Frontiers in Pharmacology最新文献

{"title":"A systematic review of progress toward unlocking the power of epigenetics in breast cancer: latest updates and perspectives.","authors":"Ghallab Alotaibi","doi":"10.3389/fphar.2025.1628165","DOIUrl":"10.3389/fphar.2025.1628165","url":null,"abstract":"<p><p>Breast cancer (BC) is among the most prevalent malignancies globally. It is progressively acknowledged as a diverse type of cancer, exhibiting considerable differences in its genomic and transcriptomic characteristics. Its growing evidence highlights the substantial role of epigenetic modification in pathogenesis, prognosis and treatment. Cancer and epigenetics are closely linked; abnormal epigenetic changes can influence numerous aspects of cancer biology, including unusual transcription patterns, initiation of cancer, its progression, resistance to drugs, and metastasis. Epigenetic drugs (epi-drugs), including DNA methyltransferase (DNMT) and histone deacetylase (HDAC) inhibitors, serve as promising therapeutic agents, particularly in combination with conventional therapies. Additionally, nanotechnology-assisted epi-drug delivery systems are emerging as innovative approaches to enhance treatment efficacy and reduce systemic toxicity. While several epigenetic biomarkers have shown potential in liquid and tissue biopsies, their clinical validation remains a challenge. The integration of epigenetic insights into personalized medicine could revolutionize BC management, offering more targeted and effective treatment strategies. This systematic review aims to evaluate recent advancement in epigenetic research related to BC, focusing on diagnostic and prognostic biomarkers, epigenetic-based therapies and ongoing clinical trials. A comprehensive literature search was carried out in databases like PubMed, Scopus, and Google Scholar up to January 2025, following PRISMA guidelines. Seventy two (72) studies were included, addressing key aspects of DNA methylation, histone modification, and non-coding RNAs as potential biomarkers for early detection and disease progression monitoring.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1628165"},"PeriodicalIF":4.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Luteolin improves the systolic and diastolic functions of the thoracic aortic vessels in type 2 diabetic rats through the Kv7.1 channel.","authors":"Weiping Li, Zerong Yang, Xingru Wang, Pengmei Guo, Li Wu, Yanru Wang, Yue Lyu, Xiaojia Xu, Haijie Ji","doi":"10.3389/fphar.2025.1651847","DOIUrl":"10.3389/fphar.2025.1651847","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the therapeutic effects of luteolin (Lut) on vascular dysfunction in type 2 diabetic rats and explore its underlying mechanisms, particularly its regulation of the myogenic response in thoracic aortic vessels via the Kv7.1 (KCNQ1) channel.</p><p><strong>Methods: </strong>Type 2 diabetes mellitus (T2DM) was induced in rats via high-fat/high-glucose diet combined with intraperitoneal streptozotocin (30 mg/kg). Animals were assigned to four groups: normal control (NC), NC + Lut (80 mg/kg), diabetic (DM), and DM + Lut. Fasting blood glucose, body weight, lipid profile, and blood pressure were monitored. Myogenic response of the thoracic aorta was assessed using vascular ring tension assays. Expression of KCNQ1 was evaluated via qRT-PCR. <i>In vitro</i>, A7r5 cells were cultured under normal (5.5 mM) or high glucose (30 mM) conditions, with or without the addition of chromanol 293B (Kv7.1 inhibitor) or PDBu (PKC agonist), the effects of Lut on the expression of KCNQ1 and Kv7.1 were observed by qRT-PCR and cellular immunofluorescence assay.</p><p><strong>Results: </strong>Luteolin significantly reduced fasting blood glucose, lowered blood pressure, and improved lipid parameters in diabetic rats. It attenuated the enhanced vasoconstriction and impaired vasodilation observed in DM rats. KCNQ1 expression was downregulated in DM rats but restored by Lut treatment. In A7r5 cells, Lut increased KCNQ1 and Kv7.1 expression, which was inhibited by high glucose or PKC activation.</p><p><strong>Conclusion: </strong>Luteolin improves vascular tone and function in diabetic rats by restoring Kv7.1/KCNQ1 expression, possibly through inhibition of PKC signaling. These findings highlight Kv7.1 as a potential therapeutic target for diabetic vascular complications.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1651847"},"PeriodicalIF":4.