Oral administration of leeches (Shuizhi): A review of the mechanisms of action on antiplatelet aggregation

Qiu, Jiamin; Wang, Ling-Na; Hu, Jing‐Hong; Yong-qing, Zhang

doi:10.1016/j.jep.2018.12.010

Cited by 22 publications

(7 citation statements)

References 53 publications

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“…The pharmacological effects and mechanism of traditional Chinese medicines with the effect of activating blood circulation and resolving stasis, such as Salvia miltiorrhiza, safflower, ginkgo biloba, leech, Chuanxiong rhizoma, etc., have been studied. Blood-vitalizing herbal medicine can improve blood rheology, hemodynamics, microcirculation, vascular regeneration, and antithrombosis through antiimproving hemodynamics antiplatelet effect, etc., effectively prevent the further development of PNS (Shu et al, 2006;Li and Wang, 2010;Qiu et al, 2018;MEIm et al, 2019). The results of this study indicated that WM alone was not as effective as WM+CHIs in the multiple group comparisons of six outcomes, such as total clinical effectiveness, 24-h urinary protein excretion, serum albumin, and lipids.…”

Section: Discussionmentioning

confidence: 82%

Efficacy of Chinese Herbal Injections for the Treatment of Primary Nephrotic Syndrome: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Han

Wei

et al. 2020

Front. Pharmacol.

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Background: Considering the adverse reactions and side effects of immunosuppressive and cytotoxic drugs for the treatment of Primary Nephrotic Syndrome (PNS) and the extensive exploration of Chinese herbal injections (CHIs), systematic evaluation of the efficacy of different CHIs in the treatment of PNS is a key imperative. In this study, we performed a network meta-analysis to investigate the efficacy of CHIs in the treatment of PNS. Methods: A systematic literature review including studies published from the establishment of each database to May 28, 2020, was conducted in PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Biological Medicine Literature Service System (CBM), the China National Knowledge Infrastructure (CNKI) database, the Chinese Scientific Journal Database (VIP), and the Wanfang Database (WF).Two evaluators independently screened the literature, extracted data and the Cochrane Reviewer's Handbook 5.1 method was used to evaluate the quality of included studies. The differences in efficacy of different CHIs were compared and ranked using Stata 16.0 software. Surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. Clustering analysis was performed to compare the effects of CHIs between two different outcomes. Results: A total of 41 eligible randomized controlled trials involving 2879 patients and nine CHIs were included. Nine CHIs were Xiangdan injection (XDI), Huangqi injection (HQI), Shenkang injection (SKI), Danshen injection (DSI), Yinxingdamo injection (YXI), Dengzhanhuasu injection (DZI), Danhong injection (DHI), Shuxuetong injection (SXI), Chuanxiongqin injection (CXI). The results of the network meta-analysis showed that: with Western medical (WM) treatment as a co-intervention, in terms of improving the total clinical effectiveness and serum albumin level, DHI was the most likely to be the best choice for treatment (SUCRA = 82.2%); YXI had the highest probability of being the best option in terms of reducing 24-h urinary protein excretion (SUCRA = 97.8%);

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Section: Discussionmentioning

confidence: 82%

Efficacy of Chinese Herbal Injections for the Treatment of Primary Nephrotic Syndrome: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Han

Wei

et al. 2020

Front. Pharmacol.

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“…Whereas, vasoactive mediators such as ET-1, Ang Ⅱ and TXA 2 were play a negative role in vascular endothelial functions. They hurt blood vessel by promoting platelet aggregation, provoking vasoconstriction, increasing oxidative stress as well as promoting inflammation 6-8. In current experiment, to explore the effects of TPE-CA on HHcy-induced vascular endothelial dysfunction, abovementioned five vasoactive mediators were measured.…”

Section: Discussionmentioning

confidence: 98%

“…Among which, NO and PGI 2 are two potent endogenous vasodilators synthesized separately by endothelial nitric oxide synthase (eNOS) and prostacyclin synthase (PGIS) in vascular endothelium, and play a critical role as regulator of vascular function 4, 5. TXA 2 is synthesized by thromboxane A 2 synthase (TXAS), which acts as a predominant platelet agonist and vasoconstrictor, and promotes platelet aggregation and vasoconstriction 6. ACE plays an essential role in regulation of the vasculature homeostasis.…”

Section: Introductionmentioning

confidence: 99%

Vascular Protection of TPE-CA on Hyperhomocysteinemia-induced Vascular Endothelial Dysfunction through AA Metabolism Modulated CYPs Pathway

Liu

et al. 2019

Int. J. Biol. Sci.

