Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies

PURPOSE

Studying the effects of uric acid levels on cognitive function and quantifying the dose-response relationship.

METHODS

Based on PubMed and Embase search terms, we identified prospective cohort studies that included blood uric acid as a risk factor and cognitive impairment as a result up to September 2022. We extracted pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs).

RESULTS

Nine reports (including 488,915 participants and 5516 cognitive impairment cases) with median follow-up of 8.8-22 years were eligible for analyses. Compared with lowest category of blood uric acid concentration, the combined RR of cognitive impairment events in the highest classification was 0.81 (95% CI: 0.70-0.92, P < 0.001). Dose-response analysis of eight reports (including 484,297 participants and 5059 cognitive impairment cases) showed that there was no evidence of a curvilinear relationship between blood uric acid levels and cognitive impairment (P = 0.51 for nonlinear relationship). The summary RR of cognitive impairment for an increase of 1 mg/dL blood uric acid level was 0.98 (95% CI: 0.95-1.00; linear trend P = 0.07, I2 = 67.1%, heterogeneity P < 0.05). There was also a linear negative association between blood uric acid levels and cognitive impairment risk in the male subgroup analysis (RR = 0.97, 95% CI: 0.95-0.99, P < 0.05).

CONCLUSION

Levels of blood uric acid are not related to risk of cognitive impairment. A subgroup analysis shows that the rise in blood uric acid levels in the male population is related to a decreased risk of cognitive impairment. These results need to be confirmed by further studies.

Slain2 attenuates brain injury following subarachnoid hemorrhage by controlling axonal microtubule structure in mice

Neuronal injury is accountable for the poor outcome of SAH patients. In this study, oxyhemoglobin (oxyHb) was used to treat cultured primary neurons to simulate SAH, while the SAH model was established by vascular puncture in mice. First, proteomics analysis and western blot assays showed Slain2 as an increased factor in neurons exposed to oxyHb treatment, which has been reported to play an important role in axonal development by regulating microtubule stability. Upregulation of neuronal Slain2 was also detected in the murine SAH model compared with sham surgery. In addition, there was no sex difference in the protein level of Slain2 in either the sham-operated or SAH groups. Furthermore, Slain2 overexpression rescued SAH-induced sensorimotor impairments in mice, while Slain2 knockdown had the opposite effect. Finally, Slain2 overexpression rescued SAH-induced axonal injury both in vivo and in vitro, which was exacerbated by Slain2 knockdown. Thus, we demonstrate here that Slain2 acts as an endogenous protective factor of neuronal axonal microtubule structure, which plays a key role in the protection against SAH-induced neuronal axonal injury. Facilitated axonal microtubule structure by Slain2 overexpression may reduce SAH-induced axonal injury and neurobehavioral dysfunction.

Efficacy and safety of Chinese patent medicine compound preparation combined with routine treatment in vitiligo: A Bayesian network meta-analysis

BACKGROUND AND PURPOSE

Treating vitiligo in clinical practice is challenging. Furthermore, oral drugs used in Western medicine have considerable side effects and are unsuitable for long-term treatment. In contrast, Chinese patent medicines (CPMs) are more suitable for long-term oral vitiligo treatment, but medical evidence of their efficacy and safety is lacking. Therefore, in this study, the efficacy and safety of CPMs were evaluated and ranked using a Bayesian network meta-analysis.

METHODS

Seven Chinese and English databases were searched for all relevant articles published up to February 2023. The Bayesian network meta-analysis method was used to analyze the extracted data to evaluate efficacy and safety.

RESULTS

Six common CPMs for treating vitiligo were selected in our study, and 48 targeted articles and 4446 patients were included. This study showed that Qubai Babuqi tablets (QT) were the most effective for short-term treatment of vitiligo, and that vitiligo capsules or pills (VCP) were the most effective for long-term treatment, together with compound Quchong Banjiuju pills (QP). In terms of surface area under the cumulative ranking curve (SUCRA) values, the order of efficacy of each treatment was as follows: QT (92.18%) > Taohong Qingxue pills (TP) (63.81%) > VCP (55.53%) > QP (50.72%) > Bailing tablets or capsules (BTC) (49.01%) > Baishi pills (BP) (35.69%)>routine therapy (RT) (3.1%) in terms of total effective rate and QT (92.05%) > VCP (71.50%) > QP (66.60%) > TP (42.95%) > BTC (39.66%) > BP (36.60%)>RT (0.6%) in terms of improvement rate. In addition, the safety of the 6 CPMs did not significantly differ in terms of adverse effects. The SUCRA values indicated that QT performed slightly worse than other drugs.

