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Wang S, Wu L, Xie Y, Ge S, Wu Y, Chen L, Yi L, Yang J, Duan F, Huang L. Erjingpill bionic cerebrospinal fluid alleviates LPS-induced inflammatory response in BV2 cells by inhibiting glycolysis via mTOR. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118412. [PMID: 38824976 DOI: 10.1016/j.jep.2024.118412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Erjingpill, a well-known prescription documented in the classic Chinese medical text "Shengji Zonglu," has been proven to have effective alleviating effects on neuroinflammation in Alzheimer's disease (AD). Although the alterations in microglial cell glycolysis are known to play a crucial role in the development of neuroinflammation, it remains unclear whether the anti-neuroinflammatory effects of Erjingpill are associated with its impact on microglial cell glycolysis. AIM OF THE STUDY This study aims to determine whether Erjingpill exerts anti-neuroinflammatory effects by influencing microglial cell glycolysis. MATERIALS AND METHODS Firstly, Erjingpill decoction was prepared into an Erjingpill bionic cerebrospinal fluid (EBCF) through a process of in vitro intestinal absorption, hepatocyte incubation, and blood-brain barrier (BBB) transcytosis. Subsequently, UPLC/Q-TOF-MS/MS technology was used to analyze the compounds in Erjingpill and EBCF. Next, an in vitro neuroinflammation model was established by LPS-induced BV2 cells. The impact of EBCF on BV2 cell proliferation activity was evaluated using the CCK-8 assay, while the NO release was assessed using the Griess assay. Additionally, mRNA levels of pro-inflammatory factors (IL-1β, IL-6, TNF-α, and COX-2), anti-inflammatory factors (IL-10, IL-4, Arg-1, and TGF-β), M1 microglial markers (iNOS, CD86), M2 microglial markers (CD36, CD206), and glycolytic enzymes (HK2, GLUT1, PKM, and LDHA) were measured using qPCR. Furthermore, protein expression of microglial activation marker Iba-1, M1 marker iNOS, and M2 marker CD206 were identified through immunofluorescence, while concentrations of pro-inflammatory cytokines IL-1β and TNF-α were measured using ELISA. Enzymatic activity of glycolytic enzymes (HK, PK, and LDH) was assessed using assay kits, and the protein levels of pro-inflammatory factors (IL-1β, iNOS, and COX-2), anti-inflammatory factors (IL-10 and Arg-1), and key glycolytic proteins GLUT1 and PI3K/AKT/mTOR were detected by Western blot. RESULTS Through the analysis of Erjingpill and EBCF, 144 compounds were identified in Erjingpill and 40 compounds were identified in EBCF. The results demonstrated that EBCF effectively inhibited the elevation of inflammatory factors and glycolysis levels in LPS-induced BV2 cells, promoted polarization of M1 microglial cells towards the M2 phenotype, and suppressed the PI3K/AKT/mTOR inflammatory pathway. Moreover, EBCF alleviated LPS-induced BV2 cell inflammatory response by modulating mTOR to inhibit glycolysis. CONCLUSIONS EBCF exhibits significant anti-neuroinflammatory effects, likely attributed to its modulation of mTOR to inhibit microglial cell glycolysis. This study furnishes experimental evidence supporting the clinical utilization of Erjingpill for preventing and treating AD.
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Affiliation(s)
- Shuaikang Wang
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Li Wu
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Yongyan Xie
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Shuchao Ge
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Yi Wu
- Jiangxi Provincial Institute of Food and Drug Inspection and Testing, Nanchang, Jiangxi, 330004, China.
| | - Liping Chen
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Longgen Yi
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Jie Yang
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Feipeng Duan
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Liping Huang
- School of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China; Jiangxi Province Key Laboratory of Pharmacology of Traditional Chinese Medicine, Nanchang, Jiangxi, 330004, China.
