Perspective on the Modern Interpretation of the Property Theory of Mild-natured and Sweet-flavored Traditional Chinese Medicine via Gut Microbiota Modulation

Abstract

ABSTRACT The property theory of traditional Chinese medicine (TCM) has guided its clinical application for thousands of years. Although the TCM modernization project has made significant progress, several challenges, such as identifying modern biological indicators, remain. Recent investigations have demonstrated that the gut microbiota contributes to the metabolism and efficacy of TCMs, providing a potential indicator of TCM properties. To investigate whether the gut microbiota can partially interpret the property theory of TCM, we searched the “PubMed” and “China National Knowledge Infrastructure” databases using “gut microbiota” and “traditional Chinese medicine” as keywords. This review mainly focused on the relationship between mild-natured and sweet-flavored TCMs (MS-TCMs) and the gut microbiota. We discovered that MS-TCMs can recalibrate the gut microbiota to alleviate various diseases. At the family level, MS-TCMs upregulated Erysipelotrichaceae, Verrucomicrobiaceae, Bacteroidaceae, Christensenellaceae, Lactobacillaceae, and Prevotellaceae, while downregulating Enterobacteriaceae, Rikenellaceae4, and S24-7. At the genus level, MS-TCMs increased the abundance of Ruminococcus, Turicibacter, Parabacteroides, Dubosiella, Bifidobacterium, Bacteroides, Lactobacillus, Oscillospira, and Prevotella, and decreased the abundance of Parasutterella, Mucispirillum, Lachnoclostridium, Escherichia, Enterococcus, Butyricicoccus, Clostridiales, Blautia, Desulfovibrio, and Oscillibacter. Mechanistically, changes in gut bacteria can influence the levels of metabolites such as short-chain fatty acids, lipopolyaccharides, and neurotransmitters, which further regulate a series of physiological signaling pathways within the host. Overall, analyzing the TCM–microbiota interaction is an effective means to reveal the mechanisms of TCM, suggesting that the gut microbiota can be developed into a modern indicator of TCM properties.