1
|
Kainuma M, Kawakatsu S, Kim JD, Ouma S, Iritani O, Yamashita KI, Ohara T, Hirano S, Suda S, Hamano T, Hieda S, Yasui M, Yoshiiwa A, Shiota S, Hironishi M, Wada-Isoe K, Sasabayashi D, Yamasaki S, Murata M, Funakoshi K, Hayashi K, Shirafuji N, Sasaki H, Kajimoto Y, Mori Y, Suzuki M, Ito H, Ono K, Tsuboi Y. Metabolic changes in the plasma of mild Alzheimer's disease patients treated with Hachimijiogan. Front Pharmacol 2023; 14:1203349. [PMID: 37377927 PMCID: PMC10292017 DOI: 10.3389/fphar.2023.1203349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Alzheimer's disease (AD), the most prevalent form of dementia, is a debilitating, progressive neurodegeneration. Amino acids play a wide variety of physiological and pathophysiological roles in the nervous system, and their levels and disorders related to their synthesis have been related to cognitive impairment, the core feature of AD. Our previous multicenter trial showed that hachimijiogan (HJG), a traditional Japanese herbal medicine (Kampo), has an adjuvant effect for Acetylcholine estelase inhibitors (AChEIs) and that it delays the deterioration of the cognitive dysfunction of female patients with mild AD. However, there are aspects of the molecular mechanism(s) by which HJG improves cognitive dysfunction that remain unclear. Objectives: To elucidate through metabolomic analysis the mechanism(s) of HJG for mild AD based on changes in plasma metabolites. Methods: Sixty-seven patients with mild AD were randomly assigned to either an HJG group taking HJG extract 7.5 g/day in addition to AChEI or to a control group treated only with AChEI (HJG:33, Control:34). Blood samples were collected before, 3 months, and 6 months after the first drug administration. Comprehensive metabolomic analyses of plasma samples were done by optimized LC-MS/MS and GC-MS/MS methods. The web-based software MetaboAnalyst 5.0 was used for partial least square-discriminant analysis (PLS-DA) to visualize and compare the dynamics of changes in the concentrations of the identified metabolites. Results: The VIP (Variable Importance in Projection) score of the PLS-DA analysis of female participants revealed a significantly higher increase in plasma metabolite levels after HJG administration for 6 months than was seen in the control group. In univariate analysis, the aspartic acid level of female participants showed a significantly higher increase from baseline after HJG administration for 6 months when compared with the control group. Conclusion: Aspartic acid was a major contributor to the difference between the female HJG and control group participants of this study. Several metabolites were shown to be related to the mechanism of HJG effectiveness for mild AD.
Collapse
Affiliation(s)
- Mosaburo Kainuma
- Department of Japanese Oriental Medicine Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shinobu Kawakatsu
- Aizu Medical Center, Department of Neuropsychiatry, Fukushima Medical University, Aizuwakamatsu, Japan
| | - Jun-Dal Kim
- Department of Research and Development, Division of Complex Biosystem Research (CBR), Institute of National Medicine (INM), University of Toyama, Toyama, Japan
| | - Shinji Ouma
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| | - Osamu Iritani
- Department of Geriatric Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Ken-Ichiro Yamashita
- Translational Neuroscience Center, Graduate School of Medicine, International University of Health and Welfare, Tochigi, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shiro Suda
- Department of Psychiatry, Jichi Medical University, Tochigi, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Sotaro Hieda
- Department of Medicine, Division of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Masaaki Yasui
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Aoi Yoshiiwa
- Department of General Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Seiji Shiota
- Department of General Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Masaya Hironishi
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Kenji Wada-Isoe
- Department of Dementia Medicine, Kawasaki Medical School, Okayama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kouta Funakoshi
- Department of Clinical Research Promotion, Kyushu University Hospital, Fukuoka, Japan
| | - Kouji Hayashi
- Department of Rehabilitation, Fukui Health Science University, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Division of Neurology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshinori Kajimoto
- Department of Internal Medicine, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
| | - Yukiko Mori
- Department of Medicine, Division of Neurology, Showa University School of Medicine, Tokyo, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University, Wakayama, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
| | - Yoshio Tsuboi
- Department of Neurology, School of Medicine, Fukuoka University, Fukuoka, Japan
| |
Collapse
|