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ObjectiveTo decipher the mechanism of Danshenyin in regulating platelet activation in the rat model of hyperlipidemia by means of proteomics and molecular biology. MethodWistar rats were randomized into blank, model, and Danshenyin groups (n=10) according to the blood lipid level. The rats in the blank group were fed with a basic diet, and those in the model and Danshenyin groups with a high-fat diet. All the rats had free access to water and food. The treatment began at the 9th week. The rats in the Danshenyin group were administrated with Danshenyin by gavage at a crude drug dose of 3.6 g·kg-1. The rats in the model and blank groups were administrated with an equal volume of normal saline according to body weight. At the 12th week, the tissue samples were collected for the measurement of related indicators, and the blood lipid level was measured by an automatic biochemical analyzer. The whole blood viscosity and plasma viscosity were measured by an automatic hemorheometer. The platelet proteome was determined by liquid chromatography-mass spectrometry. Western blotting was employed to determine the protein levels of platelet membrane glycoprotein 4 (CD36), focal adhesion kinase (FAK), phosphatidylinositol 4-phosphate 5-kinase (PIP5K), phosphorylated phosphatidylinositol 3-kinase (p-PI3K), protein kinase B (Akt), and phosphorylated protein kinase B (p-Akt). ResultCompared with the model group, Danshenyin lowered the levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) in the plasma (P<0.05), elevated the level of high-density lipoprotein cholesterol (HDL-C) (P<0.05), and reduced the platelet aggregation rate (P<0.05). Compared with the blank group, the modeling up-regulated the expression of 44 proteins and down-regulated the expression of 12 proteins. Compared with the model group, Danshenyin up-regulated the expression of 21 proteins and down-regulated the expression of 22 proteins. Compared with the blank group, Danshenyin up-regulated the expression of 31 proteins and down-regulated the expression of 49 proteins. The gene ontology (GO) functional enrichment showed that the differentially expressed proteins were mainly involved in cholesterol transport and efflux, production of cytokines, dyslipidemia, and platelet activation. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment showed that the differentially expressed proteins were mainly involved in ECM-receptor interaction, peroxisome proliferators-activated receptors (PPAR), focal adhesion, and PI3K/Akt signaling pathways. Danshenyin can significantly down-regulate the expression of CD36, FAK, PIP5K, PI3K, p-Akt (Ser473), and p-Akt1/2/3 (Thr308). ConclusionDanshenyin can restore the blood lipid level of hyperlipidemia rats and inhibit the platelet activation caused by abnormal lipid levels by down-regulating the CD36/PI3K/Akt signal cascade.
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Network Meta-analysis was employed to compare the efficacy of Chinese medicine injections for activating blood and resolving stasis combined with conventional western medicine in the treatment of acute ischemic stroke and the effects on platelet aggregation rate, fibrinogen(FIB), and hypersensitive C-reactive protein(hs-CRP), with a view to providing evidence-based medicine reference for clinical medication. CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, and EMbase were searched for randomized controlled trial(RCT) on the treatment of acute ischemic stroke with Salvia Miltiorrhiza Ligustrazine Injection, Danhong Injection, Shuxuetong Injection, Xueshuantong Injection, Shuxuening Injection, Safflower Yellow Pigment Injection, and Ginkgo Diterpene Lactone Meglumine Injection combined with conventional western medicine. The retrieval time was from database inception to March 18, 2023. The articles were extracted by two researchers and their quality was evaluated. R 4.2.2 was used for network Meta-analysis. A total of 87 RCTs involving 8 580 patients were included. Network Meta-analysis showed that, in terms of reducing National Institutes of Health stroke scale(NIHSS) scores, the surface under the cumulative ranking curve(SUCRA) showed the order of Xueshuantong Injection + conventional western medicine(88.7%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(73.7%) > Shuxuetong Injection + conventional western medicine(69.7%) > Shuxuening Injection + conventional western medicine(51.8%) > Danhong Injection + conventional western medicine(43.7%) > Safflower Yellow Pigment Injection + conventional western medicine(36.8%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(35.3%) > conventional western medicine(1.7%). In terms of improving clinical total effective rate, SUCRA showed the order of Danhong Injection + conventional western medicine(63.0%) > Shuxuening Injection + conventional western medicine(59.0%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(58.9%) > Safflower Yellow Pigment Injection + conventional western medicine(57.1%) > Xueshuantong Injection + conventional western medicine(56.8%) > Shuxuetong Injection + conventional western medicine(54.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(50.5%) > conventional western medicine(0.03%). In terms of improving Barthel index, SUCRA showed the order of Danhong Injection + conventional western medicine(84.7%) > Shuxuetong Injection + conventional western medicine(72.4%) > Safflower Yellow Pigment Injection + conventional western medicine(61.6%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(44.