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Yang L, Liu X, Zhu J, Zhang X, Li Y, Chen J, Liu H. Progress in traditional Chinese medicine against chronic gastritis: From chronic non-atrophic gastritis to gastric precancerous lesions. Heliyon 2023; 9:e16764. [PMID: 37313135 PMCID: PMC10258419 DOI: 10.1016/j.heliyon.2023.e16764] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/13/2023] [Accepted: 05/26/2023] [Indexed: 06/15/2023] Open
Abstract
Chronic gastritis (CG) is a persistent inflammation of the gastric mucosa that can cause uncomfortable symptoms in patients. Traditional Chinese medicine (TCM) has been widely used to treat CG due to its precise efficacy, minimal side effects, and holistic approach. Clinical studies have confirmed the effectiveness of TCM in treating CG, although the mechanisms underlying this treatment have not yet been fully elucidated. In this review, we summarized the clinical research and mechanisms of TCM used to treat CG. Studies have shown that TCM mechanisms for CG treatment include H. pylori eradication, anti-inflammatory effects, immune modulation, regulation of gastric mucosal cell proliferation, apoptosis, and autophagy levels.
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Affiliation(s)
- Liangjun Yang
- Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Xinying Liu
- Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Jiajie Zhu
- Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Xi Zhang
- Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Ya Li
- Lin ‘an Hospital of Traditional Chinese Medicine, Hangzhou 311300, China
| | - Jiabing Chen
- Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
| | - Haiyan Liu
- Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
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Zhang Y, Wang C, Zhang L, Yu J, Yuan W, Li L. Vitamin D 3 eradicates Helicobacter pylori by inducing VDR-CAMP signaling. Front Microbiol 2022; 13:1033201. [PMID: 36569092 PMCID: PMC9772467 DOI: 10.3389/fmicb.2022.1033201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022] Open
Abstract
Background Vitamin D3 [VitD3, 1,25 (OH)2D3] is known to have immunomodulatory and anti-microbial properties; however, its activity against Helicobacter pylori is unclear. In this study, we established H. pylori infection models in wild-type and VitD3 receptor (VDR) knockdown mice and analyzed the effects of VitD3 and their underlying mechanisms. Methods VDR+/+ and VDR+/- mice were intragastrically infected with the H. pylori SS1 strain. After confirmation of H. pylori infection, mice were treated with different doses of VitD3. The infection levels in stomach tissues were quantified using the colony-forming assay, and the expression levels of the VDR and cathelicidin antimicrobial peptide (CAMP) in the gastric mucosa were analyzed by immunohistochemistry and western blotting. Results The gastric mucosa of VDR+/- mice was more susceptible to H. pylori colonization and had lower levels of VDR and CAMP expression than that of VDR+/+ mice. H. pylori infection upregulated VDR and CAMP expression in the stomach of both wild-type and mutant mice, and VitD3 treatment resulted in further increase of VDR and CAMP levels, while significantly and dose-dependently decreasing the H. pylori colonization rate in both mouse groups, without affecting blood calcium or phosphorus levels. Conclusion Our data indicate that oral administration of VitD3 reduces the H. pylori colonization rate and upregulates VDR and CAMP expression in the gastric mucosa, suggesting a role for VitD3/VDR/CAMP signaling in the eradication of H. pylori in the stomach. These findings provide important insights into the mechanism underlying the anti-H. pylori activity of VitD3 and should be useful in the development of measures to eradicate H. pylori.
