1.Insights on Peripheral Blood Biomarkers for Parkinson’s Disease
Yu-Meng LI ; Jing-Kai LIU ; Zi-Xuan CHEN ; Yu-Lin DENG
Progress in Biochemistry and Biophysics 2025;52(1):72-87
Parkinson’s disease (PD) is a common neurodegenerative disorder with profound impact on patients’ quality of life and long-term health, and early detection and intervention are particularly critical. In recent years, the search for precise and reliable biomarkers has become one of the key strategies to effectively address the clinical challenges of PD. In this paper, we systematically evaluated potential biomarkers, including proteins, metabolites, epigenetic markers, and exosomes, in the peripheral blood of PD patients. Protein markers are one of the main directions of biomarker research in PD. In particular, α‑synuclein and its phosphorylated form play a key role in the pathological process of PD. It has been shown that aggregation of α-synuclein may be associated with pathologic protein deposition in PD and may be a potential marker for early diagnosis of PD. In terms of metabolites, uric acid, as a metabolite, plays an important role in oxidative stress and neuroprotection in PD. It has been found that changes in uric acid levels may be associated with the onset and progression of PD, showing its potential as an early diagnostic marker. Epigenetic markers, such as DNA methylation modifications and miRNAs, have also attracted much attention in Parkinson’s disease research. Changes in these markers may affect the expression of PD-related genes and have an important impact on the onset and progression of the disease, providing new research perspectives for the early diagnosis of PD. In addition, exosomes, as a potential biomarker carrier for PD, are able to carry a variety of biomolecules involved in intercellular communication and pathological regulation. Studies have shown that exosomes may play an important role in the pathogenesis of PD, and their detection in blood may provide a new breakthrough for early diagnosis. It has been shown that exosomes may play an important role in the pathogenesis of PD, and their detection in blood may provide new breakthroughs in early diagnosis. In summary, through in-depth evaluation of biomarkers in the peripheral blood of PD patients, this paper demonstrates the important potential of these markers in the early diagnosis of PD and in the study of pathological mechanisms. Future studies will continue to explore the clinical application value of these biomarkers to promote the early detection of PD and individualized treatment strategies.
2.Outcome Indicators in Randomized Controlled Trials of Traditional Chinese Medicine Intervention in Ulcerative Colitis
Yasheng DENG ; Lanfang MAO ; Jiang LIN ; Yanping FAN ; Wenyue LI ; Yonghui LIU ; Zhaobing NI ; Jinzhong YU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):245-251
To systematically review randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) intervention in ulcerative colitis (UC), and analyze the characteristics of these studies and their outcome indicators, thereby providing references for the design of future RCTs of TCM intervention in UC and offering evidence supporting the clinical application of TCM in UC. A computerized search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science databases for RCTs of TCM intervention in UC published from January 2021 to August 2024. The risk of bias was assessed, and outcome indicators were qualitatively analyzed. A total of 555 RCTs were included, with a sample size of 44 853 participants. The largest sample size was 218 cases, and the smallest was 28 cases, with most studies focusing on 60-100 participants. Of the 386 RCTs that explicitly reported TCM syndrome types, the top three were large intestine dampness-heat syndrome (31.05%), spleen and kidney yang deficiency syndrome (12.47%), and spleen deficiency with dampness syndrome (9.17%). The interventions, ranked by frequency of use, included internal Chinese medicine compounds/preparations (64.5%), Chinese medicine compounds/preparations with retained enema (18.2%), internal Chinese medicine compounds/preparations + external TCM treatment (5.95%), and external TCM treatment alone (4.86%). The treatment duration was mainly 4-8 weeks (64.86%), with 61 studies (10.99%) reporting follow-up time. A total of 157 outcome indicators were used, with a frequency of 3 460 occurrences, classified into six domains: TCM syndromes and symptoms (346 occurrences, 10%), symptoms/signs (541 occurrences, 15.64%), physical and chemical examinations (2 119 occurrences, 61.24%), quality of life (107 occurrences, 3.09%), long-term prognosis (61 occurrences, 1.76%), and safety events (284 occurrences, 8.21%). The analysis reveals several limitations in the outcome indicators of TCM intervention in UC, including the lack of a basis for sample size calculation, non-standardized TCM syndrome classification, absence of trial design and registration, inadequate blinding and allocation concealment, adherence issues with interventions, imbalanced selection of surrogate and endpoint indicators, inconsistency in the timing of outcome measurements, design issues that require standardization, and ethical and safety concerns. It is recommended that future studies actively construct a set of core indicators for UC that include standardized TCM syndrome classification, clear efficacy evaluation indicators, key endpoint indicators, and reasonable measurement time points. Long-term prognostic impacts, comprehensive assessments of patients' quality of life, and consideration of economic benefits should be emphasized, providing a basis for the clinical practice of TCM in the treatment of UC.
