The therapeutic effect of Xuanbai Chengqi Decoction on chronic obstructive pulmonary disease with excessive heat in the lung and fu-organs based on gut and lung microbiota as well as metabolic profiles

As a prescription for treating lung inflammation and intestinal diseases, Xuanbai Chengqi Decoction (XBCQD) in clinical practice can effectively treat COPD with excessive heat in the lung and fu-organs, which is characterized by phlegm-heat accumulation in the lung and constipation. This study aims to find the potential biomarkers of COPD with excessive heat in the lung and fu-organs from two aspects of lung and intestine based on metabolomics and microbiota analysis, and to evaluate the efficacy of XBCQD as well as to explore the mechanism of drug function according the regulating effect of drugs on these markers. The HPLC-Q-TOF-MS/MS, 16SrDNA technology and multiple statistical methods were used to trace the process of disease and curative effect with XBCQD. Results showed that the onset and development of disease was associated with the imbalance of 41 differential metabolites in plasma, bronchoalveolar lavage fluid and feces and 82 bacteria at the levels of phylum, class, order, family and genus from lung and intestine, including Escherichia-Shigella. However, after treatment with XBCQD, 30 differential metabolites mainly involving in the metabolism of linoleic acid, taurine and hypotaurine metabolism, arachidonic acid metabolism, biosynthesis of primary bile acids, tryptophan metabolism, arginine and proline metabolism and 65 pulmonary and intestinal bacteria at all levels were reversed in the drug group. In addition, the results of the correlation analysis showed that specific microbiota from lung and intestine and reversed differential metabolites had a significant correlation, and they could affect each other in the course of disease occurrence and treatment. This study preliminarily confirmed that XBCQD can be used to treat COPD with excessive heat in the lung and fu-organs through lung-intestine simultaneous treatment. It also provided new strategies for the treatment of lung diseases or intestinal diseases, and new research ideas for the evaluation of drug efficacy.