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Zhao W, Zhang K, Dong WY, Tang HD, Sun JQ, Huang JY, Wan GL, Guan RR, Guo XT, Cheng PK, Tao R, Sun JW, Zhang Z, Zhu X. A pharynx-to-brain axis controls pharyngeal inflammation-induced anxiety. Proc Natl Acad Sci U S A 2024; 121:e2312136121. [PMID: 38446848 PMCID: PMC10945766 DOI: 10.1073/pnas.2312136121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/12/2024] [Indexed: 03/08/2024] Open
Abstract
Anxiety is a remarkably common condition among patients with pharyngitis, but the relationship between these disorders has received little research attention, and the underlying neural mechanisms remain unknown. Here, we show that the densely innervated pharynx transmits signals induced by pharyngeal inflammation to glossopharyngeal and vagal sensory neurons of the nodose/jugular/petrosal (NJP) superganglia in mice. Specifically, the NJP superganglia project to norepinephrinergic neurons in the nucleus of the solitary tract (NTSNE). These NTSNE neurons project to the ventral bed nucleus of the stria terminalis (vBNST) that induces anxiety-like behaviors in a murine model of pharyngeal inflammation. Inhibiting this pharynx→NJP→NTSNE→vBNST circuit can alleviate anxiety-like behaviors associated with pharyngeal inflammation. This study thus defines a pharynx-to-brain axis that mechanistically links pharyngeal inflammation and emotional response.
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Affiliation(s)
- Wan Zhao
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Ke Zhang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Wan-Ying Dong
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
| | - Hao-Di Tang
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
- Laboratory of Anesthesia and Critical Care Medicine Department of Anesthesia and Critical Care Laboratory, National-Local Joint Engineering Research Center of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Chengdu610041, People’s Republic of China
| | - Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Ji-Ye Huang
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
| | - Guang-Lun Wan
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Rui-Rui Guan
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Xiao-Tao Guo
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Ping-Kai Cheng
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
| | - Ran Tao
- Department of Vascular Surgery, The Second Hospital of Anhui Medical University, Hefei230601, People’s Republic of China
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230001, People’s Republic of China
| | - Zhi Zhang
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
- The Center for Advanced Interdisciplinary Science and Biomedicine, Institute of Health and Medicine, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
| | - Xia Zhu
- Department of Neurobiology and Biophysics, Hefei National Laboratory for Physical Sciences at the Microscale, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei230026, People’s Republic of China
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Lingxia Z, Hong W, Man G, Xinzhou W, Lili W, Zhimin W, Liping D, Erping X. Rabdosichuanin C inhibits productions of pro-inflammatory mediators regulated by NF-κB signaling in LPS-stimulated RAW264.7 cells. J Cell Biochem 2023; 124:1667-1684. [PMID: 37850620 DOI: 10.1002/jcb.30474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/14/2023] [Accepted: 08/26/2023] [Indexed: 10/19/2023]
Abstract
Chronic pharyngitis (CP) is an inflammatory disease of the pharyngeal mucosa and its lymphatic tissues that is difficult to treat clinically. However, research on the exact therapeutic agents and molecular mechanisms of CP is still unclear. In this study, we investigated Rabdosichuanin C (RC) to attenuate lipopolysaccharide (LPS)-induced inflammatory damage in RAW264.7 cells by a combination of targeted virtual screening and in vitro activity assay and further clarified its molecular mechanism of action centering on the IκB/nuclear factor kappa B (NF-κB) pathway. Molecular docking and pharmacophore simulation methods were used to screen compounds with IκB inhibitory effects. Expression of genes and proteins related to the IκB/NF-κB signaling pathway by RC in LPS-induced inflammatory injury model of RAW264.7 cells was detected by PCR, enzyme-linked immunosorbent assay, and Western blot. The docking of RC with IκB protein showed good binding energy, and pharmacophore simulations further confirmed the active effect of RC in inhibiting IκB protein. RC intervention in LPS-induced RAW264.7 cells significantly reduced the expression levels of inflammatory factors tumor necrosis factor-α, interleukins-6, iNOS, and CD-86 at the messenger RNA and protein levels, downregulated IκB, p65 protein phosphorylation levels, and significantly inhibited IκB/NF-κB signaling pathway activation. Virtual screening provided us with an effective method to rapidly identify compounds RC that target inhibit the action of IκB, and the activity results showed that RC inhibits NF-κB signaling pathway activation. It is suggested that RC may play a role in the treatment of CP by inhibiting the IκB/NF-κB signaling pathway.
