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Based on the strategy of metabolomics combined with bioinformatics, this study analyzed the potential allergens and mechanism of pseudo-allergic reactions (PARs) induced by the combined use of Reduning injection and penicillin G injection. All animal experiments and welfare are in accordance with the requirements of the First Affiliated Experimental Animal Ethics and Animal Welfare Committee of Henan University of Chinese Medicine (approval number: YFYDW2020002). Based on UPLC-Q-TOF/MS technology combined with UNIFI software, a total of 21 compounds were identified in Reduning and penicillin G mixed injection. Based on molecular docking technology, 10 potential allergens with strong binding activity to MrgprX2 agonist sites were further screened. Metabolomics analysis using UPLC-Q-TOF/MS technology revealed that 34 differential metabolites such as arachidonic acid, phosphatidylcholine, phosphatidylserine, prostaglandins, and leukotrienes were endogenous differential metabolites of PARs caused by combined use of Reduning injection and penicillin G injection. Through the analysis of the "potential allergen-target-endogenous differential metabolite" interaction network, the chlorogenic acids (such as chlorogenic acid, neochlorogenic acid, cryptochlorogenic acid, and isochlorogenic acid A) and β-lactam allergens in the combination of the two may be mainly regulated by PLD1, PLA2G12A and CYP1A1. The three upstream signal target proteins mainly activate the arachidonic acid metabolic pathway, promote the degranulation of mast cells, release downstream endogenous inflammatory mediators, and induce PARs.
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OBJECTIVE@#To investigate the anti-coronavirus potential and the corresponding mechanisms of the two ingredients of Reduning Injection: quercetin and luteolin.@*METHODS@#A pseudovirus system was designed to test the efficacy of quercetin and luteolin to inhibit SARS-CoV-2 infection and the corresponding cellular toxicity. Luteolin was tested for its activities against the pseudoviruses of SARS-CoV-2 and its variants. Virtual screening was performed to predict the binding sites by Autodock Vina 1.1.230 and PyMol. To validate docking results, surface plasmon resonance (SPR) was used to measure the binding affinity of the compounds with various proteins of the coronaviruses. Quercetin and luteolin were further tested for their inhibitory effects on other coronaviruses by indirect immunofluorescence assay on rhabdomyosarcoma cells infected with HCoV-OC43.@*RESULTS@#The inhibition of SARS-CoV-2 pseudovirus by luteolin and quercetin were strongly dose-dependent, with concentration for 50% of maximal effect (EC50) of 8.817 and 52.98 µmol/L, respectively. Their cytotoxicity to BHK21-hACE2 were 177.6 and 405.1 µmol/L, respectively. In addition, luetolin significantly blocked the entry of 4 pseudoviruses of SARS-CoV-2 variants, with EC50 lower than 7 µmol/L. Virtual screening and SPR confirmed that luteolin binds to the S-proteins and quercetin binds to the active center of the 3CLpro, PLpro, and helicase proteins. Quercetin and luteolin showed over 99% inhibition against HCoV-OC43.@*CONCLUSIONS@#The mechanisms were revealed of quercetin and luteolin inhibiting the infection of SARS-CoV-2 and its variants. Reduning Injection is a promising drug for COVID-19.
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Humans , SARS-CoV-2 , COVID-19 , Luteolin , QuercetinABSTRACT
The purpose of this study is to investigate the effect of Reduning injection (RI) on influenza A virus (IAV) and its mechanism. We evaluated the cytotoxicity of RI in A549 and MDCK cells by cell counting kit-8 (CCK-8) assay. Western blot and cytopathic effect (CPE) assays were applied to test the effects of RI on viral protein, CPE and virus virulence to evaluate its inhibitory effect. The proteins level of heme oxygenase 1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2), phosphorylation of P38 mitogen-activated protein kinases (MAPK) and extracellular signal-regulated kinases 1/2 (ERK1/2) were detected by Western blot. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the RNA expression of interferon-α/β (IFN-α/β). The relative luciferase reporter assay was used to analyze the promoter activity and transcriptional regulation of Nrf2. The results indicated that RI inhibited IAV-induced MDCK cytopathies in a dose-dependent manner, decreased M2 protein of influenza virus and viral titer, indicating that it has definite effect on inhibiting IAV. RI promotes the phosphorylation of P38 MAPK and ERK1/2, activates the activity of Nrf2 nuclear transcription factor, increases the expression of Nrf2 protein in the nucleus, thus up-regulates the expression of HO-1 protein, and ultimately increases the IFN-α/β mRNA level. In summary, our results demonstrated that RI inhibits the replication of IAV by activating MAPK/Nrf2/HO-1 signaling pathway, revealing a new mechanism of RI against influenza virus, and providing theoretical basis for clinical treatment of influenza virus.
