Investigation of the efficacy and pharmacological mechanism of Danhong injections for treating chronic obstructive pulmonary disease: A PRISMA-compliant meta-analysis and network pharmacology analysis.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
03 Feb 2023
03 Feb 2023
Historique:
pubmed:
8
2
2023
medline:
10
2
2023
entrez:
7
2
2023
Statut:
ppublish
Résumé
Accumulating evidence supported the clinical efficacy of Danhong injection (DHI) on chronic obstructive pulmonary disease (COPD). It is urgent to summarize the effects of DHI on various outcomes in COPD patients and to elucidate the molecular mechanisms of DHI in treating COPD. Eligible studies were retrieved from 6 databases including China national knowledge infrastructure, Wangfang, VIP, web of science, PubMed, and Embase. The heterogeneity across studies was tested using the I2 statistic and the quality of studies was assessed. The pooled evaluation of outcomes was calculated using a fix- or random-effect model according to the heterogeneity. The underlying mechanism of DHI in treating COPD was analyzed using network pharmacology. A total of 34 eligible studies with a general medium quality were included in the meta-analysis. The pooled data showed that DHI intervention significantly increased clinical efficacy as compared to routine treatment. Meanwhile, our data also revealed that the addition of DHI markedly improved hemorheological indicators, lung function index, arterial blood gas index, and as well as blood coagulation functions. However, the current meta-analysis lacked sufficient data to support the significant effect of DHI on prothrombin time and activated partial thromboplastin time. Network pharmacology found 59 candidate targets of DHI in treating COPD, and enrichment analysis found these targets were associated with lymphocyte proliferation and activation, glucocorticoid receptor signaling, TREM1 signaling, IL-12 signaling and production in macrophages, and aryl hydrocarbon receptor signaling. Multiple core targets including AKT1, TNF, and IL1B, etc. Were identified and might play an important role in the action of DHI against COPD. Taken together, this study suggested that DHI could ameliorate hemorheological indicators, lung function, arterial blood gas, and as well as coagulation functions of COPD patients and elucidate the underlying mechanism of DHI against COPD.
Sections du résumé
BACKGROUND
BACKGROUND
Accumulating evidence supported the clinical efficacy of Danhong injection (DHI) on chronic obstructive pulmonary disease (COPD). It is urgent to summarize the effects of DHI on various outcomes in COPD patients and to elucidate the molecular mechanisms of DHI in treating COPD.
METHODS
METHODS
Eligible studies were retrieved from 6 databases including China national knowledge infrastructure, Wangfang, VIP, web of science, PubMed, and Embase. The heterogeneity across studies was tested using the I2 statistic and the quality of studies was assessed. The pooled evaluation of outcomes was calculated using a fix- or random-effect model according to the heterogeneity. The underlying mechanism of DHI in treating COPD was analyzed using network pharmacology.
RESULTS
RESULTS
A total of 34 eligible studies with a general medium quality were included in the meta-analysis. The pooled data showed that DHI intervention significantly increased clinical efficacy as compared to routine treatment. Meanwhile, our data also revealed that the addition of DHI markedly improved hemorheological indicators, lung function index, arterial blood gas index, and as well as blood coagulation functions. However, the current meta-analysis lacked sufficient data to support the significant effect of DHI on prothrombin time and activated partial thromboplastin time. Network pharmacology found 59 candidate targets of DHI in treating COPD, and enrichment analysis found these targets were associated with lymphocyte proliferation and activation, glucocorticoid receptor signaling, TREM1 signaling, IL-12 signaling and production in macrophages, and aryl hydrocarbon receptor signaling. Multiple core targets including AKT1, TNF, and IL1B, etc. Were identified and might play an important role in the action of DHI against COPD.
CONCLUSION
CONCLUSIONS
Taken together, this study suggested that DHI could ameliorate hemorheological indicators, lung function, arterial blood gas, and as well as coagulation functions of COPD patients and elucidate the underlying mechanism of DHI against COPD.
Identifiants
pubmed: 36749263
doi: 10.1097/MD.0000000000032846
pii: 00005792-202302030-00044
pmc: PMC9901954
doi:
Substances chimiques
danhong
0
Drugs, Chinese Herbal
0
Types de publication
Meta-Analysis
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e32846Informations de copyright
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations. Clin Chest Med. 2020;41:421–38.
