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Zhou Z, Zhang Y, Han F, Chen Z, Zheng Y. Umbelliferone protects against cerebral ischemic injury through selective autophagy of mitochondria. Neurochem Int 2023; 165:105520. [PMID: 36933866 DOI: 10.1016/j.neuint.2023.105520] [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: 01/18/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Effective therapeutic treatments for ischemic stroke are limited. Previous studies suggest selective activation of mitophagy alleviates cerebral ischemic injury while excessive autophagy is detrimental. However, few compounds are available to selectively activate mitophagy without affecting autophagy flux. Here, we found that acute administration of Umbelliferone (UMB) upon reperfusion exerted neuroprotective effects against ischemic injury in mice subjected to transient middle cerebral artery occlusion (tMCAO) and suppressed oxygen-glucose deprivation reperfusion (OGD-R)-induced apoptosis in SH-SY5Y cells. Interestingly, UMB promoted the translocation of mitophagy adaptor SQSTM1 to mitochondria and further reduced the mitochondrial content as well as the expression of SQSTM1 in SHSY5Y cells after OGD-R. Importantly, both the mitochondrial loss and reduction of SQSTM1 expression after UMB incubation can be reversed by autophagy inhibitor chloroquine and wortmannin, proving the mitophagy activation by UMB. Nevertheless, UMB failed to further affect neither LC3 lipidation nor the number of autophagosomes after cerebral ischemia in vivo and in vitro. Furthermore, UMB facilitated OGD-R-induced mitophagy in a Parkin-dependent manner. Inhibition of autophagy/mitophagy either pharmaceutically or genetically abolished the neuroprotective effects of UMB. Taken all, these results suggest that UMB protects against cerebral ischemic injury, both in vivo and in vitro, via promoting mitophagy without increasing the autophagic flux. UMB might serve as a potential leading compound for selectively activating mitophagy and the treatment of ischemic stroke.
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Affiliation(s)
- Zhuchen Zhou
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yan Zhang
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Feng Han
- Key Lab of Cardiovascular and Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, 210023, China
| | - Zhong Chen
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Yanrong Zheng
- Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Lee YS, Kwon S, Chae Y, Jang BH, Ko SG. A retrospective cohort study on the outcomes of ischemic stroke patients with adjuvant Korean Medicine treatment. Sci Rep 2018; 8:1656. [PMID: 29374270 PMCID: PMC5786017 DOI: 10.1038/s41598-018-19841-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/08/2018] [Indexed: 12/14/2022] Open
Abstract
This study aims to examine the long-term effect of adjuvant treatment in Korean Medicine (KM) clinics in ischemic stroke patients, using a national sample cohort from the National Health Insurance Service in Korea between 2010 and 2013. The National Health Insurance Service - National Sample Cohort database from 2002 to 2013 was used in this study. Ischemic stroke patients were defined and covariates were included to account for socioeconomic variables, comorbidities and disease severity. Propensity score matching was applied. Cox proportional hazards modeling and Kaplan-Meier analysis were applied to determine the differences between KM and non-KM treated groups. The results shows that KM-treated group had a higher probability of survival than non-KM group patients. No significant difference was observed between the risk of readmission between the treated and non-treated patients. Kaplan-Meier analysis showed a weak effect of KM treatments in the patients with 8 to 28 days of hospital stay for a lower risk of recurrence than in non-treated patients. In conclusion, KM treatment of mild to moderate ischemic stroke patients has a mild effect on the survival probability of stroke. Its effect for improving long-term recurrence need to be explored in the future studies.
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Affiliation(s)
- Ye-Seul Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Seungwon Kwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Younbyoung Chae
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447, Republic of Korea
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Wang Y, Wang Y, Ma W, Lu S, Chen J, Cao L. Correlation between cognitive impairment during the acute phase of first cerebral infarction and development of long-term pseudobulbar affect. Neuropsychiatr Dis Treat 2018; 14:871-877. [PMID: 29636612 PMCID: PMC5880411 DOI: 10.2147/ndt.s161792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The relationship between cognitive impairment during the acute phase of first cerebral infarction and the development of long-term pseudobulbar affect (PBA) has not been elucidated. Therefore, in this study, we aimed to determine if cognitive impairment during the acute phase of cerebral infarction will increase the risk of long-term post-infarction PBA. PATIENTS AND METHODS This was a nested case-control study using a prospective approach. A consecutive multicenter matched 1:1 case-control study of cognitive impairment cases following acute cerebral infarction (N=26) with 26 sex-, education years-, and age-matched controls. Univariate and multivariate conditional logistic regression analyses were performed to study the clinical features and changes in cognitive domain as well as the risk factors for PBA. RESULTS Long-term PBA was independently predicted by low Montreal cognitive assessment (MoCA) scores at baseline. Multivariable regression models showed that post-infarction low MoCA scores remained independent predictors of long-term PBA (odds ratio [OR]=0.72; 95% confidence interval [CI]=0.54-0.95; P=0.018). Among all cognitive disorders, digit span test (DST) scores (OR=0.39; 95% CI=0.16-0.91, P=0.030), StroopC time (OR=1.15; 95% CI=1.01-1.31; P=0.037), and clock-drawing task (CDT) scores (OR=0.62; 95% CI=0.42-0.90; P=0.013) were found to be the independent risk factors for PBA. CONCLUSION Cognitive impairment during the acute phase of cerebral infarction increased the risk of cerebral infarction-induced long-term PBA. Development of PBA was closely associated with executive function, attention, and visuospatial disorder.
