Traditional Chinese medicine in the treatment of Helicobacter pylori-related gastritis: The mechanisms of signalling pathway regulations

Table 1 The effects of extracts or active ingredient from herb medicines on Helicobacter pylori-associated gastritis

Ref.	Active ingredient	Experiments of the TCM group		Related signaling pathway	Mechanisms/results	Outcome
		In vitro	In vivo
Wang et al[39], 2018	Polygonum capitatum extract	-	Rats	PI3K/AKT	↑PTEN	Polygonum capitatum prevents the release of inflammatory factors, and stimulates the proliferation of gastric mucosa cells to repair damaged tissues
					↓PI3K, AKT
Peng et al[42], 2022	Syzygium aromaticum extract	GES-1	-	PI3K/AKT, MAPK	↓p-PI3K, p-AKT, p-MAPK	The active components of syzygium aromatic extract played a therapeutic role in HPAG through the synergistic regulation of the PI3K/Akt and MAPK signalling pathways
Ma et al[54], 2020; Ma et al[96], 2021	Alpiniae Officinarum Rhizoma extract	-	Mice	MAPK	↓p-ERK1/2, P-JNK, p38MAPK, IL-8	The Alpiniae Officinarum Rhizoma extract played a therapeutic role in HPAG through regulation of the and MAPK and NF-κB signalling pathways
		GES-1	Mice	NF-κB	↓IKKβ, p-IKKα/β, NF-κBp65, p-NF-κBp65, p-IκBα, IL-8
Deng and Wan[57], 2017	Baicalin	GES-1	-	MAPK	↑Bcl-2, ↓IL-1β, p-p38 MAPK, IL-8, Bax	Baicalin markedly decreased the apoptosis of gastric mucosal epithelial cells, improved proliferation, and alleviated inflammation
Tian and Huang[60], 2019	Dandelion polysaccharide	-	Rats	MAPK	↑IL-10	Dandelion polysaccharide can reduce the inflammatory response of gastric mucosa in rats with HPAG by inhibiting the MAPK/ERK signalling pathway, so as to play a protective role in gastric mucosa
					↓p-ERK1/2, IL-6, TNF-α, PGE2, iNOS, COX-2
Jia et al[66], 2024	Ferulic acid	-	Mice	Wnt/β-catenin	↓Wnt2, β-catenin, TNF-α, IL-8	Ferulic acid can reduce H. pylori colonization and gastric mucosal inflammation through inhibitory effects of the Wnt/β-catenin signalling pathway
Liu et al[69], 2022	Patchouli alcohol	-	Mice	Wnt/β-catenin, NF-κB	↓Wnt2, β-catenin, NF-κB	Patchouli alcohol reduces the inflammatory response of gastric mucosa and prevent the epithelial-mesenchymal transition of gastric mucosal cells through the synergistic regulation of the Wnt/β-catenin and NF-κB signalling pathway
Zhang et al[83], 2015	Resveratrol	-	Mice	Nrf2/HO-1, NF-κB	↑HO-1, Nrf2	Resveratrol might play a therapeutic role in HPAG through the anti-oxidant, anti-inflammatory, regulation of the NF-κB and Nrf2/HO-1 signalling pathway
					↓MPO, LPO, IL-8, iNOS, p-IκBα
Liu et al[85], 2023	Rhein	-	Mice	Nrf2/HO-1, MAPK	↑HO-1, Nrf2	Rhein can regulate the MAPK and Nrf2/HO-1 signalling pathway to inhibit gastric inflammation of HPAG
					↓p-JNK1/2, p-p38MAPK, TNF-α, COX-2, IL-6, IL-1β, PGE2
Lu et al[95], 2021	Berberine	GES-1	Mice	NF-κB	↓TNF-α, IL-6, IL-8, COX-2, NF-κB p65, NF-κB p50, CagA	Berberine can inhibit gastric inflammation and virulence of H. pylori by inhibiting the effective activation of the NF-κB signalling pathway

TCM: Traditional Chinese medicine; ↑: Increased; ↓: Decreased; H. pylori: Helicobacter pylori; PI3K: Phosphatidylinositol 3-kinase; AKT: Protein kinase B; PTEN: Phosphatase and tensin homolog; p-PI3K: Phosphorylation of phosphatidylinositol 3-kinase; p-AKT: Phosphorylation of protein kinase B; MAPK: Mitogen-activated protein kinase; p-MAPK: Phosphorylation of mitogen-activated protein kinase; HPAG: Helicobacter pylori-associated gastritis; p-JNK: Phosphorylation of c-Jun N-terminal kinase; p-ERK1/2: Phosphorylation of extracellular signal-regulated kinase1/2; IL: Interleukin; NF-κB: Nuclear factor-kappa B; IKK: Inhibitor Kappa B kinase; p-IKK: Phosphorylation of inhibitor kappa B kinase; IκB: Inhibitor of nuclear factor-κB; p-IκB: Phosphorylation of inhibitor of nuclear factor-κB; iNOS: Inducible nitric oxide synthase; COX-2: Cyclooxygenase-2; PGE2: Prostaglandin E2; CagA: Cytotoxin-associated gene A; LPO: Lipid peroxidation; MPO: Myeloperoxidase; Nrf2: Nuclear factor erythroid 2-related factor 2; HO-1: Heme oxygenase-1; TNF: Tumor necrosis factor; Bax: B-cell associated X protein; Bcl-2: B-cell lymphoma-2.