Differentiation of Yin, Yang and Stasis Syndromes in Severe Aplastic Anemia Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation and Their Correlation with Iron Metabolism, CAMP/cGMP, 17-OH-CS and Thyroxine

Overview

Journal J Blood Med

Publisher Dove Medical Press

Specialty Hematology

Date 2021 Nov 22

PMID 34803418

Citations 2

Authors

Huijin Hu

Tao Chen

Wenbin Liu

Yiping Shen

Qiushuang Li

Yuhong Zhou

Baodong Ye

Dijiong Wu

Affiliations

Soon will be listed here.

Abstract

Objective: To better understanding and differentiation of traditional Chinese medicine (TCM) syndromes in severe aplastic anemia (SAA) patients undergoing hematopoietic stem cell transplantation (Allo-HSCT) and their correlation with iron metabolism, cAMP/cGMP, 17-OH-CS and thyroxine.

Methods: Eighteen patients with SAA who underwent HSCT were enrolled. The syndrome was evaluated before conditioning and days after stem cell reinfusion (-10d, -1d, +7d, +30d, +60d, and +90d). The correlation of TCM syndrome (Yin, Yang, and stasis) to cyclic nucleotides, 17-OH-CS, thyroxine, and iron metabolism were analyzed and compared to data from normal subjects.

Results: More "Yin deficiency" (n=11, 11/18) syndrome was observed before HSCT, and nearly 61% was complicated with "blood stasis". After conditioning, the proportion of "kidney Yin and Yang deficiency" increased to 61.6%. Fourteen days after HSCT, the syndrome developed into "Spleen-Kidney Yang Deficiency," and the stasis score decreased. On +90day, majority patients were diagnosed with "Kidney Yang Deficiency" (35.7%) or "Spleen-Kidney Yang Deficiency" (28.6%), and 88.9% were diagnosed without stasis. The correlation analysis showed that cGMP might represent "Deficient Yang" as well as low total triiodothyronine (T3) and free T3 (FT3). There was also a positive relation between labile plasma iron (LPI), hepcidin, soluble transferrin receptor (sTfR), and "Yin deficiency", and the last two factors, along with marrow nitric oxide synthase were also positively related to "Stasis" syndrome.

Conclusion: During HSCT, the syndrome evolved from "kidney Yin and Yang deficiency" to "kidney Yang deficiency" or "spleen-kidney Yang deficiency", and the "stasis" along with "Yin deficiency" syndromes were quickly relieved within 90 days. The changes of cyclic nucleotides, 17-OH-CS, thyroxine, and iron metabolism indexes can be applied for better differentiation of TCM syndrome.

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References

Yu W, Zhao H, Zong X, Ji X, Han X, Wang Y . The Effects of Radix Astragali Water Abstract on Energy Metabolism in Rat Yang-Deficiency Cold Syndrome Model through PPAR Signaling Pathway. Evid Based Complement Alternat Med. 2018; 2018:9194362. PMC: 6241352. DOI: 10.1155/2018/9194362. View

. [Chinese expert consensus on the diagnosis and treatment of aplastic anemia (2017)]. Zhonghua Xue Ye Xue Za Zhi. 2017; 38(1):1-5. PMC: 7348398. DOI: 10.3760/cma.j.issn.0253-2727.2017.01.001. View

Kuang A . [Preliminary observation on endocrine and immune functions and concentration of cyclic nucleotides in plasma in "deficiency of yang" (author's transl)]. Zhonghua Nei Ke Za Zhi. 1979; 18(2):105-8. View

Zeng Y, Li T, Zhang X, Ren Y, Huang Q, Wang J . Effects of Haima Duobian Pill in a Rat Model of Kidney Yang Deficiency Syndrome. Evid Based Complement Alternat Med. 2021; 2021:6696234. PMC: 7806378. DOI: 10.1155/2021/6696234. View

Zhu N, Wu D, Ye B . The Progress of Traditional Chinese Medicine in the Treatment of Aplastic Anemia. J Transl Int Med. 2019; 6(4):159-164. PMC: 6326026. DOI: 10.2478/jtim-2018-0031. View

