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Jo HG, Baek E, Lee D. Comparative Efficacy of East Asian Herbal Formulae Containing Astragali Radix-Cinnamomi Ramulus Herb-Pair against Diabetic Peripheral Neuropathy and Mechanism Prediction: A Bayesian Network Meta-Analysis Integrated with Network Pharmacology. Pharmaceutics 2023; 15:pharmaceutics15051361. [PMID: 37242603 DOI: 10.3390/pharmaceutics15051361] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
The Astragali Radix-Cinnamomi Ramulus herb-pair (ACP) has been widely used in the treatment of diabetic peripheral neuropathy (DPN) as part of East Asian herbal medicine (EAHM). Eligible randomized controlled trials (RCTs) were identified by searching 10 databases. The outcomes investigated were response rate, sensory nerve conduction velocity (SNCV), and motor nerve conduction velocity (MNCV) in four regions of the body. The compounds in the ACP and their targets of action, disease targets, common targets, and other relevant information were filtered using network pharmacology. Forty-eight RCTs, with 4308 participants, and 16 different interventions were identified. Significant differences were observed in the response rate, MNCV, and SNCV, as all EAHM interventions were superior to conventional medicine or lifestyle modification. The EAHM formula containing the ACP ranked highest in more than half of the assessed outcomes. Furthermore, major compounds, such as quercetin, kaempferol, isorhamnetin, formononetin, and beta-sitosterol, were found to suppress the symptoms of DPN. The results of this study suggest that EAHM may increase therapeutic efficacy in DPN management, and EAHM formulations containing the ACP may be more suitable for improving treatment response rates to NCV and DPN therapy.
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Affiliation(s)
- Hee-Geun Jo
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
- Naturalis Inc., 6 Daewangpangyo-ro, Bundang-gu, Seongnam 13549, Republic of Korea
| | - Eunhye Baek
- RexSoft Inc., 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Donghun Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
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Lee CW, Jin JS, Kwon S, Jin C, Cho SY, Park SU, Jung WS, Moon SK, Park JM, Ko CN, Cho KH. Are herbal medicines alone or in combination for diabetic peripheral neuropathy more effective than methylcobalamin alone? A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 49:101657. [PMID: 36007447 DOI: 10.1016/j.ctcp.2022.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE In Asian countries, herbal medicines have been used to treat diabetic peripheral neuropathy (DPN) as an adjunctive therapy. This review aims to assess the effectiveness and safety of herbal medicines for the treatment of DPN. METHODS A literature search was conducted on PubMed, Embase, CENTRAL, Scopus, CINAHL, CNKI, DBPIA, and OASIS for randomized controlled trials that evaluated the effects of herbal medicines on DPN. The oral methylcobalamin administered group was selected as the control. The primary outcome measure was nerve conduction velocity (NCV), and the secondary outcome measure was the total efficacy rate (TER). The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. A meta-analysis was conducted using Review Manager 5.4.1 software. RESULTS Seventy-two RCTs with a total of 6260 patients were included. The meta-analysis showed that herbal medicine and co-administration of herbal medicine and methylcobalamin (CHM) treatment for DPN significantly increased the sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of the median and common peroneal nerves than methylcobalamin treatment alone. Herbal medicine and CHM treatment for DPN also significantly improved the TER compared to the control group. Herbal medicine and CHM treatment was found to be relatively safe. CONCLUSION Our study suggests that herbal medicine and CHM might be more effective than methylcobalamin alone in the management of DPN. Further rigorous studies should be conducted to make more definite conclusions.
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Affiliation(s)
- Chang-Woo Lee
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Joon-Soo Jin
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seungwon Kwon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Chul Jin
- Department of Korean Medicine Cardiology and Neurology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Seung-Yeon Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Seong-Uk Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Woo-Sang Jung
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Kwan Moon
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jung-Mi Park
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Chang-Nam Ko
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ki-Ho Cho
- Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Lu Q, Chen B, Liang Q, Wu L, Luo L, Li A, Ouyang W, Wen Z, Liu Y, Lu J, Liu Y, Fan G, Liu Z. Xiaoketongbi Formula vs pregabalin for painful diabetic neuropathy: A single-center, randomized, single-blind, double-dummy, and parallel controlled clinical trial. J Diabetes 2022; 14:551-561. [PMID: 36040201 PMCID: PMC9426277 DOI: 10.1111/1753-0407.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/18/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We assessed the efficacy and safety of the Xiaoketongbi Formula (XF) vs. pregabalin in patients with painful diabetic neuropathy (PDN). METHODS Patients with PDN (n = 68) were included in a single-center, randomized, single-blind, double-dummy, parallel controlled clinical trial. The primary outcome was the change in the Brief Pain Inventory for Diabetic Peripheral Neuropathy (BPI-DPN). Secondary outcomes evaluated included the reduction of BPI-DPN >50%, changes in the numeric rating scale-11 (NRS-11) score for pain, Daily Sleep Interference Diary (DSID), Patient Global Impression of Change (PGIC), nerve conduction velocity (NCV), and adverse events. RESULTS After 10 weeks of treatment, the BPI-DPN score reduced from 42.44 ± 17.56 to 26.47 ± 22.22 and from 52.03 ± 14.30 to 37.85 ± 17.23 in the XF and pregabalin group (Ps < 0.001), respectively. The difference in the absolute change in BPI-DPN score between both groups was -1.79 (95% CI: -9.09, 5.50; p = 0.625). In the XF and pregabalin groups, 44.1% (15/34) and 20.6% (7/34) of patients reported a BPI-DPN reduction >50% (p = 0.038), respectively. There were no significant differences between groups in NRS-11 and DSID (Ps > 0.05). A significantly greater number of patients in the XF group felt "significantly improved" or "improved" than in the pregabalin group (35.3% (12/34) vs. 11.8% (4/34), p = 0.045). The absolute change in motor nerve conduction velocity of the right median nerve was significantly different between both groups (XF group 0.7 ± 2.3 vs. pregabalin group -2.2 ± 4.1, p = 0.004). No serious adverse events were reported in either group. CONCLUSIONS XF is equivalent to pregabalin in reducing pain symptoms and improves the quality of life in patients with PDN. In addition, XF has the potential to improve nerve function by increasing NCV.
