A Classic Herbal Formula Danggui Beimu Kushen Wan for Chronic Prostatitis: From Traditional Knowledge to Scientific Exploration

Effects of Angelica Fritillaria Kushen Pill on Renal Function and Immune Function after Laparoscopic Radical Nephrectomy for Patients with Renal Carcinoma

Objective

To investigate the effect of Danggui Beimu Kushen Pills on renal cell carcinoma patients undergoing laparoscopic radical resection and their effects on renal function and immune function.

Methods

106 patients with renal cell carcinoma who underwent retroperitoneal laparoscopic radical surgery in our hospital from March 2015 to February 2017 were selected, and they were divided into control group and treatment group. The control group was treated with interferon and the treatment group was treated with Danggui Beimu Kushen pills on the basis of the control group. The clinical efficacy, incidence of adverse reactions, survival rate, and the relationship with clinical stages were detected in the two groups. The renal function index levels, immune function index levels, and quality of life levels were measured in the two groups after treatment.

Results

Compared with the control group, the total clinical effective rate was increased, the abnormal renal function, abnormal liver function, and platelet decline were decreased, and the survival rate was significantly elevated in the treatment group. The patients with clinical stage I∼II' survival rate was increased, relative to patients with clinical stage III. After treatment, the levels of β2-MG, SCr, BUN, and CD8+ in the two groups were decreased, while the levels of CD3+, CD4+, and CD4+/CD8+ were increased. Moreover, the scores of physical function, social function, emotional function, role function, cognitive function, and total score of the two groups were improved. Compared with the control group, the treatment group changes were more obvious.

Conclusion

The Danggui Beimu Kushen Pill has significant clinical effects on the treatment of renal cancer, which can improve the clinical symptoms, enhance the immune function, restore the health renal function, improve the quality of life, prolong the survival time of patients, reduce the incidence of adverse reactions, and provide high safety.

Phytochemistry, pharmacodynamics, and pharmacokinetics of a classic Chinese herbal formula Danggui Beimu Kushen Wan: A review

Danggui Beimu Kushen Wan (DBKW) is a classic herbal formula for difficult urination and has been widely used for urinary-related disorders and cancers in current clinical practice. This study aimed to comprehensively review the phytochemistry, pharmacodynamics, and pharmacokinetics of DBKW in experimental studies. We searched 21 databases to identify experimental studies of DBKW. We also searched 11 databases to identify and summarize compounds from DBKW's ingredients. A total of 423 studies of DBKW were identified and 15 studies were included. For Angelicae Sinensis Radix (ASR) and Sophorae Flavescentis Radix (SFR), 2,425 and 2,843 studies were identified, and 42 and 33 studies were included, respectively. Eight compounds were found in the whole formula, 408 compounds from ASR, and 277 compounds from SFR. DBKW may have anticancer effects (inhibiting the growth of tumors, regulating cell proliferation, inducing tumor cell apoptosis, suppressing invasion and metastasis of cancer, enhancing the therapeutic effects of chemotherapy, and relieving toxicity of chemotherapy) and have benefits on chronic prostatitis (reducing inflammation, inhibiting oxidation, regulating sex hormone, and stimulating immune system). The pharmacokinetics of the seven primary compounds from DBKW were also summarized. DBKW contains multiple compounds that may act on more than one pathway of the conditions simultaneously.

Herb-target virtual screening and network pharmacology for prediction of molecular mechanism of Danggui Beimu Kushen Wan for prostate cancer

Prostate cancer (PCa) is a cancer that occurs in the prostate with high morbidity and mortality. Danggui Beimu Kushen Wan (DBKW) is a classic formula for patients with difficult urination including PCa. This study aimed to investigate the molecular mechanisms of DBKW for PCa. We obtained DBKW compounds from our previous reviews. We identified potential targets for PCa from literature search, currently approved drugs and Open Targets database and filtered them by protein-protein interaction network analysis. We selected 26 targets to predict three cancer-related pathways. A total of 621 compounds were screened via molecular docking using PyRx and AutoDock Vina against 21 targets for PCa, producing 13041 docking results. The binding patterns and positions showed that a relatively small number of tight-binding compounds from DBKW were predicted to interact strongly and selectively with three targets. The top five high-binding-affinity compounds were selected to generate a network, indicating that compounds from all three herbs had high binding affinity against the 21 targets and may have potential biological activities with the targets. DBKW contains multi-targeting agents that could act on more than one pathway of PCa simultaneously. Further studies could focus on validating the computational results via experimental studies.

The effectiveness of Hedyotis diffusa Willd extract in a mouse model of experimental autoimmune prostatitis

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a frustrating and often debilitating disease. Current studies have shown that Traditional Chinese Medicine (TCM) can improve patients' quality of life and alleviate CP/CPPS symptoms. In this study, the efficacy of Hedyotis diffusa Willd aqueous extraction in experimental autoimmune prostatitis (EAP) mice models was revealed. The C57BL/6 mice were randomly assigned to three groups. Except for the control group, all other groups were subcutaneously injected with 0.2 ml emulsion of T2 peptide, on day 0 and day 14, for inducing EAP models. After the EAP modelling, oral saline was given to the model group, while the H. diffusa group was treated with aqueous extract of H. diffusa Willd. Micturition habits and withdrawal response frequencies were measured. Haematoxylin and eosin staining and immunohistochemistry were used to investigate inflammatory cell infiltration and TNF-α in the prostate tissue respectively. TNF-α levels in the serum were evaluated by ELISA. The H. diffusa Willd aqueous extraction considerably reduced the urine spots number and increased the pain threshold in H. diffusa group. H. diffusa group showed significantly reduced inflammatory lesion and inflammatory cell infiltration than the model group. The levels of TNF-α in H. diffusa group were considerably reduced.

