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Wang J, Zhang XY, Kang YH, Zhang Y, Chen XY, Zhou JL, Ma W. Modified Sijunzi Granules Exhibit Hemostatic Effect by Activating Akt and Erk Signal Pathways via Regulating 5-HT and Its Receptors Levels. Chin J Integr Med 2024:10.1007/s11655-023-3567-6. [PMID: 38212496 DOI: 10.1007/s11655-023-3567-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To investigate the hemostatic effect of modified Sijunzi Granules (MSG) in primary immune thrombocytopenia (ITP) zebrafish model and explore the potential mechanism. METHODS AB strain wild type zebrafish were treated with simvastatin (6 µmol/L) for 24 h to establish the hemorrhage model (model control group). The zebrafish were treated with MSG at different doses (55.6, 167, and 500 µg/mL), respectively. The hemostatic effect was assessed by examining the intestinal bleeding and hemostatic rate. 5-Hydroxytryptamine (5-HT) content was determined using enzyme-linked immunosorbent assay (ELISA) assay. The expressions of 5-HT2aR, 5-HT2bR, and SERT genes were detected by quantitative real-time polymerase chain reaction(PCR). The protein expressions of protein kinase B (Akt), p-Akt, extracellular regulated protein kinases (Erk), and p-Erk were examined using Western blot analysis. RESULTS The intestinal bleeding rate was 37%, 40%, and 80% in the 55.6, 167, and 500 µg/mL dose of MSG, respectively, in which 55.6 and 167 µg/mL MSG dose groups were associated with significantly decreased intestinal bleeding rate when compared with the model control group (70%, P<0.05). Significantly higher hemostatic rates were also observed in the 55.6 (54%) and 167 (52%) µg/mL MSG dose groups (P<0.05). MSG increased the 5-HT content and mRNA expression levels of 5-HT2aR, 5-HT2bR, and SERT (P<0.05). In addition, caspase3/7 activity was inhibited (P<0.05). Significant increase in p-Akt and p-Erk was also detected after treatment with MSG (P<0.05). CONCLUSIONS MSG could reduce the incidence and severity of intestinal bleeding in zebrafish by activating MAPK/Erk and PI3K/Akt signal pathways through regulating the levels of 5-HT and its receptors, which may provide evidence for the treatment of ITP.
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Affiliation(s)
- Jun Wang
- Department of Hematology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, China
| | - Xue-Ying Zhang
- Department of Hemato-Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yan-Hong Kang
- Department of Hemato-Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yun Zhang
- Department of Hematology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006, China
| | - Xin-Yi Chen
- Department of Hemato-Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Jia-Li Zhou
- Hunter Biotechnology, Inc., Hangzhou, 310051, China
| | - Wei Ma
- Department of Hemato-Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Wang Z, Zeng Z, Ye L, Zhu X, Pei Y, Wang Y, Zheng L. Impact of target-mediated drug disposition on hetrombopag pharmacokinetics and pharmacodynamics in Chinese healthy subjects and patients with chronic idiopathic thrombocytopenic purpura. Br J Clin Pharmacol 2021; 88:2084-2095. [PMID: 34705278 DOI: 10.1111/bcp.15130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 10/05/2021] [Accepted: 10/19/2021] [Indexed: 02/05/2023] Open
Abstract
AIMS The pharmacokinetics (PK) of hetrombopag were found to be nonlinear across evaluated dose ranges. The aim of this study was to develop a mechanism-based population pharmacokinetic/pharmacodynamic (PopPK/PD) model and to provide a reasonable expected therapeutic dose for a future confirmatory clinical study of hetrombopag. METHODS Nonlinear mixed-effects modelling was performed using pooled 2168 hetrombopag concentrations and 1526 platelet counts from 72 healthy subjects and 32 chronic idiopathic thrombocytopenic purpura (ITP) patients from two phase I studies and one phase II study. The final model was evaluated via goodness-of-fit plots, visual predictive check and nonparametric bootstrap. Simulations from the validated PopPK/PD model were used to devise an expected therapeutic dose for later confirmatory clinical study. RESULTS The pharmacokinetic data of hetrombopag were well described by a modified target-mediated drug disposition (TMDD) model with dual sequential first-order absorption. Mean parameter estimates (interindividual variability) were CL/F 7.66 L/h (63.5%), Vc /F 30.0 L (77.2%) and Kdeg 0.693/h (87.1%). The pharmacodynamic profile was well described by a five-compartment lifespan model with four-transit and one-platelet compartments. Simulation results suggested that chronic ITP patients following 10 mg once-daily hetrombopag would able to achieve an ideal platelet count level (50-200 × 109 /L). CONCLUSION TMDD was the primary reason leading to nonlinear PK profile of hetrombopag. Our PK/PD modelling and simulation results support 10 mg once-daily as the recommended therapeutic dose for chronic ITP patients in subsequent confirmatory clinical study of hetrombopag.
