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Liao J, Qin C, Wang Z, Gao L, Zhang S, Feng Y, Liu J, Tao L. Effect of shenfu injection in patients with septic shock: A systemic review and meta-analysis for randomized clinical trials. JOURNAL OF ETHNOPHARMACOLOGY 2024; 320:117431. [PMID: 37981120 DOI: 10.1016/j.jep.2023.117431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/03/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Shenfu injection (SFI) is a well-known Chinese herbal medicine widely used in the treatment of septic shock in China. AIM OF THE STUDY To explore the clinical safety and effectiveness of combined application of Shenfu injection in the treatment of septic shock on the basis of routine western medical treatment. MATERIALS AND METHODS Randomized controlled trials published before February 28, 2022 in patients with septic shock were searched in the Chinese Biomedical Literature Service System (SinoMed), Embase, PubMed, Cochrane Library, WOS, Scopus. Stata 15.0 and R 4.2.2 were used to meta-analyze sequential organ failure assessment (SOFA) score, case fatality rate, mean arterial pressure (MAP), arterial lactate (Lac). Adverse effects were analyzed by description. RESULTS A total of 904 articles were searched and 56 RCTs were included, with a total of 4279 participants. Among them, there were 2148 cases in the SFI group and 2131 cases in the control group. The meta-analysis showed that, comparing with routine western medical therapy, the combined use of SFI could effectively reduce 24 h SOFA (MD = -0.79, 95%CI: (-1.12) - (-0.46)), 72 h SOFA (MD = -1.53, 95%CI: (-1.89) - (-1.17)) and 7 d SOFA (MD = -1.55; 95%CI: (-2.86) - (-0.24)). Besides, combined use of SFI could reduce 14 d case fatality rate (RR = 0.16, 95% CI: 0.07-0.37) and 28 d case fatality rate (RR = 0.82, 95% CI: 0.71-0.95). While SFI group showed almost the same effect in 7 d case fatality rate as control (RR: 0.76; 95% CI: 0.42-1.37; P = 0.37). SFI could increase 6 h MAP (MD = 6.40, 95% CI: 3.43-9.37) and 24 h MAP (MD = 4.79, 95% CI: 1.62-7.95). Additionally, SFI could decrease 6 h Lac (MD = -0.90, 95% CI: (-1.34) - (-0.45)), 24 h Lac (MD = -0.80, 95% CI: (-1.20) - (-0.40)), 48 h Lac (MD = -0.67, 95% CI: (-1.05) - (-0.29)). CONCLUSIONS Shenfu injection combined with RWT showed better therapeutic effect than RWT. SFI plus RWT can improve clinical prognosis of patients with septic shock.
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Affiliation(s)
- Jiaojiao Liao
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Zongyu Wang
- Department of Critical Care Medicine, Peking University Third Hospital, Beijing, 100191, PR China
| | - Ling Gao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Shimo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Yuting Feng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, PR China
| | - Liyuan Tao
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, 100191, PR China.
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Zhang MQ, Li CS. Therapeutic Effects of Shenfu Injection in Shock. Chin J Integr Med 2023; 29:1142-1146. [PMID: 37222829 DOI: 10.1007/s11655-023-3631-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 05/25/2023]
Abstract
Shock is the clinical manifestation of acute circulatory failure, which results in inadequate utilization of cellular oxygen. It is a common condition with high mortality rates in intensive care units. The intravenous administration of Shenfu Injection (SFI) may attenuate inflammation, regulate hemodynamics and oxygen metabolism; inhibit ischemia-reperfusion responses; and have adaptogenic and antiapoptotic effects. In this review, we have discussed the clinical applications and antishock pharmacological effects of SFI. Further in-depth and large-scale multicenter clinical studies are warranted to determine the therapeutic effects of SFI on shock.
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Affiliation(s)
- Ming-Qing Zhang
- Department of Emergency Medicine, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Chun-Sheng Li
- Department of Emergency Medicine, Critical Care Center, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China.
