AUTHOR=Zheng Li , Mingxue Zhang , Zeng Li , Yushi Zhou , Yuhan Ao , Yi Yang , Botong Liu 

TITLE=A Landscape of Metabonomics for Intermingled Phlegm and Blood Stasis and Its Concurrent Syndromes in Stable Angina Pectoris of Coronary Heart Disease

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.871142

DOI=10.3389/fcvm.2022.871142

ISSN=2297-055X

ABSTRACT=Objectives: In this study, we analysed the metabonomics of intermingled phlegm and blood stasis (IPBS) and its three concurrent syndromes in patients with stable angina pectoris of coronary heart disease. 
Methods: Serums of 164 outpatients from 12 national TCM clinical research centers with IPBS or concurrent syndromes were collected for the study and and assessed with LC-ESI-MS/MS (Liquid Chromatography - Electrospray Ionisation tandem - Mass Spectrometry) based metabolomics and multivariate statistical analysis. 
Results: Non-differential metabolites between IPBS and its separate syndrome combined with top 100 abundance of metabolites in four groups were screened to reflect essence of IPBS. Amino acid and its metabolomics and glycerol phospholipids were screened common metabolites, and these metabolites main enriched in valine, leucine and isoleucine metabolism and glycerophospholipid metabolism. PCA revealed that difference between IPBS with its separate concurrent syndromes was not distinct. Compared with IPBS, anserine, cytidine 5'-diphosphocholine and 7,8-dihydro-L-biopterin separately significant increased in phlegm stasis and toxin (PST), phlegm stasis and Qi stagnation (PQS) and phlegm stasis and Qi deficiency (PQD). While these different metabolites were associated with histidine metabolism, beta-Alanine metabolism, glycerophospholipid metabolism, folate biosynthesis. Three accurate identification model were obtained to identify the difference between IPBS and its concurrent syndromes.
Conclusions: Our study indicated that valine, leucine and isoleucine metabolism and glycerophospholipid metabolism could represent the essence of IPBS, dysregulated metabolites were valuable in identifying PST form IPBS.