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Affiliation(s)
- Qiyun Lu
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Benjian Chen
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Qingshun Liang
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Liyan Wu
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Lulu Luo
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Anxiang Li
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Wenwei Ouyang
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Zehuai Wen
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Yunwei Liu
- Guangzhou University of Traditional Chinese MedicineGuangzhouChina
| | - Jiayan Lu
- Guangzhou University of Traditional Chinese MedicineGuangzhouChina
| | - Yunyi Liu
- Guangzhou Medical UniversityGuangzhouChina
| | - Guanjie Fan
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Zhenjie Liu
- Guangdong Provincial Hospital of Chinese MedicineGuangzhouChina
- The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
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Tsai LJ, Chung CH, Lin CJ, Su SC, Kuo FC, Liu JS, Chen KC, Ho LJ, Kuo CC, Chang CY, Lin MH, Chu NF, Lee CH, Hsieh CH, Hung YJ, Hsieh PS, Lin FH, Lu CH, Chien WC. Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan. Integr Med Res 2022; 11:100831. [PMID: 35059290 PMCID: PMC8760454 DOI: 10.1016/j.imr.2021.100831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 11/26/2021] [Accepted: 12/26/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Li-Jen Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan (Province of China)
| | - Chien-Jung Lin
- Department of Chinese Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Sheng-Chiang Su
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Jhih-Syuan Liu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Kuan-Chan Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Li-Ju Ho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chih-Chun Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chun-Yung Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Ming-Hsun Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Nain-Feng Chu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chien-Hsing Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chang-Hsun Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Yi-Jen Hung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Institute of Preventive Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Po-Shiuan Hsieh
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
| | - Chieh-Hua Lu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Corresponding author at: Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City 11490, Taiwan, Republic of China.
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan (Province of China)
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (Province of China)
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Jhang JS, Livneh H, Yang SY, Huang HJ, Chan MWY, Lu MC, Yeh CC, Tsai TY. Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study. BMJ Open Diabetes Res Care 2020; 8:8/1/e000732. [PMID: 32169932 PMCID: PMC7069272 DOI: 10.1136/bmjdrc-2019-000732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/11/2019] [Accepted: 01/04/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Patients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20-70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use. RESULTS During follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC. CONCLUSION Integrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.
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Affiliation(s)
- Jing-Siang Jhang
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Hanoch Livneh
- Rehabilitation Counseling Program, Portland State University, Portland, Oregon, USA
| | - Shu-Yi Yang
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Hui-Ju Huang
- Department of Nursing, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
| | - Michael W Y Chan
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi, Taiwan
- Epigenomics and Human Diseases Research Center, National Chung Cheng University, Chiayi, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chia-Chou Yeh
- Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Tzung-Yi Tsai
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Department of Medical Research, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan
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Xu M, Chen H, Shi ZX, Da YW, Luo YM, Gao L, Lu Y, Wang M, Di L. Pathological Observation of Blood Stasis Syndrome in Non-diabetic Peripheral Neuropathies: A Retrospective Analysis Based on Nerve Biopsy. Chin J Integr Med 2019; 26:776-782. [PMID: 31444668 DOI: 10.1007/s11655-019-3045-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the pathological features of blood stasis syndrome (BSS) in non-diabetic peripheral neuropathy. METHODS Clinical data of 31 patients with non-diabetic peripheral neuropathy who had undergone nerve biopsy during December 2004 and December 2010 in Xuanwu Hospital Capital Medical University were retrospectively analyzed. According to Chinese medicine (CM) syndrome differentiation and signs, 26 patients were blood stasis type and 5 patients were non-blood stasis type. Clinical and pathological data were compared in detail. RESULTS Clinically, although both groups shared similar symptoms of limb numbness, weakness and sensory disturbances, the prevalence of neuralgia was much grievous in BSS group (73.1%, 26/31) compared with the non-BSS group (0%, 0/5). As for signs, dermal nutrients disturbance (84.6%, 22/26), dark or purple tongue (100.0%, 26/26), and sublingual varices (80.7%, 21/26) were more common in the BSS group than the non-BSS group (0%, 60%, 20%, respectively). The prevalence of qi deficiency cases (19/26) in the BSS group was significantly higher compared with the non-BSS group (1/5). The unique histological manifestations of BSS were axonal degeneration (16/26 vs 2/5 in non-BSS group), which was the hallmark of ischemia. Cases with BSS had prominent microangiopathy (61.5%, 16/26), manifested as epineurium vasculitis (inflammatory cell infiltrated to the vessel wall, obliteration and recanalization, vascular proliferation, extravascular hemosiderin deposition), angiotelectasis, proliferation and hyaline degeneration of endoneurium capillary. In the BSS group, impaired blood-nerve barrier was indicated by sub-perineurial edema (46.2%, 11/26) and endoneurial edema (15.4%, 4/26). The Renaut body (15.4%, 4/26) and amyloid deposition (3.8%, 1/26) found in the BSS group were absent in the non-BSS group. CONCLUSIONS BBS was common in non-diabetic peripheral neuropathies. The nerves exhibited ischemic alteration of primary axon degeneration and secondary demyelination. The interstitial tissue revealed microcirculation impairment, blood-nerve barrier disturbance, amyloid deposition and proliferation changes. The high prevalence of qi deficiency also highlights the therapy of promotion of blood circulation and removal of blood stasis.
