Urine Metabonomic Study Of Phlegm-Heat Obstructing Lung Syndrome In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:The latest metabonomic technique LC-MS/MS(liquid chromatography tandem mass spectrometry)was used to compare the urine of patients with phlegm-heat obstructing lung syndrome and healthy people in the acute exacerbation of chronic obstructive pulmonary disease(COPD)to find the differences and analyze the possible metabolic pathways.Method:Ten patients with phlegm-heat obstructing lung syndrome with acute exacerbation of COPD hospitalized in Department of Respiratory Medicine and Department of Geriatrics of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from January 2020 to December2020 were selected as the experimental group,and 10 healthy subjects were selected as the blank group during the same period.After morning urine was collected,the latest metabolomics technology LC-MS/MS(liquid chromatography tandem mass spectrometry)was used to detect the differential metabolites in urine of the two groups,and principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were used to screen the differential metabolites.KEGG database and HMDB database were used to annotate and display the differential metabolites and analyze their metabolic pathways.Result:The urine of patients with phlegm-heat obstructive pulmonary disease in the acute exacerbation period was compared with that of healthy people.In the disease group,pantothenic acid,carnitine,niacin,isoleucine,tryptophan and L-cysteine decreased,while caffeine and theobromine increased.The main metabolic pathways include tryptophan metabolism,pantothenate and coenzyme A biosynthesis,caffeine metabolism,and the metabolism of arginine and proline,valine,leucine and isoleucine degradation.Conclusion:Metabolic markers of phlegm-heat obstructive pulmonary obstruction syndrome in acute exacerbation of chronic obstructive pulmonary disease may be pantothenic acid,carnitine,niacin,isoleucine,tryptophan,L-cysteine,caffeine and theobromine.It may be through metabolic pathways that affect tryptophan metabolism,pantothenate and coenzyme A biosynthesis,caffeine metabolism,and the metabolism of arginine and proline,valine,leucine and isoleucine degradation.