Following peripheral nerve injury, the sympathetic nervous system responds to noxious inputs that induce or exacerbate pain. Dorsal root ganglion (DRG) sympathetic sprouting after peripheral nerve injury may induce abnormal firing of neurons. Moreover, the areas of the brain that respond to nociceptive stimuli overlap with those areas activated by the sympathetic nervous system. Acupuncture is a widely used alternative therapy for neuropathic pain. It has been demonstrated that it has positive effects on the regulation of function in the autonomic nervous system. Based on previous studies, there are several possibilities for the regulation of sympathetic nerves by using acupuncture to relieve neuropathic pain. Acupuncture may act on the brain areas of pain and the sympathetic nervous system, decrease sympathetic nerve activity during neuropathic pain, attenuate sympathetic sprouting, and reduce the abnormal firing of neurons. Further studies are required to confirm these hypotheses. This review will help to better understand the potential mechanisms of acupuncture in neuropathic pain.
Atrial fibrillation (AF) is the most common arrhythmia disease and is associated with several cardiovascular and cerebrovascular diseases. Consequently, the mortality rate of AF has increased in recent years. At present, the treatment of AF is mainly based on medication and radiofrequency ablation, but there are limitations such as adverse reactions and high recurrence rates. Recently, autonomic nervous regulation has become a new treatment for AF. Our previous study showed that acupuncture at Neiguan (PC6) point can treat AF by regulating autonomic balance. The autonomic nervous system can be structurally divided into the central autonomic nervous (CAN) and the peripheral autonomic nervous (PAN). Several studies have shown a correlation between acupuncture and the treatment of AF and CAN. In the clinic, the positive effect of acupuncture on AF has been realized gradually, and growing experimental studies have further discovered the potential mechanism of acupuncture on AF by regulating the CAN. Therefore, this review mainly focuses on summarizing the CAN mechanism related to acupuncture in the treatment of AF to provide new ideas and directions for the treatment of AF.
The discovery of effective constituents of traditional Chinese medicine (TCM) is an important approach in new drug development. Several well-known drugs, such as artemisinin, berberine, and ephedrine have been developed using this approach. However, the efficacy and safety of TCM, two key issues for drug development based on TCM clinical experience, remain unclear worldwide. The discovery strategy of relevant constituents is the most important step for determining efficacy and safety, which still a key scientific problem that restricts the development of new drugs. Furthermore, TCM formulas used as clinical drugs address a specific TCM syndrome (Zheng), and the complexity of the formula and vagueness of the syndrome make the identification of the effective constituents related to clinical effectiveness challenging. Over decades, researchers have developed transdisciplinary technologies and research methodologies to identify effective constituents in vivo. In this paper, the history of strategy development for identifying the effective constituents related to the clinical efficacy of TCM is reviewed and summarized. The main approaches include the phytochemical method, which involves the classical systematic separation and screening (extraction, separation, purification, structure identification, and activity test); bioactivity-guided separation; serum pharmacochemistry of TCM in vivo; and Chinmedomics, which connects in vivo constituents with the biomarkers of the relevant TCM syndrome. Chinmedomics is a promising strategy that conforms to the theory and characteristics of TCM. By clarifying the effective constituents, targets and pathways of medicines, it can promote the discovery of lead compounds and the research of innovative drugs, and continuously promote the modernization of TCM.
Senkyunolides are a group of phthalide molecules that exist in Umbelliferae plants, with the highest abundance in Ligusticum chuanxiong Hort, a medicinal herb with therapeutic applications in various diseases such as coronary heart disease, migraine, and rheumatism. Modern research has highlighted the anti-inflammatory, analgesic, and cardiovascular-protective properties of senkyunolides. Recently, some novel effects, such as antibacterial, anti-osteoporosis, and anti-fibrosis, have been reported for senkyunolides, indicating their diverse biological activities. In addition, because of its high bioavailability and ability to cross the blood-brain barrier (BBB), particularly exemplified by senkyunolide I (SEI), holds promise for the treatment of brain diseases. Multiple signaling pathways have been related to the pharmacological activities of senkyunolides, such as the toll-like receptor 4/nuclear factor-kappa B (NF-κB) signaling, extracellular signal-regulated kinase (ERK) pathway, p38 mitogen-activated protein kinase, and c-Jun N-terminal kinase (JNK) pathways. Here, we review the research progress on the pharmacokinetics and pharmacological effects of senkyunolides, which are promising candidates for future drug development and have significant clinical value in the treatment of various diseases.
The etiology and exact molecular mechanisms of primary hepatocellular carcinoma (HCC) remain unclear, and its incidence has continued to increase in recent years. Despite tremendous advances in systemic therapies such as molecularly targeted drugs, HCC has some of the worst prognoses owing to drug resistance, frequent recurrence, and metastasis. Hepatocellular carcinoma is a widespread disease and its progression is regulated by the immune system. Traditional Chinese medicine (TCM) has been gradually theorized and systematized to have a holistic regulatory role for use in the prevention and treatment of tumors. Although half of the patients with HCC receive systemic therapy, traditionally sorafenib or lenvatinib are used as first-line treatment modalities. TCM is also widely used in the treatment of HCC, and the same immune checkpoint inhibitors (ICIs) such as PD-L1 have also received much focus in the field of continuously changing cancer treatment. Owing to the high probability of resistance to specific drugs and unsatisfactory efficacy due to administration of chemotherapy in single doses, the combination of drugs is the newest therapeutic option for patients with tumors and has become increasingly prominent for treatment. In this article, the research progress on combination therapy in the immunology of HCC is reviewed and the unique advantages of synergistic anti-tumor therapy with combination drugs are highlighted to provide new solutions for the clinical treatment of tumors.
