Da-yuan-yin decoction ameliorates inflammatory injury in severe pancreatitis by protecting intestinal mucosal barrier and immune function and preventing intestinal dysbiosis.

INTRODUCTION

Acute pancreatitis (AP) is a common gastrointestinal condition characterized by inflammation of the pancreas. AP treatment is highly challenging due to the long hospital stays, higher medical expenses, and multiple complications. Traditional Chinese medicine has been used in China for thousands of years and is clinically proven to be a safe and effective treatment strategy for pancreatitis.

METHODS

To investigate whether a da-yuan-yin (DYY) decoction ameliorates inflammatory injury in severe pancreatitis. The severe acute pancreatitis (SAP) model was established by retrograde injection of 5% sodium taurocholate into the bile duct of male Sprague-Dawley rats. We detected the intestinal mucosal barrier function and intestinal immune function, and analyzed the changes of gut flora using the 16S rRNA gene testing.

RESULTS

Cell damage was more serious in SAP than that of DYY + SAP. The expression of myeloperoxidase and EGF-like module-containing mucin-like hormone receptor-like 1 in SAP was significantly higher than in DYY + SAP. Serum endotoxin, d-lactate, intestinal fatty acid-binding protein, interleukin (IL)-1β, and IL-10 of SAP and DYY + SAP were significantly increased. Plasma vasoactive intestinal peptide (VIP) was significantly reduced in both SAP and DYY + SAP; plasma VIP in DYY + SAP was significantly lower than in SAP. Levels of CD3+, CD4+, and CD8+ cells from ileal Peyer's patches in SAP and DYY + SAP were decreased; the levels of CD3+, CD4+, and CD8+ cells of DYY + SAP were significantly higher than in SAP. Species difference analysis showed significant differences among the top 10 most relatively abundant species in the sham operation (SO), SAP, and DYY + SAP at each taxonomic level (phylum, class, order, family, and genus). Clustered heat map analysis showed differences in species at the genus level among the SO, SAP, and DYY + SAP. At the phylum level, there were differences in the expression levels of proteobacteria and bactroidota between the SO and SAP, but not among other groups.

CONCLUSION

The DYY decoction may reduce tissue injury, protect the intestinal mucosal barrier, enhance intestinal immune function, and help prevent intestinal dysbiosis in ascitic fluid and stool specimens.