The American Journal of Chinese Medicine

Traditional Chinese medicine (TCM) is an important component of complementary and alternative medicine (CAM). The fast economic growth of mainland China in the past two decades has promoted the use of TCM beyond Chinese-speaking countries. Chinese researchers have published more TCM research studies in CAM-related professional journals, including the American Journal of Chinese Medicine (AJCM), the highest impact journal in Chinese medicine. The consistent increase of the impact factor of the AJCM suggests a growth in TCM popularity. This study analyzed articles published in the AJCM between 2004 and 2011. Our data show that while enthusiasm towards cardiovascular, nervous system and inflammation related research remained high, more herbal investigations and cancer studies were published. Furthermore, a reduction in TCM formulation studies was replaced by increasing botanical single constituent research. Examples of frequently cited studies, including those before 2004, are presented. These data are not only important to the scientific community for recognition of trends in TCM research, but also for providing information to TCM researchers who are targeting potentially highly cited studies.

Traditional Chinese medicine (TCM), an alternative medicine, focuses on the treatment of human disease via the integrity of the close relationship between body and syndrome analysis. It remains a form of primary care in most Asian countries and its characteristics showcase the great advantages of personalized medicine. Although this approach to disease diagnosis, prognosis and treatment has served the medical establishment well for thousands of years, it has serious shortcomings in the era of modern medicine that stem from its reliance on reductionist principles of experimentation and analysis. In this way, systems biology offers the potential to personalize medicine, facilitating the provision of the right care to the right patient at the right time. We expect that systems biology will have a major impact on future personalized therapeutic approaches which herald the future of medicine. Here we summarize current trends and critically review the potential limitations and future prospects of such treatments. Some characteristic examples are presented to highlight the application of this groundbreaking platform to personalized TCM as well as some of the necessary milestones for moving systems biology of a state-of-the-art nature into mainstream health care.

Cistanche deserticola Y. C. Ma (C. deserticola, "Rou Cong Rong" in Chinese) is an officinal plant that grows in arid or semi-arid areas. The dried fleshy stem of C. deserticola has been generally used as a tonic in China and Japan for many years. Modern pharmacology studies have since demonstrated that C. deserticola possesses broad medicinal functions, especially for use in hormone regulation, aperient, immunomodulatory, neuroprotective, antioxidative, anti-apoptotic, anti-nociceptive, anti-inflammatory, anti-fatigue activities and the promotion of bone formation. The phenylethanoid glycosides (PhGs) presented in C. deserticola have been identified as the major active components. This review summarizes the up-to-date and comprehensive information on C. deserticola covering the aspects of the botany, traditional uses, phytochemistry, and pharmacology.

The objective of this review was to summarize and critically evaluate the clinical evidence of the effect of qigong exercise on immunity and its efficacy in the prevention or treatment of infectious diseases. Thirteen databases were searched from their respective inceptions through January 2011, and all controlled clinical trials of qigong exercise on immunity and infections were included. Quality and validity of the included studies were evaluated using standard scales. Seven studies including two randomized controlled trials (RCTs), two controlled clinical trials (CCTs) and three retrospective observational studies (ROSs) met the inclusion criteria. One study focused on functional measures of immunity (antigen-induced immunity) and six studies on enumerative parameters of immunity. No study on clinical symptoms relevant to infectious diseases could be identified. Overall, the included studies suggested favorable effects of qigong exercise on immunity, but the quality of research for most of the studies examined in this review was poor. Further rigorously designed studies are required, which should adhere to accepted standards of methodology for clinical trials.

This study was designed to compare the weight reduction effects of acupuncture for obese women with or without perimenopausal syndrome. We observed 60 women with either simple obesity or perimenopausal obesity (obesity complicated with perimenopausal syndrome) treated by five acupuncture treatments given in the first week of three successive four-week treatment courses, and obesity indexes including body weight, body mass index, obesity degree and waist/hip ratio were evaluated. Versus baseline, the obesity indexes decreased at the end of each treatment course in women with simple obesity (p < 0.05 or p < 0.01), while women with perimenopausal obesity showed no decrease at the end of the first course of treatment, and these indexes decreased at the end of the second and the third courses of treatment (p < 0.05). There was no difference when comparing obesity indexes recorded at the end of three courses of treatment and at the end of three-month follow-up between women with simple obesity and those with perimenopausal obesity. The results suggest that acupuncture reduced body weight in the obese women, and the weight loss occurred earlier in the treatment process for simple obesity than perimenopausal obesity.

