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Chen HT, Tung CH, Yu BH, Chen YC. Sixteen prescribed Chinese herbal medicines provide time-dependent cardiorenal and survival benefits in patients with overall and advanced diabetic kidney disease: a real-world study in Taiwan. Front Pharmacol 2024; 15:1297854. [PMID: 39239654 PMCID: PMC11374620 DOI: 10.3389/fphar.2024.1297854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 08/05/2024] [Indexed: 09/07/2024] Open
Abstract
Background A causal connection between oxidative stress and inflammation in diabetes, along with its associated renal and cardiovascular complications, has been established. Sixteen prescribed potentially renoprotective Chinese herbal medicines for diabetic kidney disease (PRCHMDKD), which are scientific Chinese medicine (botanical drug) and categorized into five classes (clearing heat, nourishing yin, dampness dispelling, tonifying qi, and harmonizing formulas), exhibit shared antioxidative properties and target multiple oxidative stress pathways. However, the time-response, cumulative effects, and safety (hyperkalemia risk) of these sixteen PRCHMDKD on cardiorenal and survival outcomes in patients with overall and advanced DKD remain unresolved. Methods This retrospective cohort study analyzed national health insurance claims data in 2000-2017. Four statistical methods, including Cox proportional hazards models, complementary restricted mean survival time (RMST), propensity score matching, and competing risk analysis for end-stage renal disease (ESRD), were employed to investigate this relationship. The study included 43,480 PRCHMDKD users and an equal number of matched nonusers within the overall DKD patient population. For advanced DKD patients, the cohort comprised 1,422 PRCHMDKD users and an equivalent number of matched nonusers. Results PRCHMDKD use in overall and advanced, respectively, DKD patients was associated with time-dependent reductions in adjusted hazard ratios for ESRD (0.66; 95% CI, 0.61-0.70 vs. 0.81; 0.65-0.99), all-cause mortality (0.48; 0.47-0.49 vs. 0.59; 0.50-0.70), and cardiovascular mortality (0.50; 0.48-0.53 vs. 0.61; 0.45-0.82). Significant differences in RMST were observed in overall and advanced, respectively, DKD patients, favoring PRCHMDKD use: 0.31 years (95% CI, 0.24-0.38) vs. 0.61 years (0.13-1.10) for ESRD, 2.71 years (2.60-2.82) vs. 1.50 years (1.03-1.98) for all-cause mortality, and 1.18 years (1.09-1.28) vs. 0.59 years (0.22-0.95) for cardiovascular mortality. Additionally, hyperkalemia risk did not increase. These findings remained consistent despite multiple sensitivity analyses. Notably, the cumulative effects of utilizing at least four or five classes and multiple botanical drugs from the sixteen PRCHMDKD provided enhanced renoprotection for patients with both overall and advanced DKD. This suggests that there is involvement of multiple targets within the oxidative stress pathways associated with DKD. Conclusion This real-world study suggests that using these sixteen PRCHMDKD provides time-dependent cardiorenal and survival benefits while ensuring safety for DKD patients.