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Affiliation(s)
- Zhenlei Wang
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
| | - Zhijun Zeng
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
| | - Lijun Ye
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China.,The Office of Clinical Trial Management/Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaohong Zhu
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
| | - Yuwen Pei
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
| | - Yongsheng Wang
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
| | - Li Zheng
- Clinical Trial Center/NMPA Key Laboratory for Clinical Research and Evaluation of Innovative Drug, West China Hospital of Sichuan University, Chengdu, China
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Li H, Jiang X, Shen X, Sun Y, Jiang N, Zeng J, Lin J, Yue L, Lai J, Li Y, Wu A, Wang L, Qin D, Huang F, Mei Q, Yang J, Wu J. TMEA, a Polyphenol in Sanguisorba officinalis, Promotes Thrombocytopoiesis by Upregulating PI3K/Akt Signaling. Front Cell Dev Biol 2021; 9:708331. [PMID: 34485295 PMCID: PMC8416095 DOI: 10.3389/fcell.2021.708331] [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: 05/11/2021] [Accepted: 07/28/2021] [Indexed: 01/14/2023] Open
Abstract
Thrombocytopenia is closely linked with hemorrhagic diseases, for which induction of thrombopoiesis shows promise as an effective treatment. Polyphenols widely exist in plants and manifest antioxidation and antitumour activities. In this study, we investigated the thrombopoietic effect and mechanism of 3,3′,4′-trimethylellagic acid (TMEA, a polyphenol in Sanguisorba officinalis L.) using in silico prediction and experimental validation. A KEGG analysis indicated that PI3K/Akt signalling functioned as a crucial pathway. Furthermore, the virtual molecular docking results showed high-affinity binding (a docking score of 6.65) between TMEA and mTOR, suggesting that TMEA might target the mTOR protein to modulate signalling activity. After isolation of TMEA, in vitro and in vivo validation revealed that this compound could promote megakaryocyte differentiation/maturation and platelet formation. In addition, it enhanced the phosphorylation of PI3K, Akt, mTOR, and P70S6K and increased the expression of GATA-1 and NF-E2, which confirmed the mechanism prediction. In conclusion, our findings are the first to demonstrate that TMEA may provide a novel therapeutic strategy that relies on the PI3K/Akt/mTOR pathway to facilitate megakaryocyte differentiation and platelet production.
