Effect of Jianpi Huazhi(健脾化滞)Pills on Serum and Urine Metabolic Spectrum in Patients with Ulcerative Colitis Based on Gas Chromatography-Mass Spectrometry
Objective:To investigate the effect of Jianpi Huazhi(健脾化滞)Pills(JPHZ)on serum and urine metabolites in patients with ulcera-tive colitis(UC)and analyze the underlying mechanism in the treatment of UC.Methods:Twenty-four patients with UC treated in the Gas-troenterology Department,Nantong Hospital Affiliated to Nanjing University of Chinese Medicine from August 2016 to June 2017 were enrolled and assigned to the case group,and 15 healthy people were enrolled and assigned to the normal group.The patients in the case group were given 10 g of JPHZ,3 times a day for four weeks.The levels of blood routine and ESR of patients and healthy people were measured before and after treatment,and the levels of TNF-α,IL-10,IL-12,IL-23,and TLR4 in the two groups were compared.The serum and urine samples of patients and healthy people were collected before and after treatment and detected by gas chromatography-mass spectrometry(GC/MS),fol-lowed by multivariate statistical analysis.Differential metabolites were screened and analyzed for their metabolic pathways.Results:Com-pared with the normal group,the case group showed increased levels of ESR,IL-12,IL-23,and TNF-α before treatment(P＜0.05 or P＜0.01)and decreased IL-10 level(P＜0.01).After treatment,the levels of ESR,IL-12,IL-23,and TNF in the case group were lower than those be-fore treatment(P＜0.05 or P＜0.01)and the IL-10 content was higher(P＜0.01).Compared with the normal group,the case group showed significant changes in serum and urine metabolic spectrum before treatment,and 24 differential metabolites were found(P＜0.05 or P＜0.01),involving glutamine,ornithine,hippuric acid,alanine,ribose,inositol,hydroxyurea,palmitic acid,methionine,lactic acid,palmitoleic acid,serine,malonic acid,tyrosine,threonine,oleic acid,3-hydroxypropionic acid,phenylacetic acid,hydrocinnamic acid,uridine,cholic acid,phosphate,glutamate,and malic acid.In the case group,12 metabolites in serum and urine returned to normal levels after treatment(P＜0.05 or P＜0.01),including glutamine,hippuric acid,ribose,hydroxyurea,tyrosine,threonine,oleic acid,hydrocinnamic acid,ornithine,cystine,ma-lonic acid,and malic acid.Conclusion:JPHZ can regulate the expression of inflammatory factors in serum and improve local immune bal-ance.Twenty-four endogenous metabolites can be used as potential markers of UC.The regulation of JPHZ on 12 metabolites may be the pathway and mechanism of JPHZ in the prevention and treatment of UC,which mainly involves amino acid metabolism,energy metabolism,fat-ty acid metabolism,and bile acid metabolism.
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