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A high concentration of homocysteine (Hcy) in plasma induces vascular endothelial dysfunction, and it may ultimately accelerate the development of cardiovascular diseases (CVDs). Although several B vitamins have been clinically applied for hyperhomocysteinemia (HHcy) treatment, the outcomes are not satisfied due to their limited therapeutic mechanism. Hence, in order to improve the curative effect, development of new effective therapeutic strategies should be put on the agenda. Total phenolic extracts of Citrus aurantium L. (TPE-CA) is a naturally obtained phenolic mixture, mainly containing flavones, flavanones and their glycosyl derivatives, flavonols, polymethoxyflavones and coumarins. Previous reports indicated that bioactive phenolic compounds possessed potent vascular protective effects and regarded as a protective agent against CVDs. Intriguingly, the exact mechanism underlying the suppressed effects of TPE-CA on HHcy could assist in revealing their therapy on CVDs. Here, the multi-targeted synergistic mechanism of TPE-CA on HHcy-induced vascular endothelial dysfunction was uncovered in a deduced manner. TPE-CA treatment exhibited an obvious superiority than that of B vitamins treatment. Network pharmacology was employed to identify the interrelationships among compounds, potential targets and putative pathways. Further experimental validation suggested that the treatment of TPE-CA for HHcy could not only effectively reduce the Hcy level in plasma through up-regulating transsulfuration pathway in Hcy metabolism, but also restore the HHcy-induced vascular endothelial dysfunction by activating cytochrome P450 enzymes (CYPs) epoxygenase signal cascades and inhibiting CYPs hydroxylase signal cascades in arachidonic acid (AA) metabolism.

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“…As proven in the previous studies, the most important agent of leech saliva involved in the coagulation process is hirudin which is comparable with heparin [ 19 ]. Qiu et al (2018) have investigated the antiplatelet aggregation effects of leech and found that prevention of ADP-induced platelet aggregation, reducing the amount of Ca2+ and TXA2, the increment of PGI2 are several mechanisms involved in antiplatelet aggregation [ 54 ]. In research conducted by Mousavi et al (2016), the effects of Hirudo therapy and heparin treatment in hindlimb acute venous congestion of rat were evaluated and concluded that leech therapy remarkably reduced edema, blood levels of creatine phosphokinase, tissue damage, and overall leech therapy was more effective in decreasing the cellular damages triggered by acute congestion [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model

et al. 2021

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Background Testicular torsion/detorsion triggers tissue ischemia/reperfusion, leading to reactive oxygen species overgeneration and apoptosis. The saliva of leeches is full of anti-inflammatory, anticoagulants, antioxidants, and antimicrobial agents. Therefore, this study aimed to assess the protective mechanism of leech therapy on testicular ischemia/reperfusion damage. Methods 18 adult male rats were randomly divided into three groups: 1-Sham-operated group (SO). 2-Torsion/detorsion (T.D) group: two hours of testicular torsion with two hours of testicular detorsion was performed. 3-Torsion/detorsion + Leech therapy (TDL) group. Sperm parameters (motility, vitality, morphology, and concentration), oxidative stress biomarkers (MDA, CAT, GPx, and TAC), histopathological factors (Mean seminiferous tubular diameter, Germinal epithelial cell thickness, Testicular capsule thickness, Johnson’s score, and Cosentino’s score), and immunohistochemical markers for apoptosis detection (Bax, Bcl-2, and Caspase-3) were measured. Results There was a significant difference for all sperm parameters in the T. D group compared to the sham group. Leech therapy significantly increased progressive motility and normal morphology and reduced non-progressive motility. In the TDL group, MDA concentration significantly reduced, and levels of GPx, TAC, and CAT remarkably increased. All evaluated histopathological parameters in the TDL group significantly increased compared to the T. D group except for the testicular capsule thickness. T. D notably increased the expression of Bax and Caspase-3, while the treatment group slowed the rate of apoptosis compared to the control group. Bcl-2 expression in the T. D group was significantly lower than that in the sham group. Leech therapy increased the Bcl-2 expression. Conclusion Leech therapy attenuates damages to testicular tissue following torsion/detorsion due to its antioxidant, anti-inflammatory, and anti-apoptotic effects. Hence, it can be considered as an effective remedy for testicular ischemia/reperfusion. Graphical abstract

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Oral administration of leeches (Shuizhi): A review of the mechanisms of action on antiplatelet aggregation

Cited by 22 publications

References 53 publications

Efficacy of Chinese Herbal Injections for the Treatment of Primary Nephrotic Syndrome: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Efficacy of Chinese Herbal Injections for the Treatment of Primary Nephrotic Syndrome: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Vascular Protection of TPE-CA on Hyperhomocysteinemia-induced Vascular Endothelial Dysfunction through AA Metabolism Modulated CYPs Pathway

Leech therapy (Hirudo medicinalis) attenuates testicular damages induced by testicular ischemia/reperfusion in an animal model

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