Systematic review of anti-inflammatory effects of Chinese herbal medicines in pre-clinical and clinical studies related to mood disorders

Hou, M, Baldwin, David and Hou, Ruihua (2018) Systematic review of anti-inflammatory effects of Chinese herbal medicines in pre-clinical and clinical studies related to mood disorders. British Association for Psychopharmacology Summer Meeting, Imperial College London, London, United Kingdom. 22 - 25 Jul 2018. p. 136 .

Abstract

Introduction: Inflammatory processes may be involved in the pathogenesis of mood disorders and medications with anti-inflammatory effects may provide new treatment approaches. We aimed to review current evidence regarding the anti-inflammatory effects of Chinese herbal medicines in animal ‘models’of depression and anxiety and in patients with mood disorders. Methods: Literature search performed in scientific databases including Pubmed, China National Knowledge Infrastructure (CNKI) Database, Scopus and Web of Science. Screening, data extraction and quality assessment were conducted. Primary outcome measures were pre- and post- treatment levels of peripheral inflammatory cytokines. Results: 112 studies were initially identified: after exclusion criteria were applied six studies could be included in this review (3animal studies, 3 human studies). Soyo-san reduced IL-1β-ir neurons and depression-like responses in rats. Salvianolic acid B decreased expression of IL-1β and TNFα, and increased expression of anti-inflammatory cytokines IL-10 and TGFβ. Rhizoma drynariae reduced blood levels of IL-6 and increased levels of IL10, and reduced anxiety-like and depression-like behaviors in rats. Three randomised controlled trials(including 272 participants, with treatment duration varying between 4-8 weeks) used Chinese herbal medicine as an adjunctive treatment to treatment as usual (TAU) comparing to TAU. All three trials found a significant reduction in depressive symptom severity (P <0.05). Two RCTs included Chaihu Shugan powder combined with venlafaxine and modified Chaihu Decoction combined with paroxetine: symptoms assessed by Hamilton Depression Rating Scale reduced from32.24 to 7.20 (intervention group) compared to 32.68to 12.49 (control group). After treatment serum levels of IL_2 and TNFα were significantly decreased in the two groups (P < 0. 05), significantly more so in the treatment group than in venlafaxine or paroxetine only group (P < 0.05). The third RCT investigated modified Chaihu-jia-long gu-muli-tang combined with paroxetine, and post-treatment serum levels of IL_ 1, TNFα and IL_ 6 significantly decreased in both groups (P < 0.05), significantly more so in the treatment group than in paroxetine only group (P <0.05). Conclusion: Certain Chinese herbal medicines have anti-inflammatory effects in pre-clinical and clinical studies, suggesting potential benefits in patients with depressive and anxiety disorders. Further exploratory studies and placebo-controlled randomised trials are warranted to explore potential clinical applications.

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Contributors

Author: David Baldwin

Author: Ruihua Hou

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