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Huang Z, Shen Y, Fan X, Guo Q, Ma W. Yinzhihuang injection induces apoptosis and suppresses tumor growth in acute myeloid leukemia cells. PLoS One 2023; 18:e0289697. [PMID: 37816017 PMCID: PMC10564230 DOI: 10.1371/journal.pone.0289697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/23/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND The unmet needs in treating acute myeloid leukemia(AML) promote us to look for more effective and less toxic therapies. In this study, we discovered that Yinzhihuang injection(YZHI), a traditional Chinese patent medicine for hepatitis treatment, suppressed the growth of AML cells. METHOD Anti-proliferative activities of YZHI were measured by CCK-8 assay. Cell cycle arrest was evaluated by PI staining, and apoptosis was evaluated by annexin V/PI staining. To explore the cell cycle arrest and cell death mechanism induced by YZHI, we assessed a series of assays, including measurements of the protein expression and cellular ATP. The anti-tumor activity was further demonstrated in nude mice. RESULTS Flow cytometric and biochemical analysis revealed that YZHI caused cell cycle arrest and induced apoptosis in the AML HL-60 cells. Mechanistically, YZHI activated AMPK by promoting phosphorylation of the kinase. The active AMPK negatively regulated the downstream target mTORC1, leading to the inhibition of cell proliferation and induction of apoptosis. Pretreatment with the AMPK inhibitor compound C rescued YZHI induced apoptosis and partially restored cell proliferation of HL-60. Consistent with the data in vitro, YZHI obviously suppressed subcutaneous xenograft growth in nude mice. CONCLUSIONS In a word, our data suggest that YZHI can be repurposed for the treatment of AML, which is worthy of further clinical evaluation.
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Affiliation(s)
- Zhe Huang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Yunfu Shen
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Xianming Fan
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Qulian Guo
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Wenzhe Ma
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
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Zeng X, Zhang T, Chen L, Zu Y. Management control matching patterns and firm innovation modes. TECHNOLOGY ANALYSIS & STRATEGIC MANAGEMENT 2022. [DOI: 10.1080/09537325.2022.2158802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Xiangfei Zeng
- School of Business, Anhui University of Technology, Ma’an Shan, People’s Republic of China
| | - Ting Zhang
- School of Business, Anhui University of Technology, Ma’an Shan, People’s Republic of China
| | - Lianghua Chen
- School of Economics and Management, Southeast University, Nanjing, People’s Republic of China
| | - Yafei Zu
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, People’s Republic of China
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Huang Z, Yang Y, Fan X, Ma W. Network pharmacology-based investigation and experimental validation of the mechanism of scutellarin in the treatment of acute myeloid leukemia. Front Pharmacol 2022; 13:952677. [PMID: 36160389 PMCID: PMC9490111 DOI: 10.3389/fphar.2022.952677] [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: 05/25/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Background: It has been demonstrated that scutellarin, a natural flavone compound from Scutellaria lateriflora and Scutellaria barbata, exerts selective cytotoxicity against a range of cancer cells. However, the underlining mechanism of scutellarin on acute myeloid leukemia (AML) remains elusive. Methods: In this study, the combination of network pharmacology and experimental verification was performed to identify the pharmacological mechanisms of scutellarin for AML therapy. The public databases, such as PharmMapper, UniProt, OMIM, GeneCards, DrugBank and PharmGkb database, were used to sceen the potential targets of scutellarin and AML. The protein-protein interaction (PPI), gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were conducted to uncover the mechanism of scutellarin in the treatment of AML. Finally, the network pharmacological results were further confirmed by in vitro and in vivo experiments. Results: First and foremost, we totally obtained 289 target genes for scutellarin and 10998 disease targets for AML. 253 overlapping genes were preliminarily considered the potential targets of scutellarin for AML treatment. The results of PPI network analysis, GO analysis and KEGG pathway enrichment demonstrated that the anti-AML effect of scutellarin may focused on MAPK signaling pathway. Furthermore, the cytologic tests suggested that scutellarin can inhibit AML cells proliferation through the mediation of JNK/Caspase-3 pathway. Meanwhile, pretreatment with the JNK inhibitor SP600125 rescued scutellarin-induced apoptosis. Similarly, scutellarin obviously suppressed subcutaneous xenograft growth in nude mice via regulating the JNK/Caspase-3 signaling pathway. Conclusion: In this study, we integrated network pharmacology-based prediction and experimental validation and revealed the importance of the JNK pathway in scutellarin-mediated AML treatment.
