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Cytotoxicity of Callerya speciosa Fractions against Myeloma and Lymphoma Cell Lines. Molecules 2022; 27:molecules27072322. [PMID: 35408721 PMCID: PMC9000591 DOI: 10.3390/molecules27072322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/27/2022] [Accepted: 03/30/2022] [Indexed: 01/27/2023] Open
Abstract
Callerya speciosa is widely distributed in tropical and subtropical countries and is traditionally used for preventing numerous disorders. In this study, a bioguided fractionation of ethyl acetate extract (SE) from C. speciosa root was carried out to target antioxidant and cytotoxic activities. Of the four fractions (SE1-SE4) obtained by column chromatography, SE4 had the strongest anti-radical ability in the DPPH and ABTS assays (IC50 = 0.05 and 0.17 mg/mL, respectively), with results close to butylated hydroxytoluene (BHT), a common antioxidant agent. The cytotoxic activities against the selected cells were analyzed in this study by MTT assay. Accordingly, SE2, SE3, and SE4 significantly inhibited the viability of multiple myeloma cell lines, comprising U266 (IC50 = 0.38, 0.09, and 0.11 mg/mL, respectively) and KMS11 (IC50 = 0.09, 0.17, and 0.15 mg/mL, respectively), mantle cell lymphoma Mino (IC50 = 0.08, 0.16, and 0.15 mg/mL, respectively), and the noncancerous cell line LCL (IC50 = 0.40, 0.32, and 0.21 mg/mL, respectively). At a concentration of 125 µg/mL, SE2, SE3, and SE4 induced the cell apoptosis of U266 (32.2%, 53.2%, and 55.6%, respectively), KMS11 (36.9%, 40.8%, and 47.9%, respectively), Mino (36.6%, 39.8%, and 22.0%, respectively), and LCL (12.4%, 17.5%, and 23.5%, respectively) via annexin V assay. The dominant compounds detected in fractions by high-performance liquid chromatography–electrospray ionization–tandem mass spectrometry (HPLC-ESI-MS/MS), were identified as isoflavones. This is the first report describing C. speciosa as a promising natural source of antileukemia and antimyeloma agents, which may be useful for the development of blood cancer treatments.
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Ruiz-Hurtado PA, Garduño-Siciliano L, Domínguez-Verano P, Balderas-Cordero D, Gorgua-Jiménez G, Canales-Álvarez O, Canales-Martínez MM, Rodríguez-Monroy MA. Propolis and Its Gastroprotective Effects on NSAID-Induced Gastric Ulcer Disease: A Systematic Review. Nutrients 2021; 13:nu13093169. [PMID: 34579045 PMCID: PMC8466107 DOI: 10.3390/nu13093169] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023] Open
Abstract
Gastric ulcer disease induced by the consumption of NSAIDs is a major public health problem. The therapy used for its treatment causes adverse effects in the patient. Propolis is a natural product that has been used for the treatments of different diseases around the world. Nevertheless, there is little information about the activity of propolis in gastric ulcers caused by treatment with NSAIDs. Therefore, this review evaluates and compares the gastroprotective potential of propolis and its function against NSAID-induced gastric ulcers, for which a systematic search was carried out in the PubMed and ScienceDirect databases. The main criteria were articles that report the gastroprotective activity of propolis against the damage produced by NSAIDs in the gastric mucosa. Gastroprotection was related to the antioxidant, antisecretory, and cytoprotective effects, as well as the phenolic compounds present in the chemical composition of propolis. However, most of the studies used different doses of NSAIDs and propolis and evaluated different parameters. Propolis has proven to be a good alternative for the treatment of gastric ulcer disease. However, future studies should be carried out to identify the compounds responsible for these effects and to determine their potential use in people.
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Affiliation(s)
- Porfirio Alonso Ruiz-Hurtado
- Laboratorio de Toxicología de Productos Naturales, Departamento de Farmacia, Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas, Av. Wilfrido Massieu, Gustavo A. Madero, Ciudad de México 07738, Mexico; (P.A.R.-H.); (L.G.-S.)
