1.Inhibition of Epithelial-mesenchymal Transition Mechanism in Chronic Atrophic Gastritis Rats by Banxia Xiexintang via Regulating IL-17/ERK/C/EBPβ Signaling Pathway
Wenyu WU ; Xinyu ZENG ; Hao LI ; Weiqi SUN ; Jiahui REN ; Yang YU ; Tingting ZHOU ; Aili XU ; Wei WEI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):1-10
ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang (BXT) inhibits epithelial-mesenchymal transition (EMT) in chronic atrophic gastritis (CAG) rats by regulating the interleukin-17(IL-17)/extracellular regulated protein kinases(ERK)/CCAAT enhancer binding protein β(C/EBPβ)signaling pathway, thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling, the rats were randomly divided into the model group, low-, medium-, and high-dose groups (0.549, 1.098, 2.196 g·kg-1, respectively) of BXT, and the positive drug group (vitacoenzyme, 0.3 g·kg-1). A normal control group was also set up. After 8 weeks of intervention, the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of IL-17, tumor necrosis factor-α (TNF-α), cyclooxygenase-2 (COX-2), and C/EBPβ in serum, as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin, N-cadherin, and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17, p-ERK, and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ, ERK, and its phosphorylated form (p)-ERK in gastric mucosa. Real-time polymerase chain reaction (Real-time PCR) was applied to measure the mRNA expression levels of ERK, COX-2, and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group, the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly increased (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBPβ in serum were significantly increased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased, while the content of E-cadherin was significantly decreased (P<0.01). Compared with the model group, after intervention with different doses of BXT, the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ, ERK, and p-ERK in gastric mucosa were significantly reduced (P<0.05,P<0.01). The levels of IL-17, TNF-α, COX-2, and C/EBP β in serum were significantly decreased (P<0.01). The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased, while the content of E-cadherin was increased (P<0.05,P<0.01). ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum, regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.
2.Application of visual perception training in ophthalmic clinical practice
Yang GU ; Qionglei ZHONG ; Han REN
International Eye Science 2026;26(3):473-476
Vision is the primary perceptual mode through which humans and higher animals acquire external information. Visual perception encompasses various aspects of visual processing and has been widely applied in ophthalmic clinical practice. Based on the principle of neural plasticity, visual perception training relies on the visual signal processing mechanism. After receiving external visual signals, the retina transmits them via the optic nerve to the brain, where the cerebral cortex decodes, extracts, and processes the information. By stimulating specific visual information, visual perception training activates visual processing pathways, strengthens synaptic connections among neurons within these pathways, and ultimately enhances the cerebral cortex's ability to integrate and process information, thereby improving patients' visual function and experience. This article explores the application of visual perception training in conditions such as amblyopia, myopia, presbyopia, strabismus, glaucoma, macular degeneration, and optic pathway lesions, discussing its value in improving visual function. It provides theoretical references for the intervention and treatment of related diseases. Visual perception training has been widely applied in various ophthalmic diseases with confirmed clinical efficacy, and it may play a broader role in neurologically related systemic diseases, demonstrating certain clinical application value.
3.Genetic analysis of a de novo EFTUD2 variant causing Mandibulofacial dysostosis with microcephaly in a fetus.
Jianyu REN ; Xiaojiao GUAN ; Shuang LIU ; Yousheng YAN ; Shufa YANG
Chinese Journal of Medical Genetics 2026;43(4):288-294
OBJECTIVE:
To investigate the genetic etiology of a fetus diagnosed with Mandibulofacial dysostosis with microcephaly (MFDM).
METHODS:
A fetus that underwent prenatal diagnosis at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, on May 19, 2025 was selected for analysis. Results of fetal ultrasound findings, chromosomal karyotyping, copy number variation sequencing (CNV-seq), and whole-exome sequencing (WES) were collected. Sanger sequencing was performed for familial validation of the pathogenic variant. The Human Protein Atlas (HPA), STRING, and Simple ClinVar databases were queried to characterize the biological features of the candidate gene. Three-dimensional structures of the wild-type and variant proteins were modeled and analyzed, and the evolutionary conservation of the affected amino acid was assessed using UGENE. Prenatal phenotypes associated with EFTUD2 variants were summarized through a review of the literature. This study was approved by the Ethics Committee of Beijing Obstetrics and Gynecology Hospital, Capital Medical University (Ethics No.: 2025-KY-029-01).
