Department of Fundamental Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China.
Department of Proctology, Chengdu First People's Hospital, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2022 Sep 14;28(34):5007-5022. doi: 10.3748/wjg.v28.i34.5007.
Slow transit constipation (STC) is a common intestinal disease with increasing incidence. STC results from various factors, such as the enteric nervous system and metabolic changes. As a classical formula of traditional Chinese medicine, Ji-Chuan decoction (JCD) has been extensively and effectively used in STC treatment, yet its pharmacological mechanism remains unclear.
To explore the integrated regulatory pattern of JCD against STC through hyphenated techniques from metabolism, network pharmacology and molecular methods.
STC model mice were generated by intragastric administration of compound diphenoxylate (10 mg/kg/d) for 14 d. The STC mice in the low dose of JCD (3.04 g/kg), middle dose of JCD (6.08 g/kg) and high dose of JCD (12.16 g/kg) groups were orally administered JCD solution once a day for 2 wk. The acetylcholine (ACH) level was examined by enzyme-linked immunosorbent assay. The pathological features of colon tissue were observed by hematoxylin and eosin staining. The differentially expressed metabolites and metabolic pathways were tested by nontargeted metabolomics. The main targets and core ingredients of JCD were identified by network pharmacology, and the expression of AKT was confirmed by immunohistochemistry. Finally, the pathways involved in JCD treatment were predicted using a combination of differentially expressed metabolites and targets, and intestinal glial cell apoptosis was demonstrated by immunofluorescence.
JCD significantly promoted intestinal motility, increased the levels of the excitatory neurotransmitter ACH and reduced intestinal inflammation in STC mice. Untargeted metabolomics results showed that JCD significantly restored metabolic dysfunction and significantly affected taurine and hypotaurine metabolism. Network pharmacology and molecular experiments showed that JCD regulates AKT protein expression, and the core component is quercetin. Combined analysis demonstrated that apoptosis may be an important mechanism by which JCD relieves constipation. Further experiments showed that JCD reduced enteric glial cell (EGC) apoptosis.
This work demonstrated that reducing EGC apoptosis may be the critical mechanism by which JCD treats STC. These findings call for further molecular research to facilitate the clinical application of JCD.
慢传输型便秘(STC)是一种常见的肠道疾病,发病率不断上升。STC 是由肠道神经系统和代谢变化等多种因素引起的。济川煎(JCD)作为一种经典的中药方剂,已广泛有效地用于 STC 的治疗,但其药理机制尚不清楚。
通过代谢组学、网络药理学和分子方法的联用技术,探讨 JCD 对 STC 的综合调控模式。
通过灌胃给予复方地芬诺酯(10 mg/kg/d)14 d 构建 STC 模型小鼠。将 STC 小鼠随机分为低剂量 JCD(3.04 g/kg)、中剂量 JCD(6.08 g/kg)和高剂量 JCD(12.16 g/kg)组,每天灌胃给药 1 次,连续 2 周。采用酶联免疫吸附试验检测乙酰胆碱(ACH)水平。苏木精-伊红染色观察结肠组织病理特征。非靶向代谢组学检测差异表达代谢物和代谢途径。网络药理学鉴定 JCD 的主要靶点和核心成分,并通过免疫组化验证 AKT 的表达。最后,通过差异表达代谢物和靶点的组合预测 JCD 治疗的途径,并通过免疫荧光法验证肠道胶质细胞的凋亡。
JCD 显著促进了 STC 小鼠的肠道蠕动,增加了兴奋性神经递质 ACH 的水平,并减轻了肠道炎症。非靶向代谢组学结果表明,JCD 显著恢复了代谢功能障碍,显著影响了牛磺酸和次牛磺酸代谢。网络药理学和分子实验表明,JCD 调节 AKT 蛋白表达,其核心成分是槲皮素。联合分析表明,细胞凋亡可能是 JCD 缓解便秘的重要机制。进一步的实验表明,JCD 减少了肠胶质细胞(EGC)的凋亡。
本研究表明,减少 EGC 凋亡可能是 JCD 治疗 STC 的关键机制。这些发现呼吁进一步的分子研究,以促进 JCD 的临床应用。