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Affiliation(s)
- Min Xu
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
| | - Hai Chen
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Zai-Xiang Shi
- Integrative Medicine Department of Cardiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yu-Wei Da
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Yu-Min Luo
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Li Gao
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Yan Lu
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Min Wang
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Li Di
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
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Li T, Hua Q, Li N, Cui Y, Zhao M. Protective effect of a polysaccharide from Dipsacus asper Wall on streptozotocin (STZ)-induced diabetic nephropathy in rat. Int J Biol Macromol 2019; 133:1194-1200. [DOI: 10.1016/j.ijbiomac.2019.04.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/01/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022]
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Kumarasingha R, Young ND, Yeo TC, Lim DSL, Tu CL, Palombo EA, Shaw JM, Gasser RB, Boag PR. Transcriptional alterations in Caenorhabditis elegans following exposure to an anthelmintic fraction of the plant Picria fel-terrae Lour. Parasit Vectors 2019; 12:181. [PMID: 31023350 PMCID: PMC6485125 DOI: 10.1186/s13071-019-3429-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/03/2019] [Indexed: 01/18/2023] Open
Abstract
Background Natural compounds from plants are known to provide a source of anthelmintic molecules. In previous studies, we have shown that plant extracts from the plant Picria fel-terrae Lour. and particular fractions thereof have activity against the free-living nematode Caenorhabditis elegans, causing quite pronounced stress responses in this nematode. We have also shown that a fraction, designated Pf-fraction 5, derived from this plant has a substantial adverse effect on this worm; however, nothing is known about the molecular processes affected in the worm. In the present study, we explored this aspect. Results Key biological processes linked to upregulated genes (n = 214) included ‘response to endoplasmic reticulum stress’ and ‘lipid metabolism’, and processes representing downregulated genes (n = 357) included ‘DNA-conformation change’ and ‘cellular lipid metabolism’. Conclusions Exposure of C. elegans to Pf-fraction 5 induces significant changes in the transcriptome. Gene ontology analysis suggests that Pf-fraction 5 induces endoplasmic reticulum and mitochondrial stress, and the changes in gene expression are either a direct or indirect consequence of this. Further work is required to assess specific responses to sub-fractions of Pf-fraction 5 in time-course experiments in C. elegans, to define the chemical(s) with potent anthelmintic properties, to attempt to unravel their mode(s) of action and to assess their selectivity against nematodes. Electronic supplementary material The online version of this article (10.1186/s13071-019-3429-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rasika Kumarasingha
- Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Clayton, Victoria, 3800, Australia.,Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia
| | - Neil D Young
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Tiong-Chia Yeo
- Sarawak Biodiversity Centre, KM 20 Jalan Borneo Heights, Semengoh, Locked Bag 3032, 93990, Kuching, Sarawak, Malaysia
| | - Diana S L Lim
- Sarawak Biodiversity Centre, KM 20 Jalan Borneo Heights, Semengoh, Locked Bag 3032, 93990, Kuching, Sarawak, Malaysia
| | - Chu-Lee Tu
- Sarawak Biodiversity Centre, KM 20 Jalan Borneo Heights, Semengoh, Locked Bag 3032, 93990, Kuching, Sarawak, Malaysia
| | - Enzo A Palombo
- Department of Chemistry and Biotechnology, Faculty of Science, Engineering and Technology, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia
| | - Jillian M Shaw
- Department of Health and Medical Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Peter R Boag
- Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Clayton, Victoria, 3800, Australia. .,Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, 3800, Australia. .,Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
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Raafat K. Phytochemical analysis of Juglans regia oil and kernel exploring their antinociceptive and anti-inflammatory potentials utilizing combined bio-guided GC–FID, GC–MS and HPLC analyses. Revista Brasileira de Farmacognosia 2018. [DOI: 10.1016/j.bjp.2018.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Chen R, Liao C, Guo Q, Wu L, Zhang L, Wang X. Combined systems pharmacology and fecal metabonomics to study the biomarkers and therapeutic mechanism of type 2 diabetic nephropathy treated with Astragalus and Leech. RSC Adv 2018; 8:27448-27463. [PMID: 35540008 PMCID: PMC9083881 DOI: 10.1039/c8ra04358b] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/19/2018] [Indexed: 02/05/2023] Open
Abstract
In our study, systems pharmacology was used to predict the molecular targets of Astragalus and Leech, and explore the therapeutic mechanism of type 2 diabetic nephropathy (T2DN) treated with Astragalus and Leech. Simultaneously, to reveal the systemic metabolic changes and biomarkers associated with T2DN, we performed 1H NMR-based metabonomics and multivariate analysis to analyze fecal samples obtained from model T2DN rats. In addition, ELISA kits and histopathological studies were used to examine biochemical parameters and kidney tissue, respectively. Striking differences in the Pearson's correlation of 22 biomarkers and 9 biochemical parameters were also observed among control, T2DN and treated rats. Results of systems pharmacology analysis revealed that 9 active compounds (3,9-di-O-methylnissolin; (6aR,11aR)-9,10-dimethoxy-6a,11a-dihydro-6H-benzofurano[3,2-c]chromen-3-ol; hirudin; l-isoleucine; phenylalanine; valine; hirudinoidine