RESULTS:
At 23+2 weeks of gestation, ultrasound examination revealed bilateral microtia with low-set ears, mild micrognathia with a reduced mandibular-facial angle, a single umbilical artery, a slightly narrow aortic diameter, and trivial mitral regurgitation. Amniotic fluid karyotyping and CNV-seq showed no abnormalities. WES identified a de novo, previously unreported EFTUD2 variant, c.698dupA (p.V235Gfs*27), in the fetus. This frameshift variant is predicted to alter the structural integrity of the EFTUD2 protein. Literature review indicated that micrognathia and microtia or low-set ears are the most common sonographic features in fetuses with EFTUD2 variants, while secondary findings may include abnormal stomach bubble, cleft palate, single umbilical artery, gastrointestinal atresia, polyhydramnios, and reduced aortic diameter.
CONCLUSION
The EFTUD2: c.698dupA (p.V235Gfs*27) variant is likely the genetic cause underlying MFDM in this fetus.
Humans
;
Mandibulofacial Dysostosis/diagnostic imaging*
;
Microcephaly/diagnostic imaging*
;
Female
;
Pregnancy
;
Ribonucleoprotein, U5 Small Nuclear/chemistry*
;
Peptide Elongation Factors/chemistry*
;
Fetus
;
DNA Copy Number Variations/genetics*
;
Adult
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Ultrasonography, Prenatal
4.Integrating Transcriptomics and 3D Organoids to Investigate Mechanism of Periplaneta americana Extract Against Lung Adenocarcinoma
Qiong MA ; Chunxia HUANG ; Jiawei HE ; Yuting BAI ; Xingyue LIU ; Yuxuan XIONG ; Yang ZHONG ; Hengzhou LAI ; Yuling JIANG ; Xueke LI ; Qian WANG ; Yifeng REN ; Xi FU ; Funeng GENG ; Taoqing WU ; Ping XIAO ; Fengming YOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):124-132
ObjectiveTo evaluate the antitumor activity of Periplaneta americana extract(PAE) against human-derived lung adenocarcinoma organoids(LUAD-PDOs) and to elucidate its potential mechanism based on transcriptomics. MethodsFresh tumor and adjacent normal tissues from patients with LUAD were collected to construct LUAD-PDOs and normal lung organoid(Nor-PDOs) models using 3D organoid culture technology. The effective intervention concentration of PAE was determined using the cell counting kit-8(CCK-8) assay. Experimental groups included the model group(LUAD-PDOs), normal group, model administration group(LUAD-PDOs+PAE), and normal administration group(Nor-PDOs+PAE). Hematoxylin-eosin(HE) staining was used to observe the pathological structures of PDOs, immunohistochemistry(IHC) was performed to detect the expressions of the proliferation marker Ki-67 and lung adenocarcinoma differentiation markers cytokeratin-7(CK-7) and Napsin A, TUNEL staining was applied to detect cell apoptosis. RNA sequencing(RNA-Seq) was conducted to identify differentially expressed genes(DEGs), followed by Gene Ontology(GO), Kyoto Encyclopedia of Genes and Genomes(KEGG), and Gene Set Enrichment Analysis(GSEA), alongside protein-protein interaction(PPI) network analysis to screen core mechanisms. Finally, key targets were validated by integrating external database analysis with immunofluorescence(IF). ResultsNor-PDOs and LUAD-PDOs that highly recapitulated the pathological characteristics of the primary tissues were successfully established. The CCK-8 assay determined that the effective intervention concentration of PAE was 16 g·L-1. Morphological observation showed that Nor-PDOs exhibited lumen-forming structures, whereas LUAD-PDOs displayed dense, solid structures. CCK-8 and TUNEL assays revealed that, compared with the model group, PAE intervention inhibited the proliferation of LUAD-PDOs and promoted apoptosis in LUAD cells, while showing no significant effect on