Advances of traditional Chinese medicine preclinical mechanisms and clinical studies on diabetic peripheral neuropathy.

CONTEXT: Diabetic peripheral neuropathy (DPN) results in an enormous burden and reduces the quality of life for patients. Considering there is no specific drug for the management of DPN, traditional Chinese medicine (TCM) has increasingly drawn attention of clinicians and researchers around the world due to its characteristics of multiple targets, active components, and exemplary safety. OBJECTIVE: To summarize the current status of TCM in the treatment of DPN and provide directions for novel drug development, the clinical effects and potential mechanisms of TCM used in treating DPN were comprehensively reviewed. METHODS: Existing evidence on TCM interventions for DPN was screened from databases such as PubMed, the Cochrane Neuromuscular Disease Group Specialized Register (CENTRAL), and the Chinese National Knowledge Infrastructure Database (CNKI). The focus was on summarizing and analyzing representative preclinical and clinical TCM studies published before 2023. RESULTS: This review identified the ameliorative effects of about 22 single herbal extracts, more than 30 herbal compound prescriptions, and four Chinese patent medicines on DPN in preclinical and clinical research. The latest advances in the mechanism highlight that TCM exerts its beneficial effects on DPN by inhibiting inflammation, oxidative stress and apoptosis, endoplasmic reticulum stress and improving mitochondrial function. CONCLUSIONS: TCM has shown the power latent capacity in treating DPN. It is proposed that more large-scale and multi-center randomized controlled clinical trials and fundamental experiments should be conducted to further verify these findings.

Evidence of traditional Chinese medicine for treating type 2 diabetes mellitus: from molecular mechanisms to clinical efficacy.

CONTEXT: The global prevalence of type 2 diabetes mellitus (T2DM) has increased significantly in recent decades. Despite numerous studies and systematic reviews, there is a gap in comprehensive and up-to-date evaluations in this rapidly evolving field. OBJECTIVE: This review provides a comprehensive and current overview of the efficacy of Traditional Chinese Medicine (TCM) in treating T2DM. METHODS: A systematic review was conducted using PubMed, Web of Science, Wanfang Data, CNKI, and Medline databases, with a search timeframe extending up to November 2023. The search strategy involved a combination of subject terms and free words in English, including 'Diabetes,' 'Traditional Chinese Medicine,' 'TCM,' 'Hypoglycemic Effect,' 'Clinical Trial,' and 'Randomized Controlled Trial.' The studies were rigorously screened by two investigators, with a third investigator reviewing and approving the final selection based on inclusion and exclusion criteria. RESULTS: A total of 108 relevant papers were systematically reviewed. The findings suggest that TCMs not only demonstrate clinical efficacy comparable to existing Western medications in managing hypoglycemia but also offer fewer adverse effects and a multitarget therapeutic approach. Five main biological mechanisms through which TCM treats diabetes were identified: improving glucose transport and utilization, improving glycogen metabolism, promoting GLP-1 release, protecting pancreatic islets from damage, and improving intestinal flora. CONCLUSIONS: TCM has demonstrated significant protective effects against diabetes and presents a viable option for the prevention and treatment of T2DM. These findings support the further exploration and integration of TCM into broader diabetes management strategies.

Clinical observations and mechanistic insights of traditional Chinese medicine in the management of diabetic retinopathy.

CONTEXT: Diabetic retinopathy (DR) is one of the leading causes of vision impairment and blindness among diabetic patients globally. Despite advancements in conventional treatments, the quest for more holistic approaches and fewer side effects persists. Traditional Chinese medicine (TCM) has been used for centuries in managing various diseases, including diabetes and its complications. OBJECTIVE: This review evaluated the efficacy and underlying mechanisms of TCM in the management of DR, providing information on its potential integration with conventional treatment methods. METHODS: A comprehensive literature review was conducted using PubMed, Web of Science, and the China National Knowledge Infrastructure (CNKI) with the search terms 'traditional Chinese medicine', 'diabetic retinopathy', 'clinical efficacies' and their combinations. Studies published before 2023 without language restriction were included, focusing on clinical trials and observational studies that assessed the effectiveness of TCM in DR treatment. RESULTS: The review synthesized evidence of empirical traditional Chinese formulas, traditional Chinese patent medicines, and isolated phytochemicals on DR treatment. The key mechanisms identified included the reduction of oxidative stress, inflammation, and neovascularization, as well as the improvement in neurovascular functionality and integrity of the retinal blood barrier. CONCLUSIONS: TCM shows promising potential to manage DR. More large-scale, randomized controlled trials are recommended to validate these findings and facilitate the integration of TCM into mainstream DR treatment protocols.

