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Objective Diterpene ginkgolides meglumine injection (DGMI) is widely used in patients with stroke, but its efficacy and safety are not consistent.We performed a Meta-analysis to comprehensively evaluate the efficacy and safety of DG-MI in acute ischemic stroke and recovered stroke.Methods The wanfang, VIP, CNKI and PubMed were searched, the randomized controlled trials (RCTs) were enrolled.Data collection and quality evaluation of the included RCTs were performed according to Cochrane systematic evaluation method.Meta-analysis was performed by using Stata software.Results 9RCTs involving 1 129subjects were included with 706subjects in DGMI treatment group and 423subjects in control group. (1) For acute ischemic stroke, DGMI group had superior effective rate compared to conventional therapy group (RR=1.19, 95％CI:1.09, 1.31, P＜0.000 1), improvement of neurologic impairments (SMD=3.23, 95％CI:2.87, 3.60, P＜0.000 1) and improvement of living quality (SMD=3.23, 95％CI:2.87, 3.60, P＜0.000 1). (2) For recovered stroke, DGMI group had better effective rate than Shuxuening injection group (RR=1.17, 95％CI:1.05, 1.30, P＜0.05) and improvement of neurologic impairments (SMD=-0.69, 95％CI:-0.88, -0.49, P＜0.000 1).There was no significant difference in adverse events between DGMI and control groups (P＞0.05).Conclusion DGMI had superior efficacy over control group for both acute ischemic stroke and recovered stroke.There was no significant difference in adverse events between these two groups.However, we still need better quality RCTs to confirm these results.
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Objective To study the effects of diterpene ginkgolides meglumine injection ( DGMI) on memory impairment, activation of microglia and astrocytes and inflammatory cytokines in aged mice. Methods Twenty aged mice (22 months old) were randomly divided into two groups:aged mouse group(n=10) and DGMI group(n=10). Another 10 mice (2 months old) were selected as young mouse control group. The mice in DGMI group were received 5 mg/kg DGMI per day by tail vain injection for 4 weeks. The mice in the other two groups were received the same amount normal saline for 4 weeks. The Morris water maze was used to evaluate the function of spacial learning and memory after administration of drugs. The ex-pression of CD11b,GFAP,IL-1β,IL-6,TNF-α and NFκB in mice brain hippocampus were detected by West-ern blot. Results (1) The escape latency time of aged mouse group was significantly longer than that of young mouse control group from the 2nd day to the 7th day(P<0. 01). The times of platform crossing,time and distance in target quadrant of aged mouse group were significantly shorter than those of young mouse group (all P<0. 01). Compared with aged mouse group,DGMI significantly reduced the escape latency time of DGMI group (P<0. 01). DGMI increased the times of platform crossing,time and distance in target quad-rant of aged mouse group (P<0. 01). (2) The expressions of CD11b,GFAP in young mouse control group, aged mouse group and DGMI group were as follows respectively:CD11b:(1. 036±0. 023),(1. 757±0. 046), (1. 214±0. 024);GFAP:(1. 022±0. 071),(1. 344±0. 021),(1. 086±0. 073). DGMI reduced the expres-sion of CD11b and GFAP in hippocampus compared with aged mouse group ( t=5. 556,P<0. 01;t=5. 484, P<0. 01). (3) The expressions of IL-1β,IL-6,TNF-α and NFκB in young mouse control group,aged mouse group and DGMI group were as follows respectively:IL-1β:( 1. 003 ± 0. 057),( 2. 062± 0. 105),( 1. 182± 0. 084);IL-6:(1. 018±0. 024),(1. 583± 0. 052),( 1. 152± 0. 031); TNF-α:( 1. 021± 0. 054),(1. 449± 0. 053),(1. 211±0. 036);p-NFκB:(1. 052±0. 034),(1. 782± 0. 113),( 1. 158± 0. 066). DGMI reduced the expression of p-NFκB(t=6. 547,P<0. 01) and pro-inflammatory cytokines including IL-1β(t=8. 513,P<0. 01),IL-6(t=3. 421,P<0. 01) and TNF-α( t=5. 562,P<0. 01) in hippocampus compared with aged mouse group. Conclusion DGMI can improve the ability of learning and memory in aged mice. The mecha-nism may be related with inhibiting activity of microgliosis,astrocytosis,NFκB and neuroinflammaton.
