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Liu R, Wang J, Zhao Y, Zhou Q, Yang X, Gao Y, Li Q, Bai M, Liu J, Liang Y, Zhu X. Study on the mechanism of modified Gegen Qinlian decoction in regulating the intestinal flora-bile acid-TGR5 axis for the treatment of type 2 diabetes mellitus based on macro genome sequencing and targeted metabonomics integration. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 132:155329. [PMID: 38853123 DOI: 10.1016/j.phymed.2023.155329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/12/2023] [Accepted: 12/30/2023] [Indexed: 06/11/2024]
Abstract
BACKGROUND Currently, there are many drugs available for the treatment of type 2 diabetes mellitus (T2DM), but most of them cause various side effects due to the need for long-term use. As a traditional Chinese medicine, Gegen Qinlian Decoction (GQD) has shown good efficacy and low side effects in the treatment of T2DM in both clinical and basic research. Based on relevant traditional Chinese medicine theories, dried ginger is innovatively added the formula of traditional GQD to create a modified GQD. This modification reduces the side effects of traditional GQD while exerting its therapeutic effect on T2DM. Previous studies have found that the modified GQD can regulate endoplasmic reticulum stress in the liver, inhibit hepatic gluconeogenesis, protect pancreatic islet β cells, and control blood sugar levels by inhibiting the FXR/neuronal ceramide signaling pathway. GQD can also regulate the intestinal microbiota to achieve therapeutic and protective effects in various gastrointestinal diseases. However, there is no research exploring whether the modified GQD achieves its therapeutic mechanism for T2DM by regulating the intestinal microbiota. PURPOSE To explore the mechanism of modified GQD in the treatment of T2DM based on multi-omics, focusing on its effect on the "intestinal flora bile acid TGR5'' axis. METHODS The T2DM model was established using db/db mice, which were randomly divided into a model group, metformin group, high-dose GQD group, medium-dose GQD group, low-dose GQD group, while m/m mice were used as blank control. The drug intervention lasted for 12 weeks, during which the general conditions, oral glucose tolerance (OGT), blood glucose, and lipid-related indexes were recorded. Additionally, the fasting insulin (FINS), c-peptide, GLP-1 in serum, and cAMP in the ileum were measured by ELISA assay. Furthermore, the composition, abundance, and function of the intestinal microbiota were determined by macro genome sequencing, while bile acid was detected by targeted metabonomics. For histological evaluation, HE staining was used to observe the pathological changes of the ileum and pancreas, and the ultrastructure of the ileum and pancreas was observed by transmission electron microscopy. Apoptosis in the ileum tissue was detected by Tunel staining. Moreover, the mRNA and protein expressions of TGR5, PKA, CREB, PC1/3, GLP-1, and their phosphorylation levels in the ileum were detected by qPCR, immunohistochemistry, and Western blot; The expression of INS in the pancreas was also evaluated using immunohistochemistry. Finally, double immunofluorescence staining was used to detect the co-localization expression of TGR5 and GLP-1, NeuroD1, and GLP-1 in the ileum. RESULTS The modified GQD was found to significantly reduce blood glucose, improve oral glucose tolerance, and blood lipid levels, as well as alleviate the injury of the ileum and pancreas in T2DM mice. Furthermore, modified GQD was found to effectively regulate intestinal flora, improve bile acid metabolism, activate the TRG5/cAMP/PKA/CREB signal pathway, and stimulate GLP-1 secretion. CONCLUSION GQD can regulate the "intestinal flora-bile acid-TGR5" axis and has a therapeutic effect on T2DM in mice.
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Affiliation(s)
- Rong Liu
- Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi, PR China; Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China; Research Center of Traditional Chinese Medicine, Gansu Province, Lanzhou 730000, Gansu, PR China
| | - Jiahui Wang
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Yikun Zhao
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Qi Zhou
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Xia Yang
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Yankui Gao
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Qin Li
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China; Gansu Health Vocational College, Gansu Province, Lanzhou 730000, Gansu, PR China
| | - Min Bai
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China
| | - Jiahui Liu
- Research Center of Traditional Chinese Medicine, Gansu Province, Lanzhou 730000, Gansu, PR China
| | - Yonglin Liang
- Gansu University of Chinese Medicine, Lanzhou 730000, Gansu, PR China; Research Center of Traditional Chinese Medicine, Gansu Province, Lanzhou 730000, Gansu, PR China.
| | - Xiangdong Zhu
- Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, PR China.
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Yi M, Toribio AJ, Salem YM, Alexander M, Ferrey A, Swentek L, Tantisattamo E, Ichii H. Nrf2 Signaling Pathway as a Key to Treatment for Diabetic Dyslipidemia and Atherosclerosis. Int J Mol Sci 2024; 25:5831. [PMID: 38892018 PMCID: PMC11172493 DOI: 10.3390/ijms25115831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/13/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Diabetes mellitus (DM) is a chronic endocrine disorder that affects more than 20 million people in the United States. DM-related complications affect multiple organ systems and are a significant cause of morbidity and mortality among people with DM. Of the numerous acute and chronic complications, atherosclerosis due to diabetic dyslipidemia is a condition that can lead to many life-threatening diseases, such as stroke, coronary artery disease, and myocardial infarction. The nuclear erythroid 2-related factor 2 (Nrf2) signaling pathway is an emerging antioxidative pathway and a promising target for the treatment of DM and its complications. This review aims to explore the Nrf2 pathway's role in combating diabetic dyslipidemia. We will explore risk factors for diabetic dyslipidemia at a cellular level and aim to elucidate how the Nrf2 pathway becomes a potential therapeutic target for DM-related atherosclerosis.
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Affiliation(s)
- Michelle Yi
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
| | - Arvin John Toribio
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
| | - Yusuf Muhammad Salem
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
| | - Michael Alexander
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
| | - Antoney Ferrey
- Department of Medicine, University of California Irvine, Irvine, CA 92697, USA; (A.F.); (E.T.)
| | - Lourdes Swentek
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
| | - Ekamol Tantisattamo
- Department of Medicine, University of California Irvine, Irvine, CA 92697, USA; (A.F.); (E.T.)
| | - Hirohito Ichii
- Department of Surgery, University of California Irvine, Irvine, CA 92697, USA; (M.Y.); (A.J.T.); (Y.M.S.); (M.A.); (L.S.)
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Takechi R, Lam V, Mamo JCL. Diabetic hypertriglyceridaemia and Alzheimer's disease: causal or not? Curr Opin Endocrinol Diabetes Obes 2022; 29:101-105. [PMID: 34845160 DOI: 10.1097/med.0000000000000696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW To summarize recent findings considering type II diabetes, or metabolic syndrome dyslipidaemia with risk for Alzheimer's disease. RECENT FINDINGS Population, genetic, clinical and preclinical studies support the hypothesis of increased risk for Alzheimer's disease in type 2 diabetes mellitus. The mechanisms are unclear. However, recent studies suggest that aberrations in the peripheral metabolism of triglyceride-rich-lipoproteins compromise the brain microvasculature. SUMMARY We review the literature of prediabetic metabolic syndrome and type 2 diabetes mellitus as a risk factor for Alzheimer's disease. We focus on a potential association with aberrations in the systemic metabolism of triglyceride-rich-lipoproteins reported over 18 months.
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Affiliation(s)
- Ryusuke Takechi
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
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