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Affiliation(s)
- Zhe Huang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Birth Defects, Luzhou, China
| | - Yan Yang
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Research Center for Birth Defects, Luzhou, China
| | - Xianming Fan
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, China
- *Correspondence: Xianming Fan, ; Wenzhe Ma,
| | - Wenzhe Ma
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
- *Correspondence: Xianming Fan, ; Wenzhe Ma,
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Sun W, Wang S, Liang P, Zhou H, Zhang L, Jia Q, Fu J, Lv Y, Han S. Pseudo-allergic compounds screened from Shengmai injection by using high-expression Mas-related G protein-coupled receptor X2 cell membrane chromatography online coupled with liquid chromatography and mass spectrometry. J Sep Sci 2021; 44:1421-1429. [PMID: 33491300 DOI: 10.1002/jssc.202001163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 11/11/2022]
Abstract
Adverse drug reactions of traditional Chinese medicine injection mainly manifested as pseudo-allergic reactions. In the present study, ginsenoside Rd, Ro, and Rg3 were identified as pseudo-allergic components in Shengmai injection by a high-expression Mas-related G protein-coupled receptor X2 cell membrane chromatography coupled online with high-performance liquid chromatography and mass spectrometry. Their pseudo-allergic activities were evaluated by in vitro and in vivo assay. The three compounds were further found to induce pseudo-allergic reaction through Mas-related G protein-coupled receptor X2. Therefore, we concluded that ginsenoside Rd, Ro and Rg3 may be potential allergens that cause pseudo-allergic reactions. This study might be helpful for the safe use of Shengmai injection.
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Affiliation(s)
- Wei Sun
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Saisai Wang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Peida Liang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Huaxin Zhou
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Liyang Zhang
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Qianqian Jia
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Jia Fu
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Yanni Lv
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
| | - Shengli Han
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, P. R. China.,Institute of Pharmaceutical Science and Technology, Western China Science &Technology Innovation Harbour, Xi'an, P. R. China
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Enhancing and Complementary Mechanisms of Synergistic Action of Acori Tatarinowii Rhizoma and Codonopsis Radix for Alzheimer's Disease Based on Systems Pharmacology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:6317230. [PMID: 32802132 PMCID: PMC7334796 DOI: 10.1155/2020/6317230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 05/20/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
Materials and Methods In this study, a systems pharmacology-based strategy was used to elucidate the synergistic mechanism of Acori Tatarinowii Rhizoma and Codonopsis Radix for the treatment of AD. This novel systems pharmacology model consisted of component information, pharmacokinetic analysis, and pharmacological data. Additionally, the related pathways were compressed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, and the organ distributions were determined in the BioGPS bank. Results Sixty-eight active ingredients with suitable pharmacokinetic profiles and biological activities were selected through ADME screening in silico. Based on 62 AD-related targets, such as APP, CHRM1, and PTGS1, systematic analysis showed that these two herbs were mainly involved in the PI3K-Akt signaling pathway, MAPK signaling pathway, neuroactive ligand-receptor interaction, and fluid shear stress and atherosclerosis, indicating that they had a synergistic effect on AD. However, ATR acted on the KDR gene, while CR acted on IGF1R, MET, IL1B, and CHUK, showing that they also had complementary effects on AD. The ingredient contribution score involved 29 ingredients contributing 90.14% of the total contribution score of this formula for AD treatment, which emphasized that the effective therapeutic effects of these herbs for AD were derived from both ATR and CR, not a single herb. Organ distribution showed that the targets of the active ingredients were mainly located in the whole blood, the brain, and the muscle, which are associated with AD. Conclusions In sum, our findings suggest that the systems pharmacology methods successfully revealed the synergistic and complementary mechanisms of ATR and CR for the treatment of AD.
