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ETHNOPHARMACOLOGICAL RELEVANCE: Shegan-Mahuang Decoction (SMD) is a classical formula that has been used to effectively treat cold-induced asthma (CA) for 1800 years. Airway smooth muscle cells (ASMCs) play a crucial role in airway remodeling of CA and can be modulated through bitter taste-sensing type 2 receptors (TAS2Rs). Given that SMD contains numerous bitter herbs and TAS2R10 expression in ASMCs remains consistently high, it is pertinent to explore whether SMD regulates ASMCs via TAS2R10 to exert its CA mechanism. AIM OF THE STUDY: This study investigated the efficacy as well as the potential mechanism of SMD in CA. MATERIALS AND METHODS: In this study, experiments in vivo were conducted using the CA rat model induced by ovalbumin (OVA) along with cold stimulation. The effects of SMD and TAS2R10 expression in CA rats were evaluated using the following methods: clinical symptoms, weights, pathological staining, immunofluorescence staining (IF), enzyme-linked immunosorbent assay (ELISA), real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB). Assays in vitro including cell counting Kit-8 (CCK-8), ELISA, flow cytometry, TUNEL staining, RT-qPCR and WB were performed to investigate potential mechanism of SMD on the proliferation and apoptosis of ASMCs through upregulation of TAS2R10. RESULTS: The administration of SMD resulted in a notable improvement in the symptoms, trends in weight, airway inflammation and airway remodeling observed in CA rats with upregulated TAS2R10. Mechanistically, we furtherly confirmed that SMD inhibits p70S6K/CyclinD1 pathway by upregulating TAS2R10. SMD furthermore blocked the G0/G1 phase, suppressed the proliferation and inducted apoptosis in ASMCs induced by platelet-derived growth factor-BB (PDGF-BB). Erythromycin (EM), a TAS2R10 agonist, can intensify these effects. CONCLUSIONS: SMD significantly ameliorates CA by upregulating TAS2R10 and inhibiting the p70S6K/CyclinD1 pathway, thereby modulating ASMCs' proliferation and apoptosis. Inspired by the Five Flavors Theory of Traditional Chinese Medicine, this study provides an updated treatment perspective for treating CA.

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Shegan Mahuang Decoction has been used in clinical practice for thousands of years, and is a classical formula for treating asthma and other respiratory diseases, with the effects of ventilating lung, dispersing cold, and relieving cough and asthma. This paper summarized the history, clinical application and mechanism of Shegan Mahuang Decoction, and predicted its quality markers(Q-markers) based on the "five principles" of Q-markers. The results suggested that irisflorentin, tectoridin, tectorigenin, irigenin, ephedrine, pseudoephedrine, asarinin, methyleugenol, shionone, epifriedelanol, tussilagone, 6-gingerol, trigonelline, cavidine, schizandrin, and schizandrin B could be used as Q-markers of Shegan Mahuang Decoction, which provided a basis for the quality control and subsequent research and development of Shegan Mahuang Decoction.

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BACKGROUND Neutrophil-lymphocyte ratio (NLR) is related to increased mortality risk in many diseases. However, there is limited research on critically ill patients with chronic obstructive pulmonary disease (COPD). A retrospective cohort study was performed to investigate whether NLR can be used as a biomarker to predict the mortality of critically ill COPD patients. MATERIAL AND METHODS In the research, the data were gathered from the database of the Medical Information Mart for Intensive Care-IV. The 28-day mortality was defined as the primary outcome, while the secondary outcomes were in-hospital and 90-day mortality. Through the application of the Kaplan-Meier curves and the multivariate Cox regression analysis, the potential association between NLR and mortality for critically ill patients with COPD was evaluated. For subgroup analysis, age, sex, ethnicity, mean blood pressure, and comorbidities were considered. RESULTS We extracted data on 2650 patients, of which 53.7% were male. A higher level of NLR was correlated with higher 28-day mortality risk. Compared to the lower quartile (NLR<4.56), HR (95% CI) of the upper quartile (NLR>16.86) was 1.75 (1.21-2.52) in the multivariate Cox regression model when adjusted for confounders (P=0.003). A similar tendency was found in the 90-day mortality (HR=1.59, 95% CI=1.16-2.19, P=0.004) and the in-hospital mortality (HR=1.71, 95% CI=1.22-2.42, P=0.002). Subgroup analyses showed that the correlation between NLR and 28-day mortality was stable. CONCLUSIONS The higher level of NLR is likely to be correlated with the increase of the all-cause mortality risk in critically ill patients with COPD, but this needs to be validated in future prospective research.

