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Yu Q, Zhang Y, Zeng W, Sun Y, Zhang X, Guo L, Zhang Y, Yu B, Guo M, Wang Y, Li H, Suo Y, Jiang X, Song L. Buyang Huanwu Decoction Alleviates Atherosclerosis by Regulating gut Microbiome and Metabolites in Apolipoprotein E-deficient Mice fed with High-fat Diet. JOURNAL OF PHYSIOLOGICAL INVESTIGATION 2024; 67:88-102. [PMID: 38780293 DOI: 10.4103/ejpi.ejpi-d-23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/25/2024] [Indexed: 05/25/2024]
Abstract
ABSTRACT The traditional Chinese herbal prescription Buyang Huanwu decoction (BHD), effectively treats atherosclerosis. However, the mechanism of BHD in atherosclerosis remains unclear. We aimed to determine whether BHD could alleviate atherosclerosis by altering the microbiome-associated metabolic changes in atherosclerotic mice. An atherosclerotic model was established in apolipoprotein E-deficient mice fed high-fat diet, and BHD was administered through gavage for 12 weeks at 8.4 g/kg/d and 16.8 g/kg/d. The atherosclerotic plaque size, composition, serum lipid profile, and inflammatory cytokines, were assessed. Mechanistically, metabolomic and microbiota profiles were analyzed by liquid chromatography-mass spectrometry and 16S rRNA gene sequencing, respectively. Furthermore, intestinal microbiota and atherosclerosis-related metabolic parameters were correlated using Spearman analysis. Atherosclerotic mice treated with BHD exhibited reduced plaque area, aortic lumen occlusion, and lipid accumulation in the aortic root. Nine perturbed serum metabolites were significantly restored along with the relative abundance of microbiota at the family and genus levels but not at the phylum level. Gut microbiome improvement was strongly negatively correlated with improved metabolite levels. BHD treatment effectively slows the progression of atherosclerosis by regulating altered intestinal microbiota and perturbed metabolites.
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Affiliation(s)
- Qun Yu
- School of Preclinical Medicine, Zunyi Medical University, Zunyi, Guizhou Province, China
| | - Yilin Zhang
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Wenyun Zeng
- Oncology, Ganzhou People's Hospital, Ganzhou, China
| | - Yingxin Sun
- School of Faculty of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Xiaolu Zhang
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Lin Guo
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Yue Zhang
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Bin Yu
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Maojuan Guo
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Yu Wang
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Huhu Li
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Yanrong Suo
- Oncology, Ganzhou People's Hospital, Ganzhou, China
| | - Xijuan Jiang
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
| | - Lili Song
- School of Integrated Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Jinghai, Tianjin, China
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Abstract
Several observational studies report decreased incidence of mortality and of exacerbations with aspirin use in patients with chronic obstructive pulmonary disease (COPD), with calls for a large randomized trial. Aspirin does have local and systemic pulmonary mechanisms of action that could make this drug beneficial in the treatment of COPD. However, the potential for biases in the observational studies has not been examined. We searched the literature for all observational studies reporting on the effect of aspirin in COPD patients on exacerbation and mortality. We reviewed the studies for the presence of time-related and other biases. We identified eight observational studies reporting an overall reduction in all-cause mortality or exacerbation with aspirin use of 21% (pooled rate ratio (RR) 0.79; 95% CI 0.71-0.86). We found two studies affected by immortal time bias (pooled RR 0.81; 95% CI 0.74-0.89), three studies affected by collider-stratification bias (pooled RR 0.66; 95% CI 0.55-0.79) and three that involved some exposure misclassification (pooled RR 0.85; 95% CI 0.78-0.92). Moreover, while adjusting for cardiovascular factors, six of the eight studies did not adjust for important markers of COPD severity and thus remain susceptible to confounding bias. In conclusion, all observational studies reporting on the effectiveness of aspirin on major outcomes of COPD are affected by biases known to exaggerate the effectiveness of a drug. As these studies cannot be used to support a beneficial effect for aspirin in COPD, it would be premature to consider a randomized trial to investigate this question until methodologically rigorous studies are available.