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Chen SY, Gao Y, Sun JY, Meng XL, Yang D, Fan LH, Xiang L, Wang P. Traditional Chinese Medicine: Role in Reducing β-Amyloid, Apoptosis, Autophagy, Neuroinflammation, Oxidative Stress, and Mitochondrial Dysfunction of Alzheimer's Disease. Front Pharmacol 2020; 11:497. [PMID: 32390843 PMCID: PMC7188934 DOI: 10.3389/fphar.2020.00497] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/30/2020] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive age-related neurodegenerative disease characterized by memory loss and cognitive impairment. The major characteristics of AD are amyloid β plaques, apoptosis, autophagy dysfunction, neuroinflammation, oxidative stress, and mitochondrial dysfunction. These are mostly used as the significant indicators for selecting the effects of potential drugs. It is imperative to explain AD pathogenesis and realize productive treatments. Although the currently used chemical drugs for clinical applications of AD are effective in managing the symptoms, they are inadequate to achieve anticipated preventive or therapeutic outcomes. There are new strategies for treating AD. Traditional Chinese Medicine (TCM) has accumulated thousands of years of experience in treating dementia. Nowadays, numerous modern pharmacological studies have verified the efficacy of many bioactive ingredients isolated from TCM for AD treatment. In this review, representative TCM for the treatment of AD are discussed, and among these herbal medicines, the Lamiaceae family accounts for the highest proportion. It is concluded that monomers and extracts from TCM have potential therapeutic effect for AD treatment.
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Affiliation(s)
- Shi-Yu Chen
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yue Gao
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jia-Yi Sun
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xian-Li Meng
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dong Yang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lin-Hong Fan
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Xiang
- Innovative Institute of Chinese Medicine and Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Wang
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Li Y, Zhang L, Lv S, Wang X, Zhang J, Tian X, Zhang Y, Chen B, Liu D, Yang J, Dong P, Xu Y, Song Y, Shi J, Li L, Wang X, Han Y. Efficacy and safety of oral Guanxinshutong capsules in patients with stable angina pectoris in China: a prospective, multicenter, double-blind, placebo-controlled, randomized clinical trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 19:363. [PMID: 31829173 PMCID: PMC6907120 DOI: 10.1186/s12906-019-2778-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/28/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND To assess the efficacy and safety of oral Guanxinshutong (GXST) capsules in Chinese patients with stable angina pectoris (SAP) in a prospective, multicenter, double-Blind, placebo-controlled, randomized clinical trial (clinicaltrials.gov Identifier: NCT02280850). METHODS Eligible patients were randomized 1:1 to the GXST or placebo group. Current standard antianginal treatment except for nitrate drugs was continued in both groups, who received an additional 4-week treatment of GXST capsule or placebo. Primary endpoint was the change from baseline in angina attack frequency after the 4-week treatment. Secondary endpoints included the reduction of nitroglycerin dose, score of Seatntle Agina Questionnaire, exercise tolerance test defined as time to onset of chest pain and ST-segment depression at least 1 mm greater than the resting one. RESULTS A total of 300 SAP patients from 12 centers in China were enrolled between January 2013 and October 2015, and they were randomly divided into the GXST group and the placebo group (150 patients in each group). Of whom, 287 patients completed the study (143 patients in the GXST group, 144 patients in the placebo group). The baseline characteristics of the two groups were comparable. After 4-week treatment with GXST capsules, the number of angina attacks and the consumption of short-acting nitrates were significantly reduced. In addition, the quality of life of patients were also substantially improved in the GXST group. No significant differences in the time of onset of angina and 1-mm ST segment depression were noted between the two groups. 7 patients (4.1%) in the GXST group and 3 patients (2.1%) in the placebo group reported at least one adverse event, respectively. CONCLUSIONS GXST capsules are beneficial for the treatment of SAP patients.
