Fufang Xueshuantong alleviates diabetic retinopathy by activating the PPAR signalling pathway and complement and coagulation cascades

Sun, Hongtao; Chai, Xiangping; Liu, Hongli; Tian, Jingyun; Jiang, Kunxiu; Song, Xingzhuo; Wang, Xirui; Fang, Yongsheng; Ji, Qingxuan; Liu, Hanying; Hao, Guiyang; Wang, Wei; Han, Jing

doi:10.1016/j.jep.2020.113324

Cited by 34 publications

(19 citation statements)

References 29 publications

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“…It counteracts DR may be related to the HIF-1 pathway, TNF pathway, VEGF pathway and Hippo pathway (53)(54)(55), thereby improving retinal hypoxic microenvironment, retinal inflammation and vascular proliferation. On the other hand, CX causes the hemodynamics and morphological alterations in diabetic rat retinas, which may via regulating the PPAR pathway and complement and coagulation cascades (56). SMC based on Chinese ancient prescriptions named Liuwei Dihuang Pill and Erzhi Pill is composed of Ligustrum lucidum Ait., Eclipta prostrata, Cornus officinalis Sieb, Dioscorea polystachya Turczaninow, Salvia miltiorrhiza Bunge, Panax notoginseng, Paeonia suffruticosa Andr., Alismatis Rhizoma, Poria cocos (Schw.…”

Section: Discussionmentioning

confidence: 99%

Effect of Chinese Patent Medicines on Ocular Fundus Signs and Vision in Calcium Dobesilate-Treated Persons With Non-Proliferative Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Zhang

Duan

et al. 2022

Front. Endocrinol.

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BackgroundDiabetic retinopathy (DR), one of the commonest microvascular complications in diabetic patients, is featured by a series of fundus lesions. Conventional Western medicine therapies for DR are always with modest treatment outcome. This paper is to assess the ocular fundus signs, vision and safety of Chinese patent medicines (CPMs) as an add-on treatment for DR.Method7 electronic databases were searched to determine eligible trials. Randomized controlled trials (RCTs) of non-proliferative diabetic retinopathy (NPDR) in which the intervention group received CPMs combined with calcium dobesilate (CD), and the control group received only CD were included for analysis. Two reviewers extracted the data independently. Results expressing as mean differences (MD) and relative risks (RR) were analyzed with a fixed-effects or random-effects models.Results19 RCTs involved 1568 participants with 1622 eyes met our inclusion criteria. The results suggested that compared with CD alone, CPMs plus CD for NPDR was superior at reducing the microaneurysm volume (MD -3.37; 95% confidence interval [CI], -3.59 to -3.14), microaneurysm counts (MD -2.29; 95%CI -2.97 to -1.61), hemorrhage area (MD -0.79; 95%CI -0.83 to -0.75), and macular thickness (MD -59.72; 95%CI -63.24 to -56.20). Participants in CPMs plus CD group also achieved a better vision. No obvious adverse events occurred.ConclusionCPMs as an add-on therapy for NPDR have additional benefits and be generally safe. This meta‐analysis demonstrated that CPMs combined with CD could improve retinal microaneurysm, hemorrhage, macular thickness, visual acuity, fasting blood glucose (FBG), and glycosylated hemoglobin (HbAlc) compared with CD alone. Further studies are needed to provide more conclusive evidence.Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/prospero/, identifier CRD42021257999.

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Section: Discussionmentioning

confidence: 99%

Effect of Chinese Patent Medicines on Ocular Fundus Signs and Vision in Calcium Dobesilate-Treated Persons With Non-Proliferative Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Zhang

Duan

et al. 2022

Front. Endocrinol.

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“…Protocatechualdehyde was related to intrinsic clotting activity, while calycosin-7-O-beta-D-glucoside was related to extrinsic clotting activity. In Sun et al's study [ 23 ], the systolic and diastolic velocity decreased while the resistance and pulsatility index increased in diabetic rat retinas. Furthermore, they also proved that the protective effects of DR were mediated by coagulation cascades and the peroxisome proliferator-activated receptor (PPAR) signaling pathway.…”

Section: Discussionmentioning

confidence: 99%

Network Pharmacology-Based Approach to Comparatively Predict the Active Ingredients and Molecular Targets of Compound Xueshuantong Capsule and Hexuemingmu Tablet in the Treatment of Proliferative Diabetic Retinopathy