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Affiliation(s)
- Zhang Lingxia
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wu Hong
- Laboratory of Cell Imaging, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Gong Man
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Xinzhou
- Laboratory of Cell Imaging, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Lili
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Zhimin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dai Liping
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xu Erping
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
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Ran F, Han X, Deng X, Wu Z, Huang H, Qiu M, Song J, Wei X, Zhang D, Wang Y, Fan S, Lin J, Han L. High or low temperature extraction, which is more conducive to Triphala against chronic pharyngitis? Biomed Pharmacother 2021; 140:111787. [PMID: 34091181 DOI: 10.1016/j.biopha.2021.111787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Explore the effects of high-temperature reflux extraction and low-temperature decompressing inner ebullition on Triphala's chemical composition and anti-chronic pharyngitis activity. METHODS The network pharmacology was used to analyze the material basis, targets and pathways of Triphala for chronic pharyngitis. HPLC were used to compare the fingerprint profile and content of components between the two extracts. The antioxidant and anti-chronic pharyngitis activities of the two extracts were compared by DPPH assay and ammonia induced chronic pharyngitis model in rats. RESULTS The network pharmacology results showed that the active ingredients of Triphala for chronic pharyngitis are epigallocatechin-3-gallate, (+)-catechin, epicatechin, epicatechin gallate, (+)-gallocatechin, quercetin, luteolin, leucodelphinidin and other flavonoids; phenolic acids such as gallic acid and ellagic acid; alkaloids such as ellipticine, cheilanthifoline; hydrolyzed tannins such as corilagin and chebulic acid. The high-temperature reflux extract and the low-temperature decompressing inner ebullition extract have extremely significant differences in the fingerprint profile. Among them, the content of gallic acid, ellagic acid, chebulic acid, catechin, epicatechin, corilagin, quercetin, and epicatechin gallate in the reflux extract is 1.1-5.3 times as much as decompressing inner ebullition extract. The free radical scavenging ability of reflux extract is significantly stronger than that of decompression extract (p < 0.01), and it has a repairing effect on pharyngeal mucosal damage (reducing keratinization or hyperplasia of mucosal epithelium, reducing inflammatory cell infiltration and bleeding), and reducing IL-1β (P<0.05), IL-6 (p<0.05), TNF-α overexpression ability is stronger than the decompressing inner ebullition extract. CONCLUSIONS gallic acid, ellagic acid, chebulic acid, catechin, epicatechin, corilagin and epicatechin gallate are the basic aglycones or oligomers of tannin. High temperature reflux extraction can significantly promote the occurrence of the hydrolysis of tannins and significantly increases the content of these components.Therefore, its anti-chronic pharyngitis activity is enhanced. It is suggested that high temperature reflux extraction should be used in the treatment of chronic pharyngitis.
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Affiliation(s)
- Fei Ran
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Xue Han
- School of Pharmacy, Chengdu Medical College, Chengdu 610500, China.
| | - Xuan Deng
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Zhenfeng Wu
- State key Laboratory of Innovation Medicine and High Efficiency and Energy Saving Pharmaceutical Equipment, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Haozhou Huang
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Ming Qiu
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Jiao Song
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Xichuan Wei
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Dingkung Zhang
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Yu Wang
- Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, China.
| | - Sanhu Fan
- Sanajon Pharmaceutical Group, Chengdu 610000, China.
| | - Junzhi Lin
- Central Laboratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China.