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Affiliation(s)
- Hsiao-Tien Chen
- Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Chien-Hsueh Tung
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ben-Hui Yu
- Department of Radiation Oncology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yi-Chun Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Nephrology, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
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Si T, Huang L, Liang T, Huang P, Zhang H, Zhang M, Zhou X. Ruangan Lidan decoction inhibits the growth and metastasis of liver cancer by downregulating miR-9-5p and upregulating PDK4. Cancer Biol Ther 2023; 24:2246198. [PMID: 37773732 PMCID: PMC10543352 DOI: 10.1080/15384047.2023.2246198] [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] [Received: 02/06/2023] [Accepted: 08/04/2023] [Indexed: 10/01/2023] Open
Abstract
A growing number of studies have suggested that traditional Chinese medicine (TCM) plays an essential role in the development and occurrence of liver cancer. However, the function of Ruangan Lidan decoction (RLD) in liver cancer are not yet adequately identified and manifested, which attracted our attention. The key genes related to liver cancer and RLD and the upstream miRNAs of PDK4 were obtained based on bioinformatics analysis, followed by verification of the targeting relationship between miR-9-5p and PDK4. Next, Huh7 cells were treated with RLD to detect cell proliferation, colony formation, migration, invasion, and apoptosis by multiple assays with gain- and loss-of-function experiments. Moreover, subcutaneous transplanted tumor model and lung metastasis model of liver cancer in nude mice were established to further verify the functional role of RLD in liver cancer growth and metastasis via miR-9-5p/PDK4 axis. Bioinformatics analysis found that PDK4 and miR-9-5p were related to liver cancer, and PDK4 may be a downstream regulator of RLD. miR-9-5p could target and inhibit PDK4. In vitro cell experiments demonstrated that RLD suppressed liver cancer cell proliferation, invasion and migration, and promoted apoptosis by inhibiting miR-9-5p expression and promoting PDK4 expression. In vivo animal experiments further confirmed that RLD inhibited liver cancer growth and metastasis via upregulation of miR-9-5p-dependent PDK4. RLD downregulated miR-9-5p and upregulated PDK4 to inhibit the proliferation, migration, invasion, and induce apoptosis, thereby suppressing the growth and metastasis of liver cancer, highlighting a potential novel target for treatment of liver cancer.
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Affiliation(s)
- Tao Si
- Department of Oncology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Liyin Huang
- Graduate school, Guangxi University of Chinese Medicine, Nanning, China
| | - Ting Liang
- Graduate school, Guangxi University of Chinese Medicine, Nanning, China
| | - Ping Huang
- Department of Oncology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Hongyu Zhang
- Department of Clinical Laboratory, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Mingmin Zhang
- Department of Oncology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
| | - Xiaoling Zhou
- Department of Gastroenterology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China
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Wang KX, Chen YP, Lu AP, Du GH, Qin XM, Guan DG, Gao L. A metabolic data-driven systems pharmacology strategy for decoding and validating the mechanism of Compound Kushen Injection against HCC. JOURNAL OF ETHNOPHARMACOLOGY 2021; 274:114043. [PMID: 33753143 DOI: 10.1016/j.jep.2021.114043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/11/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Compound Kushen Injection (CKI) is a widely used TCM formula for treatment of carcinomatous pain and tumors of digestive system including hepatocellular carcinoma (HCC). However, the potential mechanisms of CKI for treatment of HCC have not been systematically and deeply studied. AIM OF STUDY A metabolic data-driven systems pharmacology approach was utilized to investigate the potential mechanisms of CKI for treatment of HCC. MATERIALS AND METHODS Based on phenotypic data generated by metabolomics and genotypic data of drug targets, a propagation model based on Dijkstra program was proposed to decode the effective network of key genotype-phenotype of CKI in treating HCC. The pivotal pathway was predicted by target propagation mode of our proposed model, and was validated in SMMC-7721 cells and diethylnitrosamine-induced rats. RESULTS Metabolomics results indicated that 12 differential metabolites, and 5 metabolic pathways might be involved in the anti-HCC effect of CKI. A total of 86 metabolic related genes that affected by CKI were obtained. The results calculated by propagation model showed that 6475 shortest distance chains might be involved in the anti-HCC effect of CKI. According to the results of propagation mode, EGFR was identified as the core target of CKI for the anti-HCC effect. Finally, EGFR and its related pathway EGFR-STAT3 signaling pathway were validated in vivo and in vitro. CONCLUSION The proposed method provides a methodological reference for explaining the underlying mechanism of TCM in treating HCC.
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Affiliation(s)
- Ke-Xin Wang
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China.
| | - Yu-Peng Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China.
| | - Ai-Ping Lu
- Institute of Integrated Bioinformedicine and Translational Science, Hong Kong Baptist University, Hong Kong, China.
| | - Guan-Hua Du
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China; Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Xue-Mei Qin
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China.
| | - Dao-Gang Guan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China; Guangdong Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, China.
| | - Li Gao
- Modern Research Center for Traditional Chinese Medicine, Shanxi University, Taiyuan, China.
