An In Vivo and In Vitro Evaluation of the Mutual Interactions between the Lung and the Large Intestine

Yemazhui () ameliorates lipopolysaccharide-induced acute lung injury modulation of the toll-like receptor 4/nuclear factor kappa-B/nod-like receptor family pyrin domain-containing 3 protein signaling pathway and intestinal flora in rats

OBJECTIVE

To investigate the impact of Yemazhui (Herba Eupatorii Lindleyani, HEL) against lipopolysaccharide (LPS)-induced acute lung injury (ALI) and explore its underlying mechanism in vivo.

METHODS

The chemical constituents of HEL were analyzed by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry method. Then, HEL was found to suppress LPS-induced ALI in vivo. Six-week-old male Sprague-Dawley rats were randomly divided into 6 groups: control, LPS, Dexamethasone (Dex), HEL low dose 6 g/kg (HEL-L), HEL medium dose 18 g/kg (HEL-M) and HEL high dose 54 g/kg (HEL-H) groups. The model rats were intratracheally injected with 3 mg/kg LPS to establish an ALI model. Leukocyte counts, lung wet/dry weight ratio, as well as myeloperoxidase (MPO) activity were determined followed by the detection with hematoxylin and eosin staining, enzyme linked immunosorbent assay, quantitative real time polymerase chain reaction, western blotting, immunohistochemistry, and immunofluorescence. Besides, to explore the effect of HEL on ALI-mediated intestinal flora, we performed 16s rRNA sequencing analysis of intestinal contents.

RESULTS

HEL attenuated LPS-induced inflammation in lung tissue and intestinal flora disturbance. Mechanism study indicated that HEL suppressed the lung coefficient and wet/dry weight ratio of LPS-induced ALI in rats, inhibited leukocytes exudation and MPO activity, and improved the pathological injury of lung tissue. In addition, HEL reduced the expression of tumor necrosis factor-alpha, interleukin-1beta (IL-1β) and interleukin-6 (IL-6) in bronchoalveolar lavage fluid and serum, and inhibited nuclear displacement of nuclear factor kappa-B p65 (NF-κBp65). And 18 g/kg HEL also reduced the expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88, NF-κBp65, phosphorylated inhibitor kappa B alpha (phospho-IκBα), nod-like receptor family pyrin domain-containing 3 protein (NLRP3), IL-1β, and interleukin-18 (IL-18) in lung tissue, and regulated intestinal flora disturbance.

CONCLUSIONS

In summary, our findings revealed that HEL has a protective effect on LPS-induced ALI in rats, and its mechanism may be related to inhibiting TLR4/ NF-κB/NLRP3 signaling pathway and improving intestinal flora disturbance.

Age-related hearing loss and its potential drug candidates: a systematic review

BACKGROUND

Age-related hearing loss (ARHL) is one of the main illnesses afflicting the aged population and has a significant negative impact on society, economy, and health. However, there is presently no appropriate therapeutic treatment of ARHL due to the absence of comprehensive trials.

OBJECTIVES

The goal of this review is to systematically evaluate and analyze recent statistics on the pathologic classifications, risk factors, treatment strategies, and drug candidates of ARHL, including that from traditional Chinese medicine (TCM), to provide potential new approaches for preventing and treating ARHL.

METHODS

Literature related to ARHL was conducted in databases such as PubMed, WOS, China National Knowledge Infrastructure (CNKI), and Wanfang from the establishment of the database to Jan, 2023. The pathology, causal factor, pathophysiological mechanism, treatment strategy, and the drug candidate of ARHL were extracted and pooled for synthesis.

