Modified Baihu decoction therapeutically remodels gut microbiota to inhibit acute gouty arthritis

Abstract

Background: Acute gouty arthritis (AGA) is the most common first symptom of gout, and the development of gout as a metabolic and immune inflammatory disease is also correlated with the gut microbiota. However, the mechanism of the effect of changes in the gut microbiota on AGA remains unclear. The intestinal flora can not only affect purine metabolism or regulate inflammation, but also influence the therapeutic effect of drugs on AGA. The aim of this study was to investigate the exact mechanism of modified Baihu decoction (MBD) in the treatment of AGA and whether it is related to the regulation of the structure of the intestinal flora.Methods: On the 21st day of MBD administration by continuous gavage, a rat acute gouty arthritis model was constructed using sodium urate (0.1 mL/rat, 50 mg/mL), and the ankle joint swelling was measured before and 4 h, 8 h, 24 h, and 48 h after the injection of sodium urate. After 48 h of sodium urate injection, serum, liver, kidney, ankle synovial tissue and feces were collected from rats. The collected samples were examined and analyzed using H&E, Elisa, Immunohistochemistry, Histopathology, 16S rDNA, and Biochemical analysis. To investigate the mechanism of MBD to alleviate AGA using pro-inflammatory factors and intestinal flora.Results: MBD (5.84, 35 g/kg) was administered orally to AGA rats and diclofenac sodium tablets (DS-tablets) were used as standard treatment control. Serum biochemical assessment confirmed that MBD is a safe drug for the treatment of AGA. In addition, our findings confirmed that MBD relieved AGA-related symptoms, such as toe swelling. Lowering serum levels of uric acid, IL-1β, and TGF-β1 immunohistochemical results also confirmed that MBD reduced the expression of inflammatory elements such as IL-1β, NLRP3, ASC, and Caspase-1 in synovial tissue.Furthermore, compared with control group, the 16s rDNA sequencing of AGA rat faeces revealed an increase in the relative abundance of Lachnospiraceae, Muribaculaceae, and Bifidobacteriaceae species. While the relative abundance of Lactobacillaceae, Erysipelotrichaceae, Ruminococcaceae, Prevotellaceae and Enterobacteriaceae showed a relative decrease in species abundance. Of these, the reduction in species abundance of Enterobacteriaceae was associated with a reduction in amino acid metabolism and environmental perception. After MBD therapeutic intervention, the disturbance of the intestinal flora caused by AGA was restored.Conclusion: In summary, MBD is an effective agent for the treatment of AGA, with the potential mechanism being the regulation of intestinal flora to control inflammation. This would help to promote the therapeutic effect of MBD on AGA.

Anti-inflammation is an important way that Qingre-Huazhuo-Jiangsuan recipe treats acute gouty arthritis

“…Rats in the Normal group were injected with NS, and in other groups were injected with MSU. The previous studies ( Fischer et al, 2018 ; Zhao J. et al, 2022 ; Wang X. et al, 2022 ; Zhao L. et al, 2022 ) have demonstrated that 8 h after the MSU injection is the key point for AGA Model. We observed the swelling of rat knees, with few changes in the Normal control group, while it had obvious redness and swelling in the Model group ( Figure 6A ), suggesting that the AGA model was established successfully by MSU injection.…”

“…Their intricate composition, multifaceted therapeutic targets, and intricate treatment modalities present formidable challenges to the comprehensive elucidation of their underlying mechanisms. In recent times, network pharmacology has risen to prominence as a favored methodology for dissecting the intricate mechanisms of action inherent to complex Traditional Chinese Medicine (TCM) formulations ( Wang et al, 2020b ; Liu et al, 2023 ). OB and DL values are based on general rules and assumptions about compound properties, such as molecular weight, lipophilicity, and solubility.…”

TCM and related active compounds in the treatment of gout: the regulation of signaling pathway and urate transporter

“…Furthermore, the Chinese Formula Wuling san ( Yang et al, 2015 ), Cheqianzi decoction ( Meng et al, 2023 ), Baihu decoction ( Wang et al, 2022b ), Sanhuang- Xiexin decoction ( Wu et al, 2019 ) and Shizhi fang ( Zhou et al, 2023 ) have exhibited significant effects in gout prevention by operating through pathways linked to the inhibition of the NLRP3 signaling cascade and the mitigation of renal damage.…”

Therapeutic potential of traditional Chinese medicine on heat stroke

“…Another study discovered that TRQI exhibited favorable antipyretic and wake-promoting effects, while also mitigating the incidence of complications ( Yu et al, 2017 ). XNJI, another derivative CPM of the herbal prescription Angong Niuhuang, has been extensively employed as an emergency intervention in cases of acute cerebral injury or infarction and stroke ( An et al, 2022 ; Wang et al, 2022b ). A study indicated that XNJI has the potential to mitigate cerebral ischemia/reperfusion injury through the inhibition of the inflammatory response mediated by SIRT1( Zhang et al, 2020 ).…”