DISCUSSION

In treating vitiligo, QT is most effective but only suitable for short-term administration owing to its poor safety. VCP and QP could be used as first-choice long-term medications. TP may positively affect repigmentation in patients with limited lesion areas.

Quality of the Evidence Supporting the Role of Acupuncture Interventions for Vascular Dementia

BACKGROUND

Inflammation is an important pathogenesis of vascular dementia (VaD), and the regulatory effect of acupuncture on neuroinflammation has received extensive attention. There is conflicting evidence regarding the efficacy and safety of acupuncture for postpartum VaD. This overview aims to systematically evaluate systematic reviews/meta-analyses (SRs/MAs) of acupuncture on VaD.

METHODS

From the establishment of the electronic database to August 2022, search and identify SRs/MAs on acupuncture treatment for VaD. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were used to evaluate the methodological, reporting, and evidence quality of the included SRs/MAs.

RESULTS

Twelve SRs/MAs were included in this research, and the quality of methodological, reporting, and evidence for these SRs/MAs were not satisfactory. The shortcomings of these SRs/MAs mainly include lack of protocol registration, incomplete literature search, missing list of excluded literature, and high risk of bias of included original clinical trials.

CONCLUSION

VaD patients may benefit from acupuncture therapy. However, the high risk of bias in original clinical trials and the low quality of SRs/MAs make evidence-based decisions less reliable.

Quality of evidence supporting the role of non-steroidal anti-inflammatory drugs for the treatment of anxious depression: a protocol for an overview of systematic reviews and meta-analyses

INTRODUCTION

There have been several studies showing the effectiveness of non-steroidal anti-inflammatory drugs (NSAIDs) for anxious depression. We aimed to summarise the evidence and evaluate the methodological quality regarding the effectiveness and safety of NSAIDs for anxious depression from systematic reviews/meta-analyses (SRs/MAs).

METHODS AND ANALYSIS

Two researchers searched seven databases for SRs/MAs, which are randomised controlled trials on NSAIDs for anxious depression. Two investigators used the Assessment System for Evaluating Methodological Quality 2, the Risk of Bias in Systematic reviews tool, the list of preferred reporting items for SRs/MAs and the Grading of Recommendations, Assessment, Development and Evaluation system to assess the included SRs/MAs.

ETHICS AND DISSEMINATION

The findings of the study will be disseminated through peer-reviewed journals, and national and international conference presentations.

Efficacy and safety of Buyang Huanwu Decoction in the treatment of post-stroke depression: A systematic review and meta-analysis of 15 randomized controlled trials

Background

Post-stroke depression is the most common neuropsychiatric disorder after stroke, which seriously affects patients' post-stroke recovery and quality of life, and is prone to recurrence of stroke and death. Buyang Huanwu Decoction is effective in treating post-stroke depression, but there is a lack of scientific systematic review and meta-analysis.

Objective

To evaluate the efficacy and safety of Buyang Huanwu Decoction in treating post-stroke depression.

Methods

A total of eight databases were searched by two investigators from Embase, PubMed, The Cochrane Library, Web of Science, Wanfang, CNKI, VIP, and CBM to collect randomized controlled trials that applied BHD to PSD from the time of database construction to May 2022. Data analysis was performed using Review mange5.4.

Results

A total of 15 studies with 1,242 patients were included. Meta-analysis showed that compared with the antidepressant drug control group, the change value of the HAMD scale in the Buyang Huanwu Decoction group was significantly lower [p < 0.00001, SMD = −0.85, 95% CI (−1.10, −0.61)]; after subgroup analysis, the effect of BHD for 4 weeks was the most significant; the total clinical effective rate was significantly increased [p = 0.001, RR = 1.33, 95% CI (1.12, 1.57)]; neurological deficit score [p = 0.002, SMD = −1.03, 95% CI (−1.67, −0.39)], the incidence of adverse reactions [p = 0.02, RR = 0.42, 95% CI (0.20, 0.89)], and adverse reaction scale scores [p < 0.00001, MD = −3.58, 95%CI (−4.09, −3.08)] were significantly lower.

