1.Effect and Mechanism of Chinese Medicine Combined with Bone Marrow Mesenchymal Stem Cells in Treatment of Ischemic Stroke: A Review
Xiaolong PAN ; Shibiao SUN ; Zhihui WEI ; Feixiang LIU ; Yunke ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(15):248-258
Stroke is one of the major diseases threatening human health, with ischemic stroke accounting for about 70%. Ischemic stroke is characterized by complex pathological mechanism and high incidence, mobility and mortality. At present, the effective clinical treatment measures for ischemic stroke are limited, and it is urgent to develop new and effective treatment measures to improve the prognosis of patients. In recent years, bone marrow mesenchymal stem cells (BMSCs) transplantation has shown great therapeutic potential for a variety of diseases, including ischemic stroke, and has become a new research hotspot. However, due to the low homing and survival rate of BMSCs in human body after transplantation, their clinical effect on ischemic stroke needs to be further improved. With the characteristics of multi-components, multi-channels and multi-targets, Chinese medicine displays desirable curative effect on ischemic stroke, which has been widely concerned. Both Chinese medicine and BMSCs transplantation have good overall brain protection, and their combined effect on ischemic stroke is significantly better than that of single application. The mechanisms include improving the transplantation efficiency of BMSCs, promoting angiogenesis, enhancing neuroplasticity, ameliorating neuroinflammation, enhancing neuroprotection, and regulating the blood-brain barrier and exosomes. The combination of Chinese medicine and modern cutting-edge cell therapy reflects the advantages of integrative medicine, providing a new model and idea for preventing and treating ischemic stroke and improving the efficacy of BMSCs transplantation.
2.Mechanism of Kidney-tonifying and Anti-aging Chinese Medicines Combined with Stem Cell Therapy in Treatment of Alzheimer's Disease: A Review
Shibiao SUN ; Xiaolong PAN ; Zhihui WEI ; Feixiang LIU ; Yunke ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(15):199-211
Alzheimer's disease (AD) is a neurodegenerative disease associated with aging and age-related cognitive decline. It is characterized by insidious onset and progressive development, and has become a major global health and socioeconomic issue. The exact mechanisms underlying AD have not been fully elucidated, and various hypotheses have been proposed by researchers based on different etiologies, including the amyloid β (Aβ) cascade hypothesis, Tau protein hyperphosphorylation hypothesis, mitochondrial dysfunction and oxidative stress hypothesis, and neurotransmitter hypothesis. Therefore, there is an urgent need for comprehensive interventions targeting multiple pathways, links, and targets. Based on traditional Chinese medicine (TCM) theory and modern research findings, kidney-tonifying and anti-aging Chinese medicines have unique advantages of toxicity reduction, long-lasting effects, and treating both the root cause and the symptoms. They have been shown to counteract immune-inflammatory responses, clear reactive oxygen species, exhibit antioxidant properties, inhibit abnormal aggregation of Aβ and Tau proteins, reduce neuronal apoptosis, regulate central neurotransmitters, and modulate gut microbiota in AD. In recent years, stem cell therapy has been explored for the treatment of AD through two strategies: endogenous activation and exogenous transplantation, thereby replenishing and replacing damaged neurons. However, factors such as blood-brain barrier permeability, targeted delivery to the affected area, immune rejection, and cell survival rate can affect the efficacy of stem cell transplantation. Therefore, combining stem cell therapy with medication and other methods can further enhance the effectiveness of stem cell transplantation. Kidney-tonifying and anti-aging Chinese medicines can activate dormant neural stem cells(NSCs) in the body, promote neuroregeneration, and facilitate tissue and organ repair and reconstruction in AD. The combined treatment of these Chinese medicines and stem cell transplantation has shown more significant efficacy compared to either treatment alone. This combination therapy provides a new integration point for the modernization of TCM and offers new ideas and approaches for the prevention and treatment of AD, as well as improving the effectiveness of stem cell transplantation.