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
| | - Leticia Garduño-Siciliano
- Laboratorio de Toxicología de Productos Naturales, Departamento de Farmacia, Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas, Av. Wilfrido Massieu, Gustavo A. Madero, Ciudad de México 07738, Mexico; (P.A.R.-H.); (L.G.-S.)
| | - Pilar Domínguez-Verano
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
| | - Daniela Balderas-Cordero
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
| | - Gustavo Gorgua-Jiménez
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
- Laboratorio de Genética, Departamento de Farmacia, Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas, Av. Wilfrido Massieu, Gustavo A. Madero, Ciudad de México 07738, Mexico
| | - Octavio Canales-Álvarez
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
- Laboratorio de Genética, Departamento de Farmacia, Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas, Av. Wilfrido Massieu, Gustavo A. Madero, Ciudad de México 07738, Mexico
| | - María Margarita Canales-Martínez
- Laboratorio de Farmacognosia, UBIPRO, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico;
| | - Marco Aurelio Rodríguez-Monroy
- Laboratorio de Investigación Biomédica en Productos Naturales, Carrera de Medicina, UNAM, FES-Iztacala, Avenida de los Barrios Número 1, Colonia Los Reyes Iztacala, Estado de México 54090, Mexico; (P.D.-V.); (D.B.-C.); (G.G.-J.); (O.C.-Á.)
- Correspondence: ; Tel.: +52-5545-205-185
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Yuan X, Wang Z, Zhang L, Sui R, Khan S. Exploring the inhibitory effects of liquiritigenin against tau fibrillation and related neurotoxicity as a model of preventive care in Alzheimer's disease. Int J Biol Macromol 2021; 183:1184-1190. [PMID: 33965487 DOI: 10.1016/j.ijbiomac.2021.05.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/18/2021] [Accepted: 05/03/2021] [Indexed: 01/12/2023]
Abstract
Aggregation of tau protein into the form of insoluble amyloid fibrils is linked with Alzheimer's disease. The identification of potential small molecules that can inhibit tau protein from undergoing aggregation has received a great deal of interest, recently. In the present study, the possible inhibitory effects of liquiritigenin as a member of chiral flavanone family on tau amyloid fibrils formation and their resulting neurotoxicity were assessed by different biophysical and cellular assays. The inhibitory effect of the liquiritigenin against tau amyloid formation was investigated using thioflavin T (ThT) and 1-Anilino-8-naphthalene sulfonate (ANS) fluorescence spectroscopy, Congo red (CR) binding assays, transmission electron microscopy (TEM) analysis, and circular dichroism (CD) spectroscopy. Neurotoxicity assays were also performed against neuron-like cells (SH-SY5Y) using 3-(4,5-Dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) reduction, reactive oxygen species (ROS), catalase (CAT) and caspase-3 activity measurements. We found that liquiritigenin served as an efficient inhibitor of tau amyloid fibrils formation through prevention of structural transition in tau structure, exposure of hydrophobic patches and their associated neurotoxicity mediated by decrease in the production of ROS and caspase-3 activity and elevation of CAT activity. These data may finally find applications in the development of promising inhibitors against amyloid fibril formation and treatment of Alzheimer's disease.
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Affiliation(s)
- Xueling Yuan
- Department of Neurology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121099, China
| | - Zhuo Wang
- School of Nursing, Jinzhou Medical University, Jinzhou 121099, China
| | - Lei Zhang
- School of Nursing, Jinzhou Medical University, Jinzhou 121099, China
| | - Rubo Sui
- Department of Neurology, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121099, China.
| | - Suliman Khan
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Effect of Jakyakgamcho-Tang Extracts on H 2O 2-Induced C2C12 Myoblasts. Molecules 2021; 26:molecules26010215. [PMID: 33406609 PMCID: PMC7795328 DOI: 10.3390/molecules26010215] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Oxidative stress is a major contributor to muscle aging and loss of muscle tissue. Jakyakgamcho-tang (JGT) has been used in traditional Eastern medicine to treat muscle pain. Here, we compared the total phenolic and flavonoid contents in 30% ethanol and water extracts of JGT and tested the preventive effects against oxidative stress (hydrogen peroxide)-induced cell death in murine C2C12 skeletal muscle cells. The total phenolic content and total flavonoid content in 30% ethanol extracts of JGT were higher than those of water extracts of JGT. Ethanol extracts of JGT (JGT-E) had stronger antioxidant activities of 2,2′-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2′-diphenyl-1-picrylhydrazyl-scavenging activity (DPPH) than water extracts of JGT (JGT-W). JGT-E contained 19–53% (1.8 to 4.9-fold) more active compounds (i.e., albiflorin, liquiritin, pentagalloylglucose, isoliquiritin apioside, isoliquiritin, liquiritigenin, and glycyrrhizin) than JGT-W. The ethanol extracts of JGT inhibited hydrogen peroxide-induced cell death and intracellular reactive oxygen species generation more effectively than the water extract of JGT in a dose-dependent manner. For the first time, these results suggest that ethanol extract of JGT is relatively more efficacious at protecting against oxidative stress-induced muscle cell death.
