Study finds that heat is effective in treating throat condition

ASSOCIATED PRESS – Zapping away abnormal, precancerous cells in the throat may lower the risk of later developing esophageal cancer, the first major study to test this technique finds. Read more

Baby broccoli kills bacterial cause of ulcers, stomach cancer

Johns Hopkins Medical Institutions – A small, pilot study in 50 people in Japan suggests that eating two and a half ounces of broccoli sprouts daily for two months may confer some protection against a rampant stomach bug that causes gastritis, ulcers and even stomach cancer. Read more

Cirrhosis runs in the family, study says

Mayo Clinic release – Mayo Clinic researchers have found that first-degree relatives (i.e., parents, siblings, children) of patients with primary biliary cirrhosis (PBC) are more likely to have the biomarker of the disease in their blood. Armed with this new information, physicians could screen and assess first-degree relatives of PBC patients with a simple blood test, enabling them to diagnose and treat more patients before the disease causes irreversible liver damage. These findings were published in this month’s issue of Hepatology. Read more

Chinese medicine bowel drug ‘positive’

Independent, Bloomberg, MediTech release – Hutchison China MediTech, an AIM-listed drug discovery group majority owned by Hutchison, the Hong Kong-based conglomerate and Asia’s largest company, is on the verge of making its first breakthrough after successful Phase II trials of HMPL-004, its ulcerative colitis and Crohn’s disease treatment.

Hutchison set up China MediTech as a first foray into the international pharmaceutical market and the positive trial data is derived from a compound found in traditional Chinese medicine, seen as a rich source of new drugs by many in the pharmaceutical industry. As a result of its long history of use among Chinese patients, the drug was able to bypass Phase I trials and move straight into FDA-approved Phase II.

What is Intestinal Bowel Disease? Ulcerative colitis and Crohn’s Disease are forms of inflammatory bowel disease, which is considered an auto-immune disorder. They are chronic diseases which, once they start, recur regularly and cannot currently be cured. Ulcerative colitis generally affects the large intestine and Crohn’s disease generally affects the small intestine. Ulcerative colitis is the inflammation of the gut, which results in extensive ulceration of its inner surface with consequential pain, loss of function and blood loss. The disease can require surgical removal of sections of the gut and, in extreme cases, it may cause death.

Crohn’s disease displays similar but more severe laceration of the lining of the small intestine. Current first line treatments have effect on around 60% of patients. They can cause adverse events such as nausea, heartburn, diarrhea and headaches. Second line treatments can cause more severe adverse events and can be significantly more expensive.

In 2005 in the US, ulcerative colitis affected approximately 347,000 patients, an increase from around 300,000 patients in 2001. Potentially a further two to three times as many individuals may suffer from ulcerative colitis but are currently undiagnosed. Crohn’s disease is more prevalent with an estimated 558,000 cases in the US in 2005.

Current treatments include Aminosalicylates (5-ASAs) to reduce and control inflammation. In addition, corticosteroids and immunomodulators are prescribed for patients who do not respond to first line treatments.

The Phase II proof-of-concept study was a multicentre, randomized, double-blind, comparator study of 120 patients with mild-to-moderate ulcerative colitis conducted in China. The study evaluated HMPL-004 at 400mg taken three times a day, orally, compared to Mesalazine, the current first-line standard of care. The four trial endpoints were patients: clinical symptom score; overall clinical evaluation; colonoscopic score; and safety evaluation.

After treatment for eight weeks, the percentage of patient’s clinical symptom score reduction for HMPL-004 was 56% versus 59% for Mesalazine in the Intent-To-Treat population. The overall remission rate (combination of complete and partial remissions) for HMPL-004 was 57% by clinical score compared to 53% for Mesalazine in the Intent-To-Treat population and 47% for HMPL-004 versus 42% for Mesalazine by colonoscopy in the Intent-To-Treat population.

HMPL-004 was well tolerated in the study and the adverse event rate was half that of the Mesalazine group.

How does HMPL-004 work? Extensive preclinical work with HMPL-004 has shown that HMPL-004 acts on multiple cellular targets in the inflammatory signal transduction pathways resulting in suppressed inflammation cytokine expression including TNF-alpha, IL-1beta and IL-6.

HMPL-004 was demonstrated to inhibit TNF-alpha and IL-1beta production in cell-based assays and is also able to inhibit NF-kB activation. The novel mechanism of action of HMPL-004, compared to current conventional therapies, including Mesalazine, allows it to access a unique patient population.

Moreover, Mesalazine is well known to be effective in about 60% of the patients it is used in and patients’ resistance over long-term use is common.

