Research Article Pages:129-144
10.5935/0946-5448.20240020

Exploring the Efficacy and Molecular Mechanisms of Dingxuan in Alleviating Vertigo Episodes in Meniere's Disease: A Comprehensive Study

Authors: Hongting Wang*, Meimei Tang, Cunqin Wang, Fangfang Wang, Mingjie Wang1, Mengfei Bi, Huihui gao, Rongzhen Zhang, Rongbin Wang

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Abstract

Background: Meniere’s disease (MD) poses a formidable challenge, marked by debilitating symptoms such as vertigo, hearing loss, tinnitus, and aural fullness. The traditional Chinese medicine, Dingxuan, was explored here for its potential in mitigating MD challenges. We investigated Dingxuan’s efficacy in alleviating acute vertigo episodes in patients with MD and sought to understand its impact and underlying molecular mechanisms. Methods: In a clinical trial, Dingxuan was administered to patients experiencing acute vertigo episodes. Additionally, mouse experiments were conducted to assess safety at an elevated dosage, while a guinea pig model was utilized to compare Dingxuan with betahistine. Molecular responses, modulation of water channels, and evaluation of labyrinth hydrops were performed as part of the study. Results: In the clinical trial, Dingxuan significantly reduced the mean frequency of vertigo attacks. Impressively, even at a high dosage, Dingxuan showed no apparent liver or kidney toxicity in mouse experiments. In the guinea pig model, Dingxuan distinctively modulated water channels AQ2 and AQ5, regulated AVP-mediated signaling through cAMP, and ameliorated inner ear labyrinth hydrops. Conclusions: Dingxuan emerges as a promising candidate for treatment of Meniere’sdisease, effectively reducing vertigo frequency. Its safety profile, even at elevated dosages, strengthens its potential for clinical applications. Further research and clinical trials are essential to validate these findings and explore broader implications for Dingxuan use with human subjects.

Keywords: Meniere’s disease, Endolymphatic Hydrops, Water channel modulation, Liver and kidney toxicity, AQP2

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