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Effect of Yifei-Huoxue Decoction Combined with Tiotropium on Inflammatory Cytokine Levels, Pulmonary Function, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:5740181. [PMID: 35634054 PMCID: PMC9135534 DOI: 10.1155/2022/5740181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/15/2022] [Accepted: 04/23/2022] [Indexed: 01/05/2023]
Abstract
Objective The main objective is to investigate the effect of Yifei-Huoxue decoction combined with tiotropium on the inflammatory cytokine levels, pulmonary function, and quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods Ninety-eight COPD patients who were treated in our hospital from January 2021 to January 2022 were selected as the research objects, and they were divided into reference group (routine treatment) and study group (Yifei-Huoxue decoction combined with tiotropium), with 49 cases in each group. The patients' clinical indexes were compared between the two groups, and the clinical efficacy in the two groups was analyzed. Results Compared with the reference group, the study group had remarkably lower inflammatory cytokine levels (including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6)) after treatment (P > 0.05). In terms of the patients' pulmonary function indexes after treatment, the study group achieved lower forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), and FEV1/FVC levels compared with the reference group (P < 0.05). Both groups had a lower erythrocyte sedimentation rate (ESR) after treatment compared with that before treatment. However, the intergroup difference in the ESRs after treatment was remarkable, and the study group had a much lower ESR compared with the reference group (P < 0.05). Compared with the reference group, the study group achieved much higher 36-item short form health survey (SF-36) scores in dimensions of general health, physical functioning, social functioning, and mental health after treatment (P < 0.05). Conclusion Yifei-Huoxue decoction combined with tiotropium not only enhances the COPD patients' pulmonary function but also decreases their inflammatory levels. Therefore, this treatment is conducive to promoting the COPD patients' recovery and exerts positive effect on improving their quality of life.
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Lin H, Zhang X, Li J, Liang L, Zhang Q, Fang Y, Song J, Yang W, Weng Z. Unraveling the Molecular Mechanism of Xuebijing Injection in the Treatment of Chronic Obstructive Pulmonary Disease by Combining Network Pharmacology and Affymetrix Array. Nat Prod Commun 2022. [DOI: 10.1177/1934578x221092705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Xuebijing injection (XBJ), one of the classical prescriptions for treating inflammation-related diseases, has been used to chronic obstructive pulmonary disease (COPD) in clinical practice. However, its molecular mechanism is still unclear. Network pharmacology combined with Affymetrix arrays and molecular docking techniques were applied to explore the molecular mechanism of XBJ for COPD. Predictive analysis of 728 active compounds in XBJ and 6 sets of Affymetrix arrays expression data resulted in 106 potential therapeutic targets. Next, based on the active compound-co-target network topology analysis, most of these targets were found to be modulated by quercetin, myricetin, and ellagic acid. Furthermore, protein–protein interaction (PPI) analysis revealed that the key targets may be EGFR, STAT3, AKT1, CCND1, MMP9, AR, ESR1, and PTGS2. Then, by constructing a component-target-pathway network, we found that XBJ was a multi-pathway, multi-target, multi-compound synergistic therapy for COPD, and four key targets were involved in the FoxO signaling pathway. Luteolin and salvianolic acid b had the optimal binding ability to several key proteins. Therefore, we hypothesize that quercetin, myricetin, ellagic acid, luteolin, and salvianolic acid b mainly contribute to the therapeutic effect of XBJ on COPD by modulating the FoxO signaling pathway by regulating EGFR, STAT3, AKT1, and CCND1. XBJ exerts anti-inflammatory and antioxidative stress effects through the PI3K/Akt/FoxO axis combined with MMP9, AR, ESR1, and PTGS2 to regulate other signaling pathways.
