Depression is a prevalent neuropsychiatric disorder characterized by persistent sadness, anhedonia, guilt, fatigue, and impaired concentration. Although pharmacotherapy and psychotherapy can be effective, their utility is limited by adverse effects and significant inter-individual variability. Non-pharmacological therapies from traditional medicine have emerged as promising adjuncts owing to their favorable safety profiles, minimal side effects, and high patient compliance. These therapies, including acupoint stimulation, meditation, and yoga, produce antidepressant effects by reducing neuroinflammation, modulating neurotransmitter release, enhancing neuroplasticity, and regulating the gut-brain axis. This review summarizes clinical applications and mechanistic insights of traditional medicine’s non-pharmacological therapies for depression, providing a scientific rationale for their integration into comprehensive management.
Objectives: This study aimed to clarify the short-term symptoms, duration, and influencing factors in people recovering from coronavirus disease 2019 (COVID-19) after China’s dynamic zero-COVID-19 policy was implemented in December 2022.
Methods: We included data from a large-scale on-line survey conducted in China between January 14 and February 1, 2023. Participants were individuals of all ages. Chi-squared tests and multivariate logistic regression analyses were performed to identify factors associated with different symptoms.
Results: Overall, 21,012 patients from seven regions of China were included in this study (female: 71.22%). For most patients, the period from symptom onset to a negative nucleic acid test result was ≤10 days (72.33%). The distribution of symptoms varied at different times, with respiratory (1-4 weeks) and psychocardiology (5-8 weeks) symptoms being the most common. Multivariate analysis identified male sex, no comorbidity, and living in northeast and northwest China (compared with central China) as independent factors associated with a lower risk of symptoms, while age (41-60 years) was a possible risk factor (compared with 18-40 years).
Conclusions: Short-term respiratory and psychocardiology symptoms were the most common after COVID-19 recovery. Sex, age, geographical region, and comorbidities were potential influencing factors for the development of short-term symptoms.
Objective: In traditional medicine, Asari Radix et Rhizoma (Xi Xin) is used to effectively treat respiratory diseases. However, the therapeutic portion of Xi Xin contains trace quantities of aristolochic acid I (AAI), which raises safety concerns. Furthermore, no compelling laboratory evidence confirms its safety. AAI-induced extensive renal tubular necrosis and inflammatory cell infiltration occurred primarily in the cortex and outer medulla. Accordingly, we examined the changes in metabolites within the aforementioned areas and thoroughly investigated the interactions between these differential metabolites and immune cells.
Methods: We mapped the spatial distribution of the differential metabolites L-glutamic acid and glutamine in mouse kidneys and explored the underlying mechanisms using transcriptomics and flow cytometry, further validating these findings through co-culture experiments in vitro.
Results: Administering 1 mg/kg AAI daily for 7 days (approximately 200 times the pharmacopeial Xi Xin dose) did not induce detectable levels of carcinogenic 7-(deoxyadenosin-N6-yl)-aristolactam I (dA-ALI) in mouse kidneys. However, dA-ALI was detected on the day after the administration of 10 mg/kg AAI. Mice with lipopolysaccharide-induced pneumonia exhibit increased tolerance to AAI-mediated nephrotoxicity. Based on integrated spatial metabolomics and renal transcriptomic analyses, increased tolerance to AAI-mediated nephrotoxicity may be related to glutamine-mediated oxidative stress regulation mechanisms. During pneumonia, mouse kidneys exhibit both immune and metabolic stress responses. Ly6C+ macrophages convert L-glutamic acid into glutamine, thereby reducing reactive oxygen species (ROS) levels in the extracellular matrix. This process, which is regulated by the ITGA5 receptor in renal tubular epithelial cells, modulates the pAkt/pNrf2/NQO1 pathway and reduces AAI-induced kidney damage.
Conclusions: Collectively, our findings indicate that Xi Xin is safe at conventional clinical dosages, and its targeted use can further minimize potential risks.
Objective: Anshen Dingzhi prescription (ADP) is an effective remedy for treating post-traumatic stress disorder (PTSD); however, the mechanism underlying its beneficial effects is unclear. This study explores the roles of the neuroinflammation regulated by the FKBP prolyl isomerase 5 (FKBP5)-IκB kinase alpha (IKKα)-nuclear factor kappa-B (NF-κB)-NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) signaling pathway in PTSD.
