1
|
Jiang Q, Dong C, He Z, Wang Y, Jiang R, Liao W, Yang S. Research landscape and pharmacological mechanisms of traditional Chinese medicines in treating and preventing urolithiasis: Unearthing an anti-urolithic treasure trove. JOURNAL OF ETHNOPHARMACOLOGY 2024; 334:118502. [PMID: 38950794 DOI: 10.1016/j.jep.2024.118502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/13/2024] [Accepted: 06/25/2024] [Indexed: 07/03/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Urolithiasis represents a predominant concern within urology due to its high recurrence rate and consequential surgical complications. Traditional Chinese Medicine (TCM), with a history spanning over 2000 years in treating kidney diseases, not only offers a less invasive and cost-effective option for treating and preventing urolithiasis, but also serves as a pharmacological treasure trove for the development of anti-urolithic drugs. AIM OF THE STUDY With the continuous deepening of research on the anti-urolithic effects of Chinese medicines, the pharmacological mechanisms of TCMs against urolithiasis are continuously evolving. Therefore, it is essential to summarize the current research status, clinical effectiveness, and mechanisms of TCM in treating and preventing urolithiasis, to ascertain its potential in anti-urolithic treatments, and to provide a reference for future anti-urolithiasis drug research. METHODS The electronic databases such as PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) have been utilized to retrieve relevant literature spanning from 2000 to September 2023, using keywords "Traditional Chinese Medicine" and "Urolithiasis". Then we conducted a visual analysis of the current status of related research, as well as a systematic organization of the therapeutic effects and underlying mechanisms of anti-urolithic TCMs. RESULTS Through the organization of research models, therapeutic effects, and active ingredients of 31 potential anti-urolithic TCMs, we have systematically summarized the underlying mechanisms of TCMs in management of urolithiasis. Mechanistically, Chinese herbs facilitate stone expulsion by enhancing diuresis, instigating anti-spasmodic effects, and promoting ureteral peristalsis when addressing calculi. They also harbor the potential to dissolve pre-existing stones. In terms of stone recurrence prevention, TCM compounds obstruct stone formation through targeting the sequence of crystal adhesion, nucleation, growth, and aggregation to inhibit stone formation. Additionally, TCM's significant roles include stifling oxidative stress, augmenting urinary stone inhibitors, and harmonizing oxalate metabolism, all of which are critical actions in stone prevention. CONCLUSION The anti-urolithic mechanism of TCM is multifaceted. Investigating the anti-urolithiasis mechanisms of TCM not only illuminates the potential of Chinese medicine in treating and preventing urolithiasis, but also uncovers active molecules and targets for drug treatment against calculus formation.
Collapse
Affiliation(s)
- Qinhong Jiang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Caitao Dong
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Ziqi He
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Yunhan Wang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Rong Jiang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China
| | - Wenbiao Liao
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China.
| | - Sixing Yang
- Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, People's Republic of China.
| |
Collapse
|
2
|
Shen JD, Chen SJ, Chen HY, Chiu KY, Chen YH, Chen WC. Review of Animal Models to Study Urinary Bladder Function. BIOLOGY 2021; 10:biology10121316. [PMID: 34943231 PMCID: PMC8698391 DOI: 10.3390/biology10121316] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 12/24/2022]
Abstract
Simple Summary The treatment of urinary bladder dysfunction requires the knowledge of bladder function, which involves physiology, pathology, and even psychology. Several animal models are available to study a variety of bladder disorders. These models include animals from rodents, such as mice and rats, to nonhuman primates, such as rabbits, felines, canines, pigs, and mini pigs. This review adapted animal models to study bladder function according to facility, priority, and disease. Abstract The urinary bladder (UB) serves as a storage and elimination organ for urine. UB dysfunction can cause multiple symptoms of failure to store urine or empty the bladder, e.g., incontinence, frequent urination, and urinary retention. Treatment of these symptoms requires knowledge on bladder function, which involves physiology, pathology, and even psychology. There is no ideal animal model for the study of UB function to understand and treat associated disorders, as the complexity in humans differs from that of other species. However, several animal models are available to study a variety of other bladder disorders. Such models include animals from rodents to nonhuman primates, such as mice, rats, rabbits, felines, canines, pigs, and mini pigs. For incontinence, vaginal distention might mimic birth trauma and can be measured based on leak point pressure. Using peripheral and central models, inflammation, bladder outlet obstruction, and genetic models facilitated the study of overactive bladder. However, the larger the animal model, the more difficult the study is, due to the associated animal ethics issues, laboratory facility, and budget. This review aims at facilitating adapted animal models to study bladder function according to facility, priority, and disease.
Collapse
Affiliation(s)
- Jing-Dung Shen
- Division of Urology, Department of Surgery, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
- National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
| | - Szu-Ju Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Kun-Yuan Chiu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-H.C.); (W.-C.C.)
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence: (Y.-H.C.); (W.-C.C.)
| |
Collapse
|
3
|
Chen SJ, Chiu KY, Chen HY, Lin WY, Chen YH, Chen WC. Animal Models for Studying Stone Disease. Diagnostics (Basel) 2020; 10:diagnostics10070490. [PMID: 32708380 PMCID: PMC7400259 DOI: 10.3390/diagnostics10070490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022] Open
Abstract
Animals have stone disease too. There are several animal models for the research of human stone disease. Rodents are the most frequently used for stone research, although they are not prone to forming crystals in the kidneys. Ethylene glycol (EG), sodium oxalate and l-hydroxyproline are common lithogenic agents. Dogs and pigs were also reported as a study animal for stone disease. However, the breeding costs and body size are too high. The most-used genetic study animal for stone disease was the mouse, but it was high-cost. Calcium oxalate (CaOx) crystals can also be light microscopically observed in the Malphigian tubules of Drosophila melanogaster, induced by adding EG to the food. Genetic studies of flies can be done by cross-breeding, and this has a lower cost than using mice. The fly model also has several advantages, including minimal breeding equipment, the fact that it is easier to reach larger numbers in a short time with flies, that crystals can be observed under microscopy, and that they allow genetic study. We suggest the fly will be an ideal animal model for stone research in the future.
