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Hu YX, Qiu SL, Shang JJ, Wang Z, Lai XL. Pharmacological Effects of Botanical Drugs on Myocardial Metabolism in Chronic Heart Failure. Chin J Integr Med 2024; 30:458-467. [PMID: 37750985 DOI: 10.1007/s11655-023-3649-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/27/2023]
Abstract
Although there have been significant advances in the treatment of heart failure in recent years, chronic heart failure remains a leading cause of cardiovascular disease-related death. Many studies have found that targeted cardiac metabolic remodeling has good potential for the treatment of heart failure. However, most of the drugs that increase cardiac energy are still in the theoretical or testing stage. Some research has found that botanical drugs not only increase myocardial energy metabolism through multiple targets but also have the potential to restore the balance of myocardial substrate metabolism. In this review, we summarized the mechanisms by which botanical drugs (the active ingredients/formulas/Chinese patent medicines) improve substrate utilization and promote myocardial energy metabolism by activating AMP-activated protein kinase (AMPK), peroxisome proliferator-activated receptors (PPARs) and other related targets. At the same time, some potential protective effects of botanical drugs on myocardium, such as alleviating oxidative stress and dysbiosis signaling, caused by metabolic disorders, were briefly discussed.
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Affiliation(s)
- Yu-Xuan Hu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Sheng-Lei Qiu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Ju-Ju Shang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Zi Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiao-Lei Lai
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
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Li SN, Liu ZH, Zhou MX, Liu WH, Lai XL, Li P, Zhang L, Shang JJ, Qiu SL, Lou Y, Tan YP, Xing WL, Liu HX. Danhong Injection Up-regulates miR-125b in Endothelial Exosomes and Attenuates Apoptosis in Post-Infarction Myocardium. Chin J Integr Med 2023; 29:1099-1110. [PMID: 37594702 DOI: 10.1007/s11655-023-3647-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To investigate the involvement of endothelial cells (ECs)-derived exosomes in the anti-apoptotic effect of Danhong Injection (DHI) and the mechanism of DHI-induced exosomal protection against postinfarction myocardial apoptosis. METHODS A mouse permanent myocardial infarction (MI) model was established, followed by a 14-day daily treatment with DHI, DHI plus GW4869 (an exosomal inhibitor), or saline. Phosphate-buffered saline (PBS)-induced ECs-derived exosomes were isolated, analyzed by miRNA microarray and validated by droplet digital polymerase chain reaction (ddPCR). The exosomes induced by DHI (DHI-exo), PBS (PBS-exo), or DHI+GW4869 (GW-exo) were isolated and injected into the peri-infarct zone following MI. The protective effects of DHI and DHI-exo on MI hearts were measured by echocardiography, Masson's trichrome staining, and TUNEL apoptosis assay. The Western blotting and quantitative reverse transcription PCR (qRT-PCR) were used to evaluate the expression levels of miR-125b/p53-mediated pathway components, including miR-125b, p53, Bak, Bax, and caspase-3 activities. RESULTS DHI significantly improved cardiac function and reduced infarct size in MI mice (P<0.01), which was abolished by the GW4869 intervention. DHI promoted the exosomal secretion in ECs (P<0.01). According to the results of exosomal miRNA microarray assay, 30 differentially expressed miRNAs in the DHI-exo were identified (28 up-regulated miRNAs and 2 down-regulated miRNAs). Among them, DHI significantly elevated miR-125b level in DHI-exo and DHI-treated ECs, a recognized apoptotic inhibitor impeding p53 signaling (P<0.05). Remarkably, treatment with DHI and DHI-exo attenuated apoptosis, elevated miR-125b expression level, inhibited capsase-3 activity, and down-regulated the expression levels of proapoptotic effectors (p53, Bak, and Bax) in post-MI hearts, whereas these effects were blocked by GW4869 (P<0.05 or P<0.01). CONCLUSION DHI and DHI-induced exosomes inhibited apoptosis, promoted the miR-125b expression level, and regulated the p53 apoptotic pathway in post-infarction myocardium.
