Diabetes In Traditional Chinese Medicine Research Articles

Traditional processing increases biological activities of Dendrobium offificinale Kimura et. Migo in Southeast Yunnan, China

The orchid Dendrobium officinale grows throughout southeast China and southeast Asian countries and is used to treat inflammation and diabetes in traditional Chinese medicine. Tie pi feng dou is a well-known traditional Chinese medicine made from the dried D. officinale stems. Processing alters the physicochemical properties of TPFD; however, it is unclear how processing affects the quality and medicinal value of this plant. Here, we analyzed and compared the chemical composition of fresh stems of D. officinale and TPFD and explored possible explanations for the enhanced medicinal efficacy of processed D. officinale stems using qualitative and quantitative methods. To identify the components of FSD and TPFD, we used ultra-high-performance liquid chromatography combined with mass spectrometry in negative and positive ion modes and interpreted the data using the Human Metabolome Database and multivariate statistical analysis. We detected 23,709 peaks and identified 2352 metabolites; 370 of these metabolites were differentially abundant between FSD and TPFD (245 more abundant in TPFD than in FSD, and 125 less abundant), including organooxygen compounds, prenol lipids, flavonoids, carboxylic acids and their derivatives, and fatty acyls. Of these, 43 chemical markers clearly distinguished between FSD and TPFD samples, as confirmed using orthogonal partial least squares discriminant analysis. A pharmacological activity analysis showed that, compared with FSD, TPFD had significantly higher levels of some metabolites with anti-inflammatory activity, consistent with its use to treat inflammation. In addition to revealing the basis of the medicinal efficacy of TPFD, this study supports the benefits of the traditional usage of D. officinale.

Research on TCM Diabetes Assisted Diagnosis and Treatment Plan Integrating Association Mining and Quantitative Calculation

This paper attempts to explore more precise and intelligent assisted methodological references for the diagnosis and treatment of diabetes in Traditional Chinese Medicine (TCM) by using medical record data from TCM diabetes, and to construct a TCM diabetes assisted diagnosis and treatment framework of “association mining-quantifying calculation-intelligent assisted diagnosis and treatment” what can be described as cluster analyzing and match mining for symptom and drug by association mining, as quantitatively calculating and evaluating for the condition of diabetes; as disease diagnosis, drug recommendation and decision making by intelligent assisted diagnosis and treatment. This paper synthetically employs the technical methodology of association rules, topic clustering, emotion recognition and content recommendation, to realize the knowledge mining, quantify the evaluation and assist decision-making of TCM diabetes, and to propose a reference for the process of consultation and treatment. Overall, the study contributes to the academic and practical value in diabetes by elaborating a new technical methodology and providing a brief empirical test for doctors and researchers.

Anemarrhena asphodeloides modulates gut microbiota and restores pancreatic function in diabetic rats

Anemarrhena asphodeloides is an herb widely used to treat symptoms associated with diabetes in traditional Chinese medicine. However, its key components and metabolites have low bioavailability and poor host absorption. To clarify the anti-diabetic mechanism of A. asphodeloides extract (AAE), we examined the anti-diabetic effects of AAE in rats with diabetes induced by a high-fat diet and streptozotocin. Faeces levels of the main components and metabolites of AAE were significantly higher than levels in plasma, which indicated that gut microbiota might play important roles in its anti-diabetic effect. Microbiological studies showed that unabsorbed components increased the diversity of the gut microbiota, enriched potentially beneficial bacteria, and suppressed potentially harmful bacteria. In vitro studies showed that AAE promoted the proliferation of Blautia coccoides, a bacterium with positive implication for diabetes, in a dose-dependent manner. AAE also promoted pancreatic cell regeneration and restored the function of pancreatic islet cells via peroxiredoxin 4 overexpression. Overall, these results suggest that AAE alleviates diabetes via modulating gut microbiota and protein expression.

Identification of chemotypes in bitter melon by metabolomics: a plant with potential benefit for management of diabetes in traditional Chinese medicine.

