Efficacy and Safety of Modified Duhuo Jisheng Decoction in the Treatment of Lumbar Disc Herniation: A Systematic Review and Meta‐Analysis

Xiong, Zhencheng; Yi, Ping; Liu-bo, Zhang; Ma, Hu; Li, Wenhao; Tan, Mingsheng

doi:10.1155/2020/2381462

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…The combination of these herbs can eliminate pathogenic factors and play the role of removing rheumatism, relieving arthralgia, tonifying the liver and kidneys and supplementing qi and blood. At present, DHJSD is broadly employed in the clinical treatment of lumbar disk herniation because of its anti-inflammatory and analgesic effects [25,26]. A meta-analysis showed that modified DHJSD had a more favorable effect on the treatment of lumbar disk herniation than Western medicine, and there were no obvious adverse events [25].…”

Section: Introductionmentioning

confidence: 99%

Duhuo Jisheng Decoction suppresses apoptosis and mitochondrial dysfunction in human nucleus pulposus cells by miR-494/SIRT3/mitophagy signal axis

Liu

Zhao

2023

J Orthop Surg Res

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Background Increasing evidence suggests that mitophagy is responsible for the pathogenesis of intervertebral disk (IVD) degeneration. Previous studies have shown that Duhuo Jisheng Decoction (DHJSD), a classic Fangji of traditional Chinese medicine, can delay IVD degeneration; however, its specific mechanism of action is unknown. In this study, we investigated the mechanism by which DHJSD treatment prevented IVD degeneration in IL-1β-treated human nucleus pulposus (NP) cells in vitro. Methods Cell Counting Kit-8 was performed to explore the effects of DHJSD on the viability of NP cells exposed to IL-1β. The mechanism by which DHJSD delays IVD degeneration was explored using luciferase reporter assay, RT-qPCR, western blotting, TUNEL assay, mitophagy detection assay, Mito-SOX, Mitotracker and in situ hybridization. Results We observed that DHJSD enhanced the viability of NP cells treated with IL-1β in a concentration-time dependent approach. Moreover, DHJSD lessened IL-1β-induced NP apoptosis and mitochondrial dysfunction and activated mitophagy in NP cells treated with IL-1β. Mitophagy suppressor cyclosporin A reversed the beneficial impacts of DHJSD in NP cells. In addition, the differential expression of miR-494 regulated IL-1β-induced NP apoptosis and mitochondrial dysfunction, and the protective impact of miR-494 on NP cells treated with IL-1β was achieved by mitophagy activation, which was regulated by its target gene, sirtuin 3 (SIRT3). Finally, we observed that DHJSD treatment could effectively delay IL-1β-induced NP apoptosis by affecting the miR-494/SIRT3/mitophagy signal axis. Conclusions These results show that the miR-494/SIRT3/mitophagy signaling pathway is responsible for the apoptosis and mitochondrial dysfunction of NP cells and that DHJSD may exert protective effects against IVD degeneration by regulating the miR-494/SIRT3/mitophagy signal axis.

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Section: Introductionmentioning

confidence: 99%

Duhuo Jisheng Decoction suppresses apoptosis and mitochondrial dysfunction in human nucleus pulposus cells by miR-494/SIRT3/mitophagy signal axis

Liu

Zhao

2023

J Orthop Surg Res

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“…DHJSD is a TCM recorded in Bei Ji Qian Jin Yao Fang of the Tang Dynasty for the treatment of “Bi Zheng,” usually consisting of the following 15 herbs, including Du Huo ( Radix Angelicae Pubescentis ), Sang Ji Sheng ( Herba Taxilli ), Qin Jiao ( Radix Gentianae Macrophyllae ), Fang Feng ( Radix Saposhnikoviae ), Xi Xin ( Herba Asari ), Fu Ling ( Poria Cocos ), Chuan Xiong ( Rhizoma Chuanxiong ), Bai Shao ( Radix Paeoniae Alba ), Du Zhong ( Cortex Eucommiae Ulmoidis ), Ren Shen ( Panax Ginseng ), Gan Cao ( Radix Glycyrrhizae ), Dang Gui ( Radix Angelicae Sinensis ), Niu Xi ( Radix Achyranthis Bidentatae ), Shu Di Huang ( Radix Rehmanniae Preparata ), and Rou Gui ( Cortex Cinnamomi ) [ 10 ]. Among them, Du Huo has the good effects of relieving the pain of “Bi Zheng,” dispelling cold and dehumidification, nourishing blood and Qi; Xi Xin, Fang Feng, and Qin Jiao dispel rheumatism, relax tendons and muscles, and benefit joints; Sang Ji Sheng, Du Zhong, Rou Gui, and Niu Xi nourish liver and kidney and strengthen bones and muscles; Dang Gui, Bai Shao, Shu Di Huang, and Chuan Xiong promote blood circulation; Ren Shen, Gan Cao, and Fu Ling strengthen spleen and supplement Qi [ 11 ]. The combination of the above herbs forms DHJSD, the classic bone injury prescription in TCM, it has the effect of nourishing the liver and kidney, benefiting Qi and blood, and stopping the pain of “Bi Zheng”, which obviously improves the microcirculation of the body [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…And the cause of osteoporosis is the deficiency of Qi and blood in the liver and kidney and the loss of nutrition in the tendons and bones, so the treatment should be to nourish the liver and kidney and strengthen the tendons and bones as the primary treatment [ 14 ]. Therefore, DHJSD has been widely used in China to treat rheumatoid arthritis, intervertebral disc disease, knee osteoarthritis, and osteoporosis, especially postmenopausal osteoporosis [ 2 , 11 , 14 – 17 ]. However, due to the ingredients contained, the mechanism of action of TCM is often elusive.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Pharmacological Mechanism of Duhuo Jisheng Decoction in Treating Osteoporosis Based on Network Pharmacology

