Compatibility effects of ginseng and Ligustrum lucidum Ait herb pair on hematopoietic recovery in mice with cyclophosphamide-induced myelosuppression and its material basis

Chinese Herbal Medicines for Coronary Heart Disease: Clinical Evidence, Pharmacological Mechanisms, and the Interaction with Gut Microbiota

Coronary heart disease (CHD) is a common type of cardiovascular disease (CVD) that has been on the rise in terms of both incidence and mortality worldwide, presenting a significant threat to human health. An increasing body of studies has shown that traditional Chinese medicine (TCM), particularly Chinese herbal medicines (CHMs), can serve as an effective adjunctive therapy to enhance the efficacy of Western drugs in treating CHD due to their multiple targets and multiple pathways. In this article, we critically review data available on the potential therapeutic strategies of CHMs in the intervention of CHD from three perspectives: clinical evidence, pharmacological mechanisms, and the interaction with gut microbiota. We identified 20 CHMs used in clinical practice and it has been found that the total clinical effective rate of CHD patients improved on average by 17.78% with the intervention of these CHMs. Subsequently, six signaling pathways commonly used in treating CHD have been identified through an overview of potential pharmacological mechanisms of these 20 CHMs and the eight representative individual herbs selected from them. CHMs could also act on gut microbiota to intervene in CHD by modulating the composition of gut microbiota, reducing trimethylamine-N-oxide (TMAO) levels, increasing short-chain fatty acids (SCFAs), and maintaining appropriate bile acids (BAs). Thus, the therapeutic potential of CHMs for CHD is worthy of further study in view of the outcomes found in existing studies.

Carbohydrates and ginsenosides in shenmai injection jointly improve hematopoietic function during chemotherapy-induced myelosuppression in mice

Background

Shenmai injection (SMI), a traditional Chinese medicine (TCM) injection prepared from Red ginseng and Ophiopogon japonicus, is widely used in clinics to treat chemotherapy-induced myelosuppression. Similar to other TCM injections, SMI contains a high amount of carbohydrates (fructose, sucrose, and maltose) in addition to the bioactive substances, specifically ginsenosides (Rg1, Re, and Rb1). To date, the role of these carbohydrates in the hematopoietic function of SMI remains unclear.

Purpose

We aimed to investigate the hematopoietic effects and potential mechanisms of SMI and its components, focusing on the carbohydrates present in SMI.

Experimental design/methods

First, we evaluated the hematopoietic effect of SMI on 5-fluorouracil (5-FU)-induced myelotoxicity in a tumor-bearing mouse model. Then we prepared mixtures of ginsenosides and carbohydrates according to their proportions in SMI and evaluated their hematopoietic function in mice with 5-FU-induced myelosuppression. Finally, hematopoiesis-related molecular networks were built based on RNA sequencing (RNA-seq) of the bone marrow stromal cells (BMSCs), and the potential mechanisms of carbohydrates and ginsenosides were evaluated.

Results

SMI attenuated 5-FU-induced myelotoxicity in tumor-bearing mice. Both ginsenosides and carbohydrates increased the bone marrow nucleated cell (BMNC) count and improved the bone marrow morphology in myelosuppressive mice; they promoted the proliferation of BMSCs derived from those myelosuppressive mice. Bioinformatics analyses revealed ECM-receptor interaction, Hippo signaling, and Wnt signaling are common pathways regulated by both ginsenosides and carbohydrates; Gstt1, Gstp2, Gsta4 and Oplah in Glutathione metabolism pathway and Cd19, Cd79a, and Cd79b in B cell receptor pathway are uniquely regulated genes related to carbohydrates but not ginsenosides.

Conclusions

Carbohydrates may collaborate with ginsenosides and contribute to the hematopoietic function of SMI. Carbohydrates could be considered as a bioactive component in this TCM injection.

Graphical Abstract

Two birds with one stone: YQSSF regulates both proliferation and apoptosis of bone marrow cells to relieve chemotherapy-induced myelosuppression

ETHNOPHARMACOLOGICAL RELEVANCE

Yiqi Shengsui formula (YQSSF) is a commonly used formula to treat chemotherapy-induced myelosuppression, but little is known about its therapeutic mechanisms.

AIM OF THIS STUDY

This study aims to examine the effect of YQSSF in treating myelosuppression and explore its mechanism.