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the lysine histone methylase KMT2D in chronic myeloid leukemia.","authors":"Lina Schlemminger, Inga Nagel, Inga Vater, Ingolf Cascorbi, Meike Kaehler","doi":"10.3389/fphar.2025.1652373","DOIUrl":"10.3389/fphar.2025.1652373","url":null,"abstract":"<p><p>Chronic myeloid leukemia (CML) can be effectively treated inhibiting the disease-causing BCR::ABL1 kinase by tyrosine kinase inhibitors (TKIs). Although therapy is initially tremendously successful, resistance may occur in up to 25% of CML patients. Besides aberrations in the BCR::ABL1 kinase domain, a variety of resistance mechanisms are currently discussed, among them epigenetic reprogramming. The histone-modifying enzyme lysine methyltransferase 2D (KMT2D/MLL2) belongs to the most frequently mutated genes in cancer and is also known for its association with hereditary Kabuki syndrome. However, its role in CML is widely unknown. In the present study, we analyzed the role of the <i>KMT2D</i> p. (Arg191Trp) variant in imatinib-resistant CML, which was recurrently acquired in imatinib resistance <i>in vitro</i>. SiRNA-mediated <i>KMT2D</i> knockdown, but also introduction of the p. (Arg191Trp) variant into treatment-naïve K-562 cells led to impaired imatinib susceptibility visible by increased cell numbers, proliferation rates and metabolic activities under imatinib exposure (p < 0.001). The effect of <i>KMT2D</i> p. (Arg191Trp) could be overcome by inhibiting histone demethylation with the demethylase inhibitor LSD1. In addition, rescue of <i>KMT2D</i> expression in imatinib-resistant cells reinstated the response to imatinib treatment. Furthermore, gene expression analysis revealed upregulation of <i>CCNE2</i> in cells harboring <i>KMT2D</i> p. (Arg191Trp) potentially explaining increase in cell proliferation under imatinib exposure. Overall, our findings demonstrate that the loss of the tumor suppressor <i>KMT2D</i> promotes TKI resistance in CML. Thus, <i>KMT2D</i> status could serve as an additional biomarker for TKI resistance, while restoration of its expression might be a therapeutic option to overcome this resistance.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1652373"},"PeriodicalIF":4.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promising therapeutics of enterovirus 71 infection: sunshine behind cloud.","authors":"Sheng-Yu You, Shun-Hua Chen, Shih-Min Wang","doi":"10.3389/fphar.2025.1652159","DOIUrl":"10.3389/fphar.2025.1652159","url":null,"abstract":"<p><p>Enterovirus 71 (EV71) infection gave a hard hit on young children because of fatal complication, brainstem encephalitis with pulmonary edema. The occurrence of severe EV71 infections highlight the urgent need for the development and repurposing of novel antivirals for medical use. Drugs target specific steps in the cycle of viral replication, and the modification of existing factors in EV71 immunopathogenesis deciphers the current approaches for developing antivirals. In addition to identifying chemical compounds, we highlight active constituents and explore underlying mechanisms of action of antimicrobial peptides and natural products that may be active against EV71 and provide pharmacological benefits.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1652159"},"PeriodicalIF":4.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical frankincense treatment on relieving high-risk diabetic foot in rats by reducing inflammation and improving microcirculation.","authors":"Si-Yuan Ma, Xin Yin, Zhao Zhang, Yu-Sang Li, He-Bin Tang","doi":"10.3389/fphar.2025.1564236","DOIUrl":"10.3389/fphar.2025.1564236","url":null,"abstract":"<p><strong>Background: </strong>Frankincense, an ancient aromatic substance known for promoting blood circulation, is widely used in traditional Chinese medicine to treat skin lesions.</p><p><strong>Methods: </strong>This study aimed to evaluate the efficacy and underlying mechanisms of frankincense oil extract (FOE) in addressing high-risk diabetic foot by improving microvascular circulatory disorders. The vascular repair effects of FOE were assessed in a streptozotocin-induced high-risk diabetic foot animal model. Various evaluations were performed, including infrared thermometry, motor nerve conduction velocity (MNCV) testing, laser Doppler flowmetry (LDF), hematoxylin and eosin (H&E) staining, and immunohistochemical analyses for CD31, TRPV3, β-catenin, MMP-9, and COX-2 expressions.