Abstract
Traditional Chinese medicine is one of the complementary and alternative therapies to improve the prognosis of coronary heart disease (CHD). Taohong Siwu Decoction (THSWD), a classical traditional Chinese medication that promotes blood circulation, is clinically beneficial in CHD. However, the underlying mechanism of THSWD is still unclear. To comprehensively understand the material foundation of the “blood”, it is significantly important to study the differential metabolites involved in the treatment of CHD with Chinese medicinal herb promoting blood circulation in TCM theory. Hence, this study investigated the metabolic profiles of the serum in CHD patients to determine the differential metabolites between the THSWD group and the placebo group. Eleven CHD patients were recruited and divided into two groups randomly and double-blindly. Serum samples were determined by performing non-targeted ultra-performance liquid chromatography with tandem mass spectrometry-based metabolomics. Pearson’s correlation analysis was used to assess the association between identified metabolites and clinical serum indexes of CHD. Based on the result, a total of 513 metabolites were found in the serum of CHD patients, of which 27, involved in 29 metabolic pathways, were significantly different between the two groups. Among the differential metabolites, THSWD upregulated succinylcarnitine in fatty acid metabolism and 5′-methylthioadenosine in cysteine and methionine metabolism compared with the placebo group. However, THSWD downregulated pelargonic acid, involved in FA metabolism; succinate, involved in the tricarboxylic acid cycle; gluconic acid, gluconolactone, and d-glucose, involved in pentose phosphate pathway; glycerophosphocholine, involved in glycerophospholipid metabolism; 8,9-dihydroxyeicosatrienoic acid (8,9-DiHETrE), l-lysine, N-acetyl-l-aspartic acid, N-alpha-acetyl-l-asparagine, hippurate, indoxyl sulfate, and 3-ureidopropionate involved in amino acid metabolism compared with the placebo group. Moreover, succinylcarnitine, pelargonic acid, succinate, d-glucose, gluconic acid, l-lysine, N-alpha-acetyl-l-asparagine, 5′-methylthioadenosine, indoxyl sulfate, 8,9-DiHETrE, and 3-ureidopropionate were associated with total cholesterol or low-density lipoprotein. Succinylcarnitine, pelargonic acid, gluconolactone, N-acetyl-l-aspartic acid, N-alpha-acetyl-l-asparagine, hippurate, and 5′-methylthioadenosine were associated with activated partial thromboplastin time. Our findings indicated that glycerophosphocholine, 8,9-DiHETrE, 5′-methylthioadenosine, hippurate, indoxyl sulfate, and 3-ureidopropionate might constitute the partial material foundation of the “blood” in CHD patients treated with THSWD.
Highlights
Coronary heart disease (CHD) is characterized by high morbidity and mortality, which contributes to cardiovascular diseases being the leading cause of death globally (Neumann et al, 2019)
CHD patients were divided into two groups randomly and double-blindly: five patients were treated with placebo granules, and six patients were treated with Taohong Siwu Decoction (THSWD) granules for weeks
The levels of total cholesterol (TC) and low-density lipoprotein (LDL) were higher while that of activated partial thromboplastin time (APTT) was lower in the THSWD group compared with the placebo group before the treatment (P < 0.05), while all values were within the normal ranges
Summary
Coronary heart disease (CHD) is characterized by high morbidity and mortality, which contributes to cardiovascular diseases being the leading cause of death globally (Neumann et al, 2019). Traditional Chinese medicine (TCM) has been considered a safe and effective alternative therapy in the treatment of CHD. Taohong Siwu Decoction (THSWD), originated from the “Golden Mirror of Medicine (Yizong Jinjian)” in Qing Dynasty, is commonly prescribed to promote blood circulation and remove blood stasis. It is composed of the following Chinese medicinal herbs: Tao Ren, Dang Gui, Chuan Xiong, Hong Hua, Chi Shao, and Sheng Di. According to the previous studies, THSWD improves angina symptoms, reduces blood lipids, and promotes anticoagulation (Ma et al, 2018; Tao et al, 2019). THSWD has beneficial effects on CHD treatment, its underlying mechanism is still unclear
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