1.Mechanism of Ferroptosis in Regulating Chronic Heart Failure and Traditional Chinese Medicine Prevention and Treatment Based on Qi Deficiency and Stagnation: A Review
Ziyang YUAN ; Yan ZHANG ; Wei ZHANG ; Yaqin WANG ; Wenjun MAO ; Guo YANG ; Xuewei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):248-255
Chronic heart failure (CHF) is the final stage of cardiovascular diseases. It is a complex syndrome, with dyspnea and edema as the main clinical manifestations, and it is characterized by complex disease conditions, difficult cure, and high mortality. Ferroptosis, a new type of programmed cell death, is different from other types of programmed cell death. Ferroptosis is iron-dependent, accompanied by lipid peroxide accumulation and mitochondrial shrinkage, becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi, blood, and body fluid, which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi (heart Qi) is the root cause of CHF, and stagnation (phlegm turbidity and blood stasis) is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine (TCM) plays an important role in the treatment of CHF, improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore, this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation, aiming to provide new ideas and methods for the treatment of CHF with TCM.
2.Comparative analysis of characteristics and functions of exosomes from human induced pluripotent stem cell-derived platelets and apheresis platelets
Weihua HUANG ; Yan ZANG ; Aihua QIN ; Ziyang FENG ; Heshan TANG ; Fei GUO ; Chuyan WU ; Qiu SHEN ; Baohua QIAN ; Haihui GU ; Zhanshan CHA
Chinese Journal of Blood Transfusion 2025;38(9):1154-1161
Objective: To compare the biological characteristics of human induced pluripotent stem cell-derived platelet exosomes (hiPSC-Plt-Exos) with those of conventional apheresis platelet exosomes (Plt-Exos), specifically focusing on their differential abilities to enhance the proliferation and migration of human umbilical cord mesenchymal stem cells (hUC-MSCs). Methods: Exosomes were isolated from hiPSC-derived Plt and apheresis Plt concentrate using size exclusion chromatography. These exosomes were then characterized through nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and Western blotting. Co-culture experiments into hUC-MSCs were conducted with hiPSC-Plt-Exos and apheresis Plt-Exos, respectively. Their effects on the proliferation and migration of hUC-MSCs were assessed via cell proliferation assays and scratch tests. Results: hiPSC-Plt-Exos and apheresis Plt-Exos exhibited comparable particle sizes, morphological features (such as the characteristic cup-shaped structure), and surface markers (including CD9 and HSP70). Notably, hiPSC-Plt-Exos demonstrated a significantly greater ability to enhance the proliferation and migration of hUC-MSCs compared to apheresis Plt-Exos (P<0.05). These differences provide critical comparative data for their application in various clinical contexts. Conclusion: This study establishes a theoretical foundation for developing precise therapeutic strategies based on hiPSC-Plt-Exos. Furthermore, it underscores the necessity of selecting the appropriate type of exosomes according to the specific disease microenvironment to achieve optimal therapeutic outcomes.
3.Traditional Chinese Medicine Treats Heart Failure by Regulating Autophagy via AMPK/mTOR Signaling Pathway: A Review
Wenjun MAO ; Yan ZHANG ; Wei ZHANG ; Yaqin WANG ; Ziyang YUAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(21):112-122
Heart failure (HF) is a group of syndromes caused by cardiac dysfunction with impaired ventricular pumping, seriously affecting patients' health and quality of life. The pathogenesis of HF is complex, including myocardial contractility decline, myocardial fibrosis, and ventricular remodeling, and it is related to neuroendocrine regulation, inflammation, and cardiomyocyte autophagy. Autophagy is a key regulatory mechanism by which cells degrade themselves to maintain body homeostasis. In the process of HF, moderate autophagy can remove aging and damaged cardiomyocytes and maintain the balance of myocardial energy metabolism, while abnormal autophagy may lead to functional decline and pathological changes of cardiomyocytes. The adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signaling pathway is one of the classical pathways regulating autophagy. This pathway can mediate the autophagy of cardiomyocytes and play a role in protecting the cardiac function and delaying HF progression. Traditional Chinese medicine (TCM) with a long history has a unique theoretical system and shows satisfactory therapeutic effects and wide application prospects amid the integration with modern medicine. The clinical practice of TCM has accumulated rich experience in the treatment of cardiovascular diseases. A large number of studies have shown that the active components and compound prescriptions of TCM and Chinese patent medicines can mediate autophagy by regulating the AMPK/mTOR signaling pathway to treat HF. This article explains the role of AMPK/mTOR signaling pathway-mediated autophagy in the treatment of HF, introduces the understanding of autophagy, AMPK/mTOR signaling pathway, and HF based on TCM theories, and reviews the research progress in the regulation of autophagy by TCM in the treatment of HF via the AMPK/mTOR pathway. This review is expected to tap the potential of TCM in the treatment of cardiovascular diseases, provide theoretical support for subsequent experimental studies, and demonstrate the advantages of TCM in clinical practice to achieve more accurate treatment.