Dijiong W, Xiaowen W, Linlong X, Wenbin L, Huijin H, Baodong Y . Iron chelation effect of curcumin and baicalein on aplastic anemia mouse model with iron overload. Iran J Basic Med Sci. 2019; 22(6):660-668. PMC: 6570746. DOI: 10.22038/ijbms.2019.30840.7440. View

Ye B, Zhang X, Shao K, Chen D, Zhang Y, Wu D . Combined use of Chinese medicine with allogeneic hematopoietic stem cell transplantation for severe aplastic anemia patients. Chin J Integr Med. 2014; 20(12):903-9. DOI: 10.1007/s11655-014-2026-9. View

Ji B, Li Y, Yang W, Zhang L, Fang M, Fu H . Jinkui Shenqi Pills Ameliorate Asthma with "Kidney Yang Deficiency" by Enhancing the Function of the Hypothalamic-Pituitary-Adrenal Axis to Regulate T Helper 1/2 Imbalance. Evid Based Complement Alternat Med. 2018; 2018:7253240. PMC: 5822917. DOI: 10.1155/2018/7253240. View

Killick S, Bown N, Cavenagh J, Dokal I, Foukaneli T, Hill A . Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol. 2015; 172(2):187-207. DOI: 10.1111/bjh.13853. View

10.

Young N, Calado R, Scheinberg P . Current concepts in the pathophysiology and treatment of aplastic anemia. Blood. 2006; 108(8):2509-19. PMC: 1895575. DOI: 10.1182/blood-2006-03-010777. View

11.

Xu Z, Zhou M, Jia J, Mo W, Zhang X, Zhang Y . Immunosuppressive therapy versus haploidentical transplantation in adults with acquired severe aplastic anemia. Bone Marrow Transplant. 2019; 54(8):1319-1326. DOI: 10.1038/s41409-018-0410-3. View

12.

Ma R . Treatment of bone marrow failure syndrome with integrated traditional and Western medicine. Chin J Integr Med. 2007; 13(2):85-8. DOI: 10.1007/s11655-007-0085-x. View

13.

Gattermann N . Iron overload in myelodysplastic syndromes (MDS). Int J Hematol. 2017; 107(1):55-63. DOI: 10.1007/s12185-017-2367-1. View

14.

Wang Q, Ren X, Yao S, Wu H . Clinical observation on the endocrinal and immune functions in subjects with yin-deficiency constitution. Chin J Integr Med. 2010; 16(1):28-32. DOI: 10.1007/s11655-010-0028-9. View

15.

Jin P, Wang J, Li X, Wang M, Ge M, Zhang J . Evolution of iron burden in acquired aplastic anemia: a cohort study of more than 3-year follow-up. Int J Hematol. 2014; 101(1):13-22. DOI: 10.1007/s12185-014-1708-6. View

16.

Camitta B . Pathogenesis and treatment of aplastic anemia. Rinsho Ketsueki. 1984; 25(4):459-69. View

17.

Li G, Wang Q, Liu F . [Experimental study of warming and recuperating kidney yang by you-gui-yin]. Zhong Xi Yi Jie He Za Zhi. 1990; 10(9):547-8, 518. View

18.

Wu D, Ye B, Hu Z, Shen Y, Shen J, Lin S . Bone marrow angiogenesis in patients presenting with differential Chinese medicine syndrome: correlation with the clinico-pathological features of aplastic anemia. Chin J Integr Med. 2013; 19(12):905-12. DOI: 10.1007/s11655-013-1652-y. View

19.

Wu D, Shen Y, Ye B, Fang B, Lin S, Chen Z . Efficacy and advantages of modified Traditional Chinese Medicine treatments based on "kidney reinforcing" for chronic aplastic anemia: a randomized controlled clinical trial. J Tradit Chin Med. 2017; 36(4):434-43. DOI: 10.1016/s0254-6272(16)30059-0. View

20.

Zheng B, Shen J, Zhuang H, Lin S, Shen Y, Zhou Y . Treatment of severe aplastic anemia by immunosuppressor anti-lymphocyte globulin/anti-thymus globulin as the chief medicine in combination with Chinese drugs. Chin J Integr Med. 2009; 15(2):145-8. DOI: 10.1007/s11655-009-0141-9. View