RESULTS

Many hypotheses about the etiology of ARHL are based on genetic and environmental elements. Most of the current research on the pathology of ARHL focuses on oxidative damage, mitochondrial dysfunction, inflammation, cochlear blood flow, ion homeostasis, etc. In TCM, herbs belonging to the kidney, lung, and liver meridians exhibit good hearing protection. Seven herbs belonging to the kidney meridian, 9 belonging to the lung meridian, and 4 belonging to the liver meridian were ultimately retrieved in this review, such as Polygonum multiflorum Thunb., Panax ginseng C.A. Mey, and Pueraria lobata (Willd.) Ohwi. Their active compounds, 2,3,4',5-Tetrahydroxystilbene-2-O-D-glucoside, ginsenoside Rb1, and puerarin, may act as the molecular substance for their anti-ARHL efficacy, and show anti-oxidative, neuroprotective, anti-inflammatory, anti-apoptotic, or mitochondrial protective effects.

CONCLUSION

Anti-oxidants, modulators of mitochondrial function, anti-inflammation agents, vasodilators, K+ channel openers, Ca2+ channel blockers, JNK inhibitors, and nerve growth factors/neurotrophic factors all contribute to hearing protection, and herbs are an important source of potential anti-ARHL drugs.

Association of lung-intestinal microecology and lung cancer therapy

In recent years, the incidence of lung cancer is increasing. Lung cancer has become one of the most malignant tumors with the highest incidence in the world, which seriously affects people's health. The most important cause of death of lung cancer is metastasis. Therefore, it is crucial to understand the mechanism of lung cancer progression and metastasis. This review article discusses the physiological functions, pathological states and disorders of the lung and intestine based on the concepts of traditional Chinese medicine (TCM), and analyzes the etiology and mechanisms of lung cancer formation from the perspective of TCM. From the theory of "the exterior and interior of the lung and gastrointestinal tract", the theory of "the lung-intestinal axis" and the progression and metastasis of lung cancer, we proposed e "lung-gut co-treatment" therapy for lung cancer. This study provides ideas for studying the mechanism of lung cancer and the comprehensive alternative treatment for lung cancer patients.

A Comprehensive Analysis of Microflora and Metabolites in the Development of Ulcerative Colitis into Colorectal Cancer Based on the Lung–Gut Correlation Theory

The lungs and large intestine can co-regulate inflammation and immunity through the lung–gut axis, in which the transportation of the gut microbiota and metabolites is the most important communication channel. In our previous study, not only did the composition of the gut microbiota and metabolites related to inflammation change significantly during the transition from ulcerative colitis (UC) to colorectal cancer (CRC), but the lung tissues also showed corresponding inflammatory changes, which indicated that gastrointestinal diseases can lead to pulmonary diseases. In order to elucidate the mechanisms of this lung–gut axis, metabolites in bronchoalveolar lavage fluid (BALF) and lung tissues were detected using UHPLC–Q-TOF-MS/MS technology, while microbiome characterization was performed in BALF using 16S rDNA sequencing. The levels of pulmonary metabolites changed greatly during the development of UC to CRC. Among these changes, the concentrations of linoleic acid and 7-hydroxy-3-oxocholic acid gradually increased during the development of UC to CRC. In addition, the composition of the pulmonary microbiota also changed significantly, with an increase in the Proteobacteria and an obvious decrease in the Firmicutes. These changes were consistent with our previous studies of the gut. Collectively, the microbiota and metabolites identified above might be the key markers related to lung and gut diseases, which can be used as an indication of the transition of diseases from the gut to the lung and provide a scientific basis for clinical treatment.

Association of sirtuins (SIRT1-7) with lung and intestinal diseases

"Exterior-interior correlation between the lung and large intestine" is one of the important contents of traditional Chinese medicine. This theory describes the role of the lung and the intestine in association with disease treatment. The "lung-gut" axis is a modern extension of the "exterior-interior correlation between lung and large intestine" theory in TCM. Sirtuin (SIRT) is a nicotinamide adenine dinucleotide (NAD⁺)-dependent enzyme family with deacetylase properties, which is highly conserved from bacteria to humans. The sirtuin defines seven silencing regulatory proteins (SIRT1-7) in human cells. It can regulate aging, metabolism, and certain diseases. Current studies have shown that sirtuins have dual characteristics, acting as both tumor promoters and tumor inhibitors in cancers. This paper provides a comparative summary of the roles of SIRT1-7 in the intestine and lung (both inflammatory diseases and tumors), and the promoter/suppressor effects of targeting SIRT family microRNAs and modulators of inflammation or tumors. Sirtuins have great potential as drug targets for the treatment of intestinal and respiratory diseases. Meanwhile, it may provide new ideas of future drug target research.

