Tu Wenling, Tian Xiangfeng, Fu Huangjie, Xu Fuhang, Wang Hanxiao, Wang Qian, Lin Xiaoqian, Shu Jianlong, Lin Shuyuan, Cao Lingyong, Wang Lei
School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China; Nanning Seventh People's Hospital, Nanning, 530012, China.
School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
J Ethnopharmacol. 2025 Jul 18;353(Pt A):120309. doi: 10.1016/j.jep.2025.120309.
Huanglian Zhimu decoction (HLZMD), a classical formulation in traditional Chinese medicine, has historically been utilized in the management of diabetes. However, its therapeutic efficacy and the underlying mechanisms in the context of T2DM, particularly in relation to hepatic lipid dysregulation, have yet to be systematically investigated.
To explore the potential therapeutic effects and molecular mechanisms of HLZMD on T2DM.
Initially, a T2DM model was established in spontaneously diabetic Goto-Kakizaki (GK) rats through high-fat diet induction. To elucidate the molecular mechanisms underlying the therapeutic effects of HLZMD, an integrative approach combining hepatic lipidomic profiling and transcriptomic sequencing was employed to identify HLZMD-responsive pathways. Furthermore, the expression levels of key proteins within the PDE4D/cAMP/PKA signaling pathway were quantified via western blotting in both rat liver tissues and palmitic acid-stimulated HepG2 cells. To validate the pathway specificity, pharmacological inhibition experiments were performed using roflumilast, a selective PDE4D antagonist. Lastly, the chemical composition of HLZMD was characterized through ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS), and molecular docking analysis was conducted to predict potential active components interacting with PDE4D.
In vivo experiments demonstrated that HLZMD significantly ameliorated fasting blood glucose levels and hepatic steatosis in T2DM rats. Lipidomic analysis further revealed that HLZMD effectively restored the homeostasis of diacylglycerols (DG), triglycerides (TG), sterols (ST), sphingolipids (SP), and glycerophospholipids (GP) in the liver. Integrative analyses incorporating lipidomics, transcriptomics, and western blotting suggested that HLZMD-mediated hepatic lipid modulation may be attributed to the regulation of the PDE4D/cAMP/PKA signaling pathway. In vitro, HLZMD treatment resulted in a significant reduction in extracellular glucose concentrations as well as intracellular TC and TG levels. Concurrently, HLZMD markedly upregulated the expression of PDE4D, SIRT1, and PPARγ proteins while downregulating the expression of cAMP, phosphorylated PKA (p-PKA/PKA), and phosphorylated hormone-sensitive lipase (p-HSL/HSL). Notably, pharmacological inhibition with roflumilast, a selective PDE4D antagonist, partially reversed the HLZMD-induced reduction in lipid deposition, supporting the specificity of this pathway in mediating HLZMD's effects. Furthermore, UPLC-Q-TOF-MS identified 80 chemical constituents in HLZMD. Molecular docking analysis predicted that 21 of these compounds may exhibit direct binding affinity for PDE4D, potentially modulating the cAMP/PKA signaling cascade.
This study is the first to provide evidence that HLZMD exerts its pharmacological effects through multi-component interactions with PDE4D, thereby modulating the cAMP/PKA signaling pathway. This regulatory mechanism contributes to the reduction of hepatic lipid accumulation, attenuation of hepatic insulin resistance, and restoration of glucose and lipid metabolic homeostasis.
黄连知母汤(HLZMD)是中药中的经典方剂,历史上一直用于糖尿病的治疗。然而,其在2型糖尿病(T2DM)背景下的治疗效果及潜在机制,尤其是与肝脏脂质代谢失调相关的机制,尚未得到系统研究。
探讨HLZMD对T2DM的潜在治疗作用及分子机制。
首先,通过高脂饮食诱导,在自发性糖尿病Goto-Kakizaki(GK)大鼠中建立T2DM模型。为阐明HLZMD治疗作用的分子机制,采用肝脏脂质组学分析和转录组测序相结合的综合方法来鉴定HLZMD反应通路。此外,通过蛋白质印迹法对大鼠肝脏组织和棕榈酸刺激的HepG2细胞中PDE4D/cAMP/PKA信号通路关键蛋白的表达水平进行定量。为验证通路特异性,使用选择性PDE4D拮抗剂罗氟司特进行药理抑制实验。最后,通过超高效液相色谱-四极杆飞行时间质谱联用(UPLC-Q-TOF/MS)对HLZMD的化学成分进行表征,并进行分子对接分析以预测与PDE4D相互作用的潜在活性成分。
体内实验表明,HLZMD显著改善了T2DM大鼠的空腹血糖水平和肝脏脂肪变性。脂质组学分析进一步显示,HLZMD有效恢复了肝脏中二酰甘油(DG)、甘油三酯(TG)、固醇(ST)、鞘脂(SP)和甘油磷脂(GP)的稳态。结合脂质组学、转录组学和蛋白质印迹法的综合分析表明,HLZMD介导的肝脏脂质调节可能归因于PDE4D/cAMP/PKA信号通路的调节。在体外,HLZMD处理导致细胞外葡萄糖浓度以及细胞内TC和TG水平显著降低。同时,HLZMD显著上调PDE4D、SIRT1和PPARγ蛋白的表达,而下调cAMP、磷酸化PKA(p-PKA/PKA)和磷酸化激素敏感性脂肪酶(p-HSL/HSL)的表达。值得注意的是,选择性PDE4D拮抗剂罗氟司特的药理抑制部分逆转了HLZMD诱导的脂质沉积减少,支持了该通路在介导HLZMD作用中的特异性。此外,UPLC-Q-TOF-MS鉴定出HLZMD中的80种化学成分。分子对接分析预测其中21种化合物可能对PDE4D具有直接结合亲和力,潜在地调节cAMP/PKA信号级联反应。
本研究首次提供证据表明,HLZMD通过与PDE4D的多组分相互作用发挥其药理作用,从而调节cAMP/PKA信号通路。这种调节机制有助于减少肝脏脂质积累、减轻肝脏胰岛素抵抗以及恢复葡萄糖和脂质代谢稳态。