Xuanbai Chengqi Decoction alleviates acute lung injury by inhibiting NLRP3 inflammasome

Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis

Objective

To evaluate the efficacy and safety of Modified Xuanbai Chengqi Decoction as an adjunctive therapy for severe pneumonia (SP) and to explore its clinical rationale.

Methods

A comprehensive search was performed in CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, and Embase, covering database inception to November 2024. Randomized controlled trials that investigated the combination of Modified Xuanbai Chengqi Decoction with standard therapy for severe pneumonia were included. Quality evaluation, meta-analysis, and bias assessments were performed with Review Manager 5.4, using risk ratios and mean differences (MD), both with 95% confidence intervals to estimate effects.

Results

A total of 14 RCTs involving 1,061 participants met the inclusion criteria. Meta-analysis indicated that adjunctive treatment with the decoction achieved better overall response rates [RR = 1.21, 95% CI (1.14, 1.28), P < 0.00001] and demonstrated significant reductions in interleukin-6 (IL-6, MD = -15.07, 95% CI (-17.31, -12.83), P < 0.00001), interleukin-13 (IL-13, MD = -7.30, 95% CI (-7.82, -6.79), P < 0.00001), and tumour necrosis factor-α (TNF-α, MD = -0.56, 95% CI (-0.64, -0.48), P < 0.00001), high-sensitivity C-reactive protein (hs-CRP, MD = -2.09, 95% CI (-2.47, -1.71), P < 0.00001), procalcitonin (PCT, MD = -2.04, 95% CI (-2.55, -1.53), P < 0.00001), arterial blood gas lactate (LaC, MD = -2.28, 95% CI (-2.45, -2.11), P < 0.00001), mechanical ventilation time (MD = -120.03, 95% CI (-130.14, -109.92), P < 0.00001), clinical pulmonary infection score (CPIS, MD = -2.71, 95% CI (-3.95, -1.82), P < 0.00001), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (MD = -7.41, 95% CI (-7.54, -7.28), P < 0.00001), and ICU transfer rate [RR = 22.88, 95% CI (6.68, 78.32), P < 0.00001].

Conclusion

Modified Xuanbai Chengqi Decoction appears advantageous as an adjunct for SP treatment, but the evidence remains insufficient to support widespread application owing to the low quality of the included research. Future studies should incorporate higher-quality RCTs and assess drug safety and cost-effectiveness in a rigorous manner.

KAE ameliorates LPS-mediated acute lung injury by inhibiting PANoptosis through the intracellular DNA-cGAS-STING axis

Background

Acute lung injury (ALI) is a severe condition characterized by inflammation, tissue damage, and persistent activation of the cyclic GMP-AMP (cGAS)-stimulator of interferon genes (STING) pathway, which exacerbates the production of pro-inflammatory mediators and promotes the progression of ALI. Specific inhibition of this pathway has been shown to alleviate ALI symptoms. Kaempferol-3-O-α-L-(4″-E-p-coumaroyl)-rhamnoside (KAE), an active compound found in the flowers of Angelica acutiloba Kitagawa, exhibits anti-inflammatory and antioxidant properties. This study aimed to investigate the molecular mechanisms through which KAE regulates the cGAS-STING pathway in the context of ALI.

Methods

ALI was induced using LPS. Lung damage and anti-inflammatory/antioxidant effects were assessed by H&E staining, lung edema index, and SOD, MDA, and ELISA assays. NO release and mitochondrial membrane potential (MMP) were measured by JC-1 and Griess methods. The impact of KAE on the cGAS-STING pathway and PANoptosis was analyzed using flow cytometry, Western blot, and immunofluorescence.

Results

KAE significantly alleviated lipopolysaccharide-induced pulmonary injury by reducing inflammatory cell infiltration, alleviating pulmonary edema, enhancing antioxidant capacity, and decreasing levels of inflammatory cytokines in mouse lung tissues. In both in vitro and in vivo analyses, KAE downregulated the expression of key components of the cGAS-STING pathway, including cGAS, STING, p-TBK1, and nuclear factor-κB. KAE also reduced the assembly and activation of the PANoptosome, thereby attenuating apoptosis, necroptosis, and pyroptosis. Additionally, KAE inhibited cGAS activation by restoring the MMP, which reduced the release of cytosolic DNA.

