Cadmium (Cd) is a known environmental pollutant that is associated with inflammation, oxidative stress, and cell apoptosis. Astragalus polysaccharide (APS) is a major component of Astragalus membranaceus, a vital qi-reinforcing herb medicine with favorable immuneregulation properties. To study the effect of APS on the inhibition of the cadmium-induced injury of peripheral blood lymphocytes (PBLs) in chickens through the MDA5/NF-κB signaling pathway, PLBs acquired from 15-day-old chickens were divided into control group, Cd group, APS + Cd group, anti-MDA5 mAb + Cd group, BAY 11-7082 (a nuclear factor kappa-light chain-enhancer of activated B cells [NF-κB] inhibitor) +Cd group, APS group, anti-MDA5 mAb group, and BAY 11-7082 group. The transcription levels of melanoma differentiation-associated gene 5 (MDA5), interferon promoter-stimulating factor 1 (IPS-1), NF-κB, and inflammatory factors tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 were measured by quantitative real-time PCR. MDA5 protein expression was measured by western blotting. Levels of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were measured by corresponding antioxidant kit. The morphological change of PBLs was measured by transmission electron microscopy. The results showed that Cd significantly increased the expression of MDA5, IPS-1, NF-κB, and their downstream cytokines, IL-1β and TNF-α, IL-6 in PLBs. In addition, a high level of MDA was observed in the Cd treatment group; the activities of GSH-Px and SOD were significantly lower in the Cd treatment group than those in controls (p < 0.05). Ultrastructural changes of PBLs showed that Cd promoted autophagy, apoptosis, and necrosis in PBLs. However, APS can efficiently improve Cd-induced cell damage by decreasing the activation of the MDA5 signaling pathway. The effect is consistent with that of anti-MDA5 mAb or/and BAY. The results indicated that APS inhibited Cd-induced cytotoxicity through the regulation of MDA5/NF-κB signaling.

The study shows that the aqueous extract of Astragulus membranaceus (AMWE) can improve the anisodine-induced impairment on memory acquisition as well as the alcohol-elicited deficit of memory retrieval (number of errors were reduced and latent period was prolonged) in step down, and can also prolong the gasping duration of mice after decapitation at doses of 50g/kg (ig) for 7 days.

BACKGROUND

Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of clonal plasma cells in the bone marrow. The median survival has increased to 6 years in recent years. But MM remains incurable. Some studies about the effects of Chinese herb medicine on MM have been carried out. Long survival in MM patients through Traditional Chinese Medicine (TCM) therapies has been reported rarely before.

UNASSIGNED

We report a case of a female patient who was diagnosed with MM in 2000 at the age of 49. She received 9 cycles of multiple chemotherapeutic regimens mainly based on melphalan from September 2000 to May 2001. Though her condition was under control in some degree, she discontinued treatment due to significant side effects such as fatigue, hyperhidrosis, fever, chill, larynx mucosa ulcers, pharynx mucosa ulcers, and poor appetite. Instead, she sought treatment with TCM alone.

UNASSIGNED

Based on the TCM theory, the patient's condition was categorized as Xue Bi.

METHODS

Up to the present, the patient has been using modified Huangqi Guizhi Wuwu Tang (HGWT) continuously for 18 years. In this prescription, Radix Astragali is an important herb. When the patient's condition worsened, its dosage was increased from 30 to 120g. Besides, she has been eating Radix Astragali porridge or drinking Radix Astragali tea for almost 18 years at the same time.

RESULTS

Throughout the period, no obvious side effects have been observed and her health condition remains stable.

CONCLUSIONS

Polysaccharides isolated from Astragalus membranaceus (Radix Astragali) and Polyporus umbellatus could promote maturation of dendritic cells. Polysaccharides and flavonoids isolated from Astragalus membranaceus could regulate bone marrow microenvironment by inhibiting secretion of interleukin (IL)-6, IL-12 p40 and bidirectionally regulating the osteogenic capacity of osteoblasts. Besides, Rhizoma Atractylodis Macrocephalae, another important component of the prescription, has inhibitory effects on osteolytic bone lesions. This case suggests TCM treatment may have a positive therapeutic effect on MM. Modified HGWT, especially the Chinese herb medicine Radix Astragali could potentially be an alternative option for the treatment of MM. Both pharmacological studies and randomized clinical trials are needed in the future.

