Zheng Li, Mingxue Zhang, Zeng Li, Yushi Zhou, Yuhan Ao, Yi Yang, Botong Liu
First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, China.
Front Cardiovasc Med. 2022 May 13;9:871142. doi: 10.3389/fcvm.2022.871142. eCollection 2022.
In this study, we analyzed the metabonomics of intermingled phlegm and blood stasis (IPBS) and its three concurrent syndromes in patients with stable angina pectoris of coronary heart disease.
A total of 164 sera of separated outpatients from 12 national tradition Chinese medicine clinical research centers with IPBS or concurrent syndromes were collected for the study and assessed with LC-ESI-MS/MS (liquid chromatography-electrospray ionization tandem-mass spectrometry)-based metabolomics and multivariate statistical analysis.
Non-differential metabolites between IPBS and its separate syndrome combined with the top 100 most abundant metabolites in four groups were screened to reflect the essence of IPBS. Amino acid and its metabolomics and glycerol phospholipids were screened for common metabolites, and these metabolites were mainly enriched in valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism. Principal component analysis revealed that the difference between IPBS and its separate concurrent syndromes was not distinct. Compared with IPBS, anserine, cytidine 5'-diphosphocholine, and 7,8-dihydro-L-biopterin separately significant increase in phlegm stasis and toxin (PST), phlegm stasis and Qi stagnation (PQS), and phlegm stasis and Qi deficiency (PQD). While these different metabolites were associated with histidine metabolism, beta-alanine metabolism, glycerophospholipid metabolism, and folate biosynthesis. Three accurate identification models were obtained to identify the difference between IPBS and its concurrent syndromes.
Our study indicated that valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism could represent the essence of IPBS; dysregulated metabolites were valuable in identifying PST from IPBS.
本研究分析冠心病稳定型心绞痛患者痰瘀互结证及其三种兼证的代谢组学特征。
收集来自12家全国中医临床研究中心的164例痰瘀互结证或兼证门诊患者的血清，采用基于液相色谱 - 电喷雾电离串联质谱（LC - ESI - MS/MS）的代谢组学技术和多元统计分析进行研究与评估。
筛选痰瘀互结证与其单独证型合并四组中丰度最高的前100种代谢物之间的非差异代谢物，以反映痰瘀互结证的本质。筛选氨基酸及其代谢组学和甘油磷脂类的共同代谢物，这些代谢物主要富集于缬氨酸、亮氨酸和异亮氨酸代谢以及甘油磷脂代谢。主成分分析显示痰瘀互结证与其单独兼证之间差异不明显。与痰瘀互结证相比，鹅肌肽、胞苷5'-二磷酸胆碱和7,8 - 二氢 - L - 生物蝶呤分别在痰瘀毒结（PST）、痰瘀气滞（PQS）和痰瘀气虚（PQD）中显著升高。而这些不同的代谢物与组氨酸代谢、β - 丙氨酸代谢、甘油磷脂代谢和叶酸生物合成相关。获得了三个准确的识别模型以识别痰瘀互结证与其兼证之间的差异。
本研究表明缬氨酸、亮氨酸和异亮氨酸代谢以及甘油磷脂代谢可代表痰瘀互结证的本质；失调的代谢物对从痰瘀互结证中鉴别痰瘀毒结证有重要价值。
