Preventive effects of a fractioned polysaccharide from a traditional Chinese herbal medical formula (Yu Ping Feng San) on carbon tetrachloride-induced hepatic fibrosis

Efficacy and potential mechanisms of the main active ingredients of astragalus mongholicus in animal models of liver fibrosis: A systematic review and meta-analysis

ETHNOPHARMACOLOGICAL RELEVANCE

Astragalus mongholicus (AM) is a Qi-tonifying and immune-regulating herb widely used in traditional Chinese medicine (TCM), which is increasingly regarded as a profound complementary medication in the treatment of fibrosis disease. Astragaloside (AS), astragaloside flavonoids (AF) and astragaloside polysaccharides (APS) are the main active ingredients of Astragalus Mongholicus (AM) that have a significant therapeutic effect on liver fibrosis.

AIM OF THE STUDY

This systematic review and meta-analysis aims to evaluate the effects and possible mechanisms of the main active ingredients of AM including astragaloside (AS), astragalus flavone (AF) and astragalus polysaccharide (APS) in animal models of liver fibrosis.

MATERIALS AND METHODS

We systematically searched ten databases PubMed, Web of Science, Embase, Scopus, CINAHL, ProQuest database, China National Knowledge Internet (CNKI), VIP Information Chinese Periodical Service Platform (VIP), WangFang database and China Biology Medicine Disc (CBM) to identify relevant animal studies from inception to November 2022. The SYRCLE's risk of bias tool was used to assess the methodological quality. The statistical analysis was performed using RevMan 5.4 software.

RESULTS

Twenty-three studies involving 482 animals were included. Studies quality scores ranged from 4 to 5. Alanine aminotransferase (ALT) (SMD, -3.87; 95% CI, -5.09 to -2.65; P < 0.00001) aminotransferase (AST) (SMD, -4.43; 95% CI, -5.77 to -3.08; P < 0.00001), hydroxyproline (HYP) (SMD, -2.94; 95% CI, -3.83 to -2.05; P < 0.00001) and transforming growth factor-β1 (TGF-β1) (SMD, -2.82; 95% CI, -3.57 to -2.06; P < 0.00001) were the main outcome measures to be analyzed. The meta-analysis revealed that the main active ingredients of AM lowered the levels of known risk factors including liver index (SMD, -1.25; 95% CI, -1.63 to -0.87; P < 0.00001), degree of liver fibrosis (SMD, -1.93; 95% CI, -2.57 to -1.28; P < 0.00001), collagen α type I (Col)-1 (SMD, -3.71; 95% CI, -5.63 to -1.79; P = 0.0001), hyaluronic acid (HA) (SMD, -2.65; 95% CI, -3.69 to -1.61; P < 0.00001), laminin (LN) (SMD, -2.06; 95% CI, -2.51 to -1.61; P < 0.00001), type IV collagen (CIV) (SMD, -3.04; 95% CI, -4.34 to -1.74; P < 0.00001), procollagen typeIII (PCIII) (SMD, -2.60; 95% CI, -3.15 to -2.05; P < 0.00001), albumin (ALB) (SMD, -1.19; 95% CI, -1.63 to -0.75; P < 0.00001), total bilirubin (TBiL) (SMD, -3.63; 95% CI, -5.39 to -1.88; P < 0.0001), α-smooth muscle actin (α-SMA) (SMD, -5.27; 95% CI, -6.94 to -3.61; P < 0.00001) and Smad3 (SMD, -4.11; 95% CI, -7.17 to -1.05; P = 0.009) level.

CONCLUSION

Our meta-analysis demonstrates the effective role of the main active ingredients of AM in preclinical studies of liver fibrosis. The underlying mechanisms may be related to attenuation of oxidative stress, modulation of inflammatory response and inhibition of collagen production. However, due to the significant heterogeneity and poor quality of included studies, positive findings should be treated cautiously.

REGISTRATION

PROSPERO ID CRD42023382282.

