Journal of Chinese Pharmaceutical Sciences

Advancements in glucagon-like peptide-1 receptor agonist therapy for type 2 diabetes

Yaping Peng, Ying Fu

2024, 33(8): 667-685. DOI: 10.5246/jcps.2024.08.050

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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are novel hypoglycemic agents that have garnered widespread acceptance in the treatment of type 2 diabetes, largely attributed to their safety profile, potent hypoglycemic effects, and metabolic advantages. Their primary mechanisms of action encompass promoting insulin release, inhibiting glucagon secretion, bolstering pancreatic islet cell function, curbing appetite, and slowing gastric emptying. This article delves into the clinical evidence underscoring the efficacy of various GLP-1RAs. Notably, these agents have demonstrated marked improvements in glycemic control, significant weight reduction, and substantial cardiovascular and renal protection. Nonetheless, certain adverse effects of GLP-1RAs, such as pancreatitis and intestinal obstruction, have been reported, warranting vigilant monitoring by healthcare professionals. In sum, GLP-1RAs hold significant promise in the management of type 2 diabetes, offering notable cardiovascular and renal advantages.

Comparative analysis of structural characteristics and cardiomyocyte protective effects of glucomannan extracted from Bletilla striata using varied methods

Feng Pan, Nan Yang, Guoyong Ruan, Changyan Yu, Jianbo Yang, Dongxue Suo, Ying Qin, Yun Liu

2024, 33(8): 686-704. DOI: 10.5246/jcps.2024.08.051

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Doxorubicin (DOX) is a widely employed tumor therapy, yet its substantial toxic side effects pose a considerable challenge. Bletilla striata has demonstrated efficacy in preventing and treating these toxic side effects in clinical practice, with polysaccharides identified as the principal active component. In the present study, 16 fractions of B. striata polysaccharides (BsPs) were extracted using diverse methods, including hot-water extraction (HWE), ultrasonic-assisted extraction (UAE), enzyme-assisted extraction (EAE), dilute acid-water extraction (ACWE), and dilute alkali-water extraction (ALWE). These extractions were subsequently precipitated at final ethanol concentrations of 80% and 95%, respectively. The investigation encompassed yields, total carbohydrate content (TCC), total protein content (TPC), preliminary structural properties, and anti-DOX myocardial cytotoxic activity. Results indicated that the extraction method significantly influenced the physicochemical properties, associated functional properties, and anti-DOX myocardial cytotoxic activity of BsPs. HWE and UAE yielded higher BsPs quantities. The relative molecular weight (RMW) distribution of BsPs differed notably between HWE or UAE, EAE, ACWE, and ALWE. The RMW of primary BsPs obtained from HWE and UAE (1.9 × 10⁷–1.7 × 10⁷ Da) exceeded that from EAE (7.5 × 10³–2.8 × 10⁴ Da) and ALWE (5.1 × 10⁴–1.7 × 10⁴ Da), with smaller molecular weights primarily precipitated by higher ethanol concentrations. BsPs were composed of Man and Glu, with partial fractions containing small amounts of Gal or Ara, displaying varying molar ratios. Notably, BsPs from ACWE exhibited the most significant structural differences, lacking 1,4-α-D-Glcp and a triple-helical structure. Furthermore, BsPs obtained from HWE, UAE, and EAE demonstrated heightened anti-DOX myocardial cytotoxic activity compared to other methods. This study underscored the influence of extraction methods on BsPs’ structure and myocardial protective activity, offering a foundation for exploring structural diversity and employing specific extraction methods to extract polysaccharides with robust myocardial protective properties efficiently.

Assessing the therapeutic impact of Qianjinba polysaccharide in a rheumatoid arthritis murine model

