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Willcox ML, Tai CJ, Chattopadhyay K, Hu XY, Heinrich M. Editorial: Clinical phytopharmacology. Front Pharmacol 2024; 14:1353483. [PMID: 38288085 PMCID: PMC10822887 DOI: 10.3389/fphar.2023.1353483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024] Open
Affiliation(s)
- Merlin L. Willcox
- Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Chi-Jung Tai
- Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kaushik Chattopadhyay
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Xiao-Yang Hu
- Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael Heinrich
- Pharmacognosy and Phytotherapy Group, UCL School of Pharmacy, London, United Kingdom
- Chinese Medicine Research Center, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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Zhou X, Tan F, Zhang S, Wang A, Zhang T. A Strategy based on Bioinformatics and Machine Learning Algorithms Reveals Potential Mechanisms of Shelian Capsule against Hepatocellular Carcinoma. Curr Pharm Des 2024; 30:377-405. [PMID: 38310567 DOI: 10.2174/0113816128284465240108071554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a prevalent and life-threatening form of cancer, with Shelian Capsule (SLC), a traditional Chinese medicine (TCM) formulation, being recommended for clinical treatment. However, the mechanisms underlying its efficacy remain elusive. This study sought to uncover the potential mechanisms of SLC in HCC treatment using bioinformatics methods. METHODS Bioactive components of SLC were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and HCC-related microarray chip data were sourced from the Gene Expression Omnibus (GEO) database. The selection criteria for components included OB ≧ 30% and DL ≧ 0.18. By integrating the results of differential expression analysis and weighted gene co-expression network analysis (WGCNA), disease-related genes were identified. Therapeutic targets were determined as shared items between candidate targets and disease genes. Protein-protein interaction (PPI) network analysis was conducted for concatenated genes, with core protein clusters identified using the MCODE plugin. Machine learning algorithms were applied to identify signature genes within therapeutic targets. Subsequently, immune cell infiltration analysis, single-cell RNA sequencing (sc-RNA seq) analysis, molecular docking, and ADME analysis were performed for the screened genes. RESULTS A total of 153 SLC ingredients and 170 candidate targets were identified, along with 494 HCCrelated disease genes. Overlapping items between disease genes and drug candidates represented therapeutic genes, and PPI network analysis was conducted using concatenated genes. MCODE1 and MCODE2 cluster genes underwent Disease Ontology (DO), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Four signature genes (TOP2A, CYP1A2, CYP2B6, and IGFBP3) were identified from 28 therapeutic genes using 3 machine learning algorithms, with ROC curves plotted. Molecular docking validated the interaction modes and binding abilities between signature genes and corresponding compounds, with free binding energy all <-7 kcal/mol. Finally, ADME analysis revealed similarities between certain SLC components and the clinical drugs Sorafenib and Lenvatinib. CONCLUSION In summary, our study revealed that the mechanism underlying the anti-HCC effects of SLC involves interactions at three levels: components (quercetin, beta-sitosterol, kaempferol, baicalein, stigmasterol, and luteolin), pathways (PI3K-Akt signaling pathway, TNF signaling pathway, and IL-17 signaling pathway), and targets (TOP2A, CYP1A2, CYP2B6, and IGFBP3). This study provides preliminary insights into the potential pharmacological mechanisms of SLC in HCC treatment, aiming to support its clinical application and serve as a reference for future laboratory investigations.
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Affiliation(s)
- Xianqiang Zhou
- Department of Traditional Chinese Medicine, Shanghai Medical College, Jing'an District Central Hospital Affiliated to Fudan University, Shanghai 200040, China
- Department of Pulmonary Diseases, Shanghai Medical College, Jing'an District Hospital of Traditional Chinese Medicine, Shanghai 200072, China
| | - Fang Tan
- Department of Neurology, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, Anhui Province, China
| | - Suxian Zhang
- Department of Traditional Chinese Medicine, Shanghai Medical College, Jing'an District Central Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - An'an Wang
- Department of Pulmonary Diseases, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Tiansong Zhang
- Department of Traditional Chinese Medicine, Shanghai Medical College, Jing'an District Central Hospital Affiliated to Fudan University, Shanghai 200040, China
- Department of Pulmonary Diseases, Shanghai Medical College, Jing'an District Hospital of Traditional Chinese Medicine, Shanghai 200072, China
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Willcox ML, Hu XY, Oliver T, Thorne K, Boxall C, He G, Simpson C, Brotherwood B, O’Neil A, Waugh R, Tilt E, Trill J, Goward N, Francis N, Thomas M, Little P, Wilkinson T, Liu JP, Griffiths G, Moore M. Treating acute exacerbations of COPD with Chinese herbal medicine to aid antibiotic use reduction (Excalibur): a randomised double-blind, placebo-controlled feasibility trial. Front Pharmacol 2023; 14:1221905. [PMID: 37818189 PMCID: PMC10561384 DOI: 10.3389/fphar.2023.1221905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/08/2023] [Indexed: 10/12/2023] Open
Abstract
Background: Although many acute exacerbations of COPD (AECOPD) are triggered by non-bacterial causes, they are often treated with antibiotics. Preliminary research suggests that the Chinese herbal medicine "Shufeng Jiedu" (SFJD), may improve recovery and therefore reduce antibiotic use in patients with AECOPD. Aims: To assess the feasibility of conducting a randomised placebo-controlled clinical trial of SFJD for AECOPD in UK primary care. Methods: GPs opportunistically recruited patients experiencing an AECOPD. Participants were randomised 1:1 to usual care plus SFJD or placebo for 14 days. Participants, GPs and research nurses were blinded to treatment allocation. GPs could prescribe immediate, delayed or no antibiotics, with delayed prescribing encouraged where appropriate. Participants were asked to complete a participant diary, including EXACT-PRO and CAT™ questionnaires for up to 4 weeks. Outcomes included recruitment rate and other measures of study feasibility described using only descriptive statistics and with no formal