Herbal Decoction Research Articles

Chinese herbal medicine combined with cognitive–behavioural therapy for avoidant paruresis: a controlled trial

BackgroundAvoidant paruresis is a common clinical condition in urology and psychosomatic medicine. However, it has limited treatment options that are safe and effective with few side effects.AimsOur study aimed to...

Multi-omics analysis of Gwakhyangjeonggi-san for gastrointestinal complications in atopic dermatitis: A randomized, double-blinded, placebo-controlled, parallel-group clinical trial

Ethnopharmacological relevanceIn traditional Chinese medicine (TCM) and traditional Korean medicine (TKM), Gwakhyangjeonggi-san (GJS) is an herbal decoction used to treat gastrointestinal disorders and allergic diseases. However, no randomized controlled trials have reported the efficacy and safety of GJS against atopic dermatitis (AD) or its comorbidities. Aim of the studyThis clinical trial investigated the clinical efficacy and safety of GJS for treating patients with AD who have gastrointestinal symptoms, using a multi-omics approach that included 16S rRNA sequencing and metabolomics. Materials and methodsThis study was a randomized, double-blind, placebo-controlled, parallel-group clinical trial. Fifty-two patients with AD (age: 19–60) were randomly assigned to receive either the GJS (N = 27) or placebo (N = 25) granules thrice daily for 8 weeks. The primary outcome was measured as the change in the SCORing of Atopic Dermatitis index from baseline to 8 weeks. The secondary outcomes included the eczema area and severity index, dermatology life quality index, EuroQoL 5 dimensions 5 levels (EQ-5D-5L), immunological factors, gastrointestinal status, and safety evaluation. In addition, 16S rRNA sequencing on gut-microbiomes and non-targeted metabolomics approach using mass spectrometry on sera samples were applied to investigate the GJS therapeutic mechanism. ResultsAfter 8 weeks, AD symptoms were reduced in both the GJS and placebo groups without any serious adverse events, but the reduction was not significantly different between the two groups. However, the EQ-5D-5L scores and gastrointestinal symptom scores, such as bitter-tasting fluid presenting in the mouth, upper abdomen bloating, and nausea, only improved in the GJS group. To further elucidate the effect of GJS on patients with AD who have gastrointestinal symptoms, 16S rRNA sequencing and metabolomics were executed. The GJS group had lower gut microbiome diversity including observed OUT, Ace, Chao1 and Shannon index than the placebo group at enrollment time, while the difference in gut microbiome diversity between GJS and placebo group was eliminated by 8 weeks of treatment. Consistently, the metabolomics results showed that the gut microbiome-derived uremic toxins, including indoxyl sulfate and phenylacetylglutamine, significantly increased in the placebo group, while these in GJS group were maintained without any significant change. ConclusionsThese results showed that the GJS had no significant effect on AD compared to the placebo but exerted a beneficial effect on improving the quality of life and gastrointestinal symptoms in patients with AD, and it acted by modulating gut microbiome diversity and gut microbiome-derived uremic toxins. Our findings support the use of GJS for AD comorbidities and also provide evidence that multi-omics approaches can be useful for understanding herbal decoctions in TCM and TKM comprehensively.

Exploring Immune Modulatory Effects of Cyclotide-Enriched Viola tricolor Preparations.

Viola tricolor is a medicinal plant with documented application as an anti-inflammatory herb. The standard of care for the treatment of inflammatory bowel disease is immunosuppressive therapeutics or biologics, which often have undesired effects. We explored V.tricolor herbal preparations that are rich in an emerging class of phytochemicals with drug-like properties, so-called cyclotides. As an alternative to existing inflammatory bowel disease medications, cyclotides have immunomodulatory properties, and their intrinsic stability allows for application in the gastrointestinal tract, for instance, via oral administration. We optimized the isolation procedure to improve the yield of cyclotides and compared the cellular effects of violet-derived organic solvent-extracts, aqueous preparations, and an isolated cyclotide from this plant on primary human T lymphocytes and macrophages, i.e., cells that are crucial for the initiation and progression of inflammatory bowel disease. The hot water herbal decoctions have a stronger immunosuppressive activity towards proliferation, interferon-γ, and interleukin-21 secretion of primary human T cells than a DCM/MeOH cyclotide-enriched extract, and the isolated cyclotide kalata S appears as one of the active components responsible for the observed effects. This effect was increased by a longer boiling duration. In contrast, the DCM/MeOH cyclotide-enriched extract was more effective in reducing the levels of cytokines interleukin-6, interleukin-12, interleukin-23, tumor necrosis factor-α, and C - X-C motif chemokine ligand 10, secreted by human monocyte-derived macrophages. Defined cyclotide preparations of V.tricolor have promising pharmacological effects in modulating immune cell responses at the cytokine levels. This is important towards understanding the role of cyclotide-containing herbal drug preparations for future applications in immune disorders, such as inflammatory bowel disease.

