Revealing the Mechanism of Huazhi Rougan Granule in the Treatment of Nonalcoholic Fatty Liver Through Intestinal Flora Based on 16S rRNA, Metagenomic Sequencing and Network Pharmacology

Efficacy of traditional Chinese medicine-based clearing heat and laxative method against nonalcoholic fatty liver disease: A systematic review and meta-analysis

BACKGROUND

Increasing evidences support the effectiveness of traditional Chinese medicine (TCM) in the treatment of nonalcoholic fatty liver disease (NAFLD), but it involves a wide variety of therapeutic methods. We aimed to evaluate the efficacy and safety of the TCM-based clearing heat and laxative (CHL) Method for intervention in NAFLD.

METHODS

Randomized controlled trials (RCTs) of CHL method for NAFLD were included. We searched Pubmed, Scopus, Web of science, CNKI, CBM, VIP, Wanfang databases from the inception to October 2023. We performed separate meta-analyses of clinical outcomes for liver enzymes, lipid profile, and total efficiency. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on INPLASY, number INPLASY2022100002.

RESULTS

Nine trials involving 856 participants were included in this meta-analysis. The meta-analysis showed that compared with the control group, the experimental group was more conducive to ameliorating the levels of ALT [MD = -8.00, 95% CI (-9.43, -6.56), P < .00001], AST [MD = -7.41, 95% CI (-8.75, -6.07), P < .00001], GGT [MD = -29.41, 95% CI (-42.25, -16.56), P < .00001], TC [MD = -0.76, 95% CI (-1.18, -0.35), P = .0003], TG [MD = -0.54, 95% CI (-0.82, -0.27), P = .0001], HDL-C [MD = 0.15, 95% CI (-0.01, 0.31), P = .07], LDL-C [MD = -0.47, 95% CI (-0.62, -0.32), P < .00001], and the total effective rate [OR = 3.11, 95% CI (1.94, 4.99), P < .00001]. Adverse events were observed in 2 trials, mainly milder gastrointestinal symptoms.

CONCLUSION

Significant differences in the clinical efficacy were found between the experimental and control groups in treating NAFLD. Thus, the TCM-based CHL method brings significant advantages in treating NAFLD. Further, it is recommended that patients in NAFLD with abnormal liver enzymes be treated with CHL for at least 3 months, and the proportion of laxatives in TCM prescription can be appropriately increased to improve the overall curative effect.

Therapeutic Potential of Raspberry Extract in High-Fat Diet-Induced Liver Injury via Apoptosis and AMPK/PPARα Pathways

This study aimed to explore the efficacy and mechanisms of raspberry (Rubus idaeus L. fruit) aqueous extract (RE) in alleviating high-fat diet (HFD)-induced metabolic-associated fatty liver disease (MAFLD). The MAFLD mouse model was established to examine the effects of RE through liver transcriptome and metabolomics analysis. In this study, RE supplementation significantly alleviated HFD-induced liver injury, hepatosteatosis, inflammation, and insulin resistance. Liver transcriptome analysis demonstrated that RE supplementation favorably regulated signaling pathways involved in fatty acid metabolism and inflammation, including the AMPK signaling pathway, PPAR signaling pathway, apoptosis, etc. Furthermore, the injection of compound C, an antagonist of AMPK, notably reversed the hepatoprotective effects of RE, evidenced by increased lipid profile levels, accelerated fatty acid-related gene disorder, and increased positive tunnel staining area. Furthermore, liver metabolomics analysis demonstrated that RE treatment led to substantial enrichment of the liver tissue metabolite umbelliferone (UMB), which has the potential to ameliorate lipid accumulation and hepatocyte injury through the AMPK signaling pathway. In summary, RE intervention mitigated HFD-induced liver dysfunction in mice, with UMB likely being the primary component responsible for its therapeutic efficacy in the liver. In addition, this study provided new insights, suggesting that RE could be used as a promising therapeutic approach for modulating MAFLD via apoptosis and the AMPK/PPARα signaling pathway.

Application and mechanism of Chinese herb medicine in the treatment of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver condition closely associated with metabolic syndrome, with its incidence rate continuously rising globally. Recent studies have shown that the development of NAFLD is associated with insulin resistance, lipid metabolism disorder, oxidative stress and endoplasmic reticulum stress. Therapeutic strategies for NAFLD include lifestyle modifications, pharmacological treatments, and emerging biological therapies; however, there is currently no specific drug to treat NAFLD. However Chinese herb medicine (CHM) has shown potential in the treatment of NAFLD due to its unique therapeutic concepts and methods for centuries in China. This review aims to summarize the pathogenesis of NAFLD and some CHMs that have been shown to have therapeutic effects on NAFLD, thus enriching the scientific connotation of TCM theories and facilitating the exploration of TCM in the treatment of NAFLD.

Exploration of the potential mechanism of Baicalin for hepatic fibrosis based on network pharmacology, gut microbiota, and experimental validation

Baicalin (BA) is among the most effective and abundant flavonoids extracted from Scutellaria baicalensis that may be utilized to treat diseases associated with hepatic fibrosis (HF). Through network pharmacology, gut microbiota, and experimental validation, this research intends to elucidate the multi-target mechanism of BA on HF. BA targets were screened using databases and literature. As a result, In the anti-HF mechanism, the BA and 191 HF-associated targets interact, with 9 specific targets indicating that the BA's anti-HF mechanism is closely linked to gut microbiota. Consequently, rat intestinal content samples were obtained and examined using 16S rRNA sequencing. In the BA-treated group, the gut microbiota was positively regulated at the phylum,and genus levels, with Lactobacillus performing significantly. The study concluded that BA has a multi-targeted anti-HF effect and has changed the gut microbial ecosystem.

Seabuckthorn polysaccharide combined with astragalus polysaccharide ameliorate alcoholic fatty liver by regulating intestinal flora

Background

At present, the incidence of alcoholic fatty liver disease (AFLD) is increasing year by year, and numerous studies have confirmed that liver diseases are closely related to intestinal flora. Seabuckthorn and Astragalus membranaceus, as traditional Chinese medicine (TCM) with the homology of medicine and food, have good liver protection, and their polysaccharides can regulate the intestinal flora. Here, we studied the effects of HRP, APS and the combination of the two polysaccharides on the intestinal flora of AFLD mice, which provided scientific basis for the treatment of AFLD with the two polysaccharides.

Materials and methods

Thirty Kunming (KM) mice were randomly divided into the control group (Con), the model group (Mod), the HRP treatment group (HRP), the APS treatment group (APS), and HRP+APS treatment group (HRP+APS), with six mice in each group. The AFLD model was constructed by continuous intragastric administration of 42% vol Niulanshan ethanol solution for 28 days, and the mice in each polysaccharide group were given corresponding drugs. The levels of AST, ALT, TC and TG in serum of mice were measured. 16S rRNA amplicon sequencing technique was used to determine the diversity and richness of intestinal flora, and the relative abundance of intestinal flora at phylum level and genus level of the mice in each group.

Results

HRP, APS and HRP+APS could reduce the serum levels of AST, ALT, TC and TG in mice. In addition, HRP, APS and HRP + APS restored the diversity, relative abundance and community structure of intestinal mucosa bacteria in AFLD mice to a certain extent. Specifically, HRP, APS and HRP+APS remarkably decreased the ratio of Firmicutes to Bacteroidetes, and ultimately increased the abundance of beneficial bacteria and reduced the abundance of pathogenic bacteria.

Conclusion

HRP, APS, and HRP+APS can improve the intestinal microecology of AFLD model mice, alleviate liver injury, and maintain normal intestinal function in different degrees.