Effects of Chinese and Western Medicine on Patients with Dengue Fever

Tanreqing injection demonstrates anti-dengue activity through the regulation of the NF-κB-ICAM-1/VCAM-1 axis

BACKGROUND

Tanreqing injection (TRQ) has been employed in clinical practice as a treatment for dengue fever (DF). Nevertheless, the precise pharmacological mechanism underlying its efficacy remains elusive.

METHOD

Network pharmacology, molecular docking, transcriptome sequencing, and experimental evaluation were employed to analyze and study the inhibitory potential of TRQ against dengue virus (DENV).

RESULT

We found that TRQ inhibited the replication of DENV in human umbilical vein endothelial cells, Huh-7 cells, and Hep3B cells. In addition, TRQ prolonged the survival duration of AG129 mice infected with DF, decreased the viral load in serum and organs, and alleviated organ damage. Subsequently, ultra-high-performance liquid chromatography-tandem mass spectrometry analysis of TRQ was performed to identify 314 targets associated with 36 active compounds present in TRQ. Integration of multiple databases yielded 47 DF-related genes. Then, 15 hub targets of TRQ in DF were determined by calculating the network topology parameters (Degree). Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses revealed that these pathways were primarily enriched in the processes of cytokine activation and leukocyte cross-endothelial migration, with significant enrichment of cell adhesion molecules. Molecular docking revealed favorable binding affinity between TRQ's key active compounds and the predicted hub targets. Transcriptome sequencing results showed TRQ's ability to restore the expression of vascular cell adhesion molecule-1 (VCAM-1) post-DENV infection. Finally, TRQ was found to modulate the immune status by regulating the nuclear factor kappa-B (NF-κB)- intercellular cell adhesion molecule-1 (ICAM-1)/VCAM-1 axis, as well as reduce immune cell alterations, inflammatory factor secretion, vascular permeability, and bleeding tendencies induced by DENV infection.

CONCLUSION

Our research suggests that TRQ exerts therapeutic effects on DF by regulating the NF-κB-ICAM-1/VCAM-1 axis.

Identification of an effective fraction from Ampelopsis Radix with anti-dengue virus activities in vitro and in vivo

ETHNOPHARMACOLOGICAL RELEVANCE

Dengue virus (DENV) infection is a global public health issue without effective therapeutic interventions. Chinese medicine with heat-clearing and detoxifying properties has been frequently used in the treatment of viral infection. Ampelopsis Radix (AR) is a traditional Chinese medicine for clearing heat and detoxification that has been widely used in the prevention and treatment of infectious diseases. However, no studies on the effects of AR against viral infection have been reported, thus far.

AIM OF THE STUDY

To explore the anti-DENV activities of the fraction (AR-1) obtained from AR both in vitro and in vivo.

MATERIALS AND METHODS

The chemical composition of AR-1 was identified by liquid chromatography-tandem MS (LC‒MS/MS). The antiviral activities of AR-1 were studied in baby hamster kidney fibroblast BHK-21 cells, ICR suckling mice and induction of interferon α/β (IFN-α/β) and IFN-γ R^-/- (AG129) mice.

RESULTS

Based on LC‒MS/MS analysis, 60 compounds (including flavonoids, phenols, anthraquinones, alkaloids and other types) were tentatively characterized from AR-1. AR-1 inhibited the cytopathic effect, the production of progeny virus and the synthesis of viral RNA and proteins by blocking DENV-2 binding to BHK-21 cells. Moreover, AR-1 significantly attenuated weight loss, decreased clinical scores and prolonged the survival of DENV-infected ICR suckling mice. Critically, the viral load in blood, brain and kidney tissues and the pathological changes in brain were remarkably alleviated after AR-1 treatment. Further study on AG129 mice showed that AR-1 obviously improved the clinical manifestations and survival rate, reduced viremia, attenuated gastric distension and relieved the pathological lesions caused by DENV.

CONCLUSIONS

In summary, this is the first report that AR-1 exhibits anti-DENV effects both in vitro and in vivo, which suggests that AR-1 may be developed as a therapeutic candidate against DENV infection.

Molecular Mechanism of Dayuan Decoction in the Treatment of Fever Based on Network Pharmacology

Objective. To study the molecular targets and mechanisms of Dayuan Decoction in the treatment of fever. Methods. The traditional Chinese medicine system pharmacological database and analysis platform (TCMSP) was used to search for the main active components and action targets of Dayuan Decoction. The GeneCards database was used to retrieve fever-related gene targets. The common gene targets were obtained by selecting the intersection of the action targets of the main active components of Dayuan Decoction and the fever-related gene targets using a Wayne diagram. Cytoscape 3.7.2 software was used to construct the drug active component action target network diagram. The protein-protein interaction PPI network of coacting targets was constructed using the STRING database. David data were used for Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of common gene targets. Results. A total of 89 main active components and 832 acting gene targets of Dayuan Decoction were screened, of which 50 were common gene targets of Dayuan Decoction and fever, including apoptosis regulatory factor Bel (BCL2L1), interleukin 6 (IL-6), interleukin 10 (IL-10), and tumor necrosis protein 53 (TP53). A total of 47 GO and 59 KEGG enrichment entries were obtained using GO and KEGG enrichment analyses, involving the cancer pathway, hypoxia-inducible factor 1 (HIF-1) signaling pathway, and mitogen-activated protein kinase (MAPK) signaling pathway. Conclusion. Dayuan Decoction has multitarget regulation characteristics and a multifaceted role in the treatment of fever.

