Department of Neurology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicinegrid.410745.3, Nanjing, Jiangsu, China.
Microbiol Spectr. 2022 Dec 21;10(6):e0324222. doi: 10.1128/spectrum.03242-22. Epub 2022 Nov 21.
Cholestasis is characterized by bile acid (BA) circulation disorders, which is usually related to damage of hepatocyte barrier function. Currently, patients with cholestasis face several obstacles in seeking diagnosis and therapy. Da-Huang-Xiao-Shi decoction (DHXSD) is an ancient classic formula that has been used clinically for cholestasis treatment. Nevertheless, the underlying biological activities and therapeutic mechanisms remain unclear. In this study, an alpha-naphthylisothiocyanate (ANIT)-induced cholestasis rat model was established to examine the anticholestatic effects of DHXSD using histopathological and molecular analyses. Transcriptomic analysis combined with 16S rRNA gene sequencing analysis was systematically applied to study the mechanism of action of DHXSD. Simultaneously, the effect of DHXSD on gut microbiota, short-chain fatty acids (SCFAs), and intestinal barrier function were evaluated based on the ANIT-induced cholestasis model in rats. The results showed that DHXSD effectively attenuated ANIT-induced cholestasis by reducing liver function indicators (alanine transaminase [ALT], < 0.05; alkaline phosphatase [ALP], < 0.05; total bile acid [TBA], < 0.01; γ-glutamyl transpeptidase [GGT], < 0.001) and levels of hepatotoxicity-related enzymes ( < 0.05), thus improving the recovery of histopathological injuries, and regulating levels of inflammatory cytokines ( < 0.05). In addition, 16S rRNA gene sequencing analysis combined with intestinal barrier function analysis revealed that the DHXSD significantly ameliorated ANIT-induced gut microbiota dysbiosis. Significantly altered genes in the model and treatment groups were screened using transcriptomic analysis. Sixty-eight genes and four microbial genera were simultaneously altered with opposing trends in variation after ANIT and DHXSD treatments. We built a framework for predicting targets and host-microbe interaction mechanisms, as well as identifying alternative treatment for cholestasis, which should be validated further for clinical application. In conclusion, DHXSD appears to be a promising agent for protection against liver injury. Cholestasis is a serious manifestation of liver diseases resulting in liver injury, fibrosis, and liver failure with limited therapies. To date, only ursodeoxycholic acid (UDCA) has been approved by the U.S. Food and Drug Administration for the treatment of cholestasis. However, approximately one-third of patients with cholestasis are unresponsive to UDCA. Therefore, it is urgent to search for appropriate therapeutic agents for restoring stoppage status of the bile components to treat cholestasis. In this study, we investigated how the microbiome and transcriptome data sets correlated with each other to clarify the role of microbiome alterations in host metabolism. In combination, this research offers potential molecular biomarkers that should be validated for more accurate diagnosis of cholestasis and the clinical utilisation of gut microbiota as a target for treatment.
胆汁淤积症的特征是胆汁酸(BA)循环紊乱,通常与肝细胞屏障功能损伤有关。目前,胆汁淤积症患者在寻求诊断和治疗方面面临着一些障碍。大黄硝石汤(DHXSD)是一种临床用于治疗胆汁淤积症的古老经典方剂。然而,其潜在的生物学活性和治疗机制尚不清楚。本研究采用α-萘基异硫氰酸酯(ANIT)诱导的胆汁淤积症大鼠模型,通过组织病理学和分子分析研究 DHXSD 的抗胆汁淤积作用。采用转录组分析结合 16S rRNA 基因测序分析系统研究 DHXSD 的作用机制。同时,基于 ANIT 诱导的大鼠胆汁淤积模型,评价 DHXSD 对肠道微生物群、短链脂肪酸(SCFAs)和肠道屏障功能的影响。结果表明,DHXSD 通过降低肝功能指标(丙氨酸转氨酶[ALT], < 0.05;碱性磷酸酶[ALP], < 0.05;总胆汁酸[TBA], < 0.01;γ-谷氨酰转肽酶[GGT], < 0.001)和肝毒性相关酶的水平( < 0.05),有效减轻了 ANIT 诱导的胆汁淤积,改善了组织病理学损伤的恢复,并调节了炎症细胞因子的水平( < 0.05)。此外,16S rRNA 基因测序分析结合肠道屏障功能分析表明,DHXSD 显著改善了 ANIT 诱导的肠道微生物群失调。采用转录组分析筛选出模型组和治疗组中差异表达的基因。ANIT 和 DHXSD 处理后,有 68 个基因和 4 个微生物属的表达同时发生变化,且变化趋势相反。我们构建了一个预测靶点和宿主-微生物相互作用机制的框架,并确定了替代胆汁淤积症治疗的方法,这应进一步验证其在临床应用中的价值。总之,DHXSD 似乎是一种有前途的肝损伤保护剂。胆汁淤积症是一种严重的肝脏疾病表现,可导致肝损伤、纤维化和肝衰竭,目前治疗方法有限。迄今为止,只有熊去氧胆酸(UDCA)被美国食品和药物管理局批准用于治疗胆汁淤积症。然而,大约三分之一的胆汁淤积症患者对 UDCA 无反应。因此,迫切需要寻找合适的治疗药物来恢复胆汁成分的停滞状态,以治疗胆汁淤积症。在这项研究中,我们研究了微生物组和转录组数据集是如何相互关联的,以阐明微生物组改变在宿主代谢中的作用。结合起来,本研究提供了潜在的分子生物标志物,应进一步验证其用于更准确地诊断胆汁淤积症和将肠道微生物群作为治疗靶点的临床应用。