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      Clinical evidence and potential mechanisms of Chinese medicines for the treatment of diabetic retinopathy

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          Abstract

          Highlights

          This article summarizes the application of Chinese medicines and their mechanisms of action in the treatment of diabetic retinopathy.

          Editor’s Summary

          More and more Chinese formulaes have been used by China FDA for the prevention and treatment of diabetic retinopathy. And their mechanisms of action have gained increasing attention around the world.

          Abstract

          Diabetic retinopathy is one of the main causes of visual impairment and blindness on a global scale. At present, the limitations of anti-vascular endothelial growth factor agents, steroids, laser photocoagulation, and vitreous surgery have led to a growing awareness of the role of Chinese medicines in the treatment of diabetic retinopathy. This review first describes the ingredients and characteristics of the formulae including Chinese herbal formulaes, Chinese patent drugs and ancient processed drugs and summarizes the application of Chinese medicines and their mechanisms of action in the treatment of diabetic retinopathy. Due to the complexity of Chinese medicines, in-depth mechanisms, side effects of herb, and drug interactions need to be elaborated in future research. Chinese medicines have the potencial to protect the residual eyesight and delay the progression of disease, thereby offering a beneficial, exploitable option in the treatment/prevention of diabetic retinopathy.

          Most cited references91

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          Contributions of Inflammatory Processes to the Development of the Early Stages of Diabetic Retinopathy

          Diabetes causes metabolic and physiologic abnormalities in the retina, and these changes suggest a role for inflammation in the development of diabetic retinopathy. These changes include upregulation of iNOS, COX-2, ICAM-1, caspase 1, VEGF, and NF- κ B, increased production of nitric oxide, prostaglandin E2, IL-1 β , and cytokines, as well as increased permeability and leukostasis. Using selective pharmacologic inhibitors or genetically modified animals, an increasing number of therapeutic approaches have been identified that significantly inhibit development of at least the early stages of diabetic retinopathy, especially occlusion and degeneration of retinal capillaries. A common feature of a number of these therapies is that they inhibit production of inflammatory mediators. The concept that localized inflammatory processes play a role in the development of diabetic retinopathy is relatively new, but evidence that supports the hypothesis is accumulating rapidly. This new hypothesis offers new insight into the pathogenesis of diabetic retinopathy, and offers novel targets to inhibit the ocular disease.
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            A Network Pharmacology Study of Chinese Medicine QiShenYiQi to Reveal Its Underlying Multi-Compound, Multi-Target, Multi-Pathway Mode of Action

            Chinese medicine is a complex system guided by traditional Chinese medicine (TCM) theories, which has proven to be especially effective in treating chronic and complex diseases. However, the underlying modes of action (MOA) are not always systematically investigated. Herein, a systematic study was designed to elucidate the multi-compound, multi-target and multi-pathway MOA of a Chinese medicine, QiShenYiQi (QSYQ), on myocardial infarction. QSYQ is composed of Astragalus membranaceus (Huangqi), Salvia miltiorrhiza (Danshen), Panax notoginseng (Sanqi), and Dalbergia odorifera (Jiangxiang). Male Sprague Dawley rat model of myocardial infarction were administered QSYQ intragastrically for 7 days while the control group was not treated. The differentially expressed genes (DEGs) were identified from myocardial infarction rat model treated with QSYQ, followed by constructing a cardiovascular disease (CVD)-related multilevel compound-target-pathway network connecting main compounds to those DEGs supported by literature evidences and the pathways that are functionally enriched in ArrayTrack. 55 potential targets of QSYQ were identified, of which 14 were confirmed in CVD-related literatures with experimental supporting evidences. Furthermore, three sesquiterpene components of QSYQ, Trans-nerolidol, (3S,6S,7R)-3,7,11-trimethyl-3,6-epoxy-1,10-dodecadien-7-ol and (3S,6R,7R)-3,7,11-trimethyl-3,6-epoxy-1,10-dodecadien-7-ol from Dalbergia odorifera T. Chen, were validated experimentally in this study. Their anti-inflammatory effects and potential targets including extracellular signal-regulated kinase-1/2, peroxisome proliferator-activated receptor-gamma and heme oxygenase-1 were identified. Finally, through a three-level compound-target-pathway network with experimental analysis, our study depicts a complex MOA of QSYQ on myocardial infarction.
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              Rethinking Ginkgo biloba L.: Medicinal uses and conservation

              Tasiu Isah (2015)
              Ginkgo biloba (G. biloba) is an ancient medicinal tree species that has been in existence for millennia without undergoing modifications due to its resistance to environmental stresses. Palaeobotanical history showed a wide distribution of the species across the globe but declined over geological time, becoming restricted to narrow geographical range with few surviving individuals in the modern day. The tree is slow growing, adapted to many ecological conditions and shows numerous adaptation in developmental patterns. Medicinal use of the species is attracting research interest, especially the various parts of the tree that are used in orthodox or traditional medicine to treat diseases due to the many bioactive compounds. The primary compounds receiving increasing research interest are the triterpene lactones and flavonoids; these are the target of biotechnological strategies being employed to enhance production. Many genetic and environmental factors have contributed to the endangered status of the species; conservation measures are required to protect it from extinction. In many countries, the cultivation of plantations for the supply of ginkgo leaf-based pharmaceutical formulations is in progress, and efforts to standardize ginkgo leaf extract as herbal medication for human use are being made. Microcuttings and cuttings, cryopreservation, and plant tissue culture have all aided to conserve G. biloba.
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                Author and article information

                Contributors
                Journal
                TMR Editorial Board
                Traditional Medicine Research
                TMR Editorial Board (Jintang road, 99, Hedong district Tianjin,China, 300170 )
                2413-3973
                8 March 2018
                8 March 2018
                : 3
                : 2
                : 70-81
                Affiliations
                [1-2413-3973-3-2-70] 1Academy of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
                [2-2413-3973-3-2-70] 2Chengdu University of Traditional Chinese Medicine Affiliated Ineye Hospital, Chengdu, Sichuan, China.
                Author notes
                *Correspondence to: Jun-Guo Duan, Chengdu University of Traditional Chinese Medicine, 37 Shierqiao Road, Chengdu, Sichuan, China. E-mail: duanjg@ 123456vip.sina.com.
                Article
                2413-3973-3-2-70
                10.12032/TMR201810066
                728614e8-9f60-4419-86dd-c95082f54326

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                History
                : 15 December 2017
                Categories
                Orginal Article

                Medicine,Pharmacology & Pharmaceutical medicine,Health & Social care,Complementary & Alternative medicine
                Diabetic retinopathy,Chinese medicines,Formula,Chinese patent drugs

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