The aim of the study was to investigate the efficacy of electro-acupuncture coupled with conventional treatments and compare it with the efficacy of conventional treatments alone in patients with chronic plantar fasciitis. Thirty patients with chronic refractory plantar fasciitis were randomly assigned to two groups. Subjects in the control group received five weeks of conventional treatments, including stretching exercise, shoe modification and rescue analgesics. Subjects in the acupuncture group received the same treatments plus ten sessions of electro-acupuncture twice weekly. Endpoints included a success rate determined by a minimum of a 50% decrease in Visual Analog Scale (VAS) and Foot Function Index (FFI). At the end of treatment, VAS decreased significantly from 6.00 ± 1.69 to 1.89 ± 1.59 and from 6.27 ± 2.34 to 5.40 ± 2.26 in the acupuncture and control groups, respectively. FFI decreased significantly only in the acupuncture group (p < 0.05). Subjects in the acupuncture group obtained higher success rates than those in control group (80% and 13.3%, respectively). FFI in the acupuncture group was better than those in the control group (p < 0.001). At the sixth week follow-up, subjects in the acupuncture group showed a better FFI and success rate for pain during the day than those in the control group (p < 0.05). Electro-acupuncture coupled with conventional treatments provided a success rate of 80% in chronic planar fasciitis which was more effective than conventional treatments alone. The effects lasted for at least six weeks.

Diabetic nephropathy is a leading cause of chronic renal failure. Recently, Euonymus alatus showed therapeutic potential in the treatment of diabetes and its chronic complications. In this study, effects of Euonymus alatus and its mechanism in the treatment of diabetic nephropathy were investigated. Diabetic nephropathy was induced in Sprague-Dawley rats by uninephrectomy plus streptozotocin (STZ) administration. Euonymus alatus and irbesartan, as a positive control, were lavaged to these rats for 12 weeks. Our data showed that Euonymus alatus was efficient in lowering HbA1c, improving blood lipids, decreasing 24 h urine protein and protecting kidney function. Pathological studies found kidney damage, including extracellular matrix expansion and glomerulosclerosis, were improved by Euonymus alatus treatment. Further investigation found that the herb had a role in downregulating the expression of transform growth factor β₁. In conclusion, Euonymus alatus has a protective role in diabetic nephropathy, which may be related to its downregulation of transform growth factor β₁ expression.

Alpinia galanga and Languas galanga, which are plants belonging to the ginger family, are frequently used for cooking, especially in Thai and Indonesian cuisine. The compound 1′-acetoxychavicol acetate (ACA), which is naturally obtained from the rhizomes and seeds of these gingers, has antioxidant and anti-inflammatory properties. We investigated the anti-obesity effects of ACA in 3T3-L1 adipocytes and in high fat diet (HFD)-induced rat models of obesity. ACA caused a significant decrease in the activity of GPDH in 3T3-L1 adipocytes without eliciting cell cytotoxicity, and it inhibited cellular lipid accumulation through the down-regulation of transcription factors such as PPARγ and C/EBPα. ACA also induced a dose-dependent phosphorylation of AMP-activated protein kinase (AMPK). In the animal model, rats fed an HFD containing 0.05% ACA gained less weight than rats fed an HFD alone. The visceral fat mass in rats fed an HFD containing 0.05% ACA tended to be lower than that in rats fed an HFD alone. Furthermore, a histological examination of livers from rats fed an HFD showed steatohepatitis. However, rats fed an HFD containing 0.05% ACA showed no histopathological changes in the liver tissue. Our results show that ACA exerts anti-obesity activities both in vitro and in vivo and suggests that ACA may have a novel preventive activity against obesity and possibly other metabolic diseases.

Extracting active components from Chinese medicinal herbs efficiently is a key step in the investigation of their pharmacological effects and modes of action. In this project, we compared the ultrasound-assisted method and the conventional solvent method for extracting the active compound of Taxus cuspidate (dong bei hong dou shan). Through the analysis of various extractions with a quadruple time-of-fight (Q-TOF) LC/MS, we demonstrated that the ultrasound-assisted method reduced solvent consumption and had shorter extraction time, while the extraction yields of the active compound (taxol) were equivalent to or even higher than those obtained with the conventional solvent extraction method. Through the comparison of Taxus cuspidate extracts (TCEs) with different concentrations of acetone and ethanol, we proved that 50% ethanol was an optimal solvent for extracting taxol from Taxus cuspidate. Based on traditional Chinese medicine (TCM) literature, we further determined whether TCEs possess antidiabetic effects by testing glucose uptake in 3T3-L1 adipocytes treated with TCEs from Taxus cuspidate bark and twigs under insulin stimulation (100 nM). The results showed that neither taxol (10 μg/ml) nor TCEs (1 and 0.1 mg/ml) changed glucose uptake significantly compared with insulin alone. This study demonstrated that the ultrasound-assisted method with 50% ethanol is a highly efficient approach for extracting Taxus cuspidate, which may be applicable for extraction of other Chinese medicinal herbs. Extracts of Taxus cuspidate bark and twigs had no effect on insulin stimulated-glucose uptake in vitro. This result conflicts with the description in TCM literature. Further in vivo study to clarify Taxus cuspidate's metabolic actions is necessary.