Collapse
Affiliation(s)
- Szu-Ju Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407204, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Kun-Yuan Chiu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407204, Taiwan; (S.-J.C.); (K.-Y.C.)
| | - Huey-Yi Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
| | - Wei-Yong Lin
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
| | - Yung-Hsiang Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413305, Taiwan
- Correspondence: (Y.-H.C.); (W.-C.C.)
| | - Wen-Chi Chen
- Departments of Obstetrics and Gynecology, Medical Research, and Urology, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404333, Taiwan;
- Correspondence: (Y.-H.C.); (W.-C.C.)
| |
Collapse
|
4
|
Chen WC, Chou TY, Chen HY, Yang YR, Man KM, Tsai MY, Chen YH. Salvia miltiorrhiza Bunge (Danshen) for Treatment and Prevention of Urolithiasis: A Drosophila Animal Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:1408979. [PMID: 30800166 PMCID: PMC6360610 DOI: 10.1155/2019/1408979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/05/2018] [Accepted: 01/03/2019] [Indexed: 12/18/2022]
Abstract
Traditional Chinese medicine (TCM) has been prescribed for the treatment of stone disease for thousands of years. Salvia miltiorrhiza (Danshen) was previously shown to have potential for treatment of stone disease in animal and clinical studies. In this study, we further studied the antiurolithiasis effect of Danshen in a fly model. Wild-type male Drosophila melanogaster CS flies were used in this study, with 0.25% ethylene glycol (EG) as a lithogenic agent. 2% potassium citrate (K-citrate) was the positive control agent for prevention (all agents added at the start of experiment) and treatment (drugs added after 2-week addition of lithogenic agent) studies compared with 15, 30, and 60 μg/ml of Danshen extract. In the prevention study, both 2% K-citrate and Danshen (30 and 60 μg/ml) significantly inhibited EG-induced calcium oxalate (CaOx) crystal formation. In the treatment study, only 2% K-citrate and high-dose of Danshen (60 μg/ml) significantly inhibited EG-induced CaOx crystal formation. Survival analysis for EG with Danshen was compared with that for EG with K-citrate. The mean lifespan was significantly reduced by administration of EG, and the results in the Danshen group were similar to those in the control group. In conclusion, Danshen revealed both preventive and treatment effects on CaOx crystal formation in a fly model.
Collapse
Affiliation(s)
- Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Yang Chou
- Department of Chinese Medicine, Kaohsiung Municipal Gangshan Hospital, Kaohsiung, Taiwan
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - You-Rong Yang
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Kee-Ming Man
- Department of Medicinal Botanicals and Health Applications, Da Yeh University, Changhua, Taiwan
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| |
Collapse
|
5
|
Wu SY, Chen HY, Tsai KS, Chiang JH, Muo CH, Sung FC, Chen YH, Chen WC. Long-Term Therapy With Wu-Ling-San, a Popular Antilithic Chinese Herbal Formula, Did Not Prevent Subsequent Stone Surgery: A Nationwide Population-Based Cohort Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2016; 53:53/0/0046958016681148. [PMID: 27932514 PMCID: PMC5798738 DOI: 10.1177/0046958016681148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/16/2016] [Accepted: 10/22/2016] [Indexed: 12/17/2022]
Abstract
Traditional Chinese herbal medicine (CHM), which is widely used to treat pain and urolithiasis, is a promising therapy for urinary stone prevention. This study investigated the clinical efficacy of a popular CHM, Wu-Ling-San (WLS), in Taiwan for the prophylaxis of recurrent nephrolithiasis as assessed by surgical stone treatment via a nationwide population-based cohort study. The National Health Insurance Research Database, 2000–2010, which included one million patient records. All patients diagnosed with stone disease at the beginning of the study. The matched controls (4-fold the number of WLS patients) were stone patients who did not take WLS. Data analysis included the stone surgeries following the first treatment. We enrolled 11 900 patients with stone disease, and the incidence of stone patients in this database was 1.19%. The prevalence of comorbidities such as benign prostate hyperplasia, chronic kidney disease, diabetes mellitus, and urinary tract infection, but not hypertension, was significantly higher in WLS users. Several patients in both groups were prescribed potassium citrate. The stone treatment rate was significantly higher in WLS users (17.85%) than in the non-WLS users (14.47%). WLS users with an associated comorbidity had a higher treatment rate than the non-WLS users: 21.05% versus 16.70%, respectively. The surgery rate for upper urinary tract stones was higher in WLS users than in the non-WLS users (adjusted hazard ratio, 1.28; 95% confidence interval, 1.08-1.52; P < .05). The stone treatment rate (52.79%) was significantly higher in patients who used a very high amount of WLS (adjusted hazard ratio, 3.02; 95% confidence interval, 2.30-3.98). Stone patients using a high amount of WLS use had a high stone surgical rate. Long-term therapy with WLS did not have a preventive effect on stone surgical treatment. Long-term potassium citrate therapy as a preventive measure appeared to be underutilized in this study.
Collapse
Affiliation(s)
| | | | - Kao-Sung Tsai
- China Medical University, Taichung, Taiwan.,Hungkuang University, Taichung, Taiwan
| | | | | | | | - Yung-Hsiang Chen
- China Medical University, Taichung, Taiwan.,Asia University, Taichung, Taiwan
| | | |
Collapse
|