School of TCM under Jiangxi University of TCM, Nanchang, Jiangxi 330004, China.
Teaching and Research Office of basic theory on TCM in Jiangxi province, Nanchang, Jiangxi 330004, China.
J Pharm Pharmacol. 2024 May 3;76(5):462-478. doi: 10.1093/jpp/rgad076.
Irritable bowel syndrome (IBS) is a chronic intestinal disorder characterized by abdominal discomfort, stool characteristics, and changes in bowel habits. Among them, diarrhea-type (diarrhea-predominant irritable bowel syndrome, abbreviated as IBS-D) is the most common. Because its pathogenesis is not understood, symptomatic treatment is currently used in clinical practice, and its long-term effect is still unclear. Decoction of Angelica sinensis, Zingiberis Rhizoma Recens, and Mutton (DAZM) is a famous traditional Chinese medicine recipe created by Zhang Zhongjing, a famous doctor in the Eastern Han Dynasty 2000 years ago, and is still in use today. Our research team has previously investigated the clinical study of DAZM in the treatment of IBS-D and conducted animal experiment research, indicating that DAZM has a significant effect on improving IBS-D. Yet, there are few reports on the specific mechanism of action of DAZM in improving the treatment of IBS and related types. Most studies discuss and verify its efficacy and protection from a clinical perspective. For this reason, this research will explore the constituent targets and mechanisms of DAZM to improve the treatment of IBS-D, provide relevant scientific evidence, and also provide reference evidence for the efficacy of food therapy decoction in improving the treatment of diseases and mechanism to open up new experimental research ideas.
Identification of drug ingredients and collection of targets for DAZM using ultra-performance liquid chromatography with linear ion trap-electrostatic field orbitrap mass spectrometry and the Bioinformatics Analysis Tool for Molecular Mechanisms of Traditional Chinese Medicine database, active ingredients were selected based on their oral bioavailability and drug-like properties. Obtained IBS-D targets using the GeneCards database, took the intersection of IBS-D targets and DAZM targets and obtained potential targets of DAZM for the treatment of IBS-D. Using Cytoscape software to draw a network diagram of "Food therapy decoction-ingredient-target-disease" and selected the ingredients with larger parameter values by topological analysis. Correlation analysis of the selected active and parametric ingredients with prominent symptoms of IBS-D using SymMap database, and selection of potential core ingredients. The construction of protein interaction networks from the String database and the selection of potential core targets. Gene Ontology functional and Kyoto Encyclopedia of Genes and Genomes signaling pathway enrichment analyses using the Metascape database, establishing the bioinformatic processes and signaling pathways involved. Molecular docking of core ingredients and potential core targets was performed using AutoDock Vina, and the results were visualized using Python molecule (PyMOL) and LigPlus+. Finally, based on the results of this research combined with previous literature reports, the discussion section of this paper summarizes in detail the key core ingredients, targets, and signaling pathways of DAZM in improving IBS-D.
DAZM may act on eight potential core targets (threonine kinase 1, insulin, tumour necrosis factor, tumour protein p53, interleukin 6, epidermal growth factor receptor, connexin β1, and interleukin 1β) through eight core ingredients (Zingiberone, Shyobunone, Palmitic acid, Sebiferic acid, β-Bisabolene, β-Sitosterol, Stigmasterol, and Oleic acid). inhibit pro-inflammatory factors through Advanced Glycation End Products-Receptor (AGE-RAGE) signaling pathway, Cyclic Adenosine Monophosphate (cAMP) signaling pathway, MAPK signaling pathway, IL-17 signaling pathway, Calmodulin (CaM) signaling pathway, and other pathways. It can alleviate the inflammatory response, enhance the intestinal mucosal barrier and regulate intestinal motility, and play a role in the treatment and improvement of IBS-D.
This research mainly found the mechanism of DAZM on IBS-D, which may involve multiple ingredients, multiple targets, and multiple pathways. DAZM with medicinal and edible functions can effectively improve the treatment of IBS-D. This kind of dietary therapy is suitable for long-term treatment and is worthy of promotion.
肠易激综合征(IBS)是一种慢性肠道疾病,其特征为腹部不适、粪便特征和排便习惯改变。其中,腹泻型(腹泻为主的肠易激综合征,简称 IBS-D)最为常见。由于其发病机制尚不清楚,目前临床上采用对症治疗,其长期效果仍不明确。当归生姜羊肉汤(DAZM)是东汉时期著名医学家张仲景所创的著名中药方剂,至今仍在使用。本研究团队之前对 DAZM 治疗 IBS-D 的临床研究进行了调查,并进行了动物实验研究,表明 DAZM 对改善 IBS-D 有显著效果。然而,关于 DAZM 改善 IBS 治疗的具体作用机制的报道较少。大多数研究从临床角度讨论和验证其疗效和保护作用。为此,本研究将探讨 DAZM 改善 IBS-D 治疗的组成靶点和机制,为其提供相关科学依据,为食疗汤改善疾病治疗和机制的疗效提供参考依据,为开辟新的实验研究思路。
采用超高效液相色谱-线性离子阱-静电场轨道阱质谱联用技术和中药分子机制生物信息学分析工具对 DAZM 进行药物成分鉴定和收集,基于口服生物利用度和类药性选择活性成分。使用 GeneCards 数据库获取 IBS-D 靶点,取 IBS-D 靶点和 DAZM 靶点的交集,得到 DAZM 治疗 IBS-D 的潜在靶点。采用 Cytoscape 软件绘制“食疗汤-成分-靶标-疾病”网络图,通过拓扑分析选择参数值较大的成分。使用 SymMap 数据库对所选活性成分和参数成分与 IBS-D 突出症状进行相关分析,选择潜在的核心成分。从 String 数据库构建蛋白质相互作用网络,选择潜在的核心靶点。使用 Metascape 数据库进行基因本体功能和京都基因与基因组百科全书信号通路富集分析,建立涉及的生物信息学过程和信号通路。使用 AutoDock Vina 对核心成分和潜在核心靶点进行分子对接,并用 Python molecule(PyMOL)和 LigPlus+可视化结果。最后,基于本研究结果并结合以往文献报道,详细讨论 DAZM 改善 IBS-D 的关键核心成分、靶标和信号通路。
DAZM 可能通过八种核心成分(姜酮、Shyobunone、棕榈酸、Sebiferic 酸、β-菖蒲烯、β-谷甾醇、豆甾醇和油酸)作用于八个潜在核心靶点(丝氨酸/苏氨酸蛋白激酶 1、胰岛素、肿瘤坏死因子、肿瘤蛋白 p53、白细胞介素 6、表皮生长因子受体、连接蛋白 β1 和白细胞介素 1β),通过晚期糖基化终产物受体(AGE-RAGE)信号通路、环磷酸腺苷(cAMP)信号通路、MAPK 信号通路、IL-17 信号通路、钙调蛋白(CaM)信号通路等途径抑制促炎因子。可以缓解炎症反应,增强肠道黏膜屏障,调节肠道运动,从而发挥对 IBS-D 的治疗和改善作用。
本研究主要发现了 DAZM 对 IBS-D 的作用机制,可能涉及多种成分、多个靶点和多个通路。具有药食同源功能的 DAZM 能有效改善 IBS-D 的治疗,这种饮食疗法适合长期治疗,值得推广。