Research progress on effective chemical constituents of Sijunzi Decoction and mechanism of prevention and treatment of digestive system diseases

Sijunzi Decoction,as one of the classic Chinese traditional prescriptions,has been used clinically by major physicians since the Song Dynasty.This article reviewed and sorted out the literature on the effective chemistry of Sijunzi Decoction and the mechanism of its prevention and treatment of digestive system diseases.At present,its effective chemical components are derived from the saponins and flavonoids in ginseng and licorice,and are effective for gastrointestinal mucosal injury diseases and malignant digestive system.Digestive system diseases such as tumors,functional gastrointestinal diseases,non-alcoholic fatty liver,acute liver injury,and liver failure show a multi-path,multi-target effect mechanism.This article reviews the effective chemical components and research of Sijunzi Decoction and the related mechanisms of prevention and treatment of digestive system diseases,and provides valuable clues for the follow-up research of Sijunzi Decoction.

Effect of Sijunzi Decoction on the Myonuclear Domain of Rat Soleus in Spleen Qi Deficiency

Objective: To study the mechanism of Sijunzi decoction treating limb weakness in spleen Qi deficiency (SQD) based on the myonuclear domain (MND) theory. Methods: 40 male Sprague-Dawley rats were randomly divided into the normal group, SQD model group (model group), SQD+ still water group (SW group) and SQD+ Sijunzi decoction group (CM group), 10 rats each group;Grip-Strength Meter was used to measure limb grip strength;transmission electron microscope was employed to observe the ultrastructural changes of the myofibers, Image Pro 6.0 was used to measure the myonuclear numbers, cross-section area (CSA) and then their ratios (the MND sizes) were calculated, immunofluorescence assay was chosen to test the expressions of paired box gene 7 (Pax7) and myogenic differentiation antigen (MyoD). Results: Compared with those in the normal group, limb grip strength was decreased, sarcomeres were abnormal, and all the myonuclear numbers, CSA and MND sizes were reduced, but the Pax7+ cell numbers were increased, significantly, in the model and SW groups;Compared with those in the model and SW groups, limb grip strength was increased, sarcomeres were basically normal, the myonuclear number and CSA were both greater, and the Pax7+ and MyoD+ cell numbers were both increased, significantly, in the CM group. Conclusion: Sijunzi decoction might increase the myonuclear number by activating the MSCs to treat limb weakness in SQD.

Identification of anti-inflammatory components in Panax ginseng of Sijunzi Decoction based on spectrum-effect relationship

Objective: This study aimed to identify the main medicinal active components of Panax ginseng(P. ginseng) in the compatibility environment of clinical application. For this purpose, the anti-inflammatory ingredients of P. ginseng were investigated based on its therapeutic effect in Sijunzi Decoction(SJD) which is a widely used traditional Chinese formula.Methods: The fingerprints of 10 batches of SJD consisting of different sources of P. ginseng were established by UPLC technique to investigate the chemical components. At the same time, the antiinflammatory effects of these components were evaluated by dextran sulfate sodium-induced ulcerative colitis mouse model. Grey relational analysis was applied to explore the correlation degree between fingerprints and anti-inflammatory effects in SJD. Lipopolysaccharide-stimulated RAW264.7 murine macrophages were established to evaluate the anti-inflammatory action of the screened effective substances of P. ginseng.Results: According to grey relational analysis, notoginsenoside R1, ginsenoside Rg2 and ginsenoside Rb3of P. ginseng were the major anti-inflammatory contributions in SJD. They had been proven to be closely associated with the anti-inflammatory process of SJD and displayed a close effect compared with SJD by LPS-stimulated RAW264.7 murine macrophages.Conclusion: Our work provides a general strategy for exploring the pharmacological ingredients of P. ginseng in traditional Chinese formulas which is beneficial for establishing the quality standards of traditional herbs in traditional Chinese medicine prescription based on their clinical therapeutic effect.

Effects and mechanisms of Bazhen decoction,Siwu decoction,and Sijunzi decoction on 5-fluorouracil-induced anemia in mice

