Xiaochaihu decoction alleviates viral pneumonia by regulating macrophage polarization

Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral pneumonia model was established in mice using polyinosinic:polycytidylic acid,with mice being intragastrically administered different doses of XCHD.The benefits of XCHD therapy for mice with viral pneumonia were assessed by determining the weight ratio of lung tissue,wet-to-dry,overall protein concentrations,and total cell counts in bronchoalveolar lavage fluid,and hematoxylin and eosin staining of lung tissues.By determining the interleukin-1βlevels,interleukin-6,tumor necrosis factor-alpha,nitric oxide,interleukin-10,and interleukin-4,and the mRNA and protein expression of nitric oxide synthase 2,arginase-1,and macrophage mannose receptor 1 in bronchoalveolar lavage fluid,we assessed consequences of XCHD on macrophage polarization with mice suffering from viral pneumonia.Results:XCHD was found to significantly reduce lung tissue wet-to-dry and the total protein content and total number of cells of bronchoalveolar lavage fluid,while ameliorating pathological modifications to the lung tissues of rodents suffering from viral pneumonia,thereby indicating that this medicinal preparation has a healing impact on model mice with viral pneumonia.In addition,XCHD was found to reduce the magnitudes of interleukin-1β,interleukin-6,tumor necrosis factor-alpha,and nitric oxide and the mRNA and protein manifestation of nitric oxide synthase 2,and promote an increase in the levels of interleukin-10 and interleukin-4 and the mRNA and protein expression of arginase-1 and macrophage mannose receptor 1,thereby indicating that XCHD can favorably mediate polarization of macrophages in mice with viral pneumonia.Conclusion:XCHD has notable therapeutic effects on viral pneumonia in mice,the fundamental workings of action of which may be connected to regulation of macrophage polarization.

New treatment for gastroesophageal reflux disease:Traditional Chinese medicine Xiaochaihu decoction

Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.

Modified Xiaochaihu Decoction for gastroesophageal reflux disease:A randomized double-simulation controlled trial

BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.

Analysis of the effect of Bupleurum on fever in Xiaochaihu Decoction based on network pharmacology

Objective:To explore the mechanism of Bupleurum on fever by means of network pharmacology,and to provide ideas for further experimental study.Methods:The effective components and targets of Xiaochaihu Decoction and Bupleurum were extracted by searching TCM systematic pharmacology database(TCMSP),and got to the effective components and targets of Xiaochaihu Decoction.By searching GeneCards database,disGeNET database,OMIM database and symmap database to extract the disease target of fever.And the"protein interaction network"was constructed with the protein interaction relationship in HINT database as the background network,and the GO enrichment analysis and KEGG pathway enrichment analysis were carried out on the targets by using R software and DAVID database.Results:726 kinds of effective components of Xiaochaihu Decoction were obtained from TCMSP database,including 215 kinds of effective components of Bupleurum,677 targets of Xiaochaihu Decoction and 516 targets of Bupleurum.A total of 7305 fever-related genes were obtained from the disease database,and 400 key targets of Bupleurum for fever treatment were obtained by mapping drug targets and disease targets GAPDH,AKT1,INS,IL-6 and VEGFA,are the targets with high node connectivity in PPI network.The results of GO enrichment of key targets by R software are cofactor binding and coenzyme binding.KEGG enrichment pathway of key targets involves infection,cancer,immune system diseases and so on.Conclusion:This study preliminarily verified the effect and mechanism of Bupleurum on fever,and provided reference for further study.

Modified Xiaochaihu Decoction(加味小柴胡汤) Promotes Collagen Degradation and Inhibits Pancreatic Fibrosis in Chronic Pancreatitis Rats

