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Urinary metabolomic profiling reveals difference between two traditional Chinese medicine subtypes of coronary heart
Na Guo1, Yangan Chen2, Xiaofang Yang3
1Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China; State Key Laboratory Breeding Base of Dao-di Herbs, National Resource Center for Chinese Materia Medica, Center for Post-doctoral Research, China Academy of Chinese Medical Sciences, Beijing 100700, China; State Key Laboratory of Generic Manufacture Technology of Traditional Chinese Medicine, Lunan Pharmaceutical Group Co. Ltd, Shandong 276006, China.
Insights
Urinary metabolomics can objectively diagnose subtypes of coronary heart disease (CHD), differentiating Qi stagnation with blood stasis (QS) and Qi deficiency with blood stasis (QD) for personalized treatment.
Area of Science:
- Integrative medicine and metabolomics
- Biomarker discovery for cardiovascular diseases
- Traditional Chinese Medicine (TCM) research
Background:
- Coronary heart disease (CHD) is a leading cause of death globally.
- TCM classifies CHD into subtypes like Qi stagnation with blood stasis (QS) and Qi deficiency with blood stasis (QD), guiding treatment.
- Current TCM diagnosis lacks objective scientific markers, relying on subjective clinical judgment.
Purpose of the Study:
- To identify objective urinary metabolic markers for differentiating CHD subtypes.
- To investigate the utility of untargeted and targeted metabolomics in classifying QS and QD subtypes of CHD.
- To provide scientific evidence for personalized TCM treatment of CHD.
Main Methods:
- Employed untargeted (UHPLC-QTOF-MS) and targeted (UHPLC-MS/MS) metabolomics.
- Analyzed urine samples from CHD patients (QS and QD subtypes) and healthy controls.
- Identified significantly different metabolites and performed pathway analysis.
Main Results:
- Identified 42 metabolites in untargeted and 34 amino acids in targeted analyses.
- Found 16 metabolites significantly differed among the groups.
- Observed distinct urinary metabolic profiles between CHD subtypes and controls, with subtype-related pathway differences.
Conclusions:
- Urinary metabolomics can objectively differentiate between CHD subtypes (QS and QD).
- Metabolomic profiling provides a comprehensive and objective diagnostic approach for CHD.
- This approach supports personalized treatment strategies for CHD based on scientific evidence.
Abstract:
The World Health Organization has shown that coronary heart disease (CHD) is a more common cause of death than cancer. In traditional Chinese medicine (TCM), CHD is classified as a form of thoracic obstruction that can be divided in different subtypes including Qi stagnation with blood stasis (QS) and Qi deficiency with blood stasis (QD). Different treatment strategies are used based on this subtyping. Owing to the lack of scientific markers in the diagnosis of these subtypes, subjective judgments made by clinicians have limited the objective manner for utility of TCM in the treatment of CHD. Untargeted (UHPLC-QTOF-MS) and targeted (UHPLC-MS/MS) metabolomics approaches were employed to search significantly different metabolites related to the QS or QD subtypes of CHD with angina pectoris in this study. A total of 42 metabolites were obtained in the untargeted metabolomics analysis and 34 amino acids were detected in the targeted metabolomics analysis. In total, 16 metabolites were found significantly different among different groups. The results showed distinct metabolic profiles of urine samples not only between CHD patients and healthy controls, but also between the two subtypes of CHD. Pathway analysis of the significantly varied metabolites revealed that there were subtype-related differences in the activity of pathways. Therefore, urinary metabolomics can reveal the pathological changes of CHD in different subtypes, make the diagnosis of CHD in different subtypes in an objective manner and comprehensive and contribute to personalized treatment by providing scientific evidence.