Bitter melon (Momordica charantia, Cucurbitaceae) is a popular edible medicinal plant, which has been used as a botanical dietary supplement for the treatment of diabetes and obesity in Chinese folk medicine. Previously, our team has proved that cucurbitanes triterpenoid were involved in bitter melon's anti-diabetic effects as well as on increasing energy expenditure. The triterpenoids composition can however be influenced by changes of varieties or habitats. To clarify the significance of bioactive metabolites diversity among different bitter melons and to provide a guideline for selection of bitter melon varieties, an exploratory study was carried out using a UHPLC-HRMS based metabolomic study to identify chemotypes. Metabolites of 55 seed samples of bitter melon collected in different parts of China were profiled by UHPLC-HRMS. The profiling data were analysed with multivariate (MVA) statistical methods. Principle component analysis (PCA) and hierarchical cluster analysis (HCA) were applied for sample differentiation. Marker compounds were identified by comparing spectroscopic data with isolated compounds, and additional triterpenes were putatively identified by propagating annotations through a molecular network (MN) generated from UHPLC-HRMS & MS/MS metabolite profiling. PCA and HCA provided a good discrimination between bitter melon samples from various origins in China. This study revealed for the first time the existence of two chemotypes of bitter melon. Marker compounds of those two chemotypes were identified at different MSI levels. The combined results of MN and MVA demonstrated that the two chemotypes mainly differ in their richness in cucurbitane versus oleanane triterpenoid glycosides (CTGs vs. OTGs). Our finding revealed a clear chemotype distribution of bioactive components across bitter melon varieties. While bioactivities of individual CTGs and OTGs still need to be investigated in more depth, our results could help in future the selection of bitter melon varieties with optimised metabolites profile for an improved management of diabetes with this popular edible Chinese folk medicine.

Comparative Proteomic Analysis of Two Differently Extracted Coptis chinensis in the Treatment of Type 2 Diabetic Rats.

Coptis chinensis (CC) is widely used to treat diabetes in traditional Chinese medicine due to its significant hypoglycemic and hypolipidemic effects. It was reported that CC powders are more effective than CC decoctions. In this study, a rat model of type 2 diabetes was established and treated with supercritical-extracted CC and gastric juice extracted CC, respectively. Body weight, fasting plasma insulin, insulin resistance index, and lipid profiles were measured along with oral glucose tolerance tests (OGTTs). In addition, the levels of plasma proteins were compared between type 2 diabetic rats and CC-treated rats using an iTRAQ-based quantitative proteomic analysis. The results showed that the plasma levels of triglyceride (TC), total cholesterol (TG), and low-density lipoprotein (LDL) in rats of both CC-treated groups were significantly decreased. In addition, the proteomic analysis identified 929 proteins, while 15 proteins were selected from these 929 proteins based on their expression levels and bioinformatic results. Among these 15 proteins, 9 proteins (IGF-1, Igfbp4, Igfbp-6, Igfals, C2, C4, Cfi, Prdx-2, and Prdx-3) were upregulated in the two CC-treated groups, while 6 proteins (Pla2g7, Pcyox1, ApoC-1, ApoC-3, ApoB-100, and ApoE) were downregulated. The functions of these proteins are associated with glucose metabolism, insulin action, immunity, inflammation, lipid metabolism, oxidation, and antioxidation. The two differently extracted CC did not show significant differences in terms of their treatment efficacy. This research expanded our understanding on the therapeutic effects and mechanisms of CC in the treatment of type 2 diabetes.

Effect of cortex mori on pharmacokinetic profiles of main isoflavonoids from pueraria lobata in rat plasma

Ethnopharmacological relevanceRadix pueraria (the root of pueraria lobata (Wild.) Ohwi.), which contains a class of isoflavonoids as the main active components, as well as cortex mori (the root bark of Morus alba L), which contains abundant active alkaloids, have been employed for the treatment of diabetes in traditional Chinese medicine for centuries. In previous studies, pharmacodynamic synergistic reactions have been observed in compatible application of pueraria lobata isoflavonoids extracts (PLF) and cortex mori alkaloids extracts (CME) for inhibiting α-glycosidase activity. It has also been demonstrated that PLF can effectively slow down the absorption of active alkaloid from CME, so as to produce a higher effective concentration in small intestine for depressing the elevation of postprandial blood glucose through inhibiting α-glycosidase activity. Aim of the studyIn this study, the hypoglycemic effect of PLF, CME or CME-PLF mixture (the mixture of CME and PLF at a ratio of 1:6.3) was further evaluated through in vivo glucose tolerance studies. And the effect of CME on pharmacokinetic profiles of main isoflavonoids from PLF in rat plasma was investigated to further underlie compatibility mechanism of the two herbs. Materials and methodsFour groups of rats received an oral dose of starch solution alone or simultaneously with drugs by gavage feeding. The blood samples were collected to determine glucose concentrations by glucose oxidase method. In addition, another two groups of rats were orally administered with PLF or CME-PLF. The plasma samples were collected and assayed using an LC/MS/MS method for comparatively pharmacokinetic studies of five main isoflavonoids. ResultsFor starch loading, co-administration of CME-PLF resulted in more potent inhibition effects on glucose responses compared to those by CME or PLF in rat. The isoflavonoids from PLF were rapidly absorbed, presenting similarly low concentrations in plasma. When CME was added, the Cmax and AUC of all the five isoflavonoids were increased. A phenomenon of double peaks was found for all analysts. The elimination rates of all the detected isoflavonoids were also slowed down with extension of t1/2. ConclusionsCME has been found to increase the absorption and delay the elimination of main isoflavonoids from PLF, which might result in higher concentrations of circulating active compounds for anti diabetes.

