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Wang K, Xia Z, Yu R, Zhang W, Wang Z, Zhu M, Li R, Hu Z, Chen Z, Xu K, Mu C. Novel Hydrogel Adjuvant of Chinese Medicine External Preparations for Accelerated Healing of Deep Soft Tissue Injuries. ACS Biomater Sci Eng 2024; 10:4425-4436. [PMID: 38597148 DOI: 10.1021/acsbiomaterials.4c00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Traditional Chinese medicine external prescriptions have displayed excellent clinical effects for treating deep soft tissue injuries. However, the effects cannot be fully utilized due to the limitations of their dosage forms and usage methods. It is still a challenge to develop a satisfactory adjuvant of traditional Chinese medicine external prescriptions. Herein, a hydrogel adjuvant was prepared based on gallic acid coupled ε-poly-l-lysine and partially oxidized hyaluronic acid. The resulting adjuvant shows great physicochemical properties, low hemolysis rate (still much less than 5% at 5 mg/mL), excellent antibacterial ability (about 95% at 2 mg/mL), strong antioxidant ability (1.687 ± 0.085 mmol FeSO4/(g hydrogel) at 1 mg/mL), as well as outstanding biocompatibility. A clinically used Chinese medicine external preparation was selected as an example to investigate the effectiveness of the adjuvant in treating deep soft tissue injuries. The results show that the prescription can be evenly dispersed in the adjuvant. Moreover, the introduction of the prescription has not significantly changed these advanced properties of the adjuvant. Importantly, the hydrogel adjuvant significantly improves the effectiveness of the prescription in treating deep soft tissue injuries. This work offers an alternative approach to the development of a new-type adjuvant of Chinese medicine external preparations and also provides a new strategy for the combination of traditional Chinese medicine and hydrogel to treat clinical diseases.
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Affiliation(s)
- Kai Wang
- The First Clinical Medical School of Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
| | - Zuyan Xia
- The First Clinical Medical School of Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
| | - Rui Yu
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
| | - Wendi Zhang
- College of Acumox and Tuina, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
| | - Zijian Wang
- School of Life Sciences, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
| | - Minshun Zhu
- The First Clinical Medical School of Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
| | - Renzhong Li
- The First Clinical Medical School of Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
| | - Zhimu Hu
- The First Clinical Medical School of Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
| | - Zhaohui Chen
- College of Acumox and Tuina, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
| | - Kui Xu
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei 230038, Anhui, P. R. China
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
| | - Caiyun Mu
- College of Acumox and Tuina, Anhui University of Chinese Medicine, Hefei 230012, Anhui, P. R. China
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Song X, Liu Y, Chen S, Zhang L, Zhang H, Shen X, Du H, Sun R. Knee osteoarthritis: A review of animal models and intervention of traditional Chinese medicine. Animal Model Exp Med 2024; 7:114-126. [PMID: 38409942 PMCID: PMC11079151 DOI: 10.1002/ame2.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/10/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults. The pathophysiology of KOA remains poorly understood, as it involves complex mechanisms that result in the same outcome. Consequently, researchers are interested in studying KOA and require appropriate animal models for basic research. Chinese herbal compounds, which consist of multiple herbs with diverse pharmacological properties, possess characteristics such as multicomponent, multipathway, and multitarget effects. The potential benefits in the treatment of KOA continue to attract attention. PURPOSE This study aims to provide a comprehensive overview of the advantages, limitations, and specific considerations in selecting different species and methods for KOA animal models. This will help researchers make informed decisions when choosing an animal model. METHODS Online academic databases (e.g., PubMed, Google Scholar, Web of Science, and CNKI) were searched using the search terms "knee osteoarthritis," "animal models," "traditional Chinese medicine," and their combinations, primarily including KOA studies published from 2010 to 2023. RESULTS Based on literature retrieval, this review provides a comprehensive overview of the methods of establishing KOA animal models; introduces the current status of advantages and disadvantages of various animal models, including mice, rats, rabbits, dogs, and sheep/goats; and presents the current status of methods used to establish KOA animal models. CONCLUSION This study provides a review of the animal models used in recent KOA research, discusses the common modeling methods, and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.
