Abstract

Background There is still a lack of effective therapeutic drugs for nonalcoholic fatty liver disease (NAFLD) to date. In this study, we applied mouse model experiments to clarify the effect of Chinese herbal medicine “Lanzhang Granules (LZG)” on NAFLD and further explore the potential mechanism to provide an alternative method for NAFLD treatment. Methods Male C57BL/6J mice were fed with a high-fat diet (HFD) for twenty-two weeks to induce the NAFLD model. LZG intervention was then performed by gavage daily for another eight weeks. At the end of the treatment, serum and liver tissues were collected. Serum biochemical indexes, insulin levels, and liver histopathology were measured to assess the effect of LZG on NAFLD. The liver tissues were then analyzed by RNA sequence for differentially expressed genes and signaling pathways. Results were further analyzed by Protein-Protein Interaction (PPI) networks between the LZG and model groups. The selected different genes and signaling pathways were further verified by RT-PCR and Western blot analysis. Moreover, alpha mouse liver 12 (AML12) cells with lipid accumulation induced by fatty acid were treated with LZG, Fenofibrate (PPARα agonist), or Gw6471 (PPARα antagonist) to confirm the potential pharmacological mechanism. Results LZG was found to downregulate liver weight, body weight, liver index, and serum levels of ALT, AST, and serum lipid in HFD-induced NAFLD mice. HE and Oil Red O staining showed the improvement of hepatic steatosis and inflammatory infiltration in the mice with LZG treatment. The homeostasis model assessment-insulin resistance (HOMA-IR) index indicated that LZG improved the insulin resistance of NAFLD mice. The RNA sequencing and PPI analysis confirmed the role of LZG in lipid metabolism regulation and identified the peroxisome proliferator-activated receptor alpha (PPARα) signaling pathway as one of the major underlying mechanisms. Western blot and RT-PCR results verified the regulatory effect of LZG on the PPARα pathway, including the upregulation of PPARα, acyl-coenzyme A oxidase 1 (ACOX1), and enoyl-CoA hydratase and 3-hydroxyacyl-CoA dehydrogenase (EHHADH) and the downregulation of TNFα. In vitro experiments showed the effect of LZG in improving lipid accumulation and cell viability in AML12 cells induced by fatty acids, which were alleviated by Gw6471 coincubation. Gw6471could also reverse the transcription of PPAR target genes ACOX1 and EHHADH, which were upregulated by LZG treatment. Conclusion LZG can improve NAFLD in mice or cell models. A major underlying mechanism may be the regulation of the PPARα signaling pathway to improve lipid metabolism and inhibit the inflammatory response. This study will help to promote the clinical application of LZG for the treatment of NAFLD.

Highlights

  • Nonalcoholic fatty liver disease (NAFLD) is a chronic liver injury disease that is associated with lipid accumulation and insulin resistance

  • Based on the aforementioned traditional Chinese medicine (TCM) theory, we have developed the formula “Lanzhang Granules (LZG),” which consists of the following herbal medicines: Gynostemma pentaphyllum Mak, Astragalus mongholicus, Radix Angelicae Sinensis, Radix et Rhizoma Tigrinum, and Fritillariae unbergii Bulbus

  • LZG was able to downregulate the elevated levels of serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) in NAFLD mice induced by the high-fat diet. ere was no significant change in serum TG levels in any of the groups (Figure 2(b))

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Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver injury disease that is associated with lipid accumulation and insulin resistance. In 2017, the global prevalence of NAFLD was approximately 24%. With changes in daily lifestyle and dietary habits, the incidence of NAFLD continues to rapidly increase throughout the world. Without proper and effective treatment, some cases of NAFLD could progress to nonalcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma [1, 2]. Studies have found that NAFLD accounts for 14.1% of the causative factors of hepatocellular carcinoma and is increasing annually at a rate of 9% [3]. NAFLD treatment has previously focused on lifestyle

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