Xiong

Zheng

Chang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. The purpose of this work is to study the mechanism of action of Duhuo Jisheng Decoction (DHJSD) in the treatment of osteoporosis based on the methods of bioinformatics and network pharmacology. Methods. In this study, the active compounds of each medicinal ingredient of DHJSD and their corresponding targets were obtained from TCMSP database. Osteoporosis was treated as search query in GeneCards, MalaCards, DisGeNET, Therapeutic Target Database (TTD), Comparative Toxicogenomics Database (CTD), and OMIM databases to obtain disease-related genes. The overlapping targets of DHJSD and osteoporosis were identified, and then GO and KEGG enrichment analysis were performed. Cytoscape was employed to construct DHJSD-compounds-target genes-osteoporosis network and protein-protein interaction (PPI) network. CytoHubba was utilized to select the hub genes. The activities of binding of hub genes and key components were confirmed by molecular docking. Results. 174 active compounds and their 205 related potential targets were identified in DHJSD for the treatment of osteoporosis, including 10 hub genes (AKT1, ALB, IL6, MAPK3, VEGFA, JUN, CASP3, EGFR, MYC, and EGF). Pathway enrichment analysis of target proteins indicated that osteoclast differentiation, AGE-RAGE signaling pathway in diabetic complications, Wnt signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway, JAK-STAT signaling pathway, calcium signaling pathway, and TNF signaling pathway were the specifically major pathways regulated by DHJSD against osteoporosis. Further verification based on molecular docking results showed that the small molecule compounds (Quercetin, Kaempferol, Beta-sitosterol, Beta-carotene, and Formononetin) contained in DHJSD generally have excellent binding affinity to the macromolecular target proteins encoded by the top 10 genes. Conclusion. This study reveals the characteristics of multi-component, multi-target, and multi-pathway of DHJSD against osteoporosis and provides novel insights for verifying the mechanism of DHJSD in the treatment of osteoporosis.

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“…The characteristics of IVDD are complex, with pathological changes in NP and inner ring, forming cracks radiating from the central area of the intervertebral disc to the periphery (Fraser et al, 1993). The clinical symptoms of IVDD are mainly based on the degenerative changes of the intervertebral disc, leading to long-term lumbago and leg pain, neurological deficits, and loss of labor ability, which seriously affect the life quality of patients (Xiong et al, 2020). Caused by accumulation of injury on the basis of degenerative diseases, IVDD will further repeatedly attack the degeneration of the intervertebral disc.…”

Section: Introductionmentioning

confidence: 99%

Yiqi Huoxue Recipe Delayed Intervertebral Disc Degeneration by Activating Autophagy

Dai

et al. 2021

Front. Pharmacol.

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Autophagy has been proved to occur in rats with intervertebral disc degeneration (IVDD). Yiqi Huoxue recipe (YQHXR), an effective therapy of traditional Chinese medicine, was widely used for ruptured lumbar disc herniation under clinical observation. More importantly, YQHXR positively regulated the expression of autophagy-related proteins. However, little is known about the significance of YQHXR in the pathologic process of IVDD. Therefore, this study explored the protective effect of YQHXR based on IVDD rat model through magnetic resonance imaging and histopathologic analysis. Then we evaluated the formation of autophagosomes in the degenerated intervertebral disc by transmission electron microscope. Real-time PCR was used to detect the changes of autophagy-related genes. Western blot and immunoprecipitation were used to assess the protein expression of the autophagy-related pathway. We found that YQHXR-induced autophagy attenuated the release of inflammatory factors. In addition, YQHXR promoted the formation of Beclin1-VPS34 complex to activate autophagy through not only activation of the upstream protein AMPK and upregulation of the deubiquitinase USP13, thus in turn alleviating the development of IVDD. We proposed the potential molecular mechanism of YQHXR on autophagy for the first time, so as to provide a theoretical and experimental basis for the clinical application of YQHXR in the treatment of IVDD-related diseases.

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Efficacy and Safety of Modified Duhuo Jisheng Decoction in the Treatment of Lumbar Disc Herniation: A Systematic Review and Meta‐Analysis

Cited by 8 publications

References 14 publications

Duhuo Jisheng Decoction suppresses apoptosis and mitochondrial dysfunction in human nucleus pulposus cells by miR-494/SIRT3/mitophagy signal axis

Duhuo Jisheng Decoction suppresses apoptosis and mitochondrial dysfunction in human nucleus pulposus cells by miR-494/SIRT3/mitophagy signal axis

Exploring the Pharmacological Mechanism of Duhuo Jisheng Decoction in Treating Osteoporosis Based on Network Pharmacology

Yiqi Huoxue Recipe Delayed Intervertebral Disc Degeneration by Activating Autophagy

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