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Chen G, Jin Z, Wang X, Yu QH, Hu GB. Danshen injection mitigated the cerebral ischemia/reperfusion injury by suppressing neuroinflammation via the HIF-1α/CXCR4/NF-κB signaling pathway. Neuroreport 2024; 35:601-611. [PMID: 38813902 DOI: 10.1097/wnr.0000000000002043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
Danshen injection (DI) is effective in treating cardiovascular and cerebrovascular diseases, including ischemic stroke (IS), including IS, but its mechanism is unclear. A middle cerebral artery occlusion model was used to simulate ischemia/reperfusion (I/R) injury in SD rats. Overexpression of hypoxia-inducible factor 1α (HIF-1α) was achieved by AAV-HIF-1α. Rats were treated with DI or saline. Neurological scores and infarction rates were assessed. I/R damage was examined by HE, 2,3,5-triphenyltetrazolium and Nissl stainings. Expression levels of relative proteins [TNF-α, IL-6, IL-1β, SOD, MDA, ROS, HIF-1α, CXC chemokine receptor 4 (CXCR4) and NF-κB] were measured. DI treatment improved neurological scores and reduced infarction rates, suggesting that it inhibits inflammation and oxidative stress. The expression levels of HIF-1α, CXCR4 and NF-κB were decreased. However, the effectiveness of DI on inflammation inhibition was lost after HIF-1α overexpression. DI may directly target HIF-1α to suppress neuroinflammation and reduce I/R injury by suppressing the HIF-1α/CXCR4/NF-κB signaling pathway.
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Affiliation(s)
- Gao Chen
- School of Medicine, Quzhou College of Technology
| | - Zhan Jin
- School of Medicine, Quzhou College of Technology
| | - Xi Wang
- Urology Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, China
| | - Qi-Hui Yu
- School of Medicine, Quzhou College of Technology
| | - Gao-Bo Hu
- School of Medicine, Quzhou College of Technology
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Li X, Yu T, Jiang Q, Tan J, Liu K. The Efficacy of Traditional Chinese Herbal Medicine Across Multiple Cardiovascular Diseases: An Umbrella Review of Systematic Reviews of Randomized Controlled Trials. J Cardiovasc Pharmacol 2024; 83:340-352. [PMID: 38194594 DOI: 10.1097/fjc.0000000000001535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024]
Abstract
ABSTRACT Traditional Chinese herbal medicine (CHM) has been extensively used in cardiovascular disease (CVD) in modern clinical practice, alone or in combination with conventional treatment. However, its efficacy has not been assessed extensively. From inception until August 2023, we systematically searched 5 public literature databases to conduct the umbrella review. The inclusion criterion is systematic reviews of randomized controlled trials investigating the effect of CHM in the contemporary management of CVDs. The quality of the included systematic reviews, the certainty of the evidence, and the potential risk of bias were assessed. Five hundred and thirty-nine systematic reviews, including 346 studies in Chinese and 193 in English, were selected before the quantitative synthesis. The methodological quality was generally moderate, with a median value of 11. The favorable efficacy of CHM was primarily presented on 5 main conditions: coronary artery disease, hypertension, heart failure, restenosis, and angina pectoris. CHM, with or without conventional treatment, showed a consistent beneficial effect in various CVDs. Nevertheless, the magnitude of the effect requires further investigation as the lack of relevant research and the complexity of the clinical practice of CHM.
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Affiliation(s)
- Xi Li
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
- Department of Cardiac Surgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital
| | - Tao Yu
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
- Department of Cardiac Surgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital
| | - Qin Jiang
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
- Department of Cardiac Surgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital
| | - Jin Tan
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
- Department of Cardiac Surgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital
| | - Ke Liu
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
- Department of Cardiac Surgery, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital
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Huajuan J, Xulong H, Bin X, Yue W, Yongfeng Z, Chaoxiang R, Jin P. Chinese herbal injection for cardio-cerebrovascular disease: Overview and challenges. Front Pharmacol 2023; 14:1038906. [PMID: 36909150 PMCID: PMC9998719 DOI: 10.3389/fphar.2023.1038906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Cardio-cerebrovascular diseases are the leading cause of death worldwide and there is currently no optimal treatment plan. Chinese herbal medicine injection (CHI) is obtained by combining traditional Chinese medicine (TCM) theory and modern production technology. It retains some characteristics of TCM while adding injection characteristics. CHI has played an important role in the treatment of critical diseases, especially cardio-cerebrovascular diseases, and has shown unique therapeutic advantages. TCMs that promote blood circulation and remove blood stasis, such as Salvia miltiorrhiza, Carthami flos, Panax notoginseng, and Chuanxiong rhizoma, account for a large proportion of CHIs of cardio-cerebrovascular disease. CHI is used to treat cardio-cerebrovascular diseases and has potential pharmacological activities such as anti-platelet aggregation, anti-inflammatory, anti-fibrosis, and anti-apoptosis. However, CHIs have changed the traditional method of administering TCMs, and the drugs directly enter the bloodstream, which may produce new pharmacological effects or adverse reactions. This article summarizes the clinical application, pharmacological effects, and mechanism of action of different varieties of CHIs commonly used in the treatment of cardio-cerebrovascular diseases, analyzes the causes of adverse reactions, and proposes suggestions for rational drug use and pharmaceutical care methods to provide a reference for the rational application of CHIs for cardio-cerebrovascular diseases.