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Shi S, Wang F, Chen B, Pan J, Luo D, Pei C, Huang D, Wang X, Wang Y, Shen Z, Li W, Wu Y, He Y, Wang Z. Efficacy and Safety of Shenfu Injection for Severe Pneumonia in the Elderly: A Systematic Review and Meta-Analysis Based on Western and Eastern Medicine. Front Pharmacol 2022; 13:779942. [PMID: 36091817 PMCID: PMC9454296 DOI: 10.3389/fphar.2022.779942] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 06/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Although increasing clinical trials studying Shenfu injection (SFI) comprising panaxoside 0.8 mg/ml extracted from Panax ginseng C.A. Mey. and aconitine 0.1 mg/ml extracted from Aconitum carmichaeli Debeaux for elderly patients with severe pneumonia on biomarkers associated with COVID-19 progression are emerging, there is no evidence-based evaluation for the effect of SFI on elderly severe pneumonia. Objectives: To evaluate the effect of SFI on elderly patients with severe pneumonia providing hints for treating critical COVID-19, we conducted a systematic review and meta-analysis. Methods: Nine databases, namely, PubMed, EMBASE, Web of Science, Science Direct, Google Scholar, Wanfang, Chongqing VIP Database, CNKI, and SinoMed were used to search clinical trials reporting the effect of SFI as an adjuvant for elderly severe pneumonia on outcomes of interest. Primary outcomes were total effective rate, Acute Physiology and Chronic Health Evaluation (APACHE) II score, mortality, and safety. Secondary outcomes were predictors associated with COVID-19 progression. Duplicated or irrelevant articles with unavailable data were excluded. Cochrane Collaboration’s tool was used to evaluate the risk of bias by two reviewers independently. All data were analyzed by Rev Man 5.4. Continuous variables were shown as weighted mean difference (WMD) or standard mean difference (SMD) with 95% confidence intervals (95% CI), whereas dichotomous data were calculated as the risk ratio (RR) with 95% CI. Results: We included 20 studies with 1, 909 participants, and the pooled data showed that compared with standard control, SFI could improve the total effective rate (RR = 1.25, 95% CI = 1.14–1.37, and n = 689), APACHE II score (WMD = −2.95, 95% CI = −3.35, −2.56, and n = 809), and predictors associated with COVID-19 progression (brain natriuretic peptide, creatine kinase, stroke volume, cardiac output, left ventricular ejection fraction, cardiac index, sE-selectin, von Willebrand factor, activated partial thromboplastin time, platelet counts, D-Dimer, procalcitonin, and WBC count). SFI may reduce mortality (RR = 0.52, 95% CI = 0.37–0.73, and n = 429) and safety concerns (RR = 0.29, 95% CI = 0.17–0.51, and n = 150) for elderly severe pneumonia. Conclusion: SFI as an adjuvant may improve the total effective rate, APACHE II score, gas exchange, and predictors associated with COVID-19 progression, reducing mortality and safety concerns for elderly patients with severe pneumonia.
