Insights & Discussion
Traditional Chinese medication, acupuncture, and their integration can be used effectively for the treatment of Retinitis Pigmentosa (RP) improving vision and visual field.
Methodologies used in the study include treating RP patients with various Traditional Chinese Medicine preparations such as Ziyin Mingmu pill, Zhujing pill, Mingmu Dihuang decoction, Ginkgo Mingmu prescription, and Yiqi Mingmu pill. These preparations aimed to treat the syndrome of deficiency and excess by improving vision and visual field and enhancing blood supply to the eyes. Acupuncture techniques including the “two dragons playing with pearls” method and fire needling on the Fengchi point were also explored. Finally, various combinations of acupuncture and medication were tested for their efficacy in improving RP symptoms.
In terms of results, the studies found noticeable clinical effects and therapeutic outcomes. Most of the investigated treatments showed improvement in visual acuity and visual field, contributing to a high total effective rate. The effectiveness of the remedies was compared with western medication, with the integrated Traditional Chinese Medicine approaches demonstrating superior results. Each Traditional Chinese Medicine treatment method, acupuncture technique, or their combination demonstrated a significant enhancement in visual functions and patient symptoms.
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The traditional Chinese medicine prescription combination of Chrysanthemi Flos, Cassiae Semen, Lycii Fructus, Angelicae Sinensis Radix and Salviae Miltiorrhizae Radix et Rhizoma presents potential for treating retinal diseases.
2024 Traditional Medicine Research Exploring a novel traditional Chinese medicine prescription containing Chrysanthemi Flos for retinal diseases: an integrated strategy of data mining and network pharmacology Zhang JX, Zhang KL, Chang XW, Gu JF, Wei SB, Zhu BY, et al.
Data Mining Chrysanthemum Retinitis Pigmentosa
Methodology: The researchers employed data mining to discern a new traditional Chinese medicine (TCM) prescription against retinal diseases and explore its medication rule. This was followed by constructing a network of TCMs, core ingredients, core targets, and core pathways using network pharmacology. The binding ability between core active ingredients and core targets was then verified through molecular docking and molecular dynamics simulation techniques.
Discussion: The novel TCM prescription screened in this study bears great potential in retinal diseases treatment through a unique mechanism of action. This mechanism involves TCM prescriptions that possess clearing heat and supplementing activities, associated with liver and lung meridians. The mechanism was found to act by modulating several core targets implicated in multiple core pathways such as the AGE-RAGE signaling pathway in diabetic complications, and the PI3K-Akt signaling pathway, among others. This potentially inhibits the inflammatory response, oxidative stress, and retinal neovascularization and apoptosis of retinal ganglion cells and retinal pigment epithelial cells. This improves retinal structural impairment and can have a significant impact on the treatment of retinal diseases.
Lycium barbarum polysaccharide may decrease apoptosis in retinal photoreceptor cells of retinitis pigmentosa mice by suppressing nuclear factor-kappa B/NOD-like receptor thermal protein domain-associated protein 3 pathway.
2023 Digital Chinese Medicine Inhibition of photoreceptor apoptosis in mice with retinitis pigmentosa through NF-κB/NLRP3 pathway suppression with Lycium barbarum polysaccharide Wang Y, Deng Y, Lu J, Peng J, Zhou Y, Yang Y, et al.
Experimental Study Goji Berry Retinitis Pigmentosa
The team carried out both in vivo and in vitro studies. Initially, mouse retinal ganglion cells were categorized into groups based on the doses of Lycium barbarum polysaccharide they were given and a positive drug control group. These cells were then subject to different H2O2 concentrations to induce apoptosis. Techniques such as flow cytometry, immunofluorescence, and western blot were used to evaluate cell viability, apoptosis rate, and expression of various markers. For in vivo research, the team used C57/BL6 and Rd10 mice divided into similar groups as the in vitro experiment. The mice underwent drug treatment for four weeks, after which their retina's response to light and general health were evaluated using an electroretinogram and histopathological examination.
The in vitro experiments showed that the apoptosis rate of ganglion cells significantly increased in the model group, along with up-regulation of certain proteins. However, a high dose of Lycium barbarum polysaccharide decreased the cell apoptosis rate and the levels of certain proteins. Similarly, in vivo testing showed that a high dose of the substance significantly aided in morphological alterations in a retina layer of Rd10 mice, and down-regulated the expression levels of a number of apoptosis-related proteins.
Zhangyanming Tablets show potential as a protective agent for retinal function in early-stage, genetically-caused blindness in mice, possibly due to their antioxidant and anti-/pro-apoptotic properties.