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ObjectiveTo compare and observe the effect of Reduning injection （mainly clearing heat）， Shenfu injection （mainly warming Yang） combined with gefitinib on the proliferation， apoptosis， stemness characteristics and metabolism of lung cancer cells. MethodDifferent non-small cell lung cancer （NSCLC） cell lines were selected and intervened with gefitinib （5， 10， 20 μmol·L-1）， Reduning injection （0.6%， 0.9%）， Shenfu injection （0.6%， 0.9%）， gefitinib combined with Reduning injection， and gefitinib combined with Shenfu injection. Cell proliferation in each group was detected by cell counting kit-8 （CCK-8） assay， and cell apoptosis was detected by flow cytometry. The mRNA and protein expressions of lung cancer stem cell markers sex determining region Y-box 2 （Sox2） and aldehyde dehydrogenase family 1 member A1 （ALDH1A1） were determind by real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. The redox ratio of lung cancer cells was observed by femtosecond label-free imaging （FLI） and energy metabolism instrument was used to determine the glycolysis level in cells. ResultCompared with the blank group， Reduning injection reduced the survival rate of lung cancer cells （P<0.05）， increased the apoptosis rate （P<0.05）， down-regulated the mRNA and protein expressions of Sox2 and ALDH1A1 （P<0.05）， and up-regulated the redox ratio of cells （P<0.05）， while Shenfu injection exerted no remarkable effect on the above indexes. In addition， compared with gefitinib alone， Reduning injection combined with gefitinib inhibited the survival rate of lung cancer cells （P<0.05）， promoted the cell apoptosis （P<0.05）， down-regulated the mRNA and protein expressions of Sox2 and ALDH1A1 （P<0.05）， up-regulated the redox ratio of cells （P<0.05）， and lowered the proton efflux rate of glycolysis （P<0.05）， while Shenfu injection combined with gefitinib failed to affect these indexes of lung cancer cells significantly. ConclusionReduning injection may inhibit stemness characteristics of tumor cells by regulating their metabolism to enhance the proliferation-inhibiting and pro-apoptotic effects of gefitinib on lung cancer cells， while Shenfu injection had no significant enhancing effect on gefitinib. This indicates that epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs） should be used in combination with heat-clearing Chinese medicines.
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Objective: To elucidate the anti-inflammatory mechanism of Reduning Injection (RDN) by analyzing the potential biomarkers and metabolic pathways of the carrageenan-induced inflammatory model from the overall metabolic level. Methods: Rat inflammatory model was established by carrageenan. UPLC-Q-TOF/MS was used to detect and analyze changes of endogenous metabolites in the serum and urine of carrageenan-induced inflammatory rats. Combined with multivariate analysis and databases analysis, inflammatory-related potential biomarkers were screened and identified to analyze possible metabolic pathways. The reliability and biological significance of these biomarkers was verified by metabolic network analysis and correlation analysis with pharmacodynamic indicators. Results: A total of 16 potential biomarkers were screened and identified by multivariate analysis and metabolite databases, among which 13 species could be adjusted by RDN. The metabolism pathway analysis revealed that histidine metabolism, sphingolipid metabolism, and tyrosine metabolism were greatly disturbed. Their biomarkers involved urocanic acid, sphingosine, and norepinephrine, all of which showed a callback trend after RDN treatment. The three biomarkers had a certain correlation with some known inflammatory-related small molecules (histamine, arachidonic acid, Leukotriene B4, and PGE
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This study employed Box-Behnken design combined with flux attenuation to explore the nanofiltration conditions for separation of alcohol precipitation liquid during the preparation of Reduning Injection and discussed the applicability of nanofiltration in the separation of the liquid with high-concentration ethanol. The effects of nanofiltration molecular weight cut-off(MWCO) and pH on the rejection of chlorogenic acid, 3,5-dicaffeoylquinic acid, and 4,5-dicaffeoylquinic acid were consistent with the principles of pore size sieving and charge effect, respectively. The rejection of the three phenolic acids was reduced by concentration polarization effect caused by trans-membrane pressure(TMP). The swelling of membrane surface decreased the pore size and membrane flux for effective separation. Chlorogenic acid and 4,5-dicaffeoylquinic acid were more sensitive to pH and ethanol concentration than 3,5-dicaffeoylquinic acid. A certain correlation existed between the compound structure and the separation factors of nanofiltration, and the separation rules were associated with the comprehensive effect of charge effect, pore size sieving, concentration polarization, steric hindrance and so on.