In the present study, the regulation of Vitreoscilla hemoglobin (VHb) on astragaloside IV biosynthesis was investigated. An intermediate expression vector consisting of the CaMV35S promoter fused to the vgb and nopaline synthase terminator was transferred into Astragalus membranaceus via Agrobacterium rhizogenes. The transgenic hairy roots were confirmed by PCR amplification and Southern blot hybridization. The expression of vgb in transgenic hairy roots was confirmed by RT-PCR. After 15 days cultivation, the dry weight and growth rate of transgenic hairy roots were higher than that of the non-transgenic hairy root. ELSD-HPLC analysis showed that astragaloside IV content of transgenic hairy roots was 5 to 6 times of non-transgenic hairy root control and 10 to 12 times of Radix Astragali from Shanxi Province. These results suggested that the expression of vgb promoted the growth of transgenic hairy roots, and increased the content of astragaloside IV.

Magnetic biochar (M-BC) was derived from herbal medicine waste, Astragalus membranaceus residue, and was used as an adsorbent for ciprofloxacin removal from aqueous solutions. The M-BC was characterized by Brunauer-Emmett-Teller surface area analyses, Fourier transform infrared spectrometry, X-ray diffraction analysis, hysteresis loops, scanning electron microscopy energy-dispersive spectrometry, and X-ray photoelectron spectroscopy. The BET surface area increased from 4.40 to 203.70 m2/g after pyrolysis/magnetic modification. Batch experiments were performed at different dosages, initial concentrations, contact times, and solution pHs. Adsorption performances were evaluated using Langmuir and Freundlich isotherm models, and the results indicated that the Langmuir model appropriately described the adsorption process. The kinetic data were better fitted by a pseudo-second-order kinetic model. The maximum ciprofloxacin removal was observed at pH 6 (adsorption capacity of 68.9 ± 3.23 mg/g). Studies demonstrated that magnetically modified biochar might be an attractive, cost-effective, and easily separated adsorbent for contaminated water. Graphical abstract.

Astragaloside IV is a compound isolated from the Traditional Chinese Medicine Astragalus membranaceus, that has been reported to have bioactivities against cardiovascular disease and kidney disease. There is limited information on the metabolism of astragaloside IV, which impedes comprehension of its biological actions and pharmacology. In the present study, an ultra-performance liquid chromatography coupled with quadrupole/time-of-flight mass spectrometry (UPLC-Q-TOF-MS/MS)-based approach was developed to profile the metabolites of astragaloside IV in rat plasma, bile, urine and feces samples. Twenty-two major metabolites were detected. The major components found in plasma, bile, urine and feces included the parent chemical and phases I and II metabolites. The major metabolic reactions of astragaloside IV were hydrolysis, glucuronidation, sulfation and dehydrogenation. These results will help to improve understanding the metabolism and reveal the biotransformation profiling of astragaloside IV in vivo. The metabolic information obtained from our study will guide studies into the pharmacological activity and clinical safety of astragaloside IV.

Huangqi glycoprotein (HQGP) is prepared from Astragalus membranaceus by ammonium sulfate precipitation. It was indicated that HQGP has an immunoregulatory effect. In this study, we established a chronic experimental autoimmune encephalomyelitis (EAE) model and observed the therapeutic effect and possible mechanisms of HQGP (intraperitoneally at 1 mg/kg/day) on EAE. The results showed that HQGP delayed onset and ameliorated severity of EAE, and reduced the infiltration and accumulation of pathogenic T cells in the central nerves system (CNS). HQGP also reduced the production of IL-6, IL-17 and TNF-α and increased the level of IL-10. However, the level of IFN-γ production was also increased in HQGP-treated mice compared with EAE control mice. In brain, chemokines such as CCL2 and CCL5 were inhibited in HQGP-treated EAE compared with control mice. These results demonstrate that HQGP alleviates the pathogenesis of EAE possibly by suppressing the neuroinflammation and decreasing the secretion of chemokines and cell adhesion..

Altered cell-mediated immunities (CMI) is one of the important causes of increased susceptibility to infection and, high mortality of burned patients. This paper presents the experimental work on mice with scald injury to restore their altered CMI by local application of cerium nitrate (CE) or systemic administration of Astragalus membranaceus (AM) or Lonicera japonica Thunb (LJT), as well as combination use of these drugs. The proliferative response to Con A and the ability of IL-2 production of murine spleen cells and the delayed hypersensitivity test using DNFB as sensitizer were chosen as the parameters of CMI. Results showed that CMI of untreated scald mice was suppressed to 50-60% of normal control 11 days following scald injury. While either CE used locally or AM or LJT given by oral with different dosages might bring up the depressed CMI to various degrees, near the normal level and some even above normal. When CE was used accompanied with AM or LJT, their effects on restoration of CMI were significantly better than that when any single drug was administered alone.

