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[葛根芩连汤通过影响胆汁酸合成治疗溃疡性结肠炎的机制]

[Mechanism of Gegen Qinlian Decoction in treatment of ulcerative colitis through affecting bile acid synthesis].

作者信息

Sun Yi-Xuan, Fan Jia-Li, Wu Jing-Jing, Chen Li-Juan, He Jiang-Hua, Xu Wen-Juan, Dong Ling

机构信息

School of Life Sciences,Beijing University of Chinese Medicine Beijing 100029,China.

School of Chinese Materia Medica,Beijing University of Chinese Medicine Beijing 100029,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2025 May;50(10):2769-2777. doi: 10.19540/j.cnki.cjcmm.20241212.708.

Abstract

Gegen Qinlian Decoction(GQD) is a classic prescription for the clinical treatment of ulcerative colitis(UC). This study, based on the differences in efficacy observed in UC mice under different level of bile acids treated with GQD, aims to clarify the impact of bile acids on UC and its therapeutic effects. It further investigates the expression of bile acid receptors in the liver of UC mice, and preliminarily reveals the mechanism through which GQD affects bile acid synthesis in the treatment of UC. A UC mouse model was established using dextran sulfate sodium(DSS) induction. The efficacy of GQD was evaluated by assessing the general condition, disease activity index(DAI) score, colon length, and histopathological changes in colon tissue via hematoxylin and eosin(HE) staining. ELISA and Western blot were used to evaluate the inflammatory response in colon tissue. The total bile acid(TBA) level and liver damage were quantified using an automatic biochemistry analyzer. The expression levels of bile acid receptors and bile acid synthetases in liver tissue were detected by Western blot and RT-qPCR. The results showed that compared with the model group, GQD treatment significantly improved the DAI score, colon shortening, and histopathological damage in UC mice. The levels of pro-inflammatory factors TNF-α and IL-6 in the colon were significantly reduced. Serum TBA levels were significantly decreased, while alkaline phosphatase(ALP) levels significantly increased. After administration of cholic acid(CA), UC symptoms in the CA + GQD group were significantly aggravated compared with the GQD group. The DAI score, degree of weight loss, colon injury, serum TBA, and liver injury markers all increased significantly. However, compared with the CA group, the CA + GQD group showed a marked reduction in TBA levels and a significant improvement in UC-related symptoms, indicating that GQD can alleviate UC damage exacerbated by CA. Further investigation into the expression of bile acid receptors and synthetases in the liver showed that under GQD treatment, the expression of farnesoid X receptor(FXR) and small heterodimer partner(SHP) significantly increased, while the expression of G protein-coupled receptor 5(TGR5) and cholesterol 7α-hydroxylase(Cyp7A1) significantly decreased. These findings suggest that GQD may affect bile acid receptors and synthetases, inhibiting bile acid synthesis through the FXR/SHP pathway to treat UC.

摘要

葛根芩连汤(GQD)是临床治疗溃疡性结肠炎(UC)的经典方剂。本研究基于用GQD治疗的不同胆汁酸水平下UC小鼠观察到的疗效差异,旨在阐明胆汁酸对UC的影响及其治疗作用。进一步研究UC小鼠肝脏中胆汁酸受体的表达,并初步揭示GQD在治疗UC中影响胆汁酸合成的机制。采用葡聚糖硫酸钠(DSS)诱导建立UC小鼠模型。通过评估一般状况、疾病活动指数(DAI)评分、结肠长度以及通过苏木精和伊红(HE)染色观察结肠组织的组织病理学变化来评估GQD的疗效。采用酶联免疫吸附测定(ELISA)和蛋白质印迹法(Western blot)评估结肠组织中的炎症反应。使用自动生化分析仪定量总胆汁酸(TBA)水平和肝损伤情况。通过蛋白质印迹法和逆转录-定量聚合酶链反应(RT-qPCR)检测肝组织中胆汁酸受体和胆汁酸合成酶的表达水平。结果显示,与模型组相比,GQD治疗显著改善了UC小鼠的DAI评分、结肠缩短和组织病理学损伤。结肠中促炎因子肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平显著降低。血清TBA水平显著降低,而碱性磷酸酶(ALP)水平显著升高。给予胆酸(CA)后,与GQD组相比,CA + GQD组的UC症状显著加重。DAI评分、体重减轻程度、结肠损伤、血清TBA和肝损伤标志物均显著增加。然而,与CA组相比,CA + GQD组的TBA水平显著降低,UC相关症状显著改善,表明GQD可减轻CA加剧的UC损伤。对肝脏中胆汁酸受体和合成酶表达的进一步研究表明,在GQD治疗下,法尼醇X受体(FXR)和小异二聚体伴侣(SHP)的表达显著增加,而G蛋白偶联受体5(TGR5)和胆固醇7α-羟化酶(Cyp7A1)的表达显著降低。这些发现表明,GQD可能影响胆汁酸受体和合成酶,通过FXR/SHP途径抑制胆汁酸合成来治疗UC。

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