Guan WJ, Zheng XY, Chung KF, et al. Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action. Lancet. 2016;388:1939–51.
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–210.
Birnie E, Virk HS, Savelkoel J, et al. Global burden of melioidosis in 2015: a systematic review and data synthesis. Lancet Infect Dis. 2019;19:892–902.
Barnes PJ. Targeting cytokines to treat asthma and chronic obstructive pulmonary disease. Nat Rev Immunol. 2018;18:454–66.
Bowerman KL, Rehman SF, Vaughan A, et al. Disease-associated gut microbiome and metabolome changes in patients with chronic obstructive pulmonary disease. Nat Commun. 2020;11:5886.
Iepsen UW, Pedersen BK. Development of limb muscle dysfunction in chronic obstructive pulmonary disease: smoking, inflammation, or simply disuse? Am J Respir Cell Mol Biol. 2020;62:134–5.
Wang Y, Li N, Li Q, et al. Xuanbai Chengqi decoction ameliorates pulmonary inflammation via reshaping gut microbiota and rectifying Th17/Treg imbalance in a murine model of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2021;16:3317–35.
Liu S, Lai J, Wu L, et al. Chinese medicine for chronic obstructive pulmonary disease: a pilot study on patient preferences. Patient Prefer Adherence. 2021;15:1529–35.
Wang M, Gu W, Kui F, et al. The clinical efficiency and the mechanism of Sanzi Yangqin decoction for chronic obstructive pulmonary disease. Evid Based Complement Alternat Med. 2021;2021:5565562.
Hu H, Ji Z, Qiang X, et al. Chinese medical injections for acute exacerbation of chronic obstructive pulmonary disease: a network meta-analysis. Int J Chron Obstruct Pulmon Dis. 2021;16:3363–86.
Wang B, Li Y, Liu Z, et al. Meta analysis of Danhong injection in the treatment of chronic obstructive pulmonary disease. Chin J Basic Med Tradit Chin Med. 2019;25:1097–103.
Colaprico A, Silva TC, Olsen C, et al. TCGAbiolinks: an R/Bioconductor package for integrative analysis of TCGA data. Nucleic Acids Res. 2016;44:e71.
Chin CH, Chen SH, Wu HH, et al. cytoHubba: identifying hub objects and sub-networks from complex interactome. BMC Syst Biol. 2014;8 Suppl 4 (Suppl 4):S11.
Hongci C. Effect of Danhong injection on hemorheology in elderly patients with chronic obstructive pulmonary disease. Henan Tradit Chin Med. 2007;27:26–8.
Xiao L, Fanglizhou, Yan Z. Application of Danhong injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease. Shandong Med J. 2009;49:101.
Yiying S. Therapeutic effect of Danhong injection on acute exacerbation of chronic obstructive pulmonary disease. J Emerg Tradit Chin Med. 2009;18:1232–3.
Tianzhong T. Danhong injection adjuvant treatment of chronic obstructive pulmonary disease in 68 cases. J Pract Tradit Chin Int Med. 2009;23:55–6.
Zhong L, Xin L. Effect of Danhong injection on IL-8 and TNF in patients with acute exacerbation of chronic obstructive pulmonary disease- α influence. Chin J Aesthetic Med. 2010;19:115–7.
Ruifang Y, Xiu’E S, Caiyan W, et al. Clinical observation on Danhong injection in treating 42 cases of senile chronic obstructive pulmonary disease in acute exacerbation period. Health Vocat Educ. 2010;28:139.
Xiqing Z, Jianliang Z, Huimin S. Effect of Danhong injection on acute exacerbation of chronic obstructive pulmonary disease and hemorheology. J Emerg Tradit Chin Med. 2010;19:197–228.
Wei G. Effect of Danhong injection on prethrombotic state in acute exacerbation of chronic obstructive pulmonary disease. Chin J Gerontol. 2011;31:2455–6.
Hua W, Liuming Y, Ling H, et al. The clinical effect of Danhong injection on chronic obstructive pulmonary disease (COPD) in acute stress oral gravity stage and the influence of CRP, MMP-9, TIMP-1. Clin J Chin Med. 2012;4:51–3.
Jiewu Y, Min Z. Application of Danhong injection in emergency treatment of patients with acute exacerbation of COPD. J Emerg Tradit Chin Med. 2012;21:1150.
Yun Z, Wen W. Observation on the therapeutic effect of Danhong injection on senile chronic obstructive pulmonary disease. China Med Eng. 2012;20:113.
