Tokishakuyakusan directly attenuates PACAP's luteolytic action on luteal function in the rat ovary

The ameliorating effects of tokishakuyakusan in a rat model of implantation failure involves endometrial gland leukemia inhibitory factor and decidualization

ETHNOPHARMACOLOGICAL RELEVANCE

Tokishakuyakusan (TSS) is a Kampo medicine that is prescribed for the treatment of infertility in Japan. However, its precise mechanism of action remains unclear.

AIM OF THE STUDY

Leukemia inhibitory factor (LIF) in the endometrium plays an indispensable role in embryo implantation and is linked to infertility or implantation failure. Previously, we demonstrated that TSS ameliorated implantation failure induced by mifepristone (RU-486), an antagonist of progesterone, in rats. Herein, we aimed to clarify whether the ameliorating effect of TSS on implantation failure in the rat model involves endometrial LIF. Additionally, we determined whether decidualization, the dysfunction of which is linked to infertility or implantation failure similar to LIF, progesterone, and other implantation-related factors, are involved in the effect of TSS.

MATERIALS AND METHODS

The implantation failure rat model was developed via the subcutaneous administration of RU-486 (7 mg/kg) on day 3 post-coitus. Sesame oil was administered as the vehicle control. Rats were fed a diet containing 1% or 3% TSS or a control diet from day 13 pre-coitus. Subsequently, the implantation sites were assessed, and plasma progesterone levels were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) on day 8 post-coitus. The LIF mRNA of the endometrial gland, which was segmented via laser-microdissection from the endometrial tissue, was measured, and endometrial LIF immunostaining was carried out on day 5. The gene expression of different factors related to implantation, including decidualization and progesterone-responsiveness on days 5 and 6, were measured. The human endometrial Ishikawa cell line derived from human adenocarcinoma was treated with TSS (30-300 μg/mL) for 24 h, and the LIF concentrations in the cell culture supernatants were measured.

RESULTS

RU-486 decreased the number of implantation sites in the uterus of rats; however, the decrease was significantly alleviated by TSS (3%-diet), which tended to increase plasma progesterone. In rats with RU-486-induced implantation failure, endometrial gland LIF mRNA and endometrial LIF protein were markedly decreased while the gene expression of both decidualization-related factors such as interleukin-11, insulin-like growth factor binding protein-1, and cyclooxygenase-2, and progesterone responsive-related factors such as FK506 binding protein 5, were significantly decreased. These changes in the uterus of rats with implantation failure were significantly alleviated by TSS (3%-diet). Additionally, TSS significantly enhanced LIF protein production and LIF mRNA in Ishikawa cells.

CONCLUSIONS

The mechanism whereby TSS ameliorates RU-486-induced implantation failure in rats may involve the alleviation of decreased LIF production derived from the endometrial gland, and a dysfunction of decidualization, including lower progesterone responsiveness in the model. These findings may partly contribute to the interpretation of the beneficial effects of TSS on infertility.

Chinese Herbal Products for Female Infertility in Taiwan: A Population-Based Cohort Study

Female infertility and low birth rate are significant public health issues with profound social, psychological, and economic consequences. Some infertile women resort to conventional, complementary, or alternative therapies to conceive. The aim of this study was to identify the Chinese herbal products (CHPs) most commonly used for female infertility in Taiwan. The usage of traditional Chinese medicine (TCM) and the frequency of CHP prescriptions to infertile women were determined based on a nationwide 1-million randomly sampled cohort of National Health Insurance Research Database beneficiaries. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratio (aOR) for TCM usage and potential risk factors. In total, 8766 women with newly diagnosed infertility were included in this study. Of those, 8430 (96.17%) had sought TCM treatment in addition to visiting the gynecologist. We noted that female infertility patients with risk factors (e.g., endometriosis, uterine fibroids, or irregular menstrual cycle) were more likely to use TCM than those without TCM medication (aOR = 1.83, 1.87, and 1.79, respectively). The most commonly used formula and single CHP were Dang-Gui-Sha-Yao-San (17.25%) and Semen Cuscutae (27.40%), respectively. CHP formula combinations (e.g., Dang-Gui-Sha-Yao-San plus Wen-Jing-Tang 3.10%) or single Chinese herbal combinations (e.g., Semen Cuscutae plus Leonurus japonicus 6.31%) were also commonly used to treat female infertility. Further well-conducted, double-blind, randomized, placebo-controlled studies will be needed to evaluate the efficacy and safety of these CHP combinations for female infertility.

Dangguijakyak-San Protects against 1-Methyl-4-phenyl-1,2,3,6,-tetrahydropyridine-Induced Neuronal Damage via Anti-Inflammatory Action

Dangguijakyak-san (DJS), a famous traditional Korean multiherbal medicine, has been used to treat gynecological and neuro-associated disease. Recent studies demonstrated that DJS has multiple bioactivities including neuroprotection. In the present study, we were to investigate the effect of DJS and its mechanism in an in vitro and in vivo model of Parkinson's disease (PD). In primary mesencephalic culture system, DJS attenuated the dopaminergic cell damage induced by 1-methyl-4-phenylpyridine toxicity, and it inhibited production of inflammatory factors such as tumor necrosis factor α (TNF- α ), nitric oxide (NO), and activation of microglial cells. Then, we confirmed the effect of DJS in a mouse PD model induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). In the pole test, DJS at 50 mg/kg/day for 5 days showed increase of motor activity showing shortened time to turn and locomotor activity compared with the MPTP only treated mice. In addition, DJS significantly protected nigrostriatal dopaminergic neuron from MPTP stress. Moreover, DJS showed inhibition of gliosis in the substantia nigra pars compacta. These results have therapeutic implications for DJS in the treatment of PD via anti-inflammatory effects.