3.Outcome Indicators in Randomized Controlled Trials of Traditional Chinese Medicine Intervention in Ulcerative Colitis
Yasheng DENG ; Lanfang MAO ; Jiang LIN ; Yanping FAN ; Wenyue LI ; Yonghui LIU ; Zhaobing NI ; Jinzhong YU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):245-251
To systematically review randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) intervention in ulcerative colitis (UC), and analyze the characteristics of these studies and their outcome indicators, thereby providing references for the design of future RCTs of TCM intervention in UC and offering evidence supporting the clinical application of TCM in UC. A computerized search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science databases for RCTs of TCM intervention in UC published from January 2021 to August 2024. The risk of bias was assessed, and outcome indicators were qualitatively analyzed. A total of 555 RCTs were included, with a sample size of 44 853 participants. The largest sample size was 218 cases, and the smallest was 28 cases, with most studies focusing on 60-100 participants. Of the 386 RCTs that explicitly reported TCM syndrome types, the top three were large intestine dampness-heat syndrome (31.05%), spleen and kidney yang deficiency syndrome (12.47%), and spleen deficiency with dampness syndrome (9.17%). The interventions, ranked by frequency of use, included internal Chinese medicine compounds/preparations (64.5%), Chinese medicine compounds/preparations with retained enema (18.2%), internal Chinese medicine compounds/preparations + external TCM treatment (5.95%), and external TCM treatment alone (4.86%). The treatment duration was mainly 4-8 weeks (64.86%), with 61 studies (10.99%) reporting follow-up time. A total of 157 outcome indicators were used, with a frequency of 3 460 occurrences, classified into six domains: TCM syndromes and symptoms (346 occurrences, 10%), symptoms/signs (541 occurrences, 15.64%), physical and chemical examinations (2 119 occurrences, 61.24%), quality of life (107 occurrences, 3.09%), long-term prognosis (61 occurrences, 1.76%), and safety events (284 occurrences, 8.21%). The analysis reveals several limitations in the outcome indicators of TCM intervention in UC, including the lack of a basis for sample size calculation, non-standardized TCM syndrome classification, absence of trial design and registration, inadequate blinding and allocation concealment, adherence issues with interventions, imbalanced selection of surrogate and endpoint indicators, inconsistency in the timing of outcome measurements, design issues that require standardization, and ethical and safety concerns. It is recommended that future studies actively construct a set of core indicators for UC that include standardized TCM syndrome classification, clear efficacy evaluation indicators, key endpoint indicators, and reasonable measurement time points. Long-term prognostic impacts, comprehensive assessments of patients' quality of life, and consideration of economic benefits should be emphasized, providing a basis for the clinical practice of TCM in the treatment of UC.