</p><p><strong>Results: </strong>The results showed that, the femoral arteries, plantar arteries, and microvessels in high-risk diabetic foot rats displayed significant damage, evidenced by reduced blood flow velocity, ruptured vascular intima, and disorganized endothelial fibers. FOE treatment restored temperature and blood flow velocity in the foot and increased MNCV. Furthermore, FOE improved blood circulation, reversed the reduced expression of CD31, enhanced nerve sensitivity by up-regulating TRPV3 expression, and exhibited anti-inflammatory effects by reducing the overexpression of β-catenin, MMP-9, and COX-2.</p><p><strong>Conclusion: </strong>FOE effectively prevents high-risk diabetic foot by repairing vascular damage, restoring blood circulation, enhancing nerve sensitivity, and suppressing inflammatory cell infiltration. Therefore, these findings highlight the potential clinical value of FOE in managing diabetic complications.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1564236"},"PeriodicalIF":4.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of apixaban use for stroke prevention during Ramadan fasting (the API-RAM study).","authors":"Aiman Ghrab, Rania Gargouri, Faouzi Addad, Anis Cheikhrouhou, Mariem Jabeur, Selma Charfeddine, Amine Bahloul, Zied Triki, Tarek Ellouze, Omar Abidi, Souad Mallek, Faten Triki, Salem Abdessalem, Ismail Elalamy, Leila Abid","doi":"10.3389/fphar.2025.1565094","DOIUrl":"10.3389/fphar.2025.1565094","url":null,"abstract":"<p><strong>Introduction: </strong>Patients receiving anticoagulation for atrial fibrillation (AF) are required to consult their doctor before starting Ramadan fasting to get their authorization for fasting and adapt their treatment. More often, a once-daily regimen is proposed to facilitate their intake schedule. Apixaban, a direct oral anticoagulant, prescribed twice daily with an optimal benefit/risk ratio in numerous situations, has very limited data regarding its use during Ramadan.</p><p><strong>Aim: </strong>The aim of this study was to evaluate the safety and the efficacy of apixaban for stroke prevention in AF patients during the month of Ramadan.</p><p><strong>Methods: </strong>An observational, multicentric study was performed in Tunisia during two consecutive years during the specific month of Ramadan. The API-RAM study included AF patients who were on apixaban and fasted at least 10 days. Efficacy was defined by the absence of ischemic events, and safety was established by classifying bleeding events using the BARC (Bleeding Academic Research Consortium) classification during the study period.</p><p><strong>Results: </strong>A total of 257 patients were included in our study. No ischemic events were reported during the study period. Minor bleeding events were reported in only 12 patients (4.7%), with no major bleeding event. Based on multivariate analysis, independent predictors for the bleeding risk of our population were as follows: smoking, history of hypertension, and creatinine clearance.</p><p><strong>Conclusion: </strong>Apixaban seems to be safe and effective for the prevention of the thromboembolic episode in AF patients during Ramadan fasting. Larger studies such as randomized clinical trials are necessary to confirm these results.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1565094"},"PeriodicalIF":4.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticancer ethnomedicines for cancer treatment in Taiwan.","authors":"Chien-Yu Ko, Min-Han Chi, Jung Chao, Shyh-Shyun Huang, Hong-Zin Lee","doi":"10.3389/fphar.2025.1640358","DOIUrl":"10.3389/fphar.2025.1640358","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer remains a leading global health issue and has been the leading cause of death in Taiwan for over four decades. In recent years, ethnomedicines have gained growing attention as complementary therapies in cancer treatment. However, systematic investigations linking traditional medicinal practices with cancer remain limited. This study aims to explore the types, preparation methods, and parts used of anticancer ethnomedicines and cancer types across different regions in Taiwan through ethnobotanical surveys, and to preserve and transmit traditional knowledge.</p><p><strong>Methods: </strong>Data were collected through questionnaire-based interviews with 210 participants, sampled proportionally by region, age, gender, and education based on national demographics.