Clinical practice guidelines for the treatment of allergic rhinitis in children with traditional Chinese medicine.

Allergic rhinitis (AR) is one of the most common allergic diseases in children and it can lead to physical and mental health problems. Traditional Chinese medicine (TCM) plays an important role in understanding the phenotypes and treatment of AR. However, there are currently no normative clinical practice guidelines (CPGs) for the treatment of AR in children. The study aimed to develop an evidence-based CPG for the treatment of AR in children with TCM. Systematic literature research, expert questionnaire, and clinical evaluation after three rounds of surveys were adopted to form recommendations for treating children with AR using the Delphi method. Depending on the clinical manifestations, we finally recommended two decoctions with two Chinese patent medicines for an acute attack of AR and two decoctions for a chronic period of AR. For the acute attack of AR in children, Xinyi Qingfei decoction, Wenfei Zhiliu decoction, Xinqin granules, and Xinyi Biyan pills were suggested, whereas for the chronic period of AR, Buzhong Yiqi and Jingui Shenqi decoctions were recommended. The four external treatment methods suggested for the prevention and care of AR were body acupuncture, moxibustion, auricular point pressing, and acupoint application. The recommended levels of the suggested TCM strategies ranged from Grade B to D, indicating the weakness of the recommendations. TCM has the potential to offer new insights into phenotypes and the management of AR worldwide; however, more high-quality clinical studies are needed to improve the quality of evidence.

Rhein Suppresses Lung Inflammatory Injury Induced by Human Respiratory Syncytial Virus Through Inhibiting NLRP3 Inflammasome Activation via NF-κB Pathway in Mice.

Rhein is one of active anthraquinone components in traditional Chinese herbal medicine Rheum palmatum L., possessing anti-inflammatory, antioxidant, antitumor, antiviral, and hepatoprotective activities. Human respiratory syncytial virus (RSV), a common virus, is able to result in pneumonia and bronchitis, which usually can be seen in infants. However, so far the effects of Rhein on RSV-induced pneumonia are still unknown. As the NLRP3 inflammasome is activated excessively, it is able to lead to inflammatory response and tissue injury in most viral infection process (including RSV infection) of respiratory tract. Therefore, we designed experiments to reveal whether Rhein can treat RSV-induced pneumonia by inhibiting NLRP3 inflammasome activation. In present research, we established the pneumonia model of BALB/C mice caused by RSV. First of all, the pathology of lung tissue and the weight of mice were evaluated, and the corresponding lung index was calculated. Additionally, the expression of pro-inflammatory mediators in serum and lung tissues, and related proteins (NLRP3, ASC and Caspase-1) of NLRP3 inflammasome and NF-κB pathway were detected by Enzyme-linked immunosorbent assay (ELISA), Real-time PCR (RT-PCR), Immunohistochemistry (IHC), and Western blot (WB), respectively. The determination of lung index and lung tissue pathological evaluation revealed that Rhein was able to alleviate lung infection and injury caused by RSV. The results of ELISA showed that Rhein was able to reduce the release of pro-inflammatory cytokines in the serum and lung tissues of RSV-induced BALB/c mice, including IL-1ß, IL-6, TNF-α, IL-18, and IL-33. Additionally, it was revealed that Rhein inhibited the immune inflammatory response of RSV-infected mice, which was likely to be associated with the inhibition the NLRP3 inflammasome activation via NF-κB pathway. To sum up, our results indicated that Rhein may inhibit RSV-induced pulmonary inflammatory response effectively; meanwhile, it is emphasized that Rhein therapy is likely to be a promising treatment on the RSV-infected lung inflammation and avoidance of lung tissue damage.

Jinxin oral liquid inhibits human respiratory syncytial virus-induced excessive inflammation associated with blockade of the NLRP3/ASC/Caspase-1 pathway.

Human respiratory syncytial virus (RSV) is a common virus that causes pneumonia and bronchitis, mostly in infants. Our previous study showed that Jinxin oral liquid (JOL), derived from traditional Chinese medicine, had anti-inflammatory and therapeutic effects on RSV-related pneumonia. However, little is known about the underlying mechanisms of these effects. During a viral infection, including RSV infection, the inflammasome pathway is excessively activated, resulting in an inflammatory reaction and severe tissue damage. Inhibition of the inflammasome pathway has shown good therapeutic effects on lung inflammation. In the present study, we explored the effect of JOL on RSV-induced excessive inflammation in BALB/c mice. Pathological evaluation of lung tissue and measurement of the lung index showed that JOL alleviated lung infection and tissue injury induced by RSV. The enzyme-linked immunosorbent assay showed that JOL reduced the release of inflammatory factors, including interleukin-1ß(IL-1ß), interleukin-18(IL-18) and interleukin-33(IL-33), in the serum and lung homogenate of RSV-infected mice. Furthermore, the results of real-time PCR, immunohistochemistry, and western blot analyses showed that JOL inhibited the immune inflammatory response of mice infected with RSV through blockade of the NOD-like receptor protein 3(NLRP3)/apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC)/Caspase-1 signalling pathway, as evidenced by the down regulation of the mRNA and protein expression of three key components in the pathway. Collectively, our results showed that JOL inhibited pulmonary inflammation caused by RSV infection. Thus, JOL may be a promising remedy for lung inflammation caused by RSV infection and may help avoid lung tissue damage.