Current Situation and Influencing Factors of Traditional Chinese Medicine Nursing Clinic in Henan Province

Objective

To explore the current situation and influencing factors of traditional Chinese medicine (TCM) nursing clinic in Henan Province. A self-made questionnaire was made and entered into the questionnaire star. In August 2020, through "the snowball sampling method," the nursing branch of Henan Society of Traditional Chinese Medicine was used to calculate the sample size that would be further used for this study.

Results

Of the 370 medical institutions in 17 district-level cities in our province, 47 have set up TCM nursing clinics, accounting for 12.70%. From the perspective of regional distribution, there are 14 TCM nursing clinics in Zhengzhou, 8 in Luoyang, 6 in Kaifeng, 4 in Shangqiu, 3 in Jiyuan, and 3 in Zhoukou. The number of TCM nursing clinics in Jiaozuo City, Xinxiang City, Anyang City, Hebi City, Puyang City, Zhumadian City, and Nanyang City is relatively small, and there are no TCM nursing clinics in Pingdingshan City, Sanmenxia City, and Xinyang City. Among the 47 medical institutions offering TCM nursing clinics, there are 38 TCM hospitals, 5 integrated traditional Chinese and Western medicine hospitals, 3 Western medicine hospitals, and 1 ethnic medicine hospital. Among them, 31 medical institutions are tertiary care hospitals and 16 are secondary care hospitals. First-class and undetermined medical institutions do not set up TCM nursing clinics. (1) Management mode: among the 47 medical institutions, 26 medical institutions have separate nursing units, which are managed by the nursing department head nurse, and 13 medical institutions are managed by the director head nurse of the department. (2) Performance management: of the 47 medical institutions that set up TCM nursing clinics, 18 adopted independent accounting, 21 adopted secondary distribution of departmental performance, and 7 adopted average awards and other methods. (3) The process of seeing a doctor: there are three kinds of medical procedures: 124 medical institutions are treated by TCM nursing outpatients by hanging the consultation number of doctors in various departments. 210 medical institutions are treated by traditional Chinese medicine nursing outpatient nurses by hanging the consultation number of traditional Chinese medicine nursing outpatient doctors. Thirty-five medical institutions are retreated by hanging the number of nurses in the nursing clinic of TCM. (4) Allocation of human resources: in the survey of the total number of nurses in TCM nursing clinics in 74 medical institutions, the largest number of nurses was 46 in one of the TCM nursing clinics. In terms of personnel qualification requirements, 43 medical institutions put forward requirements for nurses' qualifications. Among them, 39 medical institutions have requirements for nurses' professional titles, 38 medical institutions have requirements for nurses working years, and 22 medical institutions have more specific requirements for nurses. For example, nurses are required to be the backbone of TCM nursing that includes specialist nurses, nurses who graduated from TCM colleges, and nurses who have obtained hospital assessment and certification. In terms of working years, 87.96% of medical institutions require nursing service of more than 5 years. The average number of TCM nursing technical projects offered by 47 medical institutions is about 10, a maximum of 34 and a minimum of 1. The commonly carried out TCM nursing techniques include scraping, auricular point pressing, cupping, moxibustion, and ear tip bloodletting, and among all of them, scraping technology is most important and 40 medical institutions offer this technology, followed by auricular point pressing technique, cupping, and moxibustion.

Conclusion

The construction of TCM nursing clinics in Henan Province has initially formed a scale, and all kinds of medical institutions at all levels should further strengthen the construction of TCM nursing clinics in all other provinces.

A comprehensive application: Molecular docking and network pharmacology for the prediction of bioactive constituents and elucidation of mechanisms of action in component-based Chinese medicine

Traditional Chinese medicine (TCM) has been used for more than 2000 years in China. TCM has received wide attention recently due to its unique charm. At the same time, its main obstacles have attracted wide attention, including vagueness of drug composition and treatment mechanism. With the development of virtual screening technology, more and more Chinese medicine compounds have been studied to discover the potential active components and mechanisms of action. Molecular docking is a computer technology based on structural design. Network pharmacology establishes powerful and comprehensive databases to understand the relationship between TCM and disease network. In this review, emergent uses and applications of two techniques and further superiorities of the two techniques when embarked to boil down into a tidy system were illustrated. A combination of the two provides a theoretical basis and technical support for the construction of modern TCM based on the compatibility of components and accelerates the realization of two basic elements as well, including the clearness of the pharmacodynamic substances and explanation of the effect of TCM.