Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory

Xin Su Ning (XSN) is a patented multicomponent medicine, which was certified in 2005 by the China State Food and Drug Administration to be produced pharmaceutically and to be used clinically. The XSN capsule was developed from an effective formula composed by Prof. Shuwen Ding of Shandong University...

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Autores principales:	Xuan Wang, Taiyi Wang, Shuwen Ding, Yu-Ling Ma
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	antiarrhythmia TCM theory cellular electrophysiology randomized clinical trial pharmacology Xin Su Ning Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/feb9f78c300248a6bb8fe922109414d4
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spelling	oai:doaj.org-article:feb9f78c300248a6bb8fe922109414d42021-11-11T08:59:16ZXin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory1663-981210.3389/fphar.2021.657484https://doaj.org/article/feb9f78c300248a6bb8fe922109414d42021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fphar.2021.657484/fullhttps://doaj.org/toc/1663-9812Xin Su Ning (XSN) is a patented multicomponent medicine, which was certified in 2005 by the China State Food and Drug Administration to be produced pharmaceutically and to be used clinically. The XSN capsule was developed from an effective formula composed by Prof. Shuwen Ding of Shandong University of Traditional Chinese Medicine. Through more than 30 years of clinical observation, Prof. Ding concluded that XSN has a significant effect on arrhythmia with phlegm-heat heart-disturbed syndrome according to the traditional Chinese medicine (TCM) diagnosis. XSN, derived from a classical TCM formula Huanglian Wen Dan Decoction, is formulated with 11 Chinese herbal medicines to treat cardiac ventricular arrhythmia. Clinical evidence suggests that it is particularly efficacious for the arrhythmias induced by cardiac ischemia and viral myocarditis without obvious adverse reactions being reported. Cellular electrophysiological studies in ventricular myocytes revealed that XSN prolongs the duration and suppresses the amplitude of the action potential (AP), which is supported by the blockage of sodium and potassium channels indicating the characteristics of class I and III antiarrhythmic drugs. A recently reported double-blind, placebo-controlled, multicenter clinical trial of XSN enrolled 861 patients (ChiCTR-TRC-14004180) and showed that XSN significantly inhibited premature ventricular contraction (PVC). The cellular electrophysiological discoveries provided the mechanistic evidence for the clinical efficacy on inhibition of PVC by XSN as demonstrated in the clinical trial. These studies, for the first time, provided exclusive evidence that multicomponent TCM antiarrhythmic medicine can be evaluated using conventional research methods that have been used for antiarrhythmic drug discoveries for decades. We aimed to give a comprehensive review on XSN including its origin with the support of TCM theory, its pre-licensing clinical use and development, and its pharmacological and clinical study discoveries. The review will be summarized with the discoveries reported in a novel network pharmacological study that introduced a weight coefficient, which made it possible to evaluate the pharmacological properties of the TCM formula with regard to its formation based on TCM theory. Limitations regarding XSN’s basic and clinical research and possible future studies are listed. We hope that the advances in how XSN was studied may offer useful guidance on how other TCM could be studied with respect to the integrity of the TCM formulas.Xuan WangTaiyi WangShuwen DingYu-Ling MaFrontiers Media S.A.articleantiarrhythmiaTCM theorycellular electrophysiologyrandomized clinical trialpharmacologyXin Su NingTherapeutics. PharmacologyRM1-950ENFrontiers in Pharmacology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	antiarrhythmia TCM theory cellular electrophysiology randomized clinical trial pharmacology Xin Su Ning Therapeutics. Pharmacology RM1-950
spellingShingle	antiarrhythmia TCM theory cellular electrophysiology randomized clinical trial pharmacology Xin Su Ning Therapeutics. Pharmacology RM1-950 Xuan Wang Taiyi Wang Shuwen Ding Yu-Ling Ma Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
description	Xin Su Ning (XSN) is a patented multicomponent medicine, which was certified in 2005 by the China State Food and Drug Administration to be produced pharmaceutically and to be used clinically. The XSN capsule was developed from an effective formula composed by Prof. Shuwen Ding of Shandong University of Traditional Chinese Medicine. Through more than 30 years of clinical observation, Prof. Ding concluded that XSN has a significant effect on arrhythmia with phlegm-heat heart-disturbed syndrome according to the traditional Chinese medicine (TCM) diagnosis. XSN, derived from a classical TCM formula Huanglian Wen Dan Decoction, is formulated with 11 Chinese herbal medicines to treat cardiac ventricular arrhythmia. Clinical evidence suggests that it is particularly efficacious for the arrhythmias induced by cardiac ischemia and viral myocarditis without obvious adverse reactions being reported. Cellular electrophysiological studies in ventricular myocytes revealed that XSN prolongs the duration and suppresses the amplitude of the action potential (AP), which is supported by the blockage of sodium and potassium channels indicating the characteristics of class I and III antiarrhythmic drugs. A recently reported double-blind, placebo-controlled, multicenter clinical trial of XSN enrolled 861 patients (ChiCTR-TRC-14004180) and showed that XSN significantly inhibited premature ventricular contraction (PVC). The cellular electrophysiological discoveries provided the mechanistic evidence for the clinical efficacy on inhibition of PVC by XSN as demonstrated in the clinical trial. These studies, for the first time, provided exclusive evidence that multicomponent TCM antiarrhythmic medicine can be evaluated using conventional research methods that have been used for antiarrhythmic drug discoveries for decades. We aimed to give a comprehensive review on XSN including its origin with the support of TCM theory, its pre-licensing clinical use and development, and its pharmacological and clinical study discoveries. The review will be summarized with the discoveries reported in a novel network pharmacological study that introduced a weight coefficient, which made it possible to evaluate the pharmacological properties of the TCM formula with regard to its formation based on TCM theory. Limitations regarding XSN’s basic and clinical research and possible future studies are listed. We hope that the advances in how XSN was studied may offer useful guidance on how other TCM could be studied with respect to the integrity of the TCM formulas.
format	article
author	Xuan Wang Taiyi Wang Shuwen Ding Yu-Ling Ma
author_facet	Xuan Wang Taiyi Wang Shuwen Ding Yu-Ling Ma
author_sort	Xuan Wang
title	Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
title_short	Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
title_full	Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
title_fullStr	Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
title_full_unstemmed	Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory
title_sort	xin su ning—a review of basic and clinical pharmacology integrated with traditional chinese medicine antiarrhythmic theory
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/feb9f78c300248a6bb8fe922109414d4
work_keys_str_mv	AT xuanwang xinsuningareviewofbasicandclinicalpharmacologyintegratedwithtraditionalchinesemedicineantiarrhythmictheory AT taiyiwang xinsuningareviewofbasicandclinicalpharmacologyintegratedwithtraditionalchinesemedicineantiarrhythmictheory AT shuwending xinsuningareviewofbasicandclinicalpharmacologyintegratedwithtraditionalchinesemedicineantiarrhythmictheory AT yulingma xinsuningareviewofbasicandclinicalpharmacologyintegratedwithtraditionalchinesemedicineantiarrhythmictheory
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Xin Su Ning—A Review of Basic and Clinical Pharmacology Integrated With Traditional Chinese Medicine Antiarrhythmic Theory

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