| | - Li Han
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Zhang Y, Yuan T, Li Y, Wu N, Dai X. Network Pharmacology Analysis of the Mechanisms of Compound Herba Sarcandrae (Fufang Zhongjiefeng) Aerosol in Chronic Pharyngitis Treatment. Drug Des Devel Ther 2021; 15:2783-2803. [PMID: 34234411 PMCID: PMC8254411 DOI: 10.2147/dddt.s304708] [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: 02/11/2021] [Accepted: 06/09/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose This study aimed to investigate the molecular mechanisms of compound herba Sarcandrae aerosol, also known as the Fufang Zhongjiefeng (FFZJF) aerosol, in treating chronic pharyngitis (CP) using network pharmacology and in vivo experimental approaches. Methods Active compounds and putative targets of five herbs in FFZJF were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, Chemistry Database, and Swiss Target Prediction databases. The therapeutic targets of CP were obtained from OMIM, Durgbank, DisGeNT, and GAD databases. The active compounds-target networks were constructed using Cytoscape 3.6.1. The overlapping targets of FFZJF active compounds and CP targets were further analyzed using the String database to construct protein–protein interaction (PPI) network. KEGG pathway and Gene Ontology enrichment analysis was performed using the Database for Annotation, Visualization, and Integrated Discovery. The predicted targets and pathways were validated in a group A β-hemolytic streptococcus-induced rat CP model. Results There were 45 active compounds identified from FFZJF and 11 potential protein targets identified for CP treatment. PPI network demonstrated that IL6, PTGS2, TLR-4, and TNF may serve as the key targets of FFZJF for the treatment of CP. The main functional pathways involving these key targets include cytokine secretion, inflammatory response, MyD88-dependent toll-like receptor signaling pathway, toll-like receptor signaling pathway, TNF signaling pathway, and NF-κB signaling pathway. In a rat CP model, the elevation of serum TNF-α, IL1β, and IL6 levels, as well as the upregulation of TLR-4, MyD88, NF-κB P65 in the pharyngeal mucosal tissues could be effectively reduced by FFZJF treatment in a dose-dependent manner. Conclusion Through a network pharmacology approach and animal study, we predicted and validated the active compounds of FFZJF and their potential targets for CP treatment. The results suggest that FFZJF can markedly alleviate GAS-induced chronic pharyngitis by modulating the TLR-4/MyD88/NF-κB signaling pathways.
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Affiliation(s)
- Yanping Zhang
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People's Republic of China
| | - Taohua Yuan
- Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Yunsong Li
- Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, People's Republic of China
| | - Ning Wu
- Guizhou Medical University, Guiyang, Guizhou, People's Republic of China
| | - Xiaotian Dai
- Department of Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada
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Xu M, Hu TY, Li DC, Ma L, Zhang H, Fan JT, Fan XM, Zeng XH, Qiu SQ, Liu ZQ, Cheng BH. Yan-Hou-Qing formula attenuates ammonia-induced acute pharyngitis in rats via inhibition of NF-κB and COX-2. BMC Complement Med Ther 2020; 20:280. [PMID: 32928206 PMCID: PMC7491126 DOI: 10.1186/s12906-020-03077-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Yan Hou Qing (YHQ) is a Chinese medicinal formula designed to alleviate sore throat symptoms, but underlying mechanism of YHQ treatment for pharyngitis is poorly defined up to now. METHODS In this study, the modulation of YHQ on pharyngitis is investigated in ammonia-induced acute pharyngitis rat models. After treatment with YHQ or dexamethasone respectively for five consecutive days, all rats were sacrificed for biomolecular and histopathologic study. Protein expressions of MAPKs, NF-κB, COX-2 and 5-LOX in pharyngitis tissue were evaluated by western blot analysis and the levels of TNF-α, IL-6, prostaglandin (PG) E2, leukotrienes (LT)-B4 and LT-D4 in pharyngeal tissue were measured via ELISA assay. Evans blue (EB) dye exudation test was performed parallelly to assess the integrity of pharyngeal tissue. RESULTS Compared with normal control group, EB dye exudation, and inflammatory cytokines in the model group were significantly increased, and the pharynx tissue was obviously infiltrated by inflammatory cells. YHQ treatment improved the inflammatory infiltrate in pharyngeal tissue, and reduced EB dye exudation in AP rat models. The up-regulated TNF-α and IL-6 in pharyngeal tissue of AP were significantly reduced by YHQ through inhibition of phosphorylation of p38, Erk and NF-κB. YHQ treatment also reversed the increased level of PGE2 through down-regulation of COX-2. CONCLUSIONS YHQ formula attenuated the pharyngitis related symptoms via suppression of COX-2 and phosphorylation of p38, Erk and NF-κB (p65).