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OBJECTIVE To investigate the protective effects and mechanism of diterpene ginkgolides meglumine injection (DGMI) against oxidative stress induced by oxygen-glucose deprivation (OGD) in SH-SY5Y cells. METHODS SH-SY5Y cells were divided into five groups: normal control, model control (OGD group) and drug(25 mg · L- 1) administration groups including DGMI group, extract of ginkgo biloba leaves injection group (EGBLI) and lactones ginkgo biloba injection group (LGBI). The cells suffered from oxygen-glucose deprivation (OGD) for 4 h, followed by reoxygenation with drugs for 6 h. Then, cell viabilities were detect using CCK-8 assays, reactive oxygen species (ROS) levels using fluorescence probe DCFH-DA and superoxide dismutase (SOD) activities using WST-1 test. Western blotting was used to detected protein levels of hemeoxygenase-1(HO-1), NAD(P)H, quinone oxidore?ductase l (Nqo1), protein kinase B (Akt), phosphorylated Akt (p-Akt), nuclear factor-E2-related factor2 (Nrf2) and phosphorylated Nrf2 (p-Nrf2). The cells were induced by OGD for 4 h, followed by reoxygen?ation and DGMI for 1 h, combined with different concentrations of PI3K inhibitor (LY294002) (at the final concentration of 12.5, 25 and 50 μmol · L-1) before the protein levels of AKT, p-AKT, Nrf2 and p-Nrf2 were detected by Western blotting. RESULTS SH-SY5Y cells induced by OGD for 4 h resulted in an increase in ROS(P<0.01), but a decrease in cell viabilities(P<0.01), SOD activities(P<0.01), and antioxidant protein levels ( Akt, p-Akt, Nrf2, p-Nrf2, HO-1 and Nqo1) (P<0.01). Compared with OGD group, treatment with reoxygenation and drugs (DGMI,EGBLI and LGBI respectively) for 6 h resulted in a decrease in ROS (P<0.01), but an increase in cell viabilities, SOD activities and antioxidant protein levels of p-Nrf2, HO-1, Nqo1 and p-Akt(P<0.05,P<0.01). DGMI group showed the best efficiently. Moreover, after OGD for 4 h, compared with DGMI group, combining reoxygenation and DGMI with LY294002 for 1 h resulted in a concentration-dependent inhibition of the protein levels of p-AKT and p-Nrf2(P<0.01). CONCLUSION DGMI 25 mg · L-1 can inhibit oxidative stress in SH-SY5Y cells induced by OGD by increasing the activity and expression of Nrf2 through PI3K/Akt pathway, which may be one of the mechanisms by which DGMI protects neurons from stroke.
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Objective To investigate the protective effect and therapeutic window of DGMI on ischemic stroke in rats,and to explore the related mechanism.Method The rats were subjected to middle cerebral artery occlusion (MCAO) for 90 min followed by 72 h of reperfusion.DGMI (i.p.,1.25,2.5,5.0,and 10.0 mg/kg,Bid) was administered at 1 h after the onset of ischemia.Neurological score was evaluated after 24 and 72 h of reperfusion rcspectively.In fact volume,cerebral water content,oxidative stress markers,and IL-1β were evaluated after 72 h of reperfusion.The rats were treated with DGMI 5.0 mg/kg 0.5 h before reperfusion or 1 h,2 h,3 h,and 6 h after reperfusion to determined therapeutic window.Result Treatment with DGMI (2.5,5.0 mg/kg) significantly ameliorated neurological deficit,infarct volume and cerebral water content after cerebral ischemia reperfusion.DGMI also reduced the content of malonaldehyde (MDA),IL-1β,down-regulated the activities of creatine kinase (CK),lacticdehydrogenase (LDH),and up-regulated the activities of superoxide dISmutase (SOD).Treatment with DGMI 5.0 mg/kg exhibited protective effects when administered at all time points except for 6 h after reperfusion.Conclusion DGMI plays a certain protective role in ischemic stroke of rats,and the effect may be related to the improvement on the antioxidant capacity of brain tissue and the inhibition of overproduction of inflammatory cytokine.Moreover,the therapeutic window of DGMI isless than 6 h after reperfusion.
