Abstract：
BACKGROUND: Ershiwuwei Zhenzhu pills was originally recorded in the Tibetan medical book Si Bu Yi Dian in the 8th century AD and is now included in the Pharmacopoeia of the People\'s Republic of China (2020). The pills can calm the nerves and open the mind as well as treat cerebral ischemia reperfusion injury, stroke, hemiplegia. However, its quality standards have not yet been established, and the therapeutic effect on cerebral ischemia by regulating the mitochondrial apoptosis pathway has not been elucidated.
METHODS: LC-MS was used to establish quality standards for Ershiwuwei Zhenzhu pills. Metabonomics, molecular docking, neuroethology, cerebral infarction ratio, pathological detection of diencephalon, cortex, and hippocampus, and molecular biology techniques were used to reveal the mechanism of the pills in regulating the mitochondrial apoptosis pathway to treat cerebral ischemia.
RESULTS: The contents of 20 chemical components in Ershiwuwei Zhenzhu pills from 12 batches and 8 manufacturers was determined for the first time. Eleven differential metabolites and three metabolic pathways, namely, fructose and mannose metabolism, glycerophospholipid metabolism, and purine metabolism, were identified by metabonomics. The pills improved the neuroethology abnormalities of MCAO rats and the pathological damage in the diencephalon and decreased the ratio of cerebral infarction. It also significantly reduced the mRNA expression of AIF, Apaf-1, cleared caspase8, CytC, and P53 mRNA in the brain tissue and the protein expression of Apaf-1 and CYTC and increased the protein expression of NDRG4.
CONCLUSIONS: In vitro quantitative analysis of the in vitro chemical components of Ershiwuwei Zhenzhu pills has laid the foundation for improving its quality control. The potential mechanism of the pills in treating cerebral ischemia may be related to the Apaf-1/CYTC/NDRG4 apoptosis pathway. This work provides guidance for clinical drug use for patients.
METHODS: LC-MS was used to establish quality standards for Ershiwuwei Zhenzhu pills. Metabonomics, molecular docking, neuroethology, cerebral infarction ratio, pathological detection of diencephalon, cortex, and hippocampus, and molecular biology techniques were used to reveal the mechanism of the pills in regulating the mitochondrial apoptosis pathway to treat cerebral ischemia.
RESULTS: The contents of 20 chemical components in Ershiwuwei Zhenzhu pills from 12 batches and 8 manufacturers was determined for the first time. Eleven differential metabolites and three metabolic pathways, namely, fructose and mannose metabolism, glycerophospholipid metabolism, and purine metabolism, were identified by metabonomics. The pills improved the neuroethology abnormalities of MCAO rats and the pathological damage in the diencephalon and decreased the ratio of cerebral infarction. It also significantly reduced the mRNA expression of AIF, Apaf-1, cleared caspase8, CytC, and P53 mRNA in the brain tissue and the protein expression of Apaf-1 and CYTC and increased the protein expression of NDRG4.
CONCLUSIONS: In vitro quantitative analysis of the in vitro chemical components of Ershiwuwei Zhenzhu pills has laid the foundation for improving its quality control. The potential mechanism of the pills in treating cerebral ischemia may be related to the Apaf-1/CYTC/NDRG4 apoptosis pathway. This work provides guidance for clinical drug use for patients.
摘要：
背景：二五味珍珠丸最初记载于公元8世纪的藏医著作《四布一典》，现列入《中华人民共和国药典》（2020年）。该药可以镇静神经，开放思维，治疗脑缺血再灌注损伤，中风,偏瘫.然而,其质量标准尚未建立，通过调节线粒体凋亡途径对脑缺血的治疗作用尚未阐明。
方法：采用LC-MS建立二五味珍珠丸的质量标准。代谢组学，分子对接,神经行为学，脑梗死比例,间脑的病理检测，皮质,海马体,和分子生物学技术揭示了该丸调节线粒体凋亡途径治疗脑缺血的机制。
结果：首次测定了12个批次、8个厂家的二五味珍珠丸中20种化学成分的含量。11种差异代谢物和3种代谢途径,即,果糖和甘露糖代谢，甘油磷脂代谢，嘌呤代谢，通过代谢组学鉴定。该药改善了MCAO大鼠的神经行为学异常和间脑的病理损伤，并降低了脑梗死的比例。它还显着降低了AIF的mRNA表达，Apaf-1，清除caspase8，CytC，和P53mRNA在脑组织中的表达以及Apaf-1和CYTC的蛋白表达，并增加NDRG4的蛋白表达。
结论：对二石味珍珠丸的体外化学成分进行体外定量分析，为提高其质量控制奠定了基础。该药治疗脑缺血的潜在机制可能与Apaf-1/CYTC/NDRG4凋亡通路有关。为患者临床用药提供指导。
方法：采用LC-MS建立二五味珍珠丸的质量标准。代谢组学，分子对接,神经行为学，脑梗死比例,间脑的病理检测，皮质,海马体,和分子生物学技术揭示了该丸调节线粒体凋亡途径治疗脑缺血的机制。
结果：首次测定了12个批次、8个厂家的二五味珍珠丸中20种化学成分的含量。11种差异代谢物和3种代谢途径,即,果糖和甘露糖代谢，甘油磷脂代谢，嘌呤代谢，通过代谢组学鉴定。该药改善了MCAO大鼠的神经行为学异常和间脑的病理损伤，并降低了脑梗死的比例。它还显着降低了AIF的mRNA表达，Apaf-1，清除caspase8，CytC，和P53mRNA在脑组织中的表达以及Apaf-1和CYTC的蛋白表达，并增加NDRG4的蛋白表达。
结论：对二石味珍珠丸的体外化学成分进行体外定量分析，为提高其质量控制奠定了基础。该药治疗脑缺血的潜在机制可能与Apaf-1/CYTC/NDRG4凋亡通路有关。为患者临床用药提供指导。