Hypoglycemic effects of Trichosanthes kirilowii and its protein constituent in diabetic mice: the involvement of insulin receptor pathway

BackgroundDiabetes is a serious chronic metabolic disorder. Trichosanthes kirilowii Maxim. (TK) is traditionally used for the treatment of diabetes in traditional Chinese medicine (TCM). However, the clinical application of TK on diabetic patients and the hypoglycemic efficacies of TK are still unclear.MethodsA retrospective cohort study was conducted to analyze the usage of Chinese herbs in patients with type 2 diabetes in Taiwan. Glucose tolerance test was performed to analyze the hypoglycemic effect of TK. Proteomic approach was performed to identify the protein constituents of TK. Insulin receptor (IR) kinase activity assay and glucose tolerance tests in diabetic mice were further used to elucidate the hypoglycemic mechanisms and efficacies of TK.ResultsBy a retrospective cohort study, we found that TK was the most frequently used Chinese medicinal herb in type 2 diabetic patients in Taiwan. Oral administration of aqueous extract of TK displayed hypoglycemic effects in a dose-dependent manner in mice. An abundant novel TK protein (TKP) was further identified by proteomic approach. TKP interacted with IR by docking analysis and activated the kinase activity of IR. In addition, TKP enhanced the clearance of glucose in diabetic mice in a dose-dependent manner.ConclusionsIn conclusion, this study applied a bed-to-bench approach to elucidate the hypoglycemic efficacies and mechanisms of TK on clinical usage. In addition, we newly identified a hypoglycemic protein TKP from TK. Our findings might provide a reasonable explanation of TK on the treatment of diabetes in TCM.

The protective effects and genetic pathways of thorn grape seeds oil against high glucose-induced apoptosis in pancreatic β-cells

BackgroundExcessive apoptosis of β-cell is closely related to diabetes mellitus. Chronic exposure to high glucose causes β-cell dysfunction and apoptosis in diabetes. Thorn grape (Vitis davidii Foex.) has been used to treat diabetes in Traditional Chinese medicine for many years. In our previous research, thorn grape seeds oil (TGSO) showed promising anti-diabetic effects in animal models. However, it is unknown whether TGSO played an anti-apoptotic role in the anti-diabetic effects and the mechanism regarding signal transduction pathway is unclear either.MethodsThe rattus pancreatic β-cell line RIN-m5F was treated with/without TGSO which was extracted by supercritical carbon dioxide (CO2) fluid extraction and analyzed by Gas Chromatography/Mass Spectrometry (GC/MS). Cell apoptosis was detected by fluorescence activated cell sorting (FACS), insulin secretion was assayed by Enzyme-Linked Immunosorbent Assay (ELISA), and the apoptosis-related genes expressions were evaluated by quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR).ResultsTGSO, containing 87.02% unsaturated fatty acids (UFAs), significantly reduced pancreatic β-cell apoptosis and protected the insulin secretion impaired by high glucose. The expressions of pro-apoptotic genes such as iNOS, Caspase-3, ATF-3, JNK, p38 and Fas were down-regulated while the anti-apoptotic genes Akt and Bcl-2/Bax were up-regulated.ConclusionsThe results indicated that TGSO protected β-cells from high glucose-induced apoptosis and its protective activity may be linked to mitochondrial pathway, endoplasmic reticulum (ER) stress pathway and Fas signal pathway, which implied that TGSO might be an effective complementary or alternative medicine to reduce β-cell apoptosis and dysfunction.

