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Liu T, Qin M, Xiong X, Lai X, Gao Y. Multi-omics approaches for deciphering the complexity of traditional Chinese medicine syndromes in stroke: A systematic review. Front Pharmacol 2022; 13:980650. [PMID: 36147315 PMCID: PMC9489218 DOI: 10.3389/fphar.2022.980650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Deciphering the biological basis of traditional Chinese medicine (TCM) syndromes in complex diseases is challenging. Rapid advances in multi-omics approaches provide new opportunities to unveil the biological basis of TCM syndromes. We intend to summarize the latest significant progress and highlight the crucial value of applying multi-omics approaches to reveal TCM syndromes of stroke in a new horizon. Methods: We systematically searched PubMed, EMBASE, Web of Science Core Collection (WOSCC), Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang database and China Biology Medicine Database (SinoMed) for relevant studies from their inception to 31 March 2022, and conducted a comprehensive systematic review (PROSPERO registration number: CRD42021285922). Results: A total of 43 relevant studies were included in the final systematic review, genomics, transcriptomics, proteomics, and metabolomics were all involved. Some gene polymorphisms, differential lncRNAs, mRNAs, miRNAs, proteins, and metabolites may be associated with TCM syndromes of stroke. In addition, some studies conducted a preliminary exploration on the different diseases with the same TCM syndrome. The results showed that thioredoxin-dependent peroxidase reductase may be the specific marker protein of Liver-yang transforming into wind syndrome, and the network formed by mir-146b-5p, -199a-5p, and 23 targeted mRNAs may be the biomarker of Blood-stasis syndrome. Conclusion: Multi-omics technologies have served as powerful tools to investigate the complexity of TCM syndromes and may hold the promise of promoting the modernization of TCM as well as personalized medicine of TCM in stroke.
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Affiliation(s)
- Tingting Liu
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Mingzhen Qin
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xuejiao Xiong
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xinxing Lai
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditional Chinese Medicine, Beijing, China
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ZHOU Z, WAN C, ZHAO Y, LIU X, GAO Y, AN H, LI L, ZHANG H, YU X, ZHANG X, WANG H, SHI Q, WEI C, CHEN J, HUANG W, CHEN J, GAO Y, HU M, CAI Y. Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial. J TRADIT CHIN MED 2022; 42:604-610. [PMID: 35848977 PMCID: PMC9924680 DOI: 10.19852/j.cnki.jtcm.20220617.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm (CHEP) formula and tonifying Qi and activating blood circulation (TQABC) formula in patients with acute ischemic stroke (AIS) within a 72 h time window. METHODS In this randomized, multicenter, double-blinded, placebo-controlled trial, 500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+ TQABC group or control group. In addition to guideline-based standard medical care, participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days, while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively. The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization. The secondary outcome measures will include the scores on the modified Rankin Scale, Barthel Index, Patient-Reported Outcomes, TCM symptom pattern (Zheng-hou) evaluation Scale, and the incidence of in-hospital complications. Safety assessment will include the physical examination, laboratory detection, any adverse events or serious adverse events, and the proportion of any complications during hospitalization. DISCUSSION The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on "integrating disease and symptom pattern" for patients with AIS.