Conclusion

KAE improve ALI by inhibiting the release of cytosolic DNA and suppressing cGAS-STING pathway activation, thereby protecting cells from PANoptosis. Our findings provide valuable insights for the development and application of novel therapeutic strategies for ALI.

Plumbagin ameliorates LPS-induced acute lung injury by regulating PI3K/AKT/mTOR and Keap1-Nrf2/HO-1 signalling pathways

Acute lung injury (ALI) is a major pathophysiological problem characterized by severe inflammation, resulting in high morbidity and mortality. Plumbagin (PL), a major bioactive constituent extracted from the traditional Chinese herb Plumbago zeylanica, has been shown to possess anti-inflammatory and antioxidant pharmacological activities. However, its protective effect on ALI has not been extensively studied. The objective of this study was to investigate the protective effect of PL against ALI induced by LPS and to elucidate its possible mechanisms both in vivo and in vitro. PL treatment significantly inhibited pathological injury, MPO activity, and the wet/dry ratio in lung tissues, and decreased the levels of inflammatory cells and inflammatory cytokines TNF-α, IL-1β, IL-6 in BALF induced by LPS. In addition, PL inhibited the activation of the PI3K/AKT/mTOR signalling pathway, increased the activity of antioxidant enzymes CAT, SOD, GSH and activated the Keap1/Nrf2/HO-1 signalling pathway during ALI induced by LPS. To further assess the association between the inhibitory effects of PL on ALI and the PI3K/AKT/mTOR and Keap1/Nrf2/HO-1 signalling, we pretreated RAW264.7 cells with 740Y-P and ML385. The results showed that the activation of PI3K/AKT/mTOR signalling reversed the protective effect of PL on inflammatory response induced by LPS. Moreover, the inhibitory effects of PL on the production of inflammatory cytokines induced by LPS also inhibited by downregulating Keap1/Nrf2/HO-1 signalling. In conclusion, the results indicate that the PL ameliorate LPS-induced ALI by regulating the PI3K/AKT/mTOR and Keap1-Nrf2/HO-1 signalling, which may provide a novel therapeutic perspective for PL in inhibiting ALI.

The Critical Role of Pyroptosis in Peri-Implantitis

Background

Peri-implantitis (PI) is a prevalent complication of implant treatment. Pyroptosis, a distinctive inflammatory programmed cell death, is crucial to the pathophysiology of PI. Despite its importance, the pyroptosis-related genes (PRGs) influencing PI's progression remain largely unexplored.

Methods

This study conducted histological staining and transcriptome analyze from three datasets. The intersection of differentially expressed genes (DEGs) and PRGs was identified as pyroptosis-related differentially expressed genes (PRDEGs). Functional enrichment analyses were conducted to shed light on potential underlying mechanisms. Weighted Gene Co-expression Network Analysis (WGCNA) and a pyroptotic macrophage model were utilized to identify and validate hub PRDEGs. Immune cell infiltration in PI and its relationship with hub PRDEGs were also examined. Furthermore, consensus clustering was performed to identify new PI subtypes. Protein-protein interaction (PPI) network, competing endogenous RNA (ceRNA) network, mRNA-mRNA binding protein regulatory (RBP) network, and mRNA-drugs regulatory network of hub PRDEGs were also analyzed.

Results

Eight hub PRDEGs were identified: PGF, DPEP1, IL36B, IFIH1, TCEA3, RIPK3, NET7, and TLR3, which are instrumental in the PI's progression. Two PI subtypes were distinguished, with Cluster 1 exhibiting higher immune cell activation. The exploration of regulatory networks provided novel mechanisms and therapeutic targets in PI.

Conclusion

Our research highlights the critical role of pyroptosis and identifies eight hub PRDEGs in PI's progression, offering insights into novel immunotherapy targets and laying the foundation for advanced diagnostic and treatment strategies. This contributes to our understanding of PI and underscores the potential for personalized clinical management.