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Affiliation(s)
- Ye Zhang
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Chunya Wang
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Li Zhang
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Jie Yu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Wenjie Yuan
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Lei Li
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang, China,*Correspondence: Lei Li,
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Bao Z, Wu G, Du J, Ye Y, Zheng Y, Wang Y, Ji R. The comparative efficacy and safety of 9 traditional Chinese medicines combined with standard quadruple therapy for Helicobacter pylori-associated gastritis: a systematic review and network meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1349. [PMID: 36660649 PMCID: PMC9843361 DOI: 10.21037/atm-22-5421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/08/2022] [Indexed: 01/01/2023]
Abstract
Background There are 9 traditional Chinese medicines (TCMs) combined with standard quadruple (SQ) available for the treatment of Helicobacter pylori (Hp)-associated gastritis, but their relative efficacy and best options in clinical decision making are unknown due to a lack of high-quality head-to-head randomized controlled trials (RCTs). This study aimed to explore which formulas are the most effective and/or safest for Hp-associated gastritis. Methods We performed a search of electronic databases including PubMed, Web of Science, Cochrane Library, Embase, Chinese databases and South Korean database from inception to March 2022 to identify all relevant RCTs on the comparison between TCM combined with SQ and SQ for Hp-associated gastritis. Efficacy outcomes were the eradication rate of Hp and therapeutic response rate, and safety outcome was incidence of adverse reactions. Publication bias was assessed quantitatively using Egger's regression analysis and qualitatively using trim-and-fill method. Quality assessment was performed using Cochrane Risk of Bias, version 2 (ROB 2) tool. The Bayesian methods were applied to compare each treatment. Results A total of 55 trials with 6,187 patients were involved. The experimental group included 9 TCMs combined with SQ. The control group was SQ. The pair-wise meta-analysis demonstrated that compared with control group, 8 TCMs combined with SQ could statistically improve the eradication rate of Hp in patients with gastritis, 9 TCMs combined with SQ could significantly improve the therapeutic response rate. Additionally, Banxia Xiexin decoction combined with SQ (BXS) could statistically decrease the incidence of adverse reactions. The network meta-analysis results showed that BXS, Xiangsha Liujunzi combined with SQ (XSS), and Huangqi Jianzhong decoction combined with SQ (HQS) was the best measures to effectively eradicate Hp, enhance therapeutic effect, and decrease adverse reactions, respectively. The results of trim-and-fill method indicated that the results were stable and less affected by publication bias. Conclusions Compared with SQ, TCM combined with SQ generally has a better clinical effect and higher safety in patients with Hp-associated gastritis. BXS, XSS, and HQS are recommended based on the patient's condition and needs in clinical practice. Further high-quality double-blinded RCTs are warranted to validate the conclusions.
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Affiliation(s)
- Zhixian Bao
- The First Clinical Medical College, Lanzhou University, Lanzhou, China;,Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Guobing Wu
- The First Clinical Medical College, Lanzhou University, Lanzhou, China;,Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Jie Du
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuwei Ye
- Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Zheng
- Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Yuping Wang
- Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
| | - Rui Ji
- Department of Gastroenterology, the First Hospital of Lanzhou University, Lanzhou, China;,Key Laboratory for Gastrointestinal Diseases of Gansu Province, The First Hospital of Lanzhou University, Lanzhou, China
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Li RJ, Dai YY, Qin C, Huang GR, Qin YC, Huang YY, Huang ZS, Luo XK, Huang YQ. Application of traditional Chinese medicine in treatment of Helicobacter pylori infection. World J Clin Cases 2021; 9:10781-10791. [PMID: 35047590 PMCID: PMC8678867 DOI: 10.12998/wjcc.v9.i35.10781] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/07/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) has a high rate of infection and antibiotic resistance and poses a serious threat to human life. One of the main strategies to overcome drug resistance is to develop new treatment plans. Traditional Chinese medicine (TCM) that is commonly used to treat many diseases in China can reduce drug resistance and increase the eradication rate of H. pylori. In this paper, we review the research progress on TCM in the treatment of H. pylori infection. The mechanism of action of TCM is reviewed and research and applications of TCM in the treatment of H. pylori are demonstrated. Finally, we discuss problems confronting the use of TCM for the treatment of H. pylori infection and propose possible solutions. In addition, the plans of TCM in H. pylori treatment were also screened: Dampness-heat syndrome in the spleen and stomach, deficiency of spleen and stomach, and cold-heat complicated syndrome, and the effective components therein are studied. The antibacterial effect of TCM is relatively slow; for rapid improvement of the treatment effect of refractory H. pylori gastritis, we provide an appropriate treatment regime combining TCM and Western medicine with immune-regulatory and synergistic antibacterial effects.