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Affiliation(s)
- Yuan Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, People's Republic of China.,Department of Neurology, Binzhou Medical University Hospital, Binzhou, People's Republic of China
| | - Yuliang Wang
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, People's Republic of China
| | - Wenbin Ma
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, People's Republic of China
| | - Shujun Lu
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, People's Republic of China
| | - Jinbo Chen
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, People's Republic of China
| | - Lili Cao
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, People's Republic of China
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Zhang YQ, Wang SS, Zhu WL, Ma Y, Zhang FB, Liang RX, Xu HY, Yang HJ. Deciphering the pharmacological mechanism of the Chinese formula huanglian-jie-du decoction in the treatment of ischemic stroke using a systems biology-based strategy. Acta Pharmacol Sin 2015; 36:724-33. [PMID: 25937634 DOI: 10.1038/aps.2014.124] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 10/30/2014] [Indexed: 01/01/2023] Open
Abstract
AIM Huanglian-jie-du decoction (HLJDD) is an important multiherb remedy in TCM, which is recently demonstrated to be effective to treat ischemic stroke. Here, we aimed to investigate the pharmacological mechanisms of HLJDD in the treatment of ischemic stroke using systems biology approaches. METHODS Putative targets of HLJDD were predicted using MetaDrug. An interaction network of putative HLJDD targets and known therapeutic targets for the treatment of ischemic stroke was then constructed, and candidate HLJDD targets were identified by calculating topological features, including 'Degree', 'Node-betweenness', 'Closeness', and 'K-coreness'. The binding efficiencies of the candidate HLJDD targets with the corresponding compositive compounds were further validated by a molecular docking simulation. RESULTS A total of 809 putative targets were obtained for 168 compositive compounds in HLJDD. Additionally, 39 putative targets were common to all four herbs of HLJDD. Next, 49 major nodes were identified as candidate HLJDD targets due to their network topological importance. The enrichment analysis based on the Gene Ontology (GO) annotation system and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway demonstrated that candidate HLJDD targets were more frequently involved in G-protein-coupled receptor signaling pathways, neuroactive ligand-receptor interactions and gap junctions, which all played important roles in the progression of ischemic stroke. Finally, the molecular docking simulation showed that 170 pairs of chemical components and candidate HLJDD targets had strong binding efficiencies. CONCLUSION This study has developed for the first time a comprehensive systems approach integrating drug target prediction, network analysis and molecular docking simulation to reveal the relationships between the herbs contained in HLJDD and their putative targets and ischemic stroke-related pathways.
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Relationships between Pathological Patterns and Quality of Life: Pathway Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:453096. [PMID: 24288560 PMCID: PMC3830807 DOI: 10.1155/2013/453096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 09/06/2013] [Accepted: 09/07/2013] [Indexed: 11/18/2022]
Abstract
Purpose. The purpose of our study was to examine the relationships between pathological patterns and self-rated quality of life (QoL). Methods. A total of 426 Korean subjects participated in this study (male : female = 154 : 272). The subjects were asked to complete Yin Deficiency (YD), Qi Deficiency (QD), Food Stagnation (FS), Blood Stasis (BS), Phlegm, and Seven Emotions Impairment (SEI) pattern Questionnaires and the General Health Questionnaire (GHQ). We formed a pathway model consisting of pathological patterns and QoL questionnaire scores and examined which pathological patterns resulted in decreased QoL using path analysis. Results. Our pathway model had satisfactory fitness levels (GFI = 0.975, NFI = 0.984, and CFI = 0.984) and showed that Phlegm and SEI patterns directly resulted in decreased QoL, whereas QD, YD, FD, and BS indirectly resulted in decreased QoL. The pathway model suggested that the severity or stage of decreased QoL may be estimated by pathological patterns: QD and YD patterns are associated with the early stage; FS and BS patterns are associated with the middle stage; Phlegm and SEI are associated with the later stage of decreased QoL. Conclusion. Our results suggest that pathological patterns directly or indirectly affect decreases in QoL.