Extracellular matrix turnover: phytochemicals target and modulate the dual role of matrix metalloproteinases (MMPs) in liver fibrosis

Extracellular matrix (ECM) resolution by matrix metalloproteinases (MMPs) is a well-documented mechanism. MMPs play a dual and complex role in modulating ECM degradation at different stages of liver fibrosis, depending on the timing and levels of their expression. Increased MMP-1 combats disease progression by cleaving the fibrillar ECM. Activated hepatic stellate cells (HSCs) increase expression of MMP-2, -9, and -13 in different chemicals-induced animal models, which may alleviate or worsen disease progression based on animal models and the stage of liver fibrosis. In the early stage, elevated expression of certain MMPs may damage surrounding tissue and activate HSCs, promoting fibrosis progression. At the later stage, downregulation of MMPs can facilitate ECM accumulation and disease progression. A number of phytochemicals modulate MMP activity and ECM turnover, alleviating disease progression. However, the effects of phytochemicals on the expression of different MMPs are variable and may depend on the disease models and stage, and the dosage, timing and duration of phytochemicals used in each study. Here, we review the most recent advances in the role of MMPs in the effects of phytochemicals on liver fibrogenesis, which indicates that further studies are warranted to confirm and define the potential clinical efficacy of these phytochemicals.

Natural polysaccharides as potential anti-fibrotic agents: A review of their progress

Fibrosis, as a common disease which could be found in nearly all organs, is normally initiated by organic injury and eventually ended in cellular dysfunction and organ failure. Currently, effective and safe therapeutic strategies targeting fibrogenesis still in highly demand. Natural polysaccharides derived from natural resources possess promising anti-fibrosis potential, with no deleterious side effects. Based on the etiology and pathogenesis of fibrosis, this review summarizes the intervention effects and mechanisms of natural polysaccharides in the prevention and treatment of fibrosis. Natural polysaccharides are able to regulate each phase of the fibrogenic response, including primary injury to organs, activation of effector cells, the elaboration of extracellular matrix (ECM) and dynamic deposition. In addition, polysaccharides significantly reduce fibrosis levels in multiple organs including heart, lung, liver and kidney. The investigation of the pathogenesis of fibrosis indicates that mechanisms including the inhibition of TGF-β/Smad, NF-κB, HMGB1/TLR4, cAMP/PKA signaling pathways, MMPs/TIMPs system as well as microRNAs are promising therapeutic targets. Natural polysaccharides can target these mediators or pathways to alleviate fibrosis. The information reviewed here offer new insights into the understanding the protective role of natural polysaccharides against fibrosis, help design further experimental studies related to polysaccharides and fibrotic responses, and shed light on a potential treatment for fibrosis.

Hepatoprotective effect and possible mechanism of phytoestrogen calycosin on carbon tetrachloride-induced liver fibrosis in mice

The study was to explore the hepatoprotective effect and possible mechanism of calycosin on carbon tetrachloride (CCl4)-induced liver fibrosis in mice. Hepatic fibrosis was induced by intraperitoneal injection of CCl4 in C57BL/6 male mice. Serum alanine aminotransferase (ALT) and aspartate transaminase (AST) activity, superoxide dismutase (SOD) activity, and hydroxyproline (Hyp) and malondialdehyde (MDA) levels were determined by biochemical assays. Liver histopathology was assessed by H&E and Masson trichrome staining. The mRNA expressions of α-smooth muscle actin (α-SMA), collagen-I (Col-I), Janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) were determined using qRT-PCR. The protein levels of α-SMA, Col-I, estrogen receptor α (ERα), estrogen receptor β (ERβ), tissue inhibitor of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-1 (MMP-1), JAK2, phospho-JAK2 (p-JAK2), STAT3, and phospho-STAT3 (p-STAT3) were detected by Western blotting. The levels of α-SMA and ERβ were measured by immunohistochemistry. Calycosin significantly reduced liver index, MDA level, and ALT and AST activity and increased SOD activity. The α-SMA, Col-I, and Hyp of the calycosin group were significantly lower than those of the model group. Calycosin increased MMP-1 and inhibited TIMP-1 expression resulting in the improvement of MMP-1/TIMP-1 ratio. Importantly, calycosin improved ERβ protein expression, JAK2 and STAT3 mRNA expressions, p-JAK2/JAK2, and p-STAT3/STAT3 relative protein expressions. However, ERα, JAK2, and STAT3 protein expressions were relatively unchanged. Calycosin significantly inhibits liver fibrosis in mice, and its mechanism may involve the following: calycosin inhibits oxidative stress; calycosin inhibits collagen synthesis and balances MMP-1/TIMP-1 system; calycosin increases ERβ expression and activates JAK2-STAT3 pathway.

