Effect of Hedan Tablets on Body Weight and Insulin Resistance in Patients with Metabolic Syndrome

Hypolipidemic effect and mechanism of Hedan tablet based on network pharmacology

OBJECTIVE

To examine Hedan tablet (HDT, )'s potential mechanisms in hyperlipidemic rats induced by a high-fat diet (HFD), as well as its regulatory effects and primary active constituents.

METHODS

By using ultra-performance liquid chromatography (UPLC)-quadrupole-time-of-flight (QTOF)-tandem mass spectrometry (MS/MS), the components of HDT that can enter the circulatory system were found, aiming to investigate its active constituents with pharmacological effects. Based on network pharmacology approaches, the relevant HDT targets in the therapy of hyperlipidemia were anticipated. The possible mechanism of HDT for hyperlipidemia treatment was verified by in-vivo experiments, and the main active components of HDT for hyperlipidemia treatment were analyzed via in-vitro experiments.

RESULTS

UPLC-QTOF-MS/MS identified 30 components of HDT entering the circulatory system, primarily consisting of flavonoids, diterpenoids and alkaloids. The results of a network pharmacology study revealed that 30 active components mostly target 74 genes associated with hyperlipidemia. The primary active ingredients may include quercetin, kaempferol, and epicatechin, and the main gene targets may be tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin 1 beta (IL-1β), etc. The results of animal experiments demonstrated that HDT can significantly regulate the blood lipid level in rats with HFD, improve the degree of inflammatory infiltration in rat liver cells, lower TNF-α, C-reactive protein (CRP), IL-6, matrix metalloproteinase 9 (MMP9) and malondialdehyde (MDA) levels while raising total superoxide dismutase (T-SOD) level. Meanwhile, HDT can considerably lower the expression of sterol regulatory element-binding transcription factor 2 (SREBF2), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), and MMP9 while significantly increasing the expression of peroxisome proliferator-activated receptor alpha (PPAR-α) and PPAR-γ. In vitro study confirmed that quercetin and kaempferol could reduce the levels of IL-6, IL1B, MMP9 and HMGCR in the high-fat model of hepatoma G2 cells.

CONCLUSIONS

The mechanism by which HDT treats hyperlipidemia involves modification of the lipid metabolism targets such as downregulating SREBF2, HMGCR and MMP9, and upregulating PPAR-α and PPAR-γ, as well as anti-inflammatory and antioxidant actions. This study provides a pharmacological and biological rationale for the use of HDT in clinical hyperlipidemia management.

Methodological insights into intervention and outcomes in randomised controlled trials of herbal medicine for obesity: a scoping review

Background

With rising obesity rates worldwide, clinical trials focused on identifying effective treatments are increasing. While guidelines exist for pharmaceutical drugs targeting obesity, there are none for herbal medicine clinical trials for anti-obesity. Both industries refer to the same guidelines for clinical trials.

Objectives

This scoping review aimed to gather information from herbal medicine anti-obesity randomised controlled trials (RCTs), analyse the methodologies and assess their alignment with international guidelines.

Eligibility criteria

This review included RCTs of participants of all ages with obesity utilising herbal medicine with any comparators and focusing on various outcome measures.Sources of evidence: Only published journal articles were included.

Charting methods

Articles were extracted from MEDLINE, CENTRAL and EMBASE using predetermined keywords. Relevant data, such as the study characteristics, types of herbal interventions and controls, treatment durations, outcome measures and safety monitoring methods were recorded in a table format for comparative analysis.

Results

We included 99 RCTs that showed participant sample sizes ranging from 8 to 182, ages 18 to 80 years and body mass indexes (BMIs) between 25 and 49.9 kg/m2. Herbal interventions used single herbs (n = 57) and mixtures (n = 42), given for 14 days to 56 weeks. Studies implementing diet modifications include restricted calorie diets (n = 35), food-portion controlled diets (n = 7) and fixed calorie diets (n = 7). Of the 28 studies implementing exercise, most were of moderate intensity (n = 22). All studies collected BMI and weight as primary outcomes. Body fat composition was measured in over 50% of studies using a body analyser (n = 57). Waist, hip and abdominal circumferences were infrequently measured. Radiological tools used include dual-energy X-ray absorptiometry (n = 16), computed tomography scans (n = 10) and ultrasound (n = 2). Safety monitoring methods were reported in most studies (n = 76).

Conclusion

In conclusion, almost 50% of the studies adhered to international pharmaceutical clinical trial guidelines, addressing dietary, lifestyle, physical activity and cardiovascular risk factors. Nonetheless, more herbal anti-obesity studies need to consider the assessment of weight maintenance.

Natural aporphine alkaloids: A comprehensive review of phytochemistry, pharmacokinetics, anticancer activities, and clinical application

BACKGROUND

Cancer is the most common cause of death and is still a serious public health problem. Alkaloids, a class of bioactive compounds widely diffused in plants, especially Chinese herbs, are used as functional ingredients, precursors, and lead compounds in food and clinical applications. Among them, aporphine alkaloids (AAs), as an important class of isoquinoline alkaloids, exert a strong anticancer effect on multiple cancer types.

AIM OF REVIEW

This review aims to comprehensively summarize the phytochemistry, pharmacokinetics, and bioavailability of seven subtypes of AAs and their derivatives from various plants and highlight their anticancer bioactivities and mechanisms of action. Key Scientific Concepts of Review. The chemical structures and botanical diversity of AAs are elucidated, and promising results are highlighted regarding the potent anticancer activities of AAs and their derivatives, contributing to their pharmacological benefits. This work provides a better understanding of AAs and combinational anticancer therapies involving them, thereby improving the development of functional food containing plant-derived AA and the clinical application of AAs.

Hedan tablet ameliorated non-alcoholic steatohepatitis by moderating NF-κB and lipid metabolism-related pathways via regulating hepatic metabolites

Non-alcoholic steatohepatitis (NASH) is a severe form of fatty liver disease. If not treated, it can lead to liver damage, cirrhosis and even liver cancer. However, advances in treatment have remained relatively slow, and there is thus an urgent need to develop appropriate treatments. Hedan tablet (HDP) is used to treat metabolic syndrome. However, scientific understanding of the therapeutic effect of HDP on NASH remains limited. We used HDP to treat a methionine/choline-deficient diet-induced model of NASH in rats to elucidate the therapeutic effects of HDP on liver injury. In addition, we used untargeted metabolomics to investigate the effects of HDP on metabolites in liver of NASH rats, and further validated its effects on inflammation and lipid metabolism following screening for potential target pathways. HDP had considerable therapeutic, anti-oxidant, and anti-inflammatory effects on NASH. HDP could also alter the hepatic metabolites changed by NASH. Moreover, HDP considerable moderated NF-κB and lipid metabolism-related pathways. The present study found that HDP had remarkable therapeutic effects in NASH rats. The therapeutic efficacy of HDP in NASH mainly associated with regulation of NF-κB and lipid metabolism-related pathways via arachidonic acid metabolism, glycine-serine-threonine metabolism, as well as steroid hormone biosynthesis.