A general procedure for establishing composite quality evaluation indices based on key quality attributes of traditional Chinese medicine

Effects of a 12-week Baduanjin regimen on biomechanical properties of axial muscle fascia in ankylosing spondylitis

BACKGROUND

This study aims to evaluate the effects of a 12-week Baduanjin regimen on the biomechanical properties of axial muscle fascia in patients with ankylosing spondylitis (AS) through a randomized controlled trial, and to explore the underlying mechanisms of Baduanjin in AS treatment.

METHODS

Thirty patients with AS were randomly assigned to either the Baduanjin intervention group or the nonintervention group, with 15 patients in each group. The intervention group underwent a 12-week Baduanjin fitness program, while the nonintervention group continued their usual lifestyle and medication. Biomechanical parameters of muscle fascia, including muscle stiffness (N/m), muscle tension (frequency, Hz), and muscle elasticity (logarithmic decrement of oscillation amplitude), were measured at specified spinal locations using the MyotonPRO® soft tissue tester at baseline (week 0) and after 12 weeks (week 12).

RESULTS

The Baduanjin group exhibited significant improvements in muscle fascia stiffness, tension, and elasticity in the lumbar and cervical spine compared to the nonintervention group, with notable differences in lumbar stiffness and tension (P < .05). Postintervention, lumbar stiffness and tension were significantly reduced, and elasticity increased in the Baduanjin group, indicating beneficial effects on the biomechanical properties of axial muscle fascia in AS patients. No significant changes were observed in the nonintervention group. The Baduanjin group reported only mild muscle pain initially, which resolved with appropriate management, with no serious adverse effects noted.

CONCLUSION

The findings suggest that Baduanjin significantly enhances the biomechanical properties of axial muscle fascia in AS patients. By improving these properties, Baduanjin may reduce mechanical stress, alleviate micro-damage and inflammation at attachment points, regulate downstream signaling pathways, and potentially limit new bone formation. This study provides scientific support for the use of Baduanjin in managing AS and offers a foundation for future research.

Comprehensive Quality Evaluation of Danggui-Jianzhong Decoction by Fingerprint Analysis, Multi-Component Quantitation and UPLC-Q-TOF-MS

Danggui-Jianzhong decoction (DGJZ) is a famous classical traditional Chinese medicine formula, which ingredients are complex and the quality is difficult to control. Our study aimed to identify the overall chemical profile of DGJZ qualitatively by ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) and UPLC. A total of 77 components, including terpenoids, flavonoids, phenolic acids, gingerols and other components, were firstly detected and characterized by UPLC-Q-TOF-MS and 18 peaks marked after analyzing the UPLC fingerprint. Finally, paeoniflorin, liquiritin, ferulic acid, cinnamic acid, glycyrrhizic acid and 6-gingerol were quantified, which was validated in terms of linearity, precision, accuracy, repeatability and recovery. Taken together, the chemical constitutes of DGJZ were systematically identified and a reliable quantitative method coupled with fingerprint analysis was successfully employed for evaluating the holistic quality, which will provide a robust foundation for the quality control of DGJZ.

Quantification and discovery of quality markers from Toddalia asiatica by UHPLC-MS/MS coupled with chemometrics

INTRODUCTION

Toddalia asiatica (TA) is a classical traditional Chinese medicine used to treat rheumatoid arthritis and contusions. However, research regarding TA quality control is currently limited.

OBJECTIVE

We aimed to establish a strategy for identifying quality markers that can be used for the evaluation of the quality of TA.

METHOD

A rapid and efficient ultra-high-performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UHPLC-MS/MS) method was developed for the quantitative determination of 19 compounds in TA from different regions. Then, the extraction process of TA was successively optimized by single-factor optimization and response surface methodology. Moreover, chemometrics was employed to confirm the correlation between quality and target compounds.

RESULTS

Utilizing the UHPLC-MS/MS method, separation of the 19 bioactive compounds was achieved within 14 min. The method was validated in terms of linearity (r2 > 0.9982), precision (0.08%-3.70%), repeatability (0.50%-2.54%), stability (2.26%-5.46%), and recovery (95.8%-113%). The optimal extraction process (extraction solvent, 65% ethanol aqueous solution; solid-liquid ratio, 1:20; extraction time, 25 min) was determined with the total content of 19 bioactive compounds as indicator. Significant disparities were observed in the contents of target compounds across different batches of TA. Besides, all samples could be categorized into two distinct groups, and magnoflorine, (-)-lyoniresinol, nitidine chloride, norbraylin, skimmianine, and decarine were identified as quality markers.