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Chlorogenic Acid , Drugs, Chinese Herbal/chemistry , Ethanol , InjectionsABSTRACT
Enterovirus 71 (EV71) infection is more likely to cause hand, foot and mouth disease (HFMD) in children, which can lead to neurogenic complications and higher mortality. As a commonly used clinical medicine, Reduning injection (RDN) helps to shorten the symptoms of patients with HFMD and facilitate the early recovery of children. However, the regulatory mechanism of RDN on the HFMD immune system disorder caused by EV71 remains to be discussed. This study collected detailed treatment data of 56 children with HFMD who entered the affiliated Children's Hospital of Nanjing Medical University during 2019. Retrospective analysis of clinical data showed that the symptoms of the RDN treatment group were improved compared with the untreated group. To explore its mechanism, the relevant detection indicators were detected by flow cytometry, enzyme-linked immunosorbent assay and real-time quantitative PCR. It was found that the number and function of innate immune (ILCs) and adaptive immunity (Th1, Th2 and secreted cytokines) were reduced, suggesting that RDN plays a role by regulating cellular immunity. The in vitro differentiation inhibition test further confirmed that RDN affected Th1 differentiation by inhibiting the expression of transcription factors on the basis of Th1 cell differentiation in vitro.
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OBJECTIVE: To evaluate the safety and rationality of Reduning injection in the treatment of COVID-19. METHODS: Through consulting, summarizing and analyzing literatures, the rapid HTA evaluation of Reduning was carried out, and its pharmacological rationality and drug monitoring for COVID-19 were discussed. RESULTS: Literature analysis indicated that COVID-19 belongs to the pestilence of TCM. It was characterized by “dampness, heat, deficiency, toxin and stasis”, and its clinical manifestations involved inflammatory factor storm, immune system damage, etc. Reduning injection was approved to the treatment of influenza, cough and respiratory tract infections caused by exopathic wind-heat, and a typical drug for heat-clearing and detoxifying. CONCLUSION: The rapid HTA evaluation showed that Reduning injection has good safety, effectiveness and economy. The mechanisms of Reduning in antipyretic and anti-inflammatory, immune regulation and anti-virus suggest the rationality of Reduning in treating COVID-19, but drug monitoring should be done well in the use process.
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Objective: To study the antipyretic and anti-inflammatory constituents from the active fraction of Reduning (RDN) Injection. Methods: In this study, the active fraction of RDN Injection was screened by the LPS-induced mouse endotoxin shock model. The chemical constituents were isolated by chromatography on HP-20 macroporous adsorptive resins, silica gel, ODS columns and reverse phase MPLC and HPLC repeatedly, and their structures were elucidated based on spectroscopic analysis (HR-ESI-MS, NMR, ECD) and chemical methods. Meanwhile, we evaluated the anti-inflammatory activities of the isolates by measuring their inhibitory effects on TNF-α production in LPS stimulated RAW 264.7 macrophages. Results: The 95% ethanol eluate of RDN Injection by the macroporous adsorption resin column was proved to be the antipyretic and anti-inflammatory active fraction of this injection. A novel iridoid, named jasminoide A (1), and a new guaiane sesquiterpenoid, named (1R,7R,8S,10R)-7,8,11-trihydroxy-4-guaien-3-one (2), were isolated from Reduning injection, and compound 2 can inhibit TNF-α production with IC50 values of 72.24 µmol/L. Conclusion: In this study, two new terpenoids were isolated from Reduning Injection, and compound 2 showed inhibitory activity against LPS-activated TNF-α production in RAW 264.7 cells in vitro.
