Gut Microbiota and Urine Metabonomics Alterations in Constitution after Chinese Medicine and Lifestyle Intervention.

Traditional Chinese Medicine Constitution (TCMC) divides human beings into balanced (ping-he) constitution (PH) and unbalanced constitution. Yang-deficiency (yang-xu) constitution (YAX) is one of the most common unbalanced constitutions in Chinese general population, and it causes susceptibility to particular diseases. However, unbalanced constitutions can be regulated by Chinese medicine and lifestyle intervention in clinical practice. Gui-fu-di-huang-wan (GFDHW) is a well-known Chinese medicine with yang-invigorating activity and is regarded as improving YAX. In this study, 60 healthy YAX students selected from a prospective population of 5185 were enrolled in a randomized clinical trial and completed the study. We compared the gut microbiota and urinary metabolome between individuals with PH and those with YAX before and after one-month-intervention. Compared with the control group, the health status of the intervention group improved significantly, the YAX symptom score was reduced, and the efficacy remained high at the one-year follow-up. The gut microbiota of the healthy PH exhibited greater diversity, and significantly higher species were identified. Compared to PH group, YAX individuals showed increased abundance of Bacteroidetes and Bacteroides, also had higher levels of gut microbial-derived urinary metabolites. After one-month-intervention, both GFDHW treatment and lifestyle intervention enriched the diversity and modulated the structure in YAX. The intervention group also partially restored the microbiome and metabolome to healthy PH-like levels. Further, a microbiota co-occurrence network analysis showed that the metabolites enriched in YAX were correlated with microbial community structure. Taken together, our results suggest that Chinese medicine combined with lifestyle intervention benefits YAX individuals. Gut microbiota/metabolite crosstalk might be involved in the Chinese medicine-mediated effects.

Novel chinmedomics strategy for discovering effective constituents from ShenQiWan acting on ShenYangXu syndrome.

Elucidation of the efficacy of traditional Chinese medicine (TCM) is of importance for scientists of modern medicine to understand the value of TCM clinical experience, and it is necessary to have a biological language to scientifically describe the efficacy of TCM. With this background?Chinmedomics has been proposed by our team, which includes integrating serum pharmacochemistry and metabolomics technology, defining theory and research methods for expressing the efficacy of TCMs based on the biomarkers discovery of TCM syndrome and elucidating the efficacy of TCM formulae, discovering effective constituents, and finally elucidating the scientific value of TCM. In the present study, the innovative chinmedomics strategy was conducted to evaluate the therapeutic effects of ShenQiWan (SQW) acting on ShenYangXu (kidney-yang deficiency syndrome, KYDS). We analyzed the urine metabolic trajectory between the model and control groups, and identified the biomarkers by the multivariate analysis. We found that SQW caused significant restoration of abnormal metabolism of KYDs. Using the method of metabolomics, 17 potential urine biomarkers were analyzed through 4 repeated tests in our serial studies on SQW and KYDS. Under the premise of therapeutic efficacy, a total of 56 peaks were tentatively characterized in vivo by the use of serum pharmacochemistry. Correlation analysis between marker metabolites and in vivo constituents of SQW showed that 28 compositions had a close relationship with urine biomarkers of therapeutic effects, whichmight play a key role in the therapeutic effect of SQW. These compounds were imported into an online database to predict their targets. Twenty-three important potential targets were identified, which were related to the metabolism of steroid hormone, tryptophan utilization, and thyroid hormone. In conclusion, chinmedomics is a useful strategy for discovery of potentially effective constituents from complex TCM formulae.

[Urine metabonomic study of intervention effects of Morinda officinalis how. on 'kidney-yang deficiency syndrome'].

To investigate the intervention effects of Morinda officinalis How. on 'Kidney-yang deficiency syndrome' induced by hydrocortisone in rats, the metabolic profiles of rat urine were characterized using proton nuclear magnetic resonance and principal component analysis (PCA) was applied to study the trajectory of urinary metabolic phenotype of rats with 'Kidney-yang deficiency syndrome' under administration of M. officinalis at different time points. Meanwhile, the intervention effects of M. officinalis on urinary metabolic potential biomarkers associated with 'Kidney-yang deficiency syndrome' were also discussed. The experimental results showed that in accordance to the increased time of administration, an obvious tendency was observed that clustering of the treatment group moved gradually closed to that of the control group. Eight potential biomarkers including citrate, succinate, alpha-ketoglutarate, lactate, betaine, sarcosine, alanine and taurine were definitely up- or down-regulated. In conclusion, the effectiveness of M. oficinalis on 'Kidney-yang deficiency syndrome' is proved using the established metabonomic method and the regulated metabolic pathways involve energy metabolism, transmethylation and transportation of amine. Meanwhile, the administration of M. officinalis can alleviate the kidney impairment induced by 'Kidney-yang deficiency syndrome'.

