| OBJECTIVETo investigate whether metabolic difference exists between acupuncture on specific acupoints of disease-relate meridian, on non-specific acupoints of disease-relate meridian, on acupoints of other meridian or on non-acupoints,1H NMR-based metabonomic method was used to study the metabolism changes in FD after treated by different acupuncture method.METHOD1. FD patients were recruited in and Nepean Dyspepsia Index (NDI) scale rating was employed to evaluate the the symptoms of dyspepsia and the quality of life for the patients. 1H NMR--based metabonomic techniques were used to detect the plasma metabolic profiles. Pattern recognition was used to find the difference and the key metabolites between groups. By calculating the correlation between the key metabolites and the NDI score, potential biomarkers were founded. KEGG database was mainly referenced to analyze the metabolic pathways of the potential biomarkers.2. Four kinds of methods were chosen to treat FD:(1) specific acupoints of Stomach Meridian of Foot-Yangming (group A); (2) non-specific acupoints of the stomach meridian (group B); (3) acupoints of the gallbladder meridian (group C) and (4) non-acupoints(group D). Similarly,1H NMR--based metabonomic techniques had been used to detect the metabolites over two periods and four periods of treatment.3. Analyze the eigenvalue on the loading plots of pairwise comparison and calculated the plots similarity by correlation coefficient algorithm. RESULTS1. The plasma level of phosphatidycholine (PtdCho) in FD increased significantly, and was positively related to the score of Nepean Dyspepsia Symptom Index (NDSI) (P<0.01); the plasma level of Leucine/isoleucine decreased obviously and was negatively related to the score of NDSI (P< 0.05), both compounds are FD potential biomarkers. In addition, Levels of a series compounds including glutamine, alanine, proline, HDL,β-glucose,α-glucose and LDL/VLDL were significantly changed in FD, they were considered to be FD key metabolites.2. After two periods of treatment, all groups except group D could significantly reduce the concentration of PtdCho; all groups could increase the concentration of Leu/Ile, but no group has statistical significance. Comparison between groups showed that level of Ptdcho in group A was the lowest after two periods of treatment, with all pairwise comparison P values lower than 0.05.The level of Leu/Ile in group A was significantly higher than group C and D (both P<0.05), but only slightly higher than that of group B. After four periods of treatment, PtdCho continued to decrease and Leu/Ile continued to increase in group A, B and C. However, only Leu/Ile in group A was significantly improved (P<0.05).3. After 2 periods treatment, levels of glutamine, LDL/VLDL andβ-glucose were obvoiously improved in group A (P<0.05); Level of threonine in group B was significantly improved (P<0.05). a-glucose in group B and group C was significantly changed but both were not benign improving effect. In Group D, concentrations of key metabolites were only slightly improved. After 4 periods treatment, the effects mentioned above in group A was continuously improved, however, the effect on alanine and lysine were weakened at this time point. Concentration of threonine in group B was continuously significantly increased. In group C, many compounds including acetoacetate,β-glucose, a-glucose, UFA, alanine and lactate were significantly changed, but its effect on P-glucose, a-glucose and lactate were oppositely to the 2nd periods (in other words the change was with the same trend as FD). In group D, almost all compounds slightly changed but no obvious different between 2 periods and 4 periods treatment.4. After two periods of treatment, LED eigenvalue plots showed that group B was similar to group A; after four periods of treatment, both CPMG and LED eigenvalue plots in group B was similar to that of group A.CONCLUSION1. Many plasma metabolites are deviating from normal condition in FD, among them, concentration of PtdCho and Leu/Ile are closely related to FD symptoms, they are potential biomarkers.2. Four kinds of acupuncture methods has certain positive role to FD potential biomarkers, but the intensity of adjustment and the continuation effect along with treating periods are different. Four kinds of methods can improve the levels of other key metabolites, but the main target metobolites, the intensity, the continuation effect along with treating periods and the scopes of the effect are different, The results provide some metabonomic basis for the specific effects of Foot-Yangming meridian in treating FD.3. Puncturing on specific acupoints of the stomach meridian has a more significant and intensive effect on the two kinds of potential biomarkers of FD, and this effect would be enlarged after four periods of treatment. For most of the other key metabolites, this method is more effective and has a more intensive targeted effect than other methods. Puncturing on non-acupoints could also influence the potential biomarkers and key metabolites of FD, but with lower intensity, narrow range and weaker continuous effect. Specific acupoints and non-specific acupoints in the stomach meridian have common metabolic features. Our study provides new clues for considering the connotation of the specific effects of Foot-Yangming meridian. |
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