3.Mechanism of Traditional Chinese Medicine in Treatment of Neurodegenerative Diseases by Regulating Polarization Balance of Microglia: A Review
Haolin ZHAO ; Shibiao SUN ; Guoyan QIN ; Yanyi DING ; Duo ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(2):244-253
Neuroinflammation is a common pathological feature of neurodegenerative diseases (NDs). Microglia (MG), a resident macrophage in the brain with a unique developmental origin, is the core driver of neuroinflammation. It can participate in the occurrence and development of NDs through different polarization states and play a key role in regulating neurogenesis and synapse shaping and maintaining homeostasis. MG can be divided into M1 pro-inflammatory phenotype and M2 anti-inflammatory phenotype according to its function. The inflammatory mediators released by the M1 phenotype can lead to nerve degeneration and myelin sheath damage, while the activation of the M2 phenotype is required to inhibit the inflammatory response and promote tissue repair. With the advantages of multi-pathway, multi-target, and bidirectional regulation, traditional Chinese medicine can regulate the polarization balance of MG and has dual effects on NDs such as Alzheimer's disease, Parkinson's disease, and multiple sclerosis. The active components of traditional Chinese medicine and its compound can inhibit the activation of MG by regulating phosphatidylinositol-3-kinases/protein kinase B(PI3K/Akt), NOD-like receptor thermal protein domain associated protein 3(NLRP3), signal transducer and activator of transcription factor1(STAT1), nuclear transcription factor kappa B(NF-κB), and other pathways, promote the polarization of M1 phenotype to M2 phenotype, reduce the expression of interleukin(IL)-6, tumor necrosis factor-α(TNF-α), and other pro-inflammatory factors, and increase the secretion of IL-10, arginase-1(Arg-1), and other anti-inflammatory factors. It can also reduce β-amyloid deposition and tau protein expression in Alzheimer's disease, alleviate dopaminergic neuronal damage in Parkinson's disease, and relieve demyelination, inflammatory cell infiltration, and related clinical symptoms of multiple sclerosis. The bidirectional regulation of the M1/M2 polarization balance of MG by traditional Chinese medicine is a potential strategy for the treatment of NDs. This paper focused on the targets of the regulation of MG polarization balance by traditional Chinese medicine monomer and its compound in the treatment of NDs, so as to further study and summarize the existing research results and provide ideas and basis for the future treatment of NDs.
4.Practice of two methods in occupational health risk grading and classification management in petroleum refining enterprises
Qifan HUANG ; Jiawei ZHU ; Xi ZHONG ; Rongzong LI ; Zhiheng PENG ; Shibiao SU
Journal of Environmental and Occupational Medicine 2023;40(6):648-654
Background Most of the studies on grading and classification of occupational health compre-hensive risks for specific employers still remain in the establishment and description of methodology, and practical application studies are rarely reported. Objective To explore the application of an occupational disease hazards comprehensive risk assessment method issued by the National Disease Control and Prevention Bureau in conjunction with the National Health Commission and a self-developed occupational health grading and classification method in petroleum refining enterprises, and to provide practical experience for the implementation of differentiated law enforcement by relevant regulatory authorities. Methods Two occupational health grading and classification methods were practiced in three petroleum refining enterprises in Guangdong Province. The occupational hazards comprehensive risk assessment method was provided by the Notice on Carrying out Pilot Work of Occupational Health Classification Supervision and Law Enforcement of the National Disease Control and Prevention Bureau and the National Health Commission. The principle was to derive the occupational health risk level according to nature of occupational hazards, exposure level, and number of workers exposed to them in an employer, and then to classify them into Class A, Class B, and Class C by combining with local occupational health management status level. The occupational health grading and classification method was self-developed according to available domestic and foreign occupational health risk assessment methods. Its principle was to calculate the risk level of each workstation in an employer based on published carcinogenicity classification or LD50/LC50 of chemical toxicants, level of noise, exposure parameters such as exposure level and exposure frequency, estimate the comprehensive risk Ro of the target employer by the Romanian comprehensive risk calculation method, and then calculate a comprehensive risk Ro' weighted by the occupational health management index of the target employer and classify it into class A, class B, and class C. Finally, assessment results, scope of application, inquired indicators, advantages,disadvantages and professional competence requirements of the two grading and classification methods were compared. Results The occupational hazards that were evaluated in three enterprises in this study were benzene, toluene, xylene, gasoline, hydrogen sulfide, and noise. The exposure levels of benzene, toluene, xylene, and gasoline were all below 10% OEL (occupational exposure limit), and hydrogen sulfide and noise were disqualified. Occupational hazards such as benzene and hydrogen sulfide were serious occupational hazards in the three enterprises, and the number of workers exposed was 461, 912, and 224, respectively; the HRs (hazard ratings) of benzene, toluene, xylene, gasoline, hydrogen sulfide, and noise were level 5, 3, 2, 3, 5, and 3 respectively. The occupational health management status of the three enterprises was graded as B, A, and B, respectively by the occupational disease hazards comprehensive risk assessment method. The occupational health management index of the three enterprises was graded as B, A, and A, respectively by the occupational health grading and classification method. The comprehensive risk assessment results showed that two enterprises classified into as the highest class C and one into class B by the occupational disease hazards comprehensive risk assessment method, while all three enterprises were classified into class B by the occupational health grading and classification method. Conclusion The two grading and classification methods are not consistent in the evaluation results of petroleum refining enterprises, and there are differences in the evaluation scope, indicators to be collected, and professionalism. It is recommended that occupational health regulators should fully consider the advantages and disadvantages of the two methods and choose the appropriate assessment method according to the actual regulatory purpose.