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Therapeutic and prophylactic effects of baicalin on Pneumocystis infection in immunosuppressed rats - 20/07/25

Doi : 10.1016/j.biopha.2025.118323 
Ting Xue a, b, c, d, e, , Weiqin Du e, Chaofeng Liu a, b, c, d, Wenjuan Dai a, b, c, d, Lei Wang f, Pengzhou Kong a, g, , Jia Xu h, , Lufeng Chen i,
a State Key Laboratory for Pneumoconiosis, National Health Commission, Taiyuan, Shanxi 030001, China 
b Department of Respiratory and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China 
c Shanxi Provincial Key Laboratory of Prevention, Treatment, and Basic Research of Respiratory Diseases, Taiyuan, Shanxi 030001, China 
d MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Taiyuan, Shanxi 030001, China 
e Department of Clinical Laboratory, The First People's Hospital of Lvliang, Lvliang, Shanxi 033000, China 
f Shanxi Provincial Key Laboratory of Birth Defects and Cell Regeneration, Shanxi Medical University, Taiyuan, Shanxi 030001, China 
g Key Laboratory of Cellular Physiology of The Ministry of Education and Department of Pathology, Shanxi Medical University, Taiyuan, Shanxi 030001, China 
h Clinical Practice Teaching Center, Shenyang Medical College, Shenyang, Liaoning 110034, China 
i Department of Radiation Oncology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China 

Correspondence to: State Key Laboratory for pneumoconiosis of National Health Commission, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Key Laboratory of Prevention, Treatment and Fundamental Research of Respiratory Diseases of Shanxi Academy of Medical Sciences, Department of Respiratory and Critical Care Medicine, First Hospital of Shanxi Medical University, 85# South Jiefang Road, Yingze District, Taiyuan, Shanxi 030001, China.State Key Laboratory for pneumoconiosis of National Health Commission, MOE Key Laboratory of Coal Environmental Pathogenicity and Prevention, Key Laboratory of Prevention, Treatment and Fundamental Research of Respiratory Diseases of Shanxi Academy of Medical Sciences, Department of Respiratory and Critical Care Medicine, First Hospital of Shanxi Medical University85# South Jiefang Road, Yingze DistrictTaiyuanShanxi030001China⁎⁎Correspondence to: Key Laboratory of Cellular Physiology of The Ministry of Education and Department of Pathology, Shanxi Medical University, 56 South Xinjian Road, Yingze District, Taiyuan, Shanxi 030001, China.Key Laboratory of Cellular Physiology of The Ministry of Education and Department of Pathology, Shanxi Medical University56 South Xinjian Road, Yingze DistrictTaiyuanShanxi030001China⁎⁎⁎Correspondence to: Clinical Practice Teaching Center, Shenyang Medical College, 146# North Huanghe Street, Shenyang, Liaoning 110034, China.Clinical Practice Teaching Center, Shenyang Medical College146# North Huanghe StreetShenyangLiaoning110034China⁎⁎⁎⁎Correspondence to: Department of Radiation Oncology, First Hospital of Shanxi Medical University, 85# South Jiefang Road, Yingze District, Taiyuan, Shanxi 030001, China.Department of Radiation Oncology, First Hospital of Shanxi Medical University85# South Jiefang Road, Yingze DistrictTaiyuanShanxi030001China

Abstract

Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection in immunocompromised individuals. Standard treatment with trimethoprim-sulfamethoxazole is limited by frequent side effects, potential drug resistance, and diminishing efficacy in certain patients, highlighting the need for alternative therapeutic strategies. This study evaluates the therapeutic and prophylactic potential of baicalin (Ba), a flavonoid derived from traditional Chinese medicine, in an immunosuppressed rat model of PCP. The therapeutic experiment involved intragastric administration of Ba at doses of 100, 200, or 400 mg/kg/day for 4 weeks in immunosuppressed rats, in comparison with intragastric administration of TMP-SMZ (50–250 mg/kg/day). Ba treatment demonstrated a dose-dependent reduction in Pneumocystis burden, alongside improved general health and lung histopathological scores, as well as elevated CD4 + T-cell counts, comparable to the effects observed with TMP-SMZ. In the prophylactic experiment, Ba (100 mg/kg/day) was administered intragastrically for 7 weeks, followed by 5 weeks of continued immunosuppression without further Ba treatment. Ba-treated rats exhibited significantly higher CD4 + T-cell counts, lower CD8 + T-cell counts, and attenuated inflammatory cytokine profiles. The effects of Ba treatment are associated with anti-inflammatory and antioxidant activities, regulation of protease/anti-protease balance, and inhibition of pulmonary collagen deposition. These findings support Ba’s potential as an alternative treatment regimen for PCP.

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Graphical Abstract




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Highlights

Baicalin reduces Pneumocystis burden, improves health, and enhances survival rates in immunosuppressed rats.
Baicalin sustains higher CD4+ counts, lowers CD8+ counts, and reduces inflammatory cytokines, showing prophylactic benefits.
Baicalin shows promise as a novel PCP treatment option and warrants further investigation to validate its clinical utility.

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Abbreviations : PCP, Ba, MMPs, TMP-SMZ, QPCR, FCM, IHC, ELISA, GMS, BAL, H&E, GSH-Px, T-AOC, T-SOD, MDA, MMP-2, MMP-9, MCP-1, CCL2, CXCR3, MIP-1γ/CCL9, ITAC/CXCL11, IP-10/CXCL10, CXCL9, HRP, TMB, PBS, LW/BW, COPD, ROS

Keywords : Pneumocystis, Pneumocystis pneumonia, Therapy, Protect, Prophylaxis, Baicalin


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