The Chinese herbal formula consisting of Astragalus membranaceus, Epimedium brevicornum, Paeoniae Alba Radix and Radix Ophiopogonis in proper proportions were adopted in order to investigate the immunoenhancing properties of the herbal formula. Fifty ICR mice were randomly divided into 5 groups (NS- NS+Hy-L+Hy-M+Hy-H+Hy ). The mice in hydrocortisone (Hy) groups were injected with hydrocortisone i.p. to induce the immunosuppressive condition. The mice in group NS were administered with normal saline as controls. The mice in groups NS+Hy-L+Hy-M+Hy-H+Hy were administered with normal saline, low, moderate and high dose of the herbal prescription respectively by gavage for 6 days. The level of serum hemolysin, the function of antibody function cell-AFC-and CD4⁺/CD8⁺ T cell ratio were measured at the end of experiments. The results showed that the level of serum hemolysin, the function of AFC and CD4⁺/CD8⁺ T cell ratio in L+Hy-M+Hy-H+Hy groups increased significantly compared with those in NS or NS+Hy groups. These results indicate that Chinese herbal medicine prescription can enhance humoral immunity and cellular immune function of the immunosuppressive mouse.

Ultraviolet (UV) irradiation induces skin photoaging associated with up-regulated matrix metalloproteinase (MMP) expression. Inhibition of MMP expression is suggested to alleviate photoaging induced by UV irradiation. Astragaloside IV (As-IV), one of the main active ingredients of Astragalus membranaceus (Fisch) Bge, has been reported to have various biological activities. However, its anti-photoaging effect has not been examined to date. In the present study, we observed the effect of As-IV on matrix metalloproteinase-1 (MMP-1) expression in UV-irradiated human dermal fibroblasts (HDFs). We found that treatment with As-IV significantly decreased UV-induced MMP-1 expression at the messenger RNA and protein levels. In addition, western blotting analysis revealed that As-IV concentration-dependently suppressed UV-induced phosphorylation of extracellular-regulated protein kinase, Jun-N-terminal kinase and p38 mitogen-activated protein kinase (MAPK). Furthermore, treatment with As-IV markedly inhibited UV-induced nuclear factor kappaB (NF-κB) activity. These results suggest that As-IV down-regulates UV-induced MMP-1 expression, perhaps through suppression of MAPK and NF-κB activation in HDFs. As-IV is thus a potential agent for the management of skin photoaging.

With the widespread contamination of ochratoxin A (OTA), it is of significant importance for detecting OTA in foods and traditional Chinese medicine (TCM). In this study, a novel label-free fluorescent aptasensor utilizing the interaction between OTA-triggered antiparallel G-quadruplex and (N-methyl-4-pyridy) porphyrin (TMPyP) for the rapid and sensitive determination of OTA was established. The fluorescence of CdTe quantum dots (QDs) could be quenched by TMPyP. In the presence of analyte (OTA), the aptamer could recognize OTA and transform from a random coil to the antiparallel G-quadruplex. The interaction between G-quadruplex and TMPyP could release CdTe QDs from TMPyP, and thus recover the fluorescence of CdTe QDs. Under optimized conditions, the detection limit of the designed aptasensor was 0.16 ng mL^-1, with a linear range of 0.2 to 20 ng mL^-1. Furthermore, this aptasensor showed high selectivity toward OTA against other structural analogs and other mycotoxins, and was successfully applied in Astragalus membranaceus samples. The presented aptasensor for OTA detection could be a promising tool for the field monitoring of food and TCM.

OBJECTIVE

To investigate the therapeutic effect of Astragali on sodium and water retention in aortocaval fistula-caused experimental congestive heart failure and its involved mechanisms.

METHODS

In aortocaval fistula-caused chronic (5 wk), heart failure rats treated with and without Astragali 1.0 g/day intraperitoneally, changes of cardiac and renal function, renal response to atrial natriuretic peptide (ANP) were examined. Dot blot analysis was used to determine the effect of Astragali on hypothalamic arginine vasopresin (AVP) mRNA expression, and mRNA expressions of aortic and renal AVP V1a receptor, renal AVP V2 receptor and aquaporin-2 (AQP2) were simultaneously detected by RT-PCR method.