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Spatz ES, Wang Y, Beckman AL, Wu X, Lu Y, Du X, Li J, Xu X, Davidson PM, Masoudi FA, Spertus JA, Krumholz HM, Jiang L. Traditional Chinese Medicine for Acute Myocardial Infarction in Western Medicine Hospitals in China. Circ Cardiovasc Qual Outcomes 2019; 11:e004190. [PMID: 29848478 PMCID: PMC5882246 DOI: 10.1161/circoutcomes.117.004190] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 02/15/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Amid national efforts to improve the quality of care for people with cardiovascular disease in China, the use of traditional Chinese medicine (TCM) is increasing, yet little is known about its use in the early management of acute myocardial infarction (AMI). METHODS AND RESULTS We aimed to examine intravenous use of TCM within the first 24 hours of hospitalization (early IV TCM) for AMI. Data come from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction, restricted to a large, representative sample of Western medicine hospitals throughout China (n=162). We conducted a chart review of randomly sampled patients with AMI in 2001, 2006, and 2011, comparing early intravenous TCM use across years, predictors of any early intravenous TCM use, and association with in-hospital bleeding and mortality. From 2001 to 2011, early intravenous TCM use increased (2001: 38.2% versus 2006: 49.1% versus 2011: 56.1%; P<0.01). Nearly all (99%) hospitals used early intravenous TCM. Salvia miltiorrhiza was most commonly prescribed, used in one third (35.5%) of all patients admitted with AMI. Patients receiving any early intravenous TCM, compared with those who did not, were similar in age and sex and had fewer cardiovascular risk factors. In multivariable hierarchical models, admission to a secondary (versus tertiary) hospital was most strongly associated with early intravenous TCM use (odds ratio: 2.85; 95% confidence interval: 1.98-4.11). Hospital-level factors accounted for 55% of the variance (adjusted median odds ratio: 2.84). In exploratory analyses, there were no significant associations between early intravenous TCM and in-hospital bleeding or mortality. CONCLUSIONS Early intravenous TCM use for AMI in China is increasing despite the lack of evidence of their benefit or harm. There is an urgent need to define the effects of these medications because they have become a staple of treatment in the world's most populous country. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01624883.
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Affiliation(s)
- Erica S Spatz
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Yongfei Wang
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Adam L Beckman
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Xuekun Wu
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Yuan Lu
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Xue Du
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Jing Li
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Xiao Xu
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Patricia M Davidson
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Frederick A Masoudi
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - John A Spertus
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Harlan M Krumholz
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.)
| | - Lixin Jiang
- From the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, CT (E.S.S., Y.W., Y.L., X.X., H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (E.S.S., Y.W., H.M.K.), Department of Obstetrics and Gynecology and Reproductive Sciences (X.X.), Yale School of Medicine, New Haven, CT; Harvard Medical School, Boston, MA (A.L.B.); National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China (X.W., X.D., J.L., L.J.); Johns Hopkins School of Nursing, Baltimore, MD (P.M.D.); University of Colorado Anschutz Medical Campus and the Colorado Cardiovascular Outcomes Research Consortium, Denver (F.A.M.); Saint Luke's Mid America Heart Institute/University of Missouri - Kansas City (J.A.S.); and Department of Health Policy and Administration, Yale School of Public Health, New Haven, CT (H.M.K.).
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Huang J, Su Y, Yang C, Li S, Wu Y, Chen B, Lin X, Huang L, Yao H, Shi P. An integrated pharmacokinetic study of Dengzhanxixin injection in rats by combination of multicomponent pharmacokinetics and anti-myocardial ischemic assay. RSC Adv 2019; 9:25309-25317. [PMID: 35530075 PMCID: PMC9070076 DOI: 10.1039/c9ra03917a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/07/2019] [Indexed: 12/30/2022] Open
Abstract
This study aimed to investigate the integrated pharmacokinetics (PK) of Dengzhanxixin injection (EBI) in rats by combination of multicomponent PK and pharmacological assays. First, the protective effects of 13 main components (30 mg kg−1 per day, i.v. for 7 days) on isoprenaline-induced myocardial infarction (MI) in mice were evaluated by measuring electrocardiogram and serum creatine kinase (CK) activity, and observing cardiac pathological changes. Second, the quantitative analysis method of the main components in rat plasma was established and applied to pharmacokinetic study of EBI in rats (0.72 mL kg−1 and 3.2 mL kg−1 of 10 times concentrated EBI, single i.v.). Third, based on the multicomponent PK and anti-MI effects, PK markers were selected, and the integrated PK of EBI in rats were investigated using “plasma drug concentration sum method” and “AUC weighting integrated method”. In