Neuroprotective effect of morroniside on focal cerebral ischemia in rats

Cornus officinalis Sieb. et Zucc., known as Shan-zhu-yu in Chinese, has been used to treat cerebrovascular disease and diabetes in Traditional Chinese Medicine for a long time and morroniside is the main component of Shan-zhu-yu. In this study, we examined whether morroniside could protect ischemia/reperfusion-induced brain injury by minimizing oxidative stress and anti-apoptosis. Morroniside was intragastrically administered to rats in doses of 30, 90 and 270 mg/kg/day, starting 3 h after the onset of middle cerebral artery occlusion. The behavioral test was performed by using the Zea–Longa scores, Prehensile Traction score and Ludmila Belayer score. Rats were sacrificed 3 days after ischemia occurred. The infarction volume of brain was assessed in the brain slices stained with 2,3,5-triphenyl tetrazolium chloride. Cortex tissues were also used for determination of malondialdehyde levels, glutathione levels and superoxide dismutase. The treatment with morroniside significantly improved Zea–Longa scores and Prehensile Traction score at the doses of 30, 90 and 270 mg/kg, increased Ludmila Belayer score and reduced the infarction volume at the doses of 90 and 270 mg/kg. Morroniside (30, 90 and 270 mg/kg) treatment significantly decreased the level of malondialdehyde and caspase-3 activity by colorimetric analysis in ischemic cortex tissues. Morroniside (270 mg/kg) treatment significantly increased the content of glutathione, enhanced the activity of superoxide dismutase, but decreased the caspase-3 expression by Western-blot analysis in ischemic cortex tissues. These findings demonstrated that morroniside could notably protect the brain from damage induced by focal cerebral ischemia which might be related to morroniside antioxidant and anti-apoptotic properties in the brain.

Study on the history of Traditional Chinese Medicine to treat diabetes

IntroductionIn order to introduce the diabetology history in Traditional Chinese Medicine (TCM), including nomenclature, understanding, treatment, prevention, etc., our research specifically focused on ancient medical literature used in the evaluation of diabetes in TCM or wasting-thirst (xiao-ke). MethodologyThe history of wasting-thirst was classified into four periods: (1) the nomenclature of wasting-thirst; (2) the monograph of wasting-thirst; (3) the understandings of sweet urine and its extensive development; and (4) the integration of wasting-thirst and diabetes. ResultsBy mining and reviewing the literature in the 2000-year history of wasting-thirst, it is believed that TCM has a profound understanding of, and effective management on, diabetes and its complications. For period one, wasting-thirst was first recorded in The Yellow Emperor's Classic of Internal Medicine. For period two, it was elaborated in Treatise on Febrile and Miscellenous Disease, and its “pathology” was summarized as “three wasting-thirsts (upper, middle, lower)” from the perspectives of spatial locations of organs, which serves as a guide in clinical practice. For period three, a self-contained system, including diagnosis, treatment, prevention, nursing, and education, had been established. For period four, wasting-thirst was intimately integrated into diabetes in The Integration of Traditional Chinese Medicine and Western Medicine. DiscussionTraditional Chinese Medicine harbors a long history of treating wasting-thirst/diabetes. With its unique therapeutic approaches, TCM is an effective system of understanding and managing diabetes as proven by medical literatures, clinical benefits and basic research studies.

Therapeutic effects of Jinqi Jiangtang Tablet on women with polycystic ovary syndrome

To observe the therapeutic effects of Jinqi Jiangtang Tablet (JQJTT), a commonly prescribed recipe for type 2 diabetes in traditional Chinese medicine, on obese women with polycystic ovary syndrome (PCOS). Twenty-four obese women with PCOS were prescribed JQJTT for 3 months and the changes of carbohydrate metabolism and biochemical indicators, including menstrual cycle, body mass index (BMI), the level of blood sex hormone, area under curve (AUC) of glucose and insulin during oral glucose tolerance test (OGTT), and testosterone responses during human chorionic gonadotrophin stimulation ovary test were observed. After treatment, there were significantly reductions in BMI (P<0.05), serum glucose level at 30 min during OGTT (P<0.05) and testosterone levels at eighteen hours during human chorionic gonadotrophin stimulation ovary test (P<0.05). In addition, nine patients had improved cycles among sixteen completed patients, and one patient with clomifene resistance got pregnant with response to clomifene treatment. The beneficial effects of JQJTT may result from improvement of carbohydrate metabolism and reduction in androgen biosynthesis in women with PCOS.

Metabonomic Study on the Biochemical Profiles of A Hydrocortisone-Induced Animal Model

This work describes the metabonomic study of a biochemical modification in vivo induced by high dose of hydrocortisone, which led to a unique pathologic condition similar to the 'kidney deficiency syndromes', an early stage of obesity and diabetes in traditional Chinese medicine. The methodology of the metabonomic approach consisted of GC/MS and multivariate statistical technique for the establishment of urine metabolic patterns of the treatment rats. In the study, 24-h urine was collected pre-dose and at days 1, 3, 7, and 10 post-dose after rats were injected with hydrocortisone at 1.5 mg/100 g. The acquired data were transferred into Matlab to be processed using principal components analysis (PCA). The results indicated that clear and consistent biochemical changes following hydrocortisone intervention under controlled conditions could be identified using chemometric analysis. The work suggests that this metabonomic approach could be used as a potentially powerful tool to investigate the biochemical changes of certain physiopathologic conditions such as metabolic syndrome, as an early diagnostic means.