A Study on Major Uninsured Korean Medicine Treatments Search Trends and Their Meanings in an Online Portal: Using Naver Data Lab

Objectives: The purpose of this study was to examine search trends and their meanings for major uninsuired Korean medicine (KM) treatments through analysis of an online portal search results.Methods: Keywords searches were performed using Naver Datalab on 4 July 2023. From January 2016 to June 2023, monthly relative search volume (RSV) for keywords ‘pharmacopuncture’, ‘Chuna’, and ‘needle-embedding therapy’, and ‘herbal decoction’ were extracted with a score between 0 and 100. For the obtained RSVs, longitudinal changes over time, characteristics according to sex and age group, and correlations between them were investigated.Results: The ranking of RSV for each keyword has changed from ‘Chuna’, ‘herbal decoction’, ‘needle-embedding therapy’, and ‘pharmacopuncture’ to ‘Chuna’, ‘herbal decoction’, ‘pharmacopuncture’, and ‘needle-embedding therapy’ after 2019. Overall, the RSV of needle-embedding therapy continuously decreased, while that of pharmacopuncture continuously increased. In 2019, a rapid increase in the RSV of Chuna was observed, and in 2020, a rapid increase in the RSV of herbal decoction was observed. There was a difference in the longitudinal change pattern of RSV for the keywords by age group. Importantly, in the elderly, changes in RSV were observed in a favorable pattern to KM treatment.Conclusion: Our findings enable estimation of the public's interest and its changes for the four uninsuired KM treatment, and can be used as basic data to strengthen health insurance coverage in Korea. Specifically, changes in interest in KM treatments according to sex and age can be referred to.

A comparative analysis of Vamana and ShamanaChikitsa in prediabetes management: A randomized clinical trial

BackgroundPrediabetes is a condition before manifestation of diabetes. It is associated with biochemical change in body due to disturbances in food habits, sleep patterns and sedentary lifestyle. Conventional system of medicine has limitations, however Ayurvedic medicines can be effective for management of this condition. ObjectiveTo compare the efficacy of Vamana Karma (∼therapeutic emesis) followed by Darvyadi Kwatha (∼herbal decoction) with that of oral medication of Darvyadi Kwatha with lifestyle modification in reducing HbA1c of the prediabetic participants. MethodologyAfter approval of IEC and registration under clinical trial registry of India, 40 patients were registered in two groups suffering from prediabetes in the trial. The primary criteria were HBA1c, FBS & PPBS along with secondary criterias like Agnibala (∼strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength) relief in signs & symptoms of Prameha and quality of life (SF-36 Score). ResultsStatistically significant results were observed in both the parameters: (primary & secondary) within the group [VM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001) and SM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001)] and between the group [HbA1c (P < 0.01), FBS (P < 0.01), SF-36 score (P < 0.001) as well. ConclusionThe present clinical study suggests that there is significant improvement between the groups. On comparision, it was found that treating prediabete.s Shodhana was more safe & effective than Shamana.

AN EXPLORATORY STUDY ABOUT AROHANA ANUVASANA BASTI MATRA FROM CLASSICS: A REVIEW

Panchakarma is a unique treatment modality with five specially designed procedures, vamana, virechana, asthapana vasti, anuvasana vasti and nasya where the body is purified internally through the nearest possible pathway. Out of these shodhana therapies, vasti is the most important constituent of panchakarma due to its multidimensional properties. The administration of either medicated oil (anuvasana) or herbal decoction (niruha) through the anal route with the help of vastiyanthra is generally termed vasti karma. Anuvasana vasti mainly contains sneha (unctuous substances) and does not produce any side effects. It can be done daily after taking food, hence the name anuvasana. According to Sushruta and Kashyapa, anuvasana is classified into three types, sneha vasti, anuvasana vasti and matra vasti based on the sneha matra used. It is indicated when Kapha and Pitta dosha are diminished when there is Vata prakopa and the pathology is localized in the pelvic region associated with malabandha. Arohana matra of anuvasana vasti mentioned in classics is studied in detail here.

