Abstract
Incomplete abortion, a procedure for terminating pregnancy, will lead to abnormal uterine bleeding (AUB), infections, and even death. Taohong Siwu decoction (TSD) is a traditional Chinese medicine (TCM) formula, which has been developed to treat AUB for hundreds of years. However, the mechanism of the protective effect of TSD against AUB is not clear. We performed mass spectrometry (MS) of uterine samples to observe metabolic profile resulting from the treatment with TSD. An integrated gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry based untargeted metabolomics approach combined with multivariate statistical analyses were used to investigate the metabolic profile of TSD against AUB. There was clear separation between pregnant and incomplete aborting rats as well as incomplete aborting and TSD administered rats. Based on random forest algorithm and receiver operator characteristic analysis, 12 biomarkers were optimized related to TSD administered. The effect of TSD on AUB are related to several pathways, such as AA metabolism, glyoxylate and dicarboxylate metabolism, alanine, aspartate, and glutamate metabolism. To our knowledge, this is the first uterine metabolomics study focusing on TSD on AUB and provide a new perspective for explaining the mechanism of TSD on AUB.
Highlights
Since the early 2000s, medical abortion (MA) has been accepted by more and more women who want to end the pregnancy (Singh et al, 2018)
It is reported that there is a metabolic dysfunction in idiopathic recurrent spontaneous miscarriage (Banerjee et al, 2014). 1H nuclear magnetic resonance (1H-NMR) metabolomics revealed the metabolic disturbance of amino acids (Wu et al, 2018) metabolism in aborting patients
Rats in T and Y group dramatically reduced the volume of uterine bleeding and the duration of hemorrhage (Figures 1E, F)
Summary
Since the early 2000s, medical abortion (MA) (mifepristone combined with misoprostol) has been accepted by more and more women who want to end the pregnancy (Singh et al, 2018). 1H nuclear magnetic resonance (1H-NMR) metabolomics revealed the metabolic disturbance of amino acids (Wu et al, 2018) metabolism in aborting patients. Various metabolic abnormalities such as lipid and amino acid are considered to be major contributory factors to abortion (Gong, 2017). Uterus can be sampled for metabolomic analysis to investigate specific information and provide a metabolic change that occurred within the tissue (Subramani et al, 2016). Though several metabolites may be secreted into the blood stream, mechanistic study associated with diseases originating from the affected uterus is expected to be more reliable compared with the blood samples
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