Application of metabolomics in viral pneumonia treatment with traditional Chinese medicine

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Chinese Medicine Open Access

REVIEW

Application of metabolomics in viral pneumonia treatment with traditional Chinese medicine Lili Lin1,2†, Hua Yan1,2†, Jiabin Chen3, Huihui Xie3, Linxiu Peng4, Tong Xie1,2, Xia Zhao1,2, Shouchuan Wang1,2 and Jinjun Shan1,2* 

Abstract  Nowadays, traditional Chinese medicines (TCMs) have been reported to provide reliable therapies for viral pneumonia, but the therapeutic mechanism remains unknown. As a systemic approach, metabolomics provides an opportunity to clarify the action mechanism of TCMs, TCM syndromes or after TCM treatment. This review aims to provide the metabolomics evidence available on TCM-based therapeutic measures against viral pneumonia. Metabolomics has been gradually applied to the efficacy evaluation of TCMs in treatment of viral pneumonia and the metabolomics analysis exhibits a systemic metabolic shift in lipid, amino acids, and energy metabolism. Currently, most studies of TCM in treatment of viral pneumonia are untargeted metabolomics and further validations on targeted metabolomics should be carried out together with molecular biology technologies. Keywords:  TCM, Treatment, Metabolomics, Virus, Pneumonia Introduction Pneumonia is the world’s leading cause of death in young children and elderly people. Many pathogens are associated with pneumonia, and now attention is turning to the importance of viruses as pathogens [1]. In western medicine, viral pneumonia is defined as a disease in which there are gas exchange abnormalities at the alveolar level accompanied by inflammation of the lung parenchyma [2]. While, in the theoretical system of traditional Chinese medicine (TCM), the etiologies of this disease are classified into external and internal causes. Exterior pathogenic “wind and heat” invades the weak lung (interior cause) through the skin, mouth or nose, causing lung qi obstruction and stagnation. The main pathological products are phlegm, heat and blood stasis, manifesting with fever, cough, dyspnea, wheezing, nasal flaring, *Correspondence: [email protected] † Lili Lin and Hua Yan contributed equally to this work 1 Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 138, Xianlin Avenue, Qixia District, Nanjing 210023, China Full list of author information is available at the end of the article

etc. The basic treatment principles are to regulate the lung qi, resolve phlegm, and relieve cough and dyspnea. The TCM prescriptions is composed of various kinds of medicinal plants, animals and minerals in the form of oral liquid, powder and granules. According to the TCM treatment principle, traditional Chinese medicines (TCMs) have been reported to cure viral pneumonia in lots of ancient literature and modern research [3–7]. Our research group has been engaged in TCM treatment of children with viral pneumonia for nearly 20  years. Jinxin oral liquid (JOL), modified from ma-xing-shi-gan decotion, is proved to have good treatment effects both in clinic and expe