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Affiliation(s)
- Ru-Jia Li
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuan-Yuan Dai
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Chun Qin
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Gan-Rong Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yan-Chun Qin
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yong-Yi Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Zan-Song Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xian-Ke Luo
- National Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, Guangxi Zhuang Autonomous Region, China
| | - Yan-Qiang Huang
- Research Center for the Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
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Pharmacokinetics of Bismuth following Oral Administration of Wei Bi Mei in Healthy Chinese Volunteers. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2679034. [PMID: 32855646 PMCID: PMC7442995 DOI: 10.1155/2020/2679034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022]
Abstract
Background Bismuth-containing quadruple therapy achieves higher eradication rate of Helicobacter pylori. High level of bismuth in blood may result in damage of many organs. Wei Bi Mei is a new bismuth-containing drug combining chemicals and Chinese medicine portions. The present research is to study the pharmacokinetics of bismuth to evaluate the safety and rational use of Wei Bi Mei granules. Material and Methods. Seven healthy Chinese adult subjects were enrolled in this research, which included a single-dose study and a multiple-dose study. Wei Bi Mei granules were administered orally to the subjects at corresponding time. Blood and urine were collected. All samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Results For single-dose Wei Bi Mei granules administration, the mean time to peak concentration (t max) of bismuth was 2.29 ± 0.76 h, and the mean peak concentration (C max) of bismuth was 0.85 ± 0.55 ng/mL. For multiple-dose Wei Bi Mei granules administration, the C max was 2.25 ± 1.18 ng/mL at day two, and the volume of distribution (V d ) was (22.97 ± 9.82) × 103 L. The urinary excretion of bismuth was the fastest during the first two days, with a mean excretion rate of 3.84 ± 1.23 ng/h. The bismuth concentration in urine was significantly reduced at day 16. Conclusion Bismuth has a washout period of approximately two months. The concentration of bismuth in blood was far less than the "safe level." Thus, Wei Bi Mei is a highly safe therapeutic medicine, with a good clinical application value. Wei Bi Mei should be recommended more widely for use in bismuth-containing quadruple therapy for the treatment of Helicobacter pylori infection.
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Li RJ, Dai YY, Qin C, Li XH, Qin YC, Pan Y, Huang YY, Huang ZS, Huang YQ. Treatment strategies and preventive methods for drug-resistant Helicobacter pylori infection. World J Meta-Anal 2020; 8:98-108. [DOI: 10.13105/wjma.v8.i2.98] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
The infection and drug resistance rates of Helicobacter pylori (H. pylori) are high and must be prevented and treated by better strategies. Based on recent research advances in this field as well as the results from our team and those on traditional Chinese medicine, we review the causes of drug resistance, and prevention and treatment strategies for drug-resistant H. pylori infection, with an aim to make suggestions for the development of new drugs, such as establishment of new target identification and screening systems, modification of existing drug structures, use of new technologies, application of natural products, and using a commercial compound library. This article may provide reference for eradication of drug-resistant H. pylori.
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Affiliation(s)
- Ru-Jia Li
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuan-Yuan Dai
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Chun Qin
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiao-Hua Li
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yan-Chun Qin
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yong Pan
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yong-Yi Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Zan-Song Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yan-Qiang Huang
- Research Center for Prevention and Treatment of Drug Resistant Microbial Infections, Youjiang Medical University for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China
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A Systematic Review of the Mechanisms Underlying Treatment of Gastric Precancerous Lesions by Traditional Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9154738. [PMID: 32454874 PMCID: PMC7212333 DOI: 10.1155/2020/9154738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/08/2020] [Accepted: 03/16/2020] [Indexed: 01/19/2023]
Abstract
Gastric precancerous lesions (GPLs) are an essential precursor in the occurrence and development of gastric cancer, known to be one of the most common and lethal cancers worldwide. Traditional Chinese medicine (TCM) has a positive prospect for the prevention and therapy of GPL owing to several advantages including a definite curative effect, fewer side effects compared to other treatments, multiple components, and holistic regulation. Despite these characteristic advantages, the mechanisms of TCM in treating GPL have not been fully elucidated. In this review, we summarize the current knowledge with respect to herbal formulations and the therapeutic mechanisms of TCM active ingredients for GPL. This paper elaborates on the mechanisms of TCM underlying the prevention and treatment of GPL, specifically those that are linked to anti-H. pylori, anti-inflammation, antiproliferation, proapoptotic, antioxidation, antiglycolytic, and antiangiogenesis effects.
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