Pneumonia is the world's leading cause of death in young children and elderly people. It is an infection that inflames the air sacs in one or both lungs, filling the air sacs with fluid and causing a cough, fever, chills, and breathing difficulties.
Traditional Chinese medicines (TCMs) are widely used throughout the world in the prevention and treatment of viral pneumonia through the belief in their potential to boost the body's resistance to the pneumonia virus and modulate its immune response. Many viruses have established sophisticated mechanisms to interact with the host immune system.
TCMs have been shown to enhance antibody production and T cell proliferation, and the expression of antigen-specific responses.[i] TCMs, composed of various kinds of medicinal plants, animals and minerals in the form of oral liquid, powder and granules, have been reported to achieve certain therapeutic effects but their mechanism remains unclear.
Omics technologies are valuable tools in TCM research. Metabolomics in particular is a new logical approach that can help locate functional small molecules to evaluate the pharmacological effect of TCMs.[ii] The systematic study of the metabolic profile that specific cellular processes in the body leave behind, metabolomics can provide useful information to help diagnosis and prognosis of patients as well as in predicting pharmacological responses to specific interventions.
As a novel approach to understanding disease, metabolomics provides a "snapshot" in time of all metabolites present in a biological sample such as plasma, serum and urine. Recent reports suggest that metabolomics analysis may provide clinicians with the opportunity to identify new biomarkers for detailed phenotypes and their progression in viral pneumonia.[iii]
Metabolomics helps understand the metabolic changes of a complete system under different kinds of physiological and pathological conditions. This property of metabolomics agrees with the holistic thinking of TCMs, suggesting it has the potential to improve our understanding of the theory behind the evidence based TCM.
In recent years, an increasing number of metabolomics studies have examined the metabolic profiles after TCM treatment of viral pneumonia.[iv] Metabolomics may provide an opportunity to clarify the action mechanism of TCM and the meaning of evidence-based TCM by developing the systematic analysis of the metabolites and discovering various biomarkers and perturbed pathways after TCM treatment.
One study[v] looked at eight published metabolomics and TCM extracts related articles to find several different metabolites, including triglycerides, amino acids and carbohydrates, were perturbed in viral pneumonia groups. Metabolomics data from this research suggested that the active compound and herbs, such as Scutellaria baicalensis Georgi, Polygonum cuspidatum Sieb. Et Zucc, Flos Lonicerae Japonica and Fructus Forsythiae were effective in combating viral pneumonia. Five published metabolomics and TCM formulas-related articles were listed and 17 TCM-related plant species and four TCM formulas were found to be effective to combat viral pneumonia.
Metabolomics is a top-down strategy to reflect the function of living organisms from the end products of the metabolic network.[vi]
It is set to be a powerful approach to support TCM research in the future. Current research on TCM is still in its infancy because of the multi-component mixtures that often possess their own inherent holistic bioactivities. At Bruker, we believe that metabolomics-pharmacological research supported by our cutting-edge, integrated metabolomics solutions will see exciting developments as the ancient tradition of TCM is brought to the light of science.
[i] Li Y, Ooi LS, Wang H, But PP, Ooi VE. Antiviral activities of medicinal herbs traditionally used in southern mainland China. Phytother Res. 2004;18:718-22.
Jong Seok L, Kyoung CM, Hye Suk H, Eun-Ju K, Yu-Na L, Young-Man K, Min-Chul K, Ki-Hye K, Young-Tae L, Yu-Jin J. Ginseng diminishes lung disease in mice immunized with formalin-inactivated respiratory syncytial virus after challenge by modulating host immune responses. J Interferon Cytokine Res. 2014;34:902-14.
Wang KC, Chang JS, Chiang LC, Lin CC. Sheng-Ma-Ge-Gen-Tang (Shoma-kakkon-to) inhibited cytopathic effect of human respiratory syncytial virus in cell lines of human respiratory tract. J Ethnopharmacol. 2011;135:538-44.
Lin-Lin M, Miao G, Hui-Qiang W, Jin-Qiu Y, Jian-Dong J, Yu-Huan L. Antiviral activities of several oral traditional chinese medicines against influenza viruses. Evid Based Complement Altern Med. 2015;2015:1-9.
[ii] Sun X, Song L, Feng S, Li L, Yu H, Wang Q, Wang X, Hou Z, Li X, Li Y. Fatty acid metabolism is associated with disease severity after H7N9 infection. EBioMedicine. 2018;33:218-29.
Banoei MM, Vogel HJ, Weljie AM, Kumar A, Yende S, Angus DC, Winston BW. Plasma metabolomics for the diagnosis and prognosis of H1N1 influenza pneumonia. Crit Care. 2017;21:97.
Lu C, Jiang Z, Fan X, Liao G, Li S, He C, Han L, Luo S, Liu Y, Lin H. A metabonomic approach to the effect evaluation of treatment in patients infected with influenza A (H1N1). Talanta. 2012;100:51-6.
[iii] Stewart CJ, Hasegawa K, Wong MC, Ajami NJ, Petrosino JF, Piedra PA, Espinola JA, Tierney CN, Camargo CA Jr, Mansbach JM. Respiratory syncytial virus and rhinovirus bronchiolitis are associated with distinct metabolic pathways. J Infect Dis. 2017;217:1160-9.
[iv] Meng X. Regularity of compound herbal formula for pneumonia treated by Professor Wang Shouchuan and anti-RSV effect of Jinxin oral liquid and baicalein based on metabolomics. NJUCM. 2017.
[v] Lili Lin, Hua Yan, Jiabin Chen, Huihui Xie, Linxiu Peng, Tong Xie, Xia Zhao, Shouchuan Wang and Jinjun Shan (2019) Application of metabolomics in viral pneumonia treatment with traditional Chinese medicine, China: Springer Nature.
[vi] Zhang A, Sun H, Wang Z, Sun W, Wang P, Wang X. Metabolomics: towards understanding traditional Chinese medicine. Planta Med. 2010;76:2026-35.