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Comorbid depression exacerbates Gelsemium elegans toxicity via disruption of the Clostridium-LCA-PXR-CYP3A11 metabolic axis
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Fugui Zhang1, Wanyu Hu1, Xiaojie Zhao1, Bingxuan Fu1, Yating Lin1, Cong Xie2, Ruopeng Yang1, Yufang Fu1, Weiling Tan1, Ling Ye1, *
Chinese Journal of Natural Medicines | 2026, 24(8) : 987 - 998
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Chinese Journal of Natural Medicines | 2026, 24(8): 987-998
Original Article
Comorbid depression exacerbates Gelsemium elegans toxicity via disruption of the Clostridium-LCA-PXR-CYP3A11 metabolic axis
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Fugui Zhang1, Wanyu Hu1, Xiaojie Zhao1, Bingxuan Fu1, Yating Lin1, Cong Xie2, Ruopeng Yang1, Yufang Fu1, Weiling Tan1, Ling Ye1, *
Affiliations
  • 1NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
  • 2Clinical Pharmacy Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
About Author:

These authors contributed equally to this work.

Published: 2026-08-20 doi: 10.1016/S1875-5364(26)61197-1
Outline
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Gelsemium elegans (G. elegans) is a toxic medicinal plant traditionally used to treat chronic pain, with its toxicity linked to indole alkaloids such as gelsemine and humantenmine (HMT). Chronic pain often co-occurs with depression, a condition known to disrupt host-microbiota interactions, potentially affecting drug metabolism and toxicity. However, the impact of comorbid depression on the toxicity of G. elegans remains unclear. This study investigates how depression exacerbates the neurotoxicity of G. elegans and explores the role of the gut microbiota−host metabolic axis in this process. Depression-model mice were treated with G. elegans aqueous extract, gelsemine and HMT. Multi-omics approaches, including 16S rRNA sequencing and shotgun metagenomics, were used to analyze microbiota changes under depressive conditions. Functional validation was performed using pseudo-germ-free mice, fecal microbiota transplantation, and supplementation with Clostridium species and lithocholic acid (LCA), as well as pregnane X receptor (Pxr) knockout models. The results showed that depression significantly heightened the neurotoxicity of G. elegans, gelsemine and HMT. Mechanistically, depression reduced Clostridium abundance and LCA levels, impairing PXR activation and downregulating hepatic CYP3A11 expression. This disruption of the Clostridium-LCA-PXR-CYP3A11 axis hindered the detoxification of indole alkaloids, leading to increased systemic exposure and exacerbated neurotoxicity. Restoration of this pathway through Clostridium or LCA supplementation alleviated the toxicity. These findings highlight the role of the Clostridium-LCA-PXR-CYP3A11 axis in the altered toxicity of G. elegans in a depressive state, and suggest that Clostridium species and their metabolites may serve as a potential strategy for mitigating toxicity.

Gelsemium elegans  /  Humantenmine  /  Gut microbiota  /  Pregnane X receptor  /  Depression  /  Neurotoxicity
Fugui Zhang, Wanyu Hu, Xiaojie Zhao, Bingxuan Fu, Yating Lin, Cong Xie, Ruopeng Yang, Yufang Fu, Weiling Tan, Ling Ye. Comorbid depression exacerbates Gelsemium elegans toxicity via disruption of the Clostridium-LCA-PXR-CYP3A11 metabolic axis[J]. Chinese Journal of Natural Medicines, 2026 , 24 (8) : 987 -998 . DOI: 10.1016/S1875-5364(26)61197-1
  • National Natural Science Foundation of China(82422077; 82274193)
  • Guangdong Basic and Applied Basic Research Foundation(2024B1515020093)
Year 2026 volume 24 Issue 8
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Article Info
doi: 10.1016/S1875-5364(26)61197-1
  • Receive Date:2025-10-17
  • Online Date:2026-08-20
  • Published:2026-08-20
Article Data
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History
  • Received:2025-10-17
  • Revised:2025-11-23
  • Accepted:2026-01-04
Funding
National Natural Science Foundation of China(82422077; 82274193)
Guangdong Basic and Applied Basic Research Foundation(2024B1515020093)
Affiliations
    1NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
    2Clinical Pharmacy Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

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E-mail address: (L. Ye)
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表12种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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