the in vivo anti-MI study, the ST segment elevation seldom occurred and the serum CK significantly decreased (P < 0.05 vs. model group); additionally tissue sections showed mild edema and inflammatory infiltration, and there was a little loss of striations in heart tissue in scutellarin, 3-caffeoylquinic acid (3-CQA), apigenin-7-O-glucuronide (A-7-O-G) and 4,5-dicaffeoylquinic acid (4,5-diCQA) treated groups, suggesting that scutellarin, 3-CQA, A-7-O-G and 4,5-diCQA were the main anti-MI effective substances. In the PK study, the systematic exposure level of scutellarin, erigoster B, 3,4-diCDOA (or 4,9-diCDOA), A-7-O-G, and 4,5-diCQA is relatively high. Considering the contents in EBI, anti-MI efficacy and PK properties of each component, scutellarin, 3-CQA, A-7-O-G, erigoster B, 3,4-diCDOA (or 4,9-diCDOA) and 4,5-diCQA were selected as pharmacokinetic markers to characterize the integrated pharmacokinetic behavior of EBI in vivo. The integrated pharmacokinetic study of EBI in rats could reveal the overall in vivo process and improve the safety and rationality of the clinical use of EBI. The integrated pharmacokinetic study of Dengzhanxixin injection in rats could reveal its overall in vivo process.![]()
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Li C, Xu T, Zhou P, Zhang J, Guan G, Zhang H, Ling X, Li W, Meng F, Liu G, Lv L, Yuan J, Li X, Zhu M. Post-marketing safety surveillance and re-evaluation of Xueshuantong injection. Altern Ther Health Med 2018; 18:277. [PMID: 30326892 PMCID: PMC6192149 DOI: 10.1186/s12906-018-2329-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/20/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Traditional Chinese medicine injections (TCMIs) have been widely used to treat severe and acute diseases due to their high bioavailability, accurate curative effect, and rapid effect. However, incidence rates of adverse drug reactions (ADRs) of TCMIs have also increased in recent years. Xueshuantong injection (XSTI) is a commonly-used TCMI comprised of Panax notoginseng total sapiens for the treatment of stroke hemiplegia, chest pain, and central retinal vein occlusion. Its safety remains uncelar. Therefore, post-marketing safety of XSTI was studied in this research. METHODS In present study, post-marketing safety surveillance and re-evaluation of XSTI were reported. Thirty thousand eight hundred eighty-four patients in 33 hospitals from 7 provinces participated in this study. Incidence rate, most common clinical manifestations, types, severity, occurrence time, and disposal of ADRs were calculated. RESULTS Incidence rate of ADR of XSTI was 4.14‰ and the most common clinical manifestations were skin and its appendages damage. Type A accounts for 95.49% of ADRs of XSTI and most of them (41.41%) were occurred within 24 h after receiving XSTI treatment. Severities of most ADRs of XSTI were moderate reactions (86.72%). Main disposition of ADRs of XSTI was drug withdrawal and symptomatic treatment (54.69%). CONCLUSIONS Our data provide basis for improvement of instructions of XSTI and clinical safety of XSTI. Post-marketing surveillance of TCMIs in this study is a powerful tool to identify types and manifestations of ADRs to improve safety and effectiveness of drugs in clinical applications. TRIAL REGISTRATION This protocol has international registration in China clinical trial registration center ( ChiCTR~OPC~ 14,005,718 ) at December 22, 2014.
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12
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Zhang Y, Wang J, Wang C, Li Z, Liu X, Zhang J, Lu J, Wang D. Pharmacological Basis for the Use of Evodiamine in Alzheimer's Disease: Antioxidation and Antiapoptosis. Int J Mol Sci 2018; 19:ijms19051527. [PMID: 29883380 PMCID: PMC5983845 DOI: 10.3390/ijms19051527] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 01/25/2023] Open
Abstract
Evodiamine (Evo), a major alkaloid compound isolated from the dry unripened fruit of Evodia fructus, has a wide range of pharmacological activities. The present study sought to explore the neuroprotective effects of Evo in l-glutamate (l-Glu)-induced apoptosis of HT22 cells, and in a d-galactose and aluminum trichloride-developed Alzheimer’s disease (AD) mouse model. Evo significantly enhanced cell viability, inhibited the accumulation of reactive oxygen species, ameliorated mitochondrial function, increased the B-cell lymphoma-2 protein content, and inhibited the high expression levels of Bax, Bad, and cleaved-caspase-3 and -8 in l-Glu-induced HT22 cells. Evo also enhanced the phosphorylation activities of protein kinase B and the mammalian target of rapamycin in the l-Glu-induced HT22 cells. In the AD mouse model, Evo reduced the aimless and chaotic movements, reduced the time spent in the central area in the open field test, and decreased the escape latency time in the Morris water maze test. Evo reduced the deposition of amyloid beta 42 (Aβ42) in the brain, and increased the serum level of Aβ42, but showed no significant effects on Aβ40. In addition, six weeks of Evo administration significantly suppressed oxidative stress by modulating the related enzyme levels. In the central cholinergic system of AD mice, Evo significantly increased the serum levels of acetylcholine and choline acetyltransferase and decreased the level of acetylcholinesterase in the serum, hypothalamus, and brain. Our results provide experimental evidence that Evo can serve as a neuroprotective candidate for the prevention and/or treatment of neurodegenerative diseases.