4.Role of Mitophagy in Prevention and Treatment of Heart Failure Based on PINK1/Parkin Pathway and Treatment with Traditional Chinese Medicine: A Review
Ziyang YUAN ; Yan ZHANG ; Wei ZHANG ; Yaqin WANG ; Wenjun MAO ; Guo YANG ; Xuewei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(24):262-271
Heart failure is a group of complex clinical syndromes that represent the final stage of cardiovascular disease development, characterized by an extremely high mortality rate. However, due to the complexity of the pathological mechanisms, an effective treatment method has not yet been found. Mitochondria are among the most critical organelles in cells, playing an essential role in energy supply and widely participating in various life activities, such as the regulation of oxidative stress and apoptosis. The normal functioning of mitochondria is crucial for maintaining the body's normal life activities. In recent years, studies have found that mitochondrial dysfunction is associated with the occurrence and progression of various diseases, particularly closely related to the onset of heart failure. An imbalance in mitochondrial homeostasis is a key factor in cardiomyocyte death and the onset of heart failure. Mitochondrial autophagy, as a means of regulating mitochondrial homeostasis, is significant for the prevention and treatment of heart failure. Traditional Chinese medicine (TCM) therapy is a unique treatment approach in China now widely applied in clinical practice, demonstrating significant efficacy in treating heart failure, with unique advantages. Modern pharmacological research indicates that Chinese medicine monomers and compounds can target and regulate mitochondrial homeostasis in cardiomyocytes, affect mitochondrial autophagy, and protect cardiomyocytes, though the specific mechanisms remain unclear. Therefore, this paper explored the mechanisms of the PTEN-induced putative kinase 1 (PINK1)/Parkin pathway in mitochondrial autophagy and heart failure, reviewed the effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure, and discussed the therapeutic effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure in conjunction with TCM. This paper is expected to provide new ideas and methods for the prevention and treatment of heart failure from the perspective of PINK1/Parkin regulation of mitochondrial autophagy.
5.A recombinant adeno-associated virus expressing secretory TGF-β type Ⅱ receptor inhibits triple-negative murine breast cancer 4T1 cell proliferation and lung metastasis in mice
Zhi CUI ; Cuijiao MA ; Qianru WANG ; Jinhao CHEN ; Ziyang YAN ; Jianlin YANG ; Yafeng LÜ ; Chunyu CAO
Journal of Southern Medical University 2024;44(5):818-826
Objective To investigate the effects of an adeno-associated virus(AAV2)vector expressing secretory transforming growth factor-β(TGF-β)type Ⅱ receptor(sTβRⅡ)extracellular domain-IgG2a Fc fusion protein(sTβRⅡ-Fc)on proliferation and migration of triple-negative murine breast cancer 4T1 cells in mice.Methods The pAAV-sTβRⅡ-Fc vector expressing sTβRⅡ-Fc fusion protein constructed by molecular cloning,the capsid protein-expressing vector pAAV2 and the helper vector were co-transfected into HEK 293T cells to prepare the recombinant AAV2-sTβRⅡ virus,which was purified by density gradient centrifugation with iodixanol.Western blotting was used to examine the effects of AAV-sTβRⅡ virus on Smad2/3 phosphorylation in 4T1 cells and on expression levels of E-cadherin,vimentin and p-Smad2/3 in 4T1 cell xenografts in mice.BALB/c mice bearing subcutaneous xenografts of luciferase-expressing 4T1 cells received intravenous injections of AAV-sTβRⅡ virus,AAV-GFP virus or PBS(n=6)through the tail vein,and the proliferation and migration of 4T1 cells were analyzed with in vivo imaging.Ki67 expression in the tumor tissues and sTβRⅡ protein expressions in mouse livers were detected with immunohistochemistry and immunofluorescence staining,and tumor metastases in the vital organs were examined with HE staining.Results The recombinant pAAV-sTβRⅡ-Fc vector successfully expressed sTβRⅡ in HEK 293T cells.Infection with AAV2-sTβRⅡ virus significantly reduced TGF-β1-induced Smad2/3 phosphorylation in 4T1 cells and effectively inhibited proliferation and lung metastasis of 4T1 xenografts in mice(P<0.05).In the tumor-bearing mice,intravenous injection of AAV-sTβRⅡ virus significantly increased E-cadherin expression,reduced vimentin and Ki67 protein expressions and Smad2/3 phosphorylation level in the tumor tissues(P<0.05 or 0.01),and induced liver-specific sTβRⅡ expression without causing body weight loss or heart,liver,spleen or kidney pathologies.Conclusion The recombinant AVV2 vector encoding sTβRⅡ extracellular domain is capable of blocking the TGF-β signaling pathway to inhibit the proliferation and lung metastasis of 4T1 cells in mice.