Objective: Our study aimed to investigate the action of Xuanfei Baidu granules (XFBD) and their mechanism of action in a model of coronavirus pneumonia under cold and damp conditions.
Methods: A total of 60 Bagg Albino (BALB/c) mice were randomly assigned to different groups, including the control, model, low-dose XFBD (1.84 g/kg), medium-dose XFBD (3.67 g/kg), and high-dose XFBD (7.34 g/kg) groups. To simulate the model of coronavirus infection, a combination of cold and damp stimuli and coronavirus strain 229E (CoV 229E) was employed. Subsequently, XFBD was administered on the fifth day and lasted for 3 days. To evaluate the efficacy of XFBD in BALB/c mice, various parameters, including behavior, lung index, viral load, and pulmonary pathology, were observed. Levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). The fractions of CD4+ T cells, CD8+ T cells, and B cells were measured using flow cytometry.
Results: The mice in the control group were active, in good condition, and exhibited shiny hair. After modeling, the mice demonstrated less activity, low energy levels, messy and less shiny hair, poor appetite, and soft stools. The symptoms of coronavirus pneumonia were all significantly improved after the administration of different doses of XFBD. At three dosage levels, XFBD effectively increased gastrin (GAS) content, whereas medium and high doses of XFBD reduced motilin (MTL) content. The high-dose XFBD group showed a significant reduction in pathological damage to lung tissue. Treatment with three doses of XFBD demonstrated significant downregulation of inflammatory factors and regulation of CD4+ and CD8+ T cell and B cell expression. The high-dose XFBD group exhibited enhanced efficacy compared to the other doses.
Conclusions: XFBD showed a therapeutic effect on coronavirus pneumonia under cold and damp conditions, improved the behavioral characterization and gastrointestinal index, and reduced the lung virus titer and histopathology. This may be associated with the inhibition of inflammation and an increase in the number of lymphocytes.
Objective: To evaluate the efficacy and safety of Xuanfei Baidu decoction for treating coronavirus disease 2019 (COVID-19).
Methods: Patients with COVID-19 were enrolled, and eligible patients were randomly allocated to three groups: group A (Xuanfei Baidu decoction combined with conventional treatment), group B (Ganlu Xiaodu decoction combined with conventional treatment), and group C (conventional treatment only). The duration of treatment was 14 days. The primary outcomes were the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid testing from positive to negative and hospitalization days. The secondary outcome was the rate of symptom resolution. The safety outcome was drug-related adverse events.
Results: In total, 103 patients with ordinary-type COVID-19 were included and randomly allocated to groups A (34 cases), B (35 cases), and C (34 cases). Duration for SARS-CoV-2 nucleic acid testing from positive to negative was shortest in group A [(9.88 ± 3.62) days], followed by groups C [(11.20 ± 2.93) days] and B [(12.69 ± 4.11) days]; differences between the three groups were statistically significant (P = 0.010). The number of hospitalization days was the least in group A [(14.00 ± 6.55) days], followed by groups B [(15.40 ± 4.02) days] and C [(16.38 ± 5.73) days], and differences between groups were statistically significant (P = 0.019). There was no statistically significant difference in the rate of symptom resolution between groups (P > 0.05). No deaths or serious adverse events occurred in either of the groups.
Conclusion: Considering the treatment of ordinary-type COVID-19, Xuanfei Baidu decoction can shorten the duration from a positive to negative SARS-CoV-2 nucleic acid test, as well as the duration of hospitalization. Moreover, there were no Xuanfei Baidu decoction-induced adverse reactions.
Objective: The surgical treatment of myocardial infarction often causes myocardial ischemia-reperfusion injury (MI/RI). Danhong injection (DHI) has curative effects on coronary heart disease and angina pectoris. However, its therapeutic effects on MI/RI still require further validation. This study aims to investigate the components involved and mechanism of action of DHI against MI/RI.
Methods: Primary metabolites (PM) and secondary metabolites (SM) were isolated from DHI. We established a rat model of MI/RI by administering PM, SM, and DHI. Cardiac morphology and functional parameters were evaluated using cardiac ultrasound. The metabolic effects of PM, SM, and DHI in the serum and myocardial tissue on MI/RI were investigated using 1hydrogen-nuclear magnetic resonance.
Results: Our study showed that DHI, PM, and SM could improve cardiac function by correcting the dilated cardiac structure, alleviating inflammation by downregulating complement C2 expression, reducing reactive oxygen species (ROS) production by upregulating cyclooxygenase expression, and restoring normal energy supply by inhibiting fatty acid metabolism and stimulating glycometabolism. In addition, DHI and SM could attenuate the calcium overload and trigger an inflammatory response and oxidative stress by downregulating Ca2+/calmodulin-dependent protein kinase II expression.
Conclusions: This study suggests that DHI and its components exerts resistance against MI/RI by ameliorating cardiac dysfunction, energy metabolism, and oxidative stress.