Changes of Intestinal Oxidative Stress, Inflammation, and Gene Expression in Neonatal Diarrhoea Kids

Diarrhea and disorders in young goats are serious threats to the animals' health, influencing the profitability of the goat industry. There is a need to better understand the potential biomarkers that can reflect the mortality and morbidity in neonatal diarrhea goats. Ten pairs of twin kid goats from the same does (one healthy and the other diagnosed as diarrhea) with the same age under 14 days after birth were used in this study. Since gastrointestinal infection is probably the first ailment in neonatal goats, we aimed to investigate the changes in oxidative stress, inflammation, and gene expression in the gastrointestinal tract of neonatal diarrhea goats based on an epidemiological perspective. The results showed the activity of glutathione peroxidase (GSH-Px) was less (P < 0.05) in the jejunum in neonatal diarrhea goats compared with control goats. However, the malondialdehyde (MDA) activities in the jejunum and ileum were higher (P < 0.05) in neonatal diarrhea goats. There was no significant difference in the super-oxide dismutase (SOD) and catalase (CAT) activity observed between the two groups (P > 0.05). For the concentrations of intestinal interleukin-2 (IL2) and interleukin-6 (IL6), only the IL-2 in ileum of neonatal diarrhea goats was higher than that from healthy control goats. The transcriptomic analysis of the jejunum showed a total of 364 differential expression genes (DEGs) identified in neonatal diarrhea goats compared with control goats. The Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis of up-regulated DEGs was mainly related to the ECM–receptor interaction and axon guidance, and the down-regulated DEGs mainly related to the Arachidonic acid metabolism, complement and coagulation cascades, and alpha-Linolenic acid metabolism. Real-time PCR results showed that the expression of most toll-like receptor-4-(TLR4) pathway-related genes and intestinal barrier function-related genes were similar in the two groups. These results suggest that neonatal diarrhea goats experienced a higher intestinal oxidative stress compared with control goats. Thus, it is possible that the antioxidant capacity of young ruminants acts as an indicator of health status and the measurements of oxidation stress may be useful as diagnostic biomarkers, reflecting the mortality and morbidity in neonatal diarrhea goats.

Biodistribution of andrographolide to assess the interior-exterior relationship between the lung and intestine using microPET

Background

One classic traditional Chinese medicine theory is that the “lung and intestine are exterior‐interiorly related”; however, this has not been confirmed experimentally. The aim of this study was to provide a biological basis for the theory by measuring the tissue distribution of andrographolide.

Methods

Acute pneumonia was induced in a mouse model by repeated stimulation with lipopolysaccharide. The distribution of andrographolide in mice was observed by positron emission tomography (PET) imaging with [¹⁸F]‐labeled andrographolide, and changes in the in vivo distribution before and after modeling were compared. Subsequently, the consistency of pathological changes in lung and intestine was confirmed by observation of pathological sections. Finally, the results were verified by cytokine detection.

Results

The value of organ uptake, pathological changes and inflammatory factor expression of the lung and intestine were consistent. The concentration of andrographolide in the lung and intestine increased significantly, and was confirmed by pathology and enzyme‐linked immunosorbent assays (ELISA).

Conclusions

Micro‐positron emission tomography (microPET) can be used to visually observe the distribution of medicinal ingredients in vivo, and [¹⁸F]‐andrographolide can be used as a tool to assess the interior‐exterior relationship between the lung and intestine.

