Controlled fermentation of Arisaema cum bile with isolated Fungi strains and its antipyretic effects in a febrile mouse model.

Arisaema cum Bile (DNX, Dan Nanxing) is a traditional fermented Chinese medicine renowned for its antipyretic properties. Conventionally, DNX is produced through natural fermentation using indigenous microbial strains, which often results in an unstable microbial composition and susceptibility to contamination by harmful microorganisms. Additionally, inconsistencies in the fermentation process and outdated quality control methods further compromise the quality and safety of the final product. This study aimed to investigate the production of DNX using isolated fungal combinations under controlled conditions. Based on separation and high-throughput sequencing analyses, four dominant fungi were selected for restricted fermentation. When inoculated at a ratio of 1:1:2:2, the amylase activity of DNX reached its peak, with fermentation endpoints determined by both amylase activity and changes in calcium oxalate crystal structure. Metabolomic analysis revealed that among the top 30 compounds with the highest content, 24 exhibited consistent relative content changes between restricted fermentation and natural fermentation. In febrile mice, DNX produced by both fermentation methods demonstrated comparable antipyretic effects, significantly reducing body temperature and inflammatory cytokines (p < 0.05), including IL-6 and TNF-α, to normal levels. Furthermore, inflammation-related signaling pathways, such as cAMP and PGE2 levels, were significantly downregulated following DNX treatment (p < 0.01). These findings suggest that DNX produced through restricted fermentation exhibits therapeutic effects comparable to those achieved by natural fermentation. This study proposes a novel fermentation strategy for the industrial production of DNX, offering improved consistency and quality control.