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Affiliation(s)
- Anirudh Bakshi
- Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital; Departments of Epidemiology and Biostatistics, and Medicine, McGill University, Montreal, Quebec, Canada
| | - Samy Suissa
- Centre for Clinical Epidemiology, Lady Davis Institute-Jewish General Hospital; Departments of Epidemiology and Biostatistics, and Medicine, McGill University, Montreal, Quebec, Canada
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Yayan J, Bald M, Franke KJ. No Independent Influence of Statins on the Chronic Obstructive Pulmonary Disease Exacerbation Rate: A Cohort Observation Study Over 10 Years. Int J Gen Med 2021; 14:2883-2892. [PMID: 34234518 PMCID: PMC8254092 DOI: 10.2147/ijgm.s309647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/10/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose Some previously published primarily retrospective studies have shown that statins could reduce the rate and severity of exacerbations, the length of hospital stays, and mortality in patients with chronic obstructive pulmonary disease (COPD), but retrospective data needs to be reviewed regarding this connection since statins are cholesterol-lowering drugs. Therefore, the aim of this study was to investigate the independent influence of statins on the exacerbation rate in COPD patients. Methods An observational retrospective study was conducted to assess the independent influence of statins on the COPD exacerbation rate at the Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Witten/Herdecke University from January 1, 2010 to December 31, 2020. This study enrolled patients with COPD in 2010 and documented their exacerbation rate over a further 10 years. The number of exacerbations in COPD patients was compared between statin users and non-users. Results Of the total of 295 [176 male (59.7%)] COPD patients, 105 (35.6%, CI 30.3–41.2%) patients with COPD were treated with statins, and 190 (64.4%, CI 58.8–69.7%) were treated without statins. The mean exacerbation rate in the COPD patients who received statin did not differ from that in the COPD patients who did not receive statin (p = 0.175). Also, the mortality rates did not differ between the statin-treated and non-statin-treated COPD patients (p = 0.271). Conclusion Statins have no effect on the exacerbation rate or mortality in COPD patients.
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Affiliation(s)
- Josef Yayan
- Witten/Herdecke University, Witten, Germany.,Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Lüdenscheid, Germany
| | - Markus Bald
- Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Lüdenscheid, Germany
| | - Karl-Josef Franke
- Witten/Herdecke University, Witten, Germany.,Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Lüdenscheid, Germany
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Chen YC, Chen YY, Yeh HW, Yeh TY, Huang JY, Liao PL, Yeh LT, Yang SF, Chou MC, Yeh CB. Association Between Aspirin Use and Decreased Risk of Pneumonia in Patients With Cardio-Cerebra-Vascular Ischemic Disease: A Population-Based Cohort Study. Front Public Health 2021; 9:625834. [PMID: 33816418 PMCID: PMC8013718 DOI: 10.3389/fpubh.2021.625834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/25/2021] [Indexed: 11/13/2022] Open
Abstract
This study evaluated the association between long-term low-dose aspirin use and decreased risk of pneumonia in patients with cardio-cerebra-vascular ischemic diseases (CCVDs). This retrospective cohort study used records from Taiwan's National Health Insurance Research Database of claims made between 1997 and 2013. After propensity score matching (PSM), patients who took a low dose of aspirin for more than 90 days within 1 year of diagnosis with CCVDs were identified as the exposure group (n = 15,784). A matched total of 15,784 individuals without aspirin use were selected for the non-aspirin group. The main outcome was the development of pneumonia after the index date. Multivariable Cox regression analysis and Kaplan-Meier survival analysis were performed to estimate the adjusted hazard ratio (aHR) and cumulative probability of pneumonia. The result after PSM indicated a lower hazard ratio for pneumonia in aspirin users (aHR = 0.890, 95% confidence interval = 0.837-0.945). Therefore, patients with CCVDs who took aspirin had a lower risk of developing pneumonia than those who did not. In conclusion, this population-based cohort study demonstrated that long-term low-dose aspirin use is associated with a slightly decreased risk of pneumonia in patients with CCVDs.
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Affiliation(s)
- Ying-Cheng Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Yin-Yang Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Han Wei Yeh
- School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tung-Ying Yeh
- Graduate School of Dentistry, School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Pei-Lun Liao
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Liang-Tsai Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Anesthesiology, Changhua Christian Hospital, Changhua, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-Chih Chou
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chao-Bin Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Yeh JJ, Lin CL, Hsu CY, Shae Z, Kao CH. Statin for Tuberculosis and Pneumonia in Patients with Asthma⁻Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study. J Clin Med 2018; 7:E381. [PMID: 30355982 PMCID: PMC6262333 DOI: 10.3390/jcm7110381] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 12/19/2022] Open
Abstract
We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma⁻chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000⁻2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34⁻0.70] and pneumonia (aHR 0.52, 95% CI 0.41⁻0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31⁻1.16) and 0.58 (0.40⁻0.85) for TB and 0.61 (0.39⁻0.95) and 0.57 (0.45⁻0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs.
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Affiliation(s)
- Jun-Jun Yeh
- Department of Family and Chest Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan.
- Department of Childhood Education and Nursery, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
- Department of Family Medicine, China Medical University, Taichung 40447, Taiwan.
- Department of Nursing, Mei-Ho University, Pingtung 91252, Taiwan.
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.
- College of Medicine, China Medical University, Taichung 40447, Taiwan.
| | - Chung-Y Hsu
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 40447, Taiwan.
| | - Zonyin Shae
- Department of Computer Science and Information Engineering, Asia University, Taichung 40447, Taiwan.
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 40447, Taiwan.
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 40447, Taiwan.
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 40447, Taiwan.
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