6.A recombinant adeno-associated virus expressing secretory TGF-β type Ⅱ receptor inhibits triple-negative murine breast cancer 4T1 cell proliferation and lung metastasis in mice
Zhi CUI ; Cuijiao MA ; Qianru WANG ; Jinhao CHEN ; Ziyang YAN ; Jianlin YANG ; Yafeng LÜ ; Chunyu CAO
Journal of Southern Medical University 2024;44(5):818-826
Objective To investigate the effects of an adeno-associated virus(AAV2)vector expressing secretory transforming growth factor-β(TGF-β)type Ⅱ receptor(sTβRⅡ)extracellular domain-IgG2a Fc fusion protein(sTβRⅡ-Fc)on proliferation and migration of triple-negative murine breast cancer 4T1 cells in mice.Methods The pAAV-sTβRⅡ-Fc vector expressing sTβRⅡ-Fc fusion protein constructed by molecular cloning,the capsid protein-expressing vector pAAV2 and the helper vector were co-transfected into HEK 293T cells to prepare the recombinant AAV2-sTβRⅡ virus,which was purified by density gradient centrifugation with iodixanol.Western blotting was used to examine the effects of AAV-sTβRⅡ virus on Smad2/3 phosphorylation in 4T1 cells and on expression levels of E-cadherin,vimentin and p-Smad2/3 in 4T1 cell xenografts in mice.BALB/c mice bearing subcutaneous xenografts of luciferase-expressing 4T1 cells received intravenous injections of AAV-sTβRⅡ virus,AAV-GFP virus or PBS(n=6)through the tail vein,and the proliferation and migration of 4T1 cells were analyzed with in vivo imaging.Ki67 expression in the tumor tissues and sTβRⅡ protein expressions in mouse livers were detected with immunohistochemistry and immunofluorescence staining,and tumor metastases in the vital organs were examined with HE staining.Results The recombinant pAAV-sTβRⅡ-Fc vector successfully expressed sTβRⅡ in HEK 293T cells.Infection with AAV2-sTβRⅡ virus significantly reduced TGF-β1-induced Smad2/3 phosphorylation in 4T1 cells and effectively inhibited proliferation and lung metastasis of 4T1 xenografts in mice(P<0.05).In the tumor-bearing mice,intravenous injection of AAV-sTβRⅡ virus significantly increased E-cadherin expression,reduced vimentin and Ki67 protein expressions and Smad2/3 phosphorylation level in the tumor tissues(P<0.05 or 0.01),and induced liver-specific sTβRⅡ expression without causing body weight loss or heart,liver,spleen or kidney pathologies.Conclusion The recombinant AVV2 vector encoding sTβRⅡ extracellular domain is capable of blocking the TGF-β signaling pathway to inhibit the proliferation and lung metastasis of 4T1 cells in mice.
