Is adjunctive treatment with medication of liver-soothing-oriented method beneficial for depression after cerebrovascular accident?: A PRISMA-compliant meta-analysis.

BACKGROUND: Adjunctive treatment with medication of liver-soothing-oriented method (MLSM) is one of the most commonly used approaches for subjects with depression after cerebrovascular accident (DCVA) in China. The purpose of this meta-analysis was to evaluate the outcome of MLSM treatment in subjects with DCVA using relevant published literature. METHODS: The PubMed, Cochrane Library, Embase, Chinese databases of China National Knowledge Infrastructure, WanFang, Sinomed, and VIP were used to collect all publications until March 2016. Randomized controlled trials comparing treatments with and without MLSM for subjects with DCVA were included. The quality of each publication was assessed based on the recent Handbook (5.1 version) for Cochrane Reviewers. Cochrane Collaboration's software RevMan 5.3 software was applied for data analysis. RESULTS: Thirty studies, including 2599 cases, were identified and collected. Adjunctive treatment with MLSM noticeably enhanced total effective rates (odds ratio 3.76; 95% confidence interval [CI] 2.92-4.85, I = 0%, P = 0.96) in comparison to non-MLSM conventional pharmacotherapy. Compared to non-MLSM treatment, the changes of Hamilton Depression Scale in adjunctive treatment with MLSM, respectively, decreased and showed beneficial effects after 3 weeks (weighted mean difference [WMD] -4.83; 95% CI -6.82 to -2.83; I = 86%, P < 0.001), 4 weeks (WMD -4.20; 95% CI -5.06 to -3.33; I = 78%, P < 0.001), 6 weeks (WMD -3.36; 95% CI -4.05 to -2.68; I = 54%, P = 0.02), 8 weeks (WMD -4.83; 95% CI -5.62 to -4.04; I = 73%, P < 0.001), and 12 weeks (WMD -2.88; 95% CI -4.09 to -1.67; I = 58%, P = 0.09). As for changes in inflammatory cytokine levels, adjunctive treatment with MLSM was associated with a significant decrease in tumor necrosis factor-α, IL-6, and interleukin-1ß levels in comparison to non-MLSM treatment. Moreover, there were positive effects on score changes for National Institute of Health Stroke Scale, activities of daily living, Hamilton Anxiety Scale, Modified Edinburgh Scandinavian Stroke Scale, and Self-Rating Anxiety Scale. No serious adverse events were reported. CONCLUSION: MLSM appears to improve symptoms of depressive disorders, enhance immediate responses, and the quality of life in subjects with DCVA. The positive action of MLSM might be potentially connected with its immunoregulating effects. More prospective trials with strict design and larger sample sizes are warranted to clarify its effectiveness and safety.

Generation and analysis of the Rett syndrome-associated MeCP2- null rat model.

MeCP2 mutations are associated with the Rett syndrome (RTT). Currently, there is an urgent need for new animal models for RTT as the existing MeCP2 knockout mouse models fail to fully mimic the pathogenesis and symptoms of RTT patients. In order to investigate the role of MeCP2 in brain development and RTT pathogenesis, we aimed to set up the MeCP2-null rat model using the CRISPR/Cas9 technology. Firstly we constructed the MeCP2 targeting vector and then microinjected Cas9 mRNA and sgRNA mixtures into fertilized ova of SD rats. The sgRNA was designed to target the exon 2 of MeCP2. Next, knockout rats were confirmed using DNA sequencing and Western blotting. Lastly, phenotypes including growth and behaviors of MeCP2 knockout rats were analyzed. The results indicated that the MeCP2 knockout rats showed body weight loss, anxiety tendency and cognitive deficits. The MeCP2-null rat model established in this study recapitulates the major symptoms of RTT patients and provides an alternative tool for future studies of MeCP2 functions.

Antidepressant-like effects and cognitive enhancement of the total phenols extract of Hemerocallis citrina Baroni in chronic unpredictable mild stress rats and its related mechanism.