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Affiliation(s)
- Shihua Shi
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
- *Correspondence: Shihua Shi, ; Jie Pan, ; Zhenxing Wang,
| | - Fei Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bonan Chen
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jie Pan
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, United States
- *Correspondence: Shihua Shi, ; Jie Pan, ; Zhenxing Wang,
| | - Dan Luo
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Caixia Pei
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Demei Huang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaomin Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yilan Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zherui Shen
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Weihao Li
- Cardiology Division, West China Hospital, Sichuan University, Chengdu, China
| | - Yongcan Wu
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing, China
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Yacong He
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhenxing Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Shihua Shi, ; Jie Pan, ; Zhenxing Wang,
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Protective Effect of Shenfu Injection () on Vascular Endothelial Damage in a Porcine Model of Hemorrhagic Shock. Chin J Integr Med 2022; 28:794-801. [PMID: 35023060 DOI: 10.1007/s11655-021-2876-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the effects of Shenfu Injection (, SFI) on endothelial damage in a porcine model of hemorrhagic shock (HS). METHODS After being bled to a mean arterial pressure of 40±3 mm Hg and held for 60 min, 32 pigs were treated with a venous injection of either shed blood (transfusion group), shed blood and saline (saline group), shed blood and SFI (SFI group) or without resuscitation (sham group). Venous blood samples were collected and analyzed at baseline and 0, 1, 2, 4, and 6 h after HS. Tumor necrosis factor-α (TNF-α), serum interleuking (IL)-6, and IL-10 levels were measured by enzyme-linked immunosorbent assay (ELISA); expressions of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule 1 (ICAM -1), von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1) and Bcl-2, Bax, and caspase-3 proteins were determined by Western blot. RESULTS The serum level of TNF-α in the SFI group was significantly lower than in the other groups at 0, 1, and 2 h after HS, while the level of IL-6 was lower at 4 and 6 h compared with the saline group (P<0.01 or P<0.05). The concentration of serum IL-10 was significantly higher in the SFI group than in the other groups at 0, 1, 4, and 6 h after HS (P<0.01). Western blot and immunohistochemistry of vascular tissue showed that the expression of caspase-3 was downregulated, and that of Bcl-2 and Bax was upregulated in the SFI group compared to other groups (P<0.05). CONCLUSION SFI attenuated endothelial injury in the porcine model of HS by inhibiting cell apoptosis, suppressing the formation of proinflammatory cytokines, and reducing endothelial activation.
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Veena G, Challa SR, Palatheeya S, Prudhivi R, Kadari A. Granny Smith Apple Extract Lowers Inflammation and Improves Antioxidant Status in L-arginine-induced Exocrine Pancreatic Dysfunction in Rats. Turk J Pharm Sci 2021; 18:262-270. [PMID: 34157815 DOI: 10.4274/tjps.galenos.2020.92145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objectives Granny Smith is a cultivated hybrid variety of apple with a high antioxidant content relative to all other species of apple. Acute pancreatitis (AP) is an instantly emerging inflammatory condition with a high mortality rate. The preferred treatment is restricted to symptomatic relief and supportive care. The present study was undertaken to evaluate the favorable effects of Granny Smith apple extract (GSAE) as a prophylactic treatment for L-arginine-induced AP in rats. Materials and Methods Male Sprague Dawley rats were divided in to five groups (n=6): Normal control (saline), disease control (a single dose of L-arginine 2.5 g/kg I.P.), positive control (pelatonin 10 mg/kg I.P.), and GSAE I and II (200 mg/kg and 400 mg/kg, orally, respectively). All groups were treated for 7 days. At the end of the study, blood samples were collected from the retro-orbital plexus, serum separated, and subjected to estimation of biomarker enzymes such as amylase, lipase, antioxidant enzymes, etc. The animals were then sacrificed, and the pancreas was isolated and subjected to estimation of tissue biomarkers, DNA fragmentation assay, and histopathological studies. Results Serum levels of amylase and lipase were significantly (p<0.001) reduced in L-arginine-treated rats. Similar results were also observed with tissue inflammatory markers such as malondialdehyde, nitrate, etc. There was a dramatic increase (p<0.001) in the overall antioxidant enzyme levels when compared with disease control rats. Histopathological examination of pancreatic tissue showed an intact structural feature of acinar cells in the extract-treated group of rats, which was further in pact with the intact DNA found in the DNA fragmentation assay. Conclusion Thus, GSAE treatment was found to be beneficial in lowering the inflammatory conditions of AP by improving the overall antioxidant levels, and a further investigation into its exact molecular mechanism is needed.