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Affiliation(s)
- Haochang Lin
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Xinyue Zhang
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Jiangya Li
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Liju Liang
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Qian Zhang
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Yan Fang
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingfeng Song
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Weimin Yang
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
| | - Zhiying Weng
- School of Pharmaceutical Science and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, China
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Hu H, Ji Z, Qiang X, Liu S, Sheng X, Chen Z, Liu F, Wang H, Zhang J. Chinese Medical Injections for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Network Meta-analysis. Int J Chron Obstruct Pulmon Dis 2021; 16:3363-3386. [PMID: 34949918 PMCID: PMC8691136 DOI: 10.2147/copd.s335579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/14/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The World Health Organization has indicated that chronic obstructive pulmonary disease (COPD) may become the third leading cause of death by 2030. Acute exacerbation of COPD (AECOPD) is an important process in clinical treatment. Recent studies have shown that Chinese medical injections (CMI) are effective against AECOPD, but the effective difference among different CMIs remains unclear. The aim of this network meta-analysis (NMA) is to compare the therapeutic effect of various CMIs. METHODS We conducted an overall, systematic literature search in the China National Knowledge Infrastructure, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases to retrieve randomized controlled trials (RCTs) of CMIs for AECOPD published up to January 2021. The Cochrane risk of bias tool was used to assess the risk of bias. Stata 13.1 and WinBUGS 14.3 were used for data analyses. RESULTS In total, 103 RCTs involving 8767 participants and 23 CMIs were included. The results indicated that among all treatments conventional Western medical therapy (WM) plus Dengzhanxixin injection (DZXX) led to the best improvement in the clinical efficacy and the ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) (FEV1/FVC), with surface under the cumulative ranking curve (SUCRA)=80.47% and 98.55%, respectively. Moreover, Shenmai injection (SM) plus WM and Reduning injection (RDN) plus WM led to the best improvement in the FEV1 (SUCRA=80.18%) and the ratio of forced expiratory volume in one second to the predicted value (FEV1%, SUCRA=87.28%). Shengmai injection (SGM) plus WM led to the most considerable shortening in the length of hospital stay (SUCRA=94.70%). Cluster analysis revealed that WM+DZXX had the most favorable response for clinical efficacy and FEV1, as well as clinical efficacy and FEV1/FVC, WM+RDN had the most favorable response for clinical efficacy and FEV1%, WM+SGM had the most favorable response for clinical efficacy and length of hospital stay. CONCLUSION WM+DZXX, WM+RDN, and WM+SGM were noted to be the optimum treatment regimens for improving in clinical efficacy, FEV1, FEV1/FVC, FEV1% and reducing the hospital stay length of AECOPD patients. Considering the limitations this NMA may have, the current results warrant further verification via additional high-quality studies.
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Affiliation(s)
- Haiyin Hu
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Zhaochen Ji
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Xiaoyu Qiang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Shigang Liu
- Department of Respiratory Diseases, Guang’anmen Hospital, Beijing, People’s Republic of China
| | - Xiaodi Sheng
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Zhe Chen
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Fanqi Liu
- Department of Cardiovascular Disease, The Second Affiliated Hospital of Tianjin University of Chinese Medicine, Tianjin, People’s Republic of China
| | - Hui Wang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China
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Mathioudakis AG, Ananth S, Bradbury T, Csoma B, Sivapalan P, Stovold E, Fernandez-Romero G, Lazar Z, Criner GJ, Jenkins C, Papi A, Jensen JU, Vestbo J. Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study. Biomedicines 2021; 9:biomedicines9121837. [PMID: 34944653 PMCID: PMC8698292 DOI: 10.3390/biomedicines9121837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
A recently published ERS core outcome set recommends that all trials of COPD exacerbation management should assess the treatment success (or “cure” of the exacerbation), defined as a dichotomous measure of the overall outcome of an exacerbation. This methodological systematic review describes and compares the instruments that were used to assess treatment success or failure in 54 such RCTs, published between 2006–2020. Twenty-three RCTs used composite measures consisting of several undesirable outcomes of an exacerbation, together defining an overall unfavourable outcome, to define treatment failure. Thirty-four RCTs used descriptive instruments that used qualitative or semi-quantitative descriptions to define cure, marked improvement, improvement of the exacerbation, or treatment failure. Treatment success and failure rates among patients receiving guidelines-directed treatments at different settings and timepoints are described and could be used to inform power calculations in future trials. Descriptive instruments appeared more sensitive to treatment effects compared to composite instruments. Further methodological studies are needed to optimise the evaluation of treatment success/failure. In the meantime, based on the findings of this systematic review, the ERS core outcome set recommends that cure should be defined as sufficient improvement of the signs and symptoms of the exacerbation such that no additional systemic treatments are required.