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Jiang S, Wang S, Dong P, Shi L, Li Q, Wei X, Gao P, Zhang J. A comprehensive profiling and identification of liquiritin metabolites in rats using ultra-high-performance liquid chromatography coupled with linear ion trap-orbitrap mass spectrometer. Xenobiotica 2021; 51:564-581. [PMID: 33222601 DOI: 10.1080/00498254.2020.1854366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Liquiritin (LQ), a main component of liquorice, exerts various biological activities. However, insufficient attentions have been paid to the metabolism study on this natural compound until now. Our present study was conducted to investigate the LQ metabolites in rats urine, faeces and plasma using UHPLC-LTQ-Orbitrap mass spectrometer in both positive and negative ion modes. Meanwhile, post-acquisition data-mining methods including high-resolution extracted ion chromatogram (HREIC), multiple mass defect filters (MMDFs), neutral loss fragments (NLFs) and diagnostic product ions (DPIs) were utilised to screen and identify LQ metabolites from HR-ESI-MS to ESI-MSn stage. As a result, a total of 49 metabolites were detected and characterised unambiguously or tentatively. These metabolites were presumed to generate through glucuronidation, sulfation, deglucosylation, dehydrogenation, methylation, hydrogenation, hydroxylation, ring cleavage and their composite reactions. Our results not only provided novel and useful data to better understand the biological activities of LQ, but also indicated that the proposed strategy was reliable for a rapid discovery and identification drug-related constituents in vivo.
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Affiliation(s)
- Shan Jiang
- School of Pharmacy, BIN ZHOU Medical University, Yantai, China.,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shaoping Wang
- School of Pharmacy, BIN ZHOU Medical University, Yantai, China
| | - Pingping Dong
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lei Shi
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qiyan Li
- Shandong Institute for Food and Drug Control, Jinan, China
| | - Xia Wei
- Shandong Institute for Food and Drug Control, Jinan, China
| | - Peng Gao
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jiayu Zhang
- School of Pharmacy, BIN ZHOU Medical University, Yantai, China
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Cruz LA, Díaz MA, Gupta MP, López-Pérez JL, Mondolis E, Morán-Pinzón J, Guerrero E. Assessment of the antinociceptive and anti-inflammatory activities of the stem methanol extract of Diplotropis purpurea. PHARMACEUTICAL BIOLOGY 2019; 57:432-436. [PMID: 31242794 PMCID: PMC6598500 DOI: 10.1080/13880209.2019.1628074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/17/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
Context: Since there is still a great need to search for plant species with antinociceptive and anti-inflammatory activities, Diploptropis purpurea (Rich.) Amshoff (Fabaceae) is studied for the first time. Objective: This evaluates the analgesic and anti-inflammatory activities of the stem methanol extract of Diplotropis purpurea (MEDP). Material and methods: The anti-inflammatory and analgesic effects of MEDP of D. purpurea were evaluated in vivo. The antinociceptive activity was assessed in CD1 male mice were treated by oral gavage with 500 mg/kg of MEDP 30 min before submitting to acetic acid-induced abdominal writhing, hot-plate, and formalin tests. Paws oedema induced by carrageenan, histamine or serotonin were performed in male Sprague-Dawley rats to determinate the anti-inflammatory activity. Results: Oral administration of MEDP produced significant antinociceptive effects on the inflammatory phase in the formalin test [12.0 s versus 72.5 s in carboxymethyl cellulose (CMC) control group]. MEDP produced an analgesic effect in the hot-plate model, although the effect was modest compared to tramadol (40 and 60%, respectively). The oral administration of MEDP in a dose of 500 mg/kg showed maximum inhibition (75.1%) after 0.5 h in carrageenan-induced oedema, but it did not modify histamine or serotonin-induced oedemas. Discussion and conclusion: In the peripheral nociception model, acetic acid-induced abdominal writhing, the MEDP did not show a protective effect, but its analgesic effects were evident in the inflammatory phase of the formalin test and in the hot-plate model. These results show that the anti-inflammatory effect was accompanied by a reduction in the perception of painful stimuli.