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Affiliation(s)
- Ziyi ZHOU
- 1 Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
- 2 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Can WAN
- 2 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Yuanqi ZHAO
- 2 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Xiangzhe LIU
- 3 Department of Neurology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China
| | | | - Hongwei AN
- 5 Department of Neurology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou 545001, China
| | - Lejun LI
- 6 Department of Neurology, Wuxi Traditional Chinese Medicine Hospital, Wuxi 214071, China
| | - Huili ZHANG
- 7 Department of Neurology, Qinhuangdao City Hospital of Traditional Chinese Medicine, Qinhuangdao 066000, China
| | - Xiaofei YU
- 8 Department of Neurology, Shanghai Shuguang Hospital, Shanghai 200120, China
| | - Xinchun ZHANG
- 2 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - Huijuan WANG
- 9 Department of Neurology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Qing SHI
- 10 Department of Neurology, Jiangmen Wuyi Hospital of Traditional Chinese Medicine, Jiangmen 529000, China
| | - Chunhua WEI
- 11 Department of Neurology, Nanshi Hospital Affiliated to Henan University, Nanyang 473065, China
| | - Jie CHEN
- 12 Department of Neurology, Shanxi Province Hospital of Traditional Chinese Medicine, Xi'an 710003, China
| | - Wenguo HUANG
- 13 Department of Neurology, Maoming Hospital of Traditional Chinese Medicine, Maoming 525000, China
| | - Junbin CHEN
- 14 Department of Neurology, the Northern Guangdong People's Hospital, Shaoguan 512025, China
| | - Ying GAO
- 4 Department of Neurology, Shenyang Second Hospital of Traditional Chinese Medicine, Shenyang 110100, China
- 15 Department of Neurology and Stroke Center, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing 100700, China
| | - Mingzhe HU
- Dr. HU Mingzhe, Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, China. , Telephone: +86-20-81887233
| | - Yefeng CAI
- 2 The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
- Prof. CAI Yefeng, Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, China.
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Xing Y, Pi M, Zhang R, Wen T. Study on the TCM Syndromes Evolution and Chinese Herbal Characteristics of Type 2 Diabetes Patients with Different Courses of Disease in TCM "Heat Stage": A Real-World Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:1282957. [PMID: 34221067 PMCID: PMC8225421 DOI: 10.1155/2021/1282957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/21/2021] [Accepted: 06/03/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this study is to analyze and summarize the syndrome distribution, syndrome evolution, and Chinese herb medicine characteristics of T2D in heat stage. METHOD In this study, 228 heat-stage T2D patients were divided into three groups based on the course of disease. Group 1 (the course of disease ≤5 years) included 118 patients. Group 2 (5< the course of disease ≤10 years) had 73 patients. Group 3 (the course of disease >10 years) consisted of 37 patients. The main methods used in our study were complex network community partitioning algorithms and Sankey diagram visualization, based on the clinical electronic medical record data we collected. RESULT In the three groups, the nodes with the highest node degree are all "heat syndrome." Edge weight between "heat" and "dampness," "qi stagnation," "phlegm," "liver," and "stomach" is the largest. During the whole course of treatment, 60.17%, 63.01%, and 62.16% of the patients' syndromes in groups 1, 2, and 3, respectively, were ascribed to the heat stage all the time. The patients' syndromes in groups 1 and 2 easily transformed to the syndrome of deficiency of both qi and yin of the spleen and stomach. In group 3, 27% of the patients' syndromes were easily transformed into kidney yin deficiency and qi deficiency and blood stasis syndrome. The largest Chinese herb communities of the patients whose syndromes did not change after treatment in the three groups were all heat-clearing drugs. The proportion of blood-activating drugs in patients with syndrome changes increased significantly after treatment. CONCLUSION (1) The basic syndrome of T2D patients in the heat stage is liver-stomach heat syndrome. (2) T2D patients in the heat stage tend to deteriorate towards the direction of qi and yin deficiency syndrome. However, the longer the course of the disease is, the more likely it is to deteriorate to the direction of kidney yin deficiency syndrome and blood stasis syndrome. (3) Drugs that can help T2D patients in the heat stage to maintain their condition stably are heat-clearing drugs represented by Coptis chinensis, which usually need to be combined with warming interior drugs such as Zingiberis Rhizoma and Pinelliae Rhizoma.