Investigation of Acute Toxicity and Biological Activity of an Extract obtained on the Basis of a Local Medicinal Herbal Collection

The presented article describes the results of research work on the alimentary and hemolytic anemic effect of herbal decoction of medicinal properties, which is used in folk medicine for the treatment of various diseases. The extract of the sum of decoctions of medicinal plants was administered orally to experimental rabbits for 60 days in an amount of 10 ml / kg and 25 ml / kg, and their antianemic activity was assessed by such indicators as the number of shaped blood elements, as well as the general condition of experimental animals and changes in weight. Extract of tincture of sum of medicinal plants in studies of therapeutic effect in alimentary anemia on the other hand, already on the 7th day of treatment, the effect against hemolytic anemia began to manifest itself in less than 21 days, and it becomes more intense until the end of the experiment. These effects were manifested by a positive change in the number of shaped blood elements, an improvement in the general condition of experimental animals, a significant increase in appetite, and the restoration of lost body weight. This entails extensive scientific studies of the activity and mechanism of action of this tincture against the background of various anemia.

Retracted: The Efficacy of Psychological Care and Chinese Herbal Decoction in Postoperative Chemotherapy Patients with Endometrial Cancer.

[This retracts the article DOI: 10.1155/2022/5700637.].

Chinese herbal medicine Buyang Huanwu Decoction in treatment of peripheral nerve injury: A systematic review and meta-analysis of randomized controlled trials.

Peripheral nerve injuries (PNI) resulting from trauma can be severe and permanently disabling, approximately one-third of PNIs demonstrate incomplete recovery and poor functional restoration. However, despite extensive research on this aspect, complete functional recovery remains a challenge. In East Asian countries, Chinese herbal Buyang Huanwu Decoction (BHD) has been used to treat PNI for more than 200 years, and the studies of BHD to treat PNI have been increasing in recent years based on positive clinical outcomes. The purpose of this meta-analysis was to scientifically evaluate the safety and clinical efficacy of BHD in patients with PNI. A literature search was conducted on PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, VIP, and Sinomed databases for randomized controlled clinical trials that evaluated the safety and effects of BHD alone or combination treatment on PNI. A total of 14 studies involving 1415 participants were included in this study. Each trial did not show significant heterogeneity or publication bias. The results showed that significant improvements of the total clinical effective rate (odds ratio = 3.55; 95% confidence interval [CI] = [2.62, 4.81]; P < .0001), radial nerve function score (standardized mean difference [SMD] = 1.28; 95% CI = [1.09, 1.47]; P = .007), motor nerve conduction velocity (SMD = 1.59; 95% CI = [1.40, 1.78]; P < .0001), sensory nerve conduction velocity (SMD = 1.69; 95% CI = [1.34, 2.05]; P < .0001), and electromyography amplitude (SMD = 2.67; 95% CI = [1.27, 4.06]; P = .0002), and significantly reduce of the visual analog scale scores (SMD = -3.85; 95% CI = [-7.55, -0.15]; P = .04) in the BHD group compared with the control group. In addition, there were no serious and permanent adverse effects in the 2 groups, the difference was not significant (odds ratio = 1.00; 95% CI = [0.40, 2.50]; P = 1.00). Current evidence suggests that BHD is an effective and safe treatment for PNI and could be treated as a complementary and alternative option with few side effects compared to a single treatment with neurotrophic drugs or electrical stimulation. However, considering the low methodological quality of the included studies, further rigorous studies are required.

Effectiveness and Safety of Duantengyimu-tang for Rheumatoid Arthritis: A Protocol for a Systematic Review and Meta-Analysis

Effectiveness and Safety of Duantengyimu-tang for Rheumatoid Arthritis: A Protocol for a Systematic Review and Meta-Analysis

Satisfaction and Perceived Effectiveness on Herbal Decoctions for Postpartum Care: a cross-sectional survey of mother's experience.