Objective:To investigate the effect of Modified Xiaochaihu Decoction(MXD,加味小柴胡汤)on collagen degradation in rats with chronic pancreatitis(CP).Methods:Rats were injected dibutyltin dichloride(DBTC,7 mg/kg of body weight)into the right caudal vein to induce CP model.Thirty heallhy male Wistar rats were randomly divided into three groups by a random number table:the control,the model and the treatment groups.Rats of treatment group were administered MXD(10 g/kg of body weight)orally once daily starting from the day post-model establishment.Pancreatic tissues were harvested after 28-day feeding and fibrosis was evaluated by picro-sirius red staining.The contents of collagen typeⅠandⅢwere detected using enzymelinked immunosorbent assay(ELISA),the expression of matrix metalloproteinase 13(MMP13)and tissue inhibitor of metalloproteinase 1(TIMP1)was analyzed by Western blot and real-time polymerase chain reaction(PCR).Results:The fibrosis scoring of pancreatic tissues,the concentrations of collagen typeⅠandⅢ,the expression levels of MMP13 and TIMP1 proteins and mRNA in the model group were all increased compared with the control group(P<0.05).After treatment with MXD,the fibrosis scoring of pancreatic tissues,the concentrations of collagen typeⅠandⅢ,the expression levels of MMP13 proteins and m RNA in the teatment group were all decreased compared with the model group(P<0.05),but there were no significant differences in the expression levels of TIMP1 proteins and m RNA(P>0.05).Conclusion:MXD could promote collagen degradation and reverse pancreatic fibrosis in CP rats via a mechanism involve up-regulation of MMP13 expression.

Modified Xiaochaihu Decoction(小柴胡汤)Prevents the Progression of Chronic Pancreatitis in Rats Possibly by Inhibiting Transforming Growth Factor-β 1/Sma-and Mad-Related Proteins Signaling Pathway

Objective： To investigate the effect of modified Xiaochaihu Decoction （小柴胡汤, MXD） on transforming growth factor- [3 1/Sma- and Mad-related proteins （TGF- 13 1/Smads） signaling pathway in rats with chronic pancreatitis （CP） induced by dibutyltin dichloride. Methods： Thirty healthy male Wistar rats were randomly divided into the normal control group, CP group and CP＋MXD-treated group. CP was induced by injection of dibutyltin dichloride （DBTC, 7 mg/kg of body weight） into the right caudal vein, and the control rats were treated with vehicle. MXD was given daily by gavage at a dose of 10 g/kg of body weight, starting from the day after CP induction. After 28-day treatment, the n-benzoyl-tyrosyl para-aminobenzoic acid （NBT-PABA） test was carried out to evaluate exocrine pancreatic function. Then, rats were sacrificed, and pancreatic tissues were harvested for histological evaluation. In addition, the mRNA expression of TGF- β 1, TGF- β 1 type Ⅱ receptor （TGF β R 11 ）, Smad3 and Smad7 was determined in pancreatic tissues by using real-time polymerase chain reaction. Results： Treatment of CP with MXD improved the PABA recovery, decreased the histological lesion, and reduced the mRNA expression of TGF- β 1, TGF β R 11 and Smad3 （P〈0.05）. However, MXD had no effect on Smad7 mRNA level. Conclusions： MXD could protect the pancreas against chronic injury and improve pancreatic exocrine function in DBTC induced rat CP model. Its mechanism may involve inhibition of the TGF-β 1/Smads signaling pathway.

Adult-onset Still’s disease successfully treated with Chinese herbal medicine: A case report with 15-month follow-up

Adult-onset Still’s disease(AOSD) is a rare but clinically well-known, polygenic, and systemic autoinflammatory disease, which is characterized by spiking fever, evanescent skin rash, arthralgia, and sore throat.The application of non-steroidal anti-inflammatory drugs and glucocorticoids, which are first-line therapies of AOSD, is limited due to their side effects such as liver injury or disorder of blood glucose.Therefore, patients who suffer from systemic diseases in China prefer to seek help from Chinese herbal medicine(CHM), which is an important part of complementary and alternative medicine. In this case,we report a 28-year-old male badminton coach presenting with a 15-day history of fever and skin rash,accompanied by sore throat, fatigue, myalgia and chills. Additionally, hepatosplenomegaly, multiple lymphadenopathies, aminotransferase abnormality, and elevated inflammatory factor levels were observed during hospitalization. Infectious diseases, solid tumors, hematological diseases, and common autoimmune diseases were excluded. Not benefitting from antibiotic therapy, the patient was finally diagnosed with AOSD, after a careful examination, then showed rapid remission after a six-week treatment with CHM granules based on Xiaochaihu Decoction and Yinqiao Powder. After stopping the treatment, there was no relapse within a 15-month follow-up period. To the best of our knowledge, this is the first well-documented case of this successful treatment. The present case report suggests that CHM is a reliable choice for complementary and alternative therapy for AOSD, but confirming the utility of CHM for AOSD requires further support from prospective studies.