Zhuo C, Zhong L. Effect of Danhong injection on TNF- α and IL-8 in patients with acute exacerbation of chronic obstructive pulmonary disease. J Liaoning Med Univ. 2013;34:23–5.
Jinhai W, Yingxia Y, Pei Z. Observation on the therapeutic effect of Danhong injection on 62 elderly patients with acute exacerbation of chronic obstructive pulmonary disease. Hebei J Tradit Chin Med. 2013;35:1046–7.
Yan-li W. Clinical effect and mechanism of Danhong injection in treating patients with acute exacerbation of chronic obstructive pulmonary disease. J Chengdu Med College. 2013;8:313–5.
Jing-fen X. Clinical observation on the effect of Danhong injection on prethrombotic state in patients with COPD. J Clin Pulm Med. 2013;18:1760–1.
Li Z. Observation on the therapeutic effect of integrated traditional Chinese and western medicine in the treatment of senile chronic obstructive pulmonary disease at the acute exacerbation stage. Chin Foreign Med Res. 2013:24;26–7.
Chunhui QI, Yong Y, Guohua S. Therapeutic effect of Danhong injection on elderly patients with chronic cor pulmonale at acute exacerbation stage and its influence on hemorheology. J Med Theory Pract. 2014:21;2805–7.
Du J. Effect of Danhong injection on acute exacerbation of chronic obstructive pulmonary disease. China Pract Med. 2014:32;135–6.
Shufen Y. Effect of Danhong injection combined with low molecular weight heparin on pulmonary function in elderly patients with chronic obstructive pulmonary disease. World Latest Med Inf. 2014;151:147–147.
Qinguo Z, Jialie W. Clinical observation on 50 cases of chronic obstructive pulmonary disease treated with Danhong injection. Chin Med Guide. 2014;20:39–41.
Qiong Z. Randomized parallel control study of Danhong injection combined with western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease. J Pract TCM Int Med. 2014;2:113–4.
Renqian Z. Effect of Danhong injection on the improvement of lung function in patients with chronic obstructive pulmonary disease. Clin J Tradit Chin Med. 2014;1:32–3.
Liang Z, Zhi-jian W, Hu X. Effect of Danhong injection on endothelial function and coagulation fibrinolysis system in patients with AECOPD. J Clin Pulm Med. 2016:274–6.
Zongkai G. Discussion on the application value of Danhong injection in the treatment of acute exacerbation of COPD. Grassroots Med Forum. 2016;20:1190–1.
Zhongrui J, Xiling Y. The value of Danhong injection in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease. Med Forum. 2017;21:57–8.
Qing S. Clinical efficacy of Danhong injection in treating patients with acute exacerbation of chronic obstructive pulmonary disease and its influence on immune function. Pract J Cardiac Cerebral Pneumal Vas Dis. 2017;25:91–4.
Ai-ping Y, Sheng-yao W. Clinical efficacy of phentolamine combined with Danhong injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease. J China Prescr Drug. 2018;16:53–4.
Yuxia Y, Jing B, Hongyang W. Effect of Danhong injection on endothelial function and blood coagulation function in elderly patients with acute exacerbation of chronic obstructive pulmonary disease. J Tianjin Univ Tradit Chin Med. 2018;37:118–21.
Xinyan L. Effect of Danhong injection on oxidative stress, inflammatory factors and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease. Hebei J Tradit Chin Med. 2019;41:1790–4.
Jiazhen W, Yanjun L, Duo LI. The clinical efficacy of Danhong injection and budesonide combined with non-invasive positive pressure ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease and pulmonary heart disease and its influence on the level of serum inflammatory factors and cardiopulmonary function. Pract J Cardiac Cerebral Pneumal Vasc Dis. 2019;27:86–90.
Xiuhong C. Effect of Danhong injection combined with montelukast sodium on pulmonary function and serum Fg, PCT, HCT levels in patients with acute exacerbation of COPD. J Med Forum. 2020;41:146–9.
Ya-jing H, Jia T. Effect of Danhong injection on endothelial function and coagulation function in elderly patients with chronic obstructive pulmonary disease at acute exacerbation stage. Chin J Thromb Hemost. 2021;27:426–7.
Qingfeng Z, Xiaoyu G, Danhua G. Effect of Danhong injection on acute exacerbation of chronic obstructive pulmonary disease. Mod Pract Med. 2022;34:1112–4.
