Study On The Differences Of Serum Metabolomics In Patients With Different TCM Syndromes Of Depressio

Objective:Non-targeted metabonomics method was used to study the serum of depression patients with liver-qi stagnation syndrome and kidney-yang deficiency syndrome to find the differential metabolites and abnormal metabolic pathways between depression patients and healthy people and two different TCM syndromes,to screen and mine potential biomarkers related to the occurrence and development of depression.And from the metabolic level to find the objective evaluation index of TCM syndrome classification of liver-qi stagnation syndrome and kidneyyang deficiency syndrome of depression.Methods:1.In this study,according to the diagnostic criteria of the Fifth Edition of Diagnostic Statistical Manual of Mental Disorders(DSM-5)and the scores of Hamilton Depression Scale(HAMD-24),the inclusion and exclusion criteria of patients with Drug-Naive moderate depression with first episode were established.Select the main TCM syndromes of depressionkidney yang deficiency syndrome and liver qi stagnation syndrome established by the tutor in the clinical study of TCM syndrome of depression,and refer to the relevant guidelines of depression made by the Chinese Society of Traditional Chinese Medicine and the National Society of Integrated traditional Chinese and Western Medicine.HAMD-24,Young Mania Rating Scale(TMRS)and Social Disability Screening Scale were used to determine the participation criteria of the healthy control group.2.The patients’ fasting elbow venous blood was collected,and the serum was separated by centrifugation and placed in a low temperature refrigerator at-80℃ to avoid repeated freezing and thawing.After serum samples pretreated and quality control samples prepared,high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)analysis was conducted.Multivariate statistical analysis was conducted on the results of positive and negative ion medal which had been preprocessed and quality-controlled on HPLC-MS/MS platform,such as principal component analysis(PAC),orthogonal partial least square discriminant analysis(OPLS-DA),substitution test.The obtained difference variables were matched with open databases(such as HMDB and KEGG)to identify metabolites and related metabolic pathways in serum,and to screen compounds with significant differences between groups for potential biomarkers.Results:There were 17 cases of depression with stagnation of liver qi,17 cases of depression with deficiency of kidney yang and 17 cases of healthy people living in Beijing for a long time.There was no significant difference in age,sex,and years of education.The stability of the analysis process of HPLC-MS/MS system is high,and the quality of test data meets the requirements.Compared with the healthy control group,the differences of 37 serum metabolites were statistically significant,and 5 potential biomarkers of depression and 9 related metabolic pathways were screened.Compared with the two TCM syndromes,the expression level of 9 kinds of metabolites was higher in the kidney yang deficiency syndrome group and 5 kinds of metabolites in the liver qi retention syndrome group.4 kinds of differential metabolites were screened out,which were not enriched into the potential biomarkers of TCM syndrome type.Comparing kidney-yang deficiency syndrome and liver-qi stagnation syndrome with healthy control group,it was found that there were two kinds of differential metabolites in kidney-yang deficiency syndrome,purine metabolism in differential metabolic pathway,and five kinds of differential metabolites in liver-qi stagnation syndrome.Conclusion:The abnormality of serum metabolites in patients with depression is mainly related to amino acid metabolism,energy metabolism and steroid metabolism.Most of the key metabolites and their related metabolic pathways revolve around mitochondrial/energy metabolism,neuronal integrity and signal transduction/neural transmission.The discovery of serum differential metabolites of kidney yang deficiency syndrome and liver qi stagnation syndrome of depression provides an objective clinical basis for the study of TCM syndrome,especially the syndrome differentiation of depression,but the names of these compounds are not included in the main database.It is a kind of compound which is unknown and can not be explained at present,which shows the transcendence of traditional Chinese medicine and the possibility that TCM thinking and theory can guide modern science to discover the unknown.