</p><p><strong>Results: </strong>Chi-squared tests showed that only education level significantly influenced the number of anticancer ethnomedicines mentioned (<i>p</i> < 0.001), suggesting that Taiwan's policies promoting traditional medicine education may enhance knowledge retention. A total of 159 ethnomedicines were mentioned, with 146 plant species classified into 66 families, predominantly Asteraceae, Lamiaceae, and Fabaceae. The most commonly used plant parts were whole herba for herbaceous species, herba and radix for lianas, and leaves for trees and shrubs. Water decoction was the most frequently reported preparation method. The top ten mentioned ethnomedicines were traditionally used for a broader range of cancers than reported in the PubMed literature, especially for breast, lung, liver, and colorectal cancers, showing high consistency between traditional usage and modern scientific findings. Consensus factor analysis revealed high agreement among respondents regarding remedies for the ten most common cancers in Taiwan, except for prostate and oral cancers, possibly due to clinical treatment limitations or low questionnaire response rate. Taiwan's cultural diversity, linguistic unity, and unique geographical environment facilitate the accurate and comprehensive collection of ethnomedicinal data, leading to more valuable research outcomes.</p><p><strong>Discussion: </strong>In summary, the results of this study provide a valuable foundation for future anticancer research, serving as a priority focus for further investigation into the underlying mechanisms of anticancer activity. Moreover, this research supports the scientific development and potential drug discovery of ethnomedicines in modern cancer treatment, contributing to the integration of traditional knowledge with contemporary biomedical approaches.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1640358"},"PeriodicalIF":4.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between the protective effect of the orally administered atorvastatin and safflower (<i>Carthamus tinctorius)</i> in hypercholesterolemic male rats.","authors":"Haddad A El Rabey, Eman S Attia, Nadia Bakry, Samar M Rezk, Asmaa Y Sharfeldin","doi":"10.3389/fphar.2025.1663717","DOIUrl":"10.3389/fphar.2025.1663717","url":null,"abstract":"<p><p>Hyperlipidemia is correlated with the elevation of cholesterol and triglyceride levels in the blood that increase the risk of cardiovascular events, such as heart attacks and strokes. This study aimed to test the hypolipidemic activity and other health benefits of atorvastatin and safflower (<i>Carthamus tinctorius</i> L., family <i>Asteraceae</i>) on rats with induced hypercholesterolemia in a four-week study. 24 male albino rats were divided into four groups (n = 6). The first group (G1) was given a normal basal diet as a negative control, while the other rats received a high-fat diet with 5% cholesterol. The second group (G2) served as the positive control, receiving no treatment. The third group (G3) received 200 mg/kg body weight safflower aqueous extract, and the 4th group (G4) received 20 mg/kg body weight atorvastatin. The induced hypercholesterolemia significantly raised liver function enzymes, lipid peroxidation (14.9 ± 0.11 mg/dL), total cholesterol (273.3 ± 1.1 mg/dL), triglycerides (223.0 ± 4.1 mg/dL), low-density lipoproteins (204.7 ± 0.9 mg/dL), very low-density lipoproteins (44.6 ± 0.8 mg/dL), troponin, creatine kinase (CK), and adrenaline while decreased antioxidant enzymes, high-density lipoprotein (HDL), and vitamin D (11.1 ± 0.5 ng/mL). The liver and heart tissues were also significantly injured by hypercholesterolemia. Administration of atorvastatin and safflower markedly ameliorated the biochemical and histological abnormalities associated with induced hyperlipidemia, restoring them to near-normal levels. Atorvastatin treatment in G4 demonstrated superior efficacy compared to safflower extract in addressing hypercholesterolemia, despite the latter's significant hypolipidemic effect observed in G3.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1663717"},"PeriodicalIF":4.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of HRZE-based regimens in a high-burden murine model: a back-translational assessment of rifamycins and moxifloxacin substitutions in tuberculosis treatment.","authors":"Jason E Cummings, Lisa K Woolhiser, Vincent Guglielmi, Machenzie Wernsman, Ashley Romano, Samantha Pauly, John T Belisle, Nicholas D Walter, Gregory T Robertson, Richard A Slayden","doi":"10.3389/fphar.2025.1667592","DOIUrl":"10.3389/fphar.2025.1667592","url":null,"abstract":"<p><strong>Introduction: </strong>The standard treatment for tuberculosis is the isoniazid, rifampicin, pyrazinamide, and ethambutol (HRZE) regimen. Despite its efficacy, this regimen has limitations, including prolonged treatment duration and poor clinical outcomes in drug-resistant cases. This back translational study assessed the efficacy of alternative drug combinations, focusing on high-dose rifamycins (rifampicin and rifapentine) and substituting moxifloxacin for ethambutol in the HRZE regimen.