背景:睑板腺功能障碍(MGD),并发2型糖尿病,与眼表疾病的高发病率有关,没有有效的药物治疗。糖尿病(DM)MGD显示明显的脂质代谢紊乱。二东消克汤(EDXKD)具有重要的滋阴功能,清热,去血瘀,可有效治疗DMMGD。
目的:观察EDXKD对DMMGD的治疗作用及其分子机制。
方法:建立2型DM(T2DM)诱导的MGD大鼠模型后,给予不同剂量的EDXKD和T0070907。采用液相色谱-串联质谱(LC-MS/MS)对EDXKD的化学成分进行鉴定,并利用网络药理学预测了EDXKD治疗DMMGD的分子机制。使用LC-MS/MS分析DM睑板腺(MGs)中的脂质代谢,和脂质生物标志物进行筛选和鉴定。染色检测到MGs的组织学变化和脂质积累,免疫荧光法检测MG腺泡细胞中过氧化物酶体增殖物激活受体γ(PPARG)的表达。采用逆转录-定量聚合酶链反应(RT-qPCR)或免疫印迹法检测脂质代谢相关因子的表达。
结果:EDXKD降低了DMMGD大鼠MGs中的脂质积累并改善了眼表指数。EDXKD的主要活性成分在调脂方面具有优势。此外,PPARG信号通路是EDXKD治疗DMMGD的关键通路。12种脂质代谢产物是EDXKD治疗DMMGD的生物标志物,甘油磷脂代谢是调节血脂的主要途径。此外,EDXKD改善腺泡中脂质沉积并上调PPARG的表达。Further,EDXKD调节PPARG介导的UCP2/AMPK信号网络,抑制脂质产生,并促进脂质运输。
结论:EDXKD是DM患者MGD的有效治疗方法。EDXKD可以通过调节PPARG介导的UCP2/AMPK信号网络来调节血脂,因为它减少了DMMGD大鼠MGs中的脂质积累,促进脂质代谢,改善MG功能和眼表指标。
BACKGROUND: Meibomian gland dysfunction (MGD), complicated by type 2 diabetes, is associated with a high incidence of ocular surface disease, and no effective drug treatment exists. Diabetes mellitus (DM) MGD shows a notable disturbance in lipid metabolism. Er-Dong-Xiao-Ke decoction (EDXKD) has important functions in nourishing yin, clearing heat, and removing blood stasis, which are effective in the treatment of DM MGD.
OBJECTIVE: To observe the therapeutic effect of EDXKD on DM MGD and its underlying molecular mechanism.
METHODS: After establishing a type 2 DM (T2DM)-induced MGD rat model, different doses of EDXKD and T0070907 were administered. The chemical constituents of EDXKD were identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and the molecular mechanism of EDXKD in treating DM MGD was predicted using network pharmacology. Lipid metabolism in DM meibomian glands (MGs) was analyzed using LC-MS/MS, and lipid biomarkers were screened and identified. Histological changes and lipid accumulation in MGs were detected by staining, and Peroxisome proliferator-activated receptor gamma (PPARG) expression in MG acinar cells was detected by immunofluorescence. The expression of lipid metabolism-related factors was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) or western blotting.
RESULTS: EDXKD reduced lipid accumulation in the MGs and improved the ocular surface index in DM MGD rats. The main active components of EDXKD had advantages in lipid regulation. Additionally, the PPARG signaling pathway was the key pathway of EDXKD in the treatment of DM MGD. Twelve lipid metabolites were biomarkers of EDXKD in the treatment of DM MGD, and glycerophospholipid metabolism was the main pathway of lipid regulation. Moreover, EDXKD improved lipid deposition in the acini and upregulated the expression of PPARG. Further, EDXKD regulated the PPARG-mediated UCP2/AMPK signaling network, inhibited lipid production, and promoted lipid transport.
CONCLUSIONS: EDXKD is an effective treatment for MGD in patients with T2DM. EDXKD can regulate lipids by regulating the PPARG-mediated UCP2/AMPK signaling network, as it reduced lipid accumulation in the MGs of DM MGD rats, promoted lipid metabolism, and improved MG function and ocular surface indices.