Article(id=1210148021141115216, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210148010437243088, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2022-0696, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1654444800000, receivedDateStr=2022-06-06, revisedDate=1655827200000, revisedDateStr=2022-06-22, acceptedDate=null, acceptedDateStr=null, onlineDate=1766451371702, onlineDateStr=2025-12-23, pubDate=1660233600000, pubDateStr=2022-08-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766451371702, onlineIssueDateStr=2025-12-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766451371702, creator=13701087609, updateTime=1766451371702, updator=13701087609, issue=Issue{id=1210148010437243088, tenantId=1146029695717560320, journalId=1189982191388893191, year='2022', volume='57', issue='8', pageStart='2245', pageEnd='2556', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1766451369151, creator=13701087609, updateTime=1766451533022, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1210148697808179705, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210148010437243088, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1210148697808179706, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1210148010437243088, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=2445, endPage=2452, ext={EN=ArticleExt(id=1210148021573128556, articleId=1210148021141115216, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Molecular interactions between the main components of Shuanghuanglian injection and ciprofloxacin injection based on self-assembly, columnId=1190335348761793317, journalTitle=Acta Pharmaceutica Sinica, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=

The combination of Shuanghuanglian injection (SHLI) and ciprofloxacin injection (CIPI) is frequently prescribed in clinical practice, but the basis for the combination is weak. In this study, isothermal titration calorimetry and ultraviolet-visible absorption spectrometry were applied to identify the molecular interactions of SHLI and its main components, chlorogenic acid and neochlorogenic acid with CIPI. Scanning electron microscopy, Fourier-transform infrared spectroscopy, and cold-spray ionization mass spectrometry were performed to confirm that this molecular interaction was related to the formation of self-assembled supramolecular systems induced by chlorogenic acid and neochlorogenic acid with CIPI through weak intermolecular bonds. The antibacterial activity toward Pseudomonas aeruginosa (P. aeruginosa) was evaluated via molecular interactions, and the inhibitory ability of SHLI, chlorogenic acid and neochlorogenic acid against P. aeruginosa was significantly reduced after interaction with CIPI. A molecular docking study demonstrated that the reduced antibacterial ability was closely related to the competitive binding of drug molecules to the same binding site of the DNA gyrase B (GyrB) subunit of P. aeruginosa. The present study uncovered the intermolecular interactions of SHLI and its main components chlorogenic acid and neochlorogenic acid with CIPI from the perspective of molecular self-assembly and contribute to the reduction of its antibacterial ability, providing a basis for the clinical combination of SHLI and CIPI.

, correspAuthors=Ai-ting WANG, Qiang MA, Dan YAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2022 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Jiang-ling LI, Shuang LIU, Yi-qing XIE, Jiang-lan LONG, Zhen-zhen WANG, Ai-ting WANG, Qiang MA, Dan YAN), CN=ArticleExt(id=1210148023305376228, articleId=1210148021141115216, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=基于自组装体系研究双黄连主要成分与环丙沙星的分子互作, columnId=1190335348896011050, journalTitle=药学学报, columnName=研究论文, runingTitle=null, highlight=null, articleAbstract=

双黄连注射液(双黄连) 与环丙沙星注射液(环丙沙星) 在临床联合用药的情况时有发生, 但联合用药合理性评价手段薄弱。本研究采用等温滴定量热技术和紫外光谱初步发现双黄连及其主要成分绿原酸、新绿原酸与环丙沙星均存在分子互作; 采用扫描电镜、红外光谱、冷喷雾电离质谱技术证实这种分子互作与绿原酸、新绿原酸能和环丙沙星通过分子间弱键诱导形成自组装超分子体系有关; 进一步利用铜绿假单胞菌评价其药物分子互作生物效应(抑菌活性), 发现双黄连、绿原酸、新绿原酸与环丙沙星互作后对铜绿假单胞菌的抑菌能力均显著降低; 通过分子对接研究发现, 其抑菌能力降低与药物分子在铜绿假单胞菌DNA旋转酶B亚单位(DNA gyrase B, GyrB) 有相同结合位点而产生竞争性结合密切相关。本研究从分子自组装角度, 揭示了双黄连及其主要成分绿原酸、新绿原酸与环丙沙星存在分子间互作且会导致抑菌能力降低, 为双黄连与环丙沙星临床联合用药合理性评价提供了参考依据。

