Effects Of Jiawei Xiaoyao Powder On Intestinal Flora,TSLP,IL-4,5-HT In Patients With Liver Qi Stagnation And Spleen Deficiency Syndrome Of Atopic Dermatitis

Objective: To detect the levels of interleukin-4(IL-4),TSLP,and 5-HT in peripheral blood and the distribution of gut microbiota in patients with atopic dermatitis(AD)and healthy people,to analyze the characteristics of gut microbiota in patients with AD,and to further explore the relationship between gut-brain-skin axis and the pathogenesis of AD.Modified Xiaoyao powder was used to treat patients with atopic dermatitis of liver stagnation and spleen deficiency syndrome.The severity of disease and the improvement of psychological status before and after treatment were observed,and the clinical efficacy of modified Xiaoyao powder in the treatment of atopic dermatitis was further explored,and its effect on the levels of IL-4,TSLP,5-HT and intestinal flora was also investigated.Methods: In this study,clinical data of 25 patients with AD of liver stagnation and spleen deficiency syndrome and 25 healthy controls were collected.Peripheral blood samples and fecal samples were collected before and after treatment in the patient group and the healthy control group.ELISA was used to detect the serum levels of IL-4 and 5-HT.Real-time PCR and WB were used to detect the expression of TSLP in gene and leukocyte.16 Sr DNA was used to analyze the distribution characteristics of intestinal flora.Results:1.Modified Xiaoyao Powder in the treatment of AD patients with liver stagnation and spleen deficiency syndrome could effectively reduce the SCORAD score,and the difference before and after treatment was statistically significant(P < 0.05).2.The clinical scores of DLQI,SAS and SDS in the patient group were improved after treatment,and the differences were statistically significant(P < 0.001).3.The serum level of IL-4 in AD patients was significantly higher than that in healthy controls(P < 0.05).The expression level of IL-4 in serum of patients before treatment was significantly higher than that after treatment(P < 0.05).The expression level of serum 5-HT in patients was significantly higher than that in healthy controls(P < 0.05).The expression level of 5-HT in serum of patients before treatment was significantly higher than that after treatment(P <0.05).However,due to the large individual differences,there was no significant difference in the expression of TSLP at the gene level between the patients before and after treatment and the healthy control group(P > 0.05),and the difference was still not significant after adjusting for extreme values(P > 0.05).However,the expression level of TSLP in white blood cells in healthy controls was higher than that in patients,and it was higher after treatment than before treatment.4.Intestinal flora analysis: in the alpha diversity analysis index analysis of the three groups,there was a significant difference in Simpson index between the patient group and the healthy group before treatment(P=0.016),and there was no significant difference between the patient group and the healthy control group after treatment.In the distribution of community structure,the proportion of colony composition in the three groups was significantly different.The principal component analysis of intestinal flora in the three groups showed that there were different aggregation tendencies and differences in the structural composition of intestinal flora.Through the analysis of the structure of intestinal flora at each taxonomic level and the analysis of the different species among the three groups,the results showed that Bacteroidetes at the phylum level;At the class level,Bacteroidia,Deltaproteobacteria;At the order level,Bacteroidales,Coriobacteriales;At the family level Prevotellaceae,Desulfovibrionaceae,Rikenellaceae,Barnesiellaceae,Mitochondria,Coriobacteriales;At the genus level,Prevotella＿9,Alloprevotella,Alistipes,Desulfovibrio,Lactobacillus,Mitsuokella,Barnesiella,Butyricimonas;At the species level,Lactobacillus＿murinus was significantly different between the healthy control group and the patient group before and after treatment(p<0.05).In addition,in the LEf Se analysis of the three groups,there were 13 biomarkers with statistically significant differences in abundance between the groups.There were 8 Proteobacteria,Enterobacteriaceae,Enterobacteriales,Gammaproteobacteria in the post-treatment group.Before treatment,one patient in the patient group was Escherichia＿Shigella.There were 4 in the normal group,Bacteroidales,Bacteroidia,Bactero-idetes,Prevotellaceae,Bacteroidaceae,Bacteroides,Prevotella＿9,Veillonellaceae.Conclus ions: In this study,it was found that the expression levels of IL-4 and 5-HT in peripheral blood of atopic dermatitis patients were significantly higher than that of healthy control group.There were certain differences in intestinal flora between atopic dermatitis patients and healthy control group,among which bacteroides and Proteobacteria in healthy control group were significantly higher than those in patient group,which may be related to the pathogenesis of atopic dermatitis.After oral treatment with Jiawei Xiaoyao SAN,serum IL-4 and 5HT levels decreased,and TSLP did not change significantly,which had a certain effect on intestinal flora.The mechanism of action of Jiawei Xiaoyao SAN may be related to restoring intestinal flora diversity and regulating immune balance.The gut-brain-skin axis may be involved in both the pathogenesis of atopic dermatitis and the intervention mechanism of Jiawei Xiaoyao SAN.