Chondroprotective Effect of Wufu Decoction on Tumor Necrosis Factor-α-Induced Chondrocytes via the Extracellular Signal Regulated Kinase 1/2 Signaling Pathway

Objective

Wufu Decoction (WFD) is a herbal formulation composed of five traditional Chinese herbs that is used clinically for arthritis treatment in China. The current study investigated the chondroprotective effects and the underlying mechanism of WFD for osteoarthritis (OA) therapy.

Methods

The chondroprotective effects of WFD were investigated based on vitro study. Following the successful isolation of chondrocytes from rat cartilage tissues and the identification of collagen II expression with immunofluorescence staining, chondrocytes were co‐incubated with tumor necrosis factor‐α (TNF‐α) to induce an inflammation model; WFD was also administered. After the treatment, cell viability was determined by MTT assay, cell apoptosis was assessed by DAPI staining, the concentration of inflammation cytokines interleukin (IL)‐1β and IL‐6 were detected with ELISA assay, the expression of collagen II, MEK1/2‐ERK1/2 signaling pathway proteins was detected using western blotting, and mRNA expression of MMP‐1, MMP‐9 and MMP‐13 were determined with quantitative real‐time polymerase chain reaction.

Results

Wufu Decoction significantly restored the cell viability suppressed by TNF‐α and inhibited the cell apoptosis induced by TNF‐α in chondrocytes. The high concentrations of IL‐1β and IL‐6 in TNF‐α‐induced model cells were significantly decreased in WFD‐treated chondrocytes, and the immunofluorescence staining and western blot results showed that the inhibited expression of collagen II in the TNF‐α‐induced model group was significantly increased in WFD‐treated chondrocytes. The protein expressions of MEK1/2, p‐ERK1/2, and P53 were significantly reduced in the WFD‐treated group compared with those in the model group, and the mRNA expressions of MMP‐1, MMP‐9, and MMP‐13 were also significantly reduced with WFD treatment.

Conclusion

The present study indicated that WFD exerted a chondroprotective effect in TNF‐α‐induced chondrocytes via the regulation of the ERK1/2 signaling pathway, suggesting that WFD has therapeutic potential for OA therapy.

A network pharmacology-based approach to analyse potential targets of traditional herbal formulas: An example of Yu Ping Feng decoction

Herbal formulas from traditional Chinese medicines (TCMs) have been extensively used in clinics as effective therapies, but it is still a great challenge to demonstrate the scientific basis for their therapeutic effects at the level of molecular biology. By taking a classic herbal formula (Yu Ping Feng decoction, YPF) as an example, this study developed a novel network pharmacology based method to identify its potential therapeutic targets. First, this study constructed a “targets–(pathways)–targets” (TPT) network in which targets of YPF were connected by relevant pathways; then, this network was decomposed into separate modules with strong internal connections; lastly, the propensity of each module toward different diseases was assessed by a contribution score. On the basis of a significant association between network modules and therapeutic diseases validated by chi-square test (p-value < 0.001), this study identified the network module with the strongest propensity toward therapeutic diseases of YPF. Further, the targets with the highest centrality in this module are recommended as YPF’s potential therapeutic targets. By integrating the complicated “multi-targets–multi-pathways–multi-diseases” relationship of herbal formulas, the method shows promise for identifying its potential therapeutic targets, which could contribute to the modern scientific illustration of TCMs’ traditional clinical applications.

