Clinical Efficacy of Andrographolide Sulfonate in the Treatment of Severe Hand, Foot, and Mouth Disease (HFMD) is Dependent upon Inhibition of Neutrophil Activation.

Abstract

Andrographolide sulfonate treatment has been shown to improve clinical severe hand, foot, and mouth disease (HFMD) efficacies when combined with conventional therapy. However, the mechanisms for its therapeutic effects remain elusive. In this study, we aimed to investigate whether andrographolide sulfonate exerts its efficacy by acting on neutrophil activation. We obtained serial plasma samples at two time points (before and after 5 days of therapy) from 28 HFMD patients who received conventional therapy and 18 patients who received combination therapy (andrographolide sulfonate plus conventional therapy). Then, we measured plasma myeloperoxidase (MPO), S100A8/A9, histone, and inflammatory cytokine levels. Furthermore, we examined if andrographolide sulfonate had direct effects on neutrophil activation in vitro. We observed that MPO and S100A8/A9 levels were markedly elevated in the HFMD patients before clinical treatment. At 5 days post-medication, the MPO, S100A8/A9, histone, and interleukin-6 levels were markedly lower in the combination therapy group compared with the conventional therapy group. In vitro studies showed that andrographolide sulfonate inhibited lipopolysaccharide-stimulated neutrophil activation, demonstrated by the decreased production of reactive oxygen species and cytokines. These data indicate that neutrophil activation modulation by andrographolide sulfonate may be a critical determinant for its clinical HFMD treatment efficacy. Copyright © 2015 John Wiley & Sons, Ltd.

• Authors: Tao Wen, Wenjun Xu, Lianchun Liang, Junhong Li, Xiaorong Ding, Xiao Chen, Jianhua Hu, Aiping Lv, Xiuhui Li
• Journal: Phytotherapy research : PTR (Phytother Res) Vol. 29 Issue 8 Pg. 1161-7 (Aug 2015) ISSN: 1099-1573 [Electronic] England
• PMID: 25960284 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 John Wiley & Sons, Ltd.

Chemical References

• Antiviral Agents
• Diterpenes
• Histones
• IL6 protein, human
• Interleukin-6
• Lipopolysaccharides
• Reactive Oxygen Species
• S100 Proteins
• andrographolide
• Peroxidase

Topics

• Antiviral Agents (therapeutic use)
• Child, Preschool
• Diterpenes (therapeutic use)
• Female
• Hand, Foot and Mouth Disease (drug therapy)
• Histones (blood)
• Humans
• Infant
• Interleukin-6 (blood)
• Lipopolysaccharides
• Male
• Neutrophil Activation
• Peroxidase (blood)
• Reactive Oxygen Species (metabolism)
• S100 Proteins (blood)
• Treatment Outcome