Conclusion

Compared with antidepressants, the Buyang Huanwu Decoction is more effective and safer in the treatment of post-stroke depression patients. However, more high-quality studies are needed to further support the above conclusion.

Network pharmacology and molecular docking analysis on the mechanism of Baihe Zhimu decoction in the treatment of postpartum depression

Baihe Zhimu decoction (BZD) has significant antidepressant properties and is widely used to treat mental diseases. However, the multitarget mechanism of BZD in postpartum depression (PPD) remains to be elucidated. Therefore, the aim of this study was to explore the molecular mechanisms of BDZ in treating PPD using network pharmacology and molecular docking. Active components and their target proteins were screened from the traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). The PPD-related targets were obtained from the OMIM, CTD, and GeneCards databases. After overlap, the targets of BZD against PPD were collected. Protein-protein interaction (PPI) network and core target analyses were conducted using the STRING network platform and Cytoscape software. Moreover, molecular docking methods were used to confirm the high affinity between BZD and targets. Finally, the DAVID online tool was used to perform gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of overlapping targets. The TCMSP database showed that BZD contained 23 active ingredients in PPD. KEGG analysis showed that overlapping genes were mainly enriched in HIF-1, dopaminergic synapses, estrogen, and serotonergic synaptic signalling pathways. Combining the PPI network and KEGG enrichment analysis, we found that ESR1, MAOA, NR3C1, VEGFA, and mTOR were the key targets of PPD. In addition, molecular docking confirmed the high affinity between BZD and the PPD target. Verified by a network pharmacology approach based on data mining and molecular docking methods, the multi-target drug BZD may serve as a promising therapeutic candidate for PPD, but further in vivo/in vitro experiments are needed.

Quality of Evidence Supporting the Role of Tripterygium Glycosides for the Treatment of Diabetic Kidney Disease: An Overview of Systematic Reviews and Meta-Analyses

Background

Tripterygium glycosides (TG) is widely used in the treatment of diabetic kidney disease (DKD) in China. To systematically assess and synthesize the available evidence, we present an overview of systematic reviews (SRs) and meta-analyses (MAs) on the topic of TG interventions for DKD.

Methods

SRs/MAs on TG interventions for DKD were comprehensively searched in seven databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), as well as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Results

This overview includes 13 SRs/MAs that use quantitative calculations to comprehensively assess various outcomes in TG interventions for DKD. The methodological quality, reporting quality, and risk of bias of SRs/MAs, and the quality of evidence for outcome indicators are unsatisfactory. Limitations of the included SRs/MAs consist in the lack of essential procedures such as protocol registration, screening of duplicate study, provision of the list of excluded studies, and assessment of publication bias. Besides, the reliance on small samples for quantitative synthesis of effect sizes also constitutes an important limitation.

Conclusion

TG may be a potential complementary treatment modality to DKD therapy. However, this conclusion must be treated with caution as the quality of the evidence provided by SRs/MAs is generally low.

Helicobacter pylori infection and the progression of atherosclerosis: A systematic review and meta-analysis

OBJECTIVE

In recent years, many studies have tried to prove whether Helicobacter pylori (H. pylori) can promote the progression of atherosclerosis (AS), but the reported results are conflicting. Carotid intima-media thickness (CIMT), flow-mediated dilation (FMD), or pulse wave velocity (PWV) are the most commonly used indicators to evaluate the progress of AS. So, we collected and evaluated these three indicators to provide evidence-based medicine for the clinic.

MATERIALS AND METHODS

We included and evaluated studies on H. pylori infection and CIMT, FMD, or PWV from PubMed, Cochrane trials, and Embase databases before September 1, 2021, and language restrictions: English. Research types include cross-sectional studies, cohort studies, and case-control studies. The MINORS scale was used to evaluate the quality of these studies. For all studies, we choose a random-effects model and calculate the weighted mean difference (WMD) for analysis, and all our analyses use STATA software.

RESULTS

Meta-analysis shows that H. pylori infection can significantly increase CIMT (WMD = 0.059, 95% CI: 0.039, 0.079, p < 0.001). Based on subgroup analysis, we found that the relationship between the two is more significant in the young and middle-aged people younger than 60 years old and people without cardiovascular disease. In addition, we also found an association between H. pylori infection and FMD (WMD = -3.873, 95% CI: -5.684, -2.062, p < 0.001), but it is a pity that there are few literatures that meet the standards. Finally, We concluded that H. pylori infection can significantly increase PWV (WMD = 88.033, 95%CI: 67.297,108.768. I²  = 99.63%, p < 0.001). In the subgroup analysis, we also found that this correlation is similar to CIMT, and it is more significant in the young and middle-aged population under 60 and those without cardiovascular disease. We also found in the sub-analysis that there was a significant increase in CIMT in CagA-positive individuals in H. pylori-infected patients (WMD = 0.16, 95%CI: 0.02, 0.29. p = 0.03).