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Affiliation(s)
- Gadicherla Veena
- Sri Indu Institute of Pharmacy, Department of Pharmacology, Telangana, India
| | - Siva Reddy Challa
- KVSR Siddhartha College of Pharmaceutical Sciences, Department of Pharmacology, Andhra Pradesh, India
| | - Sujatha Palatheeya
- Palamuru University College of Pharmaceutical Sciences, Department of Pharmacy, Telangana, India
| | - Ramakrishna Prudhivi
- Dayananda Sagar University, Dayananda Sagar College of Pharmaceutical Sciences, Department of Pharmacy Practice, Karnataka, India
| | - Anitha Kadari
- Sri Indu Institute of Pharmacy, Department of Pharmacology, Telangana, India
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Zhang X, Guo T, Zhang K, Guo W, An X, Gao P. Effect of shenfu injection on microcirculation in shock patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22872. [PMID: 33120828 PMCID: PMC7581111 DOI: 10.1097/md.0000000000022872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Shock is a major public health problem worldwide. At present, the morbidity and mortality of shock patients are relatively high. Vasomotor dysfunction is 1 of the key pathological aspects of shock. Shenfu injection has been widely used for the treatment of shock in China. Pharmacological studies have suggested that Shenfu injection can reduce peripheral circulation resistance and improve microcirculation. The purpose of this study is to evaluate the effect and safety of Shenfu injection on the microcirculation of patients with shock. METHODS This review summarizes and meta-analyzes randomized controlled trials of Shenfu injection for the treatment of shock.Searched the following electronic databases: PubMed, Cochrane Library, Embase, CNKI, VIP and Wanfang Data. The Cochrane risk assessment tool was used to evaluate the methodological quality of randomized controlled trials. All tests are analyzed according to the standards of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software and Grading of Recommendations Assessment, Development, and Evaluation pro GDT web solution are used for data synthesis and analysis. RESULTS This review focuses on the effects of Shenfu injection on the microcirculation of shock patients (blood lactic acid level, arteriovenous oxygen saturation, arteriovenous carbon dioxide partial pressure difference, sublingual microcirculation), 28-day mortality, 28-day ICU hospitalization and adverse reaction rate. CONCLUSION This review provides a clear basis for evaluating the impact of Shenfu injection on the microcirculation of shock patients, as well as the effectiveness and safety of the treatment.
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Affiliation(s)
| | | | | | | | - Xing An
- Department of Respiratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Ozbeyli D, Sen A, Cilingir Kaya OT, Ertas B, Aydemir S, Ozkan N, Yuksel M, Sener G. Myrtus communis leaf extract protects against cerulein-induced acute pancreatitis in rats. J Food Biochem 2019; 44:e13130. [PMID: 31851766 DOI: 10.1111/jfbc.13130] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 12/13/2022]
Abstract
In this study, the aim was to examine the potential protective effects of Myrtus communis subsp. communis leaf ethanol extract (MC) treatment against acute pancreatitis (AP) in rats. Thirty-two rats were grouped as the saline-pretreated control (C), MC-pretreated control (MC), saline-pretreated AP (AP), and MC-pretreated AP (MC + AP) groups. To induce AP, cerulein was administered (50 µg/kg) two times. The rats were given MC for 14 days before cerulein injection. Six hours after the final cerulein injection, the rats were sacrificed. Pancreatic damage was associated with an increase in the serum activity of lipase and amylase, the pancreatic activity of myeloperoxidase, and the pancreatic level of malondialdehyde, interleukin-1β, and interleukin-6. AP also led to a decrease in the pancreatic level of anti-inflammatory interleukin-10 and glutathione. Pretreatment with MC before the induction of AP significantly reduced the pancreatic damage observed during the histological examination as well as reversed the biochemical changes evoked by AP. PRACTICAL APPLICATIONS: Acute pancreatitis is characterized by high mortality (average about 5%; severe cases may reach about 30%). The current treatment for acute pancreatitis is mainly symptomatic. The introduction of herbal drugs may lead to the development of a new strategy in the treatment of this disease. This study revealed that MC reduced pancreatic injury by decreasing pro-inflammatory cytokines, increasing antioxidant capacity and anti-inflammatory cytokine, IL-10. To the authors' knowledge, this research is the first report showing that MC inhibits the development of AP. This observation suggests that MC may be useful in the prevention and the treatment of AP in clinical settings.
