Meta-Analysis of the Effects of Xingnaojing Injection on Consciousness Disturbance

Wu, Lijun; Zhang, Hua; Xing, Yanwei; Gao, Yonghong; Li, Yanda; Ren, Xiaomeng; Jiang, Li; Nie, Bo; Zhu, Li; Shang, Hongcai; Gao, Ying

doi:10.1097/md.0000000000002875

Cited by 21 publications

(15 citation statements)

References 5 publications

(5 reference statements)

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“…AGNH is widely used in acute cerebrovascular conditions including stroke, encephalitis and meningitis for hundreds of years ( Guo et al, 2014 ; Wu et al, 2016 ; Fu et al, 2017 ). However, due to the well-known hepatorenal toxicity of cinnabar and realgar in AGNH, it has been controversial for the usage of AGNH in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

UPLC/Q-TOFMS-Based Metabolomics Approach to Reveal the Protective Role of Other Herbs in An-Gong-Niu-Huang Wan Against the Hepatorenal Toxicity of Cinnabar and Realgar

Xia

Chai³

et al. 2018

Front. Pharmacol.

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An-Gong-Niu-Huang Wan (AGNH) is a well-known traditional Chinese medicine (TCM) recipe containing cinnabar (HgS) and realgar (As2S2). However, the application of AGNH is limited by the hepato- and nephrotoxicity of cinnabar and realgar. It should be noted that cinnabar and realgar in AGNH are not used alone, but rather combined with other herbs as formula to use. In this study, the protective effects and mechanisms of the other herbs in AGNH against the hepatorenal toxicity induced by cinnabar and realgar were investigated. The combination use of the other herbs in AGNH alleviated inflammatory cell infiltration and damage in the liver and kidney and restored the disturbed serum metabolic profile induced by cinnabar and realgar insults. By UPLC/Q-TOFMS combined with pattern recognition approaches, we identified 41 endogenous metabolites in the sera of mice that were related to the hepatorenal toxicity of cinnabar and realgar, 36 of which were restored to normal levels when various kinds of herbs were combined as compound recipe. These metabolites function as modulators in inflammation-associated glycerophospholipid, arachidonic acid, linoleic acid, sphingolipid, and ether lipid metabolic pathways. Notably, lysophosphatidylcholines (LysoPCs) were the most elevated among all of the metabolites detected after cinnabar and realgar treatment, while these LysoPCs did not show overt differences between the AGNH and saline control groups, which was associated with relatively unaffected or even up-regulated expression of lysophosphatidylcholine acyltransferase 1 (LPCAT1) and autotaxin (ATX). These findings indicated that other herbs in AGNH could have a protective effect against cinnabar- and realgar-induced hepatic and renal damage via modulating the disordered homeostasis of the glycerophospholipid, arachidonic acid, linoleic acid, ether lipid, and sphingolipid metabolism.

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Section: Discussionmentioning

confidence: 99%

UPLC/Q-TOFMS-Based Metabolomics Approach to Reveal the Protective Role of Other Herbs in An-Gong-Niu-Huang Wan Against the Hepatorenal Toxicity of Cinnabar and Realgar

Xia

Chai³

et al. 2018

Front. Pharmacol.

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“…The commercialized injectable product of Xingnaojing Injection was extracted and refined scientifically from classic Chinese emergency prescription "Angong Niuhuang Pill", it had the functions of clearing heat and detoxication, cooling blood and activating blood circulation, inducing resuscitation and widely used in the treatment of intracerebral haemorrhage, cerebral ischemia, and nervous system disorders in China [78][79][80]. In view of critical cases with COVID-19 might suffer from consciousness disturbance, Xingnaojing Injection had major biological effects to relax the cerebral vascular and protect the mature neuron, in vivo and in vitro research, it was confirmed that the mechanism of cerebrovascular protection might be relevant to the activation of PI3K/ Akt/eNOS signaling pathways and the suppression of NLRP3 inflammasomes [81,82].…”

Section: Therapeutic Potentials For Severe or Critical Patientsmentioning

confidence: 99%

The clinical benefits of Chinese patent medicines against COVID-19 based on current evidence