Phytochemical evaluation of Cucumis prophetarum: protective effects against carrageenan-induced prostatitis in rats

Phytochemical study of the MeOH extract of Cucumis prophetarum fruits (family Cucurbitaceae) by using different chromatographic techniques led to the isolation of three metabolites; spinasterol (1), cucurbitacin B (2), and 2-O-β-D-glucopyranosylcucurbitacin E (3). Their chemical structures were created on the basis of physical, chemical, spectroscopic data 1D (¹H and ¹³C NMR), and 2D NMR (HSQC and HMBC), as well as similarity with literature data. Cucurbitacin B (Cu-B) (2) was found to be the major constituent. Potential protective activities of MeOH extract, CHCl₃, and EtOAc fractions and Cu-B were evaluated against carrageenan-induced prostatic inflammation in rats. Acute toxicity was assessed by evaluating LD₅₀. Pretreatment with CHCl₃ fraction and Cu-B ameliorated the rise in the prostate index and obviously protected against histopathological changes. Further, MeOH, extract, CHCl₃, and EtOAc fractions as well as Cu-B significantly protected against oxidative stress in prostatic tissues. The anti-inflammatory activities of the extract, fractions and Cu-B were confirmed by ameliorating the rise in prostatic content of the inflammatory mediators TNF-α, IL-1β, COX-2, and iNOS induced by carrageenan. In addition, the rise in the chemotactic factors were myeloperoxidase (MPO), F4-80, and monocyte chemoattractant protein-1 (MCP-1) was significantly hampered. In conclusion, three known compounds (1-3) were isolated from Cucumis prophetarum fruits. Cu-B (2) was the major identified compound. Particularly, CHCl₃ fraction and isolated Cu-B exhibited potent anti-inflammatory activity against carrageenan-induced prostatitis. The anti-inflammatory activity can be attributed, at least partly, to inhibition of neutrophil and macrophage infiltration into prostatic tissues.

Herbal formula (Danggui Beimu Kushen Wan) for prostate disorders: a systematic review of classical literature

Background

Danggui Beimu Kushen Wan (DBKW) was initially known for difficult urination in pregnancy and has been widely used for prostate disorders in modern days. This study aimed to comprehensively investigate the implications of DBKW in traditional evidence.

Methods

The Encyclopedia of Traditional Chinese Medicine was searched to identify the ingredients, dosage, etiologies, pathogeneses, actions and indications related to DBKW documented in ancient books. Descriptive summary was provided to their characteristics.

Results

A total of 41 texts in 36 classic books were included. Two etiologies and 10 pathogeneses were investigated. All the identified formulas contain Angelicae Sinensis Radix, Fritillariae Thunbergii Bulbus and Sophorae Flavescentis Radix with the ratio of 1:1:1. The treatment dosage is three to 10 pills each time. The primary indication of DBKW is difficult urination with heat stagnation. Nine included texts specified that this formula could also be used for male.

Conclusion

Included classic literature has provided fundamental evidence for the management of difficult urination in female and male. Further studies should investigate its mechanisms of actions for difficult urination related conditions, such as prostate disorders.

Fritillariae Thunbergii Bulbus: Traditional Uses, Phytochemistry, Pharmacodynamics, Pharmacokinetics and Toxicity

Fritillariae Thunbergii Bulbus (FTB) has been widely used as an antitussive herb for thousands of years in China. However, FTB's traditional uses, chemical compounds and pharmacological activities have not been systematically reviewed. This study aimed to review its traditional uses, phytochemistry, pharmacodynamics, pharmacokinetics and toxicity. We searched the Encyclopedia of Traditional Chinese Medicine to explore the historical records which indicate that it acts to clear heat, resolve phlegm, relieve cough, remove toxicity and disperse abscesses and nodules. We searched 11 databases to identify potential phytochemical or pharmacological studies. Characteristics of its chemical constituents, pharmacological effects, pharmacokinetic and toxicity were descriptively summarized. A total of 9706 studies were identified and 83 of them were included. As a result, 134 chemical constituents were identified, including 26 alkaloids, 29 compounds found in essential oils, 13 diterpenoids, two carbohydrates, two sterols, 18 amino acids, six nucleosides, four nucleobases, four fatty acids, three lignans, and 27 elements. Thirteen pharmacological effects of FTB were identified, including anti-cancer, tracheobronchial relaxation, antitussive, expectorant, anti-muscarinic, anti-inflammation, anti-thyroid, regulation of blood rheology, antiulcer, anti-diarrhea, pain suppression, antioxidation and neuroprotection. These pharmacological activities may be mainly attributed to the alkaloids in FTB. Further phytochemical, pharmacological and network pharmacological studies are recommended.