Antiproteinuric Effects of Green Tea Extract on Tacrolimus-Induced Nephrotoxicity in Mice.

INTRODUCTION: It has been reported that proteinuria is an early predictive marker in detection of tacrolimus (TAC) nephrotoxicity. The aim of this study was to investigate the antiproteinuric effects of green tea extract (GTE) on TAC-induced acute nephrotoxicity in mice. METHODS: The mice (n = 20) were divided into 4 groups (n = 5 per group); control group mice were intraperitoneally (IP) injected with 0.9% saline, TAC group mice were IP injected with TAC 1 mg/kg, and inducible nitric oxide synthase (iNOS) inhibitor group mice were given in addition NG-nitro-L-arginine-methyl ester 12 mmol/L by subcutaneous injection. TAC-GTE group mice were given TAC by IP injection and GTE 100 mg/kg by subcutaneous injection. RESULTS: The 24-hour urine protein amounts were significantly increased in TAC group mice (36.1 ± 9.9 mg/d) compared with control group mice (13.3 ± 5.4 mg/d) and significantly decreased in TAC-GTE group mice (19.1 ± 6.9 mg/d, P < .01) compared with TAC group mice. The nitric oxide (NO) production by TAC was significantly suppressed by GTE and iNOS inhibitor injection. Renal tissue malondialdehyde (MDA) level was significantly increased in the TAC group compared with the control group and was significantly decreased in the TAC-GTE group compared with that of the TAC group. The antioxidant enzyme activities of superoxide dismutase and catalase were significantly suppressed in the TAC group compared with the control group and were restored in the GTE injection group. CONCLUSIONS: GTE treatment has beneficial antiproteinuric effects on TAC-induced acute renal injury in mice.

The antiproteinuric effects of green tea extract on acute cyclosporine-induced nephrotoxicity in rats.

BACKGROUND: It has been reported that the proteinuria is an early useful marker to detect cyclosporine (CsA) nephrotoxicity. The aim of this study was to investigate the antiproteinuric effects of green tea extract (GTE) on CsA-induced acute renal injury in rats. METHODS: The rats (n = 28) were divided into four groups (n = 7/group); controls intraperitoneally (IP) injected with 0.9% saline; CsA group IP injected CsA (50 mg/kg); inducible nitric oxide synthase (iNOS) inhibitor group administered in addition NG-nitro-L-arginine-methyl ester (12 mmol/L) subcutaneously and CsA-GTE group of CsA IP plus GTE (100 mg/kg) subcutaneously. RESULTS: The 24-hour urine proteins were significantly increased among the CsA (22.6 ± 3.1 mg/d) compared with the control (7.1 ± 1.5 mg/d) and significantly decreased in the CsA-GTE group (8.2 ± 1.8 mg/d, P < .01). Nitric oxide production induces by CsA treatment was significantly suppressed by GTE and iNOS inhibitor. Renal tissue malondialdehyde level was significantly increased in the CsA compared with controls and significantly decreased in the CsA-GTE group. The antioxidant enzyme activities of superoxide dysmutase and catalase, which were significantly suppressed in the CsA compared with the control group, were restored in the CsA-GTE cohort. CONCLUSION: GTE treatment of rats showed meaningful antiproteinuric effects through antioxidative activity in kidneys from CsA-induced acute renal injury.

Acupuncture for schizophrenia: a systematic review and meta-analysis.

BACKGROUND: Acupuncture is one of the most popular types of complementary/alternative medicine. It is sometimes used as a treatment for schizophrenia. AIMS: The objective of this review is to assess systematically the clinical evidence for or against acupuncture as a treatment for schizophrenia. METHODS: We searched 20 databases from their inception to May 2009 without language restrictions. All randomised clinical trials (RCTs) of acupuncture, with or without electrical stimulation or moxibustion for patients with schizophrenia were considered for inclusion. RESULTS: Thirteen RCTs, all originating from China, met the inclusion criteria. One RCT reported significant effects of electroacupuncture (EA) plus drug therapy for improving auditory hallucunations and positive symptom compared with sham EA plus drug therapy. Four RCTs showed significant effects of acupuncture for response rate compared with antipsychotic drugs [n = 360, relative risk (RR): 1.18, 95% confidence interval (CI): 1.03-1.34, p = 0.01; heterogeneity: tau(2) = 0.00, chi(2) = 2.98, p = 0.39, I(2) = 0%]. Seven RCTs showed significant effects of acupuncture plus antipsychotic drug therapy for response rate compared with antipsychotic drug therapy (n = 457, RR: 1.15, 95% CI: 1.04-1.28, p = 0.008, heterogeneity: tau(2) = 0.00, chi(2) = 6.56, p = 0.36, I(2) = 9%). Two RCTs tested laser acupuncture against sham laser acupuncture. One RCT found beneficial effects of laser acupuncture on hallucination and the other RCT showed significant effects of laser acupuncture on response rate, Brief Psychiatric Rating Scale and clinical global index compared with sham laser. The methodological quality was generally poor and there was not a single high quality trial. CONCLUSION: These results provide limited evidence for the effectiveness of acupuncture in treating the symptoms of schizophrenia. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions. As all studies originated from China, international studies are needed to test whether there is any effect.