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Affiliation(s)
- Ying Xing
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Min Pi
- Shenzhen Traditional Chinese Medicine Hospital, Guangdong, China
| | - Runshun Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tiancai Wen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- Traditional Chinese Medicine Data Center, China Academy of Chinese Medical Sciences, Beijing, China
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Wu S, Chen P, Zou Y, Jiang L, Geng H, Yan R, Wang S, Zhu L. Clinical relevance of Chinese syndrome factors and thromboelastography levels in patients with phlegm-heat and fu-organ excess syndrome. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2019. [DOI: 10.1016/j.jtcms.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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M Tulantched DS, Min Z, Feng WX. Comparison of plasma PARK7 and NDKA diagnostic value in acute stroke. Future Sci OA 2019; 5:FSO375. [PMID: 31245039 PMCID: PMC6554690 DOI: 10.2144/fsoa-2018-0080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 02/03/2023] Open
Abstract
AIM In this prospective case-control study we aimed to compare diagnostic value of plasma PARK7 and NDKA in early diagnosis of acute stroke and evaluate the validated diagnostic values of PARK7 and NDKA in an independent patient cohort. We then assessed the quantitative relationship between the release of these markers: stroke severity and time. Blood samples were drawn upon hospital admission and 14 days later. PARK7 and NDKA concentrations were measured using an ELISA. RESULTS The expression of PARK7 (area under the curve [AUC] = 0.897) in acute stroke patients was more significant than in controls, relative to the NDKA expression (AUC = 0.462); p < 0.05. Their expressions were not related to the clinical characteristics of both groups; p > 0.05. CONCLUSION Even though both markers cannot differentiate stroke etiologies (ischemic or hemorrhagic), plasma PARK7 has better diagnostic value than NDKA for early diagnosis of stroke. 72 plasma samples obtained from acute stroke patients and 78 plasma samples collected from non-stroke patients were analyzed in this study.
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Affiliation(s)
| | - Zhao Min
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, PR China
| | - Wang-Xiao Feng
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, PR China
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Comparison of plasma PARK7 and NDKA diagnostic value in acute stroke. Future Sci OA 2019. [DOI: 10.4155/fsoa-2018-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mingina T, Zhao M. Role of PARK7 and NDKA in stroke management: a review of PARK7 and NDKA as stroke biomarkers. Biomark Med 2018; 12:419-425. [PMID: 29697269 DOI: 10.2217/bmm-2018-0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIM Biomarkers are molecules measured in plasma, serum or other body fluids to characterize a disease. PARK7 and NDKA roles in the management of stroke are still on study. Therefore, their potentials need to be developed in totality. The aim of this review is to demonstrate that PARK7 and NDKA could present more clinical important information as biomarkers for management of stroke disease. Main contents: Four main aspects of PARK7 and NDKA are exploited in this review. First, their diagnostic value is discussed in order to demonstrate their possible role as stroke diagnosis markers. Second, this article will exploit the correlation of both markers with time, by showing their dynamic changes in serum and plasma. Third, it describes the observed relationship of their levels with NIH Stroke Scale. The last aspect visits the possibility of their implementation in stroke therapy. CONCLUSION This article explores recent findings and proposes the potential roles that PARK7 and NDKA play in the management of acute stroke disease.
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Affiliation(s)
- Tulantched Mingina
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 11004, PR China
| | - Min Zhao
- Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang 11004, PR China
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Liu TL, Liu MN, Xu XL, Liu WX, Shang PJ, Zhai XH, Xu H, Ding Y, Li YW, Wen AD. Differential gene expression profiles between two subtypes of ischemic stroke with blood stasis syndromes. Oncotarget 2017; 8:111608-111622. [PMID: 29340078 PMCID: PMC5762346 DOI: 10.18632/oncotarget.22877] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/17/2017] [Indexed: 12/16/2022] Open
Abstract
Ischemic stroke is a cerebrovascular thrombotic disease with high morbidity and mortality. Qi deficiency blood stasis (QDBS) and Yin deficiency blood stasis (YDBS) are the two major subtypes of ischemic stroke according to the theories of traditional Chinese medicine. This study was conducted to distinguish these two syndromes at transcriptomics level and explore the underlying mechanisms. Male rats were randomly divided into three groups: sham group, QDBS/MCAO group and YDBS/MCAO group. Morphological changes were assessed after 24 h of reperfusion. Microarray analysis with circulating mRNA was then performed to identify differential gene expression profile, gene ontology and pathway enrichment analyses were carried out to predict the gene function, gene co-expression and pathway networks were constructed to identify the hub biomarkers, which were further validated by western blotting and Tunel staining analysis. Three subsets of dysregulated genes were acquired, including 445 QDBS-specific genes, 490 YDBS-specific genes and 1676 blood stasis common genes. Our work reveals for the first time that T cell receptor, MAPK and apoptosis pathway were identified as the hub pathways based on the pathway networks, while Nfκb1, Egfr and Casp3 were recognized as the hub genes by co-expression networks. This research helps contribute to a clearer understanding of the pathological characteristics of ischemic stroke with QDBS and YDBS syndrome, the proposed biomarkers might provide insight into the accurate diagnose and proper treatment for ischemic stroke with blood stasis syndrome.