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This paper was aimed to study the human plasma protein binding rate of diterpene ginkgolides meglumine injection.The equilibrium dialysis was used to determine the human plasma protein binding rate of ginkgolide A (GA),ginkgolide B (GB) and ginkgolide K (GK) in diterpene ginkgolides meglumine injection.The LC-MS/MS method was used for the content determination of ginkgolides.And then,the plasma protein binding rate was calculated.The results showed that there was no interference from other ingredients for the determination of ginkgolides.The calibration curve of the analytes was in good linearity in certain range of contents.The precision and stability of the analytes met the methodology requirements.After 8 h incubation,the human plasma protein binding rate of GA,GB and GK achieved balance.The human plasma protein binding rate of GA (0.34,1.70 and 8.51μg·mL-1) was 84.03%-88.11%; the human plasma protein binding rate of GB (0.62,3.09 and 15.5μg·mL-1) was 41.21%-53.56%; the human plasma protein binding rate of GK (0.04,0.20 and 1.01μg·mL-1) was 45.24%-59.59%.It was concluded that the method was simple,rapid and sensitive,which met the analysis requirement for biological samples.GA had a high plasma protein binding rate; GB and GK had medium plasma protein binding rate.
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@#To investigate the anti-apoptotic effect of diterpene ginkgolides meglumine injection(DGMI)on SH-SY5Y cells induced by oxygen-glucose deprivation/reoxygenation(OGD/R), and to explore its mechanisms. After 4 h of OGD, the SH-SY5Y cells were treated with 25 mg/L DGMI for 1 h. The release of lactic dehydrogenase(LDH)was measured by cytotoxicity detection kitplus. Cell apoptosis was detected by caspase-3/7 assays. Cell death was detected by ELISA. The concentration of ［Ca2+］i in cytoplasm was measured by Fluo-3 AM and the levels of calpain and cleaved capaease-12 were evaluated by western blot. As we expected, DGMI significantly decreased the release of LDH, the concentration of ［Ca2+］i, the protein levels of calpain and cleaved caspase-12. Furthermore, DGMI injection also attenuated the activities of caspase-3/7 and the contents of cytoplasmic histone-associated- DNA-fragments. These data demonstrated that the DGMI injection showed good anti-apoptotic effect in SH-SY5Y cells induced by OGD/R. The mechanisms may be associated with the inhibition of Ca2+/calpain/caspase-12/caspase-3 signaling pathway.
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Objective: To evaluate the efficacy and safety of Diterpene Ginkgolides Meglumine Injection (DGMI) in the treatment of recovered stroke with syndrome of stagnant phlegm blocking collaterals, especially the clinical efficacy in improving the function of language and movements. Methods: The clinical trial was carried out by the methods of stratification and r andomization (416 cases of patients with atherosclerotic thrombotic cerebral infarction (ATCI) were r andomly divided into experimental and control groups by the ratio of 3:1), blindness, and positive parallel control of Shuxuening Injection (SI), and multi-center clinical study. DGMI (25 mg, 5 mL/amp) or SI (5 mL/amp) was diluted into 250 mL physiological saline, iv drip, once daily for 14 d. The dropping speed must be controlled as 10-15 drops/min for the first infusion. Results: There was statistical difference (P=0.000 1) for the variations of inducing rate of the defect extent of nervous functions before and after the treatment in the experimental and control groups. The experimental group was superior to the control group. There was no statistical difference for the variation of scales of the patient living ability in the two groups (P>0.05). For the comprehensive efficacy of cerebral infarction, the total effective rates were 85.39% and 73.27% in the experimental and control groups, respectively, with statistical difference (P=0.0001). For the efficacy of syndrome of traditional Chinese medicine (TCM), the total effective rates were 62.99% and 40.59% in the experimental and control groups, respectively, with the statistical difference (P=0.0001). For the single indicator of nervous functions, such as arm movements, h and movements, extremity movements, walking, as well as the syndromes of TCM, such as upper limb disable, lower limb disable, deviated tongue, aphasia, abate or deficiency of feeling, dizziness, more and turbid phlegm, abnormal tongue and pulse manifestation, the experimental group was superior to the control group with statistified difference. Conclusion: It is safe and effective for DGMI in the treatment of the syndrome of stagnant phlegm blocking collaterals in convalescence of ATCI. Meanwhile, it is also manifested that DGMI has the certain superiorities in the fields, such as improving the total score of nervous function deficiency for the patients with stroke, the nervous function, the total score of TCM syndromes, including upper limb disable, deviated tongue, dizziness, more and turbid phlegm, white coat of tongue, abnormal pulse, etc.