Efficacy and safety of Zuogui Pill in treating osteoporosis

Chen, Guo-Ming; Zhang, Zhaoping; Liu, Yunyun; Lu, Jiaxin; Qi, Xiangjun; Fang, Caishan; Zhou, Chi

doi:10.1097/md.0000000000013936

Cited by 6 publications

(8 citation statements)

References 27 publications

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“…In our meta‐analyses, the primary outcome was fracture incidence. However, the primary outcome in a newly published study protocol of a systematic review by Chen et al (Chen et al, 2019) was BMD. Nevertheless, more detailed indicators and subgroup analyses are provided in our review.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula

Sun

et al. 2020

Phytotherapy Research

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The aim of this study is to systematically evaluate existing evidence of the Chinese herbal formula, Zuogui pill (ZGP), for the treatment of osteoporosis. A systematic literature search was performed in six electronic databases. The authors independently extracted data in pairs and evaluated the risk of bias. A total of 221 articles were identified initially, of which 12 relevant studies were enrolled. The primary outcome was fracture incidence and bone mineral density (BMD) at different sites. Bone metabolism markers, clinical symptoms, quality of life, and adverse events or adverse drug reactions (ADRs) were secondary outcomes. The results showed that ZGP, combined with anti‐osteoporosis drugs, significantly increased BMD at the lumbar spine, Ward's area, and total hip. In terms of markers for improved bone metabolism, ZGP plus conventional drugs dramatically improved the levels of alkaline phosphatase, bone Gla protein, bone alkaline phosphatase, and tartrate‐resistant acid phosphatase. Gastrointestinal discomfort, dizziness, and fatigue were found in the combined therapy group. Although the results indicate that ZGP is a potential candidate for osteoporosis, evidence remains insufficient. Further rigorously designed and high‐quality trials with a larger sample size are warranted to verify the current conclusions.

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Section: Discussionmentioning

confidence: 99%

An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula

Sun

et al. 2020

Phytotherapy Research

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“…Interestingly, the mRNA expression of IL-1β and IL-17A in the epithelium and lamina propria of the mucosal layer of the ileum and cecum also showed differential regulation of the enteric mucosal immune responses between the CIA and control groups. The published data have shown that CIA induction increases the levels of the proinflammatory cytokines IL-1β and IL-17A ( Chen et al, 2019 ; Hui et al, 2019 ). IL-17A is the primary cytokine of Th17 cells ( Maddur et al, 2012 ), and IL-1β can induce IL-17A secretion from CD4 + T cells, which have been implicated in the pathogenesis of RA ( Yang et al, 2008 ).…”

Section: Discussionmentioning

confidence: 99%

Regional Differences in the Gut Microbiota and Gut-Associated Immunologic Factors in the Ileum and Cecum of Rats With Collagen-Induced Arthritis

Cao

et al. 2020

Front. Pharmacol.

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Rheumatoid arthritis (RA) is a common autoimmune disease characterized by chronic inflammation and a multifactorial etiology. We previously showed that gut microbiota dysbiosis in the rat ileum is involved in the development of collagen-induced arthritis (CIA). The gut microbiota in the distinct gastrointestinal tract (GIT) plays region-specific roles, but information on the different roles of the microbiota in distinct GIT compartments of CIA rats is limited. This study aimed to evaluate the region-specific differences in the gut microbial communities and certain gut-associated immunologic factors in the ileum and cecum of CIA rats. Ileal and cecal digesta were collected from CIA and control rats for microbiome analysis. We determined the microbial richness, diversity and taxa as well as the expression of interleukin (IL)-1β and IL-17A in the epithelium and lamina propria of the ileum and cecum mucosal layers. The CIA-induced microbiota alterations in the ileum differed from those in the cecum. The ileal microbiota were more markedly influenced in CIA, as revealed by sharp reductions in the abundances of the families Enterococcaceae, Lactobacillaceae and Streptococcaceae and the genera Lactobacillus and Lactococcus. Moreover, significant increases in IL-1β, and IL-17A mRNA expression were detected in only the ileal epithelium and lamina propria of the mucosal layer. Therefore, the microbial characteristics in the ileum were consistent with the immune-mediated inflammatory features of CIA, suggesting that the ileal microbiota might better represent the CIA-induced inflammatory responses than the cecal microbiota and that these responses might partially impact the progression of RA by regulating intestinal mucosal immunity.

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“…Then, the Kyoto Encyclopedia of Genes and Genomes pathway and Gene Ontology (GO) analyses were used to validate the CRN and effective proteins. (6) The TCC model was designed to select the core active component group (CACG) from the critical network. (7) Underlying EXD mechanisms for OP were deduced based on CACG.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, it is necessary to find new alternative treatments with less side effects in the treatment of osteoporosis. Traditional Chinese Medicine (TCM) approaches have been successfully used to treat OP, including Erxian Decoction [3][4][5], Zuogui Pill [6][7][8], and Liuwei Dihuang Pill [9][10][11]. A recesnt meta-analysis of 644 patients with OP showed that EXD was therapeutically beneficial [12] and its different components elicited curative effects toward OP [5,13,14].…”

Section: Introductionmentioning

confidence: 99%

“…(5) A node importance calculation method was then designed to capture the critical response network (CRN) and effective proteins. Then, the Kyoto Encyclopedia of Genes and Genomes pathway and Gene Ontology (GO) analyses were used to validate the CRN and effective proteins (6). The TCC model was designed to select the core active component group (CACG) from the critical network (7).…”

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confidence: 99%

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Analysis of Molecular Mechanism of Erxian Decoction in Treating Osteoporosis Based on Formula Optimization Model

Yang

Fan

Wang

et al. 2021

Oxidative Medicine and Cellular Longevity

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Osteoporosis (OP) is a highly prevalent orthopedic condition in postmenopausal women and the elderly. Currently, OP treatments mainly include bisphosphonates, receptor activator of nuclear factor kappa-B ligand (RANKL) antibody therapy, selective estrogen receptor modulators, teriparatide (PTH1-34), and menopausal hormone therapy. However, increasing evidence has indicated these treatments may exert serious side effects. In recent years, Traditional Chinese Medicine (TCM) has become popular for treating orthopedic disorders. Erxian Decoction (EXD) is widely used for the clinical treatment of OP, but its underlying molecular mechanisms are unclear thanks to its multiple components and multiple target features. In this research, we designed a network pharmacology method, which used a novel node importance calculation model to identify critical response networks (CRNs) and effective proteins. Based on these proteins, a target coverage contribution (TCC) model was designed to infer a core active component group (CACG). This approach decoded the mechanisms underpinning EXD’s role in OP therapy. Our data indicated that the drug response network mediated by the CACG effectively retained information of the component-target (C-T) network of pathogenic genes. Functional pathway enrichment analysis showed that EXD exerted therapeutic effects toward OP by targeting PI3K-Akt signaling (hsa04151), calcium signaling (hsa04020), apoptosis (hsa04210), estrogen signaling (hsa04915), and osteoclast differentiation (hsa04380) via JNK, AKT, and ERK. Our method furnishes a feasible methodological strategy for formula optimization and mechanism analysis and also supplies a reference scheme for the secondary development of the TCM formula.

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Efficacy and safety of Zuogui Pill in treating osteoporosis

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 27 publications

An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula

An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula

Regional Differences in the Gut Microbiota and Gut-Associated Immunologic Factors in the Ileum and Cecum of Rats With Collagen-Induced Arthritis

Analysis of Molecular Mechanism of Erxian Decoction in Treating Osteoporosis Based on Formula Optimization Model

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