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(43.2%) > Shuxuening Injection + conventional western medicine(42.2%) > conventional western medicine(1.4%). In terms of reducing platelet aggregation rate, SUCRA showed the order of Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(82.4%) > Shuxuetong Injection + conventional western medicine(81.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(40.7%) > Danhong Injection + conventional western medicine(37.3%) > conventional western medicine(8.0%). In terms of reducing FIB, SUCRA showed the order of Danhong Injection + conventional western medicine(81.0%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(71.9%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(70.0%) > Shuxuetong Injection + conventional western medicine(46.7%) > Xueshuantong Injection + conventional western medicine(22.6%) > conventional western medicine(8.7%). In terms of reducing hs-CRP, SUCRA showed the order of Shuxuening Injection + conventional western medicine(89.9%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(78.8%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(52.4%) > Danhong Injection + conventional western medicine(47.6%) > Xueshuantong Injection + conventional western medicine(43.5%) > Shuxuetong Injection + conventional Western medicine(35.6%) > conventional western medicine(2.3%). The results indicated that Xueshuantong Injection + conventional western medicine, Danhong Injection + conventional western medicine, and Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine ranked the top three. Xueshuantong Injection + conventional western medicine had the best effect on reducing NIHSS scores. Danhong Injection + conventional western medicine showed the best performance of improving clinical total effective rate, improving Barthel index, and reducing FIB in the blood. Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine had the best effect on reducing platelet aggregation rate in the blood. Shuxuening Injection + conventional western medicine had the best effect on reducing hs-CRP. However, more high-quality RCTs are needed for verification in the future to provide more reliable evidence-based medical reference.
Subject(s)
Humans , Medicine, Chinese Traditional , Ischemic Stroke/drug therapy , Network Meta-Analysis , C-Reactive Protein , Drugs, Chinese Herbal/therapeutic use , Adjuvants, Pharmaceutic , Diterpenes , Lactones , MeglumineABSTRACT
Derived from Curcuma plants, Curcumae Longae Rhizoma, Curcumae Rhizoma, Wenyujin Rhizoma Concisum, and Curcumae Radix are common blood-activating and stasis-resolving medicinals in clinical practice, which are mainly used to treat amenorrhea, dysmenorrhea, chest impediment and heart pain, and rheumatic arthralgia caused by blood stasis block. According to modern research, the typical components in medicinals derived from Curcuma plants, like curcumin, demethoxycurcumin, bisdemethoxycurcumin, curdione, germacrone, curcumol, and β-elemene, have the activities of hemorheology improvement, anti-platelet aggregation, anti-thrombosis, anti-inflammation, anti-tumor, and anti-fibrosis, thereby activating blood and resolving stasis. However, due to the difference in origin, medicinal part, processing, and other aspects, the efficacy and clinical application are different. The efficacy-related substances behind the difference have not yet been systematically studied. Thus, focusing on the efficacy-related substances, this study reviewed the background, efficacy and clinical application, efficacy-related substances, and "prediction-identification-verification" research method of blood-activating and stasis-resolving medicinals derived from Curcuma plants, which is expected to lay a theoretical basis for the future research on the "similarities and differences" of such medicinals based on integrated evidence chain and to guide the scientific and rational application of them in clinical practice.
Subject(s)
Curcuma , Curcumin , Drugs, Chinese Herbal , Plant Roots , Platelet Aggregation , RhizomeABSTRACT
The traditional Chinese medicine(TCM) syndrome of blood stasis refers to blood stagnation in meridians and viscera, with the main symptoms of pain, mass, bleeding, purple tongue, and unsmooth pulse. Cardiovascular and cerebrovascular diseases are among the major chronic diseases seriously harming the health of the Chinese. Among the coronary heart disease and stroke patients, most demonstrate the blood stasis syndrome. Platelet is considered to be one of the necessary factors in thrombosis, which closely relates to the TCM syndrome of blood stasis and the occurrence of cardiovascular and cerebrovascular diseases. The clinical and laboratory research on platelet activation and aggregation has been paid more and more attention. Its purpose is to treat and prevent blood stasis syndrome. In this study, the authors analyzed the research on the dysfunctions of platelets in blood stasis syndrome, biological basis of TCM blood stasis syndrome, and the effect of blood-activating stasis-resolving prescriptions on platelets, aiming at providing a reference for exploring the mechanism of platelet intervention in the treatment of TCM blood stasis syndrome and the pathways and targets of Chinese medicine in the prevention and treatment of the syndrome.
