Four Subgroups of Blood Stasis Syndrome Are Identified by Manifestation Cluster Analysis in Males.

Blood stasis syndrome (BSS) is an important pathological condition in traditional East Asian medicine and is associated with ischemic heart disease, cerebral vascular accident, diabetes mellitus, chronic renal failure, severe traumatic injury, and dysmenorrhea. However, previous studies have been unable to reveal the clinical and biological characteristics or biological markers of BSS. We hypothesized that the heterogeneity among the manifestations of BSS or non-BSS could interfere with an analysis to describe the characteristics of BSS. In this study, male participants based on the severity of BSS-associated symptoms and signs were clustered and classified into four subgroups: BSS subgroups (1), (2), (3), and (4). Non-BSS core subgroup was redefined using manifestation cluster analysis. Biological characteristics of subgroups BSS(1) and BSS(2) belong to the range of the non-BSS core subgroup (1), whereas that of subgroups BSS(3) and BSS(4) are characterized by different biological parameters such as systemic inflammatory conditions and elevated D-dimer level. Our results suggested that patients in subgroups of BSS(3) and BSS(4) are more likely to be exposed in an inflammatory state than other BSS subgroups. We found the heterogeneity among the manifestations which could mask the characteristics of BSS and identified the clinical and biological profiles of the four BSS subgroups through comparisons of the redefined non-BSS and BSS subgroups. This finding could provide accurate diagnostic criteria and new approaches for BSS treatments in different subgroups.

A randomized, open phase IV exploratory clinical trial to evaluate the efficacy and safety of acupuncture on the outcome of induction of ovulation in women with poor ovarian response: A study protocol for a randomized controlled trial.

INTRODUCTION: Women with infertility who have a poor ovarian responder (POR), characterized by a low number of retrieved oocytes after ovulation induction, often have a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer (IVF-ET), due to the few transferred embryos. Acupuncture is a form of Korean Traditional Medicine. It involves the insertion of a microscopic needle at a specific point in the body, known as an acupuncture point or an acupoint. In this study, our purpose is to investigate how acupuncture affects the retrieval of mature oocytes after ovulation induction in patients with POR. METHODS AND ANALYSIS: This study will be a randomized clinical trial comprising an IVF-ET trial and an IVF-ET trial after acupuncture. Seventy patients will by enrolled and randomly assigned to either of the 2 groups. The study subjects will be required to be diagnosed as having POR. Participants will be divided into 2 groups: IVF-ET single treatment group, and acupuncture and IVF-ET combined treatment group. The study subjects will be required to participate in a 15-week trial involving 16 acupuncture treatments over a period of approximately 2 months before ovulation induction for oocyte retrieval. The primary assessment of all participants will be comparing the number of oocytes. RESULT: This treatment will be a therapeutic model for POR. DISCUSSION: Our results will provide patients with POR as well as complementary and alternative medicine professionals, such as Korean medicine doctors, about the potential role of acupuncture in the treatment of POR. This will improve the quality of life in women with infertility and provide an important treatment option for patients with POR. Further studies can be performed to determine the optimal treatment for POR.

Immunodominance hierarchy of influenza subtype-specific neutralizing antibody response as a hurdle to effectiveness of polyvalent vaccine.

Strengthening of immunodominance hierarchy of influenza subtype-specific neutralizing antibody response by annual polyvalent vaccinations could increase the variation of vaccine effectiveness by subtype. Therefore, we suggest the assessment of neutralizing antibody titer prior to seasonal vaccination and recommend the inoculation of only strains lower than protective levels.

Anti-adipogenic effects of the traditional herbal formula Dohongsamul-tang in 3T3-L1 adipocytes.

BACKGROUND: Blood stasis syndrome (BSS) is a general pattern identification and refers to pathological stagnation of blood circulation, dysfunction of endothelial cells or metabolic disorder in traditional Korean medicine (TKM). Dohongsamul-Tang (DHSMT) is a well-known traditional herbal formula which used for treatment and prevention of BSS by promoting blood circulation in TKM. METHODS: Cytotoxicity of DHSMT was examined by cell counting kit-8 (CCK-8). We also investigated the anti-adipogenesis effect of DHSMT by using Oil Red O staining, intracellular triglyceride assay leptin ELISA and western blot analysis in 3T3-L1 adipocytes. In addition, the accumulation of adiponectin, resistin and plasminogen activator inhibitor-1 (PAI-1) were measured by magnetic bead panel kit. RESULTS: Oil Red O staining showed that DHSMT markedly reduced fat accumulation without affecting cell cytotoxicity. DHSMT also significantly decreased accumulation of triglyceride and adipokines such as leptin, adiponectin, resistin and PAI-1 compared with fully differentiated adipocytes. Furthermore, our results found that DHSMT significantly suppressed the adipocyte differentiation by downregulating adipogenic-specific transcriptional factors such as peroxisome proliferator-activated receptor gamma (PPARγ), CCAAT/enhancer binding proteins alpha (C/EBPα) and fatty acid binding protein 4 (FABP4) in adipocytes. CONCLUSIONS: Taken together, our findings provide that DHSMT has potential for treatment and prevention of obesity or MS related to BSS.