RESULTS

Rats with aortocaval fistula impaired cardiac and renal functions evidenced by higher right atrial pressure (RAP), left ventricular end-diastolic pressure (LVEDP), lower + dP/dtmax of left ventricle, glomerular filtration rate (GFR), renal plasma flow (RPF), urine volume (UV), urinary sodium excretion (UNaV) and free water clearance (CH2O) compared with sham-operated control (P < 0.05). There was no change in serum sodium, hematocrit and plasma osmolality. Astragali could remarkably improve the cardiac and renal functions. Dot blot analysis demonstrated upregulated hypothalamic AVP mRNA expression in this experimental heart failure. The AVP V1a receptor mRNA level of aortic arch and renal medulla were reduced, while in renal cortex it was elevated. The mRNA expressions of AVP V2 receptor and AQP2 were increased in renal cortex while decreased in medulla. Astragali could partially or completely correct those abnormal mRNA expressions. Analysis on plasma atrial natriuretic peptide (ANP), urinary cyclic guanidino monophosphate excretion (UcGMP V), urinary cyclic guanidino monophosphate excretion/plasma atrial natriuretic peptide (UcGMP V/pANP), and further correlation and linear regression analysis between UcGMP V and plasma ANP showed that there was blunted renal response to ANP in heart failure rat, and astragali could improve the renal reaction to ANP significantly.

CONCLUSIONS

Chinese herb, astragali have therapeutic effects on sodium and water retention in aortocaval fistula-induced heart failure, the mechanisms of which might be the improvement of cardiac and renal functions, partly correction of abnormal mRNA expressions of AVP system and AQP2, and amelioration of blunted renal response to ANP.

BACKGROUND

Astragalus membranaceus from traditional Chinese herbal medicines previously showed that it possesses a strong anti-inflammatory activity. The purpose of this study was to elucidate the effect of astragalus on allergen-induced airway inflammation and airway hyperresponsiveness and investigate its possible molecular mechanisms.

METHODS

Female BALB/c mice sensitized and challenged with ovalbumin (OVA) developed airway inflammation. Bronchoalveolar lavage fluid was assessed for total and differential cell counts and cytokine and chemokine levels. In vivo airway responsiveness to increasing concentrations of methacholine was measured 24 hours after the last OVA challenge using whole-body plethysmography. The expression of inhibitory κB-α and p65 in lung tissues was measured by Western blotting.

RESULTS

Astragalus extract attenuated lung inflammation, goblet cell hyperplasia and airway hyperresponsiveness in OVA-induced asthma and decreased eosinophils and lymphocytes in bronchoalveolar lavage fluid. In addition, astragalus extract treatment reduced expression of the key initiators of allergic T(H)2-associated cytokines (interleukin 4, interleukin 5) (P < 0.05). Furthermore, astragalus extract could inhibit nuclear factor κB (NF-κB) expression and suppress NF-κB translocation from the cytoplasm to the nucleus in lung tissue samples.

CONCLUSIONS

Taken together, our current study demonstrated a potential therapeutic value of astragalus extract in the treatment of asthma and it may act by inhibiting the expression of the NF-κB pathway.

The experimental hepatic fibrosis was treated with YiQi (reinforcing Qi, YQ) Huoxue (activating blood circulation, HX) principle which was consisted of astragalus membranaceus, Ligusticum wallichii, paeonia lactiflora, etc. After stimulation with CCl4 over four months, the Wistar rat developed liver fibrosis. Rats were divided into the normal control, the toxifying control, YQHX group and HX group. The experimental period lasted over four months.

RESULTS

(1) Mortality of animal: Both toxifying control and HX group reached 50%, while YQHX group was 16% only. These results suggest that YQHX agents could strengthen the body resistance; (2) The determination of serum SGPT: The mean levels in toxifying control were 39.3 +/- 39, in HX group 43.7 +/- 12.9, while in YQHX group 29.0 +/- 7.6 (units/Lserum). These results indicated that YQHX agents had the function of protecting the liver and lowering the activity of SGPT (P less than 0.01); (3) Measuring the contents of hepatic collages: The mean levels in toxifying control was 38.9 +/- 3.3 (mg/g liver), while in HX group and YQHX group 28.7 +/- 2.2 and 22.7 +/- 1.1 (mg/g liver) respectively. The results indicated that the YQHX agents had the best results in treating hepatic fibrosis; (4) Observation with hepatic histopathology: The degree of hepatocyte degeneration and necrosis in YQHX group was milder than that in toxifying and HX group. These observations revealed that YQHX agents possessed the function of protecting liver. There was severe liver fibrosis in toxifying control, but the degree of liver fibrosis in YQHX group was significantly milder than that in toxifying control.(ABSTRACT TRUNCATED AT 250 WORDS)