Subject(s)
Humans , Blood Platelets , Coronary Disease , Medicine, Chinese Traditional , Platelet Activation , SyndromeABSTRACT
Objective To study the analgesic, activating blood and resolving stasis effect of Ento-II plastic. Methods Hot plate procedure and torsion body method were used as analgesic experimental model to observe the analgesic effect of Ento-II plastic. The acute blood stasis rats experimental model was established through rat subcutaneous injection of high-dose adrenaline hydrochloride and soaked in ice water. Then, the blood stasis focal cerebral ischemia-reperfusion models were established by suture method on the rats. The hemorrheologic indicators were determined. Results Compared with control group, Ento-II plastic could significantly prolong pain thresholds in mice at 30, 60, and 90 min after final administration (P < 0.01). Ento-II plastics 20, 10, and 5 mg/kg dose groups could reduce aceticacid-induced mice writhing times and prolong the incubation period (P < 0.01). The experimental result of rats blood stasis focal cerebral ischemia-reperfusion at 24 h after reperfusion showed that Ento-II plastics 6.67, 3.33, and 1.67 mg/kg dose groups could obviously reduce the neurological function score and whole blood viscosity (P < 0.01). 3.33 mg/kg dose group could significantly reduce plasma viscosity, erythrocyte aggregation index, and casson viscosity (P < 0.05). The effect were similar to that of ligustrazine. 6.67 and 3.33 mg/kg dose groups could significantly reduce casson viscosity (P < 0.01). Conclusion Ento-II plastic has obvious analgesic effect and activating blood and resolving stasis effect.
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Objective To observe the effects of four kinds of extracts of Crataegi Folium on hemorheology, erythrocytes, platelets, coagulation time, and other indicators of 27 indicators in blood stasis rats from the aspects of whole and local double aspects by using the combination method of principal component and one-way ANOVA, and analysis of indicators contained in the information, in order to provide new analytical ideas for the mechanism of Crataegi Folium extract on activating blood and resolving stasis. Methods Forty-eight wistar rats were randomly divided into blank group, model group, and drug group. Blood stasis model was prepared by using adrenaline in ice water bath. Both blank group and model group were given normal saline, and drug group was given hawthorn leaves extract aqueous solution. Blood samples were collected and 27 indicators such as hemorheology, erythrocyte, platelet, and prothrombin time were selected. The principal component analysis (PCA) was used to decompose all the index data by dimensionless treatment and dimensionality reduction, and then the principal components were generated. The new variables (ie, principal component scores) were subsequently analyzed by one-way ANOVA. The results combined with the contribution rate of principal components and the correlation coefficient of each index was analyzed. Finally, the index groups and individual indexes in each group were analyzed synthetically, and the regularity conclusions were drawn. Results Eight principal components were extracted by principal component analysis, and the contribution rate was 77.992%. The results of theprincipal component analysis combined with the ANOVA showed that nine main components in the first principal component could replace the original 27 indicators to reflect the effect of Crataegi Folium extract on blood circulation and blood stasis, namely FIB, total number of red blood cells, total platelet count platelet volume, platelet count, blood viscosity at low shear rate, blood viscosity at middle shear rate, blood viscosity at high shear rate, and plasma viscosity. The results showed that the effects of the four extracts of Crataegi Folium on the index components were different. Conclusion The effect of activating blood and resolving stasis is mainly by reducing blood viscosity and plasma viscosity, promoting hemoglobin degradation and increasing the number of platelets, shortening the blood clotting and so on to achieve.
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Spinal cord injury is a common clinical disease .Cell apoptosis is one of important pathogeneses for spinal cord in-jury, and apoptotic gene plays a very important role in apoptosis on spinal cord injury .Chinese medicine for blood-activating and stasis-dissolving has a good therapeutic effect for spinal cord injury by reducing inflammation , inhibiting apoptosis and improving microcircu-lation.In this paper, we review the research of chinese medicine for activating blood and resolving stasis during the regulation of apoto -sis gene in spinal cord injury based on related documents in the recent five years .