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Affiliation(s)
- Jiang Huajuan
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huang Xulong
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xian Bin
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wang Yue
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhou Yongfeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ren Chaoxiang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pei Jin
- State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu, China.,Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Li L, Shao C, Liu Z, Wu X, Yang J, Wan H. Comparative efficacy of Honghua class injections for treating acute ischemic stroke: A Bayesian network meta-analysis of randomized controlled trials. Front Pharmacol 2022; 13:1010533. [PMID: 36249799 PMCID: PMC9554475 DOI: 10.3389/fphar.2022.1010533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Acute ischemic stroke (AIS) is associated with high morbidity, mortality, and disability. Clinical trials have shown that Honghua class injections (HCIs) combined with WM achieve better clinical efficacy than WM alone. In this study, we performed a Bayesian network meta-analysis (NMA) of randomized controlled trials (RCTs) to evaluate the efficacy of different HCIs combined with WM in treating AIS. Methods: First, the inclusion and exclusion criteria were established. From inception to 1 June 2022, a systematic literature search was conducted in multiple databases for the treatment of AIS with HCIs, including Honghua injection (HI), Safflower Yellow injection (SYI), Guhong injection (GHI), and Danhong injection (DHI). Subsequently, OpenBUGS 3.2.3 was applied to conduct a Bayesian algorithm, and Stata 16.0 was used to prepare the graphs. Multidimensional cluster analysis was performed using the “scatterplot3d” package in R 3.6.1 software. Results: In this NMA, a total of 120 eligible RCTs were included, involving 12,658 patients, and evaluating the clinical effectiveness rates, activities of daily living (ADL), hemorheological indexes, and adverse reactions (ADRs). DHI + WM was the best intervention for improving the clinical effectiveness rate. Moreover, cluster analysis demonstrated that DHI + WM and SYI + WM had better comprehensive therapeutic effects. As most of the included RCTs did not monitor ADRs, the safety of the HCIs remains to be further explored. Conclusion: DHI + WM and SYI + WM probably have a better clinical efficacy on AIS patients. Nevertheless, due to the limitation of this NMA, this conclusion may be biased. High-quality RCTs should be performed to validate our findings. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021229599
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Affiliation(s)
- Lan Li
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chongyu Shao
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheting Liu
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaolong Wu
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiehong Yang
- College of Basic Medical Sciences, Hangzhou, China
- *Correspondence: Jiehong Yang, ; Haitong Wan,
| | - Haitong Wan
- College of Life Science, Zhejiang Chinese Medical University, Hangzhou, China
- *Correspondence: Jiehong Yang, ; Haitong Wan,
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5
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OUP accepted manuscript. J Pharm Pharmacol 2022; 74:1006-1016. [DOI: 10.1093/jpp/rgac034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/26/2022] [Indexed: 11/12/2022]
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Wang Y, Xu J, Yang J, Zhang L, Pan Y, Dou L, Zhou P, Xu Y, Li C, He Y, Zhou H, Yu L, Chen J, Huang S, Fu W, Wan H. Effects of Guanxinshutong Capsules as Complementary Treatment in Patients With Chronic Heart Failure: Study Protocol for a Randomized Controlled Trial. Front Pharmacol 2021; 11:571106. [PMID: 33519434 PMCID: PMC7840487 DOI: 10.3389/fphar.2020.571106] [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: 06/09/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022] Open
Abstract
Chronic heart failure (CHF) is a common cardiovascular disease with high mortality and a poor prognosis, which places heavy burdens upon society and families. Traditional Chinese medicine (TCM) has been used extensively as complementary treatment for CHF. Guanxinshutong (GXST) capsules are used commonly for the treatment of coronary heart disease (CHD). Experimental research and small-sample clinical trials have shown that GXST can attenuate CHF. However, the effects of GXST as complementary medicine in CHF treatment lack high-quality clinical evidence. We have designed a multicenter, randomized, double-blind, placebo-controlled clinical trial that explores the efficacy and safety of using GXST compared with placebo for patients with CHF with reduced left ventricular ejection fraction (LVEF). A total of 480 participants will be assigned randomly to the GXST group or placebo group at a 2:1 ratio. GXST and placebo will be added to standard treatment for 12 weeks, and then followed up for another 40 weeks. The primary outcome is the improvement value of 6-min walk distance, and the secondary outcomes include plasma levels of N-terminal pro-B-type natriuretic peptide, New York Heart Association classification, Minnesota Living with Heart Failure Questionnaire scores, echocardiographic parameters, and clinical endpoint events. Adverse events will be monitored throughout the trial. Data will be analyzed following a predefined statistical analysis plan. This study will show the effects of the specific use of GXST in CHF patients with reduced LVEF. The Research Ethics Committee of the Second Affiliated Hospital of Zhejiang Chinese Medical University has approved this study (2019-Y-003-02). Written informed consent of patients will be required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR1900023877). Our results will be disseminated to the public through peer-reviewed journals, academic conferences, and the Internet.
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Affiliation(s)
- Yu Wang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaping Xu
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiehong Yang
- School of Basic Medicine and Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ling Zhang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanjiang Pan
- Department of Chemistry, Zhejiang University, Hangzhou, China
| | - Liping Dou
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Peng Zhou
- Institute of Brain and Heart CO Treatment, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yizhou Xu
- Department of Cardiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Chang Li
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yu He
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huifen Zhou
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Yu
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jingwen Chen
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuwei Huang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei Fu
- Department of Cardiac-Cerebral Diseases, Yinchuan Cardiac-Cerebral Treatment Internet Hospital, Yinchuan, China
| | - Haitong Wan
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
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