Painong San, a Traditional Chinese Compound Herbal Medicine, Restores Colon Barrier Function on DSS-Induced Colitis in Mice

Sijunzi decoction alleviates inflammation and intestinal epithelial barrier damage and modulates the gut microbiota in ulcerative colitis mice

Ethnopharmacological relevance

As a representative classical prescription, Sijunzi decoction has powerful therapeutic effects on spleen-stomach qi insufficiency. Ulcerative colitis (UC) is a chronic, diffuse, and non-specifically inflammatory disorder, the etiology of which still remains unclear. In the traditional Chinese medicine (TCM) perspective, splenic asthenia is the primary cause of UC. Based on this, Sijunzi decoction has been extensively used in TCM clinical practice to alleviate UC in recent years. However, the pharmacological mechanism of Sijunzi decoction in modern medicine is still not completely clear, which limits its clinical application.

Aim of the study

The purpose of this study was to investigate the Sijunzi decoction's curative effect on acute UC mice and probe into its potential pharmacological mechanism.

Materials and methods

The UC mouse model was set up by freely ingesting a 3% dextran sulfate sodium (DSS) solution. The relieving role of Sijunzi decoction on UC in mice was analyzed by evaluating the changes in clinical parameters, colon morphology, histopathology, inflammatory factor content, intestinal epithelial barrier protein expression level, and gut microbiota balance state. Finally, multivariate statistical analysis was conducted to elucidate the relationship between inflammatory factors, intestinal epithelial barrier proteins, and gut microbiota.

Results

First, the research findings revealed that Sijunzi decoction could visibly ease the clinical manifestation of UC, lower the DAI score, and attenuate colonic damage. Moreover, Sijunzi decoction could also significantly inhibit IL-6, IL-1β, and TNF-α while increasing occludin and ZO-1 expression levels. Subsequently, further studies showed that Sijunzi decoction could remodel gut microbiota homeostasis. Sijunzi decoction was beneficial in regulating the levels of Alistipes, Akkermansia, Lachnospiraceae_NK4A136_group, and other bacteria. Finally, multivariate statistical analysis demonstrated that key gut microbes were closely associated with inflammatory factors and intestinal epithelial barrier proteins.

Conclusion

Sijunzi decoction can significantly prevent and treat UC. Its mechanism is strongly associated with the improvement of inflammation and intestinal epithelial barrier damage by regulating the gut microbiota.

Enhanced therapeutic effect on colitis with powder formulations of Painong San associated with the promotion of intestinal adhesion and absorption

ETHNOPHARMACOLOGICAL RELEVANCE

Painong San is a prescription composed of traditional Chinese medicine, which has been used to treat colitis. The Painong San's usage recorded in "Jingui Yaolve" by Zhongjing Zhang in the Later Han Dynasty is powder. However, the decoction is often used in reality. It's unclear which dosage form of Painong San is more suitable for colitis treatment and why?

AIM OF THE STUDY

This study aims to evaluate the different therapeutic effects of Painong San (a powder of Painong San) and Painong Decoction (a decoction of Painong San) on a dextran sulfate sodium salt-induced colitis model and the possible reasons of these different effects.

MATERIALS AND METHODS

The contents of paeoniflorin, naringin, heperidin and neohesperidin in Painong San and Painong decoction were determined by an ultra-performance liquid chromatography system. The therapeutic effect on colitis was evaluated by intragastric administration of Painong San or Painong Decoction in dextran sulfate sodium salt-induced mouse model. The accumulated release rate of Painong San in vitro was analyzed with artificial gastric juice, artificial intestinal juice, and artificial colon juice. The concentrations of four compounds in the blood, intestinal contents, and intestinal fluids were detected by an-ultra performance liquid chromatography-tandem quadrupole mass spectrometry system. In situ intestinal perfusion experiments were used to observe the adhesion of Painong San to the intestine's surface. The expression of Mucin-2 and Trefoil Factor 3 in the colon was studied by immunohistochemistry.

RESULTS

There was no significant difference in the contents of the four compounds in Painong San and Painong Decoction. In vivo, Painong San has a better therapeutic effect than Painong Decoction in the treatment of colitis. Painong San could be released slowly in the simulated human digestion environment in vitro, and more Painong San particles were released on the intestinal surface in the colitis state in the healthy state. Painong San could increase the bioavailability of hesperidin and neohesperidin, and their concentrations in local intestinal tissue, intestinal fluid and intestinal contents. The expression of trefoil Factor 3 protein on the surface of the colon tended to be in the intestinal cavity and overlapped with the expression of mucin-2. Trefoil Factor 3 accumulates in the intestinal cavity of the colon in the state of colitis, which may increase the adhesion of Painong San particles.

CONCLUSION

In conclusion, this experiment proved that Painong San is a more suitable dosage form for the treatment of dextran sulfate sodium salt-induced colitis than Painong Decoction, which may be related to the enhancement of Painong San particle adhesion to the intestine in colitis. This study provides a reference for the selection of clinical dosage forms for traditional Chinese medicine.