Methods: The primary components of ADP, including ginsenosides Rg1 and Rb1, were quantified using ultra-performance liquid chromatography. Twelve C57BL/6 mice were allocated to control (D0) and experimental groups on days one, seven, and 14 of single prolonged stress (SPS). Eighteen C57BL/6 mice were allocated to control, SPS, and MCC950, an NLRP3 inhibitor (5 mg/kg) groups. Finally, 24 C57BL/6 mice were allocated to control, SPS, paroxetine hydrochloride (PRX), or ADP (18.4 and 36.8 mg/kg) groups. Mice were administered MCC950, PRX, or ADP for 14 days. The open field test and elevated plus maze were used to evaluate anxiety-like behaviors, whereas fear memory extinction was evaluated using the fear memory test. Western blotting was employed to evaluate the expression levels of the FKBP5-IKKα-NF-κB-NLRP3 signaling pathway, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-1β. The expression of FKBP5 and NLRP3 was further confirmed by immunofluorescence staining.
Results: The amounts of ginsenosides Rg1 and Rb1 in ADP were (96.85 ± 1.14) and (9.04 ± 0.22) µg/g, respectively. Compared with the D0 group, the levels of the inflammatory cytokine proteins, TNF-α, IL-6, and IL-1β were elevated 1.33- to 1.51-fold and those of FKBP5-IKKα-NF-κB-NLRP3 signaling pathway were increased 1.16- to 1.41-fold in the hippocampus of the D14 group (P < 0.05); the fluorescence intensity of FKBP5 and NLRP3 was also markedly increased (1.33-1.79-fold) in the hippocampus of the D14 group (P < 0.5). Notably, injection of MCC950 (5 mg/kg) reduced the levels of FKBP5-IKKα-NF-κB-NLRP3 (0.80-0.88-fold) and inflammatory cytokines (0.74-0.83-fold), thereby improving the PTSD-like behaviors induced by SPS (P < 0.05). In addition, ADP (36.8 g/kg) significantly improved PTSD-like behaviors and reduced levels of hippocampal inflammatory cytokines (0.70-0.79-fold) and FKBP5-IKKα-NF-κB-NLRP3 (0.50-0.79-fold) (P < 0.05) in SPS mice.
Conclusion: The results suggest a potential therapeutic benefit of ADP in PTSD due to the inhibition of the FKBP5-IKKα-NF-κB-NLRP3 signaling pathway.
Objective: Hyperuricemia (HUA) is a metabolic disease that threatens human health. The role of Penthorum chinense Pursh. (PCP) in the treatment of HUA has begun to receive attention in recent years. This study aimed to investigate the effects and potential mechanisms of PCP in HUA treatment.
Methods: A HUA murine model was induced in C57/BL6 mice using potassium oxonate (PO) and adenine (AD). Serum uric acid (SUA) was measured using ultra-performance liquid chromatography (UPLC). Serum creatinine (Scr) was detected using a creatine oxidase assay kit, and serum blood urea nitrogen (BUN) was detected using a urease indophenol blue assay kit. Protein expression levels were detected using western blotting, and gut microbiota were detected using 16S rRNA.
Results: PCP substantially improved the serum contents of SUA, Scr, and BUN and alleviated kidney injury. PCP promotes renal uric acid excretion by downregulating GLUT9 and URAT1 expression and upregulating ABCG2 and OAT1 expression PCP also regulated the NOD-like receptor family, pyrin domain-containing protein 3 (NLRP3) pathway and reduced the expression of inflammatory factors, thus attenuating kidney injury in HUA mice. PCP regulated the structure of the gut microbiota, including the relative abundance of beneficial bacteria, such as Lactobacillus and Alistipes, which promoted uric acid metabolism and anti-inflammatory effects.
Conclusions: PCP can reduce uric acid levels by promoting renal uric acid excretion and regulating the gut microbiota. PCP improves kidney injury by inhibiting the activation of the NLRP3 signaling pathway and reducing the levels of inflammatory factors.