Success with rIL-2 immunotherapy of human cancer appears to depend on the administration of high doses which are frequently associated with excessive toxicity. Future use of rIL-2 will require certain modifications based on the use of lower doses of rIL-2 without significant loss of antitumor efficacy. The authors tested in vitro the possibility of potentiating the activity of rIL-2 in terms of LAK cell generation. The authors hypothesized that co-incubation of LAK cell precursors with a Chinese herbal extract (F3) of Astragalus membranaceus (an immune modulator currently under study in the authors' laboratory), along with a low concentration of rIL-2 would generate levels of LAK cell activity equivalent to those generated by high concentrations of rIL-2 alone. The authors found: (1) a 10-fold potentiation of rIL-2 activity manifested by tumor cell killing activity of 80% resulting from LAK cell generation with F3 plus 100 u/ml of rIL-2 versus 76% generated by 1000 u/ml of rIL-2 alone; (2) a significant reduction in the number of effector LAK cells required for equicytotoxic reaction following LAK cell generation with F3 plus rIL-2 compared to rIL-2 alone. The authors conclude that potentiation of antitumor activity mediated by rIL-2 in low concentrations is possible by the concomitant use of another immune modulator such as Astragalus membranaceus.

OBJECTIVE

To initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM).

METHODS

Based on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses.

RESULTS

The treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600).

CONCLUSIONS

As a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.

Formononetin, an active ingredient isolated from the traditional Chinese medicinal herb Astragalus membranaceus, has anticancer and chemoresistance-reducing biological activities. We evaluated the efficacy of formononetin in improving the tumoricidal effect of everolimus by suppressing the mTOR pathway in breast cancer cells.

Cell survival was assessed using an MTT assay. Apoptosis was detected using flow cytometry. Proteins related to the mTOR pathway were detected and assessed using real-time PCR and Western blot analysis. Results. The results showed that formononetin enhances the efficacy of everolimus in suppressing breast cancer cell growth both in vitro and in vivo. The combination of formononetin and everolimus resulted in a 2-fold decrease in tumor volume and a 21.6% decrease in cell survival. The apoptosis ratio in cells treated with formononetin and everolimus increased by 27.9%. Formononetin and everolimus also inhibited the expression of p-mTOR and p-P70S6K and increased the expression of PTEN and p-4EBP-1. Notably, formononetin alone inhibited p-Akt expression but not everolimus.

Formononetin enhances the tumoricidal effect of everolimus by inhibiting the activity of Akt.

Background/aim: Accumulating evidence has shown therapeutic effects of herbals on breast cancer, a commonly diagnosed malignancy in women worldwide. However, their underlying mechanisms remain unclear. We aimed to explore the mode of action of a recently developed herbal combination at system-level.

Materials and methods: We employed network pharmacological approaches to study the mechanism of a combination of three herbals, Astragalus membranaceus, Angelica gigas and Trichosanthes kirilowii by investigating active compounds and performing functional enrichment analysis for the interacting targets.

Results: For in silico pharmacokinetic evaluation, ten active ingredients interacted with fifty-six breast cancer-associated therapeutic targets. Functional enrichment analysis revealed that TNF, estrogen, PI3K-Akt and MAPK signaling pathways were involved in tumorigenesis and development of breast cancer. The pharmacological mechanisms might be associated with cellular effects on proliferation, cell cycle process and apoptosis.

Conclusion: The present study provides novel insights into the system-level pharmacological mechanisms underlying a herbal combination used for breast cancer therapies.

Keywords: Systems biology; breast cancer; combination; herbal; network pharmacology; pharmacological mechanism.

