An integrated metabonomic and proteomic study on Kidney-Yin Deficiency Syndrome patients with diabetes mellitus in China.

AIM: To investigate specific changes in metabolites and proteins of Kidney-Yin Deficiency Syndrome (KYDS) patients with diabetes mellitus (DM) in China. METHODS: KYDS (n=29) and non-KYDS (n=23) patients with DM were recruited for this study. The KYDS was diagnosed by two senior TCM clinicians separately. The metabonomic and proteomic profiles of the patients were assessed using a metabonomic strategy based on NMR with multivariate analysis and a proteomic strategy based on MALDI-TOF-MS, respectively. RESULTS: Eighteen upregulated peptides and thirty downregulated peptides were observed in the plasma of the KYDS patients. Comparing the proteomic profiles of the KYDS and non-KYDS groups, however, no significantly differentially expressed peptides were found. At the same time, major metabolic alterations were found to distinguish the two groups, including eight significantly changed metabolites (creatinine, citrate, TMAO, phenylalanine, tyrosine, alanine, glycine and taurine). The levels of creatinine, citrate, TMAO, phenylalanine and tyrosine were decreased, whereas the levels of alanine, glycine and taurine were increased in the KYDS patients. These biochemical changes were found to be associated with alterations in amino acid metabolism, energy metabolism and gut microflora. CONCLUSION: The identification of distinct expression profiles of metabolites and signaling pathways in KYDS patients with DM suggests that there are indeed molecular signatures underlying the principles of 'Syndrome Differentiation' in traditional Chinese medicine.

[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.