RECENT RESEARCH
Acupuncture and TCM
Tang YN, Bai YF, Dong A, Rao QL, Wu HH, Wang CG, Xu YT. Antidepressant effects of total phenols and total saponins of Kai- Xin-San mediated by synaptic plasticity induced by BDNF / TrkB / Akt pathway. J Ethnopharmacol. 2025; 353( Pt B): 120423. doi: 10.1016 / j. jep. 2025.120423.
Ethnopharmacological relevance: Kai-Xin-San( KXS) is a classic prescription for treating affective disorders in traditional Chinese medicine( TCM) over millennium. Although antidepressant effects of KXS have been demonstrated in both clinical and preclinical studies, antidepressant constituents and action mechanisms of KXS remain unclear.
Aim of the study: To reveal antidepressant constituents and action mechanisms of KXS using the method of“ fraction-spectrum-effectmechanism”.
Materials and methods: Homologous fractions of KXS were isolated through solvent extraction combined with macroporous resin chromatography methods. The quantification of the fractions was performed using chemical chromogenic methods. Antidepressant effects of the homologous fractions were assessed using tail suspension test( TST), forced swimming test( FST) and open field test( OFT) in mice. Two major fractions of total phenols( TP) and total saponins( TS) were chosen for further studies. The constituents of TP and TS were identified using UPLC- Q-Exactive Orbitrap-MS( UPLC-MS) method, and their antidepressant effects were verified on chronic restraint stress( CRS) model in mice by behavioral evaluations including sucrose preference test( SPT), TST, FST and OFT. Network pharmacology was used to predict antidepressant mechanisms of TP and TS based on the homologous constituents determined in UPLC- MS analysis. Proteomic analyses were undertaken with tissues of hippocampus( HP) and prefrontal cortex( PFC) in CRS mice treated by TP and TS. Western blot( WB) was employed to verify the findings in network pharmacology and proteomic analyses.
Results: Five homologous fractions of essential oils( EO), TP, TS, oligosaccharides( OL) and polysaccharides( PO) were isolated from KXS with homologous contents exceeding 50 %. Results of TST and FST indicated that all the five fractions significantly decreased the immobility time of mice, while OFT results exhibited that their locomotor activities remained unchanged. A total of 50 constituents and 114 constituents were identified in the TP and TS, respectively. CRS tests demonstrated that both TP and TS significantly increased the percent of sucrose consumption and decreased the immobility time in the TST and FST, without affecting their locomotor activities. Results of both network pharmacology and proteomic analyses primarily pointed to similar contents highly related to depression. GO analysis on TP and TS principally enriched in synaptic structures and functions, as well as neural metabolic and gene expression processes. KEGG analysis on TP and TS principally enriched in pathways of neurodegeneration-multiple diseases, as well as neurotrophin signaling pathway in HP and PFC. Results of WB verified that TP and TS significantly reversed the decrease in signature proteins of synaptic plasticity including presynaptic SYN1, postsynaptic PSD95 and GRIA1, as well as the underlying mechanism of BDNF / TrkB / Akt pathway in the HP and PFC induced by CRS.
Conclusion: This is the first study on antidepressant constituents and action mechanisms of KXS guided by the method of“ fraction-spectrum-effectmechanism”. Albeit the findings are still preliminary, it provides an example in methodology for unraveling the complicated chemical system and action mechanisms of TCM prescriptions.
Thompson-Lastad A, Wennik J, Swedlow P, Wu J, Hartogensis W, Jackson JLN,
Chao MT. Group-Based Integrative Pain Management: Feasibility of a Factorial Randomized Trial in Safety-Net Primary Care. J Prim Care Community Health. 2025; 16:21501319251360113. doi: 10.1177 / 21501319251360113. 2025. PMID: 40817732.
Purpose: This pilot study tested the feasibility and acceptability of a pragmatic randomized trial evaluating group-based non-pharmacologic approaches to increase access in primary care and improve pain-related outcomes.
Methods: This 2 × 2 factorial trial assessed two 12-week interventions: group acupuncture and integrative group medical visits( IGMVs). Adults with chronic pain lasting ≥3 months were enrolled from safety-net primary care clinics. Participants were randomized to group acupuncture, IGMVs, both, or neither( usual care). We analyzed data using linear mixed models, ANCOVA, and abductive qualitative analysis.
Results: Overall, 44 participants were randomized( 25 English-speaking and 19 Spanish-speaking); 59 % were female( mean age = 55 years), 21 % African American or Black, 52 % Latine, 21 % non-Latine White, and 5 % more than 1 race; and 78 % had annual income <$ 25 000. At baseline, the average duration of chronic pain was 13.0 years, and the mean pain impact score was 36.0( SD = 6.4). Participants randomized to interventions attended 6 of 12 sessions on average; 89 % would participate again; and 86 % reported clinically relevant pain improvements versus 20 % in usual care( P <. 001). Qualitative data revealed substantial barriers to accessing multimodal care and social benefits of group-based models.
Conclusion: Group-based integrative pain management is feasible and acceptable when co-located within safety-net primary care.
Clinicaltrials. gov Registration Number: NCT05906784( http:// clinicaltrials. gov / study / NCT05906784).
176 | vol31 | no3 | JATMS