4.Total Saponins of Dioscoreae Nipponicae Rhizoma Alleviates Gouty Arthritis by Down-regulating COX-2-mediated M1 Macrophage Reprogramming
Lin HUANG ; Shumin LIU ; Huijuan SUN ; Geyu DENG ; Donghua YU ; Yu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):200-207
ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma (TSDN) in treating gouty arthritis (GA) by regulating cyclooxygenase-2 (COX-2)-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment: 24 male SD rats were randomly allocated into blank, model (GA), TSDN, and celecoxib groups, with 6 rats in each group. After 7 days of administration, pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to quantify the mRNA levels of NOD-like receptor protein 3 (NLRP3) inflammasome, apoptosis-associated speck-like protein (ASC), Caspase-1, COX-2, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the synovial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum levels of inducible nitric oxide synthase (iNOS), IL-1β, CD86, CD80, CD206, and arginase-1 (Arg-1). In vitro experiment: The GA model was established by lipopolysaccharide (LPS) + MSU induction, and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium (MTT) assay. RAW264.7 cells were allocated into blank, model, TSDN, dexamethasone, COX-2 inhibitor (celecoxib), and TSDN + COX-2 inhibitor groups. The levels of iNOS, IL-1β, CD86, CD80, CD206, and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in each group were determined by Real-time PCR and Western blot, respectively. ResultsIn vivo experiment: compared with the model group, TSDN reduced the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in the synovial tissue (P<0.05, P<0.01). ELISA results showed that TSDN lowered the serum levels of iNOS, IL-1β, CD86, and CD80 (P<0.01) while increasing the serum levels of CD206 and Arg-1 (P<0.01). In vitro experiment: compared with the model group, TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α and the protein levels of NLRP3 inflammasome, COX-2, cleaved IL-1β, and TNF-α (P<0.01). Compared with TSDN alone, TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above (P<0.01). Compared with the model group, TSDN and COX-2 inhibitor decreased the levels of IL-1β, iNOS, CD80, and CD86 (P<0.01) and increased the levels of CD206 and Arg-1 (P<0.01) in cells. Compared with TSDN alone, TSDN + COX-2 inhibitor reduced IL-1β, iNOS, CD80, and CD86 levels (P<0.05, P<0.01) and elevated CD206 and Arg-1 levels (P<0.01) in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.
5.Total Saponins of Dioscoreae Nipponicae Rhizoma Alleviates Gouty Arthritis by Down-regulating COX-2-mediated M1 Macrophage Reprogramming
Lin HUANG ; Shumin LIU ; Huijuan SUN ; Geyu DENG ; Donghua YU ; Yu WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):200-207
ObjectiveTo explore the mechanism of total saponins of Dioscoreae Nipponicae Rhizoma (TSDN) in treating gouty arthritis (GA) by regulating cyclooxygenase-2 (COX-2)-mediated M1 macrophage reprogramming by in vivo and in vitro experiments. MethodsIn vivo experiment: 24 male SD rats were randomly allocated into blank, model (GA), TSDN, and celecoxib groups, with 6 rats in each group. After 7 days of administration, pathological changes in the ankle synovial tissue were observed via hematoxylin-eosin (HE) staining. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to quantify the mRNA levels of NOD-like receptor protein 3 (NLRP3) inflammasome, apoptosis-associated speck-like protein (ASC), Caspase-1, COX-2, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the synovial tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the serum levels of inducible nitric oxide synthase (iNOS), IL-1β, CD86, CD80, CD206, and arginase-1 (Arg-1). In vitro experiment: The GA model was established by lipopolysaccharide (LPS) + MSU induction, and the inhibitor concentration was screened by the methyl thiazolyl tetrazolium (MTT) assay. RAW264.7 cells were allocated into blank, model, TSDN, dexamethasone, COX-2 inhibitor (celecoxib), and TSDN + COX-2 inhibitor groups. The levels of iNOS, IL-1β, CD86, CD80, CD206, and Arg-1 in the cell supernatant of each group were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in each group were determined by Real-time PCR and Western blot, respectively. ResultsIn vivo experiment: compared with the model group, TSDN reduced the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α in the synovial tissue (P<0.05, P<0.01). ELISA results showed that TSDN lowered the serum levels of iNOS, IL-1β, CD86, and CD80 (P<0.01) while increasing the serum levels of CD206 and Arg-1 (P<0.01). In vitro experiment: compared with the model group, TSDN and inhibitor down-regulated the mRNA levels of NLRP3 inflammasome, COX-2, IL-1β, and TNF-α and the protein levels of NLRP3 inflammasome, COX-2, cleaved IL-1β, and TNF-α (P<0.01). Compared with TSDN alone, TSDN + COX-2 inhibitor further reduced the mRNA and protein levels of the markers above (P<0.01). Compared with the model group, TSDN and COX-2 inhibitor decreased the levels of IL-1β, iNOS, CD80, and CD86 (P<0.01) and increased the levels of CD206 and Arg-1 (P<0.01) in cells. Compared with TSDN alone, TSDN + COX-2 inhibitor reduced IL-1β, iNOS, CD80, and CD86 levels (P<0.05, P<0.01) and elevated CD206 and Arg-1 levels (P<0.01) in cells. ConclusionTSDN can alleviate GA by downregulating COX-2-mediated M1 macrophage reprogramming and suppressing the inflammatory factors.