CONCLUSION

Helicobacter pylori infection can promote the process of AS, especially in people under the age of 60 and people without cardiovascular risk factors, and we hope that our meta-analysis can provide ideas for the early prevention of AS.

Quality of evidence supporting the role of Chinese herbal medicine for the treatment of poststroke depression: A protocol for systematic review and meta-analysis

BACKGROUND

Poststroke depression (PSD) is a syndrome that occurs after stroke. The efficacy of Chinese herbal medicine (CHM) for PSD has also received widespread attention, but there is still a lack of clinical evidence because this overview evaluates the published meta-analyses (MAs)/Systematic reviews (SRs). To provide evidence for the clinical application of CHM in the treatment of PSD.

METHODS

Two researchers searched 7 databases for SRs/MAs which are about randomized controlled trials on CHM for PSD. Two investigators use the systematic review assessment tool (AMSTAR-2), the risk of bias in systematic scale, the list of preferred reporting items for systematic reviews and meta-analysis, and the classification of recommended assessments for evaluation, development and evaluation system to assess the included SRs/MAs.

RESULTS

Our findings will be published in peer-reviewed journals.

CONCLUSION

This study provides evidence-based medical evidence for the impact of CHM on PSD.

REGISTRATION NUMBER

INPLASY202210001.

The Effects of Tai Chi Exercise for Patients with Type 2 Diabetes Mellitus: An Overview of Systematic Reviews and Meta-Analyses

OBJECTIVES

Tai chi (TC) is a potential complementary treatment for type 2 diabetes mellitus (T2DM). This overview systematically summarizes and evaluates the existing evidence of TC in the treatment of T2DM.

METHODS

Systematic reviews (SRs)/meta-analyses (MAs) on TC interventions for T2DM were comprehensively searched in seven databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

RESULTS

Eight published SRs/MAs were included in our study. Based on the methodology and quality of evidence assessment, all SRs/MAs are considered to be of very low quality, and only 1 SR/MA has been assessed as low risk of bias, and none of the SR/MA has been fully reported on the checklist. A total of 65 outcome indicators extracted from the included SRs/MAs were evaluated, and only 1 item was assessed as high quality.

CONCLUSIONS

TC may be an effective and safe complementary treatment for T2DM. However, this conclusion must be treated with caution because the quality of the evidence provided by the included SRs/MAs is generally low.

Establishing a competing endogenous RNA (ceRNA)-immunoregulatory network associated with the progression of Alzheimer’s disease

Background

Alzheimer’s disease (AD) is closely related to immunity and competitive endogenous RNAs (ceRNAs) are believed to play a key role in the development of AD. Therefore, understanding the ceRNA network related to AD immunity will contribute to the identification of novel immunotherapeutic targets and provide new insights into AD from an immunological perspective.

Methods

Weighted gene coexpression network analysis (WGCNA) and Enrichr enrichment analysis were performed to identify the immune-related gene coexpression modules through microarray datasets from the Gene Expression Omnibus (GEO) database. The differentially expressed long non-coding RNAs (lncRNAs) and microRNAs (miRNAs) were identified from the microarray through differential analysis and mapped with related databases. Cytoscape was used to construct a lncRNA-miRNA-mRNA network. Subsequently, ImmuCellAI immune infiltration analysis was performed and a ceRNA sub-network of related core immune cells was constructed. Finally, the potential pathways related to these core factors were determined through gene set enrichment analysis (GSEA).

Results

Through WGCNA analysis and enrichment analysis, the blue module and the green module were identified as key modules related to AD immunity. Naïve CD8 cells were shown to be the key immune cells related to AD. Correlation analysis and receiver operating characteristic (ROC) curves verified lncRNA Long Intergenic Non-Protein Coding RNA 472 (LINC00472), lncRNA HLA Complex Group 18 (HCG18), RUNX Family Transcription Factor 3 (RUNX3), Tensionin 1 (TNS1), Linker For Activation Of T Cells Family Member 2 (LAT2), and Solute Carrier Family 38 Member 2 (SLC38A2) as possible key targets related to AD immunity.