OBJECTIVE:To investigate the effects of Bazhen decoction(BZD),Siwu decoction(SWD) and Sijunzi decoction(SJZD) in mice with anemia induced by5-fluorouracil(5-FU) and discussed the possible pharmacological hematopoietic mechanism to provide experimental evidence for the clinical use of the three classical prescriptions in the treatment of anemia.METHODS:Anemia was induced by intravenous injection of 5-FU and 80 female Kunming mice were randomly,assigned to oral administration of SWD,SJZD,or BZD daily for 10 days.Peripheral blood cells count and bone marrow cell cycle were monitored to evaluate anti-anemia effects.Serum cytokines,interferon-γ(IFN-γ),interleukin-3(IL-3),erythropoietin(EPO),granulocyte-macrophage colonystimulating factor(GM-CSF),and tumor necrosis factor-α(TNF-α) were assayed.EPO m RNA expression was assayed in kidney and liver tissue homogenates.RESULTS:BZD and SWD significantly increased the number of red blood cells,hemoglobin concentration,and hematocrit,promoted bone marrow cells to enter the cell cycle,proliferate and differentiate,significantly increased IL-3 secretion,and significantly inhibited IFN-γ secretion.BZD stimulated transcription of EPO m RNA in the kidney and liver and enhanced serum EPO expression.A therapeutic effect of SJZD was not observed.CONCLUSION:BZD and SWD treatment specifically enhanced hematopoietic function and mediated myelopoiesis by altering serum cytokines levels and accelerating entry of bone marrow cells into the cell cycle.Better curative effects were achieved via nourishing both Qi and blood(BZD) than by enriching the blood(SWD) or invigorating Qi(SWZD)alone.

Chinmedomics facilitated quality-marker discovery of Sijunzi decoction to treat spleen qi deficiency syndrome

Sijunzi decoction (SJZD) is a Chinese classical formula to treat spleen qi deficiency syndrome (SQDS) and has been widely used for thousands of years.However,the quality control (QC) standards of SJZD are insufficient.Chinmedomics has been designed to discover and verify bioactive compounds of a variety of formularapidly.In this study,we used Chinmedomics to evaluate the SJZD's efficacy against SQDS to discover the potential quality-markers (q-markers) for QC.A total of 56 compounds in SJZD were characterized in vitro,and 23 compounds were discovered in vivo.A total of 58 biomarkers were related to SQDS,and SJZD can adjust a large proportion of marker metabolites to normal level and then regulate the metabolic profile to the health status.A total of 10 constituents were absorbed as effective ingredients that were associated with overall efficacy.We preliminarily determined malonyl-ginsenoside Rb2 and ginsenoside Ro as the q-markers of ginseng;dehydrotumulosic acid and dihydroxy lanostene-triene-21-acid as the q-markers of poria;glycyrrhizic acid,isoglabrolide,and glycyrrhetnic acid as the q-markers of licorice;and 2-atractylenolide as the q-marker of macrocephala.According to the discovery of the SJZD q-markers,we can establish the quality standard that is related to efficacy.

Progress in Research on Applying Sijunzi Decoction (四君子汤) in Treating Digestive Malignant Tumor

Patients with digestive malignant tumor always have their immune function, especially the cellular immunity, suppressed to a certain extent. Traditional Chinese medicine （TCM） holds that Pi （脾 ）-Wei （胃） is the essence of postnatal life, and the genesis and development of digestive tumor are chiefly due to the insufficiency of vital-qi, which makes the body open to the invasion of evil pathogens. Starting from regulating the immune function of organisms, researchers recently obtained some therapeutic effects by applying the Chinese recipe, Sijunzi Decoction （四君子汤）, in the treatment of digestive malignant tumors. In this paper, the related studies on the concerned basic theory and clinical application were reviewed.

Sijunzi Decoction Inhibits Stemness by Suppressingβ-Catenin Transcriptional Activity in Gastric Cancer Cells

Objective:To investigate a previously uncharacterized function of Sijunzi Decoction(SJZD)in inhibition of gastric cancer stem cells(GCSCs).Methods:MKN74 and MKN45,two CD44 positive gastric cancer cell lines with stem cell properties were used.The cells were divided into 2 groups.Treatment group was treated with SJZD(1-5 mg/mL)for indicated time(48 h-14 days).The control group was treated with equal volume of phosphate buffered saline.Cell Counting Assay Kit-8 were used to measure cell viability.Spheroid colony formation and GCSCs marker expression were performed to determine GCSCs stemness.Cell fractionation and chromatin immunoprecipitation assays were used to assess the distribution and DNA-binding activity of β-catenin after SJZD treatment,respectively.Results:SJZD treatment repressed cell growth and induced apoptosis in MKN74 and MKN45 cell lines(P<0.05).Moreover,SJZD dramatically inhibited formation of spheroid colony and expression of GCSC markers in GC cells(P<0.05).Mechanistically,SJZD reduced nuclear accumulation and DNA binding activity ofβ-catenin(P<0.05),the key regulator for maintaining CSC stemness.Conclusion:SJZD inhibits GCSCs by attenuating the transcriptional activity of β-catenin.