[Study on proteins in urine of chronic renal failure patients of different TCM syndrome types].

OBJECTIVE: To study different protein expressions in urine of chronic renal failure (CRF) patients of different Chinese medicine (CM) syndrome types. METHODS: Recruited were 251 CRF inpatients at the Department of Nephrology, Affiliated Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2009 to January 2010. Of them, there were 34 patients in Gan-Shen yin deficiency group (GSYDG), 75 in Pi-Shen qi deficiency group (PSQDG), 56 in Pi-Shen qi-yin deficiency group (PSQYG), 32 in Pi-Shen yang deficiency group (PSYDG), and 54 in yin-yang deficiency group (YYDG). Another 50 healthy subjects were recruited as the control group. The proteomic study of the urine was performed with H4 gene chip using surface-enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS). The gene chips were scanned and analyzed using protein array reader PBSII. RESULTS: A total of 49 differential protein peaks were detected between CM syndrome types groups and the control group (P<0.01). The area under the ROC curve of different CM syndrome types showed that obvious difference existed between GSYDG and PSQDG, PSQYG, PSYDG, and YYDG. Obvious difference existed between PSQYD and PSYDG. General difference existed between PSQDG and PSQDG as well as PSYDG. General difference existed between PSQYD and YYDG or between PSYDG and YYDG. No obvious difference existed between PSQDG and YYDG. CONCLUSION: Urine protein biomarkers could reflect different biological features of CRF patients of different CM syndrome types to some extent.

Metabonomic study on 'Kidney-Yang Deficiency syndrome' and intervention effects of Rhizoma Drynariae extracts in rats using ultra performance liquid chromatography coupled with mass spectrometry.

This paper was designed to study metabonomic characters of the 'Kidney-Yang Deficiency syndrome' induced by high dose of hydrocortisone and the therapeutic effects of Rhizoma Drynariae, classic traditional Chinese medicine (TCM) in treating the syndrome. A urinary metabonomics method based on ultra-performance liquid chromatography coupled with mass spectrometry (UPLC/MS) was developed. The significant difference in metabolic profiling was observed from model group (hydrocortisone-induced group) compared with the pre-dose group (rats before hydrocortisone inducing) by using the principal components analysis (PCA). The time-dependent regression tendency in Rhizoma Drynariae treatment group (hydrocortisone-induced rats followed by being administered with Rhizoma Drynariae ethanol extracts) from day 3 to 15 was obtained, indicating the time-dependent recovery effect of Rhizoma Drynariae on 'Kidney-Yang Deficiency syndrome' rats. Some significantly changed metabolites like phenylalanine, phenylacetylglycine, N(2)-succinyl-L-ornithine, L-proline, creatinine, hippurate and citrate have been identified. These biochemical changes are related to the disturbance in energy metabolism, amino acid metabolism and gut microflora, which are helpful to further understand the 'Kidney-Yang Deficiency syndrome' and the therapeutic mechanism of Rhizoma Drynariae. The work shows that the metabonomics method is a valuable tool for studying the essence of Chinese medicine's syndrome theory and therapeutic effect mechanism of TCM.

[Effects of Yiniao Recipe on serum antidiuretic hormone level and plasma ratio of cAMP to cGMP in rats with kidney-yang deficiency].

OBJECTIVE: To investigate the effects of Yiniao Recipe, a compound traditional Chinese herbal medicine, on contents of serum antidiuretic hormone, and plasma cyclic adenosine monophosphate and cyclic guanosine monophosphate in rats with kidney-yang deficiency. METHODS: Forty male Wistar rats were randomly divided into blank control group, untreated group, desmopressin (Minirin) group, low-dose Yiniao Recipe group and high-dose Yiniao Recipe group, with 8 rats in each group. Rats in the blank control group were injected with 0.2 mL normal saline, and rats in the other groups were given intramuscular injection of hydrocortisone 25 mg/kg, 1 time daily for 21 consecutive days; from the 8th day of injection, rats were given double distilled water, Minirin, and high- and low-dose Yiniao Recipe respectively for 30 days. Before and after treatment, 24-hour urine volume was observed, and serum antidiuretic hormone (AVP) as well as plasma cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) contents were detected by enzyme-linked immunosorbent assay. The cAMP/cGMP ratio and morphological changes in renal tissues were also observed. RESULTS: Compared with blank control group, 24-hour urine volume, serum AVP content and cAMP/cGMP ratio in the untreated group were decreased; compared with the untreated group, Minirin and Yiniao Recipe at low and high doses reduced 24-hour urine volume and increased serum AVP content and cAMP/cGMP ratio significantly (P<0.05 or P<0.01). There were no obvious pathological changes in renal tissue in all groups. CONCLUSION: Yiniao Recipe may reduce 24-hour urine volume by increasing serum AVP content and regulating the ratio of cAMP to cGMP in kidney-yang deficiency rats.