6.SIRT3 protects endometrial receptivity in patients with polycystic ovary syndrome.
Zhonghong ZENG ; Hongying SHAN ; Mingmei LIN ; Siyu BAO ; Dan MO ; Feng DENG ; Yang YU ; Yihua YANG ; Ping ZHOU ; Rong LI
Chinese Medical Journal 2025;138(10):1225-1235
BACKGROUND:
The sirtuin family is well recognized for its crucial involvement in various cellular processes. Nevertheless, studies on its role in the human endometrium are limited. This study aimed to explore the expression and localization of the sirtuin family in the human endometrium, focusing on sirtuin 3 (SIRT3) and its potential role in the oxidative imbalance of the endometrium in polycystic ovary syndrome (PCOS).
METHODS:
Endometrial specimens were collected from both patients with PCOS and controls undergoing hysteroscopy at the Center for Reproductive Medicine, Peking University Third Hospital, from July to August 2015 and used for cell culture. The protective effects of SIRT3 were investigated, and the mechanism of SIRT3 in improving endometrial receptivity of patients with PCOS was determined using various techniques, including cellular bioenergetic analysis, small interfering ribonucleic acid (siRNA) silencing, real-time quantitative polymerase chain reaction, Western blot, immunofluorescence, immunohistochemistry, and flow cytometry analysis.
RESULTS:
The sirtuin family was widely expressed in the human endometrium, with SIRT3 showing a significant increase in expression in patients with PCOS compared with controls ( P <0.05), as confirmed by protein and gene assays. Concurrently, endometrial antioxidant levels were elevated, while mitochondrial respiratory capacity was reduced, in patients with PCOS ( P <0.05). An endometrial oxidative stress (OS) model revealed that the downregulation of SIRT3 impaired the growth and proliferation status of endometrial cells and reduced their receptivity to day 4 mouse embryos. The results suggested that SIRT3 might be crucial in maintaining normal cellular state by regulating antioxidants, cell proliferation, and apoptosis, thereby contributing to enhanced endometrial receptivity.
CONCLUSIONS
Our findings proposed a significant role of SIRT3 in improving endometrial receptivity in patients with PCOS by alleviating OS and regulating the balance between cell proliferation and apoptosis. Therefore, SIRT3 could be a promising target for predicting and improving endometrial receptivity in this patient population.
Humans
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Female
;
Polycystic Ovary Syndrome/metabolism*
;
Endometrium/metabolism*
;
Sirtuin 3/genetics*
;
Oxidative Stress/genetics*
;
Adult
;
Animals
;
Mice
;
Apoptosis/physiology*
;
Immunohistochemistry
;
Cell Proliferation/physiology*
7.Effect of Biyan Jiedu Capsules on proliferation and apoptosis of nasopharyngeal carcinoma cells based on PI3K/Akt pathway.