Acupuncture for Alzheimer's disease: a systematic review.

BACKGROUND: Acupuncture is often used as a treatment for dementia and is claimed to be effective in improving intelligence. AIMS: The objective of this review is to assess the clinical evidence for or against acupuncture as a treatment for Alzheimer's disease (AD). METHODS: We searched the literature using 17 databases from their inception to August 2008, without language restrictions. We included all randomised clinical trials (RCTs) of needle acupuncture to treat human patients suffering from AD. Methodological quality was assessed using the Jadad score. RESULTS: Three RCTs met all inclusion criteria. Two RCTs assessed the effectiveness of acupuncture on cognitive function compared with drug therapy. Their results suggested no significant effect in favour of acupuncture [n = 72, weight mean difference (WMDs), -0.55; 95% confidence intervals (CIs) -1.31 to 0.21, p = 0.15, heterogeneity: tau(2) = 0, chi(2) = 0.048, p = 0.49, I(2) = 0%]. Two RCTs tested acupuncture for activities of daily living (ADL). One RCT reported favourable effects of drug therapy compared with acupuncture for ADL, while the other failed to so. The meta-analysis of these data showed significant effects of drug therapy compared with acupuncture (n = 72, WMD, -1.29; 95% CIs: -1.77 to -0.80, p < 0.001, heterogeneity: tau(2) = 0, chi(2) = 0.17, p = 0.68, I(2) = 0%). CONCLUSION: Even though the number of studies is small, the existing evidence does not demonstrate the effectiveness of acupuncture for AD.

Acupuncture for treating menopausal hot flushes: a systematic review.

OBJECTIVE: To assess the effectiveness of acupuncture as a treatment option for menopausal hot flushes. DESIGN: We have searched the literature using 17 databases from inception to October 10, 2008, without language restrictions. We included randomized clinical trials (RCTs) of acupuncture versus sham acupuncture. Their methodological quality was assessed using the modified Jadad score. RESULTS: In total, six RCTs could be included. Four RCTs compared the effects of acupuncture with penetrating sham acupuncture on non-acupuncture points. All of these trials failed to show specific effects on menopausal hot flush frequency, severity or index. One RCT found no effects of acupuncture on hot flush frequency and severity compared with penetrating sham acupuncture on acupuncture points that are not relevant for the treatment of hot flushes. The remaining RCT tested acupuncture against non-penetrating acupuncture on non-acupuncture points. Its results suggested favorable effects of acupuncture on menopausal hot flush severity. However, this study was too small to generate reliable findings. CONCLUSION: Sham-controlled RCTs fail to show specific effects of acupuncture for control of menopausal hot flushes. More rigorous research seems warranted.

Acupuncture for rheumatoid arthritis: a systematic review.

The aim of this systematic review is to evaluate the available evidence, from randomized clinical trials (RCTs), of acupuncture for treating patients with RA. Systematic searches were conducted on 17 databases up to April 2008 without the language restriction. All RCTs of acupuncture, with or without electrical stimulation or moxibustion, for patients with RA were considered for inclusion. A total of 236 potentially relevant studies were identified and eight RCTs were included. Four RCTs compared the effects of manual or electro-acupuncture with penetrating or non-penetrating sham acupuncture and failed to show specific effects of acupuncture on pain [n = 88; weighted mean differences (WMD), 10 cm VAS -0.46; 95% CI -1.70, 0.77; P = 0.46; heterogeneity: tau(2) = 0.19; chi(2) = 2.38; P = 0.30; I (2) = 16%] or other outcome measures. One RCT compared manual acupuncture with indomethacin and suggested favourable effects of acupuncture in terms of total response rate. Three RCTs tested acupuncture combined with moxibustion, vs conventional drugs and failed to show that acupuncture plus moxibustion was superior to conventional drugs in terms of response rate (n = 345; RR 1.12; 95% CI 0.99, 1.28; P = 0.08; heterogeneity: tau(2) = 0.00; chi(2) = 1.34; P = 0.51; I(2) = 0%), pain reduction (n = 105; WMD, 10 cm VAS 1.53; 95% CI -0.57, 3.63; P = 0.15; heterogeneity: tau(2) = 1.18; chi(2) = 1.81; P = 0.18; I(2) = 45%) or joint swelling index (n = 105; WMD, 10 cm VAS 0.25; 95% CI -1.31, 1.82; P = 0.75; heterogeneity: tau(2) = 0.18;chi(2) = 1.14; P = 0.28; I(2) = 13%). In conclusion, penetrating or non-penetrating sham-controlled RCTs failed to show specific effects of acupuncture for pain control in patients with RA. More rigorous research seems to be warranted.