Do In Seung Gi­Tang extract suppresses adipocyte differentiation in 3T3­L1 cells.

Blood stasis syndrome (BSS), additionally called Eohyul, is a basic pathological concept in Traditional Korean Medicine. Do In Seung Gi­Tang (DISGT) is herbal medicine used for the treatment of BSS. It primarily treats metabolic diseases (MDs) including obesity, hypertension, diabetes mellitus and gynecological diseases, by promoting blood circulation. The present study aimed to investigate the anti­adipogenesis effect of DISGT in 3T3­L1 adipocytes using Oil Red O staining, and assessing levels of triglycerides (TGs) and leptin in adipocytes by ELISA and western blot analysis. The results demonstrated that DISGT treatment had inhibitory effects on fat droplet formation, TG accumulation, leptin production and cytokine content, during 3T3­L1 adipocyte differentiation, without affecting cell viability. Additionally, DISGT treatment significantly suppressed the protein expression levels of peroxisome proliferator­activated receptor Î³ and CAAT/enhancer binding protein α. These results provide evidence that DISGT has anti­adipogenesis effects on preadipocytes and adipocytes by significantly blocking adipocyte differentiation and lipid accumulation, and suppressing adipogenic gene expression. Therefore, the present study demonstrated the potential of DISGT as a therapeutic agent for the treatment of MDs.

Traditional medicine, Sobokchukeo­Tang, modulates the inflammatory response in adipocytes and macrophages.

Sobokchukeo-Tang (ST) is a well-known formula that is used for treating primary dysmenorrhea caused by blood stasis syndrome (BSS) in Korea and China. The current study investigated the anti­inflammatory and anti­adipogenesis effects of ST on adipocytes and macrophages. The anti­inflammatory efficacy of ST was evaluated in RAW 264.7 cells and differentiated THP­1 cells. To induce inflammation, the cells were treated with lipopolysaccharide (LPS; 1 µg/ml). Following the induction of inflammation, the levels of proinflammatory cytokines, interleukin­6 (IL­6) and tumor necrosis factor­α (TNF­α) in the cell supernatant were detected using enzyme­linked immunosorbent assay. 3T3­L1 preadipocytes differentiated into adipocytes in response to insulin, isobutyl­1­methylxanthine and dexamethasone (MDI). To confirm the anti­adipogenesis efficacy of ST, we investigated Oil Red O staining was performed, triglyceride (TG) and leptin secretion were measured, and the protein expression of lipid metabolism­associated factors was determined. ST significantly inhibited TNF­α and IL­6 production in the LPS­treated RAW 264.7 cells compared with LPS stimulation alone. In addition, the concentrations of IL­6 and TNF­α were significantly inhibited by ST in LPS­treated THP­1 cells. Lipid accumulation was reduced by ST, similarly to the positive control treatment, SB203580. In the ST­treated group, the TG and leptin concentrations were inhibited by up to 50 and 83%, respectively, compared with MDI induction only. The ST­treated group reduced the protein expression of peroxisome proliferator­activated receptor­Î³ and CCAAT/enhancer­binding protein α compared with MDI induction only. The results of the present study demonstrated that ST exerts anti­inflammatory effects on LPS­treated mouse and human macrophage cell lines. ST inhibited adipogenesis in MDI­induced 3T3­L1 adipocytes, as indicated by the significant reduction in TG and leptin concentrations without cytotoxicity. Thus, ST may be useful as a therapeutic agent for preventing lipid­associated diseases, including obesity and atherosclerosis.

Effect of modified Chung-Sim-Youn-Ja-Tang on anti-inflammatory and anti-lipogenesis in RAW 264.7 and 3T3-L1 cells.

Jea-Ma-Chung-Sim-Youn-Ja-Tang (JCST), one of herbal formulae, is modified prescription base on Chung-Sim-Youn-Ja-Tang (CST) which treats cerebrovascular disease for the Tae-Eum-In (TE). This study was designed to determine the anti-inflammatory and anti-adipogenesis effect of CST and JCST in vitro. CST and JCST of various concentrations were added in RAW 264.7 and 3T3-L1 cell. To determine the anti-inflammatory and anti-adipogenesis effects of CST and JCST, the PGE2 production was measured by lipopolysaccharide (LPS) treated RAW 264.7 cell. The adipocytes was determined by Oil red O staining, triglyceride (TG) production, leptin level and the protein expressions of peroxisome proliferator-activated receptor gamma (PPARγ), CCAAT/enhancer binding proteins alpha (C/EBPα) and fatty acid binding protein 4 (FABP4) in 3T3-L1 adipocytes. Our results showed that treatment with JCST significantly decreased PGE2 production on RAW 264.7 cell and suppressed adipocyte differentiation, lipid accumulation, TG production, leptin contents and the protein expressions of PPARγ, C/EBPα and FABP4 on 3T3-L1 adipocytes compared to CST without affecting cell viability. In conclusions, our results suggest that JCST may be useful to inhibit the effect on lipid metabolism compared to CST, and regulates lipogenesis effectively. Therefore, our data provides scientific evidence to support the clinical use of JCST in the treatment of cerebrovascular diseases such as stroke in the TE.