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This study investigated the therapeutic effect of Shegan Mahuang Decoction(SGMHD) on cold-induced asthma in rats and explored its underlying mechanism. Seventy-two healthy male SD rats of specific pathogen free(SPF) grade were randomly divided into a blank group, a model group, a positive control group(dexamethasone, 0.4 mg·kg~(-1)), and low-, medium-, and high-dose SGMHD groups(3.2, 6.4, and 12.8 g·kg~(-1)). The blank group received saline, while the other groups were sensitized by intraperitoneal injection of ovalbumin(OVA) solution. Subsequently, the rats were placed in a cold chamber adjustable to 0-2 ℃, and OVA solution was ultrasonically nebulized to induce cold-induced asthma in rats. After three weeks of treatment, the general behaviors of rats were observed. Hematoxylin-eosin(HE) staining was used to evaluate pathological changes in lung tissues, periodic acid-Schiff(PAS) staining assessed mucin changes, and Masson staining was performed to examine collagen deposition. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of the inflammatory factors interleukin-4(IL-4) and vascular endothelial growth factor(VEGF) in serum and bronchoalveolar lavage fluid(BALF). Real-time quantitative polymerase chain reaction(RT-PCR) was employed to assess the mRNA expression levels of transient receptor potential vanilloid subfamily member 1(TRPV1), nuclear respiratory factor 1(NRF-1), and mitochondrial transcription factor A(mtTFA) in lung tissues. Western blot was used to measure the protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues. Compared with the blank group, the model group exhibited signs of rapid respiration, increased frequency of defecation with looser stools, and disheveled and dull fur. Pathological results showed significant infiltration of inflammatory cells in lung tissues, narrowing of bronchial lumens, increased mucin secretion, and enhanced collagen deposition in the model group. Additionally, the levels of IL-4 and VEGF in serum and BALF were significantly elevated, and the mRNA and protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues were significantly increased. Compared with the model group, SGMHD improved the behaviors of rats, alleviated pathological changes in lung tissues, mucin production, and collagen deposition, significantly decreased the levels of IL-4 and VEGF in serum and BALF, and reduced the mRNA expression levels of TRPV1, NRF-1, and mtTFA in lung tissues, with the medium-dose SGMHD group showing the most significant effect. Moreover, the protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues were also reduced, with the medium-dose SGMHD group exhibiting the most significant effect. In conclusion, this study demonstrates that SGMHD can alleviate airway inflammation and inhibit airway remodeling in cold-induced asthma rats. These effects may be associated with the modulation of the TRPV1/NRF-1/mtTFA signaling pathway.

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Background: Shegan Mahuang decoction (SGMHD) was widely used as a classic prescription of traditional Chinese medicine to treat asthma. However, there is no research on the acrid and bitter Chinese herbs in the SGMHD to treat asthma. This study aimed to investigate the effects of SGMHD and its acrid-bitter Chinese herbs composition on airway inflammation and the expression of TRPV1 and TAS2R14 genes and proteins in asthmatic rats. Methods: SD (Sprague Dawley) rats of asthma were induced by ovalbumin and aluminum hydroxide, then randomly divided into the Normal group, Model group, SGMHD group, Dexamethasone (Dex) group, Guilongkechuangning (GLKC) group, The Acrid Chinese Herbs group (ACH), and The Bitter Chinese Herbs group (BCH). The rats were given intragastric gavage after 21 days for 4 weeks. The bronchoalveolar lavage fluid (BALF) was collected, and the levels of IL-4, IL-13, nerve factors SP, CGRP, PGE2, and serum of IgE were determined by ELISA. Pathological changes in the lungs were determined by hematoxylin-eosin (HE) staining. The expression of TRPV1 and TAS2R14 in the rat lung group was detected by immunofluorescence (IF). The expression levels of TRPV1 and TAS2R14 were measured using western blotting. The mRNA levels of TRPV1 and TAS2R14 were measured using RT-qPCR. Results: The levels of serum IgE in treated rats and the cytokines IL-4, IL-13, SP, CGRP, and PGE2 were all decreased. HE-staining showed that significantly reduced inflammatory cell infiltration in lung tissue. IF-staining showed the expression levels except those of the normal group were enhanced. Acrid Chinese herbs inhibited TRPV1, and bitter Chinese herbs activated the gene and protein expression of TAS2R in the lung. Conclusion: The acrid Chinese herbs regulate TRPV1, and bitter Chinese herbs regulate the gene and protein expression of TAS2R14, through nerve and immune-inflammatory factors, reduced airway inflammation, reduced airway reactivity, promoted airway remodeling, and the combination of acrid-bitter Chinese herbs can enhance the above effects. This will lay a foundation for further in vivo study of specific compounds of acrid-bitter Chinese herbs.