HMPL-004 is an orally active, proprietary botanical product that acts on multiple targets in the pathogenesis of inflammation. It is a compound extracted from a Chinese herb that has extensive history of use in China and South East Asia against respiratory infections and inflammation.

The broker Investec believes that the successful commercialisation of the drug could result in it taking at least 20% of the global market by 2012 – a market that is currently worth a combined $3b per year, and that the drug could be worth an extra 80p per share for China MediTech. Shares in the company closed 2.5p better yesterday at 155p.

The US market for ulcerative colitis drugs was estimated to be US$420m in 2002 and is expected to reach US$500m by 2012, a CAGR of four percent. The US market for Crohn’s Disease drugs was estimated to be US$590m, growing to around US$980m by 2012. In both cases, the global market is estimated to be twice the size of the US. Global sales of ulcerative colitis drugs are estimated to reach US$1b by 2012 and, for Crohn’s Disease, the estimate is around US$2b.

Catepillar fungus powerful to relieve liver fibrosis

CM NEWS - A traditional Chinese medicine as expensive as gold could be more precious than gold as it may now be able to turn back the clock for patients with liver fibrosis. Read more

Constipation gets relief from moxibustion

CM NEWS – A special form of acupoint treatment can help push your bowel without needing you to take any medication, a recent study finds.

To test the therapeutic effect, safety of acupoint application for treatment of constipation, scientists of the First Hospital of Guangzhou University of TCM in China used a special form of acupoint treatment called herbs-partitioned moxibustion (隔藥灸).

42 cases were randomly divided into a treatment group of 22 cases and a control group of 20 cases.

In herbs-partitioned moxibustion, a small “cake” made up of herbs was placed on the specific acupoints and was lit up.

In this study, the special herbal cake was made with Sanleng (三棱, Rhizoma Spargani), Ezhu (莪朮, Rhizoma Zedoariae), Dahuang (大黃, Radix et Rhizoma Rhei) and Bingpian (冰片, Borneolum). The cake was then applied at acupoints Tianshu (天樞穴, ST 25), Qihai (氣海穴, CV 6), Guanyuan (關元穴 CV 4).

The control group were treated with oral administration of Congrong Tongbian Oral Liquid (蓯蓉通便口服液), a laxative that can be bought over the counter.

Acupoint Tianshu has been clinically proven to be effective in dealing with constipation for centuries. In combination with other adjuvant points as indicated by symptom differentiation, are very effective in the treatment of diseases of the digestive system.

Acupoint Qihai has been involved in treating back pain, overly frequent urination at night, and some gynecological conditions.

Acupoint Guangyuan is said to be effective in treating urological diseases, erectile dysfunction, menstrual cramps etc. It’s also involved in treating insomnia and panic disorder.

What is moxibustion? Practitioners use moxa, or mugwort herb, to warm regions and acupuncture points with the intention of stimulating circulation through the points and inducing a smoother flow of blood and qi.

Medical historians believe that moxibustion pre-dated acupuncture, and needling came to supplement moxa after the 2nd century BC. Different schools of acupuncture use moxa in varying degrees. For example a 5-element acupuncturist will use moxa directly on the skin, whilst a TCM-style practitioner will use rolls of moxa and hold them over the point treated. It can also be burnt atop a fine slice of ginger root to prevent scarring.

There are two types of moxibustion: direct and indirect. In direct moxibustion, a small, cone-shaped amount of moxa is placed on top of an acupuncture point and burned. This type of moxibustion is further categorized into two types: scarring and non-scarring. With scarring moxibustion, the moxa is placed on a point, ignited, and allowed to remain onto the point until it burns out completely. This may lead to localized scarring, blisters and scarring after healing.

With non-scarring moxibustion, the moxa is placed on the point and lit, but is extinguished or removed before it burns the skin. The patient will experience a pleasant heating sensation that penetrates deep into the skin, but should not experience any pain, blistering or scarring unless the moxa is left in place for too long.

Indirect moxibustion is currently the more popular form of care because there is a much lower risk of pain or burning. In indirect moxibustion, a practitioner lights one end of a moxa stick, roughly the shape and size of a cigar, and holds it close to the area being treated for several minutes until the area turns red. Another form of indirect moxibustion uses both acupuncture needles and moxa. A needle is inserted into an acupoint and retained. The tip of the needle is then wrapped in moxa and ignited, generating heat to the point and the surrounding area. After the desired effect is achieved, the moxa is extinguished and the needle(s) removed.

In the present study, a herbal cake was applied on the acupoints instead of moxa. This practice is also called herbs-partitioned moxibustion (隔藥灸).

