Identifying the molecular mechanism of blood stasis syndrome through the symptom phenotype-genotype association approach

In traditional medicine (TM), blood stasis syndrome (BSS) is characterized by insufficient blood flow, resulting in a group of symptoms such as fixed pain, a dark complexion, bleeding, and an astringent pulse. While BSS pathology has been previously explored, its molecular mechanisms remain elusive owing to challenges in linking TM symptoms to genes. Our study aimed to elucidate the mechanisms underlying BSS using a phenotype-genotype association approach. We extracted BSS symptoms from various studies, linked them to medical terms using a Unified Medical Language System, and connected these terms to genes in the DisGeNET database. The molecular network patterns of BSS symptoms were revealed through analyzing protein-protein interactions and symptom-gene associations. Our findings revealed 1325 associations between 16 BSS symptoms comprising 32 concept-unified identifier terms and 937 genes. Network analysis highlighted the centrality of JAK2, ITGB3, and F2, associated with multiple BSS symptoms (≥5 concept-unified identifier terms) and numerous protein interactions (≥20 interactions). Enrichment analysis indicated the involvement of BSS genes in the immune system (P-value = 4.49e-14) and hemostasis (P-value = 1.28e-07) pathways. BSS symptoms were linked to genes regulating blood coagulation, immune responses, blood flow, and inflammatory reactions. This approach may be extended to establish genotype networks for understanding TM pattern identifications, which are composed of diverse groups of symptoms, for personalized diagnosis and treatment.

Rapid determination of seven bioactive components in rat plasma by UPLC-MS/MS and its application to pharmacokinetic compatibility study of Jinlingzi San

Jinlingzi San (JLZS), composed of Fructus Toosendan (FT) and Rhizoma Corydalis (RC), is a classical traditional Chinese medicine prescription for regulating Qi to relieve pain. The present study investigated the pharmacokinetic compatibility of FT and RC in JLZS. A fast, selective and sensitive UPLC-MS/MS method for simultaneous determination of one limonoid (toosendanin), four tertiary alkaloids (corydaline, tetrahydropalmatine, tetrahydrocoptisine, tetrahydroberberine) and two quaternary alkaloids (palmatine, dehydrocorydaline) in rat plasma was established and fully validated. The plasma samples were pretreated by a fast protein precipitation and chromatographed using a 1.7-μm C18 column and 0.1 % formic acid-water and acetonitrile via gradient elution with a run time of 3.7 min. Multiple reaction monitoring mode with positive electrospray ionization was adopted to detect the analytes and internal standard (diphenhydramine). The lower limits of quantification were 0.08-3.09 ng/mL using only 50 μL of plasma sample. Using the proposed method, the pharmacokinetic differences of seven bioactive components in rats after administration of JLZS and the single herb (FT or RC) were investigated. The results showed that the elimination of toosendanin and alkaloids decreased significantly in the JLZS group (p < 0.05) compared with the single herb group, and the exposure of the alkaloids increased in some degree. The study demonstrated the synergistic effect of combining FT with RC on the pharmacokinetics of seven bioactive components and provided new information for a better understanding of the compatibility mechanism of JLZS.

The Effects of Curcumae Longae Radix, Curcuma phaeocaulis Radix and Their Processed Products on Epo/EpoR Pathway and CD62p

Background: Curcumae Radix (Yujin) has been widely used to treat Qi stagnation due to Liver depression (LDQS) in traditional Chinese medicine (TCM) for a long time and is good at dispelling melancholy by soothing liver to regulate qi and relieving pain by promoting blood circulation for removing blood stasis. Yujin stir-frying with vinegar can strengthen the effect of dispersing stagnated hepatoqi to stop pain by injecting medicine into the liver and stir-frying with wine can strengthen the effect of promoting blood circulation for removing blood stasis. Because the reason for the enhancement of clinical efficacy by processing is unclear, it is difficult to select and use processed products in the clinic. Aim/Hypothesis: In this study, from the point of view of the platelet function, we start to investigate the mechanism for promoting blood circulation, removing blood stasis, and enhancing clinical efficacy by processing. Methods: This study mainly takes Curcumae Longae Radix (HSYJ) and Curcuma phaeocaulis Radix (LSYJ) as the research subjects. They are genuine drugs in Sichuan Province, China. A high-performance liquid chromatography (HPLC) is used to analyze the main chemical constituents of Yujin and its processed products, and show the difference between the two species, with and without processing. A rat model of blood stasis induced by LDQS is established by giving the tail clamp stimulation, injecting epinephrine hydrochloride subcutaneously, and treating with an effective dose (0.9 g⋅kg^-1) according to the conversion of human clinical dosage for 2 weeks. After the experiment, the serum levels of erythropoietin are measured by ELISA. Furthermore, RT-PCR and WB are used to detect EpoR mRNA and protein expression in the hepatic tissue. Flow cytometry is used to measure peripheral blood CD62p expression. Results: There is a great difference between the chemical compositions of the two species, the number of chromatographic peaks of Curcumae Longae Radix is more than that of Curcuma phaeocaulis Radix. Curcuminoids is the main component of HSYJ, while curcuminoids is almost free from LSYJ. Curcuminoids is almost insoluble in water. After stir-frying with vinegar or wine, it can increase the dissolution of curcuminoids in water. In rat models, the levels of Epo, EpoR, and CD62p are significantly increased. After intragastric administration of Yujin, indicators show varying degrees of callback. HSYJ is better than LSYJ, and the processed product by stir-frying with wine is better than other processed products. Conclusion: The results show that the mechanism of promoting blood circulation for removing blood stasis in Yujin may be able to inhibit the activation and aggregation of platelets by intervening the Epo/EpoR pathway and regulating CD62p down. Stir-frying with wine can enhance this effect.