Post-ischemic Treatment with Toki-Shakuyaku-San (Tang-Gui-Shao-Yao-San) Prevents the Impairment of Spatial Memory Induced by Repeated Cerebral Ischemia in Rats

Previously we have reported that Toki-shakuyaku-san (TSS) ameliorated the impairment of spatial memory induced by single cerebral ischemia (1 × 10 minutes ) and scopolamine, a muscarinic receptor antagonist. In this experiment, we studied the effect of TSS on repeated cerebral ischemia (2 × 10 minutes , 1-hour interval) induced impairment of spatial memory and neuronal injury in rats. The 8-day post-ischemic treatment with TSS (30–300 mg/kg) was administered p.o. once per day. TSS dose-dependently prevented the impairment of spatial memory, neuronal death and TUNEL positive cells induced by repeated cerebral ischemia. In order to determine the mechanism of TSS, we also studied the effect of TSS on GluR2 mRNA, one of the glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole (AMPA) receptor subunits. Repeated cerebral ischemia significantly decreased GluR2 flop mRNA at 1 and 3 days after the occlusion. TSS (300 mg/kg) significantly suppressed the decrease in GluR2 flop at 3 days after repeated cerebral ischemia. These results suggested that the TSS has neuroprotective action which may be indirectly mediated by the AMPA receptor, and TSS may be beneficial for the treatment of cerebrovascular dementia.

Role of PACAP in Female Fertility and Reproduction at Gonadal Level - Recent Advances

Pituitary adenylate cyclase activating polypeptide (PACAP) is a pleiotropic neuropeptide, first isolated from hypothalamic extracts, but later shown in peripheral organs, such as endocrine glands, gastrointestinal system, cardiovascular system, and reproductive organs. PACAP plays a role in fertility and reproduction. Numerous studies report on the gonadal regulatory effects of PACAP at hypothalamo-hypophyseal levels. However, the local effects of PACAP at gonadal levels are also important. The present review summarizes the effects of PACAP in the ovary. PACAP and its receptors are present in the ovary, and PACAP plays a role in germ cell migration, meiotic division, follicular development, and atresia. The autocrine-paracrine hormonal effects seem to play a regulatory role in ovulation, luteinization, and follicular atrophy. Altogether, PACAP belongs to the ovarian regulatory peptides.

Theoretical Basis for Herbal Medicines, Tokishakuyaku-San and Sairei-To, in the Treatment of Recurrent Abortion: Enhancing the Production of Granulocyte?Macrophage Colony-Stimulating Factor in Decidual Stromal Cells

PROBLEM

To get insight into the basis for the empirical usage of herbal medicines, such as Tokishakuyaku-san (Toki) and Sairei-to (Sai) in the treatment of recurrent abortion and intrauterine growth restriction, we examined whether these medicines modulate the production of granulocyte-macrophage colony-stimulating factor (GM-CSF), a cytokine working as an important mediator for intercellular communication in the embryonic development, in decidual stromal cells (DSCs).

METHOD OF STUDY

Human DSCs were cultured with either Toki or Sai at several different concentrations. The effect on cell proliferation was assessed by WST-8 assay. GM-CSF released into culture medium was analyzed using enzyme-linked immunosorbent assay, and semi-quantitative polymerase chain reaction was carried out to see GM-CSF mRNA expression in DSCs.

RESULTS

Sai inhibited the proliferation of cultured DSCs, while no interference was observed in the presence of Toki. Both Toki and Sai enhanced the release of GM-CSF into culture medium. The amount of GM-CSF mRNA in cultured DSCs was as well increased by either Toki or Sai.

CONCLUSION

Considering the significance of GM-CSF in embryonic development, clinical benefit of these herbal medicines in the treatment of recurrent abortion might be based on the shown pharmacological reaction related to GM-CSF.

Neuroprotective effects of TJ-23 (Tokishakuyakusan) on adult rat motoneurons following peripheral facial nerve axotomy

OBJECTIVE

We investigated free radical scavenging activity and the possible neuroprotective effect of Tokishakuyakusan (TJ-23) on facial motor nucleus (FMN) motoneurons after peripheral axotomy.

STUDY DESIGN

In 40 adult rats, the right facial nerve was transected at the level of the stylomastoid foramen. Following axotomy, the effects of TJ-23 on nitric oxide synthase were investigated using NADPH-d histochemistry. FMN motoneurons were counted bilaterally in sections stained with cresyl violet.

RESULTS

Rats administered TJ-23 exhibited clear suppression of injury-induced neuronal NADPH-d expression in the ipsilateral FMN when compared to nontreated controls. The number of surviving motoneurons in the ipsilateral FMN was significantly greater among TJ-23-treated rats than nontreated controls on day 56 following axotomy.

CONCLUSION

The present study demonstrates the neuroprotective effect of TJ-23 after peripheral facial nerve axotomy.

SIGNIFICANCE

Antioxidants may have therapeutic potential in traumatic facial nerve dysfunction resulting from head injury, ear surgery, and parotid gland surgery.