Search

Aplastic Anemia (AA) is a rare but fatal hematologic disease that may occur at any age and especially higher in Asia. We investigated whether Chinese herbal medicine (CHM) is beneficial to AA patients as a complementary therapy using a nationwide population-based database in Taiwan between 2000–2016. Patient survival was estimated by Kaplan‒Meier survival analyses and Cox proportional-hazard model. CHM-users presented lower risks of overall and anemia-related mortalities when compared to non-users. The risk of overall mortality for CHM-users in AA patients was 0.70-fold [adjusted hazard ratio (aHR): 0.70, 95% confidence interval (CI): 0.66-0.74, p < 0.001). The risk of anemia-related mortality was lower in CHM-users when compared to non-users (aHR: 0.46, 95% CI: 0.32-0.67, p < 0.001). The association rule analysis revealed that CHM pairs were Ban-Zhi-Lian (BZL; Scutellaria barbata D. Don)→Bai-Hua-She-She-Cao (BHSSC; Oldenlandia diffusa (Willd.) Roxb.), followed by Dang-Gui (DG; Angelica sinensis (Oliv.) Diels)→Huang-Qi (HQi; Astragalus membranaceus (Fisch.) Bunge), and Xian-He-Cao (XHC; Agrimonia pilosa f. borealis (Kitag.) Chu)→Gui-Pi-Tang (GPT). Network analysis showed that BZL, BHSSC, DG, HQi, XHC, GPT, and Dan-Shen (DanS; Salvia miltiorrhiza var. charbonnelii (H.Lév.) C.Y.Wu) were commonly used CHMs for AA patients. Therefore, further studies for these commonly prescribed herbs are needed in functional investigations in hematopoiesis-stimulating effect and large-scale randomized controlled trials (RCT) in bone marrow failure related diseases. [ABSTRACT FROM AUTHOR]

Astragalus radix is a well-known herbal material in traditional Chinese medicine. Astragalus membranaceous and A. membranaceous var. mongholicus are known as the authentic origins of Astragalus medicines whereas Hedysarum polybotrys is a common adulterant of Astragalus radix in Taiwan. Random amplified polymorphic DNA (RAPD) primers were used to screen the polymorphic fragments. Among them, OPB-2 and OPC-14 directed the amplification of 3 specific fragments A1 (1.3 Kb), A2 (0.6 Kb) and H1 (0.8 Kb) from A. menthranaceous, A. membranaceous var. mongholicus and H. polybotrys respectively, which were further converted to sequence characterized amplified region (SCAR) markers. Primer pairs HG3 and HG4 derived from A1, HG7 and HG8 from A2, and RC3 and RC4 from H3, were successfully employed on the authentication of Astragalus medicines and H. polybotrys. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) has become a worldwide burden due to the high co-morbidity and mortality. Diabetic nephropathy (DN) is one of the leading causes of CKD, and pre-dialysis is one of the most critical stages before the end-stage renal disease (ESRD). Although Chinese herbal medicine (CHM) use is not uncommon, the feasibility of using CHM among pre-dialysis DN patients remains unclear. Materials and methods: We analyzed a population-based cohort, retrieved from Taiwan's National Health Insurance Research Database, to study the long-term outcome of using CHM among incident pre-dialysis DN patients from January 1, 2004, to December 31, 2007. All patients were followed up to 5 years or the occurrence of mortality. The risks of all-cause mortality and ESRD were carried out using Kaplan-Meier and competing risk estimation, respectively. Further, we demonstrated the CHM prescriptions and core CHMs using the Chinese herbal medicine network (CMN) analysis. Results: A total of 6,648 incident pre-dialysis DN patients were analyzed, including 877 CHM users and 5,771 CHM nonusers. With overlap weighing for balancing all accessible covariates between CHM users and nonusers, we found the use of CHM was associated with lower all-cause mortality (0.22 versus 0.56; log-rank test: p -value <0.001), and the risk of mortality was 0.42 (95% CI: 0.36–0.49; p -value <0.001) by adjusting all accessible covariates. Further, the use of CHM was associated with a lower risk of ESRD (cause-specific hazard ratio: 0.59, 95%CI: 0.55–0.63; p -value <0.001). Also, from the 5,901 CHM prescriptions, we found Ji-Sheng-Shen-Qi-Wan, Astragalus mongholicus Bunge or (Astragalus membranaceus (Fisch.) Bge.) , Plantago asiatica L. (or Plantago depressa Willd.), Salvia miltiorrhiza Bunge, and Rheum palmatum L. (or Rheum tanguticum (Maxim. ex Regel) Balf. , Rheum officinale Baill.) were used as core CHMs for different CHM indications. Use of core CHMs was associated with a lower risk of mortality than CHM users without using core CHMs. Conclusions: The use of CHM seemed feasible among pre-dialysis DN patients; however, the beneficial effects still need to be validated by well-designed clinical trials. [ABSTRACT FROM AUTHOR]

