Yigan Mingmu Decoction inhibits diabetic macular edema through regulating Kir4.1/AQP4 axis: a study based on network pharmacology.

OBJECTIVE: To explore the role and mechanism of Yigan Mingmu Decoction (YGMMD) in preventing and treating diabetic macular edema (DME). METHODS: The bioactive compounds in YGMMD and their targets were screened using network pharmacology. Sprague Dawley (SD) rats were treated with the respective drugs: andomine, YGMMD-L, YGMMD-M, YGMMD-H for four weeks. Blood glucose, body weight, and morphologic indicators were measured, and hematoxylin and eosin (H&E) staining was used to assess retinal pathologic changes. Western blotting was used to monitor the expression of the phosphatidylinositol 3 kinase-protein kinase B (PI3K-AKT), pathway-related proteins aquaporin 4 (AQP4), inwardly rectifying potassium channel subtype 4.1 (Kir4.1), and phosphorylase extracellular regulated protein kinases (p-ERK1/2). Immunofluorescence was used to observe the expression levels of AQP4 and Kir4.1. Immunohistochemistry was performed to determine the expression of p-ERK1/2. RESULTS: Pharmacologic network analysis and molecular docking suggested that YGMMD treatment of DME regulates AQP4/Kir4.1. In vivo experiments showed that YGMMD had significant hypoglycemic effects and reduced retinal edema in Sprague Dawley (SD) rats: YGMMD-H downregulated AQP4 and p-ERK1/2 and upregulated p-AKT and Kir4.1. Findings suggest that the therapeutic effect of YGMMD in DME is probably due to the deregulation of AQP4/Kir4.1 expression through the ERK1/2-PI3K-AKT pathway. CONCLUSION: This study shows that YGMMD inhibits the activation of p-ERK1/2 while concurrently enhancing the expression of p-AKT, leading to a decrease in AQP4 levels and the upregulation of Kir4.1 expression. As a result, the balance in the retinal fluid clearance system is restored, effectively alleviating DME.

Exploring the protective effects of herbal monomers against diabetic retinopathy based on the regulation of autophagy and apoptosis: A review.

Diabetic retinopathy (DR) has become one of the top 3 blinding eye diseases in the world. In spite of recent therapeutic breakthroughs, it is not yet possible to cure DR through pharmacotherapy. Cell death is thought to play a key role in the pathogenesis of DR. Moderate modulation of cellular autophagy and inhibition of apoptosis have been identified as effective targets for the treatment of DR. Numerous phytochemicals have emerged as potential new drugs for the treatment of DR. We collected basic DR research on herbal monomers through keywords such as autophagy and apoptosis, and conducted a systematic search for relevant research articles published in the PubMed database. This review provides the effects and reports of herbal monomers on various DR cellular and animal models in vivo and in vitro in the available literature, and emphasizes the importance of cellular autophagy and apoptosis as current DR therapeutic targets. Based on our review, we believe that herbal monomers that modulate autophagy and inhibit apoptosis may be potentially effective candidates for the development of new drugs in the treatment of DR. It provides a strategy for further development and application of herbal medicines for DR treatment.

Evidence and acupoint combinations in acupuncture for functional dyspepsia: an overview of systematic review and data mining study / 数字中医药（英文）

Objective@#To evaluate the methodological quality of papers that performed meta-analyzed and systematically reviewed acupoint selections for the treatment of functional dyspepsia (FD) and to identify the ideal acupoint combinations for FD.@*Methods@#Chinese databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), China Biology Medicine (CBM), and Wanfang Database, as well as English databases including PubMed, Embase, and Cochrane Library were searched to retrieve papers about meta-analysis and systematic literature reviews on acupuncture for FD. The time span for the paper retrieval was set from the foundation of the databases to April 30, 2022. The Veritas scores of the papers based on their publication year, study type, Assessment of Multiple Systematic Reviews 2 (AMSTAR2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), heterogeneity, and publication bias were rated to assess the methodological quality of the included studies. Then, randomized controlled trials (RCTs) were extracted from those meta-analysis papers or systematic literature reviews for analyzing acupoints frequency, meridian frequency, and association rules with the use of R software (V 4.3.1).@*Results@#Eight meta-analysis papers were included in the study after screening. The mean Veritas scores of the papers based on publication year, type of study, AMSTAR2, PRISMA, heterogeneity, and publication bias were 4.50, 8.00, 4.63, 4.63, 4.50, and 6.13, respectively. The analysis of the scores revealed insufficiencies in the reviews pertaining to the methodology, comprehension of the research strategy, detailed list of excluded studies, sources of funding, assessment of potential bias risks impact on meta-analysis results in each study, explanation of heterogeneity, and identification of potential conflicts of interest. Furthermore, a total of 85 RCTs were obtained from the eight meta-analysis papers involving 85 acupuncture prescriptions and 67 acupoints for subsequent data mining. The most commonly used meridian was Stomach meridian of Foot-Yangming (ST). Zusanli (ST36), Neiguan (PC6), Zhongwan (CV12), Taichong (LR3), Tianshu (ST25), Gongsun (SP4), Weishu (BL21), Pishu (BL20), Neiting (ST44), and Yinlingquan (SP9) topped the list of frequently selected acupoints. Additionally, a total of 28 association rules were identified, including 10 second-order, 15 third-order, and 3 fourth-order association rules. The top-ranking association rules in each order were “Neiguan (PC6) → Zusanli (ST36)” “Zhongwan (CV12) + Neiguan (PC6) → Zusanli (ST36)” and “Zhongwan (CV12) + Taichong (LR3) + Neiguan (PC6) → Zusanli (ST36)”, respectively.@*Conclusion@#Acupuncture could alleviate the clinical symptoms of FD. However, the quality of methodology applied in the meta-analysis papers on the subject needs to be improved. Through data mining, a combination of Neiguan (PC6), Zusanli (ST36), Zhongwan (CV12), and Taichong (LR3) was identified as an essential acupoint combination for the treatment of FD.

Recent Advances in Biotransformation of Saponins.

Saponins are a class of glycosides whose aglycones can be either triterpenes or helical spirostanes. It is commonly recognized that these active ingredients are widely found in various kinds of advanced plants. Rare saponins, a special type of the saponins class, are able to enhance bidirectional immune regulation and memory, and have anti-lipid oxidation, anticancer, and antifatigue capabilities, but they are infrequent in nature. Moreover, the in vivo absorption rate of saponins is exceedingly low, which restricts their functions. Under such circumstances, the biotransformation of these ingredients from normal saponins-which are not be easily adsorbed by human bodies-is preferred nowadays. This process has multiple advantages, including strong specificity, mild conditions, and fewer byproducts. In this paper, the biotransformation of natural saponins-such as ginsenoside, gypenoside, glycyrrhizin, saikosaponin, dioscin, timosaponin, astragaloside and ardipusilloside-through microorganisms (Aspergillus sp., lactic acid bacteria, bacilli, and intestinal microbes) will be reviewed and prospected.