The Anti-Inflammatory Effect of Zhibaidihuang Decoction on Recurrent Oral Ulcer with Sirt1 as the Key Regulatory Target

Abstract

The syndrome of ROU is generally manifested as obvious pain, redness, and swelling of local ulceration area, accompanied by flushed face, red eyes, sore throat, and swollen gums. Traditional Chinese medicine (TCM) doctors believe that “yin deficiency” is one causative factor of ROU. Zhibaidihuang decoction (ZBDHD) is a prescriptively developed receipt, where Anemarrhena asphodeloides and Phellodendri amurensis Cortex are added in the original Liuweidihuang decoction. It is generally used for “yin deficiency” treatment. It can effectively reduce the recurrence of oral ulcers and release the severity of the disease. However, the mechanism of this activity remains to be elucidated. In this study, we found that ZBDHD has a certain therapeutic effect on the pathological changes of oral mucosa. Furthermore, the results of serum metabolomics showed ZBDHD influenced the synthesis and metabolism of certain fatty acids. The results of western blot, immunochemical, and immunofluorescence staining indicate that ZBDHD could increase the expression of Sirt1 and Foxp3 and suppress the expression and acetylation of NF-κB in oral mucosa cells. By screening active ingredients in ZBDHD, we found berberine, as well as other compounds, presenting high fitness of the Sirt1 reactive centre. Therefore, it is possible that ZBDHD can regulate the Sirt1-NF-κB pathway to improve fatty acids metabolism in the body, thereby achieving the effect of treating ROU.

Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

“…Furthermore, it can control fasting and postprandial blood glucose and bring them to a desirable level ( Cao et al, 2010 ; Lian et al, 2015 ; Huang et al, 2019 ). However, due to the complex composition of herbs, the unclear mechanism of TCM formulas ( Shao et al, 2021 ; Yuan et al, 2021 ; Yun et al, 2021 ), and a lack of scientific data to support the dose-response relationship ( Huang et al, 2017 ; Ge et al, 2018 ), the clinical dosage modification usually lacks standardization and has become a bottleneck for detailed studies on TCM.…”

Effectiveness of Zhibai Dihuang pill (Chinese herbal formula) in combination with western drugs in the treatment of recurrent aphthous stomatitis: A systematic review and meta-analysis

“…Therefore, ZBDHP may improve fatty acid metabolism and treat RAS by regulating the Sirt1-NF-κB pathway. [ 16 ] A large number of systematic reviews and meta-analyses have been conducted to estimate the efficacy of TCM in the treatment of RAS. For example, Zhou et al [ 17 ] systematically reviewed the efficacy and safety of Chinese medicines in treating RAS.…”

Network pharmacology and bioinformatics analyses identify the intersection genes and mechanism of Huang Bai for recurrent aphthous stomatitis

“…12 Shao et al found berberine, as well as other compounds, could increase the expression of Sirt1 and Foxp3 and suppress the expression and acetylation of NF-κB in oral mucosa cells. 13 A randomized controlled trail found that HB has better effects than bingpeng powder in the ulcer healing in patients with RAS. 14 Although several studies have reported on the anti-RAS activity of HB, the mechanisms of HB contributing to therapeutic effects remain unclear.…”

“…14 Although several studies have reported on the anti-RAS activity of HB, the mechanisms of HB contributing to therapeutic effects remain unclear. 13 , 15 …”

“…14 Although several studies have reported on the anti-RAS activity of HB, the mechanisms of HB contributing to therapeutic effects remain unclear. 13,15 Network pharmacology is a useful bioinformatics tool to discover candidate targets, functions, and mechanisms of bioactive components to treat disease. In the research, we aimed to explore the potential therapeutic targets and mechanisms of HB by utilizing a network pharmacology technology.…”