Xuebijing in the treatment of patients with sepsis

Shi, Heng; Hong, Yun; Qian, Jianfang; Cai, Xuan; Chen, Shanwen

doi:10.1016/j.ajem.2016.11.007

Cited by 39 publications

(34 citation statements)

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“…The functional analysis by IPA predicted that XBJ targets signaling pathways involved in organ damage and cell death (Figures 4C, D). This is consistent with clinical observations (Shi et al, 2017;Song et al, 2018). Thus, we hypothesized that XBJ improves the survival of C. albicans-infected mice partially through protecting kidneys.…”

Section: Xuebijing Prevented C Albicans-induced Septic Shock In a Musupporting

confidence: 93%

“…XBJ has been approved to treat multiple organ dysfunction syndrome and sepsis in China for over a decade (Gao et al, 2015;Shi et al, 2017). A Meta-analysis by Song et al demonstrated that combining XBJ with conventional intervention is superior to conventional intervention alone in treating MODS (Song et al, 2018).…”

Section: Xbj and Organ Failurementioning

confidence: 99%

“…It improves microcirculation partially by inhibiting blood-clotting to prevents/treats organ injuries (Wang et al, 2015;Xu et al, 2015;Jin et al, 2018). This is reflected in reversing abnormalities of metabolic biomarkers in sepsis (Shi et al, 2017).…”

Section: Xbj and Organ Failurementioning

confidence: 99%

“…Xuebijing (XBJ) injection was prepared with extracts from five different Chinese herbs [Carthamus tinctorius flowers (Honghua), Paeonia lactiflora roots (Chishao), Ligusticum chuanxiong rhizomes (Chuanxiong), Angelica sinensis roots (Danggui), and Salvia miltiorrhiza roots (Danshen)] (Cheng et al, 2016;Li et al, 2016;Li et al, 2019;Zhang et al, 2018). Approved by the Food and Drug Administration of China in 2004, XBJ has been frequently used as an add-on therapy for multiple organ dysfunction syndromes, sepsis, and septic shock in China for over a decade (Chen et al, 2018a;Gao et al, 2015;Shi et al, 2017). It rendered a series of benefits for sepsis patients, including reducing 28-day mortality and incidence of complications, shortening dwelling time in the intensive care unit (Gao et al, 2015;Shi et al, 2017;Song et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Approved by the Food and Drug Administration of China in 2004, XBJ has been frequently used as an add-on therapy for multiple organ dysfunction syndromes, sepsis, and septic shock in China for over a decade (Chen et al, 2018a;Gao et al, 2015;Shi et al, 2017). It rendered a series of benefits for sepsis patients, including reducing 28-day mortality and incidence of complications, shortening dwelling time in the intensive care unit (Gao et al, 2015;Shi et al, 2017;Song et al, 2019). Preclinical studies indicated XBJ might be a treatment option for sepsis and septic shock individually (Jiang et al, 2013;Chen et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Xuebijing Injection Maintains GRP78 Expression to Prevent Candida albicans–Induced Epithelial Death in the Kidney

Shang

Ren

et al. 2020

Front. Pharmacol.

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Sepsis and septic shock threaten the survival of millions of patients in the intensive care unit. Secondary fungal infections significantly increased the risk of mortality in sepsis patients. Chinese medicine Xuebijing injection (XBJ) has been routinely used as an add-on treatment to sepsis and septic shock in China. Our network pharmacology analysis predicted that XBJ also influences fungal infection, consisting with results of pioneer clinical studies. We conducted in vivo and in vitro experiments to verify this prediction. To our surprise, XBJ rescued mice from lethal Candida sepsis in a disseminated Candida albicans infection model and abolished the colonization of C. albicans in kidneys. Although XBJ did not inhibit the growth and the virulence of C. albicans in vitro, it enhanced the viability of 293T cells upon C. albicans insults. Further RNA-seq analysis revealed that XBJ activated the endoplasmic reticulum (ER) stress pathway upon C. albicans infection. Western blot confirmed that XBJ maintained the expression of GRP78 in the presence of C. albicans. Interestingly, key active ingredients in XBJ (C0127) mirrored the effects of XBJ. C0127 not only rescued mice from lethal Candida sepsis and prevented the colonization of C. albicans in kidneys, but also sustained the survival of kidney epithelial cells partially by maintaining the expression of GRP78. These results suggested that XBJ may prevent fungal infection in sepsis patients. Pre-activation of ER stress pathway is a novel strategy to control C. albicans infection. Network pharmacology may accelerate drug development in the field of infectious diseases.

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Section: Xuebijing Prevented C Albicans-induced Septic Shock In a Musupporting

confidence: 93%

Section: Xbj and Organ Failurementioning

confidence: 99%

Section: Xbj and Organ Failurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Xuebijing Injection Maintains GRP78 Expression to Prevent Candida albicans–Induced Epithelial Death in the Kidney

Shang

Ren

et al. 2020

Front. Pharmacol.

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Effect of an Herbal-Based Injection on 28-Day Mortality in Patients With Sepsis

et al. 2023

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ImportancePrevious research has suggested that Xuebijing injection (XBJ), an herbal-based intravenous preparation, may reduce mortality among patients with sepsis.ObjectiveTo determine the effect of XBJ vs placebo on 28-day mortality among patients with sepsis.Design, Setting, and ParticipantsThe Efficacy of Xuebijing Injection in Patients With Sepsis (EXIT-SEP) trial was a multicenter, randomized double-blind, placebo-controlled trial conducted in intensive care units at 45 sites and included 1817 randomized patients with sepsis (sepsis 3.0) present for less than 48 hours. Patients aged 18 to 75 years with a Sequential Organ Failure Assessment score of 2 to 13 were enrolled. The study was conducted from October 2017 to June 2019. The final date of follow-up was July 26, 2019. Data analysis was performed from January 2020 to August 2022.InterventionsThe patients were randomized to receive either intravenous infusion of XBJ (100 mL, n = 911) or volume-matched saline placebo (n = 906) every 12 hours for 5 days.Main Outcomes and MeasuresThe primary outcome was 28-day mortality.ResultsAmong the 1817 patients who were randomized (mean [SD] age, 56.5 [13.5] years; 1199 [66.0%] men), 1760 (96.9%) completed the trial. In these patients, the 28-day mortality rate was significantly different between the placebo group and the XBJ group (230 of 882 patients [26.1%] vs 165 of 878 patients [18.8%], respectively; P &lt; .001). The absolute risk difference was 7.3 (95% CI, 3.4-11.2) percentage points. The incidence of adverse events was 222 of 878 patients (25.3%) in the placebo group and 200 of 872 patients (22.9%) in the XBJ group.Conclusions and RelevanceIn this randomized clinical trial among patients with sepsis, the administration of XBJ reduced 28-day mortality compared with placebo.Trial RegistrationClinicalTrials.gov Identifier: NCT03238742

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