Ting LIN ; Yang-Yang TAO ; Ying-Gang TANG ; Ju YUAN ; Hui-Ping DU ; Lin-Yu DENG ; Fang-Liang ZHOU ; Ying-Chun HE
China Journal of Chinese Materia Medica 2025;50(7):1920-1927
To investigate the effects of Biyan Jiedu Capsules on the proliferation and apoptosis of nasopharyngeal carcinoma cells and their molecular mechanism, nasopharyngeal carcinoma cells CNE1 and CNE2 were used. They were divided into control group(30% blank serum medium), low-(10% drug-containing serum + 20% blank serum medium), medium-(20% drug-containing serum + 10% blank serum medium), and high-(30% drug-containing serum medium) concentration group of Biyan Jiedu Capsules according to in vitro experiment. After 24 h of intervention, the effects of Biyan Jiedu Capsules on the proliferation of CNE1 and CNE2 were detected by CCK-8 assay, clonal formation experiment, and EdU staining. The effect of Biyan Jiedu Capsules on apoptosis of CNE1 and CNE2 was detected by flow cytometry. Western blot was used to detect the effect of Biyan Jiedu Capsules on the expression of X-linked apoptosis inhibitor protein(XIAP), survivin, proliferating cell nuclear antigen(PCNA), and PI3K/Akt pathway-related proteins in CNE1 and CNE2. The results showed that compared with the control group, the survival rate of CNE1 and CNE2 in the medium and high concentration groups of Biyan Jiedu Capsules could be decreased in a concentration-dependent way(P<0.05, P<0.01). At the same time, EdU staining and clonal formation experiments showed that the proliferation of CNE1 and CNE2 was significantly inhibited in the medium and high concentration groups of Biyan Jiedu Capsules(P<0.05, P<0.01). Flow cytometry showed that the apoptosis rate of CNE1 and CNE2 was significantly increased in all concentration groups of Biyan Jiedu Capsules(P<0.01), and the apoptosis rate was concentration-dependent. Western blot showed that the expressions of XIAP, survivin, PCNA, p-PI3K, and p-Akt in all concentration groups of Biyan Jiedu Capsules were significantly down-regulated(P<0.05, P<0.01). In conclusion, Biyan Jiedu Capsules can inhibit the proliferation and induce apoptosis of nasopharyngeal carcinoma cells possibly by down-regulating the PI3K/Akt signaling pathway.
Humans
;
Apoptosis/drug effects*
;
Cell Proliferation/drug effects*
;
Nasopharyngeal Carcinoma
;
Nasopharyngeal Neoplasms/physiopathology*
;
Proto-Oncogene Proteins c-akt/genetics*
;
Cell Line, Tumor
;
Drugs, Chinese Herbal/pharmacology*
;
Phosphatidylinositol 3-Kinases/genetics*
;
Signal Transduction/drug effects*
;
Capsules
;
Carcinoma/drug therapy*
8.Biomarkers of hepatotoxicity in rats induced by aqueous extract of Dictamni Cortex based on urine metabolomics.