Conclusions

The lncRNA LINC00472, lncRNA HCG18, RUNX3, TNS1, LAT2, and SLC38A2 identified in this study may be key targets related to AD immunity. These insights will provide future directions for the further AD research.

Efficacy of integrated traditional Chinese medicine and Western medicine in the treatment of poststroke insomnia: A protocol for systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Western medicine has played an essential role in treating poststroke insomnia (PSI) in China, and traditional Chinese medicine therapy based on Chinese characteristics is also effective. Combined with China's national conditions, we plan to conduct this systematic review and meta-analysis to compare the efficacy of integrated traditional Chinese medicine and Western medicine (INTEGRATED TCM and WM) therapy and Western medicine alone for PSI.

METHODS

We will search the following 5 electronic databases: PubMed, Wanfang, Chinese biomedical literature database, the Chongqing VIP Chinese Science and Technology Periodical, and China national knowledge infrastructure. Randomized controlled trials that compared the efficacy of INTEGRATED TCM and WM with Western medicine alone in the treatment of PSI will be considered. Primary outcomes have Treatment effectiveness rate, and Pittsburgh sleep quality index. Secondary outcomes include traditional Chinese medicine syndrome score, Athens insomnia scale, the incidence of adverse reactions, and outcome follow-up. Based on the eligibility criteria, we will conduct literature screening and data extraction. The quality of the included literature will be evaluated using the Cochrane risk of bias tools. We will use Review Manager software (Version 5.3) for data synthesis and statistical analyses. If sources of heterogeneity exist, we will perform a subgroup analysis or sensitivity analysis. A funnel plot will be used to analyze publication bias.

RESULTS

This study will provide evidence-based medicine evidence for treatment of PSI with INTEGRATED TCM and WM in terms of its efficacy.

CONCLUSION

This systematic review aims to provide new options for INTEGRATED TCM and WM treatment of PSI in terms of its efficacy.

Ping Feng Qingfei mixture treats airway hyperresponsiveness: a network pharmacology and molecular docking study

BACKGROUND

As air pollution has increased in severity over recent years, fine particulate matter (PM) (<25 µm; PM2.5) has led to a greater incidence of disease, including airway hyperresponsiveness (AHR). Ping Feng Qingfei Mixture (PFQF) is effective in treating AHR caused by PM2.5. As there is a lack of knowledge regarding the mechanisms of PFQF in the treatment of AHR, we conducted a network pharmacology study to clarify this issue.

METHODS

We obtained the composition of PFQF from the traditional Chinese medicine (TCM) systems pharmacology database and its potential targets. The potential targets of AHR were obtained from the Online Mendelian Inheritance in Man and Gene Cards databases. Then psychophysiological interaction, KEGG pathway, and Gene Ontology biological process analyses were carried out for targeting PFQF in treating AHR. We further constructed a related network diagram and verified the experimental results in molecular docking.

RESULTS

We identified a total of 4 core active compounds, and through KEGG analysis obtained multiple signaling pathways, including T helper17 (Th17) cell differentiation and interleukin-17 (IL-17) signaling pathway. Our molecular docking also verified that PFQF could effectively regulate the imbalance of Th17-T regulatory (Treg) cells.

CONCLUSIONS

PFQF can effectively treat the AHR caused by PM2.5 through Th17-Treg immune balance. The combination of molecular docking and network pharmacology provides a way to elucidate the complex mechanism of action of this Chinese herbal medicine.

Construction of a ceRNA immunoregulatory network related to the development of vascular dementia through a weighted gene coexpression network analysis

Background

To date, vascular dementia (VaD) lacks effective treatment in clinical practice. There is also growing evidence that VaD may be closely related to the immune response. The development of high-throughput technology, and the recently discovered group of new mediators called competitive endogenous RNAs (ceRNA), provides a unique opportunity to study the immunomodulation of VaD.