A–C) and 9 target proteins (l-serine dehydratase; 3-hydroxyacyl-CoA dehydrogenase; tyrosyl-tRNA synthetase; tryptophanyl-tRNA synthetase; branched-chain amino acid aminotransferase; acetyl-CoA C-acetyltransferase; isovaleryl-CoA dehydrogenase; pyruvate dehydrogenase E1 component alpha subunit; hydroxyacylglutathione hydrolase) of Astragalus and Leech were closely associated with the treatment of T2DN. Using fecal metabonomics analysis, 22 biomarkers were eventually found to be closely associated with the occurrence of T2DN. Combined with systems pharmacology and fecal metabonomics, these biomarkers were found to be mainly associated with 6 pathways, involving amino acid metabolism (leucine, valine, isoleucine, alanine, lysine, glutamate, taurine, phenylalanine, tryptophan); energy metabolism (lactate, succinate, creatinine, α-glucose, glycerol); ketone body and fatty acid metabolism (3-hydroxybutyrate, acetate, n-butyrate, propionate); methylamine metabolism (dimethylamine, trimethylamine); and secondary bile acid metabolism and urea cycle (deoxycholate, citrulline). The underlying mechanisms of action included protection of the liver and kidney, enhancement of insulin sensitivity and antioxidant activity, and improvement of mitochondrial function. To the best of our knowledge, this is the first time that systems pharmacology combined with fecal metabonomics has been used to study T2DN. 6 metabolites (n-butyrate, deoxycholate, propionate, tryptophan, taurine and glycerol) associated with T2DN were newly discovered in fecal samples. These 6 metabolites were mainly derived from the intestinal flora, and related to amino acid metabolism, fatty acid metabolism, and secondary bile acid metabolism. We hope the results of this study could be inspirational and helpful for further exploration of T2DN treatment. Meanwhile, our results highlighted that exploring the biomarkers of T2DN and therapeutic mechanisms of Traditional Chinese Medicine (TCM) formulas on T2DN by combining systems pharmacology and fecal metabonomics methods was a promising strategy. In our study, systems pharmacology was used to predict the molecular targets of Astragalus and Leech, and explore the therapeutic mechanism of type 2 diabetic nephropathy (T2DN) treated with Astragalus and Leech.![]()
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Affiliation(s)
- Ruiqun Chen
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
| | - Chengbin Liao
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
| | - Qian Guo
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
| | - Lirong Wu
- Guangdong Provincial Key Laboratory of Pharmaceutical Bioactive Substances
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
| | - Lei Zhang
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
| | - Xiufeng Wang
- School of Basic Courses
- Guangdong Pharmaceutical University
- Guangzhou 510006
- P. R. China
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Jin D, Huang WJ, Meng X, Yang F, Zheng YJ, Bao Q, Zhang MZ, Yang YN, Ni Q, Lian FM, Tong XL. Chinese herbal medicine TangBi Formula treatment of patients with type 2 diabetic distal symmetric polyneuropathy disease: study protocol for a randomized controlled trial. Trials 2017; 18:631. [PMID: 29284520 PMCID: PMC5747122 DOI: 10.1186/s13063-017-2345-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/17/2017] [Indexed: 12/28/2022] Open
Abstract
Background Diabetic distal symmetric polyneuropathy (DSPN) is one of the most common microvascular complications of diabetes mellitus, and it has become a major public health problem worldwide because of its high and increasing prevalence, morbidity, and disability rate. The current medications for DSPN are not entirely satisfactory. Preliminary studies indicated that the Chinese herbal TangBi Formula may alleviate signs and symptoms and improve the velocity of nerve conduction in patients with DSPN. This study was designed to determine if Chinese herbal medicine used in combination with conventional treatment is more effective than conventional treatment alone. Methods/design We are conducting a multicenter, placebo-controlled, double-blind, randomized, controlled clinical trial as a means of assessing the therapeutic effects of traditional Chinese medicine (TCM) treatment. A total of 188 patients will be randomized in a 1:1 ratio to a treatment group (TangBi Formula plus mecobalamin) and a control group (placebo plus mecobalamin). The test period lasts 6 months, during which all of the patients will be given standard medical care as recommended by established guidelines. The primary outcome will be development of differences in changes in clinical symptoms and signs in patients and changes in Michigan Diabetic Neuropathy Score (MDNS) between the two groups before and after treatment. The secondary outcome will be changes in nerve conduction velocity and in single clinical signs and symptoms. Safety assessments and adverse events will also be evaluated. Discussion We postulate that patients with DSPN will benefit from therapy that includes TCM. If successful, this work will provide an evidence-based complementary therapeutic approach for treatment of DSPN. Trial registration ClinicalTrials.gov, NCT03010241. Registered on 2 January 2017 Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2345-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- De Jin
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China
| | - Wen-Jing Huang
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China
| | - Xiang Meng
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Fan Yang
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Yu-Jiao Zheng
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Qi Bao
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China
| | - Mei-Zhen Zhang
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China
| | - Ya-Nan Yang
- Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Qing Ni
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China.