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Affiliation(s)
- Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester M23 9LT, UK;
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK
- Correspondence:
| | - Sachin Ananth
- West Hertfordshire Hospital NHS Trust, Watford WD18 0HB, UK;
| | - Thomas Bradbury
- The George Institute for Global Health, University of New South Wales, Sydney 1466, Australia; (T.B.); (C.J.)
| | - Balazs Csoma
- Department of Pulmonology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary; (B.C.); (Z.L.)
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.-U.J.)
- Department of Internal Medicine, Zealand University Hospital, 4000 Roskilde, Denmark
| | - Elizabeth Stovold
- Cochrane Airways Group, Population Health Research Institute, St George’s University of London, London SW17 0RE, UK;
| | - Gustavo Fernandez-Romero
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (G.F.-R.); (G.J.C.)
| | - Zsofia Lazar
- Department of Pulmonology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary; (B.C.); (Z.L.)
| | - Gerard J. Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; (G.F.-R.); (G.J.C.)
| | - Christine Jenkins
- The George Institute for Global Health, University of New South Wales, Sydney 1466, Australia; (T.B.); (C.J.)
| | - Alberto Papi
- Research Center on Asthma and COPD, Faculty of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Jens-Ulrik Jensen
- Section of Respiratory Medicine, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark; (P.S.); (J.-U.J.)
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester M23 9LT, UK;
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M23 9LT, UK
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Zhu XB, Guo M, Zhang ZH, Sun LH, Liu L, Zhou LJ, Shan CL, Yang Y, Kan LD, Li LC. Chinese herbal injections for coronavirus disease 2019 (COVID-19): A narrative review. Integr Med Res 2021; 10:100778. [PMID: 34608432 PMCID: PMC8481649 DOI: 10.1016/j.imr.2021.100778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/16/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background The outbreak of Coronavirus disease 2019 (COVID-19) has caused more than 180 million infections and 3.9 million deaths. To date, emerging clinical evidence has shown the synergetic benefits of Chinese herbal injections in treating this contagious respiratory disease. This review aims to summarize and analyze the efficacy and safety of Chinese herbal injections in the therapy of COVID-19. Methods The literature from 3 electronic databases, PubMed, CNKI, and Web of Science, were searched using the search terms “COVID-19”, “SARS-CoV-2”, “traditional Chinese medicine”, “herb”, “herbal”, and “injection”. Then the identified articles were comprehensively evaluated. Results Limited data demonstrated that Chinese herbal injections could significantly improve the clinical outcomes of COVID-19 patients, especially in combination with conventional treatment strategies. The benefits of which were mainly associated with the relief of symptoms, prevention of secondary infection, regulation of inflammation and immune function. There was also evidence showing the inhibitory effects on SARS-CoV-2 replication in vitro. Nevertheless, available real-world data suggested the increased risk of adverse event. Furthermore, the defects of existing researches and the insights for discovering novel antiviral drugs were prospectively discussed. Conclusion Evidence-based advances revealed that Chinese herbal injections such as XueBiJing injection and ShenMai injection, exerted potent effects against COVID-19. Further laboratory researches and clinical evaluation are needed to gather scientific evidence on the efficacy and safety.