ETHNOPHARMACOLOGICAL RELEVANCE: Depression induce distressed emotional state and cognitive deficits simultaneously, which both should be improved in the treatment. Hemerocallis citrina Baroni (HC) is a traditional herbal medicine in Eastern-Asia areas and the total phenols extract of HC (HCPE) contains the main active ingredients. It has been reported that HC has the emotional improvement effect. But the cognitive effect of HC was seldom researched. AIM OF THE STUDY: We designed to evaluate the antidepressant and cognitive improvement effect of HCPE using a chronic unpredictable mild stress (CUMS) model, and the potential mechanisms were explored by investigating the corticosterone (CORT), monoamine neurotansmitters, brain-derived neurotropic factor (BDNF) and oxidative stress. MATERIALS AND METHODS: The depression rats were induced by CUMS procedures and treated with HCPE (10, 20, 40mg/kg/day, by gastric gavage). The antidepressant effect was evaluated by sucrose preference test, open field test and body weight, while the cognitive improvement was investigated using morris water maze test. Besides, the levels of monoamine neurotransmitters in the hippocampus and frontal cortex were measured by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The serum CORT and BDNF in hippocampus were test using enzyme-linked immunosorbent assay (ELISA) kits. The oxidative stress indicators in frontal cortex were also analyzed. RESULTS: HCPE (40mg/kg) improved the emotion and cognition related behaviors in depression effectively. Moreover, HCPE increased the neurotransmitters concentration (5-HT, DA and NE) in the hippocampus and frontal cortex compared with CUMS rats. Meanwhile, the CUMS induced changes of serum corticosterone level and the hippocampus BDNF level were reversed. Besides, HCPE reduced malondialdehyde (MDA) in the frontal cortex of model rats. CONCLUSION: It suggested that HCPE could improve the depression-like emotional status and associated cognitive deficits in CUMS rats, which might be mediated by regulation of neurotransmitters and BDNF levels in brain, alleviation of corticosterone level as well as the alleviation of oxidative stress.

Cognitive-enhancing effects of hydrolysate of polygalasaponin in SAMP8 mice.

OBJECTIVES: The aim of the study is to evaluate the cognitive-enhancing effects of hydrolysate of polygalasaponin (HPS) on senescence accelerate mouse P8 (SAMP8) mice, an effective Alzheimer's disease (AD) model, and to research the relevant mechanisms. METHODS: The cognitive-enhancing effects of HPS on SAMP8 mice were assessed using Morris water maze (MWM) and step-through passive avoidance tests. Then N-methyl-D-aspartate (NMDA) receptor subunit expression for both the cortex and hippocampus of mice was observed using Western blotting. RESULTS: HPS (25 and 50 mg/kg) improved the escape rate and decreased the escape latency and time spent in the target quadrant for the SAMP8 mice in the MWM after oral administration of HPS for 10 d. Moreover, it decreased error times in the passive avoidance tests. Western blotting showed that HPS was able to reverse the levels of NMDAR1 and NMDAR2B expression in the cortex or hippocampus of model mice. CONCLUSIONS: The present study suggested that HPS can improve cognitive deficits in SAMP8 mice, and this mechanism might be associated with NMDA receptor (NMDAR)-related pathways.

Modified Si-Miao-San () regulates adipokine expression and ameliorates insulin resistance by targeting IKKß/Insulin receptor substrate-1 in mice.

OBJECTIVE: To evaluate modified Si-Miao-San (mSMS, ) regulation of insulin sensitivity and explore the molecular mechanism by which mSMS inhibits inflammation and improves insulin action in mice. METHODS: Insulin resistant model in mice was prepared by stimulation with macrophage-derived condition medium (Mac-CM) and the effects of mSMS on oral glucose tolerance, insulin sensitivity and liver glycogen content in mice was observed. The mice adipose tissue was isolated and the regulation of inflammation-related adipokine expression and insulin phosphatidylinositol 3-kinase (PI3K) signaling transduction by mSMS was investigated. Effect of mSMS on insulin-mediated glucose uptake was also investigated in adipocytes. RESULTS: Oral administration of mSMS improved glucose tolerance in mice. Treatment of mice with Mac-CM resulted in glucose intolerance in mice and this change was effectively reversed by mSMS. Meanwhile, mSMS enhanced insulin sensitivity and increased glucose load-stimulated liver glycogen when mice were exposed to Mac-CM. Mac-CM stimulation induced dysregulation of adipokine expression in adipose tissue of mice. mSMS downregulated tumor necrosis factor α and interleukin 6 (IL-6) overexpression and upregulated adiponectin and peroxisomal proliferator activated receptor γ with inhibition of inhibitory kappa B kinase-ß (IKKß) and p65 phophsphorylation. Meanwhile, mSMS inhibited IL-6 production and increased adiponectin secretion in adipocytes against Mac-CM insult. Mac-CM challenge impaired insulin phosphatidylinositol 3 kinase (PI3K) signaling in adipose tissue. Oral administration mSMS inhibited inflammation-induced serine phosphorylation of insulin receptor substrate-1 (IRS-1) and restored insulin-mediated tyrosine phosphorylation, and thereby facilitated insulin PI3K signaling manifested by restoration of Akt phosphorylation. The resultant improvement of insulin sensitivity promoted insulin-stimulated glucose uptake when adipocytes were exposed to Mac-CM. CONCLUSIONS: mSMS improves glucose tolerance in mice by enhancing insulin sensitivity in mice. mSMS inhibits IKKß/NF κ B (p65)-dependent inflammatory response with beneficial regulation of adipokine expression in adipose tissue. mSMS inhibits inflammation and improves insulin sensitivity by blocking inflammatory interaction between IKKß/IRS-1.