Differential Amino Acid, Carbohydrate and Lipid Metabolism Perpetuations Involved in a Subtype of Rheumatoid Arthritis with Chinese Medicine Cold Pattern

Abstract

Pattern classification is a key approach in Traditional Chinese Medicine (TCM), and it is used to classify the patients for intervention selection accordingly. TCM cold and heat patterns, two main patterns of rheumatoid arthritis (RA) had been explored with systems biology approaches. Different regulations of apoptosis were found to be involved in cold and heat classification in our previous works. For this study, the metabolic profiling of plasma was explored in RA patients with typical TCM cold or heat patterns by integrating liquid chromatography/mass spectrometry (LC/MS) and gas chromatography/mass spectrometry (GC/MS) platforms in conjunction with the Ingenuity Pathway Analysis (IPA) software. Three main processes of metabolism, including amino acid, carbohydrate and lipid were focused on for function analysis. The results showed that 29 and 19 differential metabolites were found in cold and heat patterns respectively, compared with healthy controls. The perturbation of amino acid metabolism (increased essential amino acids), carbohydrate metabolism (galactose metabolism) and lipid metabolism, were found to be involved in both cold and heat pattern RA. In particular, more metabolic perturbations in protein and collagen breakdown, decreased glycolytic activity and aerobic oxidation, and increased energy utilization associated with RA cold pattern patients. These findings may be useful for obtaining a better understanding of RA pathogenesis and for achieving a better efficacy in RA clinical practice.

Treatment of Rheumatoid Arthritis Using Combination of Methotrexate and Tripterygium Glycosides Tablets—A Quantitative Plasma Pharmacochemical and Pseudotargeted Metabolomic Approach

“…Taurine and hypoxanthine are related to oxidative damage and are the direct scavenger of reactive oxygen radicals. It has been reported that the level of reactive oxygen species in plasma was significantly increased in RA patients (Madsen et al, 2011 ; Guo et al, 2016 ). Hence, the increased levels of taurine and hypoxanthine might be the defense mechanism against oxidative damage.…”

Immunometabolism in rheumatoid arthritis

“…These findings suggested that none of the treatments truly cures RA, as the underlying pathology of the RA was not fully reversed. Several other reports also demonstrated metabolic alterations in RA patients [8][9][10][11][12] (Table 1). These data suggested that metabolic changes are closely associated with inflammation in RA patients and may represent a potential target for disease monitoring and personalized medication for RA.…”

Applications and potential mechanisms of herbal medicines for rheumatoid arthritis treatment: a systematic review

“…Carnitine and acylcarnitine supplementation may be benecial for cold RA patients, but less for hot RA patients. 22 The differences in the biological backgrounds (genes, proteins, and metabolites) of patients with RA cold and hot symptoms have been reported in the study system, 23,24 and these results broaden the prospect of personalized RA treatment.…”