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      Novel drug delivery systems of Chinese medicine for the treatment of inflammatory bowel disease

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          Abstract

          Inflammatory bowel disease (IBD) is an idiopathic intestinal inflammatory disease that comprises ulcerative colitis (UC) and Crohn’s disease (CD). IBD involves the ileum, rectum, and colon, and common clinical manifestations of IBD are diarrhea, abdominal pain, and even bloody stools. Currently, non-steroidal anti-inflammatory drugs, glucocorticoids, and immunosuppressive agents are used for the treatment of IBD, while their clinical application is severely limited due to unwanted side effects. Chinese medicine (CM) is appealing more and more attention and investigation for the treatment of IBD owing to the potent anti-inflammation pharmacological efficacy and high acceptance by patients. In recent years, novel drug delivery systems are introduced apace to encapsulate CM and many CM-derived active constituents in order to improve solubility, stability and targeting ability. In this review, advanced drug delivery systems developed in the past and present to deliver CM for the treatment of IBD are summarized and future directions are discussed.

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          Ulcerative colitis

          Ulcerative colitis is a chronic inflammatory disease affecting the colon, and its incidence is rising worldwide. The pathogenesis is multifactorial, involving genetic predisposition, epithelial barrier defects, dysregulated immune responses, and environmental factors. Patients with ulcerative colitis have mucosal inflammation starting in the rectum that can extend continuously to proximal segments of the colon. Ulcerative colitis usually presents with bloody diarrhoea and is diagnosed by colonoscopy and histological findings. The aim of management is to induce and then maintain remission, defined as resolution of symptoms and endoscopic healing. Treatments for ulcerative colitis include 5-aminosalicylic acid drugs, steroids, and immunosuppressants. Some patients can require colectomy for medically refractory disease or to treat colonic neoplasia. The therapeutic armamentarium for ulcerative colitis is expanding, and the number of drugs with new targets will rapidly increase in coming years.
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            Innate immunity.

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              Plant-Derived Exosomal MicroRNAs Shape the Gut Microbiota

              The gut microbiota can be altered by dietary interventions to prevent and treat various diseases. However, the mechanisms by which food products modulate commensals remain largely unknown. We demonstrate that plant-derived e xosomes- l ike n anoparticles (ELNs) are taken up by the gut microbiota and contain RNAs that alter microbiome composition and host physiology. Ginger ELNs (GELNs) are preferentially taken up by Lactobacillaceae in a GELN lipid-dependent manner and contain microRNAs that target various genes in Lactobacillus rhamnosus (LGG). Among these, GELN mdo-miR7267-3p-mediated targeting of the LGG monooxygenase ycnE yields increased indole-3-carboxaldehyde (I3A). GELN RNAs or I3A, a ligand for aryl hydrocarbon receptor (AHR), are sufficient to induce production of IL-22, which is linked to barrier function improvement. These functions of GELN RNAs can ameliorate mouse colitis via IL-22-dependent mechanisms. These findings reveal how plant products and their effects on the microbiome may be used to target specific host processes to alleviate disease. Teng et al. show that exosomes-like nanoparticles (ELNs) from edible plants such as ginger are preferentially taken up by gut bacteria in an ELN lipid dependent manner. ELN RNAs regulate gut microbiota composition and localization as well as host physiology, notably enhancing gut barrier function to alleviate colitis.
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                Author and article information

                Contributors
                YB87504@umac.mo
                liulijuan9048@outlook.com
                zyy2939@163.com
                bianzxiang@gmail.com
                swang@um.edu.mo
                ytwang@umac.mo , ytwang@um.edu.mo
                Journal
                Chin Med
                Chin Med
                Chinese Medicine
                BioMed Central (London )
                1749-8546
                17 June 2019
                17 June 2019
                2019
                : 14
                : 23
                Affiliations
                [1 ]State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Avenida da Universidade, Taipa, Macao, SAR China
                [2 ]PU-UM Innovative Institute of Chinese Medical Sciences, Guangdong-Macau Traditional Chinese Medicine Technology Industrial Park Development Co., Ltd, Hengqin New Area, Zhuhai, China
                [3 ]ISNI 0000 0001 0376 205X, GRID grid.411304.3, College of Pharmacy, , Chengdu University of Traditional Chinese Medicine, ; Chengdu, Sichuan China
                [4 ]ISNI 0000 0004 1764 5980, GRID grid.221309.b, School of Chinese Medicine, , Hong Kong Baptist University, ; Kowloon, Hong Kong, SAR China
                [5 ]ISNI 0000 0001 2312 1970, GRID grid.5132.5, Leiden University European Center for Chinese Medicine and Natural Compounds, Institute of Biology, , Leiden University, ; Leiden, The Netherlands
                Author information
                http://orcid.org/0000-0002-8997-456X
                Article
                245
                10.1186/s13020-019-0245-x
                6580650
                9d2ad9bd-418a-4481-9889-221710e3c994
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 14 March 2019
                : 5 June 2019
                Funding
                Funded by: Macau Science and Technology Development Fund
                Award ID: 0039/2018/A1
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2019

                Complementary & Alternative medicine
                inflammatory bowel disease,chinese medicine,drug delivery system,ulcerative colitis

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