COX-2、PPARγ和NF-κB p65在溃疡性结肠炎组织中的表达及意义

Bidirectional effects of geniposide in liver injury: Preclinical evidence construction based on meta-analysis

ETHNOPHARMACOLOGICAL RELEVANCE

Gardenia jasminoides J.Ellis is widely used to treat liver diseases in traditional Chinese medicine. Geniposide, a major active constituent of Gardenia jasminoides J.Ellis, exerts therapeutic effects against liver injury, however, it also induces hepatotoxicity.

AIM OF THE STUDY

This meta-analysis was designed to determine the mechanisms of both the hepatoprotective and hepatotoxic effects of geniposide.

MATERIALS AND METHODS

The articles analysed in this meta-analysis were primarily obtained from five databases. The 10-item SYRCLE risk-of-bias tool was used to evaluate the quality of the included articles. STATA (version 15.1) was used to evaluate the total effect or toxicity sizes. In addition, three-dimensional (3D) dose/time-effect and mechanistic analyses were performed to assess the therapeutic and toxic effects of geniposide.

RESULTS

A total of 25 studies involving 479 animals were included. Meta-analysis revealed that geniposide not only significantly (P < 0.001) increased liver injury indices including ALT and AST levels but also improved liver function by decreasing the levels of ALT, AST and inflammatory factors in animal models of liver injury. The 3D dose/time-effect analysis revealed that geniposide administered at a dose of 20-150 mg/kg for 5-28 days effectively protected the liver without inducing toxicity. Mechanistically, geniposide exerts protective or toxic effects by regulating the TNF-α/NF-κB pathway to control oxidative stress and inflammatory responses.

CONCLUSION

Geniposide exhibits dual pharmacological activity in liver injury. It exerts potent hepatoprotective effects when administered at a dose of 20-150 mg/kg for 5-28 days.

Rapamycin for treatment of ulcerative colitis

AIM: To assess the effect of mammalian target of rapamycin (mTOR) pathway inhibitor rapamycin in the management of ulcerative colitis in terms of anti-inflammation and inhibition of malignant transformation.

METHODS: Fifty patients with ulcerative colitis were enrolled, including 35 treated with rapamycin for 10 d on the basis of oral mesalazine and 20 treated with placebo on the basis of oral mesalazin. Ulcer healing was observed by electron colonoscopy. The expression of nuclear factor-kB (NF-κB) and cyclooxygenase 2 (COX-2) in colonic mucosa and serum levels of proinflammatory factors tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-10 were determined. In addition, expression of tumor suppressor genes PTEN, PHLPP and Rb was detected.

RESULTS: In the experimental group, three patients discontinued the treatment, including one due to oral ulcer and two due to abdominal pain and exacerbation of bloody stool. Thus, a total of 32 patients completed the study. Compared to the control group, ulcer surface was significantly reduced, the expression of colonic NF-κB and COX-2 and serum IL-6 were significantly decreased (all P < 0.05), and IL-10 level was significantly increased (P < 0.01) in the treatment group. In addition, the expression of PTEN, PHLPP and Rb was significantly increased in the treatment group compared to the control group (all P < 0.01), although serum TNF-α level showed no statistically significant difference between the two groups.

CONCLUSION: Rapamycin plus mesalazine can relieve inflammation and prevent malignant transformation in ulcerative colitis possibly by inhibiting the Akt/mTOR pathway.