Yao

Xin

Zhan

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Compound Xueshuantong capsule (CXC) and Hexuemingmu tablet (HXMMT) are two important Chinese patent medicines (CPMs) frequently used to treat proliferative diabetic retinopathy (PDR), especially when complicated with vitreous hemorrhage (VH). However, a network pharmacology approach to understand the therapeutic mechanisms of these two CPMs in PDR has not been applied. Objective. To identify differences in the active ingredients between CXC and HXMMT and to comparatively predict and further analyze the molecular targets shared by these CPMs and PDR. Materials and methods. The differentially expressed messenger RNAs (mRNAs) between normal retinal tissues in healthy individuals and active fibrovascular membranes in PDR patients were retrieved from the Gene Expression Omnibus database. The active ingredients of CXC and HXMMT and the targets of these ingredients were retrieved from the Traditional Chinese Medicine Systems Pharmacology database. The intersections of the CPM (CXC and HXMMT) targets and PDR targets were determined. Then, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed, and the ingredient-target networks, protein-protein interaction networks, and KEGG-target (KEGG-T) networks were constructed. Results. CXC contains 4 herbs, and HXMMT contains 19. Radix salviae is the only herb common to both. CXC had 34 potential therapeutic targets in PDR, while HXMMT had these 34 and 10 additional targets. Both CPMs shared the following main processes: response to reactive oxygen species and oxidative stress, regulation of blood vessel diameter and size, vasoconstriction, smooth muscle contraction, hemostasis, and blood coagulation. The shared pathways included the AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, relaxin signaling pathway, and IL-17 signaling pathway. Conclusions. Both CXC and HXMMT include components effective at treating PDR and affect the following main processes: response to reactive oxygen species and oxidative stress, regulation of blood vessels, and blood coagulation. Radix salviae, the only herb common to both CPMs, contains many useful active ingredients. The PDR-CXC and PDR-HXMMT networks shared 34 common genes (RELA, HSPA8, HSP90AA, HSP90AB1, BRCA, EWSR1, CUL7, HNRNPU, MYC, CTNNB1, MDM2, YWHAZ, CDK2, AR, FN1, HUWE1, TP53, TUBB, EP300, GRB2, VCP, MCM2, EEF1A1, NTRK1, TRAF6, EGFR, PRKDC, SRC, HDAC5, APP, ESR1, AKT1, UBC, and COPS5), and the PDR-HXMMT network has 10 additional genes (RNF2, VNL, RPS27, COPS5, XPO1, PARP1, RACK1, YWHAB, and ITGA4). The top 5 pathways with the highest gene ratio in both networks were the AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, relaxin signaling pathway, IL-17 signaling pathway, and focal adhesion. Additional pathways such as neuroactive ligand-receptor interaction, chemokine signaling pathway, and AMPK signaling pathway were enriched with HXMMT targets. Thus, HXMMT has more therapeutic targets shared by different active ingredients and more abundant gene functions than CXC, which may be two major reasons why HXMMT is more strongly recommended than CXC as an auxiliary treatment for new-onset VH secondary to PDR. However, the underlying mechanisms still need to be further explored.

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“…In addition, FXST also reduced the disorder and edema of the retinal structure, and improved the hemodynamics of the retina in diabetic rats. 9 In vitro and in vivo experiments have proved that FXST has beneficial effects on DR and may be a potential TCM compound formula for the treatment of DR.…”

Section: Compound Formulas Of Traditional Chinese Medicinementioning

confidence: 99%

“…However, most researchers believe that the main pathogenesis of DR involves inflammation, persistent hyperglycemia, angiogenesis, apoptosis, advanced glycation end products (AGEs), oxidative stress, and the interaction between these factors. 8,9 The clinical treatment of DR usually focuses on drugs, lasers, and surgery. However, these treatment methods have limitations and various complications.…”

Section: Introductionmentioning

confidence: 99%

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Progress in Traditional Chinese Medicine on Treatment of Diabetic Retinopathy

Xing

et al. 2022

Natural Product Communications

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Diabetic retinopathy (DR), a common and blinding diabetic microvascular complication, is a harmful metabolic effect caused by persistent hyperglycemia. Owing to the complex pathogenesis of DR, various clinical treatment methods cannot completely prevent its development and are accompanied by various complications. Therefore, there is an urgent need to identify new therapeutic drugs or complementary and alternative therapies. Traditional Chinese medicine (TCM) has the unique advantages of multi-level, multi-target, and minimal side effects. Accumulating evidence has proven that TCM may help delay or prevent the progression of DR. This paper reviews the effect and mechanism of representative TCMs (including extracts, identified compounds, and compound formulas) on DR in recent years and provides evidence for new drug development and clinical efficacy.

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Fufang Xueshuantong alleviates diabetic retinopathy by activating the PPAR signalling pathway and complement and coagulation cascades

Cited by 34 publications

References 29 publications

Effect of Chinese Patent Medicines on Ocular Fundus Signs and Vision in Calcium Dobesilate-Treated Persons With Non-Proliferative Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Effect of Chinese Patent Medicines on Ocular Fundus Signs and Vision in Calcium Dobesilate-Treated Persons With Non-Proliferative Diabetic Retinopathy: A Systematic Review and Meta-Analysis

Network Pharmacology-Based Approach to Comparatively Predict the Active Ingredients and Molecular Targets of Compound Xueshuantong Capsule and Hexuemingmu Tablet in the Treatment of Proliferative Diabetic Retinopathy

Progress in Traditional Chinese Medicine on Treatment of Diabetic Retinopathy

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