Methods

In this study, we used gene expression profiles in the Gene Expression Omnibus (GEO) database to obtain immune-related gene coexpression modules through a weighted gene coexpression network analysis (WGCNA) and gene enrichment analysis. We extracted and merged long non-coding RNA (lncRNA) and microRNA (miRNA) expressions from the GEO database and mapped them with related databases. Subsequently, we used Cytoscape to construct a lncRNA-miRNA-mRNA network, and then we performed an enrichment analysis on the mRNAs in the network to determine their regulatory function. Subsequently, we used an ImmuCellAI immune infiltration analysis and constructed a ceRNA sub-network of related immune cells. Finally, we conducted a gene set enrichment analysis (GSEA) to determine the potential regulatory pathways of the key factors.

Results

As a result, we identified the blue module as the key module of immunity and constructed the related CeRNA network. Immune infiltration analysis showed that natural killer T (NKT) cells may be the key immune cells of VaD. Using a Pearson correlation analysis, we identified that B4GALT1, PPP1R3B, MICB, HHAT, DSC2, DNA2, SCARA3, and lncRNA NEAT1 may be the key factors of VaD. Our subsequent GSEA analysis showed that lncRNA NEAT1 may be regulated by NK cells and toll-like receptors.

Conclusions

Our research provides new therapeutic targets for vascular dementia from the immunological perspective for the first time, including B4GALT1, PPP1R3B, MICB, HHAT, DSC2, DNA2, SCARA3, and lncRNA NEAT1, and our research hopes to provide new treatment options for VaD.

Exploring the mechanism of Yizhi Tongmai decoction in the treatment of vascular dementia through network pharmacology and molecular docking

BACKGROUND

Vascular dementia (VaD) is a degenerative cerebrovascular disease that leads to progressive decline of patients' cognitive ability and memory. Yizhi Tongmai (YZTM) decoction is an empirical prescription first formulated by Professor Guomin Si. Our previous experiments proved the effectiveness of this prescription in the treatment of VaD. In this study, we aimed to use network pharmacology and molecular docking technology to systematically explain the potential anti-VaD mechanism of YZTM.

METHODS

We identified the core compounds of YZTM and their potential targets through the TCMSP, BATMAN, and SwissTargetPrediction databases. Then, we identified the molecular targets of YZTM in VaD using the Online Mendelian Inheritance in Man and GeneCards databases. The common targets of YZTM and VaD were screened out, and then the pathways of these target genes were analyzed using the Database for Annotation, Visualization and Integrated Discovery v6.8. Molecular docking was used to verify the relationship between the core compounds and proteins.

RESULTS

Through network pharmacology analysis, we discovered that the 5 core compounds in YZTM exert an anti-VaD effect. The potential mechanism of YZTM anti-VaD may be through inhibiting the NLRP3 inflammasome, TNF signaling pathway, and toll-like receptor signaling pathways. Subsequently, key compounds were docked with related proteins in the NLRP3 inflammasome (NLRP3, ASC, caspase-1, interleukin-18, and interleukin-1 β) using molecular docking technology. The compounds were found to spontaneously bind to the proteins.

CONCLUSIONS

YZTM may exert an anti-VaD effect through inhibition of the NLRP3 inflammasome. In addition, TNF signaling pathway and toll-like receptor signaling pathway may also be its underlying mechanism. The application of network pharmacology and molecular docking technology may provide a novel method for research of Chinese herbal medicine. YZTM may also provide a complementary treatment option for patients with VaD.

Acupoint injection treatment for non-dialysis dependent chronic kidney disease: A meta-analysis of randomized controlled trials

AIM

To analyze the effects of acupoint injection in the treatment of non-dialysis dependent chronic kidney disease through a systematic review with meta-analysis.

METHODS

This systematic review with meta-analysis was conducted following the recommendations of the declaration of PRISMA. Full-text literature of randomized controlled trial of acupoint injection therapy for non-dialysis chronic kidney disease was searched in PubMed, Embase, Cochrane Library, China National Knowledge Internet, the Chinese Scientific Journal Database, the Wanfang Database, China Biology Medicine database. The efficacy and safety of acupoint injection for non-dialysis chronic kidney disease were evaluated.

RESULTS

Seventeen studies containing 1414 patients met the criteria. The results shows that acupoint injection combined with basic treatment can significantly improve the levels of Ccr (WMD = 4.81; 95% CI:2.54 to 7.08) and Hb (WMD = 4.56; 95% CI:1.72 to 7.39), reduce the levels of BUN (WMD = -0.90; 95% CI: -1.26 to -0.54)and Scr (WMD = -7.66; 95% CI: -12.39 to -2.93), and improve the effective rate (OR = 3.12; 95% CI: 2.29 to 4.26).