Obesity is an important and preventable risk factor for renal disease. The administration of an antioxidant with a lipid-lowering effect is an important therapeutic approach for kidney disease in obese patients. The present study was conducted to examine whether methanolic extract of Dendrobium moniliforme (DM), one of the most famous traditional medicines used in many parts of the world, has an antioxidant effect in vitro and an ameliorative effect on high-fat diet (HFD)-induced alterations such as renal dysfunction and lipid accumulation in vivo. The 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity of DM extract (IC₅₀ = 29.6 μg/mL) was increased in a dose-dependent manner. The LLC-PK1 kidney cell damage induced by oxidative stress was significantly inhibited by the treatments with DM extract. In the animal study, DM extract (200 mg/kg) was orally administered every day for nine weeks to HFD-fed mice, and its effect was compared with that of metformin. The administration of DM extract decreased the elevated serum glucose, total cholesterol concentration and renal lipid accumulation in HFD-fed mice. It also ameliorated renal dysfunction biomarkers including serum creatinine and renal collagen IV deposition. Taken together, these results provide important evidence that DM extract exhibits a pleiotropic effect on obesity induced parameters and exerted a renoprotective effect in HFD-fed mice.

The Bennett and Xie (1988) model of chronic constriction injury (CCI) investigated the effects of tetramethylpyrazine (TMP) on neuropathic pain-associated behaviors and neuronal apoptosis in the spinal dorsal horn. Fifty-four male rats were randomly divided into sham (group S), CCI (group C) and TMP groups (group T). Each group was divided into subgroups (n = 6 in each group) according the time of sacrifice: 3 d, 7 d and 14 d. Rat sciatic nerves were unligated (group S), or the right sciatic nerve was loosely ligated (groups C and T) to produce CCI. Mechanical withdrawal thresholds (MWTs) and thermal withdrawal latencies (TWLs) were measured, and the rats were sacrificed at different time points post-operation. The L4-L6 sections of the spinal cord were removed. Apoptotic changes were evaluated using the TUNEL method. Immunohistochemistry assessed Bcl-2 and caspase-3 expression. TMP treatment increased MWT and TWL values and Bcl-2 expression, but it reduced neuronal apoptosis and caspase-3 expression in laminae I–II of the spinal dorsal horn. These results suggested that the inhibition of neuronal apoptosis via the modulation of Bcl-2 and caspase-3 proteins in the rat spinal dorsal horn contributed to TMP-induced analgesia.

This study was performed to investigate effects of Curculigo orchioides rhizome (curculiginis rhizome) on acute reflux esophigitis (RE) in rats that are induced by pylorus and forestomach ligation operation. Proinflammatory cytokine, as well as tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 were all assayed and the expression of TNF-α and COX2 analyzed by RT-PCR. The esophagic tissue damage of reflux esophagitis rat was increased compared to that of normal intact group. However, the esophagic damage percentage from the extract of curculiginis rhizoma (ECR) 600 mg/kg and ECR 300 mg/kg were significantly lower than that of the RE control group. Administration of α-tocopherol (30 mg/kg) and ECR (600 mg/kg, 300 mg/kg, and 150 mg/kg) had a significant effect on the gastric acid pH in rats with induced reflux esophagitis (p < 0.05). The treatment with ECR significantly reduced the production of cytokines TNF-α, IL-1β and IL-6 levels compared to the model group (p < 0.05). The expression of TNF-α and COX2 in the intact esophageal mucosa was low while those of the RE control group were significantly higher due to an inflammatory reaction in the esophagus. Compare to the model group, treatment with α-tocopherol or ECR significantly inhibited the expression levels of COX2 and TNF-α in a dose-dependent manner. These results suggest that anti-inflammatory and protective effects of ECR could attenuate the severity of reflux esophagitis and prevent esophageal mucosal damage.

