Abstract
Objective This study aimed to analyze the differential metabolites and their metabolic pathways from the serum of patients with hepatitis B cirrhosis, with two typical patterns of Gan Dan Shi Re (GDSR) and Gan Shen Yin Xu (GSYX) based on the theory of traditional Chinese medicine (TCM). It also investigated the variation in the internal material basis for the two types of patterns and provided an objective basis for classifying TCM patterns using metabolomic techniques. Methods The serum samples taken from 111 qualified patients (40 GDSR cases, 41 GSYX cases, and 30 Latent Pattern (LP) cases with no obvious pattern characters) and 60 healthy volunteers were tested to identify the differential substances relevant to hepatitis B cirrhosis and the two typical TCM patterns under the gas chromatography–time-of-flight mass spectrometry platform. The relevant metabolic pathways of differential substances were analyzed using multidimensional statistical analysis. Results After excluding the influence of LP groups, six common substances were found in GDSR and GSYX patterns, which were mainly involved in the metabolic pathways of glycine, serine, threonine, and phenylalanine. Eight specific metabolites involved in the metabolic pathways of linoleic, glycine, threonine, and serine existed in the two patterns. Conclusions The data points on the metabolic spectrum were found to be well distributed among the differential substances between the two typical TCM patterns of patients with hepatitis B cirrhosis using metabolomic techniques. The differential expression of these substances between GDSR and GSYX patterns provided an important objective basis for the scientific nature of TCM pattern classification at the metabolic level.
Highlights
Hepatitis B cirrhosis is one of the most fatal, refractory, and progressive liver diseases worldwide according to recent qualified epidemiological studies [1]
The 22 differential metabolites obtained in the latent pattern (LP) group in this study may serve as potential markers for hepatitis B cirrhosis
Eight potential biomarkers, including citrulline, urea, myristic acid, palmitic acid, palmitoleic acid, linoleic acid, glycolic acid, and petroselinic acid, were found in the Gan Dan Shi Re (GDSR) pattern removing disease factors and common substances, and they all were involved in abnormalities of the linoleic acid metabolic pathway
Summary
Hepatitis B cirrhosis is one of the most fatal, refractory, and progressive liver diseases worldwide according to recent qualified epidemiological studies [1]. Based on its holistic and individualized diagnosis and treatment characteristics, traditional Chinese medicine (TCM) has unique advantages in treating hepatitis B cirrhosis by improving the clinical symptoms and liver function, reversing liver fibrosis, or even preventing the progression of cirrhosis. The pattern “Zheng,” according to the transliteration of Chinese, is the core concept of TCM diagnosis, treatment, and determination of curative effect. Accurate pattern discernment is the core link to improve the clinical efficacy of TCM. The pattern differentiation is based mainly on practitioners' own experience such as looking, Evidence-Based Complementary and Alternative Medicine smelling, talking, and feeling the pulse. Limited objective evidence restricts the development of the study about the Chinese pattern. With the advancement of science and technology, many researchers tried to explain the pattern classification rules by modern scientific methods to make up for the deficiency of objectivity and reproducibility in pattern differentiation
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