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Affiliation(s)
- Xiao-Bin Zhu
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Meng Guo
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhi-Hui Zhang
- Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Shanghai TCM-Integrated Institute of Vascular Anomalies, Shanghai, China
| | - Li-Hua Sun
- Department of Diagnostic Ultrasound & Echocardiography, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lei Liu
- Department of Orthopaedics, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, China
| | - Li-Juan Zhou
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chun-Lei Shan
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Yang
- Department of Pharmacy, Xiasha Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lian-Di Kan
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Liu-Cheng Li
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Giacometti M, Milesi F, Coppadoro PL, Rizzo A, Fagiani F, Rinaldi C, Cantoni M, Petti D, Albisetti E, Sampietro M, Ciardo M, Siciliano G, Alano P, Lemen B, Bombe J, Nwaha Toukam MT, Tina PF, Gismondo MR, Corbellino M, Grande R, Fiore GB, Ferrari G, Antinori S, Bertacco R. A Lab-On-chip Tool for Rapid, Quantitative, and Stage-selective Diagnosis of Malaria. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2004101. [PMID: 34306971 PMCID: PMC8292881 DOI: 10.1002/advs.202004101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/22/2021] [Indexed: 05/21/2023]
Abstract
Malaria remains the most important mosquito-borne infectious disease worldwide, with 229 million new cases and 409.000 deaths in 2019. The infection is caused by a protozoan parasite which attacks red blood cells by feeding on hemoglobin and transforming it into hemozoin. Despite the WHO recommendation of prompt malaria diagnosis, the quality of microscopy-based diagnosis is frequently inadequate while rapid diagnostic tests based on antigens are not quantitative and still affected by non-negligible false negative/positive results. PCR-based methods are highly performant but still not widely used in endemic areas. Here, a diagnostic tool (TMek), based on the paramagnetic properties of hemozoin nanocrystals in infected red blood cells (i-RBCs), is reported on. Exploiting the competition between gravity and magnetic forces, i-RBCs in a whole blood specimen are sorted and electrically detected in a microchip. The amplitude and time evolution of the electrical signal allow for the quantification of i-RBCs (in the range 10-105 i-RBC µL-1) and the distinction of the infection stage. A preliminary validation study on 75 patients with clinical suspect of malaria shows on-field operability, without false negative and a few false positive results. These findings indicate the potential of TMek as a quantitative, stage-selective, rapid test for malaria.
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Affiliation(s)
- Marco Giacometti
- Department of Electronics Information and BioengineeringPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Francesca Milesi
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Pietro Lorenzo Coppadoro
- Department of Electronics Information and BioengineeringPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Alberto Rizzo
- Specialità di Microbiologia e Virologia Università degli Studi di MilanoMilanoItaly
| | - Federico Fagiani
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Christian Rinaldi
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Matteo Cantoni
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Daniela Petti
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Edoardo Albisetti
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Marco Sampietro
- Department of Electronics Information and BioengineeringPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Mariagrazia Ciardo
- Dipartimento di Malattie InfettiveIstituto Superiore di SanitàViale Regina Elena n.299Roma00161Italy
| | - Giulia Siciliano
- Dipartimento di Malattie InfettiveIstituto Superiore di SanitàViale Regina Elena n.299Roma00161Italy
| | - Pietro Alano
- Dipartimento di Malattie InfettiveIstituto Superiore di SanitàViale Regina Elena n.299Roma00161Italy
| | | | | | | | | | - Maria Rita Gismondo
- UOC Microbiologia ClinicaVirologia e Diagnostica Bioemergenza – Sacco teaching Hospital ASST FBF Saccovia GB GrassiMilano74‐20157Italy
| | - Mario Corbellino
- Department of Biomedical and Clinical Sciences “Luigi Sacco”University of Milanovia GB GrassiMilano74‐20157Italy
| | - Romualdo Grande
- UOC Microbiologia ClinicaVirologia e Diagnostica Bioemergenza – Sacco teaching Hospital ASST FBF Saccovia GB GrassiMilano74‐20157Italy
| | - Gianfranco Beniamino Fiore
- Department of Electronics Information and BioengineeringPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Giorgio Ferrari
- Department of Electronics Information and BioengineeringPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences “Luigi Sacco”University of Milanovia GB GrassiMilano74‐20157Italy
| | - Riccardo Bertacco
- Department of PhysicsPolitecnico di MilanoPiazza Leonardo da Vinci 32Milano20133Italy
