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Realgar and cinnabar are essential components contributing to neuroprotection of Angong Niuhuang Wan with no hepatorenal toxicity in transient ischemic brain injury.

Abstract
Realgar and cinnabar are commonly used mineral medicine containing arsenic and mercury in Traditional Chinese Medicine (TCM). Angong Niuhuang Wan (AGNHW) is a representative realgar- and cinnabar-containing TCM formula for treating acute ischemic stroke, but its toxicology and neuropharmacological effects are not well addressed. In this study, we compared the neuropharmacological effects of AGNHW and modified AGNHW in an experimental ischemic stroke rat model. Male SD rats were subjected to 2 h of middle cerebral artery occlusion (MCAO) plus 22 h of reperfusion. Although oral administration of AGNHW for 7 days in the rats increased arsenic level in the blood and liver tissue, there were no significant changes in the arsenic level in kidney, mercury level in the blood, liver and kidney as well as hepatic and renal functions in MCAO rats. AGNHW revealed neuroprotective properties by reducing infarction volume, preserving blood-brain barrier integrity and improving neurological functions against cerebral ischemia-reperfusion injury. Interestingly, removing realgar and/or cinnabar from AGNHW abolished the neuroprotective effects. Meanwhile, AGNHW could scavenge peroxynitrite, down-regulate the expression of p47phox, 3-NT and MMP-9 and up-regulate the expression of ZO-1 and claudin-5 in the ischemic brains, which were abolished by removing realgar and/or cinnabar from AGNHW. Notably, realgar or cinnabar had no neuroprotection when used alone. Taken together, oral administration of AGNHW for one week should be safe for treating ischemic stroke with neuroprotective effects. Realgar and cinnabar are necessary elements with synergetic actions with other herbal materials for the neuroprotective effects of AGNHW against cerebral ischemia-reperfusion injury.
AuthorsBun Tsoi, Songlin Wang, Chong Gao, Yunhao Luo, Wenting Li, Dan Yang, Depo Yang, Jiangang Shen
JournalToxicology and applied pharmacology (Toxicol Appl Pharmacol) Vol. 377 Pg. 114613 (08 15 2019) ISSN: 1096-0333 [Electronic] United States
PMID31207256 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2019. Published by Elsevier Inc.
Chemical References
  • Arsenicals
  • Biological Products
  • Free Radical Scavengers
  • Mercury Compounds
  • Neuroprotective Agents
  • Sulfides
  • niuhuang
  • arsenic disulfide
  • Mercury
  • Arsenic
  • cinnabar
Topics
  • Animals
  • Arsenic (blood, metabolism)
  • Arsenicals (chemistry, pharmacology)
  • Biological Products (chemistry, pharmacology)
  • Chemical and Drug Induced Liver Injury (pathology)
  • Free Radical Scavengers (pharmacology)
  • Infarction, Middle Cerebral Artery (pathology, prevention & control)
  • Ischemic Attack, Transient (drug therapy, pathology)
  • Kidney Diseases (chemically induced, pathology)
  • Male
  • Medicine, Chinese Traditional
  • Mercury (blood, metabolism)
  • Mercury Compounds (chemistry, pharmacology)
  • Neuroprotective Agents (pharmacology)
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury (pathology, prevention & control)
  • Sulfides (chemistry, pharmacology)

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