| | - Feng-Mei Lian
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China.
| | - Xiao-Lin Tong
- Guang'anmen Hospital, China Academy of Traditional Chinese Medical Sciences, No. 5, Bei xian ge Xicheng District, Beijing, 100053, China.
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Panthi S, Jing X, Gao C, Gao T. Yang-warming method in the treatment of diabetic peripheral neuropathy: an updated systematic review and meta-analysis. Altern Ther Health Med 2017; 17:424. [PMID: 28841867 PMCID: PMC6389171 DOI: 10.1186/s12906-017-1927-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 08/15/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Various studies have suggested the effectiveness of Chinese medicine in the treatment of diabetic peripheral neuropathy (DPN). There are several principles and methods in Chinese medicine for the treatment of DPN and yang-warming method is one of them. The purpose of this meta-analysis was to review the effectiveness and safety of yang-warming method using yang-warming Chinese medicine (YCM) in the treatment of DPN. METHODS A computer-based search of the articles from January 2001 to April 2016 with Chinese and English databases such as CNKI, CBM, Wanfang, VIP, Medline, Embase and Cochrane central register of controlled trials as well as manual search of the related articles was conducted. Randomized Controlled Trials (RCTs) comparing yang-warming Chinese medicines with western medicines in the treatment of DPN were considered for the study. The outcome measures were change in the sensory or motor nerve conduction velocity, total efficacy rate evaluated by clinical symptoms improvement, and adverse events. Two authors independently assessed the methodological quality of the included articles using Jadad scale and the twelve criteria recommended by Cochrane Back Review Group. Data were analyzed using RevMan 5.3 software provided by Cochrane collaboration. RESULTS A total of 25 articles were taken for the study. Meta-analysis results showed that yang-warming Chinese medicines used in the formula alone or in combination with western medicines improved the nerve conduction velocity (NCV) in comparison to western medicines alone (p < 0.001). There was also a significant difference in the total efficacy rate between the two groups (p < 0.001). Most of the included studies did not clearly report the adverse events. CONCLUSIONS Yang-warming Chinese medicines alone or in combination with western medicines were apparently better than conventional western medicines in the treatment of DPN. Because of the poor quality of the reported works that were available for the present meta-analysis, it is earlier to claim the superiority of yang-warming method using YCM to western medicines for the treatment of DPN. To support these early findings, further standardized and rigorous RCTs are required.
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Dosenovic S, Jelicic Kadic A, Miljanovic M, Biocic M, Boric K, Cavar M, Markovina N, Vucic K, Puljak L. Interventions for Neuropathic Pain. Anesth Analg 2017; 125:643-652. [DOI: 10.1213/ane.0000000000001998] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kumarasingha R, Preston S, Yeo TC, Lim DSL, Tu CL, Palombo EA, Shaw JM, Gasser RB, Boag PR. Anthelmintic activity of selected ethno-medicinal plant extracts on parasitic stages of Haemonchus contortus. Parasit Vectors 2016; 9:187. [PMID: 27036205 PMCID: PMC4818492 DOI: 10.1186/s13071-016-1458-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/16/2016] [Indexed: 12/16/2022] Open
Abstract
Background Parasitic roundworms (nematodes) cause substantial morbidity and mortality in livestock animals globally, and considerable productivity losses to farmers. The control of these nematodes has relied largely on the use of a limited number of anthelmintics. However, resistance to many of these these anthelmintics is now widespread, and, therefore, there is a need to find new drugs to ensure sustained and effective treatment and control into the future. Methods Recently, we developed a screening assay to test natural, plant extracts with known inhibitory effects against the free-living worm Caenorhabditis elegans. Using this assay, we assessed here the effects of the extracts on motility and development of parasitic larval stages of Haemonchus contortus, one of the most important nematodes of small ruminants worldwide. Results The study showed that two of five extracts from Picria fel-terrae Lour. have a significant inhibitory effect (at concentrations of 3–5 mg/ml) on the motility and development of H. contortus larvae. Although the two extracts originated from the same plant, they displayed different levels of inhibition on motility and development, which might relate to the presence of various active constituents in these extracts, or the same constituents at different concentrations in distinct parts of the plant. Conclusions These results suggest that extracts from P. fel-terrae Lour. have promising anthelmintic activity and that more broadly, plant extracts are a potential rich source of anthelmintics to combat helminthic diseases.