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Affiliation(s)
- Yongfeng Zhang
- School of Life Sciences, Jilin University, Changchun 130012, China.
| | - Jiaqi Wang
- School of Life Sciences, Jilin University, Changchun 130012, China.
| | - Chunyue Wang
- School of Life Sciences, Jilin University, Changchun 130012, China.
| | - Zhiping Li
- Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun 130006, China.
| | - Xin Liu
- School of Life Sciences, Jilin University, Changchun 130012, China.
| | - Jun Zhang
- Changchun Shengjinnuo Biological Pharmaceutical Co., Ltd., Changchun 130000, China.
| | - Jiahui Lu
- School of Life Sciences, Jilin University, Changchun 130012, China.
| | - Di Wang
- School of Life Sciences, Jilin University, Changchun 130012, China.
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13
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Wang ZY, Liu JG, Li H, Yang HM. Pharmacological Effects of Active Components of Chinese Herbal Medicine in the Treatment of Alzheimer's Disease: A Review. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2016; 44:1525-1541. [PMID: 27848250 DOI: 10.1142/s0192415x16500853] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD), the most common neurodegenerative disorder associated with dementia, not only severely decreases the quality of life for its victims, but also brings a heavy economic burden to the family and society. Unfortunately, few chemical drugs designed for clinical applications have reached the expected preventive or therapeutic effect so far, and combined with their significant side-effects, there is therefore an urgent need for new strategies to be developed for AD treatment. Traditional Chinese Medicine has accumulated many experiences in the treatment of dementia during thousands of years of practice; modern pharmacological studies have confirmed the therapeutic effects of many active components derived from Chinese herbal medicines (CHM). Ginsenoside Rg1, extracted from Radix Ginseng, exerts a [Formula: see text]-secretase inhibitor effect so as to decrease A[Formula: see text] aggregation. It can also inhibit the apoptosis of neuron cells. Tanshinone IIA, extracted from Radix Salviae miltiorrhizae, and baicalin, extracted from Radix Scutellariae[Formula: see text] can inhibit the oxidative stress injury in neuronal cells. Icariin, extracted from Epimedium brevicornum, can decrease A[Formula: see text] levels and the hyperphosphorylation of tau protein, and can also inhibit oxidative stress and apoptosis. Huperzine A, extracted from Huperzia serrata, exerts a cholinesterase inhibitor effect. Evodiamine, extracted from Fructus Evodiae, and curcumin, extracted from Rhizoma Curcumae Longae, exert anti-inflammatory actions. Curcumin can act on A[Formula: see text] and tau too. Due to the advantages of multi-target effects and fewer side effects, Chinese medicine is more appropriate for long-term use. In this present review, the pharmacological effects of commonly used active components derived from Chinese herbal medicines in the treatment of AD are discussed.
