Efficacy and mechanisms of andrographolide derivative in acute exacerbations of chronic obstructive pulmonary disease: a meta-analysis, network pharmacology, molecular docking, and in vitro validation study
Abstract
Background Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) contributes substantially to morbidity and mortality. Andrographolide derivative injections (e.g., Xiyanping, Yanhuning, Chuanhuning, Lianbizhi) are widely used adjunctive treatments in China. Their clinical efficacy remains unclear, and we explored the potential mechanisms of the parent compound andrographolide in this study. Methods A systematic review and meta-analysis of 32 randomized controlled trials (n = 2,668) comparing andrographolide derivatives plus conventional therapy versus conventional therapy alone in patients with AECOPD was conducted. Pulmonary function (FEV 1 %, FEV 1 , FVC), arterial oxygen tension (PaO 2 ), inflammatory markers (CRP, WBC, NEUT%, PCT), and overall clinical response were evaluated. Network pharmacology, molecular docking, and in vitro experiments using LPS-stimulated BEAS-2B cells were performed to explore underlying mechanisms. Results Adjunctive andrographolide derivatives significantly improved overall clinical response rate [RR = 1.21, 95% CI 1.17–1.26, P < 0.00001], FEV 1 % [MD = 6.48, 95% CI 3.52–9.45], FEV 1 [MD = 0.30 L, 95% CI 0.20–0.40], FVC [MD = 0.28 L, 95% CI 0.10–0.46], and PaO 2 [MD = 6.56 mmHg, 95% CI 4.68–8.45]. Inflammatory markers were also reduced: CRP [MD = −4.72 mg/L, 95% CI -6.83 to –2.61], WBC [MD = −1.30 ×10 9 /L, 95% CI −1.79 to −0.80], NEUT% [MD = −4.36 percentage points, 95% CI -6.18 to −2.54], PCT [MD = −0.17 ng/mL, 95% CI -0.23 to…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in cell cultures (in vitro) and computer models (in silico), not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 2,668 participants or records.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.