Astragalus extract mixture HT042 is a standardized multiherbal mixture comprising Astragalus membranaceus, Eleutherococcus senticosus, and Phlomis umbrosa, which has proven to promote children's height growth. The aim of this study was to investigate the effects of HT042 on longitudinal bone growth, bone mass, and bone microstructure in growing rats using a high-resolution microcomputed tomography system. Four-week-old female rats were fed an HT042-containing diet for 2 weeks. Tibial length was measured at baseline and weekly in vivo. At the end of the study, volumetric bone mineral density (vBMD) and microarchitectural parameters were estimated in the trabecular and cortical bone of the tibia. Tibial length gain was significantly increased by HT042 compared to that reported with the control diet. In the proximal tibial metaphysis, HT042-treated rats had significantly higher trabecular vBMD, bone volume fraction, and trabecular number and lower trabecular separation, trabecular pattern factor, and structure model index values than control rats did. Total cross-sectional area and bone area of the cortical bone in the tibial diaphysis also increased. These findings suggest that HT042 increases longitudinal bone growth rate, improves trabecular bone mass, and enhances the microarchitecture of trabecular and cortical bone during growth.

Background: Chronic kidney disease (CKD) has become a worldwide burden due to the high co-morbidity and mortality. Diabetic nephropathy (DN) is one of the leading causes of CKD, and pre-dialysis is one of the most critical stages before the end-stage renal disease (ESRD). Although Chinese herbal medicine (CHM) use is not uncommon, the feasibility of using CHM among pre-dialysis DN patients remains unclear. Materials and methods: We analyzed a population-based cohort, retrieved from Taiwan's National Health Insurance Research Database, to study the long-term outcome of using CHM among incident pre-dialysis DN patients from January 1, 2004, to December 31, 2007. All patients were followed up to 5 years or the occurrence of mortality. The risks of all-cause mortality and ESRD were carried out using Kaplan-Meier and competing risk estimation, respectively. Further, we demonstrated the CHM prescriptions and core CHMs using the Chinese herbal medicine network (CMN) analysis. Results: A total of 6,648 incident pre-dialysis DN patients were analyzed, including 877 CHM users and 5,771 CHM nonusers. With overlap weighing for balancing all accessible covariates between CHM users and nonusers, we found the use of CHM was associated with lower all-cause mortality (0.22 versus 0.56; log-rank test: p-value <0.001), and the risk of mortality was 0.42 (95% CI: 0.36-0.49; p-value <0.001) by adjusting all accessible covariates. Further, the use of CHM was associated with a lower risk of ESRD (cause-specific hazard ratio: 0.59, 95%CI: 0.55-0.63; p-value <0.001). Also, from the 5,901 CHM prescriptions, we found Ji-Sheng-Shen-Qi-Wan, Astragalus mongholicus Bunge or (Astragalus membranaceus (Fisch.) Bge.), Plantago asiatica L. (or Plantago depressa Willd.), Salvia miltiorrhiza Bunge, and Rheum palmatum L. (or Rheum tanguticum (Maxim. ex Regel) Balf., Rheum officinale Baill.) were used as core CHMs for different CHM indications. Use of core CHMs was associated with a lower risk of mortality than CHM users without using core CHMs. Conclusions: The use of CHM seemed feasible among pre-dialysis DN patients; however, the beneficial effects still need to be validated by well-designed clinical trials.

Keywords: Chinese herbal medicine; diabetic nephropathy; end-stage renal disease; mortality; network analysis; pre-dialysis.

Astragaloside IV, a natural product purified from the Chinese medicinal herb Astragalus membranaceus (Fisch) Bge, is now being developed as a cardioprotective agent for treating cardiovascular diseases. In the present study developmental toxicity of astragaloside IV in Sprague-Dawley rats and New Zealand White rabbits was evaluated by intravenously administering astragaloside IV daily to rats at 0.25, 0.5 and 1.0 mg kg(-1) on gestation days 6-15, and to rabbits at 0.5, 1.0 and 2.0 mg kg(-1) daily on gestation days 6-18. Reproductive parameters were determined and fetuses were examined for external, visceral and skeletal malformations. There was significant difference in total weight gain during and after treatment between the control group and 1.0 mg kg(-1) group in rats. The percentage of fetal deaths in 0.5 and 1.0 mg kg(-1) rat groups was significantly higher than that of the control group, and higher in all treatment groups than in the control in rabbits. These results indicated that astragaloside IV was maternally toxic at 1.0 mg kg(-1) in rats and fetotoxic at a dose higher than 0.5 mg kg(-1), but devoid of teratogenic effects in rats and rabbits. In light of these findings it is perhaps prudent to advise caution to women who might use astragaloside IV to combat cardiovascular disease during pregnancy.