Icariin attenuates vascular endothelial dysfunction by inhibiting inflammation through GPER/Sirt1/HMGB1 signaling pathway in type 1 diabetic rats.

Icariin, a flavonoid glycoside, is extracted from Epimedium. This study aimed to investigate the vascular protective effects of icariin in type 1 diabetic rats by inhibiting high-mobility group box 1 (HMGB1)-related inflammation and exploring its potential mechanisms. The impact of icariin on vascular dysfunction was assessed in streptozotocin (STZ)-induced diabetic rats through vascular reactivity studies. Western blotting and immunofluorescence assays were performed to measure the expressions of target proteins. The release of HMGB1 and pro-inflammation cytokines were measured by enzyme-linked immunosorbent assay (ELISA). The results revealed that icariin administration enhanced acetylcholine-induced vasodilation in the aortas of diabetic rats. It also notably reduced the release of pro-inflammatory cytokines, including interleukin-8 (IL-8), IL-6, IL-1ß, and tumor necrosis factor-alpha (TNF-α) in diabetic rats and high glucose (HG)-induced human umbilical vein endothelial cells (HUVECs). The results also unveiled that the pro-inflammatory cytokines in the culture medium of HUVECs could be increased by rHMGB1. The increased release of HMGB1 and upregulated expressions of HMGB1-related inflammatory factors, including advanced glycation end products (RAGE), Toll-like receptor 4 (TLR4), and phosphorylated p65 (p-p65) in diabetic rats and HG-induced HUVECs, were remarkably suppressed by icariin. Notably, HMGB1 translocation from the nucleus to the cytoplasm in HUVECs under HG was inhibited by icariin. Meanwhile, icariin could activate G protein-coupled estrogen receptor (GPER) and sirt1. To explore the role of GPER and Sirt1 in the inhibitory effect of icariin on HMGB1 release and HMGB-induced inflammation, GPER inhibitor and Sirt1 inhibitor were used in this study. These inhibitors diminished the effects of icariin on HMGB1 release and HMGB1-induced inflammation. Specifically, the GPER inhibitor also negated the activation of Sirt1 by icariin. These findings suggest that icariin activates GPER and increases the expression of Sirt1, which in turn reduces HMGB1 translocation and release, thereby improving vascular endothelial function in type 1 diabetic rats by inhibiting inflammation.

Liquid-Liquid Phase Separation of Aqueous Ionic Liquids in Covalent Organic Frameworks for Thermal Switchable Proton Conductivity.

Covalent organic frameworks (COFs) have regular channels that can accommodate guest molecules to provide highly conductive solid electrolytes. However, designing smart, conductive COFs remains a great challenge. Herein, we report the first example of PEG-functionalized ionic liquids (ILs) anchored on the COF walls by strong hydrogen bonding to fabricate thermally responsive COFs (ILm@COF). We found that similar to the traditional IL/water mixture, the ILs undergo lower critical solution temperature (LCST)-type phase behavior within COF nanopores under high moisture levels. However, the phase separation temperature of aqueous IL decreases in COF channels due to the strong interaction between the IL and COF. Thus, the proton conductivity of ILm@COF can be reversibly switched by phase miscibility and separation in COF nanopores, and there is no obvious decrease even after 20 switching cycles. Our work provides important clues for understanding liquid-liquid phase separation in a confined nanospace and opens a new pathway to switchable proton conductivity.

Isomerization of DASA Molecules in the Nanopores of Metal-Organic Frameworks: What Determines Its Reversibility?

In recent years, light-responsive molecules have been incorporated in metal-organic frameworks (MOFs) to fabricate light-responsive intelligent devices, where reversible isomerization of the guest molecules in the nanopores is crucial. However, how to design a porous environment of MOFs to achieve a reversible isomerization remains unknown until now. In this work, donor-acceptor Stenhouse adducts (DASAs), a new kind of visible light responsive compound, were confined in the nanopores of different MOFs to study their isomerization upon visible-light irradiation/mild heating. We found that the polarity of the pore environment is the key to control the reversibility of isomerization of such guest molecules. Under the guidance of this principle, MIL-53(Al) was screened to investigate the proton conductivity and switching performance of the DASA-confined MOF. The proton conductance was up to 0.013 S cm-1 at 80 °C and 98 % RH, and at least 30 switching cycles were achieved thanks to the Grotthuss-type mechanism and the low polarity of MIL-53(Al) pore environment.

