Regulation of Fuzheng Huayu capsule on inhibiting the fibrosis-associated hepatocellular carcinogenesis.

In the current study, bioinformatics analysis of the hepatocellular carcinoma (HCC) dataset was conducted with the hepatoprotective effect of the Fuzheng Huayu (FZHY) capsule against the diethylnitrosamine-induced HCC progression analyzed. Eight cell clusters were defined and tanshinone IIA, arachidonic acid, and quercetin, compounds of the FZHY capsule, inhibit HCC progression-related fibrosis by regulating the expression of PLAU and IGFBP3. Combined with the ameliorative effect of the FZHY capsule against liver dysfunctions and expression of PLAU and IGFBP3, our study confirmed the effect of the FZHY capsule on inhibiting the fibrosis-associated HCC progression via regulating the expression of PLAU and IGFBP3.

Yu Jin Pulvis inhibits carbon tetrachloride-induced liver fibrosis by blocking the MAPK and PI3K/Akt signaling pathways.

Traditional Chinese medicine theory indicates that Yu Jin Pulvis (YJP) could prevent liver fibrosis progression and this has been verified in liver fibrosis patients. However, the mechanism underlying the protective effects of YJP against liver fibrosis remains unclear. While different signaling pathways are involved in liver fibrosis progression, mitogen-activated protein kinase (MAPK) and phosphoinositide-3-kinase-protein kinase B/Akt (PI3K/Akt) are the most crucial. To determine whether YJP regulates these signaling pathways to prevent liver fibrosis, we used a mouse model of liver fibrosis induced by intraperitoneal injection of carbon tetrachloride (CCl4). Mice were randomly divided into normal, CCl4, YJP (300 mg/kg), CCl4+YJP (100, 200, and 300 mg/kg), and two positive control silybin (100 mg/kg) and Fuzheng Huayu (FZHY) capsule (2 g/kg) groups. The mice were gavaged daily for 6 weeks. Then liver fibrosis markers; tissue morphology; serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and proinflammatory cytokine levels; and expression of α-smooth muscle actin (α-SMA) and collagen type I (Col1) were examined to determine liver fibrosis progression. Liver injury and collagen deposition were significantly reduced in the YJP treatment group compared with the CCl4 group. Furthermore, the expression of phosphorylated-extracellular-signal-regulated kinase (p-ERK), p-jun N-terminal kinase (p-JNK), p-P38MAPK, p-PI3K and p-Akt was decreased by YJP treatment compared with CCl4 treatment. Collectively, these results demonstrate the antifibrosis effect of YJP on CCl4-induced liver fibrosis in mice, mediated through blockade of the MAPK and PI3K/Akt signaling pathways. Therefore, YJP has therapeutic potential against liver fibrosis.

The components data of fuzheng huayu extracts, cordyceps sinensis mycelia polysaccharide, gypenosides and amygdalin.

Fuzheng Huayu (FZHY) capsule is a traditional Chinese medicine composed of six Chinese medicinal herbs Tian et al. [1] and approved by China food and drug administration for liver fibrosis treatment [2], [3] Liu et al., 2009 and Liu et al., 2005. CGA formula consisting of Cordyeps sinensis polysaccharide (CS-PS), gypenosides (G), and amygdalin (A), are derived from FZHY formula. It is necessary to identify the chemical profile of FZHY and CGA formula to describe the mechanisms and the corresponding components of anti-fibrosis. It is showed that FZHY contains adenosine (5.21 mg/g), amygdalin (5.31 mg/g), salvianolic acid b (18.22 mg/g) and deoxyschizandrin (2.62 mg/g), respectively. CS-PS contained 60.5 ± 2.2% total carbohydrate, including 14.17% arabinose, 25.35% glucose and 60.48% galactose. Gypenosides contain 10.34% gypenosides XLIX and 16.58% gypenosides A. These data provide the primary chemical profile of FZHY and CGA formula and an example for components analysis of traditional Chinese medicine.

Fuzheng Huayu capsule as an adjuvant treatment for HBV-related cirrhosis: A systematic review and meta-analysis.

Fuzheng Huayu (FZHY) capsule, a formulated traditional Chinese medicine product with 6 Chinese herbs, is widely used for HBV-related cirrhosis as an adjuvant treatment. However, the efficacy of FZHY capsule for HBV-induced cirrhosis did not be comprehensively proved by systematic analysis. Our current analysis was aimed to assess the efficacy and safety of FZHY capsule by an evidence-based method. Databases, including China National Knowledge Infrastructure, Wangfang, VIP medicine information system, Pubmed, Embase, and Cochrane Library, were searched, and the randomized controlled trials of FZHY capsule were used for the treatment of HBV-associated liver cirrhosis. Meta-analysis was performed by Review Manager 5.3. The efficacy rate, alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), Procollagen III protein (PIIIP), hyaluronic acid (HA), laminin (LN), Collagen C Type IV (IV-C), Child-Pugh score, portal vein diameter, spleen thickness, HBeAg negative conversion rate, and HBV-DNA negative conversion rate were systematically assessed. The Cochrane Risk of Bias tool was used to evaluate the methodological quality of eligible studies. Nineteen studies with 1,769 patients were included in the meta-analysis. Compared to conventional treatment, FZHY capsule was effective by increasing the efficacy. FZHY capsule was more efficient in improving ALT, AST, TBIL, PIIIP, HA, LN, IV-C, Child-Pugh grading score, portal vein diameter, spleen thickness, and HBV-DNA negative conversion rate with no serious adverse reactions. Nevertheless, a variety of well-designed randomized controlled trials are needed to confirm these findings since small samples were applied in the previous studies.

