In this video, I will discuss the pharmacological basis of Yang/Qi invigoration with the framework of Chinese Medicine. Over the past two decades, my laboratory at the Hong Kong University of Science and Technology has focused on investigating the pharmacology of Yang/Qi invigorating Chinese tonifying herbs. According to Chinese Medicine theory, Yang/Qi is a manifestation of body functions supported by various organs. A Yang/Qi-invigorating action, therefore involves the enhancement of bodily functions in general and cellular activities that can consume ATP in particular. ATP, which is the universal energy currency in the cell, is used for energizing biochemical reaction which form the basis for expressing cellular function. Yang activity can be viewed as reflecting the processes involved in the body's energy metabolism, wherein the digestion of foodstuff provides fuel molecules, such as glucose, that are metabolized, resulting in the production of ATP in mitochondria. The mitochondrion, the powerhouse of the cell, is regarded as the cellular origin of Qi and ATP as the biochemical unit of Qi. Under normal conditions, mitochondrial oxidating processes generate Reactive Oxygen Species (ROS) as byproducts. When mitochondrial dysfunction occurs, increased amount of ROS are produced. Being highly chemically reactive, ROS attack mitochondrial structures, resulting in defective mitochondrial biosynthesis and impaired energy metabolism. Under normal physiological conditions, mitochondria antioxidant defense systems which are mainly dependent on glutathione, can adequately handle the potentially detrimental effects of ROS derived from energy metabolism. Optimal body function requires a large amount of energy. In this regard, antioxidant defense components are essential in sustaining mitochondrial ATP production. Experimental evidence has demonstrated that while Yang invigorating herbs, such as Cistanches Herba and Cynomorii, Herba can stimulate mitochondrial activity. Qi invigorating herbs, such as Asian Ginseng and American Ginseng, enhance mitochondrial glutathione antioxidant capacity. Both of these lead to an increase in mitochondrial ATP generation capacity. The increase in a small amount of ROS arising from the activation of mitochondrial activity induced by Yang-invigorating herbs can trigger retrograde signal transduction, with the result in increase in the expression of antioxidant genes and cellular/mitochondrial antioxidant capacity - that means mitohormesis - a process for maintaining a stable and permissive environment for mitochondrial function. Furthermore, the increased production of ROS associated with Yang-invigoration can activate uncoupling protein in mitochondria. The increase in mitochondrial activity, which increases mitochondrial membrane potential, and the activation of uncoupling protein, which decreases mitochondrial membrane potential, constitute a substrate cycle that enables a timely increase in mitochondrial ATP production in response to an increased energy demand. In acute terms, Yang-enhancing herbs can increase ATP generation capacity in mitochondria as well as their responsiveness to energy demand. The induction of mitochondria mild uncoupling can help control body weight. In the long term, the induction of antioxidant response can lead to a longer and healthier lifespan. The stimulatory effects of Yang-invigorating herbs on both energy production and antioxidant defense system exemplify the inter-relationship between Yin and Yang, which entails the presence of Yin, that is antioxidant, within Yang, that is energy production. In addition to the stimulation of ATP production, Qi invigorating herbs such as Asian Ginseng and Huang Qi can produce a regulatory function on neuro and/or hormonal systems in the body. For example, Ginseng can show a hormonal regulatory action in male reproduction function. A clinical study has demonstrated that the use of Asian Ginseng extract significantly increases plasma levels of male sex hormones such as testosterone, follicle stimulating hormone, and luteinizing hormone. Ginseng enhances sexual performance and improve male fertility by moderating neuro and hormonal systems. Several ginsenosides, active ingredient from Ginseng, act on ERα, a receptor that mediates the action of estrogens, those are females sex hormone. Daily ginseng intake in type-2 diabetic patients demonstrate a significant reduction in fasting blood glucose levels and body weight, and an improvement in glycated hemoglobin level which is an indicator of blood glucose control, as well as in psychological performance and physical activities. Huang Qi can amplify the hormonal regulatory response in lowering of blood glucose through a mechanism that may involve glucose-sensing regions of the central nervous system. In general, pharmacological studies of Chinese Yang/Qi invigorating herbs can help explaining their beneficial effects in safeguarding health in the language of Modern Medicine.