the viability of Nor-PDOs. Transcriptomic analysis identified 719 DEGs that were significantly reversed after PAE intervention(347 up-regulated and 372 down-regulated)(P<0.05). GO enrichment analysis indicated that DEGs in the model administration group were significantly enriched in biological processes related to cell cycle regulation compared to the model group. KEGG pathway analysis revealed that PAE affected pathways related to proliferation and metabolism, including pathways in cancer and the p53 signaling pathway. GSEA further confirmed that PAE significantly enhanced the activity of the p53 signaling pathway(P<0.05). PPI network analysis indicated that breast cancer type 1 susceptibility protein(BRCA1) and checkpoint kinase 1(CHEK1) were the core down-regulated targets in the p53 pathway. IF verified the high expression of BRCA1 and CHEK1 in LUAD-PDOs and their significant downregulation after PAE intervention(P<0.05). Furthermore, survival analysis based on The Cancer Genome Atlas(TCGA) database indicated that low expression of BRCA1 and CHEK1 was significantly associated with prolonged overall survival in patients with LUAD(P<0.05). ConclusionPAE effectively inhibits proliferation of LUAD-PDOs and promotes their apoptosis, its anti-tumor mechanism is potentially associated with the activation of the p53 signaling pathway, with BRCA1 and CHEK1 genes likely serving as key downstream targets for the effects of PAE.
5.WANG Qingguo's Experience in Treatment of Headache Based on the Concept of "Achieving Harmony by Unblocking and Balancing"
Chuxin ZHANG ; Zilin REN ; Yang ZHAO ; Jinhua HAN ; Bomin ZHANG ; Fafeng CHENG ; Changxiang LI ; Xueqian WANG ;
Journal of Traditional Chinese Medicine 2026;67(9):935-940
This paper summarizes professor WANG Qingguo's experience in treatment of headache based on the "achieving harmony by unblocking and balancing" concept. It is considered that although the pathogenesis of headache is generally attributed to "pain arises from obstruction" and "pain arises from malnourishment", clinical presentations often involve a complex mixture of deficiency and excess, as well as cold and heat patterns. Professor WANG proposes the diagnostic and therapeutic theory of "achieving harmony by unblocking and balancing", advocating for equal emphasis on "freeing the flow of qi and blood" and "regulating the balance of yin and yang". He has summarized eight treatment methods for common headache patterns. For wind-cold attacking the collaterals, treatment should focus on dispersing and unblocking through modified Gegen Decoction (葛根汤). For wind-dampness binding, it is recommended to unblock and drain, using modified Qingshang Juantong Decoction (清上蠲痛汤). For damp-heat congestion, unblocking and clearing is the method, using modified Toufeng Shen Formula (头风神方). For liver-gallbladder qi constraint, unblocking and soothing is the treatment principle, and modified Sanpian Decoction (散偏汤) is suggested. For insufficiency of center qi, even supplementation method is recommended, and modified Yiqi Congming Decoction (益气聪明汤) can be used. For liver yang hyperactivity, unblocking and subduing are combined, using modified Xunlong Decoction (驯龙汤). For deficiency-cold in the liver and stomach, warming, harmonizing, unblocking, and descending are applied, using modified Wuzhuyu Decoction (吴茱萸汤). For blood deficiency with cold congelation, unblocking and nourishing are undertaken together, using modified Danggui Sini Decoction (当归四逆汤). The ultimate goal is to restore the dynamic balance of yin, yang, qi, and blood in the body, thereby allevia-ting pain by restoring clarity and function to the head orifices.