CONCLUSION

Our current analysis showed that combined acupoint injection therapy can reduce the levels of BUN and Scr, and increase Ccr and Hb in non-dialysis CKD patients. However, the existing evidence is still insufficient due to the high risk of included trial bias, and future research needs to improve methodological quality.Registration number: CRD42020168143.

A Review on Central Nervous System Effects of Gastrodin

Rhizoma Gastrodiae (also known as Tian ma), the dried rhizome of Gastrodia elata Blume, is a famous Chinese herb that has been traditionally used for the treatment of headache, dizziness, spasm, epilepsy, stoke, amnesia and other disorders for centuries. Gastrodin, a phenolic glycoside, is the main bioactive constituent of Rhizoma Gastrodiae. Since identified in 1978, gastrodin has been extensively investigated on its pharmacological properties. In this article, we reviewed the central nervous system (CNS) effects of gastrodin in preclinical models of CNS disorders including epilepsy, Alzheimer's disease, Parkinson's disease, affective disorders, cerebral ischemia/reperfusion, cognitive impairment as well as the underlying mechanisms involved and, where possible, clinical data that support the pharmacological activities. The sources and pharmacokinetics of gastrodin were also reviewed here. As a result, gastrodin possesses a broad range of beneficial effects on the above-mentioned CNS diseases, and the mechanisms of actions include modulating neurotransmitters, antioxidative, anti-inflammatory, suppressing microglial activation, regulating mitochondrial cascades, up-regulating neurotrophins, etc. However, more detailed clinical trials are still in need for positioning it in the treatment of neurological disorders.

Shenqi detoxification granule combined with P311 inhibits epithelial-mesenchymal transition in renal fibrosis via TGF-β1-Smad-ILK pathway

Shenqi detoxification granule (SDG), a traditional Chinese herbal formula, has been shown to have nephroprotective and anti-fibrotic activities in patients with chronic kidney disease (CKD). However, its mechanisms in renal fibrosis and the progression of CKD remain largely unknown. P311, a highly conserved 8-kDa intracellular protein, plays a key role in renal fibrosis by regulating epithelial-mesenchymal transition (EMT). Previously, we found P311 might be involved in the pathogenesis of renal fibrosis by inhibiting EMT via the TGF-β1-Smad-ILK pathway. We also found SDG combined with P311 could ameliorate renal fibrosis by regulating the expression of EMT markers. Here we further examined the effect and mechanism of SDG combined with P311 on TGF-β1-mediated EMT in a rat model of unilateral ureteral occlusion (UUO) renal fibrosis. After establishment of the UUO model successfully, the rats were gavaged with SDG daily and/or injected with recombinant adenovirus p311 (also called Ad-P311) through the tail vein each week for 4 weeks. Serum creatinine (Cr), blood urea nitrogen (BUN) and albumin (ALB) levels were tested to observe renal function, and hematoxylin eosin (HE) and Masson staining were performed to observe kidney histopathology. Furthermore, the expression of EMT markers (E-cadherin and α-smooth muscle actin (α-SMA)) and EMT-related molecules TGF-β1, pSmad2/3, Smad7 and ILK were observed using immunohistochemical staining and Western blot analysis. Treatment with SDG and P311 improved renal function and histopathological abnormalities, as well as reversing the changes of EMT markers and EMT-related molecules, which indicated SDG combined with P311 could attenuate renal fibrosis in UUO rats, and the underlying mechanism might involve TGF-β1-mediated EMT and the TGF-β1-Smad-ILK signaling pathway. Therefore, SDG might be a novel alternative therapy for treating renal fibrosis and delaying the progression of CKD. Furthermore, SDG combined with P311 might have a synergistic effect on attenuating renal fibrosis.