7.Role of Ferroptosis in Cardiovascular Diseases and Chinese Medicine Treatment Based on Iron Homeostasis: A Review
Ziyang YUAN ; Yan ZHANG ; Wei ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(18):198-208
Cardiovascular diseases are a class of circulatory system diseases involving the heart and vessels, including arrhythmia, hypertension, coronary heart disease, myocardial infarction, heart failure and so on. Due to the complicated pathogenesis, diverse disease types, and difficult treatment, cardiovascular diseases pose serious threatens to the human health. Therefore, it is urgent to develop effective therapies. Ferroptosis, a new type of cell death different from autophagy and apoptosis, is iron-dependent and accompanied by lipid peroxide accumulation. The mechanism of ferroptosis is complex. Recent studies have shown that iron homeostasis plays a role in the occurrence of ferroptosis, which may be induced by iron intake, utilization, and output and iron-related protein synthesis. In addition, iron homeostasis and ferroptosis have been confirmed to be involved in the pathological process of cardiovascular diseases, so regulating iron homeostasis and ferroptosis in cardiomyocytes may be a focus of the future research on cardiovascular diseases. Traditional Chinese medicine (TCM) provides a unique treatment method, and the unique syndrome differentiation system and treatment methods have been widely used in the clinical diagnosis, prevention, and treatment of cardiovascular diseases. Studies have demonstrated that TCM compound prescriptions and the active components in Chinese medicinal materials can regulate iron homeostasis and ferroptosis to protect cardiomyocytes. This paper introduces the mechanism of iron homeostasis in regulating ferroptosis and summarizes the effects of iron homeostasis-mediated ferroptosis on cardiovascular diseases. Furthermore, the research progress of TCM in regulating iron homeostasis-mediated ferroptosis in cardiovascular diseases is reviewed to provide new ideas for TCM prevention and treatment of cardiovascular diseases.
8.Metabolic profile changes of kidney aging and protective effects of Polygonatum sibiricum polysaccharides on D-galactose-induced aging mice
Di ZHAO ; Fayyaz Sharmeen ; Ziyang YI ; Zhao LIU ; Yan WANG ; Ping CAI ; Wei HE
Digital Chinese Medicine 2023;6(3):328-340
Objective:
To investigate the metabolic trajectory of kidney aging and the effects of Polygonatum sibiricum polysaccharides (PSP) against kidney aging in D-galactose (D-gal)-induced aging mice, based on ultra-performance liquid chromatography/Q-Exactive Orbitrap mass spectrometry (UPLC-Q-Exactive MS/MS).
Methods:
A total of 36 C57 BL/6J mice were randomly allocated to six groups: control (CON), model (MOD), PSP low-dose (PSP-L), PSP medium-dose (PSP-M), PSP high-dose (PSP-H), and positive drug ascorbic acid (VC) groups. To create models of aging mice, D-gal was intraperitoneally administered to all other groups of mice except the CON group. After modeling, the appropriate Chinese medicine [PSP-L: 150 mg/(kg·d), PSP-M: 300 mg/(kg·d), PSP-H: 600 mg/(kg·d)] or positive drug [ascorbic acid, 300 mg/(kg·d)] was administered for intervention. Key markers of renal function in urine and serum of mice in each group, such as creatinine (Crea), urea nitrogen (BUN), and uric acid (UA) levels, as well as key indicators of oxidative stress in serum and kidney, including superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) were determined to validate the successful establishment of kidney aging models and to estimate the effects of PSP. Hematoxylin and eosin (HE), periodic acid Schiff (PAS), and β-galactosidase staining were used to assess the renal pathological changes. The metabolic profiles of serum, kidney, and urine samples from CON, MOD, and PSP-H groups were analyzed by UPLC-Q-Exactive MS/MS, and pattern recognition methods were used to outline the metabolic trajectory of kidney aging and to identify the characteristic metabolites.
Results:
Age-related alterations in renal histopathology and impaired renal function in mice were also associated with oxidative stress indicators. Following the injection of PSP [PSP-H: 600 mg/(kg·d)], the pathological indices associated with aging were adjusted to normal levels, renal function and oxidative stress were improved in aging mice, and renal pathological damage was markedly improved. Meanwhile, the potential biomarkers were identified by UPLC-Q-Exactive MS/MS analysis and were further analyzed to form related metabolic pathways, with P < 0.05 as a threshold. The results showed that purine, sphingolipid, glycerophospholipid, tryptophan, and riboflavin metabolisms were the main metabolic pathways associated with aging. After administration of PSP, these pathological indices returned to normal levels, and biomarkers related to the aging process, such as adenosine monophosphate (AMP), tryptophan, and 5-hydroxytryptophan, also demonstrated, to some degree, reverse regulation (promoting synthesis).