Zhang

et al. 2020

Pharmacological Research

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The outbreak of emerging infectious pneumonia caused by 2019 Novel Coronavirus (2019-nCoV) has posed an enormous threat to public health, and traditional Chinese medicine (TCM) have made vast contribution to the prevention, treatment and rehabilitation of coronavirus disease 19 (COVID-19) among Chinese population. As an indispensable part of TCM, Chinese patent medicines (CPMs) are highly valued and critically acclaimed in their campaign to contain and tackle the epidemic, they can achieve considerable effects for both suspected cases under medical observation period, and confirmed individuals with serious underlying diseases or critical conditions. Given this, based on the Guideline on Diagnosis and Treatment of Coronavirus Disease 2019 in China, the present review summarized the basic information, clinical evidence and published literatures of recommended CPMs against COVID-19. The details were thoroughly introduced involving compositions, therapeutic effects, clinical indications, medication history of CPMs and the profiles of corresponding research. With regard to infected patients with different stages and syndrome, the preferable potentials and therapeutic mechanism of CPMs were addressed through the comprehensive collection of relevant literatures and ongoing clinical trials. This study could provide an insight into clinical application and underlying mechanism of recommended CPMs against COVID-19, with the aim to share the Chinese experience in clinical practice and facilitate scientific development of TCM, especially CPMs in the fierce battle of COVID-19. million confirmed cases with COVID-19 worldwide, of these, a total of 277,965 subjects were from the United States [13,14]. According to official release on April 4, 2020 by National Health Commission of the People's Republic of China, more than 80,000 cases had been confirmed as COVID-19 with 3326 death cases [15]. Currently, the global pandemic of COVID-19 continues to accelerate and escalate, the health-care systems of different countries are beavering away to contain the virus, therefore, there is urgent need to seek for effective or adjuvant therapies with excellent safety profiles against COVID-19 [16-18]. In the theory of traditional Chinese medicine (TCM), 2019-nCoV infected pneumonia was deemed to the category of "Pestilence", and the characteristics of its pathogenesis was "dampness, toxin, stasis and closure" [19,20]. Over the past few months, TCM exhibited remarkable benefits against COVID-19 in China, and it was convinced that TCM achieved satisfactory therapeutic superiority for patients infected by 2019-nCoV with regard to preventive treatment of diseases, comprehensive therapies and rehabilitation by the

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“…Quality control results confirm the reliability of clinical XNJ preparations. Both clinical trials and basic experiments have shown that XNJ can improve brain injury, promote consciousness recovery, and provide neuroprotective effects in stroke (Xu et al 2014;Wu L et al 2016;Ma et al 2017;Zhang et al 2018). However, the specific effects and mechanisms of XNJ on the cerebral I/R remains unclear, which limits further clinical application.…”

Section: Introductionmentioning

confidence: 99%

XingNaoJing injection ameliorates cerebral ischaemia/reperfusion injury via SIRT1-mediated inflammatory response inhibition

Zhang

Tao

et al. 2019

Pharmaceutical Biology

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Context: XingNaoJing injection (XNJ), extracted from a traditional compound Chinese medicine Angong niuhuang pill, is well known for treating stroke in the clinic, but the specific effects and mechanisms remain unclear. Objective: We investigated the mechanistic basis for the protective effect of XNJ on cerebral ischaemia/ reperfusion (I/R) injury. Materials and methods: Five groups of 10 SD rats underwent 2 h of middle cerebral artery occlusion (MCAO) followed by 24 h reperfusion. XNJ at 10 and 15 mL/kg was intraperitoneally administered 24 h before ischaemia and at the onset of reperfusion respectively. The silent information regulator 1 (SIRT1) inhibitor EX527 was intracerebroventricularly injected 0.5 h before reperfusion. Cerebral infarction size, neurological scores, morphological changes, and expression levels of inflammatory mediators and SIRT1 were measured. Furthermore, human brain microvascular endothelial cells (HBMECs) were subjected to 3 h oxygen and glucose deprivation (OGD) followed by 24 h reoxygenation to mimic cerebral I/R in vitro. EX527 pre-treatment occurred 1 h before OGD. SIRT1 and inflammatory mediator levels were analyzed. Results: Both XNJ doses significantly decreased cerebral infarct area (40.11% vs. 19.66% and 9.87%) and improved neurological scores and morphological changes. Inflammatory mediator levels were remarkably decreased in both model systems after XNJ treatment. XNJ also enhanced SIRT1 expression. Notably, the SIRT1 inhibitor EX527 attenuated the XNJ-mediated decrease in inflammation in vivo and in vitro. Conclusions: XNJ improved cerebral I/R injury through inhibiting the inflammatory response via the SIRT1 pathway, which may be a useful target in treating cerebral I/R injury.

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Meta-Analysis of the Effects of Xingnaojing Injection on Consciousness Disturbance

Cited by 21 publications

References 5 publications

UPLC/Q-TOFMS-Based Metabolomics Approach to Reveal the Protective Role of Other Herbs in An-Gong-Niu-Huang Wan Against the Hepatorenal Toxicity of Cinnabar and Realgar

UPLC/Q-TOFMS-Based Metabolomics Approach to Reveal the Protective Role of Other Herbs in An-Gong-Niu-Huang Wan Against the Hepatorenal Toxicity of Cinnabar and Realgar

The clinical benefits of Chinese patent medicines against COVID-19 based on current evidence

XingNaoJing injection ameliorates cerebral ischaemia/reperfusion injury via SIRT1-mediated inflammatory response inhibition

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