Objective: Arrhythmia-induced cardiomyopathy (AIC) is a reversible dilated cardiomyopathy induced by rapid or irregular heartbeat. Acupuncture has a long history of use in the treatment of cardiac diseases, and Xinshu (BL15) is a key acupoint. However, the underlying mechanism of acupuncture at BL15 in the treatment of AIC has not yet been elucidated.
Methods: AIC was induced in adult male Sprague-Dawley (SD) rats by continuous administration of acetylcholine (ACh)-CaCl2 and treatment with electroacupuncture (EA) at bilateral BL15. Echocardiography was used to evaluate cardiac function; the rotarod test for motor coordination and performance; hematoxylin and eosin (HE) staining for the morphology of ventricles; electrocardiogram for susceptibility, inducibility, and duration of atrial fibrillation (AF); and electrical and optical mapping in isolated rat hearts maintained by the Langendorff perfusion system for electrical conduction and intracellular handling, respectively. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting were used to determine the levels of cardiac conduction and intracellular calcium-handling proteins in the ventricle.
Results: The results showed that EA improved the ejection factor and morphological indices on echocardiography, restored motor coordination and performance, and alleviated ventricular dilation and AF onset. EA alleviates atrial conduction disorders, shortens APD80, and decreases calcium handling in rats with AIC. Cx43 was downregulated and CaMKII was upregulated, and both effects were reversed by EA treatment.
Conclusion: Our study provides a novel AIC model with abnormal electrical propagation and calcium handling that can be protected by EA at BL15. This potential mechanism may be associated with the modulation of Cx43 and CaMKII expression.
Objective: Breast cancer is the second most prevalent cause of mortality in women and the predominant malignancy type. However, breast cancer treatment faces challenges in managing aromatase inhibitor-induced arthralgia. Aromatase inhibitors have been shown to decrease recurrence risk in hormone receptor-positive cases; however, joint discomfort remains the primary adverse effect. Randomized clinical trials have evaluated the therapeutic outcomes of acupuncture for medication-related musculoskeletal complications. This comprehensive analysis sought to elucidate both the therapeutic efficacy and placebo responses associated with acupuncture intervention.
Methods: Two reviewers searched for randomized controlled trials (RCTs) in four English (PubMed, Embase, Web of Science, and the Cochrane Library) and four Chinese databases (CNKI, Wanfang Database, VIP, and SinoMed) from their inception to May 31, 2024. Methodological quality was assessed using the Cochrane risk of bias tool. Data were synthesized using random effects models and presented with forest plots.
Results: Seven trials involving 604 patients were included. The primary outcome and Brief Pain Inventory (BPI) score differed between the acupuncture and control groups (sham acupuncture or usual medication) in three subscales over the course of 6 weeks: worst pain: standardized mean difference (SMD) = −1.18, 95% confidence interval (CI): −1.74, −0.63, P < 0.001; pain-related interference: SMD = −0.87, 95% CI: −1.70, −0.05, P = 0.038; pain severity: SMD = −0.63, 95% CI: −1.22, −0.04, P = 0.036. No severe adverse events were reported in any study.
Conclusions: This meta-analysis showed that acupuncture is a safe and effective treatment for patients with breast cancer with aromatase inhibitor-induced arthralgia during the course of 6 weeks. Improvements in the blinding method and clarification of the total treatment recommendations and intervals need to be explored further.
Biomacromolecules derived from plant-based traditional Chinese medicines play a pivotal role in natural drug research. Ginseng, the root of Panax ginseng C.A. Meyer, has attracted significant attention due to its diverse pharmacological activities and broad therapeutic applications. This review focuses on specific active macromolecules obtained from ginseng, including pectin, exosomes, proteins, and dietary fibers. These components possess unique structural characteristics and biological activities that offer novel insights into the multifaceted applications of ginseng. To systematically assess this field, we reviewed literature published over the past 60 years and identified 119 relevant studies investigating the structural composition, pharmacological activity, and potential applications of P. ginseng biomacromolecules. By highlighting their crucial role in promoting health and enhancing disease resistance, this review synthesizes the latest research findings on ginseng’s pharmacological effects, providing new perspectives and strong theoretical support for clinical drug development.