4.7 Article

Bidirectional regulation effect of rhubarb as laxative and astringent by metabolomics studies

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JOURNAL OF ETHNOPHARMACOLOGY
卷 320, 期 -, 页码 -

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ELSEVIER IRELAND LTD
DOI: 10.1016/j.jep.2023.117348

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Laxative; Astringent; Purgative effect; Metabolomics

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This study evaluated the effects of oral supplementation with lutein on physical and immune indicators in a randomized, double-blind, placebo-controlled clinical trial. The results showed that lutein supplementation significantly improved physical and immune indicators, including body weight, body fat percentage, waist circumference, white blood cell count, C-reactive protein, tumor necrosis factor α levels, and serum lutein levels. These findings provide support for the clinical application of lutein in enhancing immune function and improving physical indicators.
Ethnopharmacological relevance: Rhubarb, a prominent traditional Chinese medicine, has been employed as a potent laxative for centuries and garnered particular popularity among the youth owing to its notable efficacy in weight management. Historical records indicated that rhubarb initially exhibited robust laxative properties, but extended and consistent usage may lead to an astringent response in the later stage of long-term use. In contrast, steamed pieces of rhubarb (SR), preparing through the process of steaming with wine, have demonstrated a gentle laxative effect with no reported adverse effects. Aim of the study: Our study was designed to explore the intricate mechanisms underlying laxative and astringent properties of rhubarb through metabolomics research. Materials and methods: In this investigation, we employed a serum metabolomics approach utilizing the UPLC-QExtractive-Orbitrap-MS method to delve into the contrasting laxative and astringent effects of rhubarb, as well as to unravel the mechanisms of underpinning its bidirectional regulatory influence. To commence, we assessed alterations in Evacuation Index (EI) values, intestinal hormone levels, and colon histopathology in mice to gauge rhubarb's laxative and astringent effects. Subsequently, metabolomics methodology was employed for cluster analysis through Principal Component Analysis (PCA) and biomarker identification via Orthogonal Partial Least Squares-Discriminant Analysis (OPLS-DA). Then, we delved into the distinctions in characteristic biomarkers, metabolic pathways, their association with pathological changes, and correlation heatmap for biomarkers between raw pieces of rhubarb (RR) and SR to gain insights into the potential mechanisms behind rhubarb's bidirectional regulatory effects. Results: Our findings revealed that RR exhibited a laxative effect in the early stage and transitioned to an astringent effect in the later stage, as indicated by the EI values. In contrast, SR consistently demonstrated a mild laxative effect. Biochemical indexes and histopathological assessments unveiled that RR triggered its astringent effect by inhibiting secretion of motilin (MTL), promoting secretion of vasoactive intestinal peptide (VIP) and epinephrine (EPI), and inducing onset of inflammation. Furthermore, serum metabolomics analysis identified 59 discriminative biomarkers modulated by RR and SR. Through comprehensive analysis, we elucidated the in vivo transformation relationships among multiple endogenous metabolites. Notably, our results underscored the down-regulation of certain phosphatidylcholines (PCs), amino acids, acylcarnitines, and up-regulation of lysophosphatidylcholines (LysoPCs) played pivotal roles in the onset of gut dysfunction, intestinal inflammation, gut barrier damage, and gastrointestinal motility disorder upon prolonging RR administration, ultimately contributing to its astringent effect. Additionally, our correlation analysis elucidated that anthraquinones, stilbenes, and phenylbutanones were the pharmacodynamic material basis responsible for inducing the astringent effect of RR.

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