In East Asia, postpartum care has traditionally been considered important for maternal health; however, studies on this are still insufficient. Therefore, we examined the satisfaction and perceived effectiveness of herbal decoctions used in postpartum care in a city in the Republic of Korea (ROK). We analyzed anonymized secondary data obtained from a retrospective cross-sectional survey of women who had taken herbal decoctions provided by the support service for women giving birth in a local city in ROK. The questionnaire items consisted of basic information regarding childbirth, the need for the herbal decoction support service, satisfaction, and the effectiveness of the service received. A total of 68 women were included in the study, and those aged 30-39 accounted for 73.13%. Of the 68 women, 79.37% visited within 3 weeks of childbirth. Women's satisfaction regarding herbal decoction support for postpartum care was 76.47%, and most women (98.53%) responded that they needed it more than twice. More than 50% of women showed improvement in puerperal wind disorders, weight gain, and delayed eliminated lochia. A large proportion of women who took herbal decoctions reported satisfaction and perceived effectiveness when used to treat puerperal wind disorders. Nevertheless, future well-designed clinical studies are needed to provide information on whether herbal decoctions effectively prevent and treat puerperal wind disorders.

The Ameliorative Effect of Ashwagandha- Withania somnifera (L.) Dunal on park25 Induced Neurodegeneration in Drosophila melanogaster Parkinson’s Disease Model

Ashwagandha - Withania somnifera (L.) Dunal is a perennial shrub belonging to the family Solanaceae. Ashwagandha has been used for over 3000 years in traditional Indian Ayurveda for treatment of various neurological, and stress disorders. The root of Ashwagandha (ASH) is regarded as a tonic, aphrodisiac, narcotic, diuretic, anthelmintic, astringent, thermogenic and stimulant. Ashwagandha with other herbal decoctions was recognized to treat Kampavatha (Parkinson’s Disease) since 18th century. With this wide array of ethnopharmacological relevance, Ashwagandha has been recognized as one of the prominent complementary and alternative medicine to treat many neurodegenerative diseases like Alzheimer’s (AD) and Parkinson’s disease (PD). There is a prominent increase in the cases of AD and PD all over the world and it demands the requirement of complementary and alternative herbal remedies with no/minimal side effects. Many genetic factors are responsible for the onset and progression of PD. Loss-of-function mutations in the parkin gene are a major cause of early onset of autosomal recessive juvenile parkinsonism (AR-JP). Drosophila park25 loss of function mutants exhibit significantly increased number of mitochondria-endoplasmic reticulum contacts and a significantly decreased number of dopaminergic neurons in the adult brain which is the main cause of PD condition. Several studies have demonstrated the ability of Ashwagandha in imparting neuroprotection, improved locomotory ability, memory and learning abilities. The challenge lies in scrutinizing the mechanism and the pathways involved in the neuroprotective properties of this well-known herb. Here in our study, we test the possible neuroprotective effect of Ashwagandha on park25 mutants of Drosophila using lifespan analysis and climbing disability as a disease marker. Parkinson’s mimicking flies were administered with aqueous extraction of Ashwagandha-root mixed with the fly food and subjected to negative geotaxis assay. We observed that there is a prominent increase in the climbing ability in park25 treated flies compared to its age-matched untreated flies. This is the first report showing that, aqueous extraction of Ashwagandha-root extract was able to ameliorate the disease phenotype in the park25 Drosophila Parkinson’s disease model.

MALANAM VINIHANTI SANGAM- REVIEW ON BASTI KARMA

Basti Karma is one of the modalities among the five detoxifying procedures (Panchakarma/SamshodhanaChikitsa) advocated in Ayurveda as i.e., Vamana (Therapeutic Emesis), Virechana (Therapeutic Purgation), Basti (Medicated Enema), Nasya (Infiltration of drugs through nostrils) and Raktamokshana (Bloodletting by different methods). Basti Karma, the medicated oil or herbal decoction is administered through the anal route. In modern medicine, enemas are most commonly given to clean the lower Bowel as a last resort for constipation treatment when all other methods fail. But rather than this, Basti Karma Mentioned in Ayurvedic classics is having broader therapeutic action on almost all the tissues of the body and has Rejuvenative, curative, preventive, and health-promotive actions.