Allergic inflammatory diseases such as food allergy, asthma, sinusitis, and atopic dermatitis are increasing worldwide. In this study, we investigated the effects of aqueous extract of Mosla chinensis Max. (AMC) on mast cell-mediated allergic inflammation and studied the possible mechanism of this action. AMC inhibited compound 48/80-induced systemic and immunoglobulin E (IgE)-mediated local anaphylaxis. AMC reduced intracellular calcium levels and downstream histamine release from rat peritoneal mast cells activated by compound 48/80 or IgE. In addition, AMC decreased gene expression and secretion of proinflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 in human mast cells. The inhibitory effect of AMC on cytokine expression was nuclear factor (NF)-κB dependent. Our results indicate that AMC inhibits mast cell-mediated allergic inflammatory reaction by suppressing histamine release and expression of proinflammatory cytokines and the involvement of calcium and NF-κB in these effects. AMC might be a possible therapeutic candidate for allergic inflammatory disorders.

Kava is one of the most widely sold herbal dietary supplements in the United States. It has been reported that, besides exhibiting hepatotoxicity, kava also possesses photosensitivity and induces dermopathy in humans. In this study, we determined that UVA irradiation of kava in the presence of a lipid, methyl linoleate, generated lipid peroxidation which was mediated by singlet oxygen generated during photoirradiation. The six major kavalactones(yangonin, 7,8-dihydrokawa in, kawain, 7,8-dihydromethysticin, methysticin, and 5,6-dehydrokawain) were also studied in parallel; only 5,6-dehydrokawain and yangonin-induced a low level of lipid peroxidation. UVA irradiation of kava in human HaCaT skin keratinocytes induced cytotoxicity which was mediated by oxidative stress, led to DNA strand cleavage, and produced 8-hydroxy-2′-deoxyguanosine (8-OHdG) adduct. Study by the electron spin resonance (ESR) method revealed that UVA irradiation of kava produced singlet oxygen and carbon-centered radicals. The overall results suggest that kava is photocytotoxic and photogenotoxic, both mediated by free radicals generated during photoirradiation.

Bone integrity is maintained through a balance between bone formation by osteoblasts and bone resorption by osteoclasts. Imbalance of the process results in metabolic bone diseases such as osteoporosis. This study investigated the yellow flag iris extract (YFIE) and revealed its anti-osteoporotic effects in osteoblastic MC3T3-E1 mouse cells and RAW 264.7 murine macrophages. When osteoblasts were treated with 1–20 μg/ml YFIE in an osteogenic medium, the bone nodule formation by calcium deposits was markedly enhanced during differentiation. Consistently, YFIE stimulated alkaline phosphatase activity and collagen type I secretion with a substantial effect on osteoblast proliferation. On the other hand, RAW 264.7 macrophages were pre-incubated with 1–20 μg/ml YFIE for 5 days in the presence of receptor activator of nuclear factor-κB ligand (RANKL). Non-toxic YFIE markedly attenuated the differentiation of macrophages to multi-nucleated osteoclasts. YFIE diminished RANKL-elevated tartrate-resistant acid phosphatase activity and bone resorption. In addition, the YFIE treatment retarded RANKL-induced cathepsin K production and carbonic anhydrase II expression, both of which are involved in bone resorption. Therefore, YFIE potentially posesses therapeutic agents that may prevent osteoporosis through promoting bone formation and reducing bone resorption.

The injury of endothelial cell is the critical event of vascular disease. In endothelial cell, oxidative stress is regarded as critical to pathogenic factors in endothelial cell injury and apoptosis. Tanshinone IIA is the main effective component of Salvia miltiorrhiza known as "Danshen" in traditional Chinese medicine for treating cardiovascular disorders, but the mechanism by which it exerts the protective effect is not well established. The present study was designed to test the hypothesis that tanshinone IIA can inhibit hydrogen peroxide (H₂O₂)-induced injury and unravel its intracellular mechanism in human umbilical vein endothelial cells (HUVECs). In this study, HUVECs were treated with tanshinone IIA in the presence/absence of H₂O₂. The protective effects of tanshinone IIA against H₂O₂ were evaluated. Our results show that HUVECs incubated with 200 μM H₂O₂ had significantly decreased the viability of endothelial cells, which was accompanied with apparent cell apoptosis, the activation of caspase-3 and the upregulation of p53 expression, which was known to play a key role in H₂O₂-induced cell apoptosis. However, pretreatment with tanshinone IIA (3–10 μM) resulted in a significant resistance to H₂O₂-induced apoptosis. In addition, pretreatment with tanshinone IIA decreased the activity of caspase-3 and p53 expression. Tanshinone IIA also induced activating transcription factor (ATF) 3 expression; while knockdown of ATF-3 with ATF-3 siRNAsignificantly reduced tanshinone IIA's protective effect. In conclusion, the present study shows that tanshinone IIA can protect endothelial cells against oxidative injury induced by H₂O₂, suggesting that this compound may constitute a promising intervention against cardiovascular disorders and ATF-3 may play an important role in this process.