[Metabonomics of Syndrome Markers in Infantile Bronchial Asthma Episode].

Objective To analyze urinary metabolites of bronchial asthma children patients with phlegm-heat obstructing Fei syndrome (PHOFS) and non-PHOFS using gas chromatography-mass spec- trometry/mass spectrometer ( GC-MS/MS) , thus performing research on syndrome markers. Methods Totally 44 bronchial asthma children patients with PHOFS and non-PHOFS in onset of asthma were recrui- ted. Another 29 healthy children were also recruited. Their urine samples were analyzed by GC-MS/MS. The profiles were analyzed using orthogonal partial least squares-discriminant analysis (OPLS-DA) , vari- able importance in the projection (VIP) , and non-parametric test to determine intergroup differential metabolites. Abnormal metabolic pathways were determined by Metaboanalyst. Results Compared with the health control group, contents of fourteen substances like inositol, uric acid, stearic acid, and so on de- creased, and mino-malonic acid content increased in asthma episode children (P <0. 05). The process was mainly involved in 5 metabolic pathways such as lysine degradation and biosynthesis, pyruvate me- tabolism, and so on. Compared with the non-PHOFS group in bronchial asthma episode, contents of nine substances like oxalic acid, L-threonine, pyrimidine, and so on decreased in the PHOFS group (P < 0. 05). The process was mainly involved in 5 metabolic pathways such as pentose phosphate pathway, inositol phosphate metabolism, and so on. Conclusions Urinary metabolites are different in infantile bronchial asthma episode and healthy children. Metabolic biomarkers and pathways exist in different syn- dromes in bronchial asthma episode.

[Regulation of Jinxin Oral Liquid for the expression of negative regulatory factor of TLR3 signaling pathway SOCS1 in RSV infected BALB/c mice].

OBJECTIVE: To investigate the regulation trend of Jinxin Oral Liquid (JXOL) on the expression of negative regulatory factor of TLR3 signaling pathway SOCS1 in the lung tissue of RSV infected BALB/c mice at different time points. METHODS: Totally 75 BALB/c mice were randomly divided into 5 groups, i.e., the normal control group, the model group, the ribavirin group, the high dose JXOL group, and the equivalent dose JXOL group, 15 in each group. Each group had 3 intervention ways (I, II, and III) with 5 mice treated in each group. BALB/c mice were nasally infected with respiratory syncytial virus (RSV), and treated by different intervention ways. After intervention, mice were killed and their lung tissues were sampled, mRNA expression levels of RSV-M, SOCS1, and IFN-ß were detected by Real time PCR. The expression of SOCSl at the protein level was detected by Western blot. RESULTS: Compared with the normal control group, the mRNA expression level of SOCS1 and IFN-ß, and the protein expression level of SOCS1 increased significantly in the model group intervened by intervention I and II (all P < 0.01), but the mRNA expression level of IFN-ß decreased significantly in model group intervened by intervention III (P < 0.01). Compared with the model group, the mRNA expression level of RSV-M all significantly decreased in the high dose JXOL group and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01). The mRNA expression level of SOCS1 significantly decreased in the high dose JXOL group intervened by intervention I and III and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01). The mRNA expression level of IFN-ß significantly decreased in the high dose JXOL group intervened by intervention I and II and the equivalent dose JXOL group intervened by intervention I (all P < 0.01), while it significantly increased in the high dose JXOL group intervened by intervention III and the equivalent dose JXOL group intervened by intervention III (all P < 0.01). The protein expression level of SOCS1 significantly decreased in the high dose JXOL group intervened by intervention I and the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01), while it significantly increased in the high dose JXOL group intervened by intervention III (all P < 0.01). Compared with the high dose JXOL group, the mRNA expression level of RSV-M decreased significantly in the equivalent dose JXOL group intervened by intervention I and II (P < 0.01). The mRNA expression level of SOCS1 and IFN-ß decreased significantly in the equivalent dose JXOL group intervened by intervention I (P < 0.01), but the mRNA expression level of IFN-ß increased significantly in the equivalent dose JXOL group intervened by intervention II and III (all P < 0.01). The protein expression level of SOCS1 decreased significantly in the equivalent dose JXOL group intervened by 3 intervention ways (all P < 0.01). CONCLUSIONS: JXOL could inhibit the expression of SOCS1 in the lung tissue of RSV infected BALB/c mice at different time points. Its regulatory effect might be associated with promoting the expression of interferon type I and further fighting against RSV.