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Affiliation(s)
- Dilek Ozbeyli
- Department of Pathology Laboratory Techniques, Vocational School of Health Services, Marmara University, Istanbul, Turkey
| | - Ali Sen
- Department of Pharmacognosy, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | | | - Busra Ertas
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Sezgin Aydemir
- Department of Pathology Laboratory Techniques, Vocational School of Health Services, Marmara University, Istanbul, Turkey
| | - Naziye Ozkan
- Department of Pathology Laboratory Techniques, Vocational School of Health Services, Marmara University, Istanbul, Turkey
| | - Meral Yuksel
- Department of Medical Laboratory Techniques, Vocational School of Health Services, Marmara University, Istanbul, Turkey
| | - Goksel Sener
- Department of Pharmacology, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
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Wang X, He C, Cai Y, Sun D, Hu G, Zhou J. Shen fu injection for patients with septic shock: Protocol for an updated systematic review. Medicine (Baltimore) 2019; 98:e17004. [PMID: 31567937 PMCID: PMC6756633 DOI: 10.1097/md.0000000000017004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/08/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Septic shock is a serious disease with high morbidity, which will lead to organ dysfunction. Shen fu injection (SFI) has been widely used for septic shock as a treatment in China. Many clinical trials have been reported that it could assess the efficacy and safety of SFI to cure septic shock and accelerate resuscitation. Reassessing the efficacy and safety of SFI as a treatment of patients with septic shock is the objective of this updated systematic review. METHODS The following electronic databases major in English and Chinese will be conducted a systematic search until September 2018: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, and Wan-fang Database. Randomized controlled trials of SFI will be included. Review Manager 5.2 software will be used for assessment of risk of bias, data synthesis, and subgroup analysis. We will conduct the GRADE system to assess the quality of evidence, if possible. RESULTS This study will provide a rational synthesis of current evidences for SFI on septic shock. CONCLUSION We hope our research results will provide an objective and reliable evidence to patients, clinicians and healthcare policymakers who are concerning the treatment options of SFI in septic shock. REGISTRATION PROSPERO CRD42016049332.
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Affiliation(s)
- Xiaojun Wang
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
| | - Canfeng He
- Guangzhou University of Chinese Medicine
| | - Yinhe Cai
- Guangzhou University of Chinese Medicine
| | | | - Guangyun Hu
- The Second Hospital of Traditional Chinese Medicine in Guangdong, Guangzhou, China
| | - Jian Zhou
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine
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Dingsheng L, Long W, Zhicheng J, Leyi C. Effects of Shen-Fu injection on random skin flap survival in rats. J Appl Biomed 2017. [DOI: 10.1016/j.jab.2017.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Zhang R, Wen L, Shen Y, Shi N, Xing Z, Xia Q, Niu H, Huang W. One compound of saponins from Disocorea zingiberensis protected against experimental acute pancreatitis by preventing mitochondria-mediated necrosis. Sci Rep 2016; 6:35965. [PMID: 27779235 PMCID: PMC5078795 DOI: 10.1038/srep35965] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/06/2016] [Indexed: 02/05/2023] Open
Abstract
Acute pancreatitis (AP) is a painful inflammatory disorder of the exocrine pancreas, ranking as the most common gastrointestinal reasons for hospitalization with no specific therapy currently. Diosgenyl saponins extracted from natural products and diosgenin or its derivatives have been shown to exert anti-inflammatory effects in various diseases. However, the therapeutic effects of diosgenyl saponins from Dioscorea zingiberensis C. H. Wright in AP have not yet been determined. Five compounds were extracted and screened for taurocholate-induced necrosis in mouse pancreatic acinar cells. Particularly, 26-O-β-d-glucopyranosyl-3β, 22α, 26-trihydroxy-25(R)-furosta-5-en-3-O-[α-L-rhamnopyranosyl-(1 → 4)]-β-d-glucopyranoside (compound 1) exhibited the best protective effects with no toxicity observed. Next, we showed compound 1 concentration-dependently inhibited necrotic cell death pathway activation and 2.5 mM compound 1 also prevented the loss of mitochondrial membrane potential, adenosine triphosphate production, and reactive oxygen species generation in mouse pancreatic acinar cells. Finally, we showed compound 1 protected against three clinically representative murine models of AP and significantly improved pancreatitis-associated acute lung injury. These data provide in vitro and in vivo evidence that one compound of diosgenyl saponins can be potential treatment for AP. This study suggests natural saponins may serve as fruitful sources for exploring/identifying potential therapies for inflammatory diseases.
