Chinese Herbal Medicines Attenuate Acute Pancreatitis: Pharmacological Activities and Mechanisms

Abstract

Acute pancreatitis (AP) is a commonly occurring gastrointestinal disorder. An increase in the annual incidence of AP has been observed, and it causes acute hospitalization and high mortality. The diagnosis and treatment guidelines for AP recommend conservative medical treatments focused on reducing pancreatic secretion and secondary injury, as a primary therapeutic approach. Unfortunately, the existing treatment options have limited impact on the incidence and severity of AP due to the complex and multifaceted pathological process of this disease. In recent decades, Chinese herbal medicines (CHMs) have been used as efficient therapeutic agents to attenuate AP in Asian countries. Despite early cell culture, animal models, and clinical trials, CHMs are capable of interacting with numerous molecular targets participating in the pathogenesis of AP; however, comprehensive, up-to-date communication in this field is not yet available. This review focuses on the pharmacological activities of CHMs against AP in vitro and in vivo and the underlying mechanisms. A computational prediction of few selected and promising plant-derived molecules (emodin, baicalin, resveratrol, curcumin, ligustrazine, and honokiol) to target numerous proteins or networks involved in AP was initially established based on a network pharmacology simulation. Moreover, we also summarized some potential toxic natural products for pancreas in order to more safe and reasonable medication. These breakthrough findings may have important implications for innovative drug research and the future development of treatments for AP.

Tetramethylpyrazine (TMP) protects rats against acute pancreatitis through NF-κB pathway

“…It has been used to treat cardiovascular and inflammatory diseases clinically in China for a long time [14]. It has recently found that TMP can ameliorate the damage to pancreas and intestine caused by AP [15,16]. However, the exact mechanism underlying the effect of TMP in AP has not been completely addressed.…”

A strategy for screening trypsin inhibitors from traditional Chinese medicine based on a monolithic capillary immobilized enzyme reactor coupled with offline liquid chromatography and mass spectrometry

“…Trypsin can activate additional pancreatic zymogens and protease zymogens, and regulate the proteolytic processes and function of pancreatic exocrine . It was reported that an excessive activity of trypsin could trigger the autodigestion of pancreatic tissues and result in pancreatitis and possible death .…”

“…; however, most TIs are proteins in nature . Historically, many traditional Chinese medicines (TCMs) have demonstrated their efficacy in pancreatitis treatment , and some of them have proved to have trypsin inhibitory activity . These facts demonstrated that TCMs could be an important potential source of TIs.…”

Emodin in Severe Acute Pancreatitis Treatment

“…The treatment of severe acute pancreatitis includes surgery and non-surgical measure. At present, it is thought that better effects of treatment can be achieved by combining rhubarb extracts or compound rhubarb preparation to medical treatment, which can effectively relieve clinical symptoms, reduce complications and mortality [3]. In this paper, the effects and mechanisms of emodin, a major effective ingredient of rhubarb, in the treatment of severe acute pancreatitis is reviewed.…”