Corrosion Resistance of the GO/ZIF-8 Hybrid Loading Benzotriazole as a Multifunctional Composite Filler-Modified MgAlY Layered Double Hydroxide Coating.

A composite coating with good load-carrying and controlled release capabilities for the corrosion inhibitor benzotriazole (BTA) was prepared while providing active and passive corrosion protection for magnesium alloy systems. In this paper, the organic corrosion inhibitor BTA was loaded into the ZIF-8/GO hybrid (GZB), and then, the GZB composite was coated with hexadecyltrimethoxysilane (HDTMS). Then, the GZB composites carried by HDTMS were made to adhere a ternary MgAlY layered double hydroxide (LDH) coating based on microarc oxidation (MAO) coating by electrophoresis (Si-MgAlY LDH coating). The successful loading of BTA by GZB composites was verified by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). Meanwhile, the Si-MgAlY LDH coating was characterized by X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy. The potentiodynamic polarization curves show that the corrosion current density of the Si-MgAlY LDH coating reaches (2.08 ± 0.49) × 10-9 A/cm2, which means that the Si-MgAlY LDH coating greatly improves the corrosion resistance of magnesium alloy AZ31. The Si-MgAlY LDH coating can also achieve self-healing function in harsh environments, which is attributed to the synergistic effect of passive and active protection. The composite coating is of great significance to expand the potential applications of magnesium alloys.

A visible light/heat responsive covalent organic framework for highly efficient and switchable proton conductivity.

In recent years, covalent organic frameworks (COFs) have attracted enormous interest as a new generation of proton-exchange membranes, chemical sensors and electronic devices. However, to design high proton conductivity COFs, especially those with stimulus responsive performance remains a great challenge. Here, the first example of a light/heat switchable COF (COF-HNU9) has been synthesized by grafting a donor-acceptor Stenhouse adduct (DASA) within the channels of a ß-ketoenamine-based COF. DASA groups in the nanopores of COF-HNU9 undergo a reversible open-closed photoisomerization upon visible light irradiation and are recovered by heating. Thus, COF-HNU9 exhibits not only a remarkably high proton conductivity, but also a highly effective switching performance. Under visible light irradiation at 98% RH, the proton conductivity of COF-HNU9 increases by three orders of magnitude at 25 °C and is up to 0.02 S cm-1 at 80 °C. Furthermore, the proton conductivity does not display any significant decrease even after 20 switching cycles. These results have been rationalized by a Grotthuss-type mechanism and verified by DFT calculations. The stimuli-responsive COF is conceptually confirmed by an optical control device with the light/heat switching proton conductive COF-HNU9 film, which is able to remote-control the illumination and switching off of an LED lamp without any current amplifier.

Icariin ameliorates endothelial dysfunction in type 1 diabetic rats by suppressing ER stress via the PPARα/Sirt1/AMPKα pathway.

Icariin (ICA), as a flavonoid glycoside, is associated with the improvement of vascular complications in diabetes. However, its protective mechanisms remain to be well-established. Here, we tested the hypothesis that ICA attenuates vascular endothelial dysfunction by inhibiting endoplasmic reticulum (ER) stress in type 1 diabetes. In streptozotocin-induced diabetic rats, ICA positively affected acetylcholine-induced vasodilation and phenylephrine-induced vasoconstriction in aortas. ICA treatment significantly attenuated ER stress in diabetic rats and high-glucose induced human umbilical vein endothelial cells. Incubation with ICA in vitro attenuated vascular reactivity in diabetic rats, which was blocked by the ER stress inducer, and peroxisome proliferator-activated receptor α (PPARα), sirtuin1 (Sirt1), or AMP-activated protein kinase-α (AMPKα) inhibitors. Western blot showed that ICA activated the PPARα/Sirt1/AMPKα pathway, which contributed to reducing ER stress and activating endothelial nitric oxide synthase in vivo and vitro. Our results implicate that ICA normalizes ER stress to attenuate endothelial dysfunction by the regulation of the PPARα/Sirt1/AMPKα pathway.