Hui-Juan SUN ; Rui GAO ; Meng-Meng ZHANG ; Ge-Yu DENG ; Lin HUANG ; Zhen-Dong ZHANG ; Yu WANG ; Fang LU ; Shu-Min LIU
China Journal of Chinese Materia Medica 2025;50(9):2526-2538
This paper aimed to use non-targeted urine metabolomics to reveal the potential biomarkers of toxicity in rats with hepatic injury induced by aqueous extracts of Dictamni Cortex(ADC). Forty-eight SD rats were randomly assigned to a blank group and high-dose, medium-dose, and low-dose ADC groups, with 12 rats in each group(half male and half female), and they were administered orally for four weeks. The hepatic injury in SD rats was assessed by body weight, liver weight/index, biochemical index, L-glutathione(GSH), malondialdehyde(MDA), and pathological alterations. The qPCR was utilized to determine the expression of metabolic enzymes in the liver and inflammatory factors. Differential metabolites were screened using principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA), followed by a metabolic pathway analysis. The Mantel test was performed to assess differential metabolites and abnormally expressed biochemical indexes, obtaining potential biomarkers. The high-dose ADC group showed a decrease in body weight and an increase in liver weight and index, resulting in hepatic inflammatory cell infiltration and hepatic steatosis. In addition, this group showed elevated levels of MDA, cytochrome P450(CYP) 3A1, interleukin-1β(IL-1β), and tumor necrosis factor-α(TNF-α), as well as lower levels of alanine transaminase(ALT) and GSH. A total of 76 differential metabolites were screened from the blank and high-dose ADC groups, which were mainly involved in the pentose phosphate pathway, tryptophan metabolism, purine metabolism, pentose and glucuronic acid interconversion, galactose metabolism, glutathione metabolism, and other pathways. The Mantel test identified biomarkers of hepatotoxicity induced by ADC in SD rats, including glycineamideribotide, dIDP, and galactosylglycerol. In summary, ADC induced hepatotoxicity by disrupting glucose metabolism, ferroptosis, purine metabolism, and other pathways in rats, and glycineamideribotide, dIDP, and galactosylglycerol could be employed as the biomarkers of its toxicity.
Animals
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Male
;
Rats, Sprague-Dawley
;
Rats
;
Metabolomics
;
Biomarkers/metabolism*
;
Liver/metabolism*
;
Drugs, Chinese Herbal/adverse effects*
;
Female
;
Chemical and Drug Induced Liver Injury/metabolism*
;
Glutathione/metabolism*
;
Humans
9.Advances in pathogenesis of asthma airway remodeling and intervention mechanism of traditional Chinese medicine.
Ya-Sheng DENG ; Jiang LIN ; Yu-Jiang XI ; Yan-Ping FAN ; Wen-Yue LI ; Yong-Hui LIU ; Zhao-Bing NI ; Xi MING
China Journal of Chinese Materia Medica 2025;50(8):2050-2070
Asthma, a chronic inflammatory airway disease with a high global prevalence, has a complex pathogenesis, in which airway remodeling plays a key role in the chronicity of the disease. Airway remodeling involves a series of pathophysiological changes, including airway epithelial damage, proliferation of mucous glands and goblet cells, subepithelial fibrosis, proliferation and migration of airway smooth muscle cells, and epithelial-mesenchymal transition. These complex pathological changes significantly increase airway resistance and responsiveness, forming an important pathological basis for refractory asthma. Currently, the regulatory mechanisms of airway remodeling focus on signaling pathways and regulatory targets. The signaling pathways include phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt), nuclear factor-κB(NF-κB), transforming growth factor-β1(TGF-β1)/Smads, and mitogen-activated protein kinase(MAPK). The regulatory targets include microRNAs(miRNAs), competing endogenous RNAs(ceRNAs), long non-coding RNAs(lncRNAs), and circular RNAs(circRNAs). Key proteins involved in these processes include TGF-β1, silencing information regulator 2-related enzyme 1(SIRT1), chitinase 3-like protein 1(YKL-40), and adenosine deaminase-metalloproteinase 33(ADAM33). In recent years, the potential of traditional Chinese medicine in the treatment of asthma has become increasingly evident. Its active ingredients, extracts, and complexes can inhibit airway remodeling in asthma through multiple pathways, demonstrating a variety of effects, including anti-inflammatory actions, inhibition of smooth muscle cell proliferation and migration, regulation of epithelial-mesenchymal transition, attenuation of fibrosis and basement membrane thickening, reduction of mucus secretion, inhibition of vascular remodeling, modulation of immune imbalance, and antioxidative stress. This paper aims to provide an in-depth analysis of the pathogenesis and therapeutic targets of asthma, offering theoretical support and innovative strategies for clinical research and drug development in the treatment of asthma.
Asthma/pathology*
;
Humans
;
Airway Remodeling/drug effects*
;
Drugs, Chinese Herbal/therapeutic use*
;
Animals
;
Signal Transduction/drug effects*
;
Medicine, Chinese Traditional
;
Transforming Growth Factor beta1/metabolism*
10.Correlation analysis of clinical features between wet and dry gangrene in diabetic foot.