[Effect of Fuzheng Huayu capsules on survival rate of patients with liver cirrhosis].

Objective: To investigate the effect of Fuzheng Huayu capsules on the survival rate of patients with liver cirrhosis. Methods: A retrospective analysis was performed for the clinical data of the patients with various types of liver cirrhosis who were hospitalized in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2006 to December 31, 2008. The data collected for these patients included their basic information, diagnosis and treatment, and results of laboratory examination. The Kaplan-Meier method was used to analyze the effect of Fuzheng Huayu capsules on the survival rate of patients with liver cancer. The starting point of observation was the first day of the patient's admission and the ending point of follow-up observation was the date of death or the end of follow-up April 1, 2014. The cut-off value was obtained if the patient did not experience any outcome event (death) at the end of follow-up. With reference to the outcome, the time when the outcome occurred, and the cut-off value, the life-table method was used to calculate survival rates and survival curves were plotted. The Kaplan-Meier product-limit method was used to calculate the arithmetic mean of survival time and median survival time, and the log-rank test was used to compare the survival data. Results: A total of 430 patients with liver cirrhosis were enrolled, among whom 191 died and 239 survived or were censored. The average constituent ratio of death was 55.6% and the average constituent ratio of survival was 44.4%. The life-table method showed that the half-, 1-, 2-, and 5-year survival rates were 70%, 64%, 58%, and 48%, respectively. The median survival time was 112.1 weeks for the patients who did not take Fuzheng Huayu capsules and 351.6 weeks for those who did, and there was a significant difference in survival rate between the two groups (P = 0.000). Among 313 patients who had an etiology of hepatitis B, 164 did not take Fuzheng Huayu capsules and had a median survival time of 195.9 weeks and a 5-year survival rate of 44%, and 149 took Fuzheng Huayu capsules and had a median survival time of 336.9 weeks and a 5-year survival rate of 59%; there was a significant difference in survival rate between the two groups (P = 0.038). Among 117 patients who did not have hepatitis B, 68 did not take Fuzheng Huayu capsules and had a median survival time of 78.1 weeks and a 5-year survival rate of 32%, and 49 took Fuzheng Huayu capsules and had a median survival time of 277.4 weeks and a 5-year survival rate of 53%; there was a significant difference in survival rate between the two groups (P = 0.013). Among 92 patients with compensated liver cirrhosis, 47 did not take Fuzheng Huayu capsules and had a 5-year survival rate of 65%, and 45 took Fuzheng Huayu capsules and had a 5-year survival rate of 82%; both groups of patients had a median survival of 440 weeks; there was a significant difference in survival rate between the two groups (P = 0.027). Among 338 patients with decompensated liver cirrhosis, 185 did not take Fuzheng Huayu capsules and had a median survival time of 60.3 weeks and a 5-year survival rate of 33%, and 153 took Fuzheng Huayu capsules and had a median survival time of 267.7 weeks and a 5-year survival rate of 51%; there was a significant difference in survival rate between the two groups (P = 0.001). Conclusion: Fuzheng Huayu capsules can improve the prognosis of patients with liver cirrhosis and increase their survival rates and have good long-term efficacy.

Effect of Fuzheng Huayu capsule combined with Pegasys on genotype 1 hepatitis C fibrosis and cell apoptosis.

The aim of the present study was to observe the effects of Fuzheng Huayu capsule combined with Pegasys (peginterferon α-2a) on hepatic fibrosis in rats and in the treatment of patients with genotype 1 hepatitis C and hepatic cirrhosis. A dimethylnitrosamine (DMN)-induced rat model of liver injury was established. Fuzheng Huayu capsule combined with Pegasys was administered to the rats and the DMN-induced hepatocyte apoptosis was observed. In addition, a total of 100 patients with genotype 1 hepatitis C and hepatic cirrhosis were treated by oral administration of Fuzheng Huayu capsule combined with Pegasys or with Pegasys alone. The therapeutic effect of Fuzheng Huayu capsule combined with Pegasys was analyzed. Following the oral administration of Fuzheng Huayu capsule combined with Pegasys to the DMN model rats, the expression of α-smooth muscle actin was found to be significantly reduced, hemopoietic stem cell apoptosis was increased and liver cell apoptosis was reduced. These indices were significantly different compared with those in the model group (P<0.05). Liver function and liver fibrosis were markedly recovered in hepatitis C patients with hepatic cirrhosis following treatment with the combination treatment compared with those in the patients treated with Pegasys alone (P<0.05). In conclusion, the combination of Fuzheng Huayu capsule with Pegasys inhibited liver fibrosis and cell apoptosis, and may be a novel therapeutic strategy for the treatment of patients with compensated cirrhosis due to hepatitis C. This study provides a method for the optimization of existing treatment strategies and for the establishment of potentially effective combination therapies.