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      Jianpi Huatan Tongfu granule alleviates inflammation and improves intestinal flora in patients with acute exacerbation of chronic obstructive pulmonary disease

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          Abstract

          Objectives

          To investigate the clinical efficacy and mechanism of Jianpi Huatan Tongfu granule in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

          Methods

          Sixty patients with AECOPD were enrolled in either of two groups: integrative treatment (Western medicine combined with Jianpi Huatan Tongfu granule) (n = 30) and Western medical treatment (n = 30). Thirty healthy individuals were included in the control group.

          Results

          Compared with healthy participants, patients with AECOPD had elevated clinical symptom and dyspnea severity scores. Patients with AECOPD had worsened lung function, compared with healthy participants. The therapeutic efficacy for integrative treatment was superior to Western medical treatment. Inflammatory proteins and cytokines were significantly elevated in patients with AECOPD, including C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α; these were alleviated by both treatments, with more obvious effects for integrative treatment. Integrative treatment significantly changed the intestinal flora in patients with AECOPD, reaching levels comparable with those of healthy participants. Firmicutes abundance was significantly higher in healthy participants, whereas Bacteroidetes abundance was significantly higher in patients with AECOPD. After treatment, Verrucomicrobia abundance was significantly reduced in patients with AECOPD.

          Conclusion

          Jianpi Huatan Tongfu granule could alleviate inflammatory responses and improve clinical therapeutic efficacy in patients with AECOPD.

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          Most cited references22

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          Administration of probiotic mixture DM#1 ameliorated 5-fluorouracil-induced intestinal mucositis and dysbiosis in rats.

          The use of probiotics to alleviate chemotherapy-induced intestinal mucositis is supported by clinical consensus. However, no studies to date, to our knowledge, have systematically analyzed the effects of a probiotic mixture on chemotherapy-induced mucositis or assessed changes in the intestinal microbiota after probiotic treatment. The aim of this study was to report the effects of a probiotic mixture, DM#1, on intestinal mucositis and dysbiosis of rats treated with 5-fluorouracil (5-FU).
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            Triple therapy (ICS/LABA/LAMA) in COPD: time for a reappraisal

            Recently, two “fixed triple” single-inhaler combinations of an inhaled corticosteroid (ICS), a long-acting β2-agonist (LABA), and a long-acting muscarinic antagonist (LAMA) have become available for patients with COPD. This review presents the clinical evidence that led to the approval of these triple therapies, discusses the role of ICS in patients with COPD, and presents data on the relative efficacy of “fixed triple” (ICS/LAMA/LABA) therapy vs LAMA, ICS/LABA, and LAMA/LABA combinations, and summarizes studies in which ICS/LABAs were combined with LAMAs to form “open triple” combinations. Of the five main fixed triple studies completed so far, three evaluated the efficacy and safety of an extrafine formulation of beclometasone dipropionate, formoterol fumarate, and glycopyrronium; the other two studies evaluated fluticasone furoate, vilanterol, and umeclidinium. Overall, compared to LAMA, ICS/LABA, or LAMA/LABA, triple therapy decreased the risk of exacerbations and improved lung function and health status, with a favorable benefit-to-harm ratio. Furthermore, triple therapy showed a promising signal in terms of improved survival. The evidence suggests that triple therapy is the most effective treatment in moderate/severe symptomatic patients with COPD at risk of exacerbations, with marginal if any risk of side effects including pneumonia. Ongoing studies are examining the role of triple therapy in less severe symptomatic patients with COPD and asthma–COPD overlap.
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              Oral Bifidobacterium modulates intestinal immune inflammation in mice with food allergy.

              It is proposed that probiotics have a therapeutic effect on the treatment of immune disorders. However, the underlying mechanisms require clarification. The present study aimed to evaluate the effect of gavage-feeding Bifidobacteria on suppression of T helper 2 (Th2) pattern inflammation in the intestines of mice with food allergy. Mice were sensitized to ovalbumin to induce the intestinal Th2 pattern inflammation. Allergic mice were treated with or without Bifidobacteria via gavage-feeding. Th2 response, number of regulatory T cells (Treg) in the spleen and intestine, intestinal epithelial barrier function and bifidobacterial translocation were examined. The results showed that serum-specific immunoglobulin E antibody and interleukin 4 (IL-4) were increased in allergic mice. Intestinal epithelial barrier function was impaired in allergic mice as shown by the increase in epithelial ion secretion and permeability to macromolecular protein horseradish peroxidase in Ussing chambers. Number of Treg was decreased in both spleen and intestines of allergic mice. Gavage-feeding Bifidobacteria significantly suppressed the skewed Th2 response and increased the number of Treg. Transient bifidobacterial translocation was observed in allergic mice. Oral administration of Bifidobacteria has the capacity to suppress the skewed Th2 response in allergic mice, increasing the number of Treg and IL-10-positive cells and improve the impaired intestinal epithelial barrier function.
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                Author and article information

                Journal
                J Int Med Res
                J. Int. Med. Res
                IMR
                spimr
                The Journal of International Medical Research
                SAGE Publications (Sage UK: London, England )
                0300-0605
                1473-2300
                15 April 2020
                April 2020
                : 48
                : 4
                : 0300060520909235
                Affiliations
                [1 ]Department of Emergency, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
                [2 ]Provincial-Level Key Laboratory for Molecular Medicine of Major Diseases and The Prevention and Treatment with Traditional Chinese Medicine Research in Gansu Colleges and Universities, Gansu University of Chinese Medicine, Lanzhou, China
                [3 ]Department of Emergency, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
                [4 ]Key Laboratory for Transfer of Dunhuang Medicine at the Provincial and Ministerial Level, Gansu University of Chinese Medicine, Lanzhou, China
                Author notes
                [*]

                These authors contributed equally to this study.

                [*]Zhiming Zhang, Department of Emergency, Affiliated Hospital of Gansu University of Chinese Medicine, No. 732, Jiayuguan West Road, Lanzhou 730000, Gansu, China. Email: zhangzhimingys@ 123456163.com
                Author information
                https://orcid.org/0000-0001-8555-3859
                Article
                10.1177_0300060520909235
                10.1177/0300060520909235
                7163244
                32295442
                f55e125b-8c96-4eec-966d-07b1f5f9d257
                © The Author(s) 2020

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 5 September 2019
                : 31 January 2020
                Funding
                Funded by: Open Fund of Key Laboratory of Molecular Medicine and Traditional Chinese Medicine Prevention and Treatment for Major Diseases for Colleges and Universities in Gansu Province;
                Award ID: FZYX14-2
                Award ID: FZYX14-7
                Funded by: National Natural Science Foundation of China, FundRef https://doi.org/10.13039/501100001809;
                Award ID: 81473457
                Award ID: 81660730
                Categories
                Prospective Clinical Research Report
                Custom metadata
                corrected-proof
                ts2

                jianpi huatan tongfu granule,acute exacerbation of chronic obstructive pulmonary disease,inflammation,intestinal flora,16s rdna,cytokines,c-reactive protein,lung function,dyspnea

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