Icariin Prevents Extracellular Matrix Accumulation and Ameliorates Experimental Diabetic Kidney Disease by Inhibiting Oxidative Stress via GPER Mediated p62-Dependent Keap1 Degradation and Nrf2 Activation.

The present study aimed to determine whether icariin could attenuate type 1 diabetic nephropathy (T1DN) induced by streptozotocin (STZ) after 4 weeks or not. Therefore, its therapeutic effect on diabetic kidney disease was investigated in view of reactive oxygen (ROS) and extracellular matrix (ECM) generation in human glomerular mesangial cells under high glucose. To establish the participation and the key role of GPER and Nrf2 in ECM deposition, a combination of G15 (antagonist of GPER) or siGPER and siNrf2 were performed, respectively. The results showed that T1DN can be significantly inhibited by oral icariin, evidenced by improvement of 24 h urinary volume, 24 h proteinuria, microalbuminuria, and histopathological changes of kidney. Icariin decreased the levels of intracellular superoxide anion, impeded the generation of fibronectin and increased the expression and activity of antioxidant enzymes in the human glomerular mesangial cells treated with high glucose. It acted as a GPER activator, increased dissociation of Nrf2/Keap1 complexes, combination of Keap1/p62 complexes, Nrf2 translocation to nuclear, Nrf2/ARE DNA binding activity, and ARE luciferase reporter gene activity in glomerular mesangial cells. The Nrf2 inhibitor ML385 or siNrf2 obviously abolished extracellular matrix (ECM) generation inhibited by icariin. Furthermore, icariin-induced Nrf2 activation was mainly dependent on p62-mediated Keap1 degradation, which functions as an adaptor protein during autophagy. The GPER antagonist G15 and siGPER obviously abolished the above effects by icariin. Taken together, the present study demonstrated that the therapeutic effects of icariin on type 1 diabetic nephropathy in rats via GPER mediated p62-dependent Keap1 degradation and Nrf2 activation.

Hierarchical virtual screening of the dual MMP-2/HDAC-6 inhibitors from natural products based on pharmacophore models and molecular docking.

The dual-target inhibitors tend to improve the response rate in treating tumors, comparing with the single-target inhibitors. Matrix metalloproteinase-2 (MMP-2) and histone deacetylase-6 (HDAC-6) are attractive targets for cancer therapy. In this study, the hierarchical virtual screening of dual MMP-2/HDAC-6 inhibitors from natural products is investigated. The pharmacophore model of MMP-2 inhibitors is built based on ligands, but the pharmacophore model of HDAC-6 inhibitors is built based on the experimental crystal structures of multiple receptor-ligand complexes. The reliability of these two pharmacophore models is validated subsequently. The hierarchical virtual screening, combining these two different pharmacophore models of MMP-2 and HDAC-6 inhibitors with molecular docking, is carried out to identify the dual MMP-2/HDAC-6 inhibitors from a database of natural products. The four potential dual MMP-2/HDAC-6 inhibitors of natural products, STOCK1 N-46177, STOCK1 N-52245, STOCK1 N-55477, and STOCK1 N-69706, are found. The studies of binding modes show that the screened four natural products can simultaneously well bind with the MMP-2 and HDAC-6 active sites by different kinds of interactions, to inhibit the MMP-2 and HDAC-6 activities. In addition, the ADMET properties of screened four natural products are assessed. These found dual MMP-2/HDAC-6 inhibitors of natural products could serve as the lead compounds for designing the new dual MMP-2/HDAC-6 inhibitors having higher biological activities by carrying out structural modifications and optimizations in the future studies.

Screening for the selective inhibitors of MMP-9 from natural products based on pharmacophore modeling and molecular docking in combination with bioassay experiment, hybrid QM/MM calculation, and MD simulation.