, correspAuthors=王爱婷, 马强, 鄢丹, authorNote=null, correspAuthorsNote=
*王爱婷, Tel: 86-10-63139318, E-mail: ;
马强, Tel: 86-10-53897463, E-mail:
鄢丹, Tel: 86-10-63139318, E-mail:
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A: The 3D and 2D binding conformation of chlorogenic acid interacts with the amino acid residues of GyrB; B: The 3D and 2D binding conformation of neochlorogenic acid interacts with the amino acid residues of GyrB; C: The 3D and 2D binding conformation of ciprofloxacin interacts with the amino acid residues of GyrB , figureFileSmall=eN54Ep6ELGzJC8WMKdA1/A==, figureFileBig=md0YA/kjFdwFcVqEuP3ryA==, tableContent=null), ArticleFig(id=1210148031987585102, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210148021141115216, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
SampleMICFICIEffect
SHLI250.00 mg·mL-1
Chlorogenic acid8.22 mg·mL-1
Neochlorogenic acid8.00 mg·mL-1
CIPI61.04 ng·mL-1
SHLI/CIPI> 500.00 mg·mL-1/ > 122.07 ng·mL-1> 4.00Antagonism
Chlorogenic acid/CIPI16.43 mg·mL-1/15.26 ng·mL-12.25Antagonism
Neochlorogenic acid/CIPI16.00 mg·mL-1/15.26 ng·mL-12.25Antagonism
), ArticleFig(id=1210148032184717392, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1210148021141115216, language=CN, label=Table 1, caption=

Antibacterial activity of SHLI and its main components chlorogenic acid and neochlorogenic acid in combination with CIPI against P. aeruginosa. MIC: Minimum inhibitory concentration; FICI: Fractional inhibitory concentration index

, figureFileSmall=null, figureFileBig=null, tableContent=
SampleMICFICIEffect
SHLI250.00 mg·mL-1
Chlorogenic acid8.22 mg·mL-1
Neochlorogenic acid8.00 mg·mL-1
CIPI61.04 ng·mL-1
SHLI/CIPI> 500.00 mg·mL-1/ > 122.07 ng·mL-1> 4.00Antagonism
Chlorogenic acid/CIPI16.43 mg·mL-1/15.26 ng·mL-12.25Antagonism
Neochlorogenic acid/CIPI16.00 mg·mL-1/15.26 ng·mL-12.25Antagonism
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基于自组装体系研究双黄连主要成分与环丙沙星的分子互作
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李江玲 1 , 刘爽 2, 3 , 谢以清 4 , 龙江兰 2, 3 , 王真真 2, 3 , 王爱婷 2, 3, * , 马强 4, * , 鄢丹 2, 3, *
药学学报 | 研究论文 2022,57(8): 2445-2452
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药学学报 | 研究论文 2022, 57(8): 2445-2452
基于自组装体系研究双黄连主要成分与环丙沙星的分子互作
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李江玲1, 刘爽2, 3, 谢以清4, 龙江兰2, 3, 王真真2, 3, 王爱婷2, 3, * , 马强4, * , 鄢丹2, 3, *
作者信息
  • 1.成都中医药大学药学院, 四川 成都 611137
  • 2.首都医科大学附属北京友谊医院, 北京 100050
  • 3.北京市临床药学研究所, 北京 100050
  • 4.中国检验检疫科学研究院, 北京 100176

通讯作者:

*王爱婷, Tel: 86-10-63139318, E-mail: ;
马强, Tel: 86-10-53897463, E-mail:
鄢丹, Tel: 86-10-63139318, E-mail:
Molecular interactions between the main components of Shuanghuanglian injection and ciprofloxacin injection based on self-assembly
Jiang-ling LI1, Shuang LIU2, 3, Yi-qing XIE4, Jiang-lan LONG2, 3, Zhen-zhen WANG2, 3, Ai-ting WANG2, 3, * , Qiang MA4, * , Dan YAN2, 3, *
Affiliations
  • 1. School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
  • 2. Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • 3. Beijing Institute of Clinical Pharmacy, Beijing 100050, China
  • 4. Chinese Academy of Inspection and Quarantine, Beijing 100176, China
出版时间: 2022-08-12 doi: 10.16438/j.0513-4870.2022-0696
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双黄连注射液(双黄连) 与环丙沙星注射液(环丙沙星) 在临床联合用药的情况时有发生, 但联合用药合理性评价手段薄弱。本研究采用等温滴定量热技术和紫外光谱初步发现双黄连及其主要成分绿原酸、新绿原酸与环丙沙星均存在分子互作; 采用扫描电镜、红外光谱、冷喷雾电离质谱技术证实这种分子互作与绿原酸、新绿原酸能