Yinzhihuang oral liquid in the treatment of neonatal jaundice: a meta-analysis

Investigating the mechanisms of yinchen in the treatment of immune hemolysis: Quercetin's role in complement inhibition and suppression of IL-6/STAT3 signaling

Yinchen (YC), the dried aerial parts of the medicinal plant Artemisia capillaris Thunb. (family Asteraceae), is primarily distributed across the Asia-Pacific Region. Although YC exhibits clinically validated efficacy against immune hemolytic disorders, its mechanistic underpinnings remain insufficiently elucidated in pharmacological research. This study investigates the potential targets and mechanisms of YC in treating immune hemolysis based on network pharmacology and bioinformatic analysis. Additionally, it aims to verify quercetin's anti-complement activity and inhibition of IL-6-induced STAT3 activation, a key component of YC, through in vitro experiments, molecular docking and molecular dynamics simulations. 13 active components in YC with 143 putative targets were identified by Network pharmacology. Quercetin, beta-sitosterol, and isorhamnetin were top-ranked by target count. 1231 gene targets related to immune hemolysis, with 60 overlapping targets mapping to both YC and the disease were identified. Quercetin exhibited inhibitory activity against both classical and alternative complement pathways, with IC50 values of 528.3 mg/L and 212.5 mg/L, respectively. Quercetin (80 μM) suppressed IL-6-induced IgG secretion and attenuated STAT3 signaling in murine splenic lymphocytes, as evidenced by decreased levels of STAT3 mRNA expression, STAT3 and phosphorylated STAT3 (p-STAT3) proteins. Molecular docking analysis revealed quercetin's putative binding affinity to key complement system components (C1, C2, C3, C4, C5, C8, C9, Factor B) and IL-6, suggesting a dual mechanism of complement pathway modulation and IL-6/IL-6R interaction blockade. Simulation studies confirmed the stable interaction between C1s, C3, C5 and IL-6 and quercetin. Quercetin, a key component of Yinchen used in treating immune hemolysis, demonstrates anti-complement activity and can inhibit IL-6-induced STAT3 activation in vitro.

Effects of Yinzhihuang on Alleviating Cyclosporine A-Induced Cholestatic Liver Injury via Farnesoid X Receptor-Mediated Regulation of Transporters and Enzymes in Vitro and in Vivo

Yinzhihuang (YZH), a traditional Chinese medicine prescription, was widely used to treat cholestasis. Cholestatic liver injury limited the use of the immunosuppressive drug cyclosporine A (CsA) in preventing organ rejection after solid organ transplantation. Clinical evidences suggested that YZH could enhance bile acids and bilirubin clearance, providing a potential therapeutic strategy against CsA-induced cholestasis. Nevertheless, it remains unclear whether YZH can effectively alleviate CsA-induced cholestatic liver injury, as well as the molecular mechanisms responsible for its hepatoprotective effects. The purpose of the present study was to investigate the hepatoprotective effects of YZH on CsA-induced cholestatic liver injury and explore its molecular mechanisms in vivo and vitro. The results demonstrated that YZH significantly improved the CsA-induced cholestatic liver injury and reduced the level of liver function markers in serum of Sprague-Dawley (SD) rats. Targeted protein and gene analysis indicated that YZH increased bile acids and bilirubin efflux into bile through the regulation of multidrug resistance-associated protein 2 (Mrp2), bile salt export pump (Bsep), sodium taurocholate cotransporting polypeptide (Ntcp) and organic anion transporting polypeptide 2 (Oatp2) transport systems, as well as upstream nuclear receptors farnesoid X receptor (Fxr). Moreover, YZH modulated enzymes involved in bile acids synthesis and bilirubin metabolism including Cyp family 7 subfamily A member 1 (Cyp7a1) and uridine 5'-diphosphate (UDP) glucuronosyltransferase family 1 member A1 (Ugt1a1). Furthermore, the active components geniposidic acid, baicalin and chlorogenic acid exerted regulated metabolic enzymes and transporters in LO2 cells. In conclusion, YZH may prevent CsA-induced cholestasis by regulating the transport systems, metabolic enzymes, and upstream nuclear receptors Fxr to restore bile acid and bilirubin homeostasis. These findings highlight the potential of YZH as a therapeutic intervention for CsA-induced cholestasis and open avenues for further research into its clinical applications.

