IL-4, IL-5, and IL-13 in BALF and OVA-specific IgE in serum were significantly reduced by bufalin. Histological staining of lung tissues showed that bufalin reduced inflammatory cell infiltration and goblet cell hyperplasia. The results of Western blotting indicated that bufalin suppressed the IκBα degradation from NF-κB, and reduced the level of phosphorylated p65 protein in the lung tissues. These data suggest that bufalin can exert its anti-inflammatory effects possibly through the inhibition of the NF-κB activity.

Effects of Astragalus and Codonopsis pilosula polysaccharides on alveolar macrophage phagocytosis and inflammation in chronic obstructive pulmonary disease mice exposed to PM2.5

Astragalus and Codonopsis pilosula are used for their immunomodulatory and anti-inflammatory effects. Here, we investigated the effects of Astragalus polysaccharides (APS) and Codonopsis pilosula polysaccharides (CPP) on alveolar macrophage (AM) phagocytosis and inflammation in chronic obstructive pulmonary disease (COPD) associated with exposure to particulate matter with a mean aerodynamic diameter ≤2.5μm (PM2.5). A mouse model of COPD was established by cigarette smoke exposure. PM2.5 exposure was performed by inhalation of a PM2.5 solution aerosol. APS and CPP were administered intragastrically. COPD showed defective AM phagocytosis and increased levels of interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α in bronchoalveolar lavage fluid and serum. PM2.5 exposure aggravated the damage, and this effect was reversed by APS and CPP gavage. The results indicate that APS and CPP may promote defective AM phagocytosis and ameliorate the inflammatory response in COPD with or without PM2.5 exposure.

Targeted inhibition of Six1 attenuates allergic airway inflammation and remodeling in asthmatic mice

Asthma is an inflammatory disease of the airways, characterized by lung eosinophilia, mucus hypersecretion by goblet cells and airway hyperresponsiveness to inhaled allergens. The purpose of this study was to evaluate the effects of Six1 on airway inflammation and remodeling and the underlying mechanisms in a murine model of chronic asthma. Female BALB/c mice were randomly divided into four groups: phosphate-buffered saline control, ovalbumin (OVA)-induced asthma group, OVA+siNC and OVA+siSix1. In this mice model, Six1 expression level was significantly elevated in OVA-induced asthma of mice. Additionally, downregulation of Six1 dramatically decreased OVA-challenged inflammation, infiltration, and mucus production. Moreover, silencing of Six1 resulted in decreased levels of immunoglobulin E and inflammatory mediators and reduced inflammatory cell accumulation, as well as inhibiting the expression of important mediators including matrix metalloproteinase MMP-2 and MMP-9, which is related to airway remodeling. Further analysis indicated that silencing of Six1 can significantly inhibit NF-kB pathway activation in the lungs. .In conclusion, these findings indicated that the downregulation of Six1 effectively inhibited airway inflammation and reversed airway remodeling, which suggest that Six1 represents a promising therapeutic strategy for human allergic asthma.

Herbal Medicines for Asthmatic Inflammation: From Basic Researches to Clinical Applications

Asthma is one of the most common chronic inflammatory disorders, associated with reversible airflow obstruction, airway hyperresponsiveness, and airway remodeling. This disease has a significant impact on individuals, their families, and society. Standardized therapeutics such as inhaled corticosteroid in combination with long acting β2 agonist have been applied for asthma control; however, complementary and alternative medicines, especially herbal medicines, are still widely used all over the world. A growing body of literature suggests that various herbals or related products might be effective in inhibiting asthmatic inflammation. In this review, we summarize recent advances about the mechanistic studies of herbal medicines on allergic airway inflammation in animal models and their potential application into clinic for asthma control.

Herbal medicine for adults with asthma: A systematic review

BACKGROUND

Many people with asthma use herbal medicines to help reduce symptoms and improve asthma control.

OBJECTIVE

To update the systematic review and meta-analysis of randomised controlled trials of herbal medicine for adult asthma.

DATA SOURCES

Nine English and Chinese databases were searched (PubMed, Embase, CINAHL, CENTRAL, AMED, CBM, CNKI, CQVIP, Wanfang).

STUDY SELECTIONS

Herbal medicines combined with routine pharmacotherapies compared with the same pharmacotherapies alone or placebo. Cochrane Risk of Bias Tool and GRADE Summary of Findings tables were used to evaluate methodological quality.