6.WANG Qingguo's Experience in Treatment of Headache Based on the Concept of "Achieving Harmony by Unblocking and Balancing"
Chuxin ZHANG ; Zilin REN ; Yang ZHAO ; Jinhua HAN ; Bomin ZHANG ; Fafeng CHENG ; Changxiang LI ; Xueqian WANG ;
Journal of Traditional Chinese Medicine 2026;67(9):935-940
This paper summarizes professor WANG Qingguo's experience in treatment of headache based on the "achieving harmony by unblocking and balancing" concept. It is considered that although the pathogenesis of headache is generally attributed to "pain arises from obstruction" and "pain arises from malnourishment", clinical presentations often involve a complex mixture of deficiency and excess, as well as cold and heat patterns. Professor WANG proposes the diagnostic and therapeutic theory of "achieving harmony by unblocking and balancing", advocating for equal emphasis on "freeing the flow of qi and blood" and "regulating the balance of yin and yang". He has summarized eight treatment methods for common headache patterns. For wind-cold attacking the collaterals, treatment should focus on dispersing and unblocking through modified Gegen Decoction (葛根汤). For wind-dampness binding, it is recommended to unblock and drain, using modified Qingshang Juantong Decoction (清上蠲痛汤). For damp-heat congestion, unblocking and clearing is the method, using modified Toufeng Shen Formula (头风神方). For liver-gallbladder qi constraint, unblocking and soothing is the treatment principle, and modified Sanpian Decoction (散偏汤) is suggested. For insufficiency of center qi, even supplementation method is recommended, and modified Yiqi Congming Decoction (益气聪明汤) can be used. For liver yang hyperactivity, unblocking and subduing are combined, using modified Xunlong Decoction (驯龙汤). For deficiency-cold in the liver and stomach, warming, harmonizing, unblocking, and descending are applied, using modified Wuzhuyu Decoction (吴茱萸汤). For blood deficiency with cold congelation, unblocking and nourishing are undertaken together, using modified Danggui Sini Decoction (当归四逆汤). The ultimate goal is to restore the dynamic balance of yin, yang, qi, and blood in the body, thereby allevia-ting pain by restoring clarity and function to the head orifices.
7.Xiaozheng Zhitong Paste Alleviates Bone Cancer Pain by Regulating PD-1/PD-L1-induced Osteoclast Formation
Lu SHANG ; Juanxia REN ; Guangda ZHENG ; Linghan MENG ; Lingyun WANG ; Changlin LI ; Dongtao LI ; Yaohua CHEN ; Guiping YANG ; Yanju BAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):72-79
ObjectiveThis study aims to investigate the action mechanism by which Xiaozheng Zhitong paste (XZP) alleviates bone cancer pain (BCP) by regulating programmed death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) pathway-induced osteoclast formation. MethodsThirty female C57BL/6 mice were randomly allocated into the following groups (n=6 per group): normal control group, model group, low‑dose XZP group (31.5 g·kg-1), high‑dose XZP group (63 g·kg-1), and PD‑1 inhibitor (Niv) group. A bone cancer pain (BCP) model was established by injecting Lewis lung carcinoma cells. Mice in the normal control and model groups received topical application of a blank paste matrix at the wound site. Mice in the low‑ and high‑dose XZP groups were treated with XZP applied topically twice daily. Mice in the Niv group were topically administered the blank paste matrix and additionally received Niv via tail‑vein injection every two days. All interventions were continued for 21 days. During this period, behavioral tests were performed to assess mechanical, motor, and thermal nociceptive sensitivities. After 21 days, all mice were euthanized, and bone tissue from the operated side was collected for sectioning and preservation. Tartrate‑resistant acid phosphatase (TRAP) staining was used to evaluate osteoclast expression in the lesioned bone tissue. Immunohistochemistry was performed to detect the expression of Runt‑related transcription factor 2 (Runx2) in the lesioned bone tissue. Immunofluorescence was employed to assess the expression of PD‑1 and PD‑L1 in the lesioned bone tissue. ResultsCompared with the normal group, the model group showed significantly decreased limb mechanical withdrawal threshold, spontaneous paw flinching, and thermal withdrawal latency (P<0.01), increased number of osteoclasts in the lesioned bone tissue (P<0.01), and reduced expression of Runx2 (P<0.01). Compared with the model group, the BCP mice in the XZP low-dose group, XZP high-dose group, and Niv group exhibited increased limb mechanical withdrawal threshold, movement scores, and thermal withdrawal latency (P<0.01). The XZP low-dose group showed no significant changes in osteoclast number or Runx2 expression, while the XZP high-dose group and Niv group demonstrated significantly reduced osteoclast numbers (P<0.01) and significantly increased Runx2 expression (P<0.01). In the lesioned bone tissue of BCP mice, the XZP low-dose group showed no significant decrease in the percentage of PD-1 expression, but a decrease in the percentage of PD-L1 expression (P<0.05). In contrast, both the XZP high-dose group and the Niv group exhibited significant reductions in the percentages of PD-1 and PD-L1 expression (P<0.01). ConclusionXZP alleviates the pain of mice with BCP by blocking the PD-1/PD-L1 pathway to inhibit osteoclastogenesis.