Network Pharmacology-Based Analysis on the Potential Biological Mechanisms of Yinzhihuang Oral Liquid in Treating Neonatal Hyperbilirubinemia

Objective

Neonatal hyperbilirubinemia is caused by the excessive production of bilirubin and decreased excretion ability in the neonatal period. It leads to a concentration of blood bilirubin that exceeds a certain threshold. Yinzhihuang oral liquid (YZH) is a traditional Chinese medicine mixture used in the treatment of neonatal hyperbilirubinemia in China. This article systematically explores the pharmacological mechanisms by which YZH acts in the treatment of neonatal hyperbilirubinemia through network pharmacology at the molecular level.

Methods

We adopted the method of network pharmacology, which includes active component prescreening, target gene prediction, gene enrichment analysis, and network analysis.

Results

According to the network pharmacological analysis, 8 genes (STAT3, AKT1, MAPK14, JUN, TP53, MAPK3, ESR1, and RELA) may be targets of YZH in the treatment of neonatal hyperbilirubinemia. In addition, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that YZH may regulate antioxidation, modulate lipid metabolism, and have anti-infective properties.

Conclusion

In this study, the pharmacological action and molecular mechanisms of YZH were predicted as a whole. It was found that YZH is a promising drug for treating oxidative stress due to bilirubin, as it reduces immunosuppression and helps to eliminate virus infection.

Efficacy of Circumferential Intensive Phototherapy in Treating Neonatal Hyperbilirubinemia: A Pilot Study

OBJECTIVE

The present study was aimed at developing a circumferential phototherapy unit using 3M reflective materials in the double-sided phototherapy unit and investigating its efficacy in treating neonatal hyperbilirubinemia.

STUDY DESIGN

Forty-two infants with neonatal hyperbilirubinemia were selected from our hospital; they were randomly divided into control (n = 21) and experimental groups (n = 21). The experimental group was treated with the circumferential phototherapy unit, while the control group was treated with an ordinary phototherapy unit.

RESULTS

No significant differences were noted between the two groups in the levels of transcutaneous bilirubin before phototherapy (p > 0.05). After 12 hours of phototherapy, the value of transcutaneous bilirubin decreased significantly in the experimental group compared with that of the control group (p < 0.05). Additionally, the two groups did not exhibit any significant difference in the side effects (p > 0.05).

CONCLUSION

Our results indicated that the circumferential phototherapy unit was more effective than the ordinary phototherapy unit in treating neonatal hyperbilirubinemia.

KEY POINTS

· A circumferential phototherapy unit was developed using 3M reflective materials.. · The circumferential phototherapy unit was more effective than the ordinary.. · The two groups did not exhibit any significant difference in the side effects..

Neonatal hyperbilirubinemia: Background and recent literature updates on the diagnosis and treatment

Hyperbilirubinemia or jaundice has been studied by many researchers because of its diverse causes and potential for toxicity especially in the neonate but to a lesser extent beyond the neonate as well. Several studies have been performed on the normal metabolism and metabolic disorders of bilirubin in last decades of the 20th century. The recent advancement in research and technology facilitated for the researchers to investigate new horizons of the causes and treatment of neonatal hyperbilirubinemia. This review gives a brief introduction to hyperbilirubinemia and jaundice and the recent advancement in the treatment of neonatal hyperbilirubinemia. It reports modifications in the previously used methods and findings of some newly developed ones. At present, ample literature is available discussing the issues regarding hyperbilirubinemia and jaundice, but still more research needs to be done.

Effects and therapeutic mechanism of Yinzhihuang on steatohepatitis in rats induced by a high-fat, high-cholesterol diet

OBJECTIVES

We aimed to investigate the therapeutic mechanism of Yinzhihuang (YZH) liquid, a traditional Chinese medicine mainly composed of extracts of four components, on nonalcoholic steatohepatitis (NASH) induced by a high-fat, high-cholesterol diet (HFHCD) in rats.

METHODS

Altogether 30 Sprague-Dawley rats were randomized into three groups: control, the model group (HFHCD + saline) and the treatment group (HFHCD + YZH). Liver histological features and serum biochemical parameters were assessed by the end of the 16th week. RNA sequencing and protein mass spectrometry detection were performed. The genes and proteins expressed differentially were subjected to KEGG pathway enrichment analysis and included in a network-based regulatory model.