2023 Biomedicine & Pharmacotherapy Protective effect of ZYMT, a traditional Chinese patent medicine in a mouse model of retinitis pigmentosa Huang Z, Huang Q, Xu K, Liang L, Li Y, Zhou W, et al.
Experimental Study Dang Shen Ge Gen Goji Berry
Eighty mice with Retinitis Pigmentosa (RP) were divided into two groups, with one group receiving Zhangyanming Tablets (ZYMT) and a control group getting distilled water. After a period of 7 and 14 days, the researchers conducted tests through electroretinogram, fundus photography, and histological examination to assess the retinal function and structure of the subjects. They furthered the study using TUNEL, immunofluorescence and qPCR to evaluate cell apoptosis and the expressions of particular genes.
The ZYMT-treated mice displayed a notable enhancement in retinal reactions and overall preservation of retinal structure when compared to the control group. Particularly noticeable were increases in retinal thickness and cell count, alongside a significantly lowered rate of cell death. A comprehensive follow-up shows the altered expressions of several genes in the retina following the application of ZYMT. These results, combined, suggest a key role of ZYMT in mitigating the effects of RP especially in early stages.
The Chinese herbal medicine Bujing Yishi tablets could alleviate photoreceptor degeneration in retinitis pigmentosa by inhibiting microglial over-activation and inflammation.
2023 Phytomedicine Bujing Yishi tablets alleviate photoreceptor cells death via the P2X7R/CX3CL1/CX3CR1 pathway in Retinitis Pigmentosa rats Qi Y, Liu L, Liang D, Tang S, Yu X, Ye H, et al.
Experimental Study Bu Jing Yi Shi Tablets Retinitis Pigmentosa
This experiment began with the creation of a rat model for retinitis pigmentosa through intraperitoneal injection of N-Methyl-N-Nitrosourea. After the rats developed retinal degeneration, they were treated with Bujing Yishi tablets. To confirm the impact of these tablets on the rat model, the researchers conducted several tests, including examination of the retinal cytokine levels and expression of IBA-1 in microglia. This let them monitor the apoptotic cells, ONL thickness, retinal morphology, and photoreceptor degeneration. They further used western blot, real-time polymerase chain reaction, and immunofluorescence to determine the mRNA and protein expression levels involved in the P2X7R/CX3CL1/CX3CR1 pathway.
Following the treatment of the rats with Bujing Yishi tablets, there was significant relief in the morphological structure deterioration of the retinas and the photoreceptor degeneration. The herbal tablets also reduced the number of apoptotic cells in the ONL and prevented the thinning of the ONL, pointing to their effectiveness in retinal preservation. Additionally, the tablets lowered the level of over-activated microglia and decreased retinal levels of inflammatory markers. Bujing Yishi tablets were also observed to decrease the protein and mRNA expression of P2X7, CX3CL1, and CX3CR1, further exhibiting their mechanism of retinal preservation through influence on the P2X7R/CX3CL1/CX3CR1 pathway.
The research unveils luteolin, quercetin, and kaempferol in RALRG as promising complementary components for RP treatment, with a key role in managing oxidative stress and PI3K/AKT signaling pathways.
2023 Annals of Translational Medicine Mechanism and ingredients prediction of Radix Salviae-Angelicae Sinensis Radix-Lycii Fructus-Rehmanniae Radix Praeparata-Ginkgo Folium for retinitis pigmentosa therapy using network pharmacology and molecular docking analysis Wu J, Sun Z, Zhang D, Liu H, Wu J, Zhang S
Network Pharmacology Dang Gui Ginkgo Folium Goji Berry
The research used various databases such as Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, GeneCards, and the Online Mendelian Inheritance in Man database to gather the ingredients of RALRG and potential targets of RP and RALRG. A protein-protein interaction network was constructed to visualize these interactions. The R program was utilized to perform functional enrichment. The researchers constructed a visual RALRG-RP-pathway pharmacology network using Cytoscape 3.9.1 and applied molecular docking to compute binding affinity.
The research revealed a total of 132 effective active elements in RALRG correlating to 248 target genes. Ninety-two intersection target genes were discovered from the overlap of RP- and RALRG-related genes. These intersection targets were discovered to be primarily involved in oxidative stress, responding to metal ions, and handling chemical stress. Several molecular pathways such as PI3K-AKT and MAPK were identified as closely connected to RP therapy. A potential pharmacology network was designed for the RALRG-RP-pathway with AKT1 and JUN being considered the main targets. The active ingredients luteolin, quercetin, and kaempferol were highlighted as crucial for this mechanism. RALRG overall was established as a main regulator for oxidative stress and PI3K/AKT signaling pathways in the treatment of RP.
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