Prospects for the future of clinical efficacy evaluation of traditional Chinese medicine——Emphasis on original theory and clinical practice
TMR Modern Herbal Medicine. 2020, 3 (1): 1-5.
Traditional Chinese medicine (TCM) clinical efficacy evaluation runs through the development of TCM and has been progressing so far. With the introduction of evidence-based medicine (EBM) in recent 20 years, TCM clinical efficacy evaluation has developed rapidly, accumulated research and experience, improved the quality and standardization of research, but also gradually found deep-seated deficiencies. In 2019, the China Center for Evidence-based Traditional Chinese Medicine (CCEBTCM) was established, and TCM was included in the 11th revision of the International Statistical Classification of Diseases (ICD-11). In above opportunities for TCM clinical efficacy evaluation, it is necessary to face up to the previous deficiencies, so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics, including TCM clinical problems, TCM thinking and TCM diagnosis & treatment mode. Based on the summary and analysis of past research, development concepts are proposed in this article. On the one hand, original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice. On the other hand, it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy. Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice, and unknown evaluated object combined with new methods, technologies and concepts should be maturely integrated in clinical practice firstly.
Effects of Angelica Polysaccharide on telomere length in mice with benzene-induced aplastic anemia
TMR Modern Herbal Medicine. 2020, 3 (1): 6-12.
Objective: To investigate the changes in telomere length and the level of burst-forming units-erythrocyte (BFU-Es) and colony-forming unit-erythrocytes (CFU-Es) in mice with benzene-induced aplastic anemia (AA), and follow-up the therapeutic effects of Angelica Polysaccharide (AP). Methods: Male BALB/c mice (n = 120) were randomly divided into three groups (1, 2, 3): normal control (n = 24), AA control (n = 48), and treated AA (n = 48), respectively. Mice in Group 2 received benzene inhalation for 2.5 months and 1 ml distilled water p.o. per day for 2 weeks after the establishment of AA models. Similar procedure was applied to the mice in Group 3 and AP was given for 2 weeks after the establishment of AA models. Real-time polymerase chain reaction was used to survey relative telomere length measurement of the bone marrow cells. A BFU-Es and CFU-Es survey was done to follow-up the therapeutic effects of AP. Results: Compared with normal control, significant reductions of RBC, WBC, and platelet counts were found in peripheral blood of AA mice. After treatment with AP, counts of BFU-Es and CFU-Es were restored up to 66.8% and 77.25%, respectively, and length of telomere was restored up to 76.34%, of the normal levels. The telomere length in treated AA group was higher than the control AA group. Conclusion: The AP can protect the telomere length and differentiation of hemopoietic stem/progenitor cells, accelerate the recovery of BFU-Es and CFU-Es of AA mice, and then improve the bone marrow failure.
Protective effects of Pulsatilla chinensis Regel against isoproterenol-induced heart failure in mice
TMR Modern Herbal Medicine. 2020, 3 (1): 21-29.
Objective: To study the cardioprotective effect of Baitouwen (Pulsatilla chinensis Regel, PR) in isoproterenol (ISO) induced heart failure in mice, and investigated the molecular targets using network pharmacological prediction and experimental validation. Methods: PR were orally administered to ISO induced HF mice for two weeks. The cardiac function was analyzed by echocardiography. Hematoxylin-eosinstaining (HE) was used to evaluate the pathological changes. The PR targets for HF were predicted by bioinformatics analysis tool (BATMAN-TCM). The expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and HF related genes Phosphodiesterase (PDEs), were detected by real-time fluorescence quantitative PCR or Immunohistochemical staining in heart tissues. Results: Cardiac hypertrophy was observed after ISO treatment, and hypertrophic cardiomyocytes were arranged in disorder. Moreover, the expression of ANP and BNP gene in myocardium were upregulated (P < 0.05). Treatment of HF mice with PR aqueous extract improved cardiac function characterized by enhanced ejection fraction (EF) and fraction shortening (FS). Furthermore, PR extract also downregulated the expression of ANP and BNP in the heart tissues. Arrangement of cardiomyocytes was also improved. Furthermore, administration of PR group decreased target genes PDE5 and PDE1C expression in the hearts. In addition, PR treatment also improved myocardial fiber distribution and decreased myocardial thickness in the hearts of HF mice. Conclusion: PR treatment may suppress cardiac hypertrophy and improve myocardial function in HF mice via inhibiting the predicted targets PDE5 expression. These results suggest the potential of using PR in preventing the development of HF.
Phytomedicines as therapeutic interventions for hepatic encephalopathy
TMR Modern Herbal Medicine. 2020, 3 (1): 30-49.
Hepatic encephalopathy (HE) describes a broad range of neuropsychiatric abnormalities caused by advance hepatic insufficiency or portosystemic shunting, and manifests as a spectrum of neurological dysfunction. Hepatic necrosis, Kupffer cell hyperplasia, haemosiderosis, periportal mononuclear cell infiltration, neuroinflammation, irregularity in mitochondrial function and oxidative stress are the major pathological hallmark of hepatic encephalopathy. Treatment of hepatic and neuropsychiatric disorders has gone through several revolutions. In recent time, phytomedicines are gaining grounds as an effective therapeutic option. Noteworthy, plants have been used widely as therapeutic agents for liver and neuronal ailments. The potential of plants as agents for the treatment of various neuropsychiatric and liver impairments have been confirmed by several clinical research. Chemicals obtained from plants, provide the possibility of an alternate potential tool to neutralize the disease mechanism of hepatic and neuropsychiatric disorders including HE. This may be achieved through curtailing the actions of scavenging free radicals, ROS, and proinflammatory cytokines in the periphery, relieving systemic inflammation to prevent inflammation of the brain via the BBB. In endothelial cells, phytochemicals can also reduce protein expression of ICAM. This ensures an intact BBB and shut inflammatory infiltration linked with gateway reflex and infiltrating into the brain. Recent research has enabled the elucidation of the ways by which the therapeutic effects of these plants are achieved. This review discusses in details, some medicinal plants with neuroprotective and hepatoprotective effects. A peculiar interest is also given to the cellular and molecular mechanism of action. Beyond reasonable doubt, this review shows that herbal drug formulations possess significance hepatoprotective and neuroprotective activity in therapeutic intervention and prophylactic measures in HE.