MATERIALS AND METHODS

A myelosuppression BALB/c mouse model was established by intraperitoneal (i.p.) injection of cyclophosphamide (CTX). The efficacy of YQSSF in alleviating chemotherapy-induced myelosuppression was evaluated by blood cell count, immune organ (thymus, spleen, liver) index, bone marrow nucleated cell (BMNC) count and histopathological analysis of bone marrow and spleen. Then, ultra-performance liquid chromatograph quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was performed to analyze the ingredients of YQSSF extract. Key effects and potential mechanism of YQSSF extract in alleviating myelosuppression were predicted by network pharmacology method. Finally, cell cycle and TUNEL staining of bone marrow cells was detected to verify the key effects, and RT-qPCR or Western blotting were performed to measure the gene and protein expressions of the effect targets respectively to confirm the predicted mechanism of YQSSF for myelosuppression.

RESULTS

YQSSF up-regulated the number of peripheral blood leukocytes and BMNC, reduced spleen index and liver index, improved the pathological morphology of bone marrow and spleen. A total of 40 ingredients were isolated from YQSSF extract using UPLC-Q/TOF-MS analysis. Network pharmacology revealed that YQSSF regulated both proliferation and apoptosis to alleviate myelosuppression. Finally, YQSSF decreased G0/G1 ratio, increased the proportion of bone marrow cells in S phase and proliferation index (PI), and reduced apoptotic cells in femur bone marrow. RT-qPCR and Western blotting showed that YQSSF up-regulated the expression levels of CDK4, CDK6, CyclinB1, c-Myc and Bcl-2, as well as down-regulated the expression levels of Cyt-c, Fas, Caspase-8/3 and p53.

CONCLUSIONS

YQSSF promotes the proliferation and inhibits the apoptosis of bone marrow cells to relieve chemotherapy-induced myelosuppression.

Panax ginseng and its ginsenosides: potential candidates for the prevention and treatment of chemotherapy-induced side effects

Chemotherapy-induced side effects affect the quality of life and efficacy of treatment of cancer patients. Current approaches for treating the side effects of chemotherapy are poorly effective and may cause numerous harmful side effects. Therefore, developing new and effective drugs derived from natural non-toxic compounds for the treatment of chemotherapy-induced side effects is necessary. Experiments in vivo and in vitro indicate that Panax ginseng (PG) and its ginsenosides are undoubtedly non-toxic and effective options for the treatment of chemotherapy-induced side effects, such as nephrotoxicity, hepatotoxicity, cardiotoxicity, immunotoxicity, and hematopoietic inhibition. The mechanism focus on anti-oxidation, anti-inflammation, and anti-apoptosis, as well as the modulation of signaling pathways, such as nuclear factor erythroid-2 related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), P62/keap1/Nrf2, c-jun N-terminal kinase (JNK)/P53/caspase 3, mitogen-activated protein kinase (MEK)/extracellular signal-regulated kinases (ERK), AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR), mitogen-activated protein kinase kinase 4 (MKK4)/JNK, and phosphatidylinositol 3-kinase (PI3K)/AKT. Since a systemic review of the effect and mechanism of PG and its ginsenosides on chemotherapy-induced side effects has not yet been published, we provide a comprehensive summarization with this aim and shed light on the future research of PG.

Ameliorative effects of ginsenosides on myelosuppression induced by chemotherapy or radiotherapy

BACKGROUND

and ethnopharmacological relevance: As the major side effect of radiotherapy or chemotherapy, myelosuppression usually leads to anemia, hemorrhage, immunosuppression, and even fatal infections, which may discontinue the process of cancer treatment. As a result, more and more attention is paid to the treatment of myelosuppression. Ginseng, root of Panax ginseng Meyer (Panax ginseng C. A. Mey), is considered as the king of herbs in the Orient, particularly in China, Korea and Japan. Ginsenosides, the most important active ingredients of ginseng, have been shown to have a variety of therapeutic effects, such as neuroprotective, anti-cancer and anti-diabetic properties. Considering that ginsenosides are closely associated with the pathogenesis of myelosuppression, researchers have carried out a few experiments on ginsenosides to attenuate myelosuppression induced by chemotherapy or radiotherapy in recent years.

AIM OF THE STUDY

To summarize previous studies about the effects of ginsenosides on alleviating myelosuppression and the mechanisms of action.

METHODS

Literatures in this review were searched in PubMed, China National Knowledge Infrastructure (CNKI), Web of Science, and ScienceDirect.

RESULTS

Ginsenosides play an important role in relieving myelosuppression predominantly by restoring hematopoiesis and immunity.

CONCLUSION

Ginsenosides might be potential candidates for the treatment of myelosuppression induced by chemotherapy or radiotherapy.