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Affiliation(s)
- Hong Li
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Xueqin Jiang
- School of Pharmacy, Southwest Medical University, Luzhou, China.,State Key Laboratory of Biotherapy and Cancer Center, West China Medical School, Sichuan University, Chengdu, China
| | - Xin Shen
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yueshan Sun
- School of Pharmacy, Southwest Medical University, Luzhou, China.,Medical Research Center, The Third People's Hospital of Chengdu, Chengdu, China
| | - Nan Jiang
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jing Zeng
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jing Lin
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Liang Yue
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jia Lai
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yan Li
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Anguo Wu
- School of Pharmacy, Southwest Medical University, Luzhou, China.,The Key Laboratory of Medical Electrophysiology, Medical Key Laboratory for Drug Discovery and Druggability Evaluation of Sichuan Province, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Ministry of Education of China, Institute of Cardiovascular Research, Luzhou, China
| | - Long Wang
- School of Pharmacy, Southwest Medical University, Luzhou, China.,The Key Laboratory of Medical Electrophysiology, Medical Key Laboratory for Drug Discovery and Druggability Evaluation of Sichuan Province, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Ministry of Education of China, Institute of Cardiovascular Research, Luzhou, China
| | - Dalian Qin
- School of Pharmacy, Southwest Medical University, Luzhou, China.,The Key Laboratory of Medical Electrophysiology, Medical Key Laboratory for Drug Discovery and Druggability Evaluation of Sichuan Province, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Ministry of Education of China, Institute of Cardiovascular Research, Luzhou, China
| | - Feihong Huang
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Qibing Mei
- The Key Laboratory of Medical Electrophysiology, Medical Key Laboratory for Drug Discovery and Druggability Evaluation of Sichuan Province, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Ministry of Education of China, Institute of Cardiovascular Research, Luzhou, China
| | - Jing Yang
- School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Jianming Wu
- School of Pharmacy, Southwest Medical University, Luzhou, China.,The Key Laboratory of Medical Electrophysiology, Medical Key Laboratory for Drug Discovery and Druggability Evaluation of Sichuan Province, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Ministry of Education of China, Institute of Cardiovascular Research, Luzhou, China
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Pizzi M, Friziero A, Vianello F, Binotto G, Da Dalt G, Zoletto S, Carraro E, Fassan M, Sbaraglia M, Sperti C, Baldan N, D'Amore F, Bertozzi I, Righi S, Pierobon ES, Moletta L, Capovilla G, Grego A, Sabattini E, Fabris F, Merigliano S, Dei Tos AP. Histology of the spleen in immune thrombocytopenia: clinical-pathological characterization and prognostic implications. Eur J Haematol 2020; 106:281-289. [PMID: 33190299 DOI: 10.1111/ejh.13547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Immune thrombocytopenia (ITP) is an acquired disorder, characterized by immune-mediated platelet destruction. The spleen plays a key pathogenic role in ITP and splenectomy is a valuable second-line therapy for this disease. Little is known on ITP spleen histology and response to splenectomy is unpredictable. This study aims to characterize ITP spleen histology and assess possible predictors of splenectomy outcome. METHODS A series of 23 ITP spleens were retrospectively assessed for the following histological parameters: density of lymphoid follicles (LFs), marginal zones (MZs), T helper and cytotoxic T cells; presence of reactive germinal centers (GCs); width of perivascular T cell sheaths; and red pulp features. Clinical and histological data were matched with postsplenectomy platelet counts to assess their prognostic relevance. RESULTS Three histological patterns were documented: a hyperplastic white pulp pattern, a non-activated white pulp pattern (lacking GCs), and a white pulp-depleted pattern. Poor surgical responses were associated with presplenectomy high-dose steroid administration, autoimmune comorbidities and low T follicular helper cell density. The combination of such parameters stratified patients into different splenectomy response groups. The removal of accessory spleens was also associated with better outcome. CONCLUSION ITP spleens are histologically heterogeneous and clinical-pathological parameters may help predict the splenectomy outcome.
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Affiliation(s)
- Marco Pizzi
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Alberto Friziero
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fabrizio Vianello
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Gianni Binotto
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Gianfranco Da Dalt
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Simone Zoletto
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Elisa Carraro
- Oncohematology Unit, Department of Women and Children's Health, University of Padova, Padova, Italy
| | - Matteo Fassan
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Marta Sbaraglia
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Cosimo Sperti
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Nicola Baldan
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Fabio D'Amore
- Hematology and Clinical Immunology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Irene Bertozzi
- 1st Medical Clinic, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Simona Righi
- Haematopathology Unit, Sant'Orsola Hospital, Bologna, Italy
| | - Elisa Sefora Pierobon
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Lucia Moletta
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Giovanni Capovilla
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Andrea Grego
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | | | - Fabrizio Fabris
- 1st Medical Clinic, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Stefano Merigliano
- 3rd Surgical Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Angelo Paolo Dei Tos
- Surgical Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
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