UPLC-Q-TOF-MS/MS代谢组学分析针刺对抑郁症患者血浆代谢物变化的影响

目的 运用高效液相色谱-飞行时间质谱联用(UPLC-Q-TOF-MS/MS)技术研究针刺治疗抑郁症的潜在生物标志物，探究针刺抗抑郁的潜在代谢调节机制。方法 选取2017年10月至2018年6月南京脑科医院的抑郁症患者25例，随机分为针刺药物组13例和药物组12例(脱落4例),药物组予SSRIs口服治疗，针刺药物组在药物组治疗基础上加予耳内皮刺治疗。收集治疗前后2组患者血浆样品，运用UPLC-Q-TOF/MS检测治疗前后2组患者的血浆代谢产物，比较2组治疗前后代谢物的差异。结果 针刺药物组筛选出16个潜在生物标记物，推测针刺药物组通过调节苯丙氨酸代谢、组氨酸代谢、酮体的合成与降解、赖氨酸降解4条代谢途径改善抑郁症患者的异常状态。药物组筛选出9个潜在生物标记物，推测药物组通过调节亚油酸代谢、咖啡因代谢、牛磺酸和亚牛磺酸的代谢、精氨酸和脯氨酸代谢4条代谢途径发挥治疗作用。结论 对抑郁症患者代谢物的调控可能是针刺发挥抗抑郁作用的内在机制。

UPLC-Q-TOF-MS/MS Metabolomics Analysis of the Effect of Acupuncture on Changes in Plasma Metabolites in Patients with Depression

  OBJECTIVE  Using UPLC-Q-TOF-MS/MS to study the potential biomarkers of acupuncture in the treatment of depression, and to explore the potential metabolic regulatory mechanism of acupuncture treatment for depression.  METHODS  25 depression patients from Nanjing brain hospital from October 2017 to June 2018 were selected and randomly divided into 13 cases in acupuncture drug group and 12 cases in drug group(with 4 cases fell off). The drug group received oral treatment with SSRIs, while the acupuncture drug group received ear endothelial puncture treatment in addition to the treatment of drug group. Plasma samples were collected from the two groups of patients before and after treatment, and UPLC-Q-TOF-MS/MS was used to detect plasma metabolites before and after treatment. The differences in metabolites between the two groups were compared before and after treatment.  RESULTS  16 potential biomarkers were screened out in the acupuncture drug group. It is speculated that the acupuncture drug group can improve the abnormal metabolism of patients with depression by regulating phenylalanine metabolism, histidine metabolism, synthesis and degradation of ketone bodies, and lysine degradation. 9 potential biomarkers were screened out in the drug group. It is speculated that the acupuncture drug group improves abnormal metabolism in patients with depression by regulating the four metabolic pathways: phenylalanine metabolism, histidine metabolism, ketone synthesis and degradation, and lysine degradation.  CONCLUSION  The regulation of metabolites in patients with depression may be the internal mechanism by which acupuncture exerts its antidepressant effect.