Auricular acupuncture for insomnia: a systematic review.

OBJECTIVE: Auricular acupuncture (AA) is a therapeutic method by which specific points on the auricle are stimulated to treat various conditions. AA is often recommended as treatment for insomnia. The aim of this systematic review was to evaluate data from randomised, placebo-controlled clinical trials testing the effectiveness of AA for treating insomnia. METHODS: We searched the literature using 18 databases from their inception to April 2008 without language restrictions. All prospective randomised clinical trials (RCTs) of AA for subjects with insomnia were considered. Methodological quality was assessed using the Jadad score. RESULTS: We identified 433 possible relevant articles, in which include 10 acceptable RCTs. The methodological quality of the trials was generally poor. Magnetic pellets AA was compared with placebo AA in three of the studies. The results suggested beneficial effects on sleep efficiency compared with placebo AA. One RCT tested needle AA compared with placebo AA and failed to show the effectiveness of AA. Four RCTs compared Semen Vaccariae or magnetic pellet AA with conventional drugs (estazolam or diazepam). Favourable effects for AA were found. Two RCTs tested thumbtack needle AA vs. no treatment suggested beneficial effects of AA on a sleep score. CONCLUSION: We conclude that, because of the paucity and of the poor quality of the data, the evidence for the effectiveness of AA for the symptomatic treatment of insomnia is limited. Further, rigorously designed trials are warranted to confirm these results.

Tai chi for osteoporosis: a systematic review.

INTRODUCTION: Tai chi may have beneficial effects with respect to balance, falls and non-vertebral fractures. The purpose of this systematic review was to evaluate evidence from controlled clinical trials testing the effectiveness of tai chi for osteoporosis. METHODS: Systematic searches were conducted on 20 electronic databases. The outcome measures considered for inclusion were changes in bone parameters. RESULTS: Five randomized clinical trials (RCTs) and two controlled clinical trials (CCT) met all inclusion criteria. In postmenopausal women, one RCT found tai chi to be superior for loss of bone mineral density (BMD) compared with sedentary lifestyle, while two other RCTs found no differences between tai chi and exercises or calcium supplementation for BMD. The meta-analysis showed no significant effect of tai chi on BMD change at the spine compared with no treatment in postmenopausal women. One RCT failed to show favorable effects of tai chi compared with resistance training (RT) for total hip BMD in elderly women. A further RCT compared tai chi with RT on bone metabolism and reported favorable effects compared with RT in the elderly. CONCLUSION: The evidence for tai chi in the prevention or treatment of osteoporosis is not convincing. More rigorous research seems warranted.

Drug targeting using thermally responsive polymers and local hyperthermia.

We report a new thermal targeting method in which a thermally responsive drug carrier selectively accumulates in a solid tumor that is maintained above physiological temperature by externally applied, focused hyperthermia. We synthesized two thermally responsive polymers that were designed to exhibit a lower critical solution temperature (LCST) transition slightly above physiological temperature: (1) a genetically engineered elastin-like polypeptide (ELP) and (2) a copolymer of N-isopropylacrylamide (NIPAAm) and acrylamide (AAm). The delivery of systemically injected polymer-rhodamine conjugates to solid tumors was investigated by in vivo fluorescence video microscopy of ovarian tumors implanted in dorsal skin fold window chambers in nude mice, with and without local hyperthermia. When tumors were heated to 42 degrees C, the accumulation of a thermally responsive ELP with a LCST of 40 degrees C was approximately twofold greater than the concentration of the same polymer in tumors that were not heated. Similar results were also obtained for a thermally responsive poly(NIPAAM-co-AAm), though the enhanced accumulation of this carrier in heated tumors was lower than that observed for the thermally responsive ELP. These results suggest that enhanced delivery of drugs to solid tumors can be achieved by conjugation to thermally responsive polymers combined with local heating of tumors.