Integrating network pharmacology and experimental verification to explore the protective effects of <i>Evodia rutaecarpa</i> in ischemic stroke

by Zhixuan Huang, Jian Liu, Hui Li, Hengjun Huang, Yangwen Ai, Dongyue Zhou

Evodia rutaecarpa is a traditional Chinese herbal medicine known for its potential benefits in the treatment of cardiovascular and cerebrovascular diseases. Despite its recognized effects, the effects of Evodia rutaecarpa on ischemic stroke (IS), along with the primary active compounds and precise mechanisms of action, require elucidation.

Network pharmacology analyses and molecular docking were performed to integrate information related to Evodia rutaecarpa and IS. Cell oxygen–glucose deprivation (OGD) and rat middle cerebral artery occlusion (MCAO) models were established to simulate cerebral ischemic injury. The effects of rutaecarpine on these models were evaluated to assess its effect on IS.

Network pharmacological analysis indicated that rutaecarpine from Evodia rutaecarpa showed therapeutic effects against IS. The mechanism underlying these effects mainly involved the mitogen-activated protein kinase (MAPK), and targets such as matrix metalloproteinase (MMP)-9, caspase 3 and MMP-2 may be activated to exert these effects. In vitro studies showed that rutaecarpine significantly improved the mitochondrial membrane potential of HT22 cells, reduced the production of reactive oxygen species, and reversed OGD-induced cytotoxicity. In the MCAO rat model, pretreatment with rutaecarpine significantly reduced neuronal death, decreased infarct volume, and improved neurological functional deficits. In addition, rutaecarpine alleviated damage to the blood–brain barrier in the brain tissue. These effects may be related to the regulation of the MAPK-mediated MMPs pathway.

This study revealed the neuroprotective effects and molecular mechanisms of rutaecarpine on IS, providing a new theoretical basis for the clinical application of Evodia rutaecarpa.

Instruments for Measuring the Burden of Family Caregivers of Cancer Patients: A Systematic Review of Measurement Properties

ABSTRACT

Aims

This study identifies instruments for assessing the burden on family caregivers of cancer patients and evaluates their psychometric properties using COSMIN criteria.

Design

A systematic review based on COSMIN methodology.

Methods

The review adhered to PRISMA guidelines. Relevant studies were identified through searches in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database, covering literature from inception to September 2024. Included studies focused on developing or validating measurement tools and assessing psychometric properties such as reliability, internal consistency and construct validity. Two independent researchers screened the literature, extracted data and evaluated psychometric properties using COSMIN criteria while assessing evidence quality via the GRADE method.

Results

A total of 32 studies were included, encompassing 17 tools for assessing caregiver burden. None reported measurement error, cross-cultural validity or responsiveness. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) demonstrated strong reliability, validity and internal consistency, receiving a strong recommendation for clinical practice. In contrast, the Zarit Burden Interview (ZBI), Family Caregiver Burden Interview Scale (FBIS) and Bakas Caregiving Outcomes Scale (BCOS) are not recommended due to insufficient supporting evidence. Other tools showed weak evidence, leading to weak recommendations.

Conclusions

The CBS-EOLC exhibits comprehensive psychometric properties suitable for clinical applications. The ZBI, FBIS and BCOS lack adequate supporting evidence and are not recommended. Future research should focus on measurement error, cross-cultural validity and responsiveness to enhance these tools' applicability and reliability.

Relevance to Clinical Practice

This review provides evidence for healthcare providers to select instruments for assessing caregiver burden in cancer patients.

Impact

This systematic review highlights the need for comprehensive assessments of caregiver burden based on COSMIN guidelines.

No Patient or Public Contribution

This study is a systematic review with no patient or public participation.