8.Mechanism of Xiaozheng Zhitong Paste in Alleviating Bone Cancer Pain by Regulating Microglial Pyroptosis Based on PINK1/Parkin/NLRP3 Signaling Pathway
Lingyun WANG ; Guangda ZHENG ; Lu SHANG ; Juanxia REN ; Changlin LI ; Dongtao LI ; Haixiao LIU ; Yaohua CHEN ; Guiping YANG ; Yanju BAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):80-90
ObjectiveThe paper aims to investigate the mechanism by which Xiaozheng Zhitong paste (XZP) alleviates bone cancer pain (BCP) through regulating the PTEN-induced putative kinase 1 (PINK1)/Parkin-mediated mitophagy-NOD-like receptor protein 3 (NLRP3) inflammasome pathway to suppress microglial pyroptosis. MethodsLipopolysaccharide (LPS) and LPS-adenosine triphosphate (ATP) were used to establish an inflammation and pyroptosis model in microglial cells. The cells were randomly divided into the following groups: control group, LPS group, LPS+low-dose XZP group, LPS+high-dose XZP group, LPS-ATP group, LPS-ATP+low-dose XZP group, LPS-ATP+high-dose XZP group, LPS-ATP+XZP group, and LPS-ATP+XZP+CsA group. Techniques including terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining, enzyme-linked immunosorbent assay (ELISA), Western blot, and confocal fluorescence staining were employed to assess the effects of XZP on microglial apoptosis, inflammatory cytokine release, inflammasome activation, pyroptosis, and mitophagy. ResultsIn vitro experiments showed that compared with the blank group, the LPS group exhibited significantly increased levels of microglial apoptosis and pro-inflammatory factors interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α)(P<0.01), along with significantly upregulated protein expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and phosphorylated nuclear factor-κB p65 (p-NF-κB p65) (P<0.01). Compared with the LPS group, the high-dose LPS-XZP group significantly reduced the level of apoptosis (P<0.01) and the content of the aforementioned pro-inflammatory factors (P<0.01). Both the low- and high-dose LPS-XZP groups dose-dependently downregulated the protein expression of iNOS, COX-2, and p-NF-κB p65 (P<0.05, P<0.01). Compared with the blank group, the LPS-ATP group showed significantly upregulated expression of pyroptosis-related proteins, including Caspase-1/pro-Caspase-1, N-terminal fragment of gasdermin D (GSDMD-N)/full-length gasdermin D (GSDMD-F), NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), IL-1β precursor (pro-IL-1β), and mature IL-1β (P<0.01). The levels of pyroptotic factors IL-1β and IL-18 were significantly elevated (P<0.01), and membrane pore formation and intracellular reactive oxygen species (ROS) levels were significantly increased (P<0.01). Compared with the LPS-ATP group, both the low- and high-dose LPS-ATP+XZP groups dose-dependently downregulated the expression of the aforementioned pyroptosis-related proteins (P<0.05, P<0.01). The low-dose LPS-ATP+XZP group reduced IL-1β levels (P<0.01), while the high-dose group reduced both IL-1β and IL-18 levels (P<0.01) Both the low- and high-dose LPS-ATP+XZP groups dose-dependently reduced membrane pore formation and intracellular ROS production (P<0.01). Compared with the blank group, the LPS-ATP group showed significantly reduced expression of mitophagy-related proteins PINK1 and Parkin, and a decreased ratio of microtubule-associated protein 1 light chain 3Ⅱ(LC3Ⅱ) to LC3Ⅰ(P<0.01), while p62 expression was significantly increased (P<0.01). Mitochondrial ROS levels were significantly enhanced (P<0.01). Compared with the LPS-ATP group, both the low- and high-dose LPS-ATP+XZP groups dose-dependently reversed the expression of these proteins (P<0.05, P<0.01) and reduced mitochondrial ROS levels (P<0.01). After treatment with the mitophagy inhibitor cyclosporin A (CsA), the beneficial effects of XZP on mitochondrial function and its inhibitory effects on pyroptosis-related protein expression were significantly reversed (P<0.05, P<0.01). ConclusionXZP reduces ROS levels by activating PINK1/Parkin-mediated mitophagy, thereby inhibiting NLRP3 inflammasome activation and microglial pyroptosis, which provides new molecular evidence for the mechanism by which XZP alleviates BCP.