Efficacy of Sijunzi decoction(四君子汤) on limb weakness in spleen Qi deficiency model rats through adenosine monophosphate-activated protein kinase/unc-51 like autophagy activating kinase 1 signaling

OBJECTIVE:To investigate the efficacy of Sijunzi decoction(四君子汤)on limb weakness in a rat model of spleen Qi deficiency(SQD),and to study its effect on mitophagy in skeletal muscle through adenosine monophosphate-activated protein kinase(AMPK)/unc-51 like autophagy activating kinase 1(ULK1)signaling.METHODS:SQD model rats were produced by fasting combined with forced swimming method for15 d.After model assessment,rats were randomly divided into four groups of 10[low/middle/high(L/M/H)Sijunzi decoction dose groups and a normal saline(S)group].Limb holding power(HP)and body mass(BM)were measured after 2 weeks of treatment.Following euthanasia,quadriceps femoris were dissected and myofiber and mitochondrial morphology were observed by transmission electron microscopy(TEM).Mitochondrial membrane potential(MMP),adenosine triphosphatase(ATP)and reactive oxygen species(ROS)levels were determined using colorimetric methods,and immunoblot analysis of Microtubule-associated protein light chain 3(LC3)and Sequestosome 1(p62)was performed to monitor mitophagy and AMPK/ULK1 signaling.RESULTS:Compared with control(C)group rats,in the S group,HP was reduced,the myofiber Z line was disordered,mitochondria were scattered,and numerous vacuoles and mitophagy were observed.MMP and ATP levels were reduced,ROS levels were elevated,and LC3B expression,and p-AMPKα(Thr172)/AMPKα,p-ULK1(Ser555)/ULK1,and p-Raptor(Ser792)/Raptor ratios were increased,while p62 expression and p-mT OR(Ser2448)/mT OR and p-ULK1(Ser757)/ULK1 ratios were decreased.After treatment,compared with the S group,HP was improved in M and H groups but not in the L group.Mitophagy was reduced in M,H and L groups but the Z line was disordered and vacuolization remained in the L group.ATP levels were elevated in M,H and L groups,and MMPs were elevated in M and H groups but not in the L group.ROS levels were decreased in M,H and L groups,as were LC3B expression and p-Raptor(Ser792)/Raptor ratios,while p62 expression and p-mT OR(Ser2448)/mT OR and p-ULK1(Ser757)/ULK1 ratios were increased in M and H groups but not in the L group.p-AMPKα(Thr172)/AMPKαand p-ULK1(Ser555)/ULK1 ratios were decreased in M,H and L groups.CONCLUSIONS:Sijunzi decoction improved HP,possibly by inhibiting mitophagy via suppression of AMPK/ULK1 signaling.This restored mitochondrial morphology and improved oxidative phosphorylation,which contributed to recovery of limb weakness in SQD model rats.

Effects of Traditional Herbal Formulae on Human CYP450 Isozymes

Objective：To assess the effects of traditional herbal formulae Sijunzi Decoction（四君子汤,Sagunja-tang,SJZD）,Siwu Decoction（四物汤,Samul-tang,SWD）,Bawu Decoction（八物汤,Palmul-tang,BWD）and Shiquan Dabu Decoction（十全大补汤,Sipjeondaebo-tang,SDD）on the activities of human cytochrome P450（CYP450）,a drug-metabolizing enzyme.Methods：Herbal formula water extracts were filtered and lyophilized after the powder extracts were dissolved in distilled water.The activities of major human CYP450isozymes（CYP3A4,CYP2C19,CYP2D6 and CYP2E1）were measured using in vitro fluorescence-based enzyme assays.The inhibitory effects of the herbal formulas on the activities of CYP450 were characterized as half maximal inhibition concentration（IC50）values.Results：All the tested herbal formulae inhibited CYP2C19activity（IC50：SJZD,83.28μg/m L;SWD,235.54μg/m L;BWD,166.82μg/m L;SDD,178.19μg/m L）;SJZD（IC50=196.46μg/m L）,SWD（IC50=333.42μg/m L）and SDD（IC50=163.42μg/m L）inhibited CYP2E1-mediated metabolism;whereas BWD exhibited comparatively weak inhibition of CYP2E1（IC50=501.78μg/m L）.None of the four herbal formulas significantly affected CYP3A4 or CYP2D6.Conclusions：These results suggest that SJZD,SWD,BWD and SDD could potentially inhibit the metabolism of co-administered synthetic drugs whose primary route of elimination is via CYP2C19.In addition,clinically relevant pharmacokinetic interactions could occur when SJZD,SWD or SDD is co-administered with drugs metabolized by CYP2E1.Our findings provide information for the safety and effective clinical use of these four classic herbal formulas.