CONCLUSION

In the present study, we developed a strategy to improve the quality control of TA. In consideration of the pharmacodynamic activity and statistical differences, six compounds are proposed as quality markers for TA.

Quality grade evaluation of Nvjin Pills based on traditional Chinese medicine reference drug and network pharmacology of target-focused compounds

To improve the effectiveness of marketed drugs related to active ingredients, it is necessary to designate a more unified quality evaluation standard. Taking Nvjin Pills as an example, this study reported the development of a novel principle of analysis in traditional Chinese medicine. The core of the experiment is to prepare three batches of traditional Chinese medicine reference drugs by high-quality Chinese materia medica. The active ingredients identified in the herbal formula including glycyrrhizic acid, cinnamaldehyde, paeonol, baicalin, hesperidin, paeoniflorin, and ferulic acid were analyzed in traditional Chinese medicine reference drugs by the high-performance liquid chromatography method combined with wavelength switching. The simple prediction results of network pharmacological analysis verified the feasibility and reliability of the established quantitative analysis method for seven target-focused compounds in Nvjin Pills, which were recommended as candidate indicators for quality evaluation ultimately. Using the seven target-focused compounds as the scientific ruler, quality grade specifications of Nvjin Pills were proposed by comprehensive analysis. Accordingly, 16, 47, and 13 batches of samples were primarily graded as first grade, second grade, and unqualified grade, respectively. This study will provide a chemical basis for quality control of Nvjin Pills, which is necessary for the production process of pharmaceutical development.

A quality-comprehensive-evaluation-index-based model for evaluating traditional Chinese medicine quality

BACKGROUND

Evaluating traditional Chinese medicine (TCM) quality is a powerful method to ensure TCM safety. TCM quality evaluation methods primarily include characterization evaluations and separate physical, chemical, and biological evaluations; however, these approaches have limitations. Nevertheless, researchers have recently integrated evaluation methods, advancing the emergence of frontier research tools, such as TCM quality markers (Q-markers). These studies are largely based on biological activity, with weak correlations between the quality indices and quality. However, these TCM quality indices focus on the individual efficacies of single bioactive components and, therefore, do not accurately represent the TCM quality. Conventionally, provenance, place of origin, preparation, and processing are the key attributes influencing TCM quality. In this study, we identified TCM-attribute-based quality indices and developed a comprehensive multiweighted multi-index-based TCM quality composite evaluation index (QCEI) for grading TCM quality.

METHODS

The area of origin, number of growth years, and harvest season are considered key TCM quality attributes. In this study, licorice was the model TCM to investigate the quality indicators associated with key factors that are considered to influence TCM quality using multivariate statistical analysis, identify biological-evaluation-based pharmacological activity indicators by network pharmacology, establish real quality indicators, and develop a QCEI-based model for grading TCM quality using a machine learning model. Finally, to determine whether different licorice quality grades differently reduced the inflammatory response, TNF-α and IL-1β levels were measured in RAW 264.7 cells using ELISA analysis.

RESULTS

The 21 quality indices are suitable candidates for establishing a method for grading licorice quality. A computer model was established using SVM analysis to predict the TCM quality composite evaluation index (TCM QCEI). The tenfold cross validation accuracy was 90.26%. Licorice diameter; total flavonoid content; similarities of HPLC chromatogram fingerprints recorded at 250 and 330 nm; contents of liquiritin apioside, liquiritin, glycyrrhizic acid, and liquiritigenin; and pharmacological activity quality index were identified as the key indices for constructing the model for evaluating licorice quality and determining which model contribution rates were proportionally weighted in the model. The ELISA analysis results preliminarily suggest that the inflammatory responses were likely better reduced by premium-grade than by first-class licorice.

CONCLUSIONS

In the present study, traditional sensory characterization and modern standardized processes based on production process and pharmacological efficacy evaluation were integrated for use in the assessment of TCM quality. Multidimensional quality evaluation indices were integrated with a machine learning model to identify key quality indices and their corresponding weight coefficients, to establish a multiweighted multi-index and comprehensive quality index, and to construct a QCEI-based model for grading TCM quality. Our results could facilitate and guide the development of TCM quality control research.

