Effect of Toona microcarpa Harms leaf extract on the coagulation system

Coagulation Dysfunction in Patients with Liver Cirrhosis and Splenomegaly and Its Countermeasures: A Retrospective Study of 1522 Patients

Objective

Patients with cirrhosis and splenomegaly often have coagulation dysfunction which affects treatment and prognosis. This study explores the status, grading, and treatment strategies of coagulation dysfunction in patients with liver cirrhosis and splenomegaly.

Methods

A retrospective cohort study was conducted on the clinical data on consecutive patients with cirrhosis and splenomegaly treated at Hainan General Hospital, China, from January 2000 to December 2020. Starting research in January 2022.

Results

Among 1522 patients included into this study, 297 (19.5%) patients had normal results in all five coagulation tests (prothrombin time, prothrombin activity, activated partial thromboplastin time, thrombin time, and fibrinogen), and 1225 (80.5%) had coagulation dysfunction in at least one of these tests. There were significant differences (P < 0.05) in treatment efficacy on these patients for three of these five coagulation tests, with the exception of prothrombin activity and thrombin time. When coagulation dysfunction was classified into grades I, II, and III based on scores from the three significant coagulation tests, prothrombin time, activated partial thromboplastin time, and fibrinogen, significant differences in surgical outcomes were found among the three grades of coagulation dysfunction and between grades I and III (P < 0.05). The operative mortality rate in patients with grade III in treating liver cancer, portal hypersplenism, and/or splenomegaly was 6.5%. There was no significant difference between patients with grades I and II (P > 0.05).

Conclusions

Approximately, 80% of patients with liver cirrhosis and splenomegaly had coagulation dysfunction. Surgery is feasible for grade I and II patients. For grade III patients, nonsurgical treatment should be given first, and surgery should only be considered when the coagulation function returns to normal or near-normal levels after treatment. This trial is registered with MR-46-22-009299.

Effects of Alcoholic Extracts of Bangladeshi Mangrove Acanthus ilicifolius Linn. (Acanthaceae) Leaf and Stem on Atherogenic Model of Wistar Albino Rats

Acanthus ilicifolius Linn. (Acanthaceae) is a popular mangrove ethnomedicinal plant that cures several ailments, including asthma, diabetes, cancer, and many others. Our experiment was aimed at evaluating the anti-atherogenic effect of A. ilicifolius (leaf and stem) on a high-fat diet-induced atherogenic rat model. Atherosclerosis was developed in 12 weeks. Treatment with the standard drug (3 mg/kg b.w./day, p.o. of Simvastatin), separate doses of methanolic and ethanolic extracts of A. ilicifolius leaf (250 and 500 mg/kg b.w./day, p.o.), and stem (200 and 400 mg/kg b.w./day, p.o.) was subsequently conducted for additional 15 days. The anti-atherogenic effect was evaluated by estimating the change in body weight, systolic blood pressure, and lipid profile. Histopathology of aorta, liver, and kidney of atherogenic models was done for further evaluation. The antioxidant effect of different extracts was performed via DPPH (2,2-diphenyl-1-picrylhydrazyl) assay using ascorbic acid as standard. The anticoagulant effect was determined after 15 days of treatment with the same doses of the plant extracts and the standard Warfarin (2 mg/kg b.w./day, p.o.). When compared with atherogenic control, treatment with A. ilicifolius significantly reduced (p < 0.01) body weight, systolic blood pressure, and serum lipid levels while it elevated HDL (high-density lipoprotein) level in a dose-dependent manner. Moreover, bleeding and clotting time was significantly decreased (p < 0.01) under the treatment of plant extracts. The histopathological data showed considerable improvement in tissue morphology after treatment. Our study evidenced that the alcoholic extracts of A. ilicifolius leaf and stem have anti-atherogenic properties and may be recommended as a potential herbal remedy for preventing cardiovascular diseases.

Phytochemicals, Nutritional Value, Antioxidant, and Anticoagulant Activity of Lactuca sativa L. Leaves and Stems

The main ingredient in the daily salad dish is the leaves of Lactuca sativa, while the stems are usually discarded and not eaten. This study was conducted to compare the stems and leaves of two selected L. sativa varieties (L. sativa var. longifolia L. and L. sativa var. capitata L.) related to the preliminary phytochemical investigation, nutrient content, DPPH assay, and in vitro anticoagulant activity by determination of prothrombin time (PT) and activated partial thromboplastin time (aPTT). The findings revealed almost the same phytoconstituents in the leaves and stems of each variety, such as terpenoids, flavonoids, coumarins, and others. Exceptionally, tannins have only been detected in the leaves. Compared to the stems, the leaves of both varieties showed statistically significantly higher levels of raw protein and raw fat. For the DPPH assay, the leaves of both varieties have a statistically significantly higher antioxidant activity than the stems. The leaves and stem extract of the two selected varieties showed a significant prolongation of PT (P <0.05 vs. NS= 12:30 s). On the other hand, the aPTT test showed a significant increase in aPTT (P <0.05 vs. NS = 32:44 s) in the stem extract of both varieties, whereas there was no statistically significant increase in aPTT in the leaves of both varieties. Both parts of each variety have a diversity of phytochemicals and nutrients. The leaves of both varieties have a higher antioxidant activity than the stems. While the stems had higher anticoagulant activity than the leaves.