Nan Zhang, Zhimin Liu, Xuanmei Yang, Shuang Li, Yiwen Gao, Haiguang Qin

2024, 33(8): 705-713. DOI: 10.5246/jcps.2024.08.052

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Qianjinba is primarily cultivated in the southern regions of China and finds extensive use in traditional Chinese medicine (TCM) for conditions such as rheumatism, arthralgia, and gynecological ailments. It has been officially recognized as a protected variety of TCM by the state. The aim of this study was to investigate the therapeutic potential of Qianjinba polysaccharide (QJBDT) in treating rheumatoid arthritis (RA) in mice, along with a preliminary exploration of its mechanisms for inhibiting RA in these animals. Kunming mice (KM) were randomly divided into several groups, including a normal group, a model group (LPS group), low-dose, medium-dose, and high-dose QJBDT groups, as well as a positive control group (TGP group), each consisting of 10 mice. To induce inflammation and create an RA model, type II collagen was injected into the right hind foot joint. Following a 7-day modeling period, various concentrations of QJBDT and the positive control drug total glycoside of peony were administered via gavage once a day for 21 consecutive days. Throughout the study, we monitored and recorded the mice's weight, measured foot swelling, and assessed the arthritis index on a weekly basis. We also conducted pathological examinations of joint tissues and analyzed the signal pathway of p38 mitogen-activated protein kinase (MAPK) as well as the protein expression of nuclear factor NF-κB in the mice’s right foot joint tissues. Additionally, we employed ELISA to detect the levels of interleukin-β (IL-β), IL-17, and tumor necrosis factor-α (TNF-α) in the mice’s serum. The results of this study revealed that QJBDT effectively reduced the degree of foot swelling and the arthritis index in collagen-induced arthritis mice while improving their weight loss (P < 0.05). Furthermore, it alleviated the pathological damage observed in the mice’s joints. Notably, the expression of transcription factors p38 and NF-κB proteins was down-regulated (P < 0.05), and the levels of inflammatory cytokines IL-β, IL-17, and TNF-α in the mice’s serum were decreased (P < 0.05). In conclusion, this study demonstrated that polysaccharides could inhibit the expression of transcription factors p38 and NF-κB, reduce the production of inflammatory factors, and alleviate the progression of RA to a certain extent.

Quercetin, the key constituent of Astragali Radix, modulates ferroptosis in PASMCs and attenuates hypoxia pulmonary hypertension via the MAPK signaling pathway

Xia Li, Beibei Cheng, Junlan Tan, Jiajing Wan, Yuhong Wang, Aiguo Dai

2024, 33(8): 714-729. DOI: 10.5246/jcps.2024.08.053

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This study delved into the mechanism by which the principal component of Astragali Radix regulated ferroptosis in the context of hypoxia-induced pulmonary hypertension, employing a combination of network pharmacology and experimental validation techniques. Active constituents of Astragali Radix and their corresponding targets were identified using the TCMSP database, while therapeutic targets associated with hypoxia-induced pulmonary hypertension were sourced from the GeneCards database. The Venn online tool facilitated the identification of overlapping targets between the active constituents of Astragali Radix and hypoxia-induced pulmonary hypertension. Interaction network diagrams depicting the relationship between Astragali Radix’s active constituents and their targets were constructed using Cytoscape software, with core targets and sub-networks identified using the CytoHubba plug-in. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted using the DAVID database. Additionally, the FerrDb database was consulted to analyze genes implicated in regulating ferroptosis. The investigation revealed 18 active constituents selected from Astragali Radix, with quercetin emerging as the key component. A total of 35 potential targets associated with Astragali Radix in regulating ferroptosis and addressing hypoxia-induced pulmonary hypertension were predicted. Experimental validation demonstrated that quercetin could inhibit the MAPK signaling pathway, resulting in reduced Fe²⁺ and lipid peroxide levels, increased GPX4 expression, and the reversal of ferroptosis. In summary, this study elucidated the fundamental constituents and pivotal signaling pathways through which Astragali Radix modulated ferroptosis and mitigated hypoxia-induced pulmonary hypertension. Specifically, quercetin, a core constituent of Astragali Radix, was observed to inhibit ferroptosis in pulmonary arterial smooth muscle cells via the MAPK pathway and alleviate hypoxia-induced pulmonary hypertension.

Observational study: efficacy of aspirin and low-molecular-weight heparin in the management of recurrent miscarriage