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Lonicerae Japonicae Flos and Artemisiae Annuae Herba(LA or Jinqing) alcohol precipitation has various process parameters and complex process mechanism, and is one of the key units for manufacturing Reduning Injection. In order to identify the critical process parameters(CPPs) affecting the weight of the extract produced from the alcohol precipitation process, 259 batches of historical production data from 2017 to 2018 were collected, with a total of 829 318 data points. These data showed characteristics of large data, such as a large data volume, a low value density, and diverse sources. The data cleaning and feature extraction were first performed, and 48 feature variables were selected. The original data points were reduced to 9 936. Then, a combination of Pearson correlation analysis and grey correlation analysis were used to screen out 15 potential critical process parameters(pCPPs). After that, the partial least squares(PLS) was used in prediction of the weight of the extract, proving that the performance of predictive model based on 15 pCMAs is equivalent to that of predictive model based on 48 feature variables. The variable importance in projection(VIP) index was used to identify 9 CPPs, including 2 alcohol precipitation supernatant volume parameters, 4 initial extract weight parameters and 3 added alcohol volume parameters. As a result, the number of data points was 1 863, accounting for 0.28% of the original data. The big data analysis approach from a holistic point of view can effectively increase the value density of the original data. The critical process parameters obtained can help to accurately describe the quality transfer mechanism of the Jinqing alcohol precipitation process.
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Alcohols , Big Data , Drugs, Chinese Herbal/chemistry , Solvents , Technology, PharmaceuticalABSTRACT
Objective: To study the antipyretic and anti-inflammatory constituents from the active fraction of Reduning (RDN) Injection. Methods: In this study, the active fraction of RDN Injection was screened by the LPS-induced mouse endotoxin shock model. The chemical constituents were isolated by chromatography on HP-20 macroporous resin, silica gel, MCI, ODS, reverse MPLC, and HPLC repeatedly, and their structures were identified by spectral data and physicochemical property. Taking PGE2 as the evaluating indicator, the model of LPS-induced RAW264.7 cells was used to evaluare the in vitro anti-inflammatory activity of these compounds. Results: The 95% ethanol eluate of RDN Injection on the macroporous adsorption resin column was proved to be the antipyretic and anti-inflammatory active fraction of RDN Injection. A total of 24 compounds were isolated and identified as (4aS,7aS,7bS)-4,4a,7a,7b-tetrahydro-2H-1,7-dioxacyclopent [cd] indene-5-carboxylic acid methyl ester (1), (4aS,7aS)-1,4a,5,7a- tetrahydro-7-(hydroxymethyl)-cyclopenta [c] pyran-4-carboxy licacid methyl ester (2), 3α,5α-tetrahydrodeoxycordifoline lactam (3), R-(Z)-4-methyl-5-[(2',6',6'-trimethyl-4'-oxo-2'-cyclohexen-1'-yl) methylene]-2(5H)-furanone (4), (1α,2α,3β,4β)-2,4-bis(4-hydroxy-3- methoxyphenyl)-1,3-cyclobutanedicarboxylic acid (5), 4-[(6-O-benzoyl-β-D-glucopyranosyl) oxy]-3-methoxybenzoic acid (6), syringaresinol (7), E-3-(3,4-dihydroxybenzylidene)-5-(3,4-dihydroxyphenyl) dihydrofuran-2-one (8), 6,7-dimethoxy coumarin (9), 7-hydroxy-6-methoxy coumarin (10), salicylic acid (11), syringaldehyde (12), phenylacetic acid (13), vanillin (14), caffeic acid (15), aceto-vanillone (16), 3,5-di-O-caffeoylquinic acid (17), 4,5-di-O-caffeoylquinic acid (18), 3,4-di-O-caffeoylquinic acid methyl ester (19), 3,5-di-O-caffeoylquinic acid methyl ester (20), 4,5-di-O-caffeoylquinic acid methyl ester (21), 5-O-caffeoylquinic acid ethyl ester (22), 3,5-di-O-caffeoylquinic acid ethyl ester (23), and 4,5-di-O-caffeoylquinic acid ethyl ester (24). Among them, compounds 1, 10, and 14-24 significantly inhibited PGE2 expression in RAW 246.7 cells stimulated by LPS. Conclusion: Compounds 1-9, 11-13, and 22-24 are isolated from RDN Injection for the first time; And organic acids may be one of the main pharmacodynamic substances of RDN injection for antipyresis and anti-inflammation.