Conclusion
Metabolomics methods based on UPLC-Q-Exactive MS/MS and multivariate statistical analysis can be adopted to establish metabolic profiles in aging mice. PSP has been shown to protect against kidney aging by interfering with the purine, sphingolipid, glycerophospholipid, tryptophan, and riboflavin metabolisms in the kidney.
9.Clinical blood transfusion quality management in Shanghai
Heshan TANG ; Aihua QIN ; Weihua HUANG ; Zhanshan ZHA ; Fei GUO ; Ziyang FENG ; Baohua QIAN ; Yan ZANG
Chinese Journal of Blood Transfusion 2023;36(12):1154-1158
【Objective】 To analyze the data of clinical blood transfusion quality control supervision in Shanghai, so as to provide reference for the improvement of clinical blood transfusion quality management in hospitals at all levels. 【Methods】 The data of clinical blood transfusion quality control supervision in hospitals at all levels from 2016 to 2021 were retrospectively analyzed to obtain the characteristics and indicators in the quality management. 【Results】 The overall level of clinical blood transfusion quality management in Shanghai steadily improved from 2016 to 2021 (F=3.82, P<0.01), and the management level of different hospitals varied significantly (F=9.00, P<0.01). In 2021, the full compliance rates of housing facilities, instruments and equipment, diagnostic reports and medical record writing among the third-level indicators of clinical blood transfusion quality management in hospitals at all levels were as follows: 86.49%(32/37), 100% (37/37)and 43.24%(16/37) for tertiary comprehensive hospitals; 61.11%(11/18), 88.89%(16/18) and 50.00% (9/18)for tertiary specialized hospitals; 60.87%(14/23), 78.26%(18/23)and 47.83%(11/23) for secondary comprehensive hospitals, ; 60.00%(9/15), 66.67%(10/15), 40.00%(6/15) for secondary specialized hospitals; 52.38%(11/21), 38.10%(8/21), 42.86%(9/21) for private hospitals. 【Conclusion】 The characteristics of clinical blood transfusion quality management in hospitals at all levels in Shanghai differed significantly, with different strengths and weaknesses. Hospitals should improve blood transfusion management in terms of housing facilities, personnel management, system process as well as diagnostic reports and medical record writing, in order to enhance the clinical blood transfusion quality management.
10.Effect of posaconazole combined with proton pump inhibitors on blood concentrations and invasive fungal infec-tion in patients with malignant hematological disorders
Ruochen QU ; Jing YU ; Ziyang WANG ; Minglin LIU ; Jiahui LIU ; Xinying LIU ; Xinyu CUI ; Ziyi WANG ; Yan LIU
China Pharmacy 2023;34(10):1237-1241
OBJECTIVE To explore the effects of posaconazole combined with proton pump inhibitors (PPI) on the blood concentration and the risk of invasive fungal disease (IFD) in patients with malignant hematological disorder. METHODS In accordance with the random number table method, 40 patients with malignant hematological disorders who were admitted to the hematology department of our hospital between December 2020 and December 2021 were chosen and divided into control group (20 cases) and observation group (20 cases). The control group received Posaconazole oral suspension alone, while the observation group received Posaconazole oral suspension combined with PPI. The incidence of IFD, attainment rate of blood concentration, the time from the start of prophylaxis to IFD onset, the fatality associated with IFD, treatment of infected patients, and blood concentrations of posaconazole on 7th, 14th, 21st, and 28th day after posaconazole application were compared between 2 groups; the occurrence of adverse events during drug administration in the two groups was recorded. RESULTS The study was stopped because 2 patients in the observation group and 9 patients in the control group received hospital departures after taking posaconazole for fewer than 7 days. The incidence of IFD in the observation group was significantly higher than control group, and the attainment rate of blood concentration in the observation group was significantly lower than control group (P<0.05). There was no significant difference in the time from the start of prophylaxis to IFD onset, the fatality associated with IFD, treatment of infected patients and the incidence of adverse events (P> 0.05). The blood concentration of posaconazole in the observation group was significantly lower than control group on 7th day of medication (P<0.05); there was no significant in blood concentration of posaconazole between 2 groups on the 14th day of medication (P>0.05). CONCLUSIONS Posaconazole combined with PPI can reduce the blood concentration of patients with malignant hematological disorders, increase the risk of IFD. Clinical practice should try to avoid the combination of the two or use them under the guidance of therapeutic drug monitoring.

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