Matrix metalloproteinase-9 (MMP-9) has been considered as an attractive target involving cancer therapy. In this study, the 3D QSAR pharmacophore model of MMP-9 inhibitors is built, and its reliability is subsequently validated based on different methods. The built pharmacophore model consists of the four chemical features, including two hydrogen bond acceptors (HBA), one hydrophobic (HY), and one ring aromatic (RA). Among them, both HY and RA are found to be especially important features because they involve the interactions of inhibitors with the S1' pocket of MMP-9, which determines the selectivity of MMP-9 inhibitors. By combining pharmacophore model with molecular docking, the virtual screening is carried out to identify the selective MMP-9 inhibitors from natural products. The four potential selective MMP-9 inhibitors of natural products are found. One of them was used to carry out the bioassay experiment inhibiting MMP-9, and the estimated IC50 value of only 26.94 µM clearly shows its strongly inhibitory activity; besides, both the hybrid quantum mechanics/molecular mechanics (QM/MM) calculation and the molecular dynamics simulation are performed to examine the reliability regarding the binding mode of this inhibitor with MMP-9 active sites predicted by molecular docking. All the screened four natural products are found to well bind with the MMP-9 active sites by different kinds of interactions. Finally, the ADMET properties of screened four natural products are assessed. These screened MMP-9 inhibitors of natural products could be used as the lead compounds to perform structural modifications and optimizations in the future work. Communicated by Ramaswamy H. Sarma.

Transparent, conductive, and superhydrophobic nanocomposite coatings on polymer substrate.

Transparent, conductive, and superhydrophobic nanocomposite coatings were fabricated on the polyethylene terephthalate substrate by a spray method. Different concentrations of multi-walled carbon nanotubes (MWCNTs) entwined with SiO2 nanoparticles, which originated from the hydrolysis and condensation of tetraethyl orthosilicate, were sprayed to form MWCNTs/SiO2 nanocomposite coatings. The coatings were characterized by scanning electron microscopy, contact angle measurements, and other analytical techniques. The surface morphology, hydrophobicity, transparency, and conductivity of the nanocomposite coating were found to be strongly dependent on the MWCNT concentration. With increasing MWCNT concentration, the hydrophobicity increased first and then decreased, and the optical transmittance and sheet resistance decreased. The enhanced hydrophobicity was associated with the surface microstructure and chemical composition of the coating. The decreased hydrophobicity resulted mainly from the decrease in the trapped air between the water droplet and the nanocomposite coating. Owing to the hierarchically porous 3-dimensional microstructure and opportune fluorinated MWCNT content, the nanocomposite coating with 0.2wt% MWCNTs exhibited the best hydrophobicity with a contact angle of 156.7°, good transparency with 95.7% transmittance and relatively high conductivity with a sheet resistance of 3.2×104Ωsq-1.

Tuning phase behaviour of PEG-functionalized ionic liquids from UCST to LCST in alcohol-water mixtures.

Thermo-responsive materials with reversible phase transition in molecular solvents are of great importance for catalysis reaction, product separation, and catalyst recycling among others. In this work, liquid-liquid phase transition of PEG-functionalized ionic liquids [PEGm(mim)2][NTf2]2 (m = 200, 400, 600, 800, 1000) in aliphatic alcohol (ethanol, 1-propanol or isopropanol) and in aqueous aliphatic alcohol was investigated by turbidity and dynamic light scattering (DLS) measurements, and the effects of the alkyl chain length of the alcohol molecules and molecular weight of the PEG middle block of the ionic liquids on the phase transition behaviour were examined. It was found that these ionic liquids exhibited a unique UCST phase transition in the aliphatic alcohol, but their liquid-liquid phase transition behaviour could be tuned precisely from UCST to LCST in aqueous aliphatic alcohol. Furthermore, temperature-dependent FT-IR and/or 1H NMR measurements were performed to understand the possible origin of phase behavior of both [PEGm(mim)2][NTf2]2 in the aliphatic alcohol and [PEG800(mim)2][NTf2]2 in ethanol-d6/H2O.

Tuning the Hydrophilicity and Hydrophobicity of the Respective Cation and Anion: Reversible Phase Transfer of Ionic Liquids.

The separation and recycling of catalyst and cocatalyst from the products and solvents are of critical importance. In this work, a class of functionalized ionic liquids (ILs) were designed and synthesized, and by tuning the hydrophilicity and hydrophobicity of cation and anion, respectively, these ILs could reversibly transfer between water and organics triggered upon undergoing a temperature change. From a combination of multiple spectroscopic techniques, it was shown that the driving force behind the transfer was originated from a change in conformation of the PEG chain of the IL upon temperature variation. By utilizing the novel property of this class of ILs, a highly efficient and controllable CuI-catalyzed cycloaddition reaction was achieved wherein the IL was used to entrain, activate, and recycle the catalyst, as well as to control the reaction.