Combinatory effects of current regimens and Guizhi Fuling Wan on the development of endometriosis

Chih-Chen Chen; Chun-Yen Huang; Li-Yen Shiu; Ya-Chun Yu; Jui-Chi Lai; Chi-Chang Chang; Chi-Feng Fu; S Joseph Huang

doi:10.1016/j.tjog.2021.11.013

Combinatory effects of current regimens and Guizhi Fuling Wan on the development of endometriosis

Taiwan J Obstet Gynecol. 2022 Jan;61(1):70-74. doi: 10.1016/j.tjog.2021.11.013.

Authors

Chih-Chen Chen¹, Chun-Yen Huang², Li-Yen Shiu³, Ya-Chun Yu², Jui-Chi Lai⁴, Chi-Chang Chang⁵, Chi-Feng Fu⁶, S Joseph Huang⁷

Affiliations

¹ Department of Obstetrics and Gynecology, E-Da Hospital, Kaohsiung, Taiwan.
² Department of Obstetrics and Gynecology, E-Da Hospital, Kaohsiung, Taiwan; Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan.
³ Center for Cell Therapy, E-Da Cancer Hospital, Kaohsiung, Taiwan; Center for Cell Therapy, E-Da Hospital, Kaohsiung, Taiwan.
⁴ Center for Cell Therapy, E-Da Cancer Hospital, Kaohsiung, Taiwan.
⁵ Department of Obstetrics and Gynecology, E-Da Da-Chang Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁶ Department of Obstetrics and Gynecology, E-Da Cancer Hospital, Kaohsiung, Taiwan. Electronic address: ed102146@edah.org.tw.
⁷ Department of Obstetrics and Gynecology, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA. Electronic address: ed108566@edah.org.tw.

PMID: 35181049
DOI: 10.1016/j.tjog.2021.11.013

Abstract

Objective: Endometriosis, defined as the growth of endometrial glands and stromal cells in a heterotopic location under the cyclic influence of ovarian hormones, is a common gynecological disorder manifested by chronic pelvic pain and infertility. In traditional Chinese medicine, endometriosis is characterized by stagnation of vital energy (qi) and blood stasis. Guizhi Fuling Wan (GFW) was first described in Chinese canonical medicine to treat disorders associated with stagnation of qi and blood stasis, including endometriosis. Therefore, the current study aimed to test the effects of combining GFW with western medicine on the suppression of endometriosis.

Materials and methods: Endometriosis was generated by suturing endometrial tissue on the peritoneal wall of C57BL/6JNarl mice. The mice were subsequently treated with either GFW or current hormonal therapies or in combination for 28 days.

Results: Endometriosis development was inhibited by GFW, Gestrinone, Visanne, GFW + Gestrinone or GFW + medroxyprogesterone acetate (MPA). The expression of intercellular adhesion molecule 1 (ICAM-1) was inhibited by GFW, Gestrinone, MPA, Visanne, GFW + Gestrinone, GFW + MPA and GFW + Visanne. Vascular endothelial growth factor (VEGF) expression was inhibited by GFW, Gestrinone, Visanne, GFW + Gestrinone and GFW + MPA. Both ICAM-1- and VEGF-reducing effects of GFW were attenuated by western medicines. Administration of GFW, MPA, Visanne, GFW + MPA and GFW + Visanne also correspondingly reduced macrophage population in peritoneal fluid. GFW, MPA, Visanne, GFW + MPA and GFW + Visanne enhanced B-cell population in peritoneal fluid.

Conclusion: The current study reveals the therapeutic effects of GFW on endometriosis. However, the combination of GFW and current hormonal therapies potentially impedes the efficacy of each individual agent in treating endometriosis.

Keywords: Endometriosis; Guizhi Fuling Wan; Traditional Chinese medicine; Western medicine.

MeSH terms

Animals
Drugs, Chinese Herbal / therapeutic use*
Endometriosis / drug therapy*
Female
Gestrinone / therapeutic use*
Intercellular Adhesion Molecule-1 / drug effects*
Medroxyprogesterone Acetate / therapeutic use*
Mice
Mice, Inbred C57BL
Vascular Endothelial Growth Factor A / drug effects*

Substances

Drugs, Chinese Herbal
Vascular Endothelial Growth Factor A
keishibukuryogan
Intercellular Adhesion Molecule-1
Gestrinone
Medroxyprogesterone Acetate