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Affiliation(s)
- Tian-Long Liu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Department of Pharmacy, 25th Hospital of PLA, Jiuquan, China
| | - Min-Na Liu
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,State Key Laboratory of Cancer Biology, Fourth Military Medical University, Xi'an, China
| | - Xin-Liang Xu
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China.,Department of Traumatic Surgery, Jining No.1 Peoples Hospital, Jining, China
| | - Wen-Xing Liu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Pei-Jin Shang
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao-Hu Zhai
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hang Xu
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yi Ding
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu-Wen Li
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Department of Pharmacy, The First Affiliated Hospital of SooChow University, Suzhou, China
| | - Ai-Dong Wen
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Wei D, Xie D, Li H, Chen Y, Qi D, Wang Y, Zhang Y, Chen K, Li C, Zhang Z. The positive effects of Xueshuan Xinmai tablets on brain functional connectivity in acute ischemic stroke: a placebo controlled randomized trial. Sci Rep 2017; 7:15244. [PMID: 29127417 PMCID: PMC5681502 DOI: 10.1038/s41598-017-15456-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/25/2017] [Indexed: 11/09/2022] Open
Abstract
Through a placebo controlled randomized study, the purpose of this report was to investigate the effects of Xueshuan Xinmai tablets (XXMT) on neurologic deficits, quality of life and brain functional connectivity in acute ischemic stroke patients and to explore the mechanism of action of XXMT. In total, 44 acute ischemic stroke patients were randomly divided to the XXMT treatment group (n = 22) or the placebo group (n = 22) in a 2-week trial. Before and after the treatment, the neurological assessment and functional magnetic resonance imaging examinations were carried out. Compared to the placebo group, the scores of the National Institutes of Health Stroke Scale (NIHSS) and Stroke-Specific Quality of Life Scale (SSQOL) significantly improved in the treatment group. In addition, XXMT-treated patients demonstrated significantly enhanced functional connectivity within the default mode, frontal-parietal, and motor control networks. Furthermore, the changed connectivity in the left precuneus was positively correlated to the improvement of NIHSS and SSQOL scores. The present study indicated that XXMT treatment significantly improved the neurologic deficit and quality of life of acute ischemic stroke patients and that the therapeutic effect may be based on the modulation of XXMT on the functional connectivity of brain networks.
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Affiliation(s)
- Dongfeng Wei
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Daojun Xie
- The First Affiliated Hospital of Anhui University of traditional Chinese Medicine, Hefei, 230031, P.R. China
| | - He Li
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Di Qi
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Yujiao Wang
- Graduate School of Anhui University of traditional Chinese Medicine, Hefei, 230038, P.R. China
| | - Yangjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China.,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China
| | - Kewei Chen
- BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China.,Banner Alzheimer's Institute, Phoenix, Arizona, 85006, USA
| | - Chuanfu Li
- The First Affiliated Hospital of Anhui University of traditional Chinese Medicine, Hefei, 230031, P.R. China.
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, P.R. China. .,BABRI Centre, Beijing Normal University, Beijing, 100875, P.R. China.
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