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Objective: To identify the key process parameters of the Chinese materia medica (CMM) production process by using grey relation analysis (GRA) method. Methods: Taking Lonicerae Japonicae Flos and Artemisiae Annuae Herba extraction section of Reduning Injection as an example, GRA was adopted to calculate and compare the influence of the process parameters on the quality index. Meanwhile, analytic hierarchy process (AHP) combined with Spearman rank correlation analysis was used to validate mutually. Results: According to GRA Results:, the relative importance of process parameters was ranked as follows: average volume flow rate of extraction (X4) > pH after acid adjustment (X2) > the paste temperature of extracting concentration (X7) > alcohol precipitation concentrated extract weight (X1) > hydrochloric acid weight (X3) > extraction time (X6) > relative standard deviation of flow rate (X5). The correlation coefficient between the order by GRA and that by AHP was 0.893. According to the importance of process parameters, the average volume flow rate of extraction, the pH after acid adjustment, and the paste temperature of extracting concentration were identified as the key process parameters. Conclusion: The Results: obtained in this study show the feasibility of GRA in selecting key process parameters, which can provide theoretical reference for the establishment of prediction model as well as online feedback regulation.
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To systematically review the effectiveness and safety of Reduning Injection in the treatment of acute tracheal-bronchitis.Four Chinese databases( CNKI,VIP,Wan Fang,Sino Med) and three English databases( Cochrane Library,Medline,Web of Science) were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to April 2019.Randomized controlled trials( RCTs) for the treatment of acute tracheal-bronchitis with Reduning Injection were collected. Two researchers independently conducted literature screening,data extraction and risk assessment for bias. Rev Man 5.3 software was used for data analysis. Fourteen studies were included,and the total sample size was 1 652 at last. Meta-analysis results show that in the aspect of total clinical effective rate,Reduning Injection was superior to ribavirin( RR = 1. 37,95%CI[1. 28,1. 47],P<0. 000 01); Reduning Injection combined with conventional therapy was better than conventional therapy alone( RR = 1. 14,95% CI[1. 09,1. 19],P <0. 000 01); Reduning Injection combined with azithromycin was better than azithromycin therapy alone( RR = 1. 21,95% CI[1. 07,1. 37],P = 0. 002). In the aspect of clinical symptoms,the time in average fever disappearance of Reduning Injection therapy was shorter than that of ribavirin therapy( MD =-1.68,95%CI[-1. 72,-1. 49],P<0. 000 01); the time in cough disappearance of Reduning Injection therapy was shorter than that of ribavirin therapy( MD =-2. 57,95%CI[-2. 91,-2. 24],P<0. 000 01); the time in lung rales disappearance,Reduning Injection therapy was superior to ribavirin therapy( MD =-2. 26,95% CI[-2. 71,-1. 80],P<0. 000 01),and Reduning Injection combined with conventional therapy was superior to conventional therapy( MD =-1. 77,95% CI[-1. 95,-1. 59],P<0. 000 01). Based on the findings,Reduning Injection can improve the total effective rate,reduce the average time of disappearance in fever,cough and lung rales,with mild adverse reactions and a low incidence. However,the quality of the literatures included is not high,it is necessary to adopt large-sample-size,rigorously designed clinical trial protocols in line with the international standards,in a bid to improve the quality of evidence.
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Humans , Azithromycin/therapeutic use , Bronchitis/drug therapy , Drug Therapy, Combination , Drugs, Chinese Herbal/therapeutic use , InjectionsABSTRACT
Objective To investigate the effect of Reduning Injection on Vero cells and suckling mice infected by EV71 virus and its mechanism in vitro and in vivo. Methods The anti-virus ability was exhibited in Vero cells which were infected by 33 TCID50 and 25 TCID50 titers of EV71 in vitro. Meanwhile, the antiviral activity in vivo was evaluated on suckling mice model, in which suckling mice were intraperitoneal injected with EV71 at 100 μL. After 2 h infection, Reduning Injection 2.60, 1.30, and 0.65 g/kg and ribavirin 10 mg/kg were followed for treatment. To further understand the antiviral effects of Reduning Injection, weigh of suckling mice, clinical symptoms, expression of IL-1β, IL-6, MCP-1, and TNF-α in skeletal muscle were recorded. Moreover, histological examination of skeletal muscle was examined. Results The results demonstrated that Reduning Injection 5.0 mg/mL could obviously inhibit Vero cells lesion induced by EV71 in vitro. Compared with the model group, suckling mouse model results showed the high and middle dose of Reduning Injection could reduce clinical manifestations scores, increase the weight and improve living conditions of model mice, decrease the expression of IL-1β, IL-6, TNF-α, and MCP-1 in skeletal muscle of suckling mice (P<0.05, 0.01). Histological damages in skeletal muscle were also alleviated with Reduning Injection treatment. Conclusion In a suckling mouse model, Reduning Injection can reduce mortality and obviously prolong the survival time of suckling mice caused by EV71 infection. It can alleviate clinical symptoms and growth inhibition caused by the EV71 virus. Inhibition of IL-1β, IL-6, TNF-α, and MCP-1 levels may be the important mechanism of Reduning Injection in the treatment of hand-foot-and-mouth disease.