9.Xiaozheng Zhitong Paste Relieves Bone Cancer Pain in Mice by Alleviating Activation of Microglia in Spinal Cord and Damage to Neurons via Blocking PAR2/NF-κB/NLRP3 Pathway
Guangda ZHENG ; Linghan MENG ; Lu SHANG ; Juanxia REN ; Dongtao LI ; Haixiao LIU ; Lingyun WANG ; Changlin LI ; Yaohua CHEN ; Guiping YANG ; Yanju BAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):91-100
ObjectiveTo investigate the effects and underlying mechanisms of Xiaozheng Zhitong Paste (XZP) on bone cancer pain (BCP). MethodsThirty female BALB/c mice were randomly divided into five groups: a Sham group, a BCP group, a BCP+low-dose XZP group, a BCP+high-dose XZP group, and a BCP+high-dose XZP + protease-activated receptor 2 (PAR2) agonist GB-110 group. BCP mice model was constructed by injecting Lewis lung carcinoma cells into the femoral cavity of the right leg, which was followed by being treated with XZP for 21 d. After 21 d, the mice were sacrificed. Nissl staining was used to evaluate the survival of spinal cord neurons. Immunofluorescence staining was conducted to localize ionized calcium-binding adapter molecule 1 (Iba1) and neuronal nuclear antigen (NeuN) in spinal cord tissue, thereby assessing microglial activation and neuronal survival. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), transforming growth factor-β (TGF-β), interleukin-4 (IL-4), and interleukin-10 (IL-10) in spinal cord tissue. Real-time quantitative polymerase chain reaction (Real-time PCR) was used to detect mRNA expression levels associated with M1/M2 polarization of microglia. Western blot analysis was performed to examine the expression of proteins related to microglial polarization as well as those involved in the PAR2/nuclear factor kappa B (NF-κB)/NOD-like receptor protein 3 (NLRP3) signaling pathway in the spinal cord. ResultsCompared with the Sham group, the spinal cord neurons were damaged, the number of Nissl-positive spinal cord neurons in the spinal cord tissue was significantly reduced (P<0.01), and the rate of NeuN-positive cells was significantly decreased (P<0.01). The spinal cord microglia were activated, the inflammatory level of the spinal cord tissue was enhanced, and Iba1 staining was significantly enhanced (P<0.01). The levels of IL-1β, TNF-α, IL-6, TGF-β, IL-4 and IL-10 were significantly increased (P<0.01). The mRNA expressions of IL-1β, TNF-α and inducible nitric oxide synthase (iNOS) were significantly increased (P<0.01), and the expression of PAR2, NLRP3, ASC and NF-κB p65 proteins in the spinal cord tissue of the BCP mice was significantly enhanced (P<0.01). Compared with the BCP group, high-dose XZP treatment significantly increased the number of Nissl-positive spinal cord neurons in the BCP mice (P<0.01), significantly enhanced the rate of NeuN-positive cells in the spinal cord tissue, and significantly weakened Iba1 staining (P<0.01). In addition, the levels of IL-1β, TNF-α, and IL-6 were significantly decreased, while the levels of TGF-β, IL-4, and IL-10 were significantly increased (P<0.05, P<0.01). The mRNA expression levels of IL-1β, TNF-α, and iNOS were decreased, whereas those of cluster of differentiation 206 (CD206), arginase-1 (Arg-1), and YM1/2 were significantly increased (P<0.05, P<0.01). Low-dose and high-dose XZP treatment significantly decreased the expression of PAR2, NLRP3, ASC, and NF-κB p65 proteins in the spinal cord tissue (P<0.05, P<0.01). These effects could all be significantly eliminated by the PAR2 agonist GB-110. ConclusionXZP can mitigate BCP in mice, which may be achieved through blocking the activated PAR2/NF-κB/NLRP3 pathway.