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Affiliation(s)
- Lorena A. Cruz
- Dirección Nacional de Farmacia y Drogas, Ministerio de salud, Panama, Panama
| | - Miguel A. Díaz
- Dirección Nacional de Farmacia y Drogas, Ministerio de salud, Panama, Panama
| | - Mahabir P. Gupta
- Centro de Estudios Farmacognósticos de la Flora Panameña, Facultad de Farmacia, Universidad de Panamá, Panama, Panama
| | - José Luis López-Pérez
- Departamento de Farmacología, Escuela de Medicina, Universidad de Panamá, Panama, Panama
- Departmento de Ciencias Farmacéuticas, IBSAL-CIETUS, Universidad de Salamanca, Salamanca, Spain
| | - Eily Mondolis
- Departamento de Farmacología, Escuela de Medicina, Universidad de Panamá, Panama, Panama
| | - Juan Morán-Pinzón
- Departamento de Farmacología, Escuela de Medicina, Universidad de Panamá, Panama, Panama
| | - Estela Guerrero
- Departamento de Farmacología, Escuela de Medicina, Universidad de Panamá, Panama, Panama
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Shan J, Qian W, Peng L, Chen L, Kang A, Xie T, Di L. A Comparative Pharmacokinetic Study by UHPLC-MS/MS of Main Active Compounds after Oral Administration of Zushima-Gancao Extract in Normal and Adjuvant-Induced Arthritis Rats. Molecules 2018; 23:molecules23010227. [PMID: 29361795 PMCID: PMC6017738 DOI: 10.3390/molecules23010227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/11/2018] [Accepted: 01/18/2018] [Indexed: 02/07/2023] Open
Abstract
A sensitive and rapid ultra high-performance liquid-chromatography tandem mass spectrometry (UHPLC-MS/MS) method has been applied to investigate the influence of rheumatoid arthritis (RA) on the pharmacokinetics of nine analytes (daphnetin, daphnoretin, 7-hydroxycoumarin, liquiritin, isoliquiritin, liquiritigenin, isoliquiritigenin, glycyrrhizin, and glycyrrhetinic acid), which are major active components in Zushima-Gancao extract. The analytes and internal standard (IS) were separated in a Hypersil Gold C18 column and detected on a triple-stage quadrupole mass spectrometer using the validated method. All analytes exhibited good linearities (R2 > 0.98), and the lower limit of quantification (LLOQs) were sufficient for quantitative analysis. Intra- and inter-batch precision were all within 14.96% while the accuracy of nine analytes ranged from −17.99 to 14.48%, and these results were all within acceptance criteria. The extraction recoveries, matrix effects, and stabilities were all satisfactory. Main pharmacokinetic parameters of each compound were compared, and significant differences were found in parameters of daphnetin, daphnoretin, liquiritin, isoliquiritin, isoliquiritigenin, glycyrrhizin, and glycyrrhetinic acid, especially the last one, between the two groups. Therefore, adjuvant-induced arthritis has different effects on the pharmacokinetics of ingredients in Zushima-Gancao extract. The comparative pharmacokinetic study between normal and adjuvant-induced arthritis rats might provide more comprehensive information to guide the clinical usage of Zushima-Gancao extract for treating RA.
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Affiliation(s)
- Jinjun Shan
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Wenjuan Qian
- State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Linxiu Peng
- State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Lianghui Chen
- State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - An Kang
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Tong Xie
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China.
| | - Liuqing Di
- Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China.
- Jiangsu Key Laboratory for Functional Substance of Chinese Medicine, Nanjing 210023, China.
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Influence of Jiegeng on Pharmacokinetic Properties of Flavonoids and Saponins in Gancao. Molecules 2017; 22:molecules22101587. [PMID: 28934158 PMCID: PMC6151572 DOI: 10.3390/molecules22101587] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 09/14/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022] Open
Abstract
Jiegeng Gancao decoction, which is composed of Jiegeng and Gancao at a weight ratio of 1:2, was widely used for treating pharyngalgia and cough for thousands of years. Our previous work indicated that Gancao could increase the systemic exposure of platycodin D and deapio-platycodin D, two main components in Jiegeng. However, whether Jiegeng could alter the pharmacokinetics of the main compounds in Gancao is still unknown. Thus, the purpose of this study was to compare the oral pharmacokinetics of flavonoids and saponins from Gancao alone vs. after co-administration with Jiegeng. Furthermore, Caco-2 cell transport and fecal hydrolysis were investigated to explain the altered pharmacokinetic properties. Pharmacokinetics results suggested that the bioavailability of liquiritin, isoliquiritin, glycyrrhizin and its metabolite, glycyrrhetinic acid, could be improved while bioavailability of liquiritigenin and isoliquiritigenin deteriorated when co-administered with Jiegeng. The Caco-2 transport study showed no significant difference of the Papp values of the main components in Jiegeng Gancao decoction when compared with those in Gancao decoction (p > 0.05). The in vitro metabolism study suggested that saponins and flavonoids glycosides in Gancao were influenced and the metabolic characteristics of most ingredients were consistent with pharmacokinetic results, such as liquiritin and glycyrrhetinic acid. The hydrolysis of liquiritigenin and glycyrrhizin observed with fecal lysate in vitro appeared consistent with the oral pharmacokinetics. Based on experiments, the pharmacokinetic profiles of six components in Gancao were influenced by Jiegeng. The metabolic process might partially contribute to the altered pharmacokinetic behavior. The metabolism of some components of Gancao appeared to be inhibited when coadministered with Jiegeng, possibly by the Jiegeng constituent platycodin.
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