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This study was designed to determine the metabolites of Renduining injection in rats. The ultra-high performance liquid chromatography-LTQ Orbitrap mass spectrometric (UHPLC-LTQ-Orbitrap-MS) and mass defect filter techniques were applied to analyze the metabolites of Reduning injection in rat plasma, bile, urine and feces. As a result, we determined 14 metabolites of geniposide, including oxidation, dehydration, hydroxymethylene loss, hydrolysis, ring-opened, cysteine conjugation and glucuronidation conjugation of aglycone; 9 metabolites of geniposidic acid, consisting of dehydration, ring-opened, double-bond reduction and cysteine conjugation; 6 metabolites of secoxylogain including hydrolysis, hydroxymethylene loss, hydroxylation and ethylation; 12 metabolites of chlorogenic acid, containing decarboxylation, hydrolysis, methylation, acetylation, cysteinylglycine conjugation and glutathione conjugation. It provided information for the therapeutic effect of Reduning in vivo.
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The method of physical fingerprint spectrum for Reduning injection (RI) was proposed in this paper to improve its quality standards based on the strong correlation between physicochemical properties of drugs, their safety, effectiveness and stability. The quality of RI was studied by the thought and method of physical chemistry. The physical fingerprint spectrum was visually showed by the radar map, and consisted of eight indexes (pH, conductivity, turbidity, refractive index, osmolarity, surface tension, relative density, and kinematic viscosity). Then 12 batch of samples were verified. It was found that the physical fingerprint spectra of 3 batches of RI were in line with the standards within their validity time, with similarity above 0.999; in addition for the expired 9 batches of RI, their physical fingerprint spectra did not meet the standards. The results showed that physical fingerprint spectrum can be used for the quality control of RI, with a certain exemplary role in the quality evaluation of traditional Chinese medicine injection.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Chinese medicine (CM) plus Western medicine (WM) in the treatment of pediatric patients with severe hand, foot and mouth disease (HFMD) by conducting a prospective, controlled, and randomized trial.</p><p><b>METHODS</b>A total of 451 pediatric patients with severe HFMD were randomly assigned to receive WM therapy alone (224 cases, WM therapy group) or CM [Reduning Injection ( ) or Xiyanping Injection ()] plus WM therapy (227 cases, CM plus WM therapy group) for 7-10 days, according to a web-based randomization system. The primary outcome was fever clearance time, which was presented as temperature decreased half-life time. The secondary outcomes included the rate of rash/herpes disappearance within 120 h, as well as the rate for cough, runny nose, lethargy and weakness, agitation or irritability, and vomiting clearance within 120 h. The drug-related adverse events were also recorded.</p><p><b>RESULTS</b>The temperature decreased half-life time was 40.4 h in the WM therapy group, significantly longer than 27.2 h in the CM plus WM therapy group (P<0.01). Moreover, the rate for rash/herpes disappearance within 120 h was 43.6% (99/227) in the CM plus WM therapy group, significantly higher than 29.5% (66/224) in the WM therapy group (P<0.01). In addition, the rate for cough, lethargy and weakness, agitation or irritability disappearance within 120 h was 32.6% (74/227) in the CM plus WM therapy group, significantly higher than 19.2% (43/224) in the WM therapy group (P<0.01). No drug-related adverse events were observed during the course of the study.</p><p><b>CONCLUSION</b>The combined CM and WM therapy achieved a better therapeutic efficacy in treating severe HFMD than the WM therapy alone. Reduning or Xiyanping Injections may become an important complementary therapy to WM for relieving the symptoms of severe HFMD. (Registration No. NCT01145664).</p>