Background Cancer-related fatigue (CRF), cachexia, or poor performance status, which occurs among patients with advanced malignancy, has always frustrated clinicians and patients and been primarily managed via conservative treatments. The botanically derived drug extracted from Astragalus membranaceus(PG2) has been approved by Taiwan FDA as a standard of choice for CRF management. We show real-world practice about combination treatment of PG2, dose-modified chemotherapy, and anti-PD1 checkpoint inhibitor in patients with advanced malignancy with cachexia, fatigue, or poor performance status here. Methods We conducted a retrospective chart review of patients with advanced malignancy with CRF or cachexia who received a combination treatment mentioned above from Dec. 2016 to Dec. 2018. Results The medical charts of 23 patients with different malignancies who received PG2 during the systemic treatment, including chemotherapy and immunotherapy, were reviewed. The following types of cancers were detected among these patients: digestive system (n = 7), head and neck (n = 7), gynecological (n = 6), and others (n = 3). During recruitment, 22 patients had stage IV cancer. The initial ECOG performance status was 1 (n = 5), 2 (n = 11), > 2 (n = 7). The objective responses were 3 CR (13%), 13 PR (57%), 1 SD (4%), 5 PD (22%), and 1 death with treatment related tumor lysis syndrome of 6 days (4%). The median overall survival (OS) was 20.5 months (95% CI = 14.364, 26.636). The median progression-free survival (PFS) was 11.6 months (95% CI = 2.017, 21.249). Adverse events included anorexia (30%), neutropenia (26%), pneumonia (22%), nephrotoxicity (13%), and nausea and vomiting (13%). The adverse effect for grade 3/4/5 was rare. Conclusions This retrospective study provided real-world data for the management of initially presenting CRF, cachexia, or poor performance status with PG2 injection in 23 advanced cancer patients. The treatment was relatively fair tolerated with impressive results of OS and PFS. Further prospective study of combination therapies including immunotherapy and PG2 injection is warranted for more robust evidence. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

This study was to investigate the protective and recovery effects of Danggui Buxue Tang (DBT) supplementation on exercise performance, hepcidin, iron status, and other related biochemical parameters after being challenged by a single bout of intense aerobic exercise. A total of 36 recreationally active males were pair-matched and randomly assigned to receive DBT or a placebo for 11 days, while using clusters based on their aerobic capacities. On the eighth day of the supplementation, the participants performed a 13-km run with maximal effort. Blood and urine samples were collected and analysed before treatment (Pre-Tre) and immediately after (Post-Ex), 24 h after (24-h Rec), and 72 h after (72-h Rec) the run. DBT supplementation dramatically shortened the finish times by 14.0% (12.3 min) when compared with that in the placebo group. Significant group × time effects were observed in serum hepcidin and iron levels. DBT supplementation repressed hepcidin levels at Post-Ex and 24-h Rec, thereby causing a significant increase in iron levels by 63.3% and 31.4% at Post-Ex and 72-h Rec, respectively. However, DBT supplementation had no significant anti-inflammatory or haemolysis-preventative effects. Short-term DBT supplementation shortened the running time and repressed exercise-induced hepcidin levels, thereby boosting iron levels and accelerating iron homeostasis during recovery.