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Drews T, Hummel T, Rochlitzer B, Hauswald B, Hähner A. Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss-a controlled prospective study. Eur Arch Otorhinolaryngol 2021; 279:1329-1334. [PMID: 34032906 PMCID: PMC8897321 DOI: 10.1007/s00405-021-06872-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/04/2021] [Indexed: 01/05/2023]
Abstract
Introduction Smell disorders are common in the general population and occur e.g., after infections, trauma or idiopathically Treatment strategies for smell loss range from surgery, medication to olfactory training, depending on the pathology, but they are limited This study examined the effect of acupuncture on olfactory function. Methods Sixty patients with smell loss following infections of the upper respiratory tract were included in this investigation Half of the study group were randomly assigned to verum acupuncture and the other half to sham acupuncture Olfaction was measured by means of the “Sniffin’ Sticks” test battery (odour threshold, discrimination and identification). Results Compared to sham acupuncture, verum was associated with an improvement of smell function as measured by the TDI score (p = 0.039) The improvement was largely determined by improvement in odour discrimination, and was significantly better in patients with a shorter duration of the disorder. Conclusion The present results suggest that acupuncture is an effective supplementary treatment option for patients with olfactory loss.
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Affiliation(s)
- Tanja Drews
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany. .,Department of Otorhinolaryngology, Bundeswehrkrankenhaus Berlin, Scharnhorststr 13, 10115, Berlin, Germany.
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Bettina Rochlitzer
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany.,Klinik Für Augenheilkunde, Städtisches Klinikum Görlitz, Girbigsdorfer Str 1-3, Görlitz, Germany
| | - Bettina Hauswald
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Antje Hähner
- Department of Otorhinolaryngology, Smell and Taste Clinic, Technische Universität Dresden, Technical University of Dresden Medical School, Fetscherstrasse 74, 01307, Dresden, Germany
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What Do Primary Healthcare Providers and Complementary and Alternative Medicine Practitioners in Palestine Need to Know about Exercise for Cancer Patients and Survivors: A Consensual Study Using the Delphi Technique. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7695818. [PMID: 31118968 PMCID: PMC6500610 DOI: 10.1155/2019/7695818] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/22/2019] [Accepted: 04/14/2019] [Indexed: 12/24/2022]
Abstract
Background Exercise has physiologic and psychological benefits for cancer patients and survivors. Today, various exercises are recommended as adjunct to therapies for cancer patients and survivors. This study was conducted to develop a consensual core list of important knowledge items that primary healthcare providers and complementary and alternative medicine (CAM) practitioners need to know on the role of exercises and physical activities in stimulating anticancer immunity. Methods Knowledge items were collected following interviews with key contact experts (4 oncologists, 3 exercise and medicine specialists, 2 researchers, 2 cancer patients, and 3 survivors) and extensive literature review. The collected knowledge items were rated by 9 researchers who conducted research on exercise and cancer. A modified two-iterative Delphi technique was employed among a panel (n = 65) of healthcare providers and CAM practitioners to develop the consensual core list of knowledge items. Results Of the 49 knowledge items, consensus was achieved on 45 (91.8%) items in 6 categories. Of those, 9 (20.0%) were general items on recommending moderate to vigorous habitual exercises and physical activities. The rest of items were related to the effects of habitual exercises and physical activities on the functions of immune system and exposure to carcinogens 16 (35.6%), anticancer therapies 12 (26.7%), metastasis of cancer 3 (6.7%), metabolism within tumors 3 (6.7%), and myokines release 2 (4.4%). Conclusion Formal consensus was achieved for the first time on a core list of knowledge items on how exercises and physical activities might stimulate anticancer immunity. This core list might be considered at the time of developing training/educational interventions and/or continuing education for primary healthcare providers and CAM practitioners. Future studies are still needed to investigate if such consensual lists might improve congruence in cancer care continuum and improve survival rates and wellbeing of cancer patients and survivors.
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