The correlation between pharmacological activity and contents of eight constituents of Glycyrrhiza uralensis Fisch

Licorice (Glycyrrhiza uralensis Fisch. (GUF), Leguminosae) has been extensively applied in traditional Chinese medicine (TCM) to treat diseases, exactly, in almost half of Chinese herbal prescription. However, the relationship between chemical contents and efficacy has not been established, which could evaluate GUF quality. To create a simple and effective quality-evaluation method, 33 batches of GUF from different habitats in China were collected. The correlation between eight constituents (liquiritin, isoliquiritin, liquiritigenin, isoliquiritigenin, glycyrrhizic acid, licochalcone A, glabridin and glycyrrhetinic acid) and pharmacological activities (anti-inflammatory, antioxidant and immunoregulatory) was analyzed per the partial least squares regression method. Results showed that eight constituents correlated significantly with the pharmacological activity. The correlation equation modes between pharmacological activity and contents of eight constituents were constructed and verified to be reliable. In GUF extract, the main constituents liquiritin, isoliquiritin and glycyrrhizic acid exhibited positive influence on anti-inflammatory and antioxidant effect with different potent, while the metabolites liquiritigenin and isoliquiritigenin exhibited positive effect on the immunoregulatory activity and glycyrrhetinic acid exhibited positive effect on all the tested activities. Thus, our chemical-efficacy correlation method is reliable and feasible to predict the pharmacological activity based on its eight constituents. It could be powerful in quality control of GUF and provides a useful way for quality evaluation of other medicinal herbs.

Iron oxides based nanozyme sensor arrays for the detection of active substances in licorice

With the increasing applications of traditional Chinese medicines worldwide, authenticity identification and quality control are significant for them to go global. Licorice is a kind of medicinal material with various functions and wide applications. In this work, colorimetric sensor arrays based on iron oxide nanozymes were constructed to discriminate active indicators in licorice. Fe₂O₃, Fe₃O₄, and His-Fe₃O₄ nanoparticles were synthesized by a hydrothermal method, possessing excellent peroxidase-like activity that can catalyze the oxidation of 3,3',5,5' -tetramethylbenzidine (TMB) in the presence of H₂O₂ to produce a blue product. When licorice active substances were introduced in the reaction system, they showed competitive effect on peroxidase-mimicking activity of nanozymes, resulting in inhibitory effect on the oxidation of TMB. Based on this principle, four licorice active substances including glycyrrhizic acid, liquiritin, licochalcone A, and isolicoflavonol with the concentration ranging from 1 μM to 200 μM were successfully discriminated by the proposed sensor arrays. This work supplies a low cost, rapid and accurate method for multiplex discrimination of active substances to guarantee the authenticity and quality of licorice, which is also expected to be applied to distinguish other substances.

Qualitative and quantitative method for quality control of Itea ilicifolia based on antioxidant Q-markers

Itea ilicifolia Oliv is a folk medicine with antioxidant potential. In this study, the fingerprints of 14 batches of I. ilicifolia were established by HPLC with 17 common peaks. The similarities evaluated by Similarity Evaluation System for Chromatographic Fingerprint of Chinese Materia (version 2012) were >0.89. Ten compounds were identified with definite structures by comparing the retention time and characteristic UV spectral pattern with those of reference substances. The antioxidant capacities of 14 batches of I. ilicifolia were evaluated based on O₂ ^·- , DPPH and ABTS^·+ radical scavenging assays in combination with ferric reducing antioxidant power assay. Via multivariate statistical analyses of gray relation analysis, bivariate correlation analysis and partial least squares regression analysis, a study on the spectrum-effect relationship was then performed to screen eight peaks as the antioxidant Q-markers of I. ilicifolia. The contents of representative antioxidant Q-markers (isoorientin, orientin, vitexin, isovitexin and iteafuranal A) in samples were accurately determined to be 0.054-0.118%, 0.034-0.080%, 0.018-0.055%, 0.031-0.091% and 0.033-0.140%, respectively. The qualitative and quantitative analytical method based on Q-markers helps to control the antioxidant quality of I. ilicifolia, which will lay the foundation to promote the rational utilization of I. ilicifolia in curing diseases related to oxidative stress.