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Affiliation(s)
- Rui Zhang
- Laboratory of Ethnopharmacology, Regenerative Medicine Research Center, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | - Li Wen
- Department of Pediatric Gastroenterology, Children’s Hospital of Pittsburgh of UPMC and School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Shen
- Laboratory of Ethnopharmacology, Regenerative Medicine Research Center, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | - Na Shi
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhihua Xing
- Laboratory of Ethnopharmacology, Regenerative Medicine Research Center, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hai Niu
- Laboratory of Ethnopharmacology, Regenerative Medicine Research Center, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
- College of Mathematics, Sichuan University, Chengdu, Sichuan, China
| | - Wen Huang
- Laboratory of Ethnopharmacology, Regenerative Medicine Research Center, West China Hospital/West China Medical School, Sichuan University, Chengdu, China
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Zeren S, Bayhan Z, Koçak C, Koçak FE, Metineren MH, Savran B, Kocak H, Algin MC, Kahraman C, Kocak A, Cosgun S. Antioxidant Effect of Ukrain Versus N-Acetylcysteine Against Acute Biliary Pancreatitis in An Experimental Rat Model. J INVEST SURG 2016; 30:116-124. [PMID: 27690697 DOI: 10.1080/08941939.2016.1230247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose/Aim: Oxidative stress plays an important role in the pathogenesis of acute pancreatitis (AP). We compared the therapeutic effects of Ukrain (NSC 631570) and N-acetylcysteine (NAC) in rats with AP. MATERIALS AND METHODS Forty male Sprague Dawley rats were divided into four groups: controls; AP; AP with NAC; and AP with Ukrain. AP was induced via the ligation of the bile-pancreatic duct; drugs were administered intraperitoneally (i.p.) 30 min and 12 h after AP induction. Twenty-four hours after AP induction, animals were sacrificed and the pancreas was excised. Levels of malondialdehyde (MDA) and nitric oxide (NO), and activity levels of tumor necrosis factor (TNF)-α, and myeloperoxidase (MPO) were measured in tissue samples. Total oxidant status (TOS), total antioxidant status (TAS), and total bilirubin, as well as activity levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase and lipase were measured in serum samples. Pancreatic tissue histopathology was also evaluated. RESULTS Test drugs reduced levels of MDA, NO, TNF-α, total bilirubin, AST, ALT, TOS and MPO, amylase and lipase activities (P < 0.001), and increased TAS (P < 0.001). Rats treated with test drugs attenuated AP-induced morphologic changes and decreased pancreatic damage scores compared with the AP group (P < 0.05). Both test drugs attenuated pancreatic damage, but the therapeutic effect was more pronounced in rats that received Ukrain than in those receiving NAC. CONCLUSIONS These results suggest that treatment with Ukrain or NAC can reduce pancreatic damage via anti-inflammatory and antioxidant effects.
