Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome

Si-Qi Tang; Yun-Liang Wang; Zi-Ye Xie; Yang Zhang; Yi Guo; Kang-Li Gao; Tang-You Mao; Chun-E Xie; Jun-Xiang Li; Xiao-Yan Gao

doi:10.1016/j.joim.2021.03.002

Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome

J Integr Med. 2021 May;19(3):274-281. doi: 10.1016/j.joim.2021.03.002. Epub 2021 Mar 16.

Authors

Si-Qi Tang¹, Yun-Liang Wang², Zi-Ye Xie¹, Yang Zhang², Yi Guo³, Kang-Li Gao⁴, Tang-You Mao², Chun-E Xie², Jun-Xiang Li⁵, Xiao-Yan Gao⁶

Affiliations

¹ School of Chinese Material Medica, Beijing University of Chinese Medicine, Beijing 102488, China.
² Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China.
³ Gastroenterology Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
⁴ Gastroenterology Department, First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031, Anhui Province, China.
⁵ Gastroenterology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China. Electronic address: lijunxiang1226@163.com.
⁶ School of Chinese Material Medica, Beijing University of Chinese Medicine, Beijing 102488, China. Electronic address: gaoxiaoyan@bucm.edu.cn.

PMID: 33775600
DOI: 10.1016/j.joim.2021.03.002

Abstract

Objective: The clinical symptoms of diarrhea-predominant irritable bowel syndrome (IBS-D) can be effectively improved by traditional Chinese medicine (TCM) treatment, based on the usage of specific therapies for different TCM syndromes. However, in the stage of diagnosis, the standard criteria for the classification of TCM syndrome were still deficient. Through serum metabolic profiling, this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes, which can assist in diagnosis of the disease.

Methods: Serum samples were collected from healthy controls (30 cases), IBS-D patients with Liver-Stagnation and Spleen-Deficiency syndrome (LSSD, 30 cases), Yang Deficiency of Spleen and Kidney syndrome (YDSK, 11 cases) and Damp Abundance due to Spleen-Deficiency syndrome (DASD, 22 cases). Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. The potential biomarkers were screened by orthogonal partial least square-discriminate analysis, while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in MetaboAnalyst 4.0.

Results: Overall, 34 potential biomarkers were identified in LSSD group, 36 in YDSK group and 31 in DASD group. And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D. Glycerophospholipid metabolism was disturbed significantly in IBS-D patients, which may play a role in IBS-D through inflammation. What's more, three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.

Conclusion: The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways, whose metabolism was disturbed differently among three TCM syndromes in IBS-D. Therefore, the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators, which can facilitate the TCM-syndrome objective classification of IBS-D.

Keywords: Diarrhea; Irritable bowel syndrome; Metabolomics; Traditional Chinese medicine syndromes.

MeSH terms

Diarrhea / diagnosis
Drugs, Chinese Herbal* / therapeutic use
Humans
Irritable Bowel Syndrome* / diagnosis
Medicine, Chinese Traditional
Metabolomics

Substances

Drugs, Chinese Herbal