A proportion of patients who recovered from COVID-19 have ongoing, recurrent, or new symptoms with negative nucleic acid/antigen test results, which has become a new public health problem that needs to be concerned. Traditional Chinese medicine (TCM) has shown its unique advantages in preventing, treating, and rehabilitating COVID-19. To further standardize clinician's clinical diagnosis and use of TCM for the treatment of common symptoms associated with COVID-19 infection following negative nucleic acid/antigen results, the front-line clinical experts were invited for discussion on the concepts, etiology, clinical manifestations of post-COVID-19 condition, and on treatment with TCM to form the consensus. Clinicians of TCM, Western medicine, or integration of both can use this consensus document for clinical practice and research purposes.
Acupuncture is an effective therapy used worldwide to treat various diseases, including infections, allergic disorders, autoimmune diseases, and immunodeficiency syndromes. Except for the hypothalamic-pituitary-adrenal axis, acupuncture exerts its regulatory effect mainly by producing autonomic reflexes, including somatic-sympathetic and somatic-parasympathetic reflexes. In this review, we discuss the updated progress of the cholinergic vagal efferent pathway, vagal-adrenal axis, local spinal sacral-parasympathetic pathway, and the somatotopic evocation of parasympathetic responses related to restoring immune homeostasis within acupuncture therapy. Targeting the parasympathetic reflex offers scientific instruction for the design of acupuncture protocols for immunological diseases, providing more specialized comprehensive treatment recommendations.
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by recurrent abdominal pain, bloating, and irregular bowel movements with complex pathogenesis. Due to its high prevalence and reoccurring symptoms, it seriously impacts patients' quality of life. One of the causes of IBS is turbulence of gastrointestinal motility and intestinal secretion due to dysfunction of the autonomic nervous system (ANS), which the includes the sympathetic nervous system, parasympathetic nervous system, and enteric nervous system. Current research has proven that acupuncture, a traditional Chinese therapy, is useful and effective for treating IBS. The ANS is a key pathway for bidirectional information transmission between the gastrointestinal tract and the central nervous system, which plays an important role in IBS treatment with acupuncture. Research on the mechanisms of acupuncture for IBS is receiving more attention, and the use of contemporary methods has made significant progress. Evidence suggests that acupuncture may mitigate the negative consequences of IBS, as seen by reduced inflammatory signaling, neurotransmitter levels in the colon and central neural tissues, and balanced gut flora. We review and discuss acupuncture's possible mechanisms of action for IBS treatment via the ANS, including modulation of gastrointestinal motility, improvement of visceral hypersensitivity, and innervation of the gut-brain-microbiota axis. Our review demonstrates the available evidence for acupuncture treatment of IBS in clinical settings; however, we also observe that the relationship between the ANS and the gut-brain-microbiota axis is unclear, and further research is needed.
Coronavirus disease 2019 (COVID-19) is a major disease that threatens human life and health. Its pathogenesis is complex and still not fully clarified. The clinical treatment is mainly supportive and lacks specific treatment methods. Acupuncture treatment can inhibit immune inflammatory reactions, neuroinflammatory reactions, oxidative stress levels, and hypothalamus-pituitary-adrenal (HPA) axis activity, improve lung function, and relieve migraine, fatigue, anxiety, and depression. However, whether acupuncture treatment is suitable for treating these symptoms in patients with COVID-19 still needs to be investigated. For this review, the literature was systematically searched for multiple databases to summarize the mechanisms of acupuncture treatment for COVID-19-related symptoms and complications. A complex network analysis of acupoints and symptoms was also performed to clarify acupoint selection in the acupuncture treatment of symptoms related to COVID-19. The evidence indicates that acupuncture can improve the respiratory, digestive, nervous, and mental and psychological symptoms related to COVID-19 by inhibiting immune inflammatory reactions, regulating intestinal flora, mitochondrial function, oxidative stress level, cardiomyocyte apoptosis, neurotransmitter release, and HPA axis activity, and alleviating basic diseases such as diseases of the vascular system. Acupuncture can improve various clinical and concomitant symptoms of COVID-19; however, its mechanism of action is complex and requires further study.
Objective: Polygonum multiflorum Thunb. (PMT) is a widely used traditional Chinese herbal medicine with a variety of pharmacological effects. This study investigates the chemical composition of a water extract of PMT and its potential as a therapy for osteoarthritis (OA).
Methods: The components of the aqueous extract of PMT were determined using high-performance liquid chromatography (HPLC). Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses of a gene expression dataset downloaded from the Gene Expression Omnibus (GEO) were performed using Limma in R language. Differential chondrocyte metabolites were determined using gas chromatography-mass spectrometry (GC-MS) before and after treatment.
Results: The water extract of PMT showed good ability in improving OA, and the content of the active ingredient emodin increased significantly after processing. Analysis of the GEO database further demonstrated a strong association between OA and metabolic pathways. Emodin promotes chondrocyte proliferation and significantly reduces the number of inflammatory factors. The metabolomic results showed that emodin affected five metabolic pathways related mainly to primary bile acid biosynthesis, steroid biosynthesis, and biosynthesis of unsaturated fatty acids.