Adenovirus-mediated P311 inhibits TGF-β1-induced epithelial-mesenchymal transition in NRK-52E cells via TGF-β1-Smad-ILK pathway

P311, a highly conserved 8-kDa intracellular protein, has been indicated as an important factor in myofibroblast transformation and in the progression of fibrosis. In the present study, we constructed a recombinant adenovirus vector of p311 (called Ad-P311) and transferred it into rat renal proximal tubular epithelial cells (NRK-52E) to explore the effect of P311 on epithelial-mesenchymal transition (EMT) of NRK-52E cells induced by TGF-β1 and to elucidate its underlying mechanism against EMT. After successfully construction of Ad-P311 and transfer into NRK-52E cells, the proliferation and growth of P311-expressing cells was detected by MTT assay. TGF-β1 was used to induce NRK-52E cells and Western blot analysis was used to examine the EMT markers (E-cadherin and α-smooth muscle actin (α-SMA)), signal transducers (p-Smad2/3 and Smad7). Integrin Linked Kinase (ILK) as a key intracellular mediator that controls TGF-β1-induced-EMT was also assayed by Western blot analysis. The results showed that P311 transfection could significantly inhibit the proliferation and growth of TGF-β1 induced NRK-52E cells. The results also showed that TGF-β1 could induce EMT in NRK-52E cells through Smad-ILK signaling pathway with an increase in α-SMA, pSmad2/3 and ILK expression, and a decrease in E-cadherin and Smad7 expression. However, P311 efficiently blocked Smad-ILK pathway activation and attenuated all these EMT changes induced by TGF-β1. These findings suggest that P311 might be involved in the pathogenesis of renal fibrosis by inhibiting the EMT process via TGF-β1-Smad-ILK pathway. P311 might be a novel target for the control of renal fibrosis and the progression of CKD.

Chinese herbal medicine Shenqi Detoxification Granule inhibits fibrosis in adenine induced chronic renal failure rats

BACKGROUND

Progressive fibrosis accompanies all chronic renal disease, connective tissue growth factor (CTGF,) and platelet-derived growth factor-B, (PDGF-B,) play important roles in extra-cellular matrix abnormal accumulation, while endothelin-1 (ET-1) nitric oxide (NO,) are related to endothelial dysfunction, which mediates the progression of renal fibrosis. Shenqi Detoxification Granule (SDG), a traditional Chinese herbal formula, has been used for treatment of chronic renal failure in clinic for many years.

MATERIALS AND METHODS

In order to evaluate the efficacy, and explore the mechanism of SDG to inhibit the progression of renal fibrosis, study was carried out using the adenine-induced Wister rats as the CRF model, and losartan as postive control drug. Levels of serum creatinine [Scr], and blood urea nitrogen (BUN), albumin (ALB), 24hrs, urine protein (24hUP), triacylglycerol (TG), and cholesterol (CHO), together with ET-1, and NO were detected. Pathological changes of renal tissues were observed by HE, staining. In addition, CTGF and PDGF-B expression were analyzed by immuno-histo-chemistry.

RESULTS

The results indicated that SDG can effectively reduce Scr, BUN, 24hUP, TG, and CHO levels, increase ALB levels, inhibit renal tissue damage in CRF rats, and the mechanism maybe reduce PDGF-B, CTGF expression and ET-1/NO.

CONCLUSION

Shenqi Detoxification Granule is a beneficial treatment for chronic renal failure.

[Study on polymorphism of D gene exons among RhD-negative Chinese Han population]

OBJECTIVE

To explore the genomic structure of 8 exons in D gene of RhD(-) Chinese Han population.

METHODS

Polymerase chain reaction-sequence specific primers(PCR-SSP) were used to study genomic DNA from 50 samples of RhD(-) Chinese Han donors. Exons 2, 3, 4, 5, 6, 7, 9, 10 of RHD gene and exons 1, 2, 4, 5 of RHCE gene were specifically amplified, also intron 4 of them was amplified.

RESULTS

Phenotypes of the 50 RhD(-) donors were: 22 ccdee, 22 Ccdee, 3 CcdEe, 3 CcdEe. The 8 exons of RHD gene were completely absent in 25 donors with ccdee or ccdEe phenotype, while polymorphisms of D gene exons were found in 25 donors with Ccdee or CcdEe phenotype: the presence of all 8 exons of D gene in 9 donors, the absence of the 8 exons in 7 donors, the presence of exon 2 in 5 donors, the presence of exon 6 in 3 donors and the presence of exons 2, 6, 10 in 1 donor were demonstrated.

CONCLUSION

Polymorphisms of RHD gene exons were present among RhD(-) Chinese Han blood donors. The 8 exons of RHD gene were completely absent in donors with Rhesus cc phenotype, while 5 polymorphisms of RHD gene exons were found in donors with Rhesus Cc phenotype. The discrepancy of the RHD gene in RhD(-) individuals between Chinese Hans and Caucasians indicates that care should be exercised by clinicians in the use of the RhD genotyping results.