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Alpinia Oxyphylla-Shenqi Siwu Decoction protects against high glucose-induced retinal pigment epithelial cell injury involving the PI3K/AKT/mTOR pathway.

Created on 10 Sep 2026

Authors

Weiling Zhang, Chunying Jing

Published in

International ophthalmology. Volume 46. Issue 1. Sep 10, 2026. Epub Sep 10, 2026.

Abstract

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults, and current treatments (anti-VEGF drugs, steroids, laser photocoagulation) mainly target late-stage microvascular complications while offering little for the neurodegeneration and neurovascular unit dysfunction that characterize early DR. Multi-component, multi-target traditional Chinese medicine compound decoctions are attractive candidates for early intervention. Here we investigated the protective effect and molecular mechanism of Alpinia Oxyphylla-Shenqi Siwu Decoction (AOSWSD) in a high glucose-induced ARPE-19 injury model of early DR.
ARPE-19 cells were exposed to 30 mmol/L glucose and treated with drug-containing rat serum obtained from rats gavaged with AOSWSD at low, middle and high doses (4.6, 9.2 and 18.4 g/kg/day of crude drug), with a matched normal-rat-serum control. Cell viability, migration, apoptosis, intracellular ROS, cytokine secretion, VEGFR2 immunofluorescence, p-AKT/AKT and p-mTOR/mTOR ratios, and mRNA levels of VEGFA, VEGFR2, HIF-1α, PIK3CA, AKT1, mTOR, Caspase-3, Bcl-2 and Bax were quantified by CCK-8 assay, scratch assay, flow cytometry, DCFH-DA staining, ELISA, immunofluorescence and RT-qPCR, respectively.
Under high-glucose exposure, AOSWSD-containing serum dose-dependently improved cell viability, restored migration, suppressed apoptosis, reduced intracellular ROS, and lowered the secretion of VEGFA, TNF-α and IL-6. Mechanistically, AOSWSD acted along a coordinated VEGFA/VEGFR2-PI3K/AKT/mTOR axis: it reduced secreted VEGFA and VEGFR2 protein at the upstream end, and lowered PIK3CA, AKT1 and mTOR transcripts together with the p-AKT/AKT and p-mTOR/mTOR ratios at the downstream end. Bcl-2, Bax and Caspase-3 expression and the Bax/Bcl-2 ratio were likewise restored towards control values.
AOSWSD protects ARPE-19 cells from high glucose-induced injury through simultaneous, dose-dependent modulation of oxidative stress, inflammation, apoptosis and angiogenic signaling, with the VEGFA/VEGFR2-PI3K/AKT/mTOR cascade acting as a principal molecular substrate. These results support AOSWSD as a candidate multi-target intervention for early-stage DR and provide a basis for further mechanistic, chemical and translational studies.

PMID:
42720704
Bibliographic data and abstract were imported from PubMed on 10 Sep 2026.

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