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Affiliation(s)
- Zhi-Yong Wang
- * Geriatric Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, P.R. China.,† Graduate School, Beijing University of Chinese Medicine, Beijing, P.R. China
| | - Jian-Gang Liu
- * Geriatric Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, P.R. China
| | - Hao Li
- * Geriatric Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, P.R. China
| | - Hui-Ming Yang
- ‡ Geriatric Department, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, P.R. China
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Wang PQ, Li DD, Dong W, Liu J, Yu YN, Shen CT, Chen QG, Chen BW, Chen YD, Wang Z. Danhong injection in the treatment of chronic stable angina: study protocol for a randomized controlled trial. Trials 2015; 16:474. [PMID: 26489511 PMCID: PMC4618746 DOI: 10.1186/s13063-015-0998-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 10/05/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Chronic stable angina is a leading cause of death worldwide. Danhong injection, a complementary alternative medicine for chronic stable angina, has been demonstrated to be effective in numerous studies and is widely prescribed to patients. However, the methodological quality of most prior studies was found to be, in general, low. Therefore, we designed this randomized controlled trial to evaluate the efficacy and safety of using Danhong injection to treat chronic stable angina. METHODS/DESIGN This is a randomized multicentre, double-blind, placebo-controlled, adaptive clinical trial. A total of 870 patients meeting the eligibility criteria will be randomly assigned into either the Danhong injection or the placebo group in a 2:1 ratio. Participants will then undergo a 2-week treatment regimen and a 76-day follow-up period. Because this is an adaptive trial, two interim analyses are prospectively planned. These will be performed after one-third and two-thirds of the patients, respectively, have completed the trial. Based on the results of these interim analyses, a data monitoring committee will determine how to modify aspects of the study without undermining the validity and integrity of the trial. The primary outcome measure is the proportion of patients who show a clinically significant change, which is defined as at least a 20-point improvement in angina frequency score on the Seattle Angina Questionnaire, which will be administered on day 30. Other secondary efficacy and safety outcomes will also be assessed. DISCUSSION This trial will provide high-quality evidence regarding the use of Danhong injection to treat chronic stable angina. TRIAL REGISTRATION ClinicalTrials.gov: NCT01681316 .
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Affiliation(s)
- Peng Qian Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen nei, Beijing, 100700, China.
| | - Dan Dan Li
- Department of Cardiology, PLA General Hospital, Beijing, 100853, China.
| | - Wei Dong
- Department of Cardiology, PLA General Hospital, Beijing, 100853, China.
| | - Jun Liu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen nei, Beijing, 100700, China.
| | - Ya Nan Yu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen nei, Beijing, 100700, China.
| | - Chun Ti Shen
- Changzhou Traditional Chinese Medicine Hospital, Heping North Road, Changzhou, 213004, Jiangsu, China.
| | - Qi Guang Chen
- School of Public Health, Southeast University, Dijia Qiao 87, Nanjing, 210009, Jiangsu, China.
| | - Bing Wei Chen
- School of Public Health, Southeast University, Dijia Qiao 87, Nanjing, 210009, Jiangsu, China.
| | - Yun Dai Chen
- Department of Cardiology, PLA General Hospital, Beijing, 100853, China.
| | - Zhong Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, No. 16 Nanxiaojie, Dongzhimen nei, Beijing, 100700, China.
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15
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Luo J, Song W, Yang G, Xu H, Chen K. Compound Danshen (Salvia miltiorrhiza) Dripping Pill for Coronary Heart Disease: An Overview of Systematic Reviews. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2015; 43:25-43. [PMID: 25582415 DOI: 10.1142/s0192415x15500020] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Compound Danshen dripping pill (CDDP) is commonly used to treat coronary heart disease (CHD) in China. However, clinical practice has not been informed by evidence from relevant systematic reviews (SRs). This overview aims at summarizing evidence from SRs on CDDP for the treatment of CHD. We included SRs of randomized controlled trials (RCTs) on CDDP in treating CHD until March 2014 by searching the Cochrane Library, PubMed, EMBASE and four Chinese databases. Data were extracted according to a pre-designed form. We assessed the quality of SRs according to AMSTAR and graded the quality of evidence in the included SRs using the GRADE approach. All data analyses were descriptive. About 13 SRs involving a total of 34,071 participants with angina or acute myocardial infarction (AMI) were included. Few SRs assessed endpoints (5/13, 38.5%) and quality of life (QOL) (4/13, 30.8%). Most of the SRs suggested that CDDP had potential benefits for patients with CHD, such as improving symptoms and electrocardiogram (ECG) results, with few adverse reactions, while benefits in endpoints were unproved. Moreover, the overall quality of evidence in the SRs was poor, ranging from "very low" to "moderate", and most of the included SRs were of "low" (3/13, 23.1%) or "moderate" (9/13, 69.2%) quality with many serious flaws. Current SRs suggested potential benefits of CDDP for the treatment of CHD. However, high-quality evidence is warranted to support the application of CDDP in treating CHD.
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Affiliation(s)
- Jing Luo
- Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Weijiang Song
- Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Guoyan Yang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Hao Xu
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
| | - Keji Chen
- Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China
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