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| Preventive effect and transcriptomic analysis of Jianpi Iishi Jiedu Granule in patients with spleen deficiency and dampness toxicity type colorectal adenoma treated by endoscopy |
| Hits 347 Download times 158 Received:March 28, 2025 |
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| DOI
10.11656/j.issn.1672-1519.2025.09.05 |
| Key Words
Jianpi Lishi Jiedu Granule;colorectal adenomas;recurrence;transcriptomics;signaling pathway |
| Author Name | Affiliation | E-mail | | WU Hao | Department of Gastroenterology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China | | | LIU Wanli | Department of Gastroenterology, Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital), Nanjing 210006, China | njzxjh001@njucm.edu.cn | | HUANG Yuzhen | Department of Gastroenterology, Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital), Nanjing 210006, China | | | SU Kunhan | Department of Gastroenterology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China | | | CHANG Chen | Department of Rehabilitation Medicine, Jinling Hospital Affiliated to Medical School of Nanjing University, Nanjing 210002, China | | | YANG Lu | Department of Gastroenterology, Nanjing Pukou District Hospital of Traditional Chinese Medicine, Nanjing 210000, China | | | WANG Guangming | Department of Gastroenterology, Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China | |
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| Abstract
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| [Objective] To observe the recurrence rate of Jianpi Lishi Jiedu Granules in treating patients with colorectal adenomas induced by spleen deficiency and dampness toxin after endoscopic treatment and preliminarily explore the potential mechanism through transcriptomics. [Methods] The 80 criteria-fulfilling patients with colorectal adenoma induced by spleen deficiency and dampness toxin were randomly divided into the experimental group（40 cases） and the control group（40 cases）. Afterward，patients in the experimental and control groups were respectively prescribed Jianpi Lishi Jiedu Granules and placebo control granules for 3 months. All patients were also scheduled for colonoscopy follow-ups after 12 months for inspections of colorectal adenoma recurrences. Pre-treatment samples of colorectal adenoma tissues and peritumoral tissues（normal colon tissues located within a 5 cm radius from the adenomas），as well as post-treatment samples of recurrent colorectal adenoma tissues were collected from all patients. Moreover，the total RNA was extracted from the colorectal adenoma tissues and adjacent tissues，after which transcriptomic sequencing was performed to verify the expression of related genes and proteins in key signaling pathways through qRT-PCR and Western blot. [Results] The recurrence rate of colorectal adenoma in the experimental group was lower than that in the control group after 1 year（P<0.05）. The results of transcriptomic sequencing suggested that，compared with the pre-treatment status，a total of 471 differential genes were selected from colorectal adenoma tissues in the experimental group post-treatment，of which 315 were up-regulated and 156 were down-regulated；after treatment，a total of 1 518 differential genes were selected from colorectal adenoma tissues in the experimental group compared with the control group，of which 952 were up-regulated and 566 were down-regulated. Meanwhile，GO and KEGG analysis showed an enrichment of differential genes primarily in the Wnt/β-catenin signaling pathway. Moreover，qRT-PCR validation indicated a decreased expression of FZD10，DVL1，GSK3B，WNT5，CCND1，MYC，and MMP7 gene（P<0.05） and an elevated expression of APC2（P<0.05） in recurrent colorectal adenoma tissues of patients in the experimental group compared with the control group. Furthermore，Western blot validation revealed a lower expression of Wnt5a，GSK-3β，β-catenin，and cyclin D1 protein（P<0.05） in recurrent colorectal adenoma tissues of patients in the experimental group than in the control group. [Conclusion] The Jianpi Lishi Jiedu Granules have a good effect in preventing the recurrence of colorectal adenomas（CRAs） in patients，and possess good safety. Inhibiting the excessive activation of the Wnt/β-catenin signaling pathway and regulating the transcription of downstream related genes and the expression of proteins may be one of the mechanisms by which it prevents the recurrence of CRAs. |
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