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黄芪和丹参通过“肠-肾轴”改善糖尿病肾病。

Astragalus membranaceus and Salvia miltiorrhiza ameliorate diabetic kidney disease via the "gut-kidney axis".

机构信息

Shandong University of Traditional Chinese Medicine, No.4655 Daxue Road, Jinan 250014, China.

Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan 250200, China.

出版信息

Phytomedicine. 2023 Dec;121:155129. doi: 10.1016/j.phymed.2023.155129. Epub 2023 Sep 29.


DOI:10.1016/j.phymed.2023.155129
PMID:37804821
Abstract

BACKGROUND: The combination of Astragalus membranaceus and Salvia miltiorrhiza (AS) is an effective prescription for treating diabetic kidney disease (DKD) in traditional Chinese medicine. Its efficacy in treating DKD has been confirmed, but the potential regulatory mechanism has not yet been fully clarified. PURPOSE: To explore the mechanism by which AS regulates the "gut-metabolism-transcription" coexpression network under the action of the "gut-kidney axis" to ameliorate DKD. METHODS: SD rats were used to establish the DKD model by injecting STZ. After AS intervention, the structure and function of the kidney and colon were observed. We sequenced the gut microbiota utilizing 16S rDNA, identified serum differential metabolites using LC‒MS/MS, and observed renal mRNA expression by RNA seq. The "gut-metabolism-transcription" coexpression network was further constructed, and the target bacteria, target metabolites, and target genes of AS were ultimately screened and validated. RESULTS: AS improved renal pathology and functional damage and increased the abundance of Akkermansia, Akkermansia_muciniphila, Lactobacillus and Lactobacillus_murinus. Fourteen target metabolites of AS were identified, which were mainly concentrated in 19 KEGG pathways, including sphingolipid metabolism and glycerophospholipid metabolism. Sixty-three target mRNAs of AS were identified. The top 20 pathways were closely related to glycolipid metabolism, and 14 differential mRNAs were expressed in these pathways. Correlation analysis showed that Akkermansia, Akkermansia muciniphila, Lactobacillus and Lactobacillus murinus were closely associated with sphingolipid metabolism, glycerophospholipid metabolism, arachidonic acid metabolism, ascorbate and aldarate metabolism and galactose metabolism. Moreover, the target metabolites and target mRNAs of AS were also enriched in five identical pathways of sphingolipid metabolism, glycerophospholipid metabolism, arachidonic acid metabolism, ascorbate and aldarate metabolism and galactose metabolism, including 8 different metabolites, such as sphingosine, and 5 different genes, such as Kng1. The 8 metabolites had high AUC prediction values, and the validation of the 5 genes was consistent with the sequencing results. CONCLUSION: Our research showed that AS can improve DKD via the "gut-kidney axis". Akkermansia muciniphila and Lactobacillus murinus were the main driving bacteria, and five pathways related to glycolipid metabolism, especially sphingolipid metabolism and glycerophospholipid metabolism, may be important follow-up reactions and regulatory mechanisms.

摘要

背景:黄芪和丹参(AS)的联合应用是中医治疗糖尿病肾病(DKD)的有效方剂。其治疗 DKD 的疗效已得到证实,但潜在的调节机制尚未完全阐明。

目的:探讨 AS 通过“肠-肾轴”作用调节“肠-代谢-转录”共表达网络改善 DKD 的机制。

方法:采用 STZ 注射建立 SD 大鼠 DKD 模型,AS 干预后观察肾脏和结肠的结构和功能。我们利用 16S rDNA 对肠道微生物群进行测序,利用 LC-MS/MS 鉴定血清差异代谢物,并通过 RNA-seq 观察肾脏 mRNA 表达。进一步构建“肠-代谢-转录”共表达网络,筛选和验证 AS 的靶细菌、靶代谢物和靶基因。

结果:AS 改善了肾脏的病理和功能损伤,增加了 Akkermansia、Akkermansia muciniphila、Lactobacillus 和 Lactobacillus murinus 的丰度。鉴定出 AS 的 14 个靶代谢物,主要集中在 19 个 KEGG 通路,包括鞘脂代谢和甘油磷脂代谢。鉴定出 AS 的 63 个靶基因。前 20 条通路与糖脂代谢密切相关,其中 14 个差异表达的 mRNAs 也在这些通路中表达。相关性分析表明,Akkermansia、Akkermansia muciniphila、Lactobacillus 和 Lactobacillus murinus 与鞘脂代谢、甘油磷脂代谢、花生四烯酸代谢、抗坏血酸和醛酸盐代谢以及半乳糖代谢密切相关。此外,AS 的靶代谢物和靶基因也富集在鞘脂代谢、甘油磷脂代谢、花生四烯酸代谢、抗坏血酸和醛酸盐代谢以及半乳糖代谢等 5 个相同的通路中,包括 8 种不同的代谢物,如神经鞘氨醇,以及 5 种不同的基因,如 Kng1。这 8 种代谢物具有较高的 AUC 预测值,5 种基因的验证结果与测序结果一致。

结论:本研究表明,AS 可通过“肠-肾轴”改善 DKD。Akkermansia muciniphila 和 Lactobacillus murinus 是主要的驱动菌,与糖脂代谢相关的 5 条通路,特别是鞘脂代谢和甘油磷脂代谢,可能是重要的后续反应和调节机制。

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Gut Microbiota and Metabolites: Biomarkers and Therapeutic Targets for Diabetes Mellitus and Its Complications.

Nutrients. 2025-8-11

[2]
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Sci Rep. 2025-8-20

[3]
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[4]
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[5]
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[6]
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Cell Biochem Biophys. 2025-6-16

[7]
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[8]
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[9]
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[10]
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