The characteristics and prescription patterns of Chinese herbal medicine in clinical practice for the treatment of anemia

Chen, Wei-Di; Huang, Hui-Ting; Su, Yi‐Chang; Chou, Shih‐Chien; Ho, Wen‐Chao; Kao, Ming‐Ching; Lin, Hung-Jen; Huang, Sheng‐Teng

doi:10.1016/j.tjog.2018.06.030

Cited by 17 publications

(17 citation statements)

References 30 publications

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“…Traditional Chinese medicine (TCM) plays a unique role in the treatment of many diseases, and a growing body of evidence has shown that TCM is increasingly being used for preventing CKD and anemia [ 13 – 15 ]. Jian-Pi-Yi-Shen (JPYS), a Chinese herbal formula, is composed of eight medicinal herbs, that is, Astragali Radix, Atractylodis Macrocephalae Rhizoma, Amomi Fructus Rotundus, Dioscoreae Rhizoma, Cistanches Herba, Rhei radix et Rhizoma, Salviae miltiorrhizae Radix et Rhizoma, and Glycyrrhizae radix et Rhizoma Praeparata cum Melle.…”

Section: Introductionmentioning

confidence: 99%

Jian‐Pi‐Yi‐Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor‐2α via ERK Signaling

Wang

Hou

Huang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Jian-Pi-Yi-Shen (JPYS), the traditional Chinese medicine (TCM) decoction, has been commonly used to treat chronic kidney disease (CKD) and its complications such as anemia. JPYS has been previously found to induce erythropoietin (EPO) production in HEK293T cells and CKD rats. However, the mechanism of JPYS in treating anemia of CKD rats has remained largely unknown. Here, we further extend our effort to investigate the translational control of hypoxia inducible factor- (HIF-) α protein via ERK signaling and the effect on iron recycling-related protein expression by JPYS, thus revealing the mechanism of JPYS in correcting anemia in CKD. Experimental CKD rats with anemia were induced by 5/6 nephrectomy. Rats were administrated orally with high dose (6.0 g/kg/d) and low dose (1.5 g/kg/d) of JPYS for 90 days. Serum hepcidin level was determined to evaluate iron homeostasis. The protein expressions of HIF-2α, erythropoietin (EPO), ferritin, and ferroportin (FPN) and the phosphorylation level of extracellular signal-regulated kinase 1/2 (ERK1/2) were detected by Western blot. The results showed that JPYS treatment significantly ameliorated kidney function by reducing increased levels of blood urea nitrogen (BUN), serum creatinine (Scr), and urine protein (UPRO). Periodic acid-Schiff (PAS) and Masson staining observation showed that the renal pathological damage was restored in JPYS-treated CKD rats. In parallel, JPYS markedly improved CKD anemia through upregulation of red blood cell (RBC), hemoglobin (HGB), and hematocrit (HCT). JPYS stimulated EPO and HIF-2α protein expressions in both the kidney and liver of CKD rats. Furthermore, JPYS induced the phosphorylation of ERK1/2 protein. In addition, JPYS regulated protein expression of ferritin and FPN in both the liver and spleen of CKD rats and the serum level of hepcidin. In conclusion, JPYS induces the expression of EPO through ERK-mediated HIF-2α protein accumulation and regulates systemic iron recycling, supporting its role in promoting erythropoiesis and improvement of anemia in CKD.

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Section: Introductionmentioning

confidence: 99%

Jian‐Pi‐Yi‐Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor‐2α via ERK Signaling

Wang

Hou

Huang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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“…Chinese herbal medicine (CHM) has been widely used to treat anemia (Bradley et al, 1999;Chen et al, 2018). According to Traditional Chinese Medicine (TCM) theory, blood deficiency is the main feature of anemia and spleen and kidney deficiencies are the basic pathological features.…”

Section: Introductionmentioning

confidence: 99%

Effects of Jianpi Bushen Therapy for Treatment of CKD Anemia: A Meta-Analysis of Randomized Controlled Trials

Zhou

et al. 2020

Front. Pharmacol.