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Affiliation(s)
- Rasika Kumarasingha
- Development and Stem Cells Program, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, 3800, Australia
| | - Sarah Preston
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Tiong-Chia Yeo
- Sarawak Biodiversity Centre (SBC), KM 20 Jalan Borneo Heights, Semengoh, Locked Bag No. 3032, 93990, Kuching, Sarawak, Malaysia
| | - Diana S L Lim
- Sarawak Biodiversity Centre (SBC), KM 20 Jalan Borneo Heights, Semengoh, Locked Bag No. 3032, 93990, Kuching, Sarawak, Malaysia
| | - Chu-Lee Tu
- Sarawak Biodiversity Centre (SBC), KM 20 Jalan Borneo Heights, Semengoh, Locked Bag No. 3032, 93990, Kuching, Sarawak, Malaysia
| | - Enzo A Palombo
- Department of Chemistry and Biotechnology, Faculty of Science, Engineering and Technology, Swinburne University of Technology, Victoria, 3122, Australia
| | - Jillian M Shaw
- Department of Health and Medical Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Peter R Boag
- Development and Stem Cells Program, Monash Biomedicine Discovery Institute and Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, 3800, Australia. .,Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
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15
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Yang X, Yao W, Li Q, Liu H, Shi H, Gao Y, Xu L. Mechanism of Tang Luo Ning effect on attenuating of oxidative stress in sciatic nerve of STZ-induced diabetic rats. J Ethnopharmacol 2015; 174:1-10. [PMID: 26254599 DOI: 10.1016/j.jep.2015.07.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/29/2015] [Accepted: 07/31/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tang Luo Ning recipe (TLN), a traditional Chinese herbal medicine based on Huangqi Guizhi Wuwu decoction, has been used clinically to treat diabetic peripheral neuropathy in China. However, the effect of TLN on diabetic peripheral neuropathy is unclear. The objective of this study was to determine the main components in TLN and to investigate the effects of TLN on oxidative stress in diabetic peripheral neuropathy rats. MATERIALS AND METHODS The effect of TLN on oxidative stress was investigated in streptozocin (STZ)-induced diabetic rats. Fasting blood glucose, body weight, thermal perception threshold test and motor and sensory nerve conduction velocity of sciatic nerve were measured. Sciatic nerve morphology was observed by Haematoxylin and eosin staining and under transmission electron microscope. T-AOC was measured by colorimetric assay. ROS were measured using enzyme-linked immunosorbent assay. Nrf2 and γGCS protein levels were measured by Western blot analysis. The expression of Bcl2, Bax and Cyto C were examined by immunohistochemistry. RESULTS TLN markedly improved the neurological function including thermal perception threshold and nerve conduction velocity of DPN rats. Haematoxylin and eosin (HE) and transmission electron microscopy (TEM) staining results showed that TLN attenuated axon atrophy and demyelination in DPN rats. Moreover, TAOC were increased, whereas ROS content was decreased after treatment with TLN in rats with DPN. Furthermore, TLN increased protein levels of Nrf2, γGCS and Bcl2, and decreased Bax and Cyto C expression. CONCLUSIONS TLN improved neurological function to prevent diabetic peripheral neuropathy by attenuating oxidative stress through Nrf2 and Bcl2 activation.
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Affiliation(s)
- Xinwei Yang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Weijie Yao
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Qingqin Li
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Haolong Liu
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Haotian Shi
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Yanbin Gao
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China
| | - Liping Xu
- School of Traditional Chinese Medicine, Capital Medical University, Beijing Key Lab of TCM Collateral Diasease Theory Research, No.10, Youanmenwai Xitoutiao, Fengtai District, Beijing 100069, China.
