Xiongzhi Dilong decoction interferes with calcitonin gene-related peptide(CGRP)-induced migraine in rats through the CGRP/iNOS pathway

Objective: To evaluate the effects of Xiongzhi Dilong decoction(XZDLD) and its wind medicine on calcitonin gene-related peptide(CGRP)-induced migraine and explore the mechanism through the CGRP/inducible nitric oxide synthase(iNOS) pathway.Methods: Rats were divided into control, model, XZDLD, XZDLD(external wind), XZDLD(internal wind),and olcegepant groups. CGRP was injected into the dura mater to induce a migraine. The frequency of head scratching, cage climbing, and facial grooming was observed. The pain threshold, the levels of CGRP,pituitary adenylate cyclase activating polypeptide(PACAP), substance P(SP), and the plasma protein extravasation(PPE) ratio were measured. The phosphorylation levels of p38, extracellular signalregulated kinase 1/2(ERK1/2), and expression of iNOS were detected by western blot.Results: Compared with the model group, the three modified XZDLD groups showed reduced frequency of head scratching and cage climbing in the first 30 min(all P <.05). Facial grooming frequency was reduced in XZDLD and XZDLD(external wind) groups(P =.0003 and P =.0131, respectively). External wind medicine played a more important role in increasing mechanical pain threshold than internal wind medicine. Moreover, compared with the model group, the three modified XZDLD groups demonstrated reduced plasma levels of CGRP and PACAP(all P <.05). No difference in the SP level was observed among the six groups. XZDLD reduced PPE ratio. XZDLD and XZDLD(external wind) groups suppressed the CGRP/iNOS pathway by inhibiting the p-p38/p38 ratio and the expression of iNOS. No difference in pERK1/2/ERK1/2 ratio was detected among the six groups.Conclusion: XZDLD increases pain threshold, downregulates the expression of CGRP and PACAP, and reduces PPE ratio by inhibiting the CGRP/iNOS pathway. External wind medicine is more effective than internal one on improving facial grooming and head scratching, increasing the mechanical pain threshold, and inhibiting the expression of iNOS.

基于血浆代谢组学和网络药理学探讨芎芷地龙汤治疗偏头痛的作用机制

目的:基于网络药理学和血浆代谢组学探讨芎芷地龙汤(Xiongzhi Dilong decoction,XZDLD)对降钙素基因相关肽(calcitonin gene-related peptide,CGRP)诱导的偏头痛的作用机制。方法:采用超高效液相色谱-线性离子阱-静电场轨道阱高分辨质谱法(ultra-high-performance liquid chromatography-linear trap quadrupole orbitrap mass spectrometry,UPLC-LTQ-Orbitrap-MS)对XZDLD的化学成分进行鉴定。经硬脑膜套管注射CGRP建立偏头痛大鼠模型,通过观察大鼠偏头痛样行为、测定机械痛阈和温度痛阈评估XZDLD治疗偏头痛的疗效。基于网络药理学和血浆代谢组学的联合分析识别其治疗偏头痛的关键靶点,并应用蛋白免疫印迹法和免疫组织化学对相关蛋白进行验证。结果:应用UPLC-LTQ-Orbitrap-MS共识别出方中38个化合物。与模型大鼠相比,XZDLD各组在前30分钟显著改善了偏头痛样行为(均P<0.05),并在第19‒22天提高了机械痛阈(均P<0.05),在第20‒22天提高了温度痛阈(均P<0.05)。基于网络药理学识别出128个XZDLD治疗偏头痛的潜在靶点。基于血浆代谢组学识别出在对照组、模型组和XZDLD组中有17种不同的内源性代谢产物,主要与色氨酸和酪氨酸代谢途径相关。将二者联合分析后确定了6个关键靶点进行验证:MAOA、MAOB、CYP1A1、CYP1A2、CYP1B1和ADH1C。与模型组相比,XZDLD显著降低了MAOA、MAOB和CYP1B1蛋白的表达(P=0.024;P=0.004;P=0.039),并升高了CYP1A1、CYP1A2和ADH1C的表达(P=0.033;P=0.045;P=0.027)。结论:芎芷地龙汤可以改善大鼠偏头痛样行为,提高痛阈,其作用机制可能与调节色氨酸和酪氨酸代谢途径有关,为其临床应用提供依据,同时为偏头痛研究提供思路。