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1 Polychemical Activities and Mechanism Study III Panellists Dr. Qihe Xu ( 徐啟河 ), Session Chair Co Director, Centre for Integrative Chinese Medicine Senior Lecturer in Renal Medicine King s College London, University of London Dr. Clara B.S. Lau ( 劉碧珊 ), Session Co Chair Deputy General Secretary, CGCM Assistant Director and MSc Programme Director Institute of Chinese Medicine, CUHK Prof. Lee Yan Sheen ( 沈立言 ), Session Co Chair Director, National Center for Food Safety Education and Research, National Taiwan University Editor in chief, Journal of Traditional & Complementary Medicine Prof. Paul Tam ( 譚廣亨 ), Panellist Vice Chairman, CGCM Vice President and Chair of Paediatric Surgery The University of Hong Kong Sharing is good practice Dr. Xu: Opening and concluding discussions. Prof. Sheen: The first 6 abstracts. Dr. Lau: The remaining 6 abstracts. Prof. Tam: To facilitate discussions.
2 Abstracts , chaired by Prof. Sheen. No. Title Institute Region Corresponding 184 Achyranthes Bidentata Extract Exerts Osteoprotective Effects on Steroid induced Osteonecrosis of the Femoral Head in Rats by Regulating RANKL/RANK/OPG Signaling 185 Tetramethylpyrazine Enhances Vascularization and Prevents Osteonecrosis in Steroid treated Rats 186 Effects of Tangshen Formula on Liver Oxidative Stress and Pathologic Changes in Type Ⅱ Diabetic Rats 187 Identification of Core Regulatory Region in QDPR Gene Promoter and Regulation of QDPR Promoter Expression by Tangshen Formula 188 Renoprotective Effect of Berberine on Kidney Injury of Type 2 Diabetic Rat Model via Upregulating Smad7 189 The Decreased Expression of Electronic Transfer Flavoprotein β Involving in Apoptosis of Renal Tubular Epithelial Cells in Diabetic Nephropathy China Academy of Chinese Medical Sciences China Japan Friendship Hospital Beijing Beijing Author Na LIN Ping LI Summaries Presented by authors: Osteoprotective effects and mechanisms of action of Jianpi Formula; Huái niú xī (Achyranthes Bidentata); Tetramethylpyrazine. Apologies from Dr. Ping LI. Presented by Qihe Xu. Reno and hepato protective effects and mechanisms of action of Tangshen Formula; Berberine. Jiang et al. China Academy of Chinese Medical Sciences 184. Huái niú xī (Achyranthes Bidentata Blume) extract exerts osteoprotective effects in a rat model of steroid induced osteonecrosis through the Receptor Activator of NFκ B (RANK)/RANK ligand/osteoprotegerin pathway Tetramethylpyrazine enhances vascularization and prevents osteonecrosis in steroid treated rats via regulating VEGF/FLK1, i.e. vascular endothelial growth factor/kinase insert domain protein receptor pathway.
3 Li & Liu et al. China Japan Friendship Hospital Tangshen formula (Shenghuangqi, Taizishen, Shudihuang, Danggui, etc) 186. Reduces liver oxidative stress and fatty liver pathologies in type 2 diabetic rats Regulates the promoter activity of QDPR, a reductase encoding gene implicated in diabetic nephropathy (DN). Sun & Wang et al. China Japan Friendship Hospital 188. Berberine has renoprotective effect in type 2 DN through up regulating Smad ETF β, expression of which is diminished in advanced DN, is proposed renoprotective; silencing the gene increases apoptosis of cultured rat kidney tubular cells.
4 Abstracts , chaired by Dr Clara Lau. 190 A Systematic Review on Toxicities of Chinese Medicines in Clinical Setting 191 Protective Effects of Herba Cistanches on Simvastatin induced Myotoxicity In Vitro 192 Pharmacokinetic Effects of Individual Herbal Preparations on Clozapine Metabolism in Rats: Evidence for Herb drug Interactions 193 Herbal Medicines for Acute Kidney Injury: Evidence, Gaps and Frontiers Hong Kong Hospital Authority The Chinese University of Hong Kong The University of Hong Kong Hong Kong Hong Kong Hong Kong Winnie SZE TO King's College London London Qihe XU Clara Bik San LAU Zhang Jin ZHANG Author presentations 194 Metabolomic Study Reveals the Effect of Huang Qin Decoction on the Gastrointestinal Toxicity Induced by Irinotecan 195 Acute and Sub acute Oral Toxicological Study of Coptis chinensis Inflorescence and Its Main Alkaloids Macau University of Science and Technology Macau Wei ZHANG Wuhan University Wuhan Youwei WANG Apologies received 190. Sze To et al. Hong Kong Hospital Authority Reviewed clinical reports on toxicity of 232 TCMs most commonly used in Hong Kong. o24%: at least one type of toxicity; o15%: cardiovascular toxicity; o9%: hepatotoxicity; and o7%: nephrotoxicity. Toxicities often associated with improper use, concurrent use of toxic related herbs or drugs, and the evidence base of causal relation is often poor.
5 191. Elaine Wat et al Chinese University of Hong Kong Statins have myotoxicity in some patients. Using L6 rat skeletal muscle cells as a model, the authors found that an aqueous extract of Roucongrong (Cistanche deserticola) dosedependently ameliorated simvastatin induced cell death and improving ATP production Wang et al The University of Hong Kong Uses of Di Huang, Wu Wei Zi, Chai Hu and Zhi Zi are associated with worse clozapine treatment outcomes. In rats, these four herbs did not appear to affect the pharmacokinetics of clozapine.
6 193. Bunel, et al. King s College London Preventing or mitigating AKI induction Promoting repair or regeneration Clearing toxins via non kidney routes Suppressing chronicity (e.g. fibrosis) Summary to literature findings 16 herbal formulae and a few herbal extracts were reported to prevent or mitigate AKI in animal models. 4 formulae or herbs accelerated recovery and/or prevented CKD in AKI animal models. 7intrarectalherbal medicines were reported to increase extrarenal clearance of uremic toxins. 13 additional clinical trials reported herbal interventions in AKI of different etiologies. Emerging evidence also supports roles for botanicals in promoting regeneration and preventing renal fibrosis. Recurring problems and limitations: Poor compliance with good practices for herbal QC and GCP.
7 194. Chen Q et al. Macau University of Science & Technology Metabolomic study reveals the effect of PHY906 (Huang Qin Decoction) on the gastrointestinal toxicity induced by chemotherapeutic drug Camptothecin 11 (CPT 11) Wang et al. Wuhan University Coptis chinensis inflorescence ( 黄连花序 )is often used as a herbal tea. Acute and sub acute oral toxicity studies, in mice and rats, of this Huanglian byproduct, reveal a rather safe profile and warrant its further R&D in food industry.
8 Panel discussions on the needs for: Industrial academic collaborations to solve the crisis of herbal identity and QC, which endanger scientific integrity; Good practices in TCM research; Caution when deciding doses and treatment duration to secure efficacy and safety; Scientific approach to quality control beyond the often arbitrary, pass criteria of pharmacopoeia; Developing ever updating open access online databases on cardio, hepato, and nephro toxicities, of botanicals and TMs; First line tools to generate reliable warning signals, given the difficulties to establish chronic toxicities of botanicals and TMs; The need for a network pharmacology approach to understand mechanisms of action.
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