</p><p><strong>Methods: </strong>Using a preclinical high-burden aerosol model of tuberculosis in BALB/c mice, we tested seven treatment combinations, including high-dose rifampicin (HD-RIF), high-dose rifapentine (HD-RPT), and moxifloxacin.</p><p><strong>Results: </strong>By day 12, the HD-RIF+HZM and HD-RPT+HZM regimens reduced lung bacterial burdens from 6.59 ± 0.08 log₁₀ CFU in untreated controls to 3.70 ± 0.19 and 3.91 ± 0.43 log₁₀ CFU, respectively. By day 54, bacterial loads were undetectable (<1 log₁₀ CFU) in all groups except for HRZE (1.48 ± 0.32 log₁₀ CFU). RS ratio analysis showed lower ratios for HD-RIF+HZM and HD-RPT+HZM compared to HRZE by day 26, indicating a superior ability of both regimens to interrupt rRNA synthesis. Histopathological analysis revealed similar granulomatous changes across all treatment groups. Mass spectrometry confirmed higher systemic exposure for HD-RIF and HD-RPT groups than RIF used in HRZE.</p><p><strong>Discussion: </strong>The findings indicate that higher doses of rifamycins and the substitution of moxifloxacin offer improved bactericidal activity and could shorten TB treatment duration.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1667592"},"PeriodicalIF":4.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy and safety of Yupingfengsan in the treatment of allergic rhinitis: a systematic review and meta-analysis.","authors":"Yi Wang, Yumei Tang, Jili Xu, Yangziting Bu, Lan Luo, Jie Wu","doi":"10.3389/fphar.2025.1628640","DOIUrl":"10.3389/fphar.2025.1628640","url":null,"abstract":"<p><strong>Background: </strong>Allergic rhinitis (AR) is a chronic, non-infectious inflammation of the nasal mucosa, primarily mediated by immunoglobulin E (IgE) following allergen exposure in atopic individuals. Yupingfengsan (YPFS), a classical traditional Chinese medicine (TCM) formula, has been used to manage AR. However, its efficacy and safety require comprehensive evaluation.</p><p><strong>Methods: </strong>This review was registered in PROSPERO (CRD420251009897). Eight databases were systematically searched up to December 2024 for randomized controlled trials (RCTs) evaluating YPFS for AR. Meta-analyses were conducted using Review Manager 5.4 and Stata 18.0. Subgroup and sensitivity analyses explored heterogeneity and result stability. Publication bias was assessed using funnel plots and Egger's test. Evidence quality was appraised with GRADEpro, and potential mechanisms of YPFS in AR were summarized.</p><p><strong>Results: </strong>Thirty-nine RCTs involving 4,578 participants met the inclusion criteria. YPFS combined with conventional pharmacotherapy significantly improved Total Nasal Symptom Score (TNSS), regulated Th1/Th2 and Treg/Th17 balance, and reduced serum IgE, IL-4, and IL-6 levels compared with conventional pharmacotherapy alone. As monotherapy, YPFS improved TNSS and lowered IgE, IL-4, and IL-6 levels more effectively than conventional treatment, though its effects on immune balance and IL-4 modulation remain uncertain due to limited data. Both regimens increased overall clinical effectiveness and reduced relapse rates. No specific adverse reactions to YPFS were reported in studies that monitored safety; however, many trials did not report adverse events, limiting conclusions about its safety profile and long-term tolerability.</p><p><strong>Conclusion: </strong>YPFS, particularly when combined with conventional pharmacotherapy, offers superior benefits over conventional treatment alone in modulating immune function, reducing inflammation, improving clinical outcomes, and lowering relapse risk in AR. YPFS monotherapy also shows potential immunomodulatory and anti-inflammatory effects. Current safety data do not indicate major concerns, but incomplete reporting and limited immune parameter data restrict definitive conclusions. High-quality, rigorously monitored RCTs are needed to confirm these findings and better define the safety of YPFS in clinical use.</p><p><strong>Systematic evaluation registry: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251009897. Identifier [CRD420251009897].</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1628640"},"PeriodicalIF":4.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}