Exploring the mechanism of Qinbaiqingfei-concentrate pills in the treatment of Mycoplasma pneumoniae pneumonia from the perspective of intestinal microbiota and mucosal immunity

J Ethnopharmacol. 2022 Jul 15:293:115308. doi: 10.1016/j.jep.2022.115308. Epub 2022 Apr 20.

Abstract

Ethnopharmacological relevance: Traditional Chinese medicine categorizes Mycoplasma pneumoniae pneumonia as "lung heat", and treatment with heat clear and detoxify. Traditional Chinese medicine believes that the lungs and intestines come from the same source, and the intestine is related to pneumonia. This is the same as the gut-lung axis theory. Qinbaiqingfei concentrate pills (QBs) were modified based on Cough San in the ancient medical book Medical Awareness. It clears lung heat, moisturizes the lungs and dredges collaterals, and has a good ability to treat Mycoplasma pneumoniae.

Aim of the study: A rat model of Mycoplasma pneumoniae was established. From the aspect of intestinal flora and mucosal immunity, the potential mechanism of the QBs was researched.

Materials and methods: First, the content of Mycoplasma pneumoniae in lung tissue and the levels of the inflammatory factors IL-4, IL-10, TNF-α and INF-γ were detected. To determine the expression of NF-kB related proteins in lung tissue, which can understand the ability in treating disease. Next, metagenomic sequencing was performed to detect changes in short-chain fatty acids, proving the ability of the drug to regulate intestinal microecology. Finally, HDAC, LPS, SIgA, etc. were detected to facilitate the correlation of the overall experimental indicators.

Results: QBs reduces the levels of IL-4, IL-10, TNF-α and INF-γ in the serum by inhibiting the expression of MyD88, IKKα, IκBα, and NF-κB p65 in lung tissue. In addition, QBs restores the ratio of gram-negative bacteria to gram-positive bacteria in the intestine, restores the secretion of acetic acid, propionic acid, butyric acid, isobutyric acid and isovaleric acid, and promotes the secretion of NF-κB p65 and SIgA by HDAC1/3. The result is that the lung tissue is repaired and the proliferation of Mycoplasma pneumoniae is inhibited.

Conclusions: From the "gut-lung axis", a new research perspective was discovered. QBs intervened in the intestines and lungs to treat Mycoplasma pneumoniae.

Keywords: Gut lung axis; Intestinal flora; Mycoplasma pneumoniae; NF-κB; Qinbaiqingfei concentrated pills; Short-chain fatty acids.

MeSH terms

  • Animals
  • Drugs, Chinese Herbal* / therapeutic use
  • Gastrointestinal Microbiome*
  • Immunity, Mucosal*
  • Immunoglobulin A, Secretory
  • Interleukin-10
  • Interleukin-4
  • Mycoplasma pneumoniae
  • NF-kappa B / metabolism
  • Pneumonia, Mycoplasma* / drug therapy
  • Rats
  • Tumor Necrosis Factor-alpha

Substances

  • Drugs, Chinese Herbal
  • Immunoglobulin A, Secretory
  • NF-kappa B
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interleukin-4