The results were very positive for the moxibustion group. The total effective rate was 81.8% in the treatment group and 50.0% in the control group, the treatment group being better than the control group (P < 0.05).

Patients in the treatment group made their first bowel movement 5.1 hours +/- 2.8 hours after treatment, whereas the first defecation time for the control group was 10.1 hours +/- 7.3 hours after treatment.

The scientists then conclude that TCM acupoint application therapy has a definite therapeutic effect on constipation.

[Zhongguo Zhen Jiu. 2007 Mar;27(3):189-90.]

acupuncture

TCM herb can treat acutely inflammed pancreas

CM NEWS – A common Chinese herb dan shen (丹参, Salvia miltiorrhiza) may help patients with severe acute pancreatitis, in which the pancreas is dying from the acute inflammation, by controlling the serum levels of cytokines that play a key role in advancing inflammation to mulitple organs.

In the present study by researchers at the Department of Gastroenterology of Yingtan 184 Hospital in Jiangxi, China, 36 patients with severe acute pancreatitis were randomly divided into dan shen-treated group and non-danshen-treated group with eighteen patients in each group. 14 age-matched healthy volunteers were assigned to control group.

What is acute pancreatitis? Pancreatitis is a condition associated with development of acute and sudden inflammation of the pancreas. Experimental data show that during an attack of pancreatitis, pancreatic enzymes are released in the abdomen and cause inflammation by the damage from digestion of normal body structures, especially fat in the abdomen. In about 85% of patients, acute pancreatitis is a mild disease and is usually associated with a rapid recovery within a few days of onset of the illness.

Gallstones and excessive alcohol usage are the most common causes for injury to the pancreas and account for more than 85% of all patients that develop pancreatitis. Many medications, and conditions such as hyperlipidemia (high levels of fat in the blood), and hypercalcemia (high levels of calcium in the blood) may also cause pancreatitis.

In about 15-20% of patients with acute pancreatitis, severe damage to the pancreas may lead to a life threatening illness that is often associated with prolong hospitalization, multiple surgical procedures, and death in some patients. Severe acute pancreatitis usually develops when parts of the pancreas become necrotic (dead) from the acute inflammation. Many of the complications seen in severe acute pancreatitis are associated with the presence of this dead pancreatic tissue in the abdomen.

Severe acute pancreatitis is a serious and life threatening disease and require intensive and aggressive management of multiple organ failure and severe infective complications that develop in these patients. Many of the complications seen in severe acute pancreatitis are associated with the presence of the dead pancreatic tissue in the abdomen.

The researchers tested patients’ serum levels of three cytokines: interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) within 24 hours of admission and 7 days after admission.

What are cytokines? Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. These chemical signals are similar to hormones and neurotransmitters and are used to allow one cell to communicate with another. While hormones are released from specific organs into the blood and neurotransmitters are released by nerves, cytokines are released by many types of cells. They are particularly important in both innate and adaptive immune responses. Due to their central role in the immune system, cytokines are involved in a variety of immunological, inflammatory and infectious diseases.

Some patients with severe acute pancreatitis progress from a limited local inflammation to a potentially dangerous systemic inflammatory response. According to literature, the probable cause is high levels of circulating proinflammatory cytokines, which induce activated white cells to escape into the tissue parenchyma of lungs, kidneys, liver, haemopoetic and vascular system. Cytokine release from tissue macrophages are thought to be the trigger for the cytokine cascade.

This event leads to the migration of blood monocytes and neutrophils to the site of injury and these cells are then capable of secreting a large variety of damaging inflammatory mediators. The degree to which these mediators escape into the circulation contributes to the induction of the systemic inflammatory response syndrome (SIRS), acute phase response, and multiple organ failure. Organ dysfunction occurs in one in four patients with acute pancreatitis and 60% of patients who die in the first week of the disease die from pulmonary damage resulting from adult respiratory distress syndrome.

Controlling the levels of pro-inflammatory cytokines thus becomes a crucial way to prevent inflammation to advance to multiple organs.

The results of the present study show that serum levels of the three cytokines were significantly decreased in both dan shen-treated group and non-dan shen-treated group after 7-day treatment. The declining of the serum levels of the three cytokines in danshen-treated group was more obvious than that in non-dan shen-treated group.

The researchers thus conclude that by reducing serum levels of the three cytokines, dan shen can treat patients with severe acute pancreatitis.

[Zhong Xi Yi Jie He Xue Bao. 2007 Jan;5(1):28-31.]

See also:
Danshen can reduce blood pressure, study says

chinese medicine

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