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Affiliation(s)
- Min Xu
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China.,Zunyi Medical University, Zunyi, 563000, Guizhou, China.,Department of Otolaryngology, The third hospital of Mianyang, Mianyang, 621000, China
| | - Tian-Yong Hu
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Dong-Cai Li
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Li Ma
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Hua Zhang
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Jun-Ting Fan
- Department of Pharmaceutical Analysis, School of Pharmacy, Nanjing Medical University, Nanjing, 211166, China
| | - Xiao-Mei Fan
- Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, 518102, China
| | - Xian-Hai Zeng
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Shu-Qi Qiu
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Zhi-Qiang Liu
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China
| | - Bao-Hui Cheng
- Department of Otolaryngology, Longgang E.N.T hospital & Shenzhen Key Laboratory of E.N.T, Institute of E.N.T, 3004 Longgang Avenue, Shenzhen, 518172, China.
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Boarino V, Raguzzi I, Marocchi M, Merighi A. Symptomatic response to GERDOFF® in patients with gastro-esophageal reflux disease and poor response to alginates: an exploratory, post-market, open-label study. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:466-473. [PMID: 32721918 DOI: 10.5152/tjg.2020.19327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS A novel medical device based on hyaluronic acid, chondroitin sulphate plus aluminum hydroxide (GERDOFF®, melt-in-mouth tablets) showed efficacy in reducing GER-related symptoms. This exploratory, open-label study evaluated symptomatic effects of a 14-day treatment with GERDOFF® in GERD patients. MATERIALS AND METHODS GERD Impact Scale (GIS) questionnaire was filled at baseline visit, after 7 and 14 days of treatment; patients' Global Satisfaction was evaluated at the final visit. Primary endpoint was the reduction of heartburn episodes per week; secondary endpoints were GERD-related symptoms, patients' satisfaction, and safety. RESULTS Forty patients were included, 22 were on stable therapy with proton pump inhibitor (PPI). Compared to baseline, the days with heartburn episodes and the GIS score progressively decreased during the first (p<0.0001) and the second week of treatment (p<0.0001). Heartburn episodes per week (p<0.0001) and the GIS score (p<0.0001) decreased in the first and the last 7 days of 14-day treatment and did not differ between patients on and off PPI. The treatment was safe and well-tolerated, and it was rated as very good (46.2%) or good (43.6%) on the satisfaction questionnaire. CONCLUSION GERDOFF® could effectively treat GER symptoms in patients not responding to PPI or alginate-based formulation. ISRCTN_15143752.
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Affiliation(s)
- Valentina Boarino
- Department of Gastroenterology and Digestive Endoscopy, University of Modena, Modena, Italy
| | - Ivana Raguzzi
- Department of Gastroenterology and Digestive Endoscopy, Hospital of Cernusco sul Naviglio, Milan, Italy
| | - Margherita Marocchi
- Department of Gastroenterology and Digestive Endoscopy, University of Modena, Modena, Italy
| | - Alberto Merighi
- Department of Gastroenterology and Digestive Endoscopy, University of Modena, Modena, Italy
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Polysaccharides from Citrus grandis L. Osbeck suppress inflammation and relieve chronic pharyngitis. Microb Pathog 2017; 113:365-371. [DOI: 10.1016/j.micpath.2017.11.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 12/18/2022]
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