Yu-Zhen WANG ; Cheng-Lin JIA ; Yong-Kang ZHANG ; Jun-Lin DENG ; Zong-Hao DAI ; Cheng ZHAO ; Ye-Min CAO
China Journal of Orthopaedics and Traumatology 2025;38(9):884-890
OBJECTIVE:
To explore clinical characteristics, lesion sites and correlation differences of different types of diabetic foot gangrene, and to provide evidence-based basis for clinical classification of diabetic foot gangrene.
METHODS:
A retrospective analysis was conducted on 266 patients with newly diagnosed diabetic foot gangrene who were admitted from January 2018 to December 2018, including 183 males and 83 females, aged from 35 to 92 years old with an average of (69.55±10.84) years old, and they were divided into wet gangrene group and dry gangrene group according to the different natures of gangrene. There were 139 patients in wet gangrene group, including 98 males and 41 females, aged from 35 to 90 years old with an average of (68.95±10.93) years old. There were 127 patients in dry gangrene group, including 85 males and 42 females, aged from 38 to 92 years old with an average of (70.21±10.75) years old. Body mass index (BMI), waist-to-hip ratio (WHR), body temperature, skin temperature difference between the affected and healthy sides of the lower extremities, and Wagner grade between two groups were recorded to evaluate symptoms and signs. The white blood cell count (WBC), neutrophil percentage (NEUT%), and C-reactive protein (C-reactive protein), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and interleukin-6 (IL-6) in peripheral blood between two groups were detected and compared to evaluate the infection status;the severity of diabetic peripheral neuropathy (DPN) was evaluated by using Toronto Clinical Scoring System (TCSS);the degree of pain in patients with diabetic foot gangrene was evaluated by numerical rating scale (NRS); ankle-brachial index (ABI) and popliteal artery blood flow velocity were used to evaluate the degree of arterial lesions. Spearman correlation analysis was used to analyze the correlations between gangrene TCSS, ABI and age, BMI, WHR, body temperature, calf skin temperature difference, WBC, NEUT%, CRP, ESR, PCT, IL-6, NRS, and Wagner classification indicators.
RESULTS:
The body temperature, skin temperature difference between the affected and healthy sides of the lower extremities, Wagner grade, WBC, NEUT%, CRP, ESR, PCT, IL-6, TCSS score, ABI, and popliteal artery blood flow velocity in wet gangrene group were higher than those in dry gangrene group (P<0.01), and BMI, WHR, and NRS score in dry gangrene group were higher than those in wet gangrene group;the differences were all statistically significant (P<0.01). The results of Spearman correlation analysis showed TCSS score of gangrene patients was correlated with body temperature (r=0.214), calf skin temperature difference (r=0.364), WBC (r=0.240), NEUT% (r=0.291), CRP (r=0.347), ESR (r=0.167), PCT (r=0.241), IL-6 (r=0.316), and popliteal fossa arterial blood flow velocity (r=0.261) and Wagner grade (r=0.273) were positively correlated, and the differences were statistically significant (P<0.01). ABI was negatively correlated with age (r=-0.183), BMI (r=-0.252), WHR (r=-0.288), and NRS score (r=-0.354), and the differences were statistically significant (P<0.01).
CONCLUSION
Diabetic foot gangrene is an extremely difficult and critical disease. Wet gangrene has a significant synergic effect with infection and neuropathy, while dry gangrene is closely related to vascular occlusion. The main contradiction of gangrene could be revealed through blood vessels, nerves and infection, providing evidence-based basis for the selection of debridement timing, anti-infection strategies and revascularization, with the aim of reducing the risk of amputation.
Humans
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Male
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Female
;
Aged
;
Middle Aged
;
Diabetic Foot/diagnosis*
;
Aged, 80 and over
;
Adult
;
Retrospective Studies
;
Gangrene/physiopathology*
;
C-Reactive Protein

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