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Affiliation(s)
- Xuyu Song
- Orthopaedic trauma surgeryThe Second Hospital of Shandong UniversityJinanShandongChina
| | - Ying Liu
- Academy of Traditional Chinese MedicineTianjin University of Traditional Chinese MedicineTianjinChina
| | - Siyi Chen
- Academy of Traditional Chinese MedicineTianjin University of Traditional Chinese MedicineTianjinChina
| | - Lei Zhang
- Department of Traditional Chinese MedicineThe Second Hospital of Shandong UniversityJinanShandongChina
| | - Huijie Zhang
- College of pharmacyShandong University of Traditional Chinese MedicineJinanShandongChina
| | - Xianhui Shen
- The Second Clinical College of Shandong UniversityShandong UniversityJinanShandongChina
| | - Hang Du
- The Second Clinical College of Shandong UniversityShandong UniversityJinanShandongChina
| | - Rong Sun
- Advanced Medical Research InstituteShandong UniversityJinanShandongChina
- The Second Hospital of Shandong UniversityJinanShandongChina
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Liang X, Xia Y, Xu Z, Zeng Q, Gao G, He J, Xu D. Treatment of diabetic foot ulcers with external application of Chinese herbal medicine: An overview of overlapping systematic reviews. Int Wound J 2024; 21:e14563. [PMID: 38135909 PMCID: PMC10961878 DOI: 10.1111/iwj.14563] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
This overview of systematic reviews (SRs) and meta-analysis (MAs) aimed to systematically collate, appraise and synthesize evidence for the treatment of diabetic foot ulcers (DFUs) with the external application of Chinese herbal medicine (CHM). SRs/MAs of external application of CHM for DFUs were collected by searching Cochrane Library, Web of science, CNKI, PubMed, VIP, Embase and Wanfang. Two independent reviewers carried out the literature selection and data extraction. Subsequently, AMSTAR-2 tool, PRISMA, and GRADE system were applied by two reviewers independently to evaluate the methodological quality, reporting quality, and evidence quality of the included studies, respectively. Eight SRs/MAs met the eligibility criteria and were included. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the flaws of items 2, 4 and 7. The PRISMA system identified protocol and registration weaknesses, as well as search method weaknesses. With GRADE, no high-quality evidence was identified to support the role of external application of CHM for DFUs, and the quality of evidence for the vast majority of outcomes was rated as low or moderate. In conclusion, low- to moderate-quality evidence supports the promise of external application of CHM for the treatment of DFUs. Due to the limitations of the evidence supporting external application of CHM for DFUs, rigorously designed and larger samples of high-quality studies are needed going forward before broad recommendations can be made.
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Affiliation(s)
- Xiaolun Liang
- The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Yuge Xia
- The Second Affiliated Hospital of Anhui University of Chinese MedicineHefeiChina
| | - Zhirui Xu
- Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Qiang Zeng
- The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
| | - Guochuan Gao
- Guangzhou Hospital of Integrated Chinese and Western MedicineGuangzhouChina
| | - Jiangshan He
- The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
- Guangzhou University of Chinese MedicineGuangzhouChina
| | - Danping Xu
- The Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenChina
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Wang Y, Ding T, Jiang X. Network Pharmacology Study on Herb Pair Bletilla striata-Galla chinensis in the Treatment of Chronic Skin Ulcers. Curr Pharm Des 2024; 30:1354-1376. [PMID: 38571354 DOI: 10.2174/0113816128288490240322055201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Herb pair Bletilla striata-Galla chinensis (BS-GC) is a classic combination of topical traditional Chinese medicine formulae in the treatment of chronic skin ulcers (CSUs). OBJECTIVE The aim of this study is to explore the effective active ingredients of BS-GC, as well as the core targets and signal transduction pathways of its action on CSUs. METHODS The ingredients of BS-GC were obtained from TCMSP and HERB databases. The targets of all active ingredients were retrieved from the SwissTargetPrediction database. The targets of CSUs were obtained from OMIM, GeneCards, Drugbank, and DisGeNET databases. A drug-disease target protein-protein interaction (PPI) network was constructed to select the most core targets, and an herb-ingredient-target network was built by utilizing Cytoscape 3.7.2. Furthermore, we performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes database (KEGG) analysis and verified the results of network pharmacology through molecular docking. RESULTS A total of 40 active ingredients from the herb pair BS-GC were initially screened, and a total of 528 targets were retrieved. Meanwhile, the total number of CSU targets was 1032. Then, the number of common targets between BS-GC and CSUs was 107. The 13 core targets of herb pair BS-GC with CSUs were filtered out according to the PPI network, including AKT1, TNF, EGFR, BCL2, HIF1A, MMP-9, etc. The 5 main core active ingredients were 1-(4-Hydroxybenzyl)-2-methoxy-9,10-dihydrophenanthrene-4,7-diol, 1-(4- Hydroxybenzyl)-4-methoxy-9,10-dihydrophenanthrene-2,7-diol, physcion, dihydromyricetin, and myricetin. The main biological processes were inflammation, oxidative stress, and immune response, involving the AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, NF-κB signaling pathway, and calcium signaling pathway. Molecular docking results showed good binding activity between the 5 main core active ingredients and 13 core targets. CONCLUSION This study predicted the core targets and signal transduction pathways in the treatment of CSUs to provide a reference for further molecular mechanism research.