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Affiliation(s)
- Si-Nai Li
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Zi-Hao Liu
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Ming-Xue Zhou
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Wei-Hong Liu
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Xiao-Lei Lai
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Ping Li
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Lei Zhang
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing Institute of Chinese Medicine, Beijing, 100010, China
| | - Ju-Ju Shang
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Sheng-Lei Qiu
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Yan Lou
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Yu-Pei Tan
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Wen-Long Xing
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Hong-Xu Liu
- Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
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Li M, Li H, Liu H, Lai X, Xing W, Shang J. Effect of Traditional Chinese Medicine Cutaneous Regions Therapy as adjuvant treatment of chronic heart failure: A systematic review and meta-analysis. Heliyon 2023; 9:e16012. [PMID: 37206004 PMCID: PMC10189498 DOI: 10.1016/j.heliyon.2023.e16012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/21/2023] Open
Abstract
Objective To systematically evaluate the effectiveness of Traditional Chinese Medicine Cutaneous Regions Therapy (TCMCRT) as an adjunctive treatment for chronic heart failure. Methods China National Knowledge Infrastructure (CNKI), Wanfang database, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), Cochrane Library, PubMed, Web of Science, and EMBASE database were searched to screen randomized controlled trials (RCTs) of TCMCRT for chronic heart failure versus conventional western treatment for chronic heart failure. The Cochrane Risk of Bias Collaboration tool was used to assess the risk of bias in RCTs. Meta-analysis was performed using RevMan 5.3 software to systematically evaluate the effects of conventional western treatment combined with TCMCRT on the cardiac function efficacy, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), 6-min walk test (6MWT), Minnesota Heart Failure Quality of Life Scale (MLHFQ) and Adverse effects, as well as to evaluate the safety of this treatment modality. Results 18 RCT studies were finally included, with a total of 1388 patients, including 695 in the experimental group and 693 in the control group. The results of the Meta-analysis showed that the efficacy of improved cardiac function was better in the experimental group than in the control group [RR = 1.24, 95%CI (1.16, 1.32), P < 0.00001]. Improvement of LVEF in the experimental group was better than the control group [MD = 0.04, 95%CI (0.02, 0.05), P < 0.00001]. LVEDD were better in the experimental group than in the control group after treatment [MD = -3.63, 95% CI (-6.14, -1.12), P = 0.005]. The experimental group improved NT-proBNP better than the control group [MD = -586.26, 95%CI (-857.83, -314.68), P < 0.0001]. The experimental group improved 6MWT better than the control group [MD = 38.76, 95%CI (20.77, 56.75), P < 0.0001]. The experimental group improved MLHFQ values better than the control group [MD = -5.93, 95%CI (-7.70, -4.16), P < 0.00001]. Nine of the included studies mentioned the occurrence of adverse reactions, but none reported serious adverse reactions. Conclusion The available evidence suggests that TCMCRT has good efficacy in the adjuvant treatment of chronic heart failure. However, due to the limitations of this study, more high-quality studies are needed to further validate this conclusion.
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Affiliation(s)
- MingXuan Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - HongDian Li
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - HongXu Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - XiaoLei Lai
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Wenlong Xing
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - JuJu Shang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Corresponding author.
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Lai XL, Liu HX, Hu X, Tian JF, Shang JJ, Li X, Zhou Q, Xing WL. Acute Myocardial Infarction in Chinese Medicine Hospitals in China from 2006 to 2013: An Analysis of 2311 Patients from Hospital Data. Chin J Integr Med 2020; 27:323-329. [PMID: 32107728 DOI: 10.1007/s11655-020-3189-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To assess the trends in characteristics, treatments, and outcomes of acute myocardial infarction (AMI) patients in tertiary Chinese medicine (CM) hospitals in China between 2006 and 2013. METHODS This retrospective study was based on two nationwide epidemiological surveys of AMI in tertiary CM hospitals during 2 years (2006 and 2013). Patients admitted to the hospital for AMI were enrolled. Hospital records were used as the data source. Case data were derived regarding baseline characteristics, treatments, and outcomes of patients to assess changes from 2006 to 2013. Logistic regression was used to analyze the relationship between prognosis, general influencing factors of disease, and various treatment measures. RESULTS Totally 26 tertiary CM hospitals in 2006 and 29 tertiary CM hospitals in 2013 (18 were repetitive) were surveyed. A total of 2,311 patients with AMI were enrolled (1,094 cases in 2006 and 1,217 cases in 2013). From 2006 to 2013, the mean age did not significantly change, but the proportion of patients younger than 65 years increased. The prevalence of risk factors such as hypertension, diabetes, and hyperlipidemia also increased. Significant increases were observed in primary percutaneous coronary intervention [20.48% (2006) vs. 24.90% (2013)] and revascularization [36.11% (2006) vs. 52.42% (2013)]. In-hospital mortality decreased from 11.15% in 2006 to 10.60% in 2013. A mortality logistic regression analysis identified reperfusion therapy [odds ratio (OR), 0.222; 95% confidence interval (CI), 0.106-0.464], Chinese patent medicines (OR, 0.394; 95% CI, 0.213-0.727), and CM decoctions (OR, 0.196; 95% CI, 0.109-0.353) as protective factors. CONCLUSION Reperfusion and revascularization capabilities of tertiary CM hospitals have improved significantly, but in-hospital mortality has not significantly decreased. Efforts are needed to improve medical awareness of AMI and expand the use of CM to reduce in-hospital mortality in China.
