Zhibaidihuang Decoction Ameliorates Cell Oxidative Stress by Regulating the Keap1‐Nrf2‐ARE Signalling Pathway

Abstract

Zhibaidihuang decoction (ZBDHD) is a Chinese herbal formula, which is used in Chinese traditional medicine to treat symptoms of Yinxuhuowang (Yin deficiency and high fire) syndrome. This study elucidates the mechanism of ZBDHD on oral ulcers, one Yinxuhuowang syndrome. Simultaneously, some ingredients in ZBDHD were found and identified by ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). A Ganjiangfuzirougui decoction- (GJD-) induced Yinxuhuowang syndrome SD rat model was used to demonstrate the efficiency of ZBDHD treatment. The oral mucosa of rat in the GJD group, stained with hematoxylin and eosin (H&E), showed epidermal shedding and inflammatory cell infiltration. And an alleviation efficiency of ZBDHD in GJD-induced pathological changes in the oral mucosa could be obtained. ZBDHD treatment restored the GJD-induced imbalance of metabolites, which were choline, glycocholic acid, and palmitoyl-L-carnitine (PALC). GJD stimulated the expression of NF-κB. And the overexpressed of NF-κB in mucosa of rat in the GJD group could be inhibited by ZBDHD treatment. Simultaneously, the optimal efficiency of ZBDHD treatment on the cellular ATP content, oxygen consumption rate (OCR), and superoxide dismutase (SOD) concentration was evaluated, in vitro assay. Compared to the control cells, the ATP content, OCR, and SOD activity in the ZBDHD-treated cells were significantly higher. For the mechanisms study, seven cytokines were screened with a Dual-Luciferase Reporter gene assay. In the ARE assay, the luciferase signal was stimulated significantly by ZBDHD. In cells, the transcription of nrf2, maf, and keap1, which were related to the ARE pathway, was elevated by ZBDHD treatment. Our study demonstrated that high-dose GJD could lead to Yinxuhuowang syndrome, such as oral ulcers, and the imbalance in serum metabolites. And ZBDHD can improve oral cell inflammation and the imbalance of metabolism by inhibiting NF-κB and enhancing the activity of the ARE signalling pathway to ameliorate oxidative stress in the cell. This study provides a theoretical basis for the clinical application of ZBDHD.

Nephroprotective Role of Zhibai Dihuang Wan in Aristolochic Acid-Intoxicated Zebrafish

“…For example, the study of the protective effect of ZDW on gentamycin-induced renal tubular cell apoptosis in mice suggests ZDW can reduce apoptosis and necrosis [ 8 ]. Another study showed ZDW can improve oral cell inflammation and the imbalance of metabolism by inhibiting NF- κ B and enhancing the activity of the ARE signaling pathway to ameliorate oxidative stress in the cultured cells [ 5 ]. Thus, we suggested the protective effect of ZDW is efficient in different experimental models.…”

“…Clinically, it was used to treat chronic kidney disease and diabetic nephropathy and to regulate immunity, even was used to treat chronic renal insufficiency and relieve the symptoms [ 1 – 4 ]. The laboratory results showed that ZDW is able to regulate the inflammatory response and heart function and to treat diabetic nephropathy [ 5 , 6 ]. In rats, ZDW treatment could lead to protein alteration in immune response, especially in coagulation and complement cascades [ 6 – 8 ].…”

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

“…High dose ZBDHD treatment attenuated AZC induced distractive expression of cytokines, Sirt1, NF-κB, and TNF-α (Figures 3 and 4). e results of our previous study also indicated that AZC can stimulate the expression of NF-κB [13]. e expression of cytokines in Sirt1 signaling pathway was quantitatively analyzed by western blot (Figure 5).…”

“…In modern medicine, oral ulcer is a kind of inflammatory diseases, which occurs due to a damage in epithelium induced by many certain factors, such as hormonal changes [23], lack of essential vitamins [24], and Evidence-Based Complementary and Alternative Medicine disorder of metabolism which could induce oral ulcer [25]. It is validated by clinical trial that ZBDHD treatment could promote the ulcer healing [26] and improve the fitness of recurrent oral ulcer significantly [13].…”

“…This is due to the complex mechanisms of ZBDHD treatment. It was identified with modern biological method that AZC can influence the AMPK/Sirt1 pathway [ 10 ], as well as expression of NF- κ B, one of inflammatory response cytokines [ 13 ]. Previous studies proved that Sirt1 was correlated to cell metabolism [ 14 , 15 ].…”