RESULTS

Twenty-nine (29) studies involving 3,001 participants were included. Herbal interventions used multi-ingredients such as licorice root, crow-dipper, astragali, and angelica. Compared with routine pharmacotherapies alone, herbal medicines as add-on therapy improved lung function (FEV1: MD 7.81%, 95% CI 5.79, 9.83, I(2) = 63%; PEFR: MD 65.14 L/min, 95% CI 58.87, 71.41, I(2) = 21%); asthma control (MD 2.47 points, 95% CI 1.64, 3.29, I(2) = 55%); reduced salbutamol usage (MD -1.14 puffs/day, 95% CI -2.20, -0.09, I(2) = 92%); and reduced acute asthma exacerbations over one year (MD -1.20, 95% CI -1.82, -0.58, one study). Compared with placebo plus pharmacotherapies herbal medicines as add-on therapy improved lung function (FEV1: MD 15.83%, 95% CI 13.54, 18.12 and PEFR: MD 55.20 L/min, 95% CI 33.41, 76.99). Other outcomes were not reported in these placebo studies. Included studies were low to moderate quality. Adverse events were rare.

CONCLUSIONS

Herbal medicines combined with routine pharmacotherapies improved asthma outcomes greater than pharmacotherapies alone. Included studies did not blind participants therefore more studies that address such weaknesses are warranted.

Astragalus injection attenuates bleomycin-induced pulmonary fibrosis via down-regulating Jagged1/Notch1 in lungs

OBJECTIVES

Inhibition of Notch signalling is a potential therapeutic strategy for pulmonary fibrosis. This study was designed to investigate the antifibrosis effects and possible mechanism of astragalus injection (AI) on bleomycin (BLM)-induced pulmonary fibrosis in rats.

METHODS

Pulmonary fibrosis was induced by intratracheal instillation of bleomycin (5 mg/kg) in male SD rats. All rats received daily intraperitoneally administration of dexamethasone (DEX, 3 mg/kg), astragalus injection (AI, 8 g/kg) or saline 1 day after bleomycin instillation daily for 28 days. Histological changes in the lung were evaluated by haematoxylin and eosin and Masson's trichrome staining. The expression of α-smooth muscle protein (α-SMA) was assayed by immunohistochemical (IHC). The mRNA and protein level of Jagged1, Notch1 and transforming growth factor-β1 (TGF-β1) was analysed by qPCR and Western blot.

KEY FINDINGS

BLM-induced severe alveolitis and pulmonary fibrosis; together with significant elevation of α-SMA, TGF-β1, Jagged1 and Notch1. Astragalus injection (AI, 8 g/kg) administration notably attenuated the degree of alveolitis and lung fibrosis, and markedly reduced the elevated levels of α-SMA, TGF-β1, Jagged1 and Notch1 in lungs.

CONCLUSIONS

Astragalus injection (AI, 8 g/kg) may exert protective effects on bleomycin-induced pulmonary fibrosis via downregulating Jagged1/Notch1 in lung.

Astragalus membranaceus modulates Th1/2 immune balance and activates PPARγ in a murine asthma model

Astragalus membranaceus, a traditional Chinese herb, has been used to improve airway inflammation and asthma. The present study investigated whether A. membranaceus has immunotherapeutic effects on asthma, a chronic inflammatory mucosal disease that is associated with excess production of IgE, eosinophilia, T helper 2 (Th2) cytokines, and bronchial hyperresponsiveness. An ovalbumin (OVA)-induced, chronic inflammatory airway murine asthma model was used to examine the status of pulmonary inflammation after the administration of A. membranaceus. The IgE levels in serum and bronchoalveolar lavage fluid showed a tendency to decrease after the administration of A. membranaceus. The number of eosinophils decreased and infiltration of inflammatory cells and collagen deposition declined in lung sections after A. membranaceus administration. The RNA and protein levels of Th2 cytokines and the ratio of the GATA3/T-bet mRNA levels decreased after A. membranaceus treatment. Furthermore, the mRNA level of peroxisome proliferator-activated receptor γ (PPARγ), a nuclear hormone receptor, increased in the lung tissues of A. membranaceus-treated mice. Finally, an A. membranaceus water extract activated PPARγ activity in either human embryonic kidney 293 (HEK293) or A549 cells in a PPARγ-responsive element-containing luciferase reporter assay. These results indicate that A. membranaceus has an inhibitory effect on airway inflammation in a murine model of asthma through modulating the imbalanced relationship between Th1 and Th2 cytokines.

Asthma research in China: a five-year review

Asthma is one of the most common chronic diseases worldwide with increasing morbidity. China has the largest asthmatic population and is one of the countries with the highest asthma mortality. Fortunately, asthma research in China, both clinical and scientific, has developed markedly over the past few years. This has resulted in significant increases in our understanding of Chinese asthma prevalence, risk factors, control status, pathogenesis, and new prevention or treatment strategies. In this review, the major achievements of asthma research in China from 2008 to 2012 are summarized.