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Affiliation(s)
- Sezgin Zeren
- a Faculty of Medicine , Department of General Surgery , Dumlupinar University , Kutahya , Turkey
| | - Zulfu Bayhan
- a Faculty of Medicine , Department of General Surgery , Dumlupinar University , Kutahya , Turkey
| | - Cengiz Koçak
- b Faculty of Medicine , Department of Pathology , Dumlupinar University , Kutahya , Turkey
| | - Fatma Emel Koçak
- c Faculty of Medicine , Department of Medical Biochemistry , Dumlupinar University , Kutahya , Turkey
| | | | - Bircan Savran
- d Faculty of Medicine , Department of Pediatric Surgery , Dumlupinar University , Kutahya , Turkey
| | - Havva Kocak
- c Faculty of Medicine , Department of Medical Biochemistry , Dumlupinar University , Kutahya , Turkey
| | - Mustafa Cem Algin
- a Faculty of Medicine , Department of General Surgery , Dumlupinar University , Kutahya , Turkey
| | - Cuneyt Kahraman
- e Faculty of Medicine , Department of Internal Medicine , Dumlupinar University , Kutahya , Turkey
| | - Ahmet Kocak
- f Faculty of Medicine , Department of Histology and Embrology , Dumlupinar University , Kutahya , Turkey
| | - Suleyman Cosgun
- g Faculty of Medicine , Department of Gastroenterology and Hepatology , Dumlupinar University , Kutahya , Turkey
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Clinical Effect of Shenfu Injection in Patients with Septic Shock: A Meta-Analysis and Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015. [PMID: 26199638 PMCID: PMC4496657 DOI: 10.1155/2015/863149] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Purpose. To conduct a meta-analysis evaluating the efficacy of Shenfu injection for treating patients with septic shock when compared with conventional therapy. Methods. Eight databases including Pubmed, EMBASE, Cochrane Library, ISI Web of Science, CNKI, Wanfang, VIP, and CBM were searched up to October 2014. Randomized controlled trials assessing the efficacy of Shenfu injection were identified. Mean arterial pressure, heart rate, lactate, and mortality were included as outcome measurements.
Results. We analyzed data from 12 randomized controlled trials involving 904 participants. Compared with conventional therapy, Shenfu injection could further increase the mean arterial pressure at 1 hour (SMD 0.38; 95% CI, 0.01–0.74) and 6 hours (SMD 0.82; 95% CI, 0.03–1.61). Shenfu injection could further normalize heart rate at 6 hours (SMD −0.90; 95% CI, −1.47–0.33) and clear serum lactate at 6 hours (SMD −0.51; 95% CI, −0.70–0.32) and 24 hours (SMD, 0.52; 95% CI, −0.77–0.26). As the endpoint of mortality was not unified, it was not meta-analyzed. Conclusions. Based on the findings in present review, Shenfu injection is more effective than conventional therapy in increasing mean arterial pressure, normalizing heart rate, clearing serum lactate, and reducing mortality. These results should be confirmed in higher level clinical trials in the future.
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The protective effects of curcumin on experimental acute liver lesion induced by intestinal ischemia-reperfusion through inhibiting the pathway of NF-κB in a rat model. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2014; 2014:191624. [PMID: 25215173 PMCID: PMC4158106 DOI: 10.1155/2014/191624] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/29/2014] [Accepted: 08/01/2014] [Indexed: 02/05/2023]
Abstract
Objective. In this study, we investigated the protective effect and mechanism of curcumin on a rat model of intestinal ischemia/reperfusion (I/R), which induces an acute liver lesion. Methods. Curcumin was injected into rats in the curcumin groups through left femoral vein. The same volume of vehicle (0.9% normal saline) was injected into sham and I/R groups. Blood and liver tissue were gathered for serological and histopathological determination. Results. Intestinal I/R led to severe liver injury manifested as a significant increase in serum AST and ALT levels; all of those were reduced by treatment with curcumin. Simultaneously, the activity of SOD in liver decreased after intestinal I/R, which was increased by curcumin treatment. On the other hand, curcumin reduced MPO activity of liver tissue, as well as serum IL-6 and TNF-α levels observably. This is in parallel with the decreased level of liver intercellular cell adhesion molecule-1 (ICAM-1) and nuclear factor-κB (NF-κB) expression. Conclusion. Our findings suggest that curcumin treatment attenuates liver lesion induced by intestinal I/R, attributable to the antioxidative and anti-inflammatory effect via inhibition of the NF-κB pathway.
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