RESULTS

The weight, liver and fat indices and serum alanine transaminase, aspartate transaminase and total cholesterol levels of the HFHCD + YZH group were all significantly lower than those of the HFHCD + saline group. Moreover, their hepatic steatosis, ballooning and lobular inflammation were relieved, and 64 hepatic genes and 73 hepatic proteins were found to be reversed in their expression patterns after YZH treatment (P < 0.05). The network-based regulatory model showed that these deregulated genes and proteins were mainly involved in oxidative phosphorylation, Toll-like receptor, nucleotide-binding oligomerization domain-like receptor, peroxisome proliferator-activated receptor signaling, nuclear factor-kappa B tumor necrosis factor signaling pathways and fatty acid metabolism.

CONCLUSION

YZH could alleviate NASH in HFHCD-fed rats by inhibiting lipogenesis, accelerating lipid β-oxidation, alleviating oxidative stress and relieving necroinflammation in the liver.

Yin Zhi Huang, a traditional Chinese herbal formula, ameliorates diet-induced obesity and hepatic steatosis by activating the AMPK/SREBP-1 and the AMPK/ACC/CPT1A pathways

Background

Yin Zhi Huang (YZH) is a formula composed of Artemisia scoparia, Gardeniae fructus, Scutellaria baicalensis Georgi, and Lonicerae Japonicae Flos. Most of the components are eaten as food in Asia. Here, we evaluated the role of YZH on a high-fat diet (HFD)-induced obesity and hepatic steatosis.

Methods

Male C57BL/6J mice were fed with normal-chow diet, HFD, and HFD with low- or high-dose YZH for 16 weeks. Body weight gain, adipose mass, and plasma lipids levels were measured to evaluate the effect of YZH on obesity. Liver weight and staining methods on liver tissues were used to determine hepatic steatosis. The expression of involved genes and proteins were screened with qRT-PCR and immunoblotting, respectively.

Results

The results showed that YZH significantly reduced body weight gain, adipose mass, and the size of adipocytes, while did not affect food intake in HFD-fed mice. H&E staining, bodipy staining, and oil red O staining displayed that YZH alleviates hepatic lipid accumulation. It also effectively restored elevated plasma levels of triglycerides (TG), total cholesterol (TC), alanine aminotransferase, and aspartate aminotransferase in HFD-fed mice. Mechanistically, these effects of YZH have associated with a decrease of AMPK/SREBP-1 pathway-mediated de novo lipogenesis and an increase of AMPK/ACC/CPT1A pathway-mediated mitochondrial fatty acid β oxidation.

Conclusions

YZH supplementation ameliorated diet-induced obesity and hepatic steatosis by decreasing AMPK/SREBP-1 pathway-mediated de novo lipogenesis and increasing AMPK/ACC/CPT1A pathway-mediated mitochondrial fatty acid β oxidation.

Effect of Yinzhihuang combined with bifid triple viable powder on liver function and C-reactive protein in neonates with jaundice

AIM

To investigate the effect of Yinzhihuang combined with bifid triple viable powder on liver function and C-reactive protein in neonates with jaundice.

METHODS

Eighty-six neonates with jaundice treated at the Yiwu Maternal and Child Health Family Planning Service Center from December 2015 to October 2017 were divided into a control group and a study group. Both groups were given routine treatment and blue light treatment, and the study group was additionally given Yinzhihuang granules combined with bifid triple viable powder. The total effective rate, liver function, serum cytokines, C-reactive protein, and adverse reations were compared between the two groups.

RESULTS

The total effective rate was significantly higher in the study group than in the control group (97.7% vs 81.4%, P < 0.05). There was no significant difference in alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), total bile acid (TBA), transferrin (TRF), or C-reactive protein (CRP) between the two groups before treatment (P > 0.05). After treatment, ALP, AST, ALT, TBIL, DBIL, TBA, and CRP were significantly lower in the study group than in the control group (P < 0.05), while TRF was significantly higher in the study group (P < 0.05). There was no significant difference in the rate of adverse reactions between the two groups (P > 0.05).

CONCLUSION

Yinzhihuang combined with bifid triple viable powder is effective for neonates with jaundice and can improve liver function and C-reactive protein level with good safety.