Jianpi Huatan Tongfu granule alleviates inflammation and improves intestinal flora in patients with acute exacerbation of chronic obstructive pulmonary disease

Objectives

To investigate the clinical efficacy and mechanism of Jianpi Huatan Tongfu granule in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods

Sixty patients with AECOPD were enrolled in either of two groups: integrative treatment (Western medicine combined with Jianpi Huatan Tongfu granule) (n = 30) and Western medical treatment (n = 30). Thirty healthy individuals were included in the control group.

Results

Compared with healthy participants, patients with AECOPD had elevated clinical symptom and dyspnea severity scores. Patients with AECOPD had worsened lung function, compared with healthy participants. The therapeutic efficacy for integrative treatment was superior to Western medical treatment. Inflammatory proteins and cytokines were significantly elevated in patients with AECOPD, including C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α; these were alleviated by both treatments, with more obvious effects for integrative treatment. Integrative treatment significantly changed the intestinal flora in patients with AECOPD, reaching levels comparable with those of healthy participants. Firmicutes abundance was significantly higher in healthy participants, whereas Bacteroidetes abundance was significantly higher in patients with AECOPD. After treatment, Verrucomicrobia abundance was significantly reduced in patients with AECOPD.

Conclusion

Jianpi Huatan Tongfu granule could alleviate inflammatory responses and improve clinical therapeutic efficacy in patients with AECOPD.

The roles of the TLR/NF‑κB signaling pathway in the mutual interactions between the lung and the large intestine

The 'exterior-interior relationship between the lung and the large intestine' is a classical basic theory in Traditional Chinese Medicine. The present study aimed to investigate the roles of the toll like receptor/nuclear factor‑κB (TLR/NF‑κB) signaling pathway in the mutual interactions between the lung and the large intestine. A rat model of allergic asthma complicated with intestinal flora disorder was established by oral administration of Candida albicans and intraperitoneal injection with ovalbumin. The number of inflammatory cells and expression levels immunoglobulin (Ig)E, secretory IgA, interleukin (IL)‑4 and interferon‑γ in serum and bronchoalveolar lavage fluid were subsequently measured. Bacterial colonies and expression of 16S ribosomal DNA were studied in feces samples and pathological alterations of lung tissues were identified. Furthermore, the expression levels of genes associated with the TLR/NF‑κB signaling pathway in the lung and intestinal tissues were determined by reverse transcription‑quantitative polymerase chain reaction. The results of the present study indicated that, in the rat model of allergic asthma complicated with intestinal flora disorder, the expression levels of IL‑4 and IgE, and the numbers of inflammatory cells and C. albicans increased, and marked inflammatory cell infiltration was observed in lung tissues, suggesting that the animal model was successfully established. Furthermore, the present results revealed the mRNA expression levels of genes associated with the TLR/NF‑κB signaling (including myeloid differentiation primary response 88, TNF receptor associated factor 6 and β‑arrestin) were upregulated in both of the lung and intestinal tissues of the model group rats. Collectively, the results demonstrated that the TLR/NF‑κB signaling may serve roles in the mutual interactions between the lung and the large intestine, and TLR and NF‑κB may be potential targets for the treatment of lung diseases complicated with intestinal disorders.

The research of acupuncture effective biomolecules: retrospect and prospect

Acupuncture is an effective, safe and convenient therapy that has been applied for 2,500 years. The acupuncture researches have obtained significant improvement with the technical support of the life sciences and the studies of acupuncture have in turn accelerated the development of biomedical science. The effects of acupuncture influence important physiopathologic and biological activities, including gene expression, protein-protein interactions, and other biological processes. Cerebrospinal fluid, serum, organs, and tissues are reported to be carriers of the biomolecules of the effects of acupuncture. The paper summarized the progress of acupuncture effective biomolecules researches and found that biomolecules play important roles in the mechanism of acupuncture. With the development of omics technologies and translational medicine, the acupuncture research will meet both opportunities and challenges.