[Relevant pathogenesis of heat and phlegm in infantile viral pneumonia: an analysis by association rules].

OBJECTIVE: To study the application of association rules in Chinese medical pathogeneses and pathologies of heat and phlegm in infantile viral pneumonia. METHODS: Association rules were applied to analyze dynamic changes of heat and phlegm correlated symptoms and signs in 297 infants with respiratory syncytial virus (RSV) pneumonia, thus understanding its evolution or pathogenesis. RESULTS: Heat and phlegm co-exist in infantile viral pneumonia. In their relationship, heat was more likely to affect phlegm, but phlegm was less likely to affect heat. Under the intervention of drugs, the possibility of heat induced by phlegm was gradually reduced. But the possibility of phlegm induced by heat was not obvious as time went by. CONCLUSIONS: Heat and phlegm have a close relationship in the pathogenesis of infantile viral pneumonia. The intervention of drugs could reduce the pathologic evolution of phlegm causing heat. However, it has little effect on the pathologic evolution of heat causing phlegm.

[Regulation trend of resveratrol on TNFα-,IL-1ß, IL-6 expressions in bronchoalveolar lavage fluid of RSV-infected BALB/c mice].

OBJECTIVE: To study the regulation trend of resveratrol on TNF-alpha, IL-1beta, IL-6 expressions in bronchoalveolar layage fluid (BALF) of RSV-infected BALB/c mice at different time points. METHOD: RSV-induced BALB/c mice were orally administered with resveratrol. Their BALFs were collected at 24, 72 and 144 h after the first nasal drip with RSV to detect the level of TNF-alpha, IL-1P3, IL-6 by EILSA. RESULT: The expression of TNF-alpha, IL-1Pf and IL-6 in BALF increased significantly compared with the normal group (P <0. 01) after 24 hours of RSV infection, while the expression of TNF-alpha (P < 0.01), IL-1beta (P < 0.05), IL-6 (P < 0.01) in the resveratrol group decreased notably compared with the model group. After 72 hours of infection with RSV, although the expression of TNF-alpha (P < 0.05), IL-1beta (P < 0.01) and IL-6 (P < 0.01) in BALF in model group were higher than those in the normal group, they were much more lower than at 24 h. The expression of IL-1beta and IL-6 (P < 0.05) in the resveratrol groups were down-regulated significantly, but no difference had been shown in TNF-alpha expression compared with the RSV infection group. After infection with RSV for 144 h, the expression of IL-1beta (P < 0.01) and IL-6 (P < 0.05) in BALF in the model group were higher than those in the normal group, but there was no difference in the secretion of TNF-alpha. The expression of TNF-alpha, IL-1beta and IL-6 showed also no remarkable difference between the resveratrol groups and the RSV infection group. CONCLUSION: Resveratrol can inhibit the over expression of inflammatory factors TNF-alpha, IL-1beta, IL-6 in bronchoalveolar lavage fluid of RSV-induced BALB/c mice and keep them at a low level with the passing of infection time.

[Study on fibrolytic and hypotensive activity of earthworm homogenate of ultrafiltration separation from enzymolysis].

OBJECTIVE: To study the fibrolytic and hypotensive activity of earthworm homogenate of ultrafiltration separation from simulated enzymolysis of gastrointestinal tract system. METHODS: The before and after enzymolysis homogenate of fresh earthworm was seperated with different pore size PVDF ultrafiltration membrane and its fibrolytic and hypotensive activity was assayed. RESULTS: The fibrolytic activity of the total homogenate after enzymolysis overall changed little, but decreased in the the site of higher molecular weight and increased in the lower site of molecular weight; The ACE inhibitory activity improved, especially in the filtrate of the MW 4000 membrane. CONCLUSION: The fibrolytic activity of earthworm homogenate was not reduced by the digestive simulated enzymolysis, and the retention site of MW 10 000 membrane have more fibrolytic activity; The hypotensive activity of earthworm homogenate is enhanced by the digestive simulated enzymolysis. So the stronger activity could be obtained from enzymolysis.