comparisons between groups. We also conducted qualitative interviews with recruited and non-recruited COPD patients and clinicians, analysed using framework analysis. Results: Over 6 months, 19 participants (6 SFJD, 13 placebo) were recruited. Sixteen (84%) participants returned diaries or provided a diary by recall. Overall, 1.3 participants were recruited per 1,000 patients on the COPD register per month open. Median duration of treatment was 9.8 days in the intervention group vs 13.3 days in the placebo group. The main reason for discontinuation in both groups was perceived side-effects. in both groups. Point estimates for both the EXACT-PRO and CAT™ outcomes suggested possible small benefits of SFJD. Most patients and clinicians were happy to try SFJD as an alternative to antibiotics for AECOPD. Recruitment was lower than expected because of the short recruitment period, the lower incidence of AECOPD during the COVID-19 pandemic, patients starting antibiotics from "rescue packs" before seeing their GP, and workforce challenges in primary care. Conclusion: Recruitment was impaired by the COVID-19 pandemic. Nevertheless, we were able to demonstrate the feasibility of recruiting and randomising participants and identified approaches to address recruitment challenges such as including the trial medication in COPD patients' "rescue packs" and delegating recruitment to a central trials team. Clinical Trial Registration: Identifier, ISRCTN26614726.
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Affiliation(s)
- Merlin L. Willcox
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Xiao-Yang Hu
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Tom Oliver
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Kerensa Thorne
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Cherish Boxall
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - George He
- Phoenix Medical Ltd, Chelmsford, United Kingdom
| | - Catherine Simpson
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Becci Brotherwood
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Alice O’Neil
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Robert Waugh
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Emma Tilt
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Jeanne Trill
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Neville Goward
- Patient and Public Representative, Southampton, United Kingdom
| | - Nick Francis
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Michael Thomas
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Tom Wilkinson
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jian-Ping Liu
- Centre for Evidence-based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Michael Moore
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
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Yan LJ, Wang ZJ, Fang M, Lan HD, Moore M, Willcox M, Trill J, Hu XY, Liu JP. Bupleuri radix for Acute Uncomplicated Respiratory Tract Infection: A Systematic Review of Randomized Controlled Trials. Front Pharmacol 2022; 12:787084. [PMID: 35185539 PMCID: PMC8855037 DOI: 10.3389/fphar.2021.787084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/28/2021] [Indexed: 12/26/2022] Open
Abstract
Objective: To evaluate the efficacy, clinical effectiveness, and safety of the Chinese herb Bupleuri radix for the treatment of acute uncomplicated respiratory tract infections (ARTIs). Methods: Four English and four Chinese databases were searched from their inception to June 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of Bupleuri radix on ARTI were eligible for inclusion. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses with effects estimated as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). The certainty of the evidence was assessed using the online GRADEpro tool. Results: Seven randomized trials involving 910 patients with acute upper respiratory tract infection (AURTI) were included. The review identified Bupleuri radix agents with four administration routes (oral, acupoint injection, intramuscular injection, nebulized inhalation). Bupleuri radix acupoint injection compared with placebo showed statistically significant effects in reducing fever resolution time (MD: −33.32 h, 95%CI: −35.71, −30.93), and in increasing the proportion of participants with fever resolved within 48 h from treatment onset (RR: 14, 95%CI: 1.96, 99.94). Bupleuri radix acupoint injection combined with usual care is more effective in reducing the temperature at day 1 from treatment onset (MD: −1.00°C, 95%CI: −1.19, −0.81) compared with usual care alone. Bupleuri radix pills showed similar antipyretic effects to acetaminophen. However, Bupleuri radix intramuscular injection plus vitamins failed to demonstrate an effect in reducing fever, when compared with ribavirin plus vitamins. It suggested that oral administration of Bupleuri radix solution for injections, pills, and Bupleuri radix decoction have a similar effect on improving global AURTI symptoms including two key symptoms (nasal discharge and cough), when compared with usual care alone. Only two trials reported whether or not there were any AEs and found no occurrence of adverse events in the herbal group. Conclusion: Low-certainty or very low-certainty evidence demonstrated that Bupleuri radix (solution for injections and pills) has an antipyretic effect on febrile patients with AURTI, but it has no effect on other AURTI symptoms. However, these findings need to be further confirmed by well-designed clinical trials with adequate sample sizes. Systematic review registration: (https://www.crd.york.ac.uk/prospero/#recordDetails), PROSPERO registration number: CRD42021234066.
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Affiliation(s)
- Li-Jiao Yan
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhi-Jie Wang
- Department of Oncology, Shanxi Provincial Hospital of Traditional Chinese Medicine, Shanxi, China
| | - Min Fang
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hui-Di Lan
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
| | - Michael Moore
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Merlin Willcox
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jeanne Trill
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Xiao-Yang Hu
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Research Design Service South Central, National Institute of Health Research, Southampton, United Kingdom
- *Correspondence: Jian-Ping Liu, ; Xiao-Yang Hu,
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- *Correspondence: Jian-Ping Liu, ; Xiao-Yang Hu,
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