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Objective: To study the antipyretic and anti-inflammatory constituents from the active fraction of Reduning Injection (RI). Methods: The active fraction of RI was screened by the LPS-induced mouse endotoxin shock model. The chemical constituents were isolated by chromatography on silica gel, ODS, Sephadex LH-20, Toyopearl HW-40 columns, reverse phase MPLC, and HPLC repeatedly, and their structures were identified by spectral data and physicochemical property. Results: The 95% ethanol eluate of RI on the macroporous adsorption resin column was proved to be the antipyretic and anti-inflammatory active fraction of RI. Fourteen compounds were isolated and identified as dibutyl phthalate (1), isovanillic acid (2), acetovanillone (3), phenylpropionic acid (4), geniposide (5), jasmigeniposide B (6), geniposidic acid (7), genipin-1-β-D-gentiobioside (8), 6″-O-trans-p-coumaroylgenipin gentiobioside (9), 6″-O-trans-feruloylgenipin gentiobioside (10), 6″-O-trans-sinapoylgenipin gentiobioside (11), jasmigeniposide A (12), 6″-O-trans-cinnamoylgenipin gentiobioside (13), and 2'-O-trans-caffeoylgardoside (14). Conclusion: Compounds 1-4 and 13 are reported from RI for the first time; And UPLC analyses and literature data showe that compounds 5 and 7-13 are originated from Gardenia jasminoides.
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Objective: An ultra high performance liquid chromatography coupled to triple quadrupole mass spectrometry (UPLC- QqQ-MS/MS) method has been established to simultaneously determine the contents of six bioactive constituents [japonicaside A (JA), L-phenylalanion secologanin B (PSB), luteolin, scopolamine, (1S,6R,7R,10R)-6-carboxy-10-methyl-α-methylene-1-(1- oxobutyl)-cyclohexane acrylic acid (CMCA), and 3α,5α-tetrahydrodeoxycordifoline lactam (TL)] from Reduning Injection. Methods: This chromatographic separation was performed on an Agilent Zorbax SB-Aq C18 (150 mm × 2.1 mm, 3.5 μm) column with the mobile phase consisting of 0.1% formic acid water (A) and methanol (B) in a gradient elution (0.01-2.00 min, 5% B; 2.00-4.00 min, 5%-40% B; 4.00-11.00 min, 40%-95% B; 11.00-13.00 min, 95% B; 13.00-13.10 min, 95%-5% B; 13.10-14.00 min, 5% B) at a flow rate of 0.5 mL/min and the colunm temperature was set at 20℃. The analytes were detected using electrospray ionization (ESI) source by positive and negative ion monitoring mode. A triple quadrupole mass spectrometer was operated by ESI source in positive and negative ionization mode with multiple reaction monitoring for the detection of the six compounds. In the positive ion monitoring mode, the flow rate of Collision Gas (CAD) was 8 mL/min, the flow rate of Curtain Gas (CUR) was 20 mL/min, the temperature (TEM) was 500℃ and the Ion Spray Voltage (IS) was 4 500 V. In the negative ion monitoring mode, the flow rate of Collision Gas (CAD) was 8 mL/min, the flow rate of Curtain Gas (CUR) was 20 mL/min, the temperature (TEM) was 500℃ and the Ion Spray Voltage (IS) was -4 500 V. Results: All calibration curves of the six components showed excellent linear regressions (r ≥ 0.999 0) within the test range. The average recoveries were 78.93%, 114.65%, 101.99%, 90.98%, 98.08%, and 115.58%, and the average contents of six bioactive constituents in 16 batches of Reduning Injection were 2.00, 26.63, 52.63, 5.29, 34.64, and 9.69 μg/mL, respectively. Conclusion: The established method is rapid, accurate, and has high repeatability, which could provide scientific evidences for the quality control of Reduning Injection.
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Reduning Injection (RI) has the effects of clearing heat, dispelling wind, and detoxification. It has been proved to be widely used for the treatment of wind-heat cold, cough, fever, upper respiratory tract infection, and acute bronchitis with good therapeutic effect and high security in clinical practice. Main chemical composition of RI includes iridoids, lignans, coumarins, sesquiterpenoids, flavonoids, coffee acyl quinine acids, phenolic acids, etc. This paper reviews domestic and foreign researches about RI in recent years and summarizes the chemical constituents, pharmacological action, and clinical application.