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Zhao T, Zhang H, Zhang X, Zhao T, Lan HY, Liang Q, Luo G, Li P. Metabolomic and lipidomic study of the protective effect of Chaihuang-Yishen formula on rats with diabetic nephropathy. J Ethnopharmacol 2015; 166:31-41. [PMID: 25698246 DOI: 10.1016/j.jep.2015.02.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 02/06/2015] [Accepted: 02/08/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Chaihuang-Yishen formula (CHYS) is a Chinese herbal formula that has been shown clinically to effectively treat chronic kidney disease including diabetic nephropathy (DN), also known as diabetic kidney disease. Our previous animal studies showed that numerous intrarenal metabolites were associated with the development of DN. In the present work, an integrated metabolomic and lipidomic analysis was used to further examine whether CHYS could attenuate the development of DN by regulating the disordered metabolic pathways. METHOD Progressive diabetic kidney disease was induced in Wistar rats by uninephrectomy and a single intraperitoneal injection of streptozocin. Over 20 weeks, one group of animals was treated with CHYS and another group went untreated. Effects of CHYS on metabolomic and lipidomic changes in the renal cortex of diabetic rats were studied using gas chromatography/time-of-flight mass spectrometry, ultra-performance liquid chromatography/time-of-flight mass spectrometry, and tandem MS-based metabolomic and lipidomic. The well-established drug fosinopril was used as positive control throughout the experiment. RESULTS Like fosinopril, treatment with CHYS produced a renoprotective effect against DN. Metabolomic and lipidomic analyses showed that the therapeutic effect of CHYS on DN was significantly associated with inhibition of the elevated organic toxins including several uremic toxins and glucuronides, and normalization of diminished phospholipids, especially sphingomyelins. CONCLUSION Improved abnormal metabolic and lipidomic disorders, such as accumulation of uremic toxins and glucuronides and phospholipids, may be mechanisms by which treatment of CHYS inhibits DN. Results from this study provide new evidence for the pharmacologic characteristics of CHYS on DN.
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Affiliation(s)
- Tie Zhao
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China
| | - Haojun Zhang
- Department of Pharmacology, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Yinghua Donglu, Hepingli, Chaoyang District, Beijing 100029, China
| | - Xianglin Zhang
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China
| | - Tingting Zhao
- Department of Pharmacology, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Yinghua Donglu, Hepingli, Chaoyang District, Beijing 100029, China
| | - Hui-Yao Lan
- Department of Medicine and Therapeutics, and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Qionglin Liang
- Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Guoan Luo
- Key Laboratory of Bioorganic Phosphorus Chemistry & Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, China
| | - Ping Li
- Department of Pharmacology, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Yinghua Donglu, Hepingli, Chaoyang District, Beijing 100029, China.
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Homayouni Moghadam F, Dehghan M, Zarepur E, Dehlavi R, Ghaseminia F, Ehsani S, Mohammadzadeh G, Barzegar K. Oleo gum resin of Ferula assa-foetida L. ameliorates peripheral neuropathy in mice. J Ethnopharmacol 2014; 154:183-189. [PMID: 24709312 DOI: 10.1016/j.jep.2014.03.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 03/11/2014] [Accepted: 03/30/2014] [Indexed: 06/03/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE According to the Chinese, European, Iranian and Indian traditional medicines, oleo gum resin of Ferula assa-foetida (asafoetida) has therapeutic effects on different kinds of diseases. Some of these effects are related to the diseases of nervous system such as hysteresis and convulsion. In recent studies, some anti-epileptic and neuroprotective roles were also considered for it and we examined its possible role on treatment of peripheral neuropathy. MATERIAL AND METHODS in vitro studies were carried out to identify the response of isolated sciatic nerves to different concentrations of oleo gum resin of asafoetida solved in Lock׳s solution. Then, in vivo studies were conducted to evaluate its effect on amelioration of peripheral neuropathy in mice. Peripheral neuropathy was induced by intraperiotoneal injection of high doses of pyridoxine in adult Balb/c male mice. Tail flick tests were performed to identify the incidence of neuropathy in animals. After 10 days treatment with asafoetida, the efficiency of treatment was assessed by behavioral, electrophysiological and histological studies. RESULTS in vitro experiments confirmed that incubating the nerves in aqueous extract of oleo gum rein of asafoetida increased the amplitude and decreased the latent period of nerve compound action potential (CAP). Nerve conduction velocity (NCV) and amplitude of CAP also improved in asafoetida treated animals. Histological and behavioral studies showed that asafoetida was able to facilitate the healing process in peripheral nerves. CONCLUSIONS in vitro experiments showed that asafoetida is a nerve stimulant and its administration in neuropathic mice exerted neuroprotecting effects through stimulating axonal regeneration and remyelination and decrement of lymphocyte infiltration.
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Affiliation(s)
- Farshad Homayouni Moghadam
- Department of Physiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Neurobiomedical Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Maryam Dehghan
- Neurobiomedical Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ehsan Zarepur
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reyhaneh Dehlavi
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Ghaseminia
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Ehsani
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Golnaz Mohammadzadeh
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kazem Barzegar
- English Language Department, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Kumarasingha R, Palombo E, Bhave M, Yeo T, Lim D, Tu C, Shaw J, Boag P. Enhancing a search for traditional medicinal plants with anthelmintic action by using wild type and stress reporter Caenorhabditis elegans strains as screening tools. Int J Parasitol 2014; 44:291-8. [DOI: 10.1016/j.ijpara.2014.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/20/2013] [Accepted: 01/09/2014] [Indexed: 11/23/2022]
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Galuppo M, Giacoppo S, Bramanti P, Mazzon E. Use of natural compounds in the management of diabetic peripheral neuropathy. Molecules 2014; 19:2877-95. [PMID: 24603557 DOI: 10.3390/molecules19032877] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/20/2014] [Accepted: 02/26/2014] [Indexed: 11/18/2022] Open
Abstract
Nephropathy, retinopathy cardiomyopathy and peripheral neuropathy are all recognized as important complications in about 50% of diabetes mellitus (DM) patients, mostly related to a poor glycemic control or to an improper management of this pathology. In any case, amongst others, diabetic peripheral neuropathy (DPN) seems the leading and most painful complication usually affecting many DM patients. For this reason, this work was conceived to review the large variety of strategies adopted for management of DPN, starting from the most conventional therapies to arrive at alternative approaches. From this perspective, both the most popular pharmacological treatments used to respond to the poorly effect of common analgesics—non-steroidal anti-inflammatory drugs (NSAIDS) and opioids—understood as gabapentin vs. pregabalin clinical use, and the guidelines provided by Oriental Medicine as well as by a long list of natural compounds that many authors identify as possible therapeutic or alternative agents to replace or to combine with the existing therapies will be included. Moreover, in the effort to provide the widest panel of remedies, the most antique techniques of acupuncture and electrostimulation will be considered as alternative, which are useful approaches to take into account in any non-pharmacological strategy for DPN management.