N6-methyladenosine profiling reveals that Xuefu Zhuyu decoction upregulates METTL14 and BDNF in a rat model of traumatic brain injury

Ethnopharmacological relevanceThe traditional Chinese herbal formula Xuefu Zhuyu decoction (XFZYD) is a classic formula in the category of invigorating blood circulation and resolving blood stasis. It has been proven to improve the neurological and ethological prognosis of traumatic brain injury. XFZYD promotes synaptic and axonal regeneration after traumatic brain injury, which is functionally modulated by the N6-methyladenosine (m6A) modification of RNA. However, the epigenetic effects of XFZYD on m6A modification remain unknown. Aim of the studyTo explore how XFZYD protects against traumatic brain injury induced by controlled cortical impact (CCI) injury by altering RNA m6A modification. Materials and methodsThe modified neurological severity scoring and Morris water maze were performed to evaluate the neuroprotective effects of XFZYD for 14 days and screen the dose. Then, dot blot, western blotting, and methylated RNA immunoprecipitation sequencing (MeRIP-Seq) were used to explore changes in RNA m6A modification in the perilesional cortex. The Metascape platform was used to analyze the Gene Ontology, Kyoto Encyclopedia of Genes and Genomes (KEGG), and Reactome pathway of the differential m6A-tagged genes. Furthermore, MeRIP-qPCR was conducted to quantify differences in the hub differential m6A modification gene brain-derived neurotrophic factor (Bdnf). ResultsXFZYD significantly ameliorated the neurological deficits, spatial learning, and memory impairments in rats post-CCI on day 14. XFZYD enhanced the m6A level, and the expression of METTL14 and YTHDC2 in the perilesional cortex of CCI rats. In all three groups, the 3'-untranslated regions and coding sequence were primarily enriched for m6A peaks. XFZYD reversed the increased proportion of 3'-untranslated regions, and the decreased proportion of coding sequence and 5'-untranslated regions post-CCI. Moreover, XFZYD markedly downregulated 41 elevated m6A-tagged transcripts and upregulated 119 decreased m6A-tagged transcripts following CCI. Gene ontology and KEGG pathway analysis revealed that XFZYD-regulated m6A-tagged transcripts were predominantly enriched in synapse assembly, synaptic plasticity, learning or memory, and MAPK signaling pathway. Then, the hub-regulated m6A-tagged gene BDNF was identified. Both the m6A methylation level and the protein level of BDNF were ascended by XFZYD treatment. ConclusionXFZYD improves neurological deficits, spatial learning and memory impairments in rats post-TBI probably through increasing the expression of METTL14 and BDNF in the cortex. Our study highlights a novel post-transcriptional regulation mechanism mediated by herbal medicine for traumatic brain injury treatment.

Study on the mechanism of Shuganzhi Tablet against nonalcoholic fatty liver disease and lipid regulation effects of its main substances in vitro

Ethnopharmacological relevanceShuganzhi Tablet (SGZT) originates from a famous traditional Chinese herbal formula Chaihu Decoction which can be applied to treat liver diseases, however, the pharmacodynamic mechanism of SGZT needs to be evaluated. Aim of this studyTo study the mechanism of SGZT in the treatment of non-alcoholic fatty liver disease (NAFLD), and screen out its effective ingredients. Materials and methodsIn this study, firstly, the main components of SGZT were analyzed qualitatively. And a rat model of NAFLD was established by feeding high-fat diet. Serum biochemical indexes and liver pathological analysis were used to evaluate the pharmacodynamic effect of SGZT in the treatment of NAFLD. In order to explore the pharmacodynamic mechanism, proteomics and metabolomics analysis were used. Western blotting was used to verify the expression of important differential proteins. And L02 cells were treated with free fatty acids (FFA) and the main substances of SGZT to establish the cell model of NAFLD in vitro and to reveal the pharmacodynamic substance of SGZT. ResultsTwelve components were detected in SGZT, and according to the results of serum biochemical indexes and liver pathological analysis, SGZT could effectively treat NAFLD. Combined with the results of bioinformatics analysis, we found that 133 differentially expressed proteins were reversed in liver samples of rats treated with SGZT. The important proteins in PPAR signaling pathway, steroid biosynthesis, cholesterol metabolism and fatty acid metabolism were mainly regulated to maintain cholesterol homeostasis and improve lipid metabolism. SGZT also affected various metabolites in rat liver, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and taurine. In addition, the main components contained in SGZT (hesperidin, polydatin, naringin, emodin, specnuezhenide, saikosaponin A) and a metabolite (resveratrol) could significantly reduce FFA-induced intracellular lipid accumulation. ConclusionSGZT effectively treated NAFLD, and PPAR-γ, Acsl4, Plin2 and Fads1 may be the main targets of SGZT. And Fads1-EPA/DHA-PPAR-γ may be the potential pharmacodynamic pathway. Cell experiments in vitro revealed that the main components of SGZT and their metabolites, such as hesperidin, polydatin, naringin, emodin, specnuezhenide, saikosaponin A and resveratrol may be the main components of its efficacy. Further research is needed to reveal and validate the pharmacodynamic mechanism.