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Affiliation(s)
- Xiao-Lei Lai
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Hong-Xu Liu
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Xin Hu
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Jing-Feng Tian
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Ju-Ju Shang
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiang Li
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Qi Zhou
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Wen-Long Xing
- Department of Cardiovascular, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
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Li X, Lai XL, Fei YT, Shang JJ, Zhou Q, Sun XY, Xing WL, Jia SH, Liu HX. Efficacy and safety of Shen-Yuan-Dan capsules for peri-procedural myocardial injury following percutaneous coronary intervention: study protocol for a randomized, double-blind, placebo-controlled trial. Ann Transl Med 2019; 7:119. [PMID: 31032274 DOI: 10.21037/atm.2018.09.44] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Peri-procedural myocardial injury (PMI) during percutaneous coronary intervention (PCI) will result in an unfavorable clinical prognosis in patients, thus urgently necessitating effective drug treatment measures. Shen-Yuan-Dan (SYD) capsules are a traditional Chinese medicine (TCM) preparation that have been found to have potential myocardial protection effects during the peri-procedural phase of PCI in previous clinical and basic research; however, there is a lack of rigorous, randomized, and controlled studies. The aim of this study is to evaluate the efficacy and safety of SYD in decreasing PMI. Methods This is a randomized, double-blind, placebo-controlled clinical trial. A total of 284 patients with unstable angina will be randomized into test and control groups. The two groups will be given SYD or a placebo (three times each day, four capsules each time) 3 days before PCI on the basis of conventional treatment. Twelve hours before PCI, an additional 4 capsules will be given, and drug treatment is planned to be maintained for 1 month after surgery. Dynamic changes in the myocardial enzyme in four time-points (before PCI, and 4, 24, 48 hours after PCI) in both groups of patients that will be observed. The follow-up period will be 1 month. The primary observation markers are planned to evaluate the efficacy and safety of SYD in decreasing PMI. The secondary observation markers will be to evaluate the major adverse cardiovascular events (MACEs) status at day 30 after PCI, (all-cause mortality, non-fatal myocardial infarction, repeated revascularization of target blood vessel) and Seattle Angina Questionnaire scores. GRACE scores will be used for risk stratification, and the intervention efficacy of SYD on PMI patients with different risks will be retrospectively evaluated. Discussion This study will provide a rigorous clinical evidence to evaluate the efficacy and safety of SYD in decreasing PMI and the results are worth anticipating. Trial registration The design of this trial has been registered with the Chinese Clinical Trial Registry (No. ChiCTR-IPR-17011069).
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Affiliation(s)
- Xiang Li
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Xiao-Lei Lai
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Yu-Tong Fei
- Centre for Evidence-Based Chinese Medicine, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
| | - Ju-Ju Shang
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Qi Zhou
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Xue-Yan Sun
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Wen-Long Xing
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
| | - Si-Han Jia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Traditional Chinese Medicine, Beijing 100029, China
| | - Hong-Xu Liu
- Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China
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Lai XL, Tang B. [Recent advances in the experimental study and clinical application of Pueraria lobata (Willd) Ohwi]. Zhongguo Zhong Yao Za Zhi 1989; 14:308-11, 277. [PMID: 2512952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This paper presents a review on recent advances in experimental study and clinical application of Pueraria lobata. Experiments indicate that from Pueraria lobata many effective constituents can be extracted. The efficacy for arrhythmia etc. is obvious. The clinical use for various diseases in internal medicine, surgery, pediatrics, dermatology and E.N.T. has also proved effective. pueraria lobata is supposed to have wide application.
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