Chen Ke-Dian, Gao Shuang-Rong, Liu Xue-Ting, Lin Na, Zhang Yan-Qiong
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2024 Jul;49(13):3608-3618. doi: 10.19540/j.cnki.cjcmm.20240410.401.
Premenstrual syndrome(PMS) lacks a highly consistent and feasible animal model that aligns with diagnostic and therapeutic standards in both traditional Chinese medicine(TCM) and western medicine, resulting in a lack of reliable experimental carriers for studying its pathogenesis and pharmacological effects. This study aims to systematically analyze the biological implications of PMS from the perspective of the "disease-syndrome-symptom" correlation and establish preparation and evaluation methods for an improved animal model of this disease. Firstly, clinical symptom gene sets related to the Qi stagnation syndromes due to liver depression and blood stasis in PMS in both modern medicine and TCM diagnostic standards were collected through GeneCards, DisGeNET, Mala-Cards, and the System of Foundational Diagnostic Association(SoFDA) database, as well as published literature. Based on the interaction information between genes, a "disease-syndrome-symptom" correlation network of PMS was established. Based on data mining results, an improved rat model of PMS was prepared by combining chronic restraint stress with the classical progesterone-withdrawal mo-del to simulate emotional depression caused by external environmental stimuli during the clinical onset process, inducing pathological damage from both physiological and emotional dimensions. The evaluation of the improved model before and after modification included open field experiment scores, organ indices, ovarian pathological changes, serum levels of estradiol(E_2), follicle-stimulating hormone/luteinizing hormone(FSH/LH), 5-hydroxytryptamine(5-HT), dopamine(DA), norepinephrine(NE), as well as coagulation parameters and hemorheology indexes. By calculating the degree, betweenness, and closeness centrality of nodes in the "disease-syndrome-symptom" correlation network, 163 core genes with topological importance were identified. Further biological function mining results indicated that core genes in PMS mainly participated in the regulation of the "nervous-endocrine-immune" system and pathways related to circulatory disorders. Mapping analysis of clinical phenotype symptom gene sets suggested significant correlations between core genes in PMS and depressive symptoms and pain symptoms caused by blood stasis. Compared with the simple progesterone withdrawal model, rats subjected to combined injections and restraint stress showed more significant abnormalities in open field experiment scores, ovarian tissue pathology, serum neurotransmitter levels of 5-HT and DA, as well as serum hormone levels of E_2 and FSH/LH. The modified modeling conditions exacerbated the pathological changes in blood rheology, coagulation function, and red blood cell morphology in model rats, confirming that the improved rat model could characterize the "nervous-endocrine-immune" system disorder and circulatory system disorders in the occurrence and progression of PMS, consistent with the clinical diagnostic and therapeutic standards of both TCM and western medicine. The establishment of the improved rat model of PMS can provide a reliable experimental carrier for elucidating the pathogenesis of PMS and discovering and evaluating therapeutic drugs. It also provides references for objectively reflecting the clinical characteristics of PMS in TCM and western medicine and precision treatment.
经前期综合征(PMS)缺乏一种高度一致且可行的动物模型,该模型无法同时符合中医和西医的诊断及治疗标准,导致缺乏用于研究其发病机制和药理作用的可靠实验载体。本研究旨在从“病-证-症”相关性的角度系统分析PMS的生物学意义,并建立该疾病改良动物模型的制备及评价方法。首先,通过GeneCards、DisGeNET、Mala-Cards和基础诊断关联系统(SoFDA)数据库以及已发表的文献,收集了符合现代医学和中医诊断标准的与PMS中肝郁血瘀气滞证相关的临床症状基因集。基于基因之间的相互作用信息,建立了PMS的“病-证-症”相关网络。基于数据挖掘结果,通过将慢性束缚应激与经典的孕酮撤药模型相结合,制备了改良的PMS大鼠模型,以模拟临床发病过程中外部环境刺激引起的情绪抑郁,从生理和情绪两个维度诱导病理损伤。改良前后对模型的评价包括旷场实验得分、脏器指数、卵巢病理变化、血清雌二醇(E_2)、促卵泡生成素/促黄体生成素(FSH/LH)、5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)水平,以及凝血参数和血液流变学指标。通过计算“病-证-症”相关网络中节点的度中心性、介数中心性和紧密中心性,确定了163个具有拓扑重要性的核心基因。进一步的生物学功能挖掘结果表明,PMS中的核心基因主要参与“神经-内分泌-免疫”系统的调节以及与循环系统紊乱相关的通路。临床表型症状基因集的映射分析表明,PMS中的核心基因与抑郁症状和血瘀引起的疼痛症状之间存在显著相关性。与单纯孕酮撤药模型相比,联合注射和束缚应激的大鼠在旷场实验得分、卵巢组织病理学、血清5-HT和DA神经递质水平以及血清E_2和FSH/LH激素水平方面表现出更显著的异常。改良后的建模条件加剧了模型大鼠血液流变学、凝血功能和红细胞形态的病理变化,证实改良的大鼠模型能够表征PMS发生发展过程中的“神经-内分泌-免疫”系统紊乱和循环系统紊乱,符合中医和西医的临床诊断及治疗标准。改良的PMS大鼠模型的建立可为阐明PMS的发病机制以及发现和评价治疗药物提供可靠的实验载体。它还为客观反映PMS在中医和西医中的临床特征及精准治疗提供参考。