
L. M. Zhang et al. / HEALTH 2 (2010) 79-81
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80
injection of escin [13]. In another study, we further
found escin to be a safe and potent anti-inflammatory
drug with long effective anti-inflammation and without
immunosuppression [14].
It is well known that GCs possess both anti-inflam-
matory and immunosuppressive effects. The anti-in-
flammatory and immunosuppressive effects of GCs rely
on several molecular mechanisms, including direct ef-
fects on gene expression by the binding of glucocorti-
coid receptors (GR) to GC-responsive elements (i.e., the
induction of annexin I and MAPK phosphatase 1), indi-
rect effects on gene expression through the interactions
of GR with other transcription factors (i.e., NF-κB and
activator protein 1), and GR–mediated effects on sec-
ond-messenger cascades (i.e., the PI3K–Akt–eNOS
pathway) [15]. Unfortunately, because some of these
mechanisms are also involved in physiologic signaling
rather than inflammatory signaling, the therapeutic ef-
fects of GCs in inflammation are often accompanied by
clinically significant side effects.
3. THE HYPOTHESIS
Based on the aforementioned data, we hypothesize that
escin may exert a synergistic anti-inflammatory effect
with GCs, which could explain the relationship de-
scribed between escin and its anti-inflammatory mecha-
nism, and the molecular mechanisms of the synergistic
anti-inflammatory effect between escin and GCs may be
derived from amplification of endogenous GC action
through affecting GR or other elements in the signaling
pathways. In fact, this hypothesis is not difficult to test.
We can design experiments to confirm whether the com-
bination of escin with GCs, which alone had no anti-
nflammatory action in rodent animals by adrenalectomy,
can greatly inhibit inflammation after the administration
of physiological dose corticosterone. However, the dif-
ficulty in conducting these studies is how to precisely
discover the molecular mechanisms of synergistic anti-
inflammatory effects between escin and GCs, that is, to
determine escin how to affect the GC signaling pathway,
from GR to other elements [15].
4. CONSEQUENCES OF THE
HPOTHESIS
GCs are widely used to treat inflammatory diseases.
However, GCs has multiple effects to inhibit the immune
system and it is also associated with an increased sus-
ceptibility to infection and a risk for reactivation of la-
tent tuberculosis. If our hypothesis could be proved cor-
rect, escin has its own virtue compared with GCs, as
escin is not only a safe and potent anti-inflammatory dr
ug, but also an anti-gastric ulcer agent [16]. Furthermore,
it is easy to obtain and can be taken orally and venously
with less side effects and complications. In conclusion,
escin is a promising anti-inflammatory drug, promising
wide clinical use within the population.
5. ACKNOWLEDGEMENTS
This study was supported by the National Natural Science Foundation
of China (No.30772760), the 11th Five Years Key Programs for Sci-
ence and Technology Development of China (No. 2008ZX09202-008),
and Shandong Province Natural Science Foundation (No. Y2008C51).
6. CONFLICT OF INTEREST STATEMENT
All authors declare that there are no conflicts of interest.
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