Research Papers:

Effects of Chinese herbal medicines on the occurrence of diabetic retinopathy in type 2 diabetes patients and protection of ARPE-19 retina cells by inhibiting oxidative stress

Fuu-Jen Tsai, Te-Mao Li, Cheng-Hang Ko, Chi-Fung Cheng, Tsung-Jung Ho, Xiang Liu, Hsinyi Tsang, Ting-Hsu Lin, Chiu-Chu Liao, Ju-Pi Li, Shao-Mei Huang, Jung-Chun Lin, Chih-Chien Lin, Wen-Miin Liang and Ying-Ju Lin _

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Oncotarget. 2017; 8:63528-63550. https://doi.org/10.18632/oncotarget.18846

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Fuu-Jen Tsai1,2,3,*, Te-Mao Li1,*, Cheng-Hang Ko4,*, Chi-Fung Cheng5, Tsung-Jung Ho1, Xiang Liu6, Hsinyi Tsang6, Ting-Hsu Lin2, Chiu-Chu Liao2, Ju-Pi Li1,7, Shao-Mei Huang2, Jung-Chun Lin8, Chih-Chien Lin9, Wen-Miin Liang5,* and Ying-Ju Lin1,2,*

1School of Chinese Medicine, China Medical University, Taichung, Taiwan

2Genetic Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan

3Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan

4Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan

5Graduate Institute of Biostatistics, School of Public Health, China Medical University, Taichung, Taiwan

6National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

7Rheumatism Research Center, China Medical University Hospital, Taichung, Taiwan

8School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan

9Department of Cosmetic Science, Providence University, Taichung, Taiwan

*These authors have contributed equally to this work

Correspondence to:

Ying-Ju Lin, email: [email protected]

Wen-Miin Liang, email: [email protected]

Keywords: type 2 diabetes, diabetic retinopathy, Chinese herbal medicine, oxidative stress, retina cells

Received: March 02, 2017     Accepted: June 05, 2017     Published: June 29, 2017


Diabetic retinopathy is a microvascular complication of type 2 diabetes and the leading cause of acquired blindness. In Taiwan, Chinese herbal medicine (CHM) is a popular adjunctive therapy. In this study, we investigated the CHM prescription patterns and their effects. We identified 23,701 subjects with type 2 diabetes in a database, and after matching for age and gender, 6,948 patients each were assigned to CHM and non-CHM groups. In the female subgroups, the cumulative retinopathy probability was lower for the CHM users than that for the CHM non-users (P < 0.001, log-rank test). Among the top 10 CHMs, Jia-Wei-Xiao-Yao-San (JWXYS; 52.9%), Shu-Jing-Huo-Xue-Tang (SJHXT; 45.1%), and Ge-Gen-Tang (GGT; 43.7%) were the most common herbal formulas. Yan-Hu-Suo (48.1%), Ge-Gen (42.1%), and Huang-Qin (HQin; 40.1%) were the most common single herbs. CHM network analysis showed that JWXYS was the core CHM of cluster 1. JWXYS, DS, XF, and SZRT exhibited both of the reductions of H2O2-induced phosphorylation of p38 MAPK and p44/42 MAPK (Erk1/2) in human ARPE-19 retina cells. In cluster 2, SJHXT was the core CHM. SJHXT and NX showed both of the phosphorylation reductions. In cluster 3, GGT was the core CHM, and it reduced the phosphorylation of both MAPKs. In cluster 4, HQin was the core CHM, and it also reduced the phosphorylation of both MAPKs. Our study suggests that adjunctive CHM therapy may reduce diabetic retinopathy via antioxidant activity of the herbs and provides information on core CHM treatments for further scientific investigations or therapeutic interventions.

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