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Objectives: To evaluate the efficacy of Traditional Chinese Medicine, specifically Jianpi Bushen (JPBS) therapy, for treatment of patients with chronic kidney disease (CKD) anemia. Methods: Randomized controlled trials of JPBS therapy for CKD anemia were searched and selected from seven electronic databases. The Cochrane collaboration tool was used to conduct methodological quality assessment. RevMan v5.3 software was utilized to perform data analysis. Results: In total, 12 randomized controlled trials with 799 patients met the meta-analysis criteria. The aggregated results indicated that JPBS therapy is beneficial for CKD anemia by improving the clinical efficacy rate [risk ratio (RR) = 1.23, 95% confidence interval (CI): (1.14, 1.33), P < 0.00001] and hemoglobin (Hb) [weighted mean difference (WMD) = 9.

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“…Traditional Chinese medicine (TCM) plays a unique role in the treatment of many diseases, and a growing body of evidence has shown that TCM is increasingly being used for preventing CKD and anemia [8][9][10]. Jian-Pi-Yi-Shen improved the anemia symptoms by increasing the serum EPO level and hypoxia inducible factor (HIF)-α protein in 5/6 nephretomized rats [11,12].…”

Section: Introductionmentioning

confidence: 99%

Jian-Pi-Yi-Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor-2α via ERK Signaling

Wang

Huang

et al. 2020

Preprint

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Background: Jian-Pi-Yi-Shen (JPYS), the traditional Chinese medicine (TCM) decoction has been commonly used to treat chronic kidney disease (CKD) and its complications such as anemia. JPYS has been previously found to induce erythropoietin (EPO) production in HEK293T cells and CKD rats. However, the mechanism of JPYS in treating anemia of CKD rats has remained largely unknown. Here, we further extend our effort to investigate the translational control of hypoxia inducible factor (HIF)-α protein via ERK signaling and the effect on iron recycling related protein expression by JPYS, thus revealing the mechanism of JPYS in correcting anemia in CKD. Methods: Experimental CKD rats with anemia were induced by 5/6 nephrectomy. Rats were administrated orally with high dose (6.0 g/kg/d) and low dose ( 1.5 g/kg/d ) of JPYS for 90 days. Serum hepcidin level was determined to evaluate iron homeostasis. Protein expressions of HIF-2α, erythropoietin (EPO), ferritin and ferroportin (FPN), as well as the phosphorylation level of extracellular signal regulated kinase 1/2 (RK1/2) were detected by Western blot. Results: Our data showed that JPYS treatment significantly ameliorated kidney function by reducing increased levels of blood urea nitrogen (BUN), serum creatinine (Scr) and the urine protein (UPRO). Periodic acid-Schiff (PAS) and Masson staining observation showed that the renal pathological damage was restored in JPYS-treated CKD rats. In parallel, JPYS markedly improved CKD anemia through up-regulation of red blood cell (RBC), hemoglobin (HGB) and haematocrit (HCT). JPYS stimulated EPO and HIF-2α protein expression in both kidney and liver of CKD rats. Furthermore, JPYS induced the phosphorylation of ERK1/2 protein. In addition, JPYS regulated protein expressions of ferritin and FPN in both liver and spleen of CKD rats, as well as serum level of hepcidin. Conclusions: JPYS induces the expression of EPO through ERK-mediated HIF-2α protein accumulation, and regulates systemic iron recycling, supporting its role in promoting erythropoiesis and improvement of anemia in CKD.

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The characteristics and prescription patterns of Chinese herbal medicine in clinical practice for the treatment of anemia

Cited by 17 publications

References 30 publications

Jian‐Pi‐Yi‐Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor‐2α via ERK Signaling

Jian‐Pi‐Yi‐Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor‐2α via ERK Signaling

Effects of Jianpi Bushen Therapy for Treatment of CKD Anemia: A Meta-Analysis of Randomized Controlled Trials

Jian-Pi-Yi-Shen Regulates EPO and Iron Recycling Protein Expressions in Anemic Rats with Chronic Kidney Disease: Accumulation of Hypoxia Inducible Factor-2α via ERK Signaling

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