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Affiliation(s)
- Yue Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Tengteng Ding
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing Jiang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Tang X, Li L, You G, Li X, Kang J. Metallic elements combine with herbal compounds upload in microneedles to promote wound healing: a review. Front Bioeng Biotechnol 2023; 11:1283771. [PMID: 38026844 PMCID: PMC10655017 DOI: 10.3389/fbioe.2023.1283771] [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: 08/27/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Wound healing is a dynamic and complex restorative process, and traditional dressings reduce their therapeutic effectiveness due to the accumulation of drugs in the cuticle. As a novel drug delivery system, microneedles (MNs) can overcome the defect and deliver drugs to the deeper layers of the skin. As the core of the microneedle system, loaded drugs exert a significant influence on the therapeutic efficacy of MNs. Metallic elements and herbal compounds have been widely used in wound treatment for their ability to accelerate the healing process. Metallic elements primarily serve as antimicrobial agents and facilitate the enhancement of cell proliferation. Whereas various herbal compounds act on different targets in the inflammatory, proliferative, and remodeling phases of wound healing. The interaction between the two drugs forms nanoparticles (NPs) and metal-organic frameworks (MOFs), reducing the toxicity of the metallic elements and increasing the therapeutic effect. This article summarizes recent trends in the development of MNs made of metallic elements and herbal compounds for wound healing, describes their advantages in wound treatment, and provides a reference for the development of future MNs.
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Affiliation(s)
- Xiao Tang
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Li Li
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Gehang You
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xinyi Li
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jian Kang
- Department of Proctology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Five Traditional Chinese Medicine External Treatment Methods Combined with Mecobalamin for Diabetic Peripheral Neuropathy: A Network Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4251022. [PMID: 36569342 PMCID: PMC9788892 DOI: 10.1155/2022/4251022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/20/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
Background Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. Traditional Chinese medicine (TCM) external treatment has been widely used in China as adjunctive treatment, and some small sample clinical studies have proved its effectiveness. However, due to the limited number of studies, we used network meta-analysis to compare the effectiveness of 5 commonly used external treatment methods of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy. Methods We searched PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, CBM, WanFang Knowledge Service Platform, and VIP databases and collected and screened randomised controlled trials on the external treatment of traditional Chinese medicine combined with mecobalamin in the treatment of DPN according to the inclusion and exclusion criteria. The search period was from 2011 to May 2021. The quality of included studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The outcome indicators are Toronto score, median nerve sensory conduction velocity, and median nerve motor conduction velocity. Results A total of 22 publications were included in the study. The results of the network meta-analysis showed that acupuncture combined with mecobalamin was superior to other TCM external treatments combined with mecobalamin in terms of decreasing the Toronto score (MD = -2.8, 95% CI: -5.2∼-0.49), improving median nerve sensory conduction velocity (MD = 3.6, 95% CI: 2.4∼4.9), and median nerve motor conduction velocity (MD = 4.5, 95% CI: 2.6∼6.5). The SUCRA value and probability ranking chart showed that among the three outcome indicators, acupuncture combined with mecobalamin was the best, followed by acupoint injection combined with mecobalamin. Conclusion In this network meta-analysis, acupuncture combined with mecobalamin shows the best results in the treatment of DPN, followed by acupoint injection combined with mecobalamin.
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Qi F, Huang H, Cai Y, Fu Z. Adjacent Fu's subcutaneous needling as an adjunctive healing strategy for diabetic foot ulcers: Two case reports. Medicine (Baltimore) 2022; 101:e32271. [PMID: 36550916 PMCID: PMC9771185 DOI: 10.1097/md.0000000000032271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RATIONALE Diabetic foot ulcers (DFUs) present with different grades of ischemia and infection and are associated with high mortality and disability rates with little effective treatment. We used Fu Subcutaneous Needling (FSN) to treat 2 cases with DFUs and achieved satisfactory results. PATIENT CONCERNS Two cases of DFUs showed poor recovery after conventional wound care treatment, and case 2 was confronted with the risk of amputation. DIAGNOSIS Two patients with history of diabetes were diagnosed with DFUs, presenting with lower leg and foot ulcers. INTERVENTIONS Case 1 received 6 sessions of FSN treatment in 8 days, and case 2 received 10 sessions of FSN treatment in 14 days. OUTCOMES Case 1 completely healed from a 1 × 0.5-cm blister and a 0.5 × 0.5-cm ulcer of the right lower leg 14 days after the first FSN treatment. The ulcer area of the left foot in case 2 decreased from 6 × 7 cm to 4 × 3.5 × 0.2 cm. Three months of follow-up revealed full wound closure. LESSONS FSN is effective for healing with DFUs, and it may be used as an adjunctive healing strategy for DFUs patients when conventional treatments such as infection, glycemic control, and local ulcer care are not available.
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Affiliation(s)
- Fei Qi
- Clinical Medical College of Acupuncture & Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Foshan hospital of Chinese Medicine, Foshan, Guangdong, China
| | - Huiyi Huang
- Clinical Medical College of Acupuncture & Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yanyan Cai
- Clinical Medical College of Acupuncture & Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhonghua Fu
- Clinical Medical College of Acupuncture & Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- The Institute of Fu’s Subcutaneous Needling, Beijing University of Chinese Medicine, Beijing, China
- * Correspondence: Zhonghua Fu, Clinical Medical College of Acupuncture & Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China (e-mail: )
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