Coagulatory active constituents of Malus pumila Mill. flowers

Background

The flowers of Malus pumila Mill (Rosaceae) is rich in resources, but lack of medicinal value research. Chemical constituents of the same family M. pumila have coagulatory activity. Considering the coagulatory activity could be beneficial for various cardiovascular diseases, the aim of this study is to evaluate coagulatory active constituents of M. pumila flowers.

Methods

Chemical constituents of M. pumila flowers were isolated by various column chromatographies, and their coagulatory activity were evaluated by activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB) in vitro.

Results

Nine compounds were isolated from M. pumila flowers, and identified as kaempferol-3-O-β-d-glucopyranoside (1), kaempferol-7-O-β-d-glucopyranoside (2), kaempferol-3-O-α-l-arabinofuranoside (3), phloridzin (4), kaempferol (5), phloretin (6), β-sitosterol (7), lupeol (8) and pyracanthoside (9). Compounds 1–9 were isolated from the flowers for the first time, compounds 1, 2 and 9 were isolated from the genus for the first time. Compound 2 could significantly shorten APTT, TT and PT, but significantly decrease the content of FIB. Compound 3 could shorten PT. Compound 4 could significantly shorten TT and PT, but significantly decrease the content of FIB. Compound 5 shortened APTT. Compound 6 and 7 could significantly shorten APTT and PT. Compound 9 was able to prolong TT and decrease the content of FIB, but shorten PT.

Conclusions

Compounds 2–7 possessed significant procoagulant activity in vitro, compound 9 had anticoagulant activity in vitro, which showed coagulation potential of compounds from M. pumila flowers, as a new source of bioactive molecules for therapeutic purposes.

Antithrombotic Effect and Mechanism of Radix Paeoniae Rubra

The compounds of Radix Paeoniae Rubra (RPR) were isolated and identified by bioassay-guided method, and antithrombotic effects and mechanism were investigated by the acute blood stasis rat model. The RPR extract was evaluated by APTT, TT, PT, and FIB assays in vitro. Results indicated that RPR extract exhibited the anticoagulant activity. In order to find active compounds, six compounds were isolated and identified, and four compounds, paeoniflorin (Pae), pentagalloylglucose (Pen), albiflorin (Ali), and protocatechuic acid (Pro), exhibited the anticoagulant activity in vitro. Therefore, the antithrombosis effects of RPR extract and four active compounds were investigated in vivo by measuring whole blood viscosity (WBV), plasma viscosity (PV), APTT, PT, TT, and FIB. Meanwhile, the levels of TXB₂, 6-Keto-PGF_1α, eNOS, and ET-1 were detected. Results suggested that RPR extract and four active compounds had the inhibition effect on thrombus formation, and the antithrombotic effects were associated with the regulation of vascular endothelium active substance, activating blood flow and anticoagulation effect.

Chemical constituents and coagulation activity of Agastache rugosa

Background

In the Chinese traditional medicine, plant of Agastache rugosa (Fisch. & C.A. Mey.) Kuntze (A. rugosa) has been used to treat nausea, vomiting and dispel damp. However, currently, few reports about the chemical constituents, especially the non-volatile components of A. rugosa are available.

Methods

Through separation with various column chromatographies to elucidate the chemical constituents of A. rugosa, the biological activities of the major constituents were investigated. The extracts and main constituents of A. rugosa were evaluated for their anticoagulant effects by assaying the activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen (FIB) in vitro.

Results

Seven known compounds (namely compounds 1–7) were isolated from the aerial parts of A. rugosa. They were identified as methyl hexadecanoate (1), β-sitosterol (2), acacetin (3), ursolic acid (4), apigenin (5), protocatechuic acid (6) and tilianin (7), respectively. Compounds 1 and 6 were isolated from the genus Agastache for the first time, and compound 4 was obtained from the plants for the first time. The results showed that the extract of A. rugosa had a significant procoagulant activity by shortening the time of PT (P < 0.001) and increasing FIB content (P < 0.001), as compared with Vitamin K₁. While its major constituents acacetin and tilianin exhibited significant anticoagulant activities by prolonging the times of PT, APTT, TT and reducing FIB content (P < 0.001), as compared with blank control group.

Conclusions

The total extract of A. rugosa possessed significant procoagulant activity, while its main components, acacetin and tilianin possessed significant anticoagulant activities. Further investigation should be pursued to find out the bioactivity components responsible for the procoagulant action of the plant.