Conclusions: This study revealed the pharmacological effects of PMT and emodin as the main active components, thereby providing a scientific basis for the treatment of OA.
Objective: To investigate the inhibitory effect and mechanism of Wei Chang An pill (WCA) on ulcerative colitis (UC).
Methods: A 2,4,6-trinitro-benzenesulfonic acid (TNBS)-induced UC model was established, and WCA was administered orally for 1 week. Body weight, colon length, disease activity index (DAI) score, and colon mucosa damage index (CMDI) score were recorded. Cytokine expression in lipopolysaccharide (LPS)-stimulated THP-1 cells was evaluated to determine the anti-inflammatory effects of WCA and its active ingredients. Immunohistochemistry and immunofluorescence were performed to detect the expression of epithelial-mesenchymal transition (EMT) markers E-cadherin and vimentin in rat UC and WCA groups, and in Caco-2 cells stimulated with conditioned medium (CM) from THP-1 cells, with or without LPS or WCA.
Results: WCA significantly inhibited body weight loss, decreased DAI and CMDI scores, blocked colon length shortening, and improved histological damage in UC rats. Furthermore, both myeloperoxidase (MPO) activities and cytokine expression in UC tissues were significantly suppressed by WCA as well. In THP-1 cells, the mRNA expression of interferon-inducible protein (IP)-10, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and NF-κB inhibitor α (IκBα) was significantly suppressed by WCA and its active ingredients. E-cadherin expression in UC rats and CM-stimulated Caco-2 cells was downregulated and vimentin expression was upregulated, whereas both were blocked when administered with WCA.
Conclusions: Our data showed that WCA alleviated UC progression by inhibiting inflammation-induced EMT progression.
Objective: As an injection made from traditional Chinese medicine, Shuxuetong (SXT) injection is used for the treatment of ischemic stroke. Hypoxanthine is regarded as one of its potential quality markers. The purpose of this study is to lay the foundation for the quality control of SXT injection by the analysis of the quantitation and pharmacokinetic behavior of hypoxanthine.
Methods: A quantitative method of hypoxanthine in SXT injection based on standard addition method by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was established for the first time. On the other hand, a determination method of hypoxanthine in rat plasma samples after administration of SXT was also successfully established based on LC-MS/MS.
Results: It was found that the content of hypoxanthine was higher using conventional liquid-mass spectrometry technology compared to the application of LC-MS/MS combined standard addition method in the same batch of SXT injection. The ratio of low, medium and high doses of intravenous SXT were 1:2:4, and the AUC0-t was (848.34 ± 324.53) μg·h/L, (1483.94 ± 497.74) μg·h/L, and (3074.84 ± 910.29) μg·h/L, respectively. AUC0-t shows a good linear dose-dependent relationship.
Conclusions: The influences of endogenous substances tend to be eliminated by calibrating the concentration level of the target compound by the introduction of the standard addition method. The added allopurinol could inhibit the conversion of the target compound, and ensure the accuracy of the detection during the pharmacokinetic studies. “Blank biological matrix” obtained from the pretreatment of blank plasma successfully distinguished endogenous and drug-derived hypoxanthine. There is a good linear relationship between the blood concentration of intravenous hypoxanthine and the dosage of administration. Similarly, there was no drug accumulation in the multiple medium-dosage group, which is similar to the pharmacokinetic characteristics of the single medium-dosage group.
Objective: This study aimed to determine whether Tongmai Yangxin pills (TM) can attenuate ventricular remodeling (VR) and to explore the underlying mechanisms.
Methods: After the myocardial ischemia-reperfusion (I/R) injury model has been established, the rats were divided into seven groups: control, Sham, I/R, TM (1.0 g/kg), TM (2.0 g/kg), TM (4.0 g/kg), and Tongxinluo capsules, respectively. Experimental parameters were assessed on days 3 and 28 after drug administration. Cardiac structure and function were assessed by echocardiography. Myocardial ischemia was quantified using triphenyl tetrazolium chloride staining, and the cardiac pathology was evaluated using hematoxylin-eosin staining. Myocardial enzyme and oxidant activities were detected using an automatic biochemical analyzer and kit, respectively. Masson's trichrome staining was used to analyze the degree of collagen deposition. The expression levels of inflammation and fibrosis-related proteins were detected using enzyme-linked immunosorbent assays.
Results: After 3 days of administration, TM improved cardiac function and morphology. It effectively reduced the area of myocardial infarction in I/R rats, inhibited the abnormal activity of myocardial enzymes, and significantly reduced superoxide dismutase activity, as well as C-reactive protein, tumor necrosis factor-α, and interleukin-1β expression at the protein level. TM administration inhibited oxidative stress, inflammation, and myocardial pathological damage. After 28 d of administration, TM improved heart function; inhibited ventricular dilation and the thinning of the ventricular wall; significantly reduced the protein expression of connective tissue growth factor, matrix metalloproteinase 2, and matrix metalloproteinase 9; and decreased the degree of myocardial fibrosis.
Conclusions: TM can effectively reduce the infarct size, improve the cardiac structure and function, reduce myocardial collagen deposition, and attenuate VR. The underlying mechanisms involve the inhibition of inflammatory responses in the early stages and a reduction of myocardial fibrosis in the late stages.