Antioxidant activity of Inonotus obliquus polysaccharide and its amelioration for chronic pancreatitis in mice

Inonotus obliquus polysaccharide (IOP) was extracted by water with a yield of 9.83% and purified by an anion-exchange DEAE cellulose column and Sephadex G-200 gel with a polysaccharide content of 98.6%. The scavenging activities for 2,2-diphenyl-1-picryl-hydrazyl (DPPH) and hydroxyl radicals of IOP were 82.3% and 81.3% respectively at a concentration of 5 mg/mL. IOP was composed of Man, Rha, Glu, Gal, Xyl and Ara in a molar ratio of 9.81:3.6：29.1：20.5：21.6：5.4 respectively. The gel permeation chromatography indicated that IOP was a homogeneous polysaccharide with molecular weight of 32.5 kDa. IOP helped to alleviate pancreatic acinar atrophy and weight loss for chronic pancreatitis (CP) mice induced by Diethyldithiocarbamate (DDC). The SOD level was increased most by IOP-H treatment (400 mg/kg body weight). MDA, IL-1β and LDH were significantly decreased by IOP treatment, especially hydroxyproline, IFN-γ and AMS levels were decreased 39.18%, 37.82% and 41.57% by IOP-H treatment respectively compared to MC group. In conclusion, IOP possessed strong antioxidant activity for scavenging free radicals in vitro and vivo which could be propitious to CP therapy in mice.

The influence of astragalus polysaccharide and β-elemene on LX-2 cell growth, apoptosis and activation

Background

Activated hepatic stellate cells are the main source of excessive collagen deposition in liver fibrosis. Here we report the inhibitory effects of the combinational treatment of two natural products, astragalus polysaccharide (APS) and β-elemene (ELE) on the activation of human liver hepatic stellate cell line LX-2 cells.

Methods

Cultured LX-2 cells were treated with different concentrations of APS or ELE for 24 or 48 hours. Cell viability/apoptosis was measured by MTT assay and Annexin V/PI staining , activation related genes including α-SMA and CD44 expressions were measured by real-time PCR and western blot respectively.

Results

The majority of LX-2 cells showed morphological change in the presence of APS or ELE for 24 hours. Treatment with APS + ELE for 24 or 48 hours significantly inhabited the cell proliferation compared with APS or ELE treatment alone on LX-2 cells. APS + ELE may block the up-regulation of α-SMA and CD44 both in mRNA and protein levels through TGF-β pathway in LX-2 cells.

Conclusion

APS or ELE treatment alone on LX-2 cells could inhibit cell proliferation and induce apoptosis. The combinational treatment using APS + ELE significantly increased the killing efficiency on LX-2 cells. α-SMA and CD44 expressions was inhibited upon APS + ELE treatment through TGF-β pathway in LX-2 cells. The results indicated a novel treatment using natural products for liver diseases with anti-fibrotic effect.

Total polysaccharide of Yupingfeng protects against bleomycin-induced pulmonary fibrosis via inhibiting transforming growth factor-β1-mediated type I collagen abnormal deposition in rats

Objective

This study was to explore the antifibrotic effect and the possible mechanism of total polysaccharides of Yupingfeng (YPF-P) on bleomycin (BLM)-induced pulmonary fibrosis in rats.

Methods

Pulmonary fibrosis was induced in Sprague-Dawley rats by BLM (5 mg/kg), killed 14 and 28 days after BLM administration by abdominal aorta exsanguination and removed the lungs. Lung coefficient was counted at the same time. Besides, H&E and Masson's trichrome staining for histopathological changes of lung tissues were observed. Additionally, western blotting and immunohistochemical staining techniques were used to detect expression of transforming growth factor-β1 (TGF-β1), type I collagen (Col-I) and α-smooth muscle actin (α-SMA). Finally, the levels of Col-I and hydroxyproline (HYP) in lung tissues were also utilized.

Key findings

YPF-P alleviated the increase of lung coefficient induced by BLM instillation in pulmonary fibrosis rat, pathologic changes and collagen distribution were obviously ameliorated, while the increase of α-SMA-positive cells and TGF-β1 expression was prevented after YPF-P treatment. Moreover, the contents of HYP and Col-I were decreased in YPF-P group.

Conclusions

YPF-P had antifibrotic effect in experiment, which may reduce the synthesis and promote the deposition of Col-I via suppressing the increase of TGF-β1-mediated activation of myofibroblasts.