Comparison of the Saponins in Three Processed American Ginseng Products by Ultra-High Performance Liquid Chromatography-Quadrupole Orbitrap Tandem Mass Spectrometry and Multivariate Statistical Analysis

A method with ultrahigh performance liquid chromatography Quadrupole-Orbitrap tandem mass spectrometry (UHPLC-Q-Orbitrap-MS/MS) was applied for the quality evaluation of different processing and drying of American ginseng, including natural drying (ND), steam drying (SD), and vacuum freeze-drying (VFD). A total of 51 saponins were successfully identified in three processed products. Three processed American ginseng products were well-differentiated in orthogonal partial least-squares discriminant analysis (OPLS-DA). The S-plot also identified the marker compounds in each product, while the major ginsenosides of ND (malonyl (M)-Rd, M-Rb₁, Rg₁), SD (20 (S)-Rg₃, 20 (S)-Rg₂), and VFD (M-Rd, M-Rb₁) were found. The results indicate that the method by vacuum freeze-drying can retain the content of rare ginsenosides and malonyl-ginsenosides. The marker compounds selected will benefit the holistic evaluation of related American ginseng products.

Chemical Antioxidant Quality Markers of Chrysanthemum morifolium Using a Spectrum-Effect Approach

Traditionally, the quality evaluation of Chrysanthemum morifolium (CM) cv. (Juhua) attributes its habitats and processing methods, however, this strategy of neglecting bioactive ingredients usually results in deviation of quality evaluation. This study aims to explore the quality marker (Q-marker) based on spectrum-effect relationship and quality control strategy of CMs. The chromatographic fingerprint of 30 flower head samples of CMs from five different habitats including Hang-baiju, Gongju, Huaiju, Taiju and Boju were constructed by high performance liquid chromatography and analyzed through chemometrics methods such as similarity analysis (SA), cluster analysis (CA) and principal component analysis (PCA). The common peaks were quantified by external standard method and relative correction factor method. The in-vitro radical scavenging capacity assays of DPPH·, ·OH and ABTS were carried out. The Q-marker was explored by the correlation analysis between the contents of common peaks and in-vitro radical scavenging capacity, and then used to evaluate the quality of 30 flower head samples of CMs. A total of eight common peaks were appointed in 30 flower head samples of CMs, and their similarities ranged from 0.640 to 0.956. CA results showed that 30 flower head samples of CMs could be divided into five categories with reference to the Euclidean distance of 5. PCA results showed that common peaks played a major role in differential contribution of CMs. The quantification of common peaks hinted that their contents possessed significant variation whether for different accessions or the same accessions of CMs. The correlation analysis showed that chlorogenic acid, 3,5-O-dicaffeoylquinic acid, unknown peak 1, 4,5-O-dicaffeoylquinic acid and kaempferol-3-O-rutinoside could be used as the Q-markers for the quality evaluation of 30 flower head samples of commercially available CMs. The analysis strategy that combines chromatographic fingerprint analysis, multiple ingredients quantification, in-vitro chemical anti-oxidant activity evaluation and spectrum-effect relationship analysis clarified the therapeutic material basis and discovered the Q-markers, which possibly offers a more comprehensive quality assessment of CMs.

Comprehensive characterization and identification of chemical constituents in Yangwei decoction using ultra-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry

Yangwei decoction, a classical traditional Chinese medicine prescription, has been widely used to treat exogenous cold and internal injury with damp stagnation for many centuries. However, its systematic chemical profiling remains ambiguous, which has hampered the interpretation of pharmacology and the mechanism of its formula. In the present study, a ultra-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry method was successfully established for the first time to separate and identify the complicated components of Yangwei decoction. The accurate mass data of the protonated molecules, deprotonated molecules, and fragment ions were detected in positive and negative ion modes. A total of 226 compounds in Yangwei decoction were tentatively identified and unambiguously characterized by comparing their retention times and mass spectrometry data with those of reference standards and literature, including 24 lignans, 18 alkaloids, 9 phenylpropanoid glycosides, 76 flavonoids, 59 triterpenoids, 17 organic acids, 7 gingerols, 8 lactones, and 8 other compounds. The present study provides a novel method of constituents characterization for well-known Chinese medicine prescriptions. The study aims to lay a robust foundation for future research, providing the holistic quality control and pharmacology of Yangwei decoction. This article is protected by copyright. All rights reserved.