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Discovering the efficacy and mechanism of Chinese herbal medicine for distal symmetric polyneuropathy via integrating meta-analysis and network pharmacology analysis

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TMR Modern Herbal Medicine 2023年第1期6卷 1-13页

作者： Tong-Tong Wu Zun-Jiang Li Li-Hong Yang Shao-Nan Liu Jing Chen Wei Zhu Xin-Feng Guo The second clinical college of Guangzhou University of Chinese Medicine Guangzhou City 510405China The Second Affiliated Hospital of Guangdong University of Chinese Medicine Guangdong Provincial Hospital of Chinese MedicineGuangzhou City 510120China

Objective Chinese herbal medicine(CHM)has been commonly used in distal symmetric polyneuropathy(DSPN)treatment with satisfactory clinical effects,but the underlying pharmacological mechanism of CHM on DSPN remains *** aimed to identify frequently used clinically effective CHM and its potential pharmacological mechanisms for DSPN by conducting meta-analysis and network pharmacology *** We searched both Chinese and English databases from March 1990 to October *** that met the inclusion criteria were selected for *** extracting the relevant data,we performed meta-analysis and frequency *** active compounds and predicted targets of high-frequency herbs and DSPN-related targets were extracted from public *** we conducted network construction,Gene Ontology(GO)enrichment,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis to discover the potential pharmacological *** Sixteen articles were selected for meta-analysis,and nine high-frequency CHMs were identified,including Radix Astragali seu Hedysari,Rhizoma Ligustici,Caulis Spatholobi,Radix Salviae Miltiorrhizae,Radix Paeoniae Alba,Flos Carthami,Radix Notoginseng,Radix Rehmanniae Recens,Rhizoma *** hub targets including STAT3,CTNNB1,MAPK14,SRC,AKT1,TP53,EGFR,JUN,RELA,MAPK1,FOS,CCND1,HSP90AA1,MYC,and ten active compounds including Quercetin,Kaempferol,Luteolin,Apigenin,beta-sitosterol,Stigmasterol,Caffeic Acid,Aeginetic Acid,Vanillin,and Lauric Acid were identified by network *** analysis showed that the biological process of hub targets included transcriptional regulation,cell proliferation,redox processes,apoptosis processes,ERK1 and ERK2 cascades,hypoxia reactions,MAPK cascades,and inflammatory *** main signalling pathways included HIF,TNF,and PI3K-AKT *** Nine herbs were involved in the clinical therapeutic effect of CHM on DSPN treatment,and they may exert an an

关键词： distal symmetric polyneuropathy Chinese herbal medicine Meta-analysis Network pharmacology

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Physical Exercise as Treatment for Type 2 Diabetes distal symmetric polyneuropathy: A Systematic Review of Randomized and Controlled Studies

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Journal of Diabetes Mellitus 2022年第3期12卷 167-186页

作者： Giulio Zampogna United States Army Medical Center of Excellence Joint Base San Antonio United States of America Evans Army Community Hospital Fort Carson United States of America University of Nebraska Medical Center Omaha United States of America

Pharmaceuticals targeting the pathogenesis of diabetic distal symmetric polyneuropathy have all failed in clinical trials, limiting recourse to palliative treatments. The American Diabetes Association regards the effectiveness of glycemic control and lifestyle modification therapies on diabetic neuropathies as inconclusive. The objective of this research was to determine if and how physical exercise influences distal symmetric polyneuropathic severity in type 2 diabetes patients. Embase, MEDLINE, and Google Scholar were searched to collect randomized and controlled studies published between January 1, 2012 and April 20, 2020. Titles had to mention diabetes, physical exercise of any type or lifestyle interventions in general, and neuropathy. Abstracts had to indicate satisfaction of PICOS criteria, whereas full-text reviews had to be fully confirmatory. Extracted data was thematically synthesized based primarily on relationships between exercise interventions and effects on distal symmetric polyneuropathic severity outcomes in type 2 diabetes patients. Qualitative analysis scoring criteria objectively mirrored PICO except for the bias and limitation score component, which assessed common markers of validity for randomized trials (as specified in the PRISMA statement). Database searches yielded 379 unique records, 15 of which passed eligibility screening. Thematic synthesis supported exercise as an ameliorative treatment of type 2 diabetes distal symmetric polyneuropathy through improved Michigan Diabetic Neuropathy Scores and increased sural sensory nerve conduction velocity, though efficacy may be limited by neuropathic severity. This is the first systematic review to acquire these results, and to do so within the context of neuropathic severity. This review protocol is registered on PROSPERO (CRD42020181211) at https://***/prospero/display_***?ID=CRD42020181211

关键词： Type 2 Diabetes Peripheral Neuropathy distal symmetric polyneuropathy Physical Exercise Lifestyle Interventions

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