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Park SU, Cho SY, Park JM, Ko CN, Park HJ, Lauren Walls B, Cotter AC, Park JJ. Integrative treatment modalities for stoke victims in Korea. Complement Ther Clin Pract 2013; 20:37-41. [PMID: 24439643 DOI: 10.1016/j.ctcp.2013.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 10/14/2013] [Accepted: 10/14/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To suggest and discuss an integrative medicine model for stroke patients, we introduce our experience in Korea, describe treatment modalities used for stroke in Korean medicine, and present safety data on integrative care. SUMMARY For inpatients, integrative management is applied at the request of the primary physician with the consent of patients or their families. In the acute stage, neurologists or neurosurgeons take charge as the primary physicians. Korean medicine doctors cooperate as secondary physicians to the neurologists and neurosurgeons. After the acute stage, responsibilities are exchanged. The rehabilitation program is conducted under the supervision of rehabilitation medicine doctors. The most frequently used complementary and alternative medicine modalities are acupuncture (including manual acupuncture, electroacupuncture and intradermal acupuncture), moxibustion, herbal prescriptions, and acupuncture point injection. CONCLUSION Based on our field experiences, we believe it is worthwhile to continue efforts to integrate complementary and alternative medicine and Western medicine.
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Affiliation(s)
- Seong-Uk Park
- Stroke & Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea; Asian Medicine & Acupuncture Research, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Seung-Yeon Cho
- Stroke & Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea
| | - Jung-Mi Park
- Stroke & Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea
| | - Chang-Nam Ko
- Stroke & Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea
| | - Hi-Joon Park
- Department of Meridian and Acupoint, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - B Lauren Walls
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ann C Cotter
- Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
| | - Jongbae J Park
- Asian Medicine & Acupuncture Research, Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Regional Center for Neurosensory Disorders, UNC School of Dentistry, Chapel Hill, NC, USA.
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King RR, Reiss JP. The epidemiology and pathophysiology of pseudobulbar affect and its association with neurodegeneration. Degener Neurol Neuromuscul Dis 2013; 3:23-31. [PMID: 30890891 PMCID: PMC6065587 DOI: 10.2147/dnnd.s34160] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Pseudobulbar affect is a disorder resulting from neurologic damage manifesting as sudden, stereotyped affective outbursts that are not reflective of internal emotion. A literature review was completed to examine the current understanding of the epidemiology, characterization, diagnosis, pathophysiology, and treatment of pseudobulbar affect. This review revealed that it is common in neurodegenerative disorders but is poorly recognized, placing significant impacts on patients and their families. The disorder appears to result from a disruption of the cortico-limbic-subcortical-thalamic-pontocerebellar network involved in emotional expression and regulation with resulting disruptions of neurotransmitter systems. Effective treatment is available with agents such as selective serotonin reuptake inhibitors and dextromethorphan combined with quinidine, but further well-designed comparative studies are needed. Advances in technology such as neuroimaging may enhance knowledge about the pathophysiology of this disorder, and help guide future interventions.
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Affiliation(s)
- Rebecca R King
- Department of Psychiatry, University of Western Ontario, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada,
| | - Jeffrey P Reiss
- Department of Psychiatry, University of Western Ontario, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada,
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The exploration of disease pattern, zheng, for differentiation of allergic rhinitis in traditional chinese medicine practice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:521780. [PMID: 22899954 PMCID: PMC3414236 DOI: 10.1155/2012/521780] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 04/27/2012] [Indexed: 11/17/2022]
Abstract
Pattern, or "zheng," differentiation is the essential guide to treatment with traditional Chinese medicine (TCM). However, the considerable variability between TCM patterns complicates evaluations of TCM treatment effectiveness. The aim of this study was to explore and characterize the relationship between patterns and the core patterns of allergic rhinitis. We summarized 23 clinical trials of allergic rhinitis with mention of pattern differentiation; association rule mining was used to analyze TCM patterns of allergic rhinitis. A total of 205 allergic rhinitis patients seen at Chang Gung Memorial Hospital from March to June 2005 were included for comparison. Among the 23 clinical trials evaluated, lung qi deficiency and spleen qi deficiencies were the core patterns of allergic rhinitis, accounting for 29.50% and 28.98% of all patterns, respectively. A higher prevalence of lung or spleen qi deficiency (93.7%) was found in Taiwan. Additionally, patients with lung or spleen qi deficiency were younger (27.99 ± 12.94 versus 58.54 ± 12.96 years) and the severity of nasal stuffiness was higher than among patients with kidney qi deficiency (1.35 ± 0.89 versus 0.62 ± 0.65; P < 0.05). Lung and spleen qi deficiencies are the core patterns of allergic rhinitis and determining the severity of nasal stuffiness is helpful in differentiating the TCM patterns.
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