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Hao CZ, Wu F, Lu L, Wang J, Guo Y, Liu AJ, Liao WJ, Zheng GQ. Chinese herbal medicine for diabetic peripheral neuropathy: an updated meta-analysis of 10 high-quality randomized controlled studies. PLoS One 2013; 8:e76113. [PMID: 24146822 PMCID: PMC3797714 DOI: 10.1371/journal.pone.0076113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/21/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Diabetic peripheral neuropathy (DPN) is very common in people with diabetes. Chinese herbal medicine (CHM) therapy has been developed for DPN empirically over the years. The aim of this systematic review and meta-analysis was to assess the efficacy and safety of CHMs for patients suffering from DPN. METHODS We performed a meta-analysis of randomized-controlled clinical trials (RCTs) evaluating the efficacy and safety of CHM on DPN. Six databases were searched up to November 2012. The primary outcome measures were the absolute values or changing of motor or sensory nerve conduction velocity (NCV), and the secondary outcome measurements were clinical symptoms improvements and adverse events. The methodological quality was assessed by Jadad scale and the twelve criteria recommended by the Cochrane Back Review Group. RESULTS One hundred and sixty-three studies claimed RCTs. Ten studies with 653 individuals were further identified based on the Jadad score ≥ 3. These 10 studies were all of high methodological quality with a low risk of bias. Meta-analysis showed the effects of NCV favoring CHMs when compared with western conventional medicines (WCM) (P<0.05 or P<0.01). There is a significant difference in the total efficacy rate between the two groups (P<0.001). Adverse effects were reported in all of the ten included studies, and well tolerated in all patients with DPN. CONCLUSION Despite of the apparently positive findings and low risk of bias, it is premature to conclude the efficacy of CHMs for the treatment of DPN because of the high clinical heterogeneity and small sample sizes of the included studies. However, CHM therapy was safe for DPN. Further standardized preparation, large sample-size and rigorously designed RCTs are required.
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Affiliation(s)
- Chi-zi Hao
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fan Wu
- Center of Neurology, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Lin Lu
- Center of Neurology, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Juan Wang
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yi Guo
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan, China
- State Key Lab of Virology, Wuhan University, Wuhan, China
| | - Ai-ju Liu
- Center of Neurology, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Wei-jing Liao
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
- * E-mail: (WJL); (GQZ)
| | - Guo-qing Zheng
- Center of Neurology, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
- * E-mail: (WJL); (GQZ)
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Tsai CI, Li TC, Chang MH, Lin SY, Lee IT, Lee CH, Wang TY, Su YC. Chinese Medicinal Formula (MHGWT) for Relieving Diabetic Neuropathic Pain: A Randomized, Double-Blind, Placebo-Controlled Trial. Evid Based Complement Alternat Med 2013; 2013:767498. [PMID: 24062790 DOI: 10.1155/2013/767498] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Revised: 06/27/2013] [Accepted: 07/14/2013] [Indexed: 01/18/2023]
Abstract
Objective. To investigate the effects of modified Hungqi Guizhi Wuwu Tang (MHGWT), a formula that comprises Chinese medicinal herbs, in relieving neuropathic pain in diabetics. Method. Between March 2008 and April 2009, 112 participants were randomly assigned to either the MHGWT group, whose members received MHGWT (n = 56), or the control group, whose members received a placebo (n = 56). Diabetic neuropathic pain (DNP) was rated using the 15-item Short-Form Brief Pain Inventory (SF-BPI), the 17-item Short-Form McGill Pain Questionnaire (SF-MPQ), the 13-item Modified Michigan Neuropathy Screening Instrument (MMNSI), and the 36-item “SF-36.” Nerve conduction studies (NCSs) were performed before and after treatment. Results. After 12 weeks of treatment, the SF-MPQ and SF-BPI scores of the MHGWT group were significantly (P < 0.05) reduced and a significant difference between the groups was observed (P < 0.05). The levels of NCS in the MHGWT group were nonsignificantly (P > 0.05) reduced, and no significant difference in NCS level was observed between the groups (P > 0.05). Conclusions. MHGWT shows promise in relieving DNP and deserves further investigation.
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