- CNR‐IFNInstitute for Photonics and NanotechnologiesPiazza Leonardo da Vinci 32Milano20133Italy
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Li C, Wang P, Li M, Zheng R, Chen S, Liu S, Feng Z, Yao Y, Shang H. The current evidence for the treatment of sepsis with Xuebijing injection: Bioactive constituents, findings of clinical studies and potential mechanisms. JOURNAL OF ETHNOPHARMACOLOGY 2021; 265:113301. [PMID: 32860891 DOI: 10.1016/j.jep.2020.113301] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/16/2019] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Xuebijing (XBJ) injection is a Chinese medicine containing extracts from Carthamus tinctorius L. (Carthami Flos, hong hua, Asteraceae), Paeonia lactiflora Pall. (Paeoniae radix rubra, chi shao, Ranunculaceae), Ligusticum chuanxiong Hort. (Chuanxiong Rhizoma, chuan xiong, Umbelliferae), Salvia miltiorrhiza Bge. (Salviae miltiorrhizae Radix Et Rhizoma, dan shen, Labiatae) and Angelica sinensis (Oliv.) Diels (Angelicae sinensis Radix, dang gui, Umbelliferae). It has been approved for the treatment of sepsis in China since 2004 and has been widely used as an add-on treatment for sepsis or septic shock with few side effects. AIM OF THE STUDY The aim of the present review was to analyse up-to-date information related to the treatment of sepsis with XBJ, including the bioactive constituents, clinical studies and potential mechanisms, and to discuss possible scientific gaps, to provide a reliable reference for future studies. MATERIALS AND METHODS Scientific resources concentrating on treating sepsis with XBJ were searched through PubMed, the Chinese National Knowledge Infrastructure (CNKI) and WanFang databases from inception to November 2018. Dissertations were also searched, and eligible dissertations were selected. Studies related to the identification of constituents, bioactive components and their targets of action or pathways, clinical trials, and animal or cellular experiments that explored pharmacological mechanisms were manually selected. The quality of reporting and methodology of the included pharmacological experiments were assessed using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines and the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE)'s risk of bias tool. RESULTS A total of 108 relative studies were eventually included, containing 12 bioactivity research studies, 10 systematic reviews on clinical trials and 86 animal or cellular experiments. We noted that as identification methods progressed, further constituents could be detected in XBJ. XBJ was also found to have "multi-ingredient, multi-target and multi-pathway" effects. The systematic review revealed that XBJ could improve the 28-day mortality and other indexes, such as the APACHE II score, body temperature, and white blood cell (WBC) count, to some extent. A major organ protection effect was demonstrated in septic rats. Pharmacological investigations suggested that XBJ acts in both the early and late stages of sepsis by anti-inflammatory, anti-coagulation, immune regulation, vascular endothelial protection, anti-oxidative stress and other mechanisms. However, most of the included studies were poorly reported, and the risk of bias was unclear. CONCLUSIONS With respect to the multiple therapeutic mechanisms contributing to both the early and late stages of sepsis, the multiple effective constituents detected and randomized controlled trials (RCTs) performed to prove its efficacy, XBJ is a promising therapy for the treatment of sepsis. However, although XBJ has shown some efficacy for the treatment of sepsis, there are currently some scientific gaps. More studies concerning the pharmacokinetics, interactions with antibiotics, real-world efficacy and safety, pharmacological mechanisms of the bioactive components and large-scale clinical trials should be conducted in the future.
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Affiliation(s)
- Chengyu Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Haiyuncang Lane, Dongcheng District, Beijing, 100700, China.
| | - Ping Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Sunny South Street, Fangshan District, Beijing, 102488, China.
| | - Min Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Haiyuncang Lane, Dongcheng District, Beijing, 100700, China.
| | - Rui Zheng
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Haiyuncang Lane, Dongcheng District, Beijing, 100700, China.
| | - Shiqi Chen
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Haiyuncang Lane, Dongcheng District, Beijing, 100700, China.
| | - Si Liu
- Tianjin Chase Sun Pharmaceutical Co. LTD, 20 Quanfa Road, Tianjin Wuqing Development Area, Tianjin, 300170, China.
| | - Zhiqiao Feng
- Tianjin Chase Sun Pharmaceutical Co. LTD, 20 Quanfa Road, Tianjin Wuqing Development Area, Tianjin, 300170, China.
| | - Yongming Yao
- First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, 51 Bucheng Road, Haidian District, Beijing, 100048, China.
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Haiyuncang Lane, Dongcheng District, Beijing, 100700, China.
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