10.Xiaozheng Zhitong Paste Alleviates Bone Cancer Pain of Mice by Reducing Ferroptosis in Spinal Cord Tissue and Neuronal Damage via Regulating Nrf2/HO-1/GPX4/SLC7A11 Signaling Pathway
Juanxia REN ; Lu SHANG ; Guangda ZHENG ; Linghan MENG ; Lingyun WANG ; Changlin LI ; Dongtao LI ; Yaohua CHEN ; Guiping YANG ; Yanju BAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):101-113
ObjectiveThe paper aims to investigate the action mechanism by which the Xiaozheng Zhitong paste (XZP) relieves bone cancer pain (BCP). MethodsA model of mice with BCP was established by using Lewis tumor cells. The therapeutic effects of XZP, the ferroptosis inhibitor Ferrostatin-1 (Fer-1), and the nuclear factor erythroid 2-related factor 2 (Nrf2) inhibitor Brusatol (Bru) on BCP were examined. Mice were randomly divided into the Sham operation group, BCP group, BCP+XZP-L group, BCP+XZP-H group, BCP+Fer-1 group, and BCP+XZP-H+Bru group, with six mice in each group. Pain behavior tests were conducted on the mice to assess pain levels. Colorimetric assays were employed to measure ferroptosis-related factors in serum and spinal cord tissue including Fe, malondialdehyde (MDA), reactive oxygen species (ROS), and superoxide dismutase (SOD). Immunofluorescence staining was used to assess ROS production in spinal cord tissue. Transmission electron microscopy was used to observe the ultrastructure of mitochondria in lumbar spinal cord tissue. Quantitative real-time polymerase chain reaction (Real-time PCR) was employed to detect mRNA expression of Nrf2, heme oxygenase-1 (HO-1), glutathione peroxidase 4 (GPX4), and solute carrier family 7 member 11 (SLC7A11) in spinal cord neuron tissue. The protein expression of Nrf2, HO-1, GPX4, and SLC7A11 in spinal cord neurons was measured by Western blot. ResultsCompared with the Sham group, mice in the BCP group exhibited significantly reduced limb usage scores, mechanical foot withdrawal thresholds, and thermal foot withdrawal thresholds (P<0.01). Serum and lumbar spinal cord tissue levels of Fe, MDA, and reactive oxygen species (ROS) were significantly elevated (P<0.05), while superoxide dismutase (SOD) levels were significantly decreased (P<0.05). Lumbar spinal cord mitochondrial structural damage was observed, and mRNA and protein expression of Nrf2, HO-1, GPX4, and SLC7A11 were significantly downregulated (P<0.01). Compared with the BCP group, both low- and high-dose XZP groups improved the aforementioned pain behavioral indicators (P<0.05,P<0.01), reduced ferroptosis-related biomarkers including Fe, MDA, and ROS levels (P<0.05), increased SOD levels (P<0.05,P<0.01), alleviated mitochondrial damage, and upregulated Nrf2, HO-1, GPX4, SLC7A11 mRNA and protein expression (P<0.05,P<0.01). The high-dose XZP group exhibited comparable efficacy to Fer-1 in alleviating pain and inhibiting ferroptosis. Following Bru administration, XZP's effects on pain behavioral indicators, regulation of ferroptosis-related markers, mitochondrial structural protection, and activation of the Nrf2/HO-1/GPX4/SLC7A11 pathway were significantly reversed (P<0.05,P<0.01). ConclusionExternal application of XZP alleviates pain symptoms in BCP mice by activating the Nrf2/HO-1/GPX4/SLC7A11 pathway, thereby inhibiting ferroptosis and neuronal damage in spinal cord neurons.

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