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BACKGROUND: Inflammatory response plays a crucial role in the development and deterioration of asthma. The aim of this study was to assess the association between Dietary Inflammatory Index (DII) score and all-cause mortality among patients with asthma in the United States (US). METHODS: We included participants aged ≥20 years and excluded those with no data relating to 24-hour dietary recall of dietary intake interview and asthma status. DII score was calculated based 25 food parameters. Multivariate Cox regression analysis was used to analyze the linear association between DII score and all-cause mortality, and a generalized additive model (GAM) with a spline smoothing function was used to analyze the nonlinear dose-response relationship. RESULTS: Among the 20,573 participants, 2,805 (13.63%) participants had a current or past diagnosis of asthma, and 17,768 (86.37%) participants had no history of asthma. DII score was associated with increased all-cause mortality among participants who had previously been diagnosed with asthma [hazard ratio (HR): 1.13; 95% confidence interval (CI): 1.04, 1.23; P=0.004] and participants who were currently diagnosed with asthma (HR: 1.13; 95% CI: 1.03, 1.24; P=0.010) after multivariable adjustment for age, sex, race, education, family income, body mass index, physical activity, smoking status, diabetes, hypertension, and coronary heart disease. When DII score was transformed into a categorical variable, participants with a current or past diagnosis of asthma who were in the DII score fifth quintile were associated with increased all-cause mortality when compared with participants in the lowest quintile (HR: 2.34; 95% CI: 1.34, 4.11). The association was stronger in these participants than in participants with no history of asthma (HR: 1.25; 95% CI: 1.04, 1.49). Furthermore, the GAM model showed a linear dose-response relationship, which indicated that increased DII score was associated with increased all-cause mortality among participants with a current or past diagnosis of asthma. CONCLUSIONS: Our study is the first to provide evidence that DII score is associated with increased all-cause mortality among patients with asthma in the US. Due to potential bias and residual confounding, our findings require further investigation and confirmation in randomized controlled trials.

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OBJECTIVE: To observe the therapeutic effect of moxibustion combined with Guifu Yuhe decoction on allergic acne and the influence on immunologic function in the patients. METHODS: A total of 60 patients with allergic acne were rando-mized into an observation group (30 cases) and a control group (30 cases).Thirty healthy employees were in the healthy group. In the control group, Guifu Yuhe decoction was prescribed for oral administration, while in the observation group, on the base of the treatment as the control group, moxibustion was exerted at Dazhui (GV14) and Shenque (GV8). The treatment duration was 8 weeks. Before and after treatment, serum IgE, blood EOS, CD4+T cell, CD8+ T cell and CD4+T/CD8+T, as well as the conversion score of idiopathic constitution and the symptom score were compared in the patients of two groups. The clinical therapeutic effect was observed in the two groups. RESULTS: Before treatment, compared with the healthy group, IgE and EOS, CD4+T cell and CD8+T cell all increased (P<0.05), and CD4+T/CD8+T decreased in the two groups (P<0.05). After treatment, IgE, EOS and CD4+T cell and CD8+T cell decreased (P<0.05), and CD4+T/CD8+T increased (P<0.05) in the intra-group comparison in the patients. The changes of IgE, EOS, CD4+T cell and CD8+T cell in the observation group were more larger than those in the control group (P<0.05). After treatment, the conversion score of body constitution and symptom score all decreased in either group (P<0.05) and the scores in the observation group were lower than those of the control group (P< 0.05). The total effective rate of the observation group (29/30, 96.7%) was higher than that of the control group (22/30, 73.3%, P<0.05). CONCLUSION: Moxibustion combined with Guifu Yuhe decoction can significantly improve immune function and body constitution of the patients with allergic acne, which may be related to rectifying idiopathic constitution, improving in lymphocyte subsets dysfunction and inhibiting allergic reaction.

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BACKGROUND Several studies have suggested the importance of autophagy during esophageal adenocarcinoma (EAC) development. This study aimed to explore the autophagy-related genes correlated with overall survival in patients with EAC. MATERIAL AND METHODS The RNA-seq expression profiles and clinical data of patients with EAC were screened using The Cancer Genome Atlas (TCGA) database. Screening of autophagy-related genes was conducted using the human autophagy database (HADb). Bioinformatic analysis was conducted and included the following: univariate cox, lasso regression, and multivariate cox regression analysis; building overall survival assessment of the prognosis model; drawing the model of receiver operating characteristic (ROC) curve and determining the area under the curve; and a C-index reliability index assessment model through Kaplan-Meier screening of statistically significant genes in the model. The screening results were verified via Oncomine differential expression analysis. Gene set enrichment analysis (GSEA) was further used to analyze the molecular biological functions and related pathways of the gene model. RESULTS Through cox regression and ROC analysis, the model showed that the risk score could accurately and independently predict the prognosis of EAC. The screening identified 4 genes: DAPK1, BECN1, ATG5, and VAMP7. GSEA showed that the high and low expression levels of the 4 genes were mainly enriched in biological functions, such as cell production and regulation, and metabolic pathways that maintain cell activity. CONCLUSIONS Our research found that autophagy was involved in the process of EAC development and that several autophagy-related genes may provide prognostic information and clinical application value for patients with EAC.

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