Shenghua Z, Qin Y. Clinical observation of Danhong injection combined with western medicine in treating elderly patients with acute exacerbation of chronic obstructive pulmonary disease. Geriatr Health Care. 2022;28:135–9.
Zhang Y, Lu W, Zhang X, et al. Cryptotanshinone protects against pulmonary fibrosis through inhibiting Smad and STAT3 signaling pathways. Pharmacol Res. 2019;147:104307.
Liu Y, Huang Y, Zhao C, et al. Salvia miltiorrhiza injection on pulmonary heart disease: a systematic review and meta-analysis. Am J Chin Med. 2014;42:1315–31.
Bai Y, Lu P, Han C, et al. Hydroxysafflor yellow A (HSYA) from flowers of Carthamus tinctorius L. and its vasodilatation effects on pulmonary artery. Molecules. 2012;17:14918–27.
Wang C, Wang C, Ma C, et al. Hydroxysafflor yellow A of Carthamus tinctorius attenuates lung injury of aged rats exposed to gasoline engine exhaust by down-regulating platelet activation. Phytomedicine. 2014;21:199–206.
Cukic V. The changes of arterial blood gases in COPD during four-year period. Med Arch. 2014;68:14–8.
Sun CY, Pei CQ, Zang BX, et al. The ability of hydroxysafflor yellow a to attenuate lipopolysaccharide-induced pulmonary inflammatory injury in mice. Phytother Res. 2010;24:1788–95.
Cakmak G, Alkan FA, Korkmaz K, et al. Blood viscosity as a forgotten factor and its effect on pulmonary flow. Transl Respir Med. 2013;1:3.
Hou WC, Tsay HS, Liang HJ, et al. Improving abnormal hemorheological parameters in aging guinea pigs by water-soluble extracts of Salvia miltiorrhiza Bunge. J Ethnopharmacol. 2007;111:483–9.
Fermont JM, Masconi KL, Jensen MT, et al. Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis. Thorax. 2019;74:439–46.
Zheng X, Liu H, Ma M, et al. Anti-thrombotic activity of phenolic acids obtained from Salvia miltiorrhiza f. alba in TNF-α-stimulated endothelial cells via the NF-κB/JNK/p38 MAPK signaling pathway. Arch Pharm Res. 2021;44:427–38.
Chambellan A, Chailleux E, Similowski T. Prognostic value of the hematocrit in patients with severe COPD receiving long-term oxygen therapy. Chest. 2005;128:1201–8.
Li HX, Han SY, Wang XW, et al. Effect of the carthamins yellow from Carthamus tinctorius L. on hemorheological disorders of blood stasis in rats. Food Chem Toxicol. 2009;47:1797–802.
Wu LC, Lin X, Sun H. Tanshinone IIA protects rabbits against LPS-induced disseminated intravascular coagulation (DIC). Acta Pharmacol Sin. 2012;33:1254–9.
Zhu TF, Chu ZF, Li JH. [Effect of tripterygium glycosides and Danshen injection on blood coagulation mechanism in children with allergic purpura nephritis]. Zhongguo Zhong Yao Za Zhi. 2016;41:2162–7.
Wang Y, Liu L, Qu Z, et al. Tanshinone ameliorates glucocorticoid-induced bone loss via activation of AKT1 signaling pathway. Front Cell Dev Biol. 2022;10:878433.
Zhang Y, Song L, Pan R, et al. Hydroxysafflor yellow A alleviates lipopolysaccharide-induced acute respiratory distress syndrome in mice. Biol Pharm Bull. 2017;40:135–44.
Hodge G, Jersmann H, Tran HB, et al. Lymphocyte senescence in COPD is associated with loss of glucocorticoid receptor expression by pro-inflammatory/cytotoxic lymphocytes. Respir Res. 2015;16:2.
Kadmiel M, Cidlowski JA. Glucocorticoid receptor signaling in health and disease. Trends Pharmacol Sci. 2013;34:518–30.
Wang L, Chen Q, Yu Q, et al. TREM-1 aggravates chronic obstructive pulmonary disease development via activation NLRP3 inflammasome-mediated pyroptosis. Inflamm Res. 2021;70:971–80.
Tetley TD. Macrophages and the pathogenesis of COPD. Chest. 2002;121(5 Suppl):156S–9S.