Yuehong Tang, Ting Wang, Ai-e Cao, Huizhi Lian, Chunping Qiu

2024, 33(8): 730-736. DOI: 10.5246/jcps.2024.08.054

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In the present study, we aimed to assess the comparative efficacy of low-molecular-weight heparin (LMWH) in combination with low-dose aspirin for the management of recurrent miscarriage and scrutinize alterations in coagulation function following such treatment. A retrospective analysis was conducted on clinical data obtained from 97 patients with recurrent miscarriage treated at our institution from January 2019 to June 2020. Patients were categorized into either the study or control groups based on the administration of LMWH. The control group comprised 48 patients treated solely with aspirin, while the study group included 49 patients treated with both LMWH and aspirin. Comparative evaluations between the two groups encompassed pregnancy outcomes, coagulation function, adverse reactions, and blood loss during delivery. Results revealed a higher term birth rate in the study group (83.67%) compared to the control group (50%). Post-treatment, the study group exhibited lower prothrombin time, plasminogen activator inhibitor, and D-dimer levels than the control group. Moreover, the study group experienced fewer adverse reactions and reduced blood loss during delivery in comparison to the control group, demonstrating statistical significance (P < 0.05). The combination of LMWH and low-dose aspirin exhibited noteworthy application in the management of recurrent miscarriage. This therapeutic approach not only fostered the enhancement of coagulation function conducive to pregnancy but also diminished the incidence of adverse reactions observed with aspirin alone.

Exploring the impact of tacrolimus on kidney transplant recipients: insights into immunological outcomes

Zainab A Abbood, Ahmed Hamza AL-Shammari, Eman M. Jasim, Amjad I. Oraibi

2024, 33(8): 737-750. DOI: 10.5246/jcps.2024.08.055

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To minimize graft rejection, it is crucial to reduce immunosuppression. In the present study, we investigated immunological markers in the blood of transplant patients who did not receive tacrolimus. We also assessed alloreactive CD4+CD25+FoxP3+ Tregs both before transplantation and after tacrolimus reduction. The comparative analysis included 50 individuals experiencing early rejection after tacrolimus discontinuation and 100 non-rejectors. Before reducing tacrolimus, rejectors exhibited elevated levels of memory CD8+ T cells compared to Tregs, while non-rejectors displayed a lower ratio of memory CD4+ T cells to Tregs. Following tacrolimus removal, rejectors showed an increase in naïve T cells and a decrease in effector T cells. After transplantation, CD4+ Treg levels declined, but their anti-donor regulatory function remained consistent in both rejectors and non-rejectors. Immunological correlation revealed an association between acute rejection after tacrolimus discontinuation and the pre-reduction ratio of memory T cells to regulatory T cells. These indicators identified individuals whose immunosuppression could be safely reduced.

Pharmacist-led interventions in older adults: A bibliometric analysis of scientific literature

Xiaojing Lu, Xuedong Jia, Fangying Si, Xi Yang, Wan Zhang, Zhao Yin

2024, 33(8): 751-765. DOI: 10.5246/jcps.2024.08.056

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Pharmacist-led interventions have demonstrated significant benefits for older adults, with a plethora of studies dedicated to this subject. A bibliometric study was conducted to assess the current state of research and summarize key themes in the domain of pharmacist-led interventions for older adults. The analysis encompassed publications available in the Web of Science Core Collection from its inception until September 8, 2022. To perform the bibliometric analysis, VOSviewer and CiteSpace software were employed. The initial query yielded a substantial 6 084 relevant documents spanning the period from 1995 to September 8, 2022. Of these, 5496 (constituting 90.34%) were categorized as "Article". Notably, the yearly output of publications displayed an upward trajectory. This body of work emanated from 120 countries and regions, with the United States being the foremost contributor, accounting for the majority of publications (n = 2637). The University of Sydney in Australia emerged as the institution with the highest number of publications (n = 155). Timothy F Chen, affiliated with the University of Sydney, was the most prolific author, boasting 35 publications. Joseph T Hanlon, a scholar affiliated with the University of the Sciences in Philadelphia, emerged as the most frequently co-cited author. When considering journal productivity, The Journal of Managed Care & Specialty Pharmacy stood out as the most prolific journal (n = 251). Conversely, the Journal of the American Geriatrics Society garnered the highest number of co-citations (n = 5293). The predominant research themes encompassed the development of new criteria, updates to existing criteria, the utilization of criteria for identifying potentially inappropriate medications in older populations, concerns surrounding inappropriate polypharmacy in this demographic, and the evaluation of the positive impact of pharmacist-led interventions for older adults. In conclusion, this comprehensive bibliometric analysis offers a panoramic view of pharmacist-led interventions for older adults, providing valuable insights into the field’s evolution over the past three decades.

The research team of Prof. Yang Xu has made progress on the evaluation of cardio-renal-metabolic effectiveness of novel hypoglycemic drugs

Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center

2024, 33(8): 766-766.

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