The role of Chinese acupuncture plus herbal decoction for chemotherapy induced cognitive impairment in elderly cancer patients.

e24018 Background: Elderly cancer patients would suffer cognitive impairment due to chemotherapy, and a series of neurocognitive symptoms, known as "chemobrain". Chinese acupuncture plus herbal decoction is an emerging therapeutic option for chemotherapy-induced cognitive impairment in elderly cancer patients, despite limited supporting evidence. By evaluating this novel Chinese medicine mode in elderly cancer patients at our institution, we aimed to contribute to the existing knowledge in this area while establishing a basis for further research. Methods: We performed a retrospective review of all cases of “chemobrain” related elderly cancer patients treated with Chinese acupuncture plus herbal decoction between 2019 and 2022. We identified 168 elderly cancer patients with clinically confirmed chemobrain; 83 were treated with electroacupuncture (2 sessions per week over 8 weeks) plus herbal decoction(Chines herbal medicine); 85 received either conventional drug therapy, or palliative-intent therapy. The Montreal Cognitive Assessment(MoCA) served as the primary outcome. Digit span test was the secondary outcome for attentional function and working memory. The quality of life and multiple functional assessments were also evaluated. Results: Those with Chinese acupuncture plus herbal decoction had much better performance than the remainder(as control), reverse digit span test at Week2 and Week8, with medium effect size of 0.53 and 0.48, respectively, the difference in MoCA score and prevalence of chemobrain between cohorts was underpowered and not statistically significant. Higher baseline ECOG and comorbidity was noted in the latter cohort. Conclusions: These results suggest that Chinese electroacupuncture plus herbal decoction might have particular benefits in reducing chemotherapy-induced working memory impairment and could markedly reduce various side effects caused by cytotoxic chemotherapy drugs.

Prescription system to calculate precise doses of Chinese herbal medicine to avoid toxic effects

Background and objectivesTraditional Chinese Medicine (TCM) is a therapeutic system which has been practiced for thousands of years. Although for much of its history the decoction of medicinal herbs was the most common method of consuming the herbal treatments, TCM prescriptions are now primarily prepared using concentrated Chinese herbal extracts (CCHE) in powder or granular form. However, determining the precise dose of each single Chinese herbal constituent within a prescription creates a challenge in clinical practice due to the potential risk of toxicity. To alleviate this, we invented the Chinese Intelligence Prescription System (CIPS) to calculate the exact dose of each single herb within an individual prescription. MethodsIn this study, we applied CIPS in a real-world setting to analyze clinical prescriptions collected and prepared at the TCM Pharmacy of China Medical University Hospital (CMUH). ResultsOur investigation revealed that 3% of all prescriptions filled in a 1-month period contained inexact dosages, suggesting that more than 170,000 prescriptions filled in Taiwan in a given month may contain potentially toxic components. We further analyzed the data to determine the excess dosages and outline the possible associated side effects. ConclusionsIn conclusion, CIPS offers TCM practitioners the ability to prepare exact Chinese herbal medicine (CHM) prescriptions in order to avoid toxic effects, thereby ensuring patient safety.

Jie Geng Tang reverses cisplatin resistance through the Nrf2 pathway in lung cancer

Jie Geng Tang (JGT) is an ancient traditional Chinese herbal decoction that exhibits various pharmacological activities, however, is poorly understood in the sensitivity of lung cancer to chemotherapy. Here, we explored the effect of JGT on sensitizing cisplatin (DDP)-resistant A549 cells (A549/DDP). Cell viability was assessed using cell counting kit-8 assay. Flow cytometry was applied to detected cell apoptosis, mitochondrial membrane potential (MMP) and reactive oxygen species (ROS) levels. Western blotting and qRT-PCR were performed to determine protein and mRNA levels. The results demonstrated that DDP co-treatment with JGT significantly increased the cytotoxicity of A549/DDP cells and exhibited efficacy in suppressing the migration and proliferation. The rate of apoptosis was increased by co-treatment with DDP and JGT, along with a higher rate of Bax/Bcl-2, and increased loss of MMP. Furthermore, the combination promoted ROS accumulation and increased γ-H2AX levels. Moreover, Nrf2 levels were suppressed in a dose- and time-dependent manner, Nrf2 stability was reduced following treatment with JGT. Notably, the combination induced inhibition of the Nrf2/ARE pathway at the mRNA and protein levels. Collectively, these results indicate that co-treatment with JGT and DDP can be considered a combinational approach to treating DDP resistance.

Effectiveness of Traditional Chinese Medicine on coronavirus disease 2019 in 92 patients: a retrospective study.

To investigate the antipyretic effect of early treatment with Traditional Chinese Medicine (TCM) on coronavirus disease 2019 (COVID-19) patients. We retrospectively analyzed 369 patients from January 26th, 2020 to April 15th, 2020, who had been diagnosed with COVID-19. Among 92 eligible cases, 45 cases were identified as treatment group Ⅰ ( 45) and 47 cases were identified as treatment group Ⅱ. Patients in the treatment group Ⅰ were treated with TCM herbal decoction within 5 d after admission. Patients in the treatment group Ⅱ were treated with TCM herbal decoction after the 6th admission day. The onset time of antipyretic effect, the antipyretic time, the time of negative oropharyngeal swab nucleic acid conversion, and the changes of cell count in blood routine test were compared. The treatment group I showed shorter average antipyretic duration (4 7 d; <0.05), and shorter average time for polymerase chain reaction (PCR) nucleic acid test results to turn negative (7 11 d; <0.05) than the treatment group II. For patients ( 54) with body temperature>38 ℃, patients in the treatment group I had shorter median onset time of antipyretic effect than those in the treatment group II (3 4 d; <0.05). The absolute lymphocyte (LYMPH) count and absolute eosinophil (EOS) count on the 3rd day after admission and the neutrophil/lymphocyte ratio on the 6th day after admission of patients in the treatment group I were notably different from those in the treatment group II at the same time point (0.05). Based on Spearman's rank correlation analysis, the change of body temperature on the 3rd day after admission was positively correlated with the increase of EOS count and the increase of EOS count and LYMPH counts on the 6th day after admission (0.01). Early TCM intervention within 5 d after hospital admission shortened the onset time of antipyretic effect and fever duration of COVID-19 patients, reduced the time required for PCR test results to turn negative. Moreover, early TCM intervention also improved the results of inflammatory markers for COVID-19 patients. LYMPH and EOS counts can be used as indicators of TCM antipyretic effect.

Evaluation of the potential herb-drug interaction between Bojungikki-tang and PD-L1 immunotherapy in a syngeneic mouse model.

Atezolizumab (a PD-L1 inhibitor) has shown remarkable efficacy and tolerability in various cancer types. Despite its efficacy and safety, atezolizumab monotherapy has limitations, such as acquired resistance and adverse events. Bojungikki-tang (BJIKT) is an herbal decoction widely prescribed in Asian countries and used to treat cancer-related symptoms including fatigue, appetite loss, gastrointestinal disorders, and other side effects from cancer therapy. Due to its immunomodulatory effects, Bojungikki-tang has been investigated as a combined treatment with anticancer agents. We evaluated the potential drug-drug interaction (DDI) between Bojungikki-tang and the anti-PD-L1 antibody based on the Food and Drug Administration (FDA) guidelines. In the study, we conducted an in vivo drug-drug interaction study using a syngeneic mouse model of CMT-167 in C57BL/6. We then determined the antibody concentrations to evaluate the pharmacokinetic (PK) drug-drug interaction and measured variable biomarkers related to therapeutic efficacy and immune response. The pharmacodynamic (PD) drug-drug interaction study investigated changes in response between anti-PD-L1 antibody monotherapy and combination therapy. Using the pharmacokinetic and pharmacodynamic data, we conducted a statistical analysis to assess drug-drug interaction potential. In the presence of Bojungikki-tang, the pharmacokinetic characteristics of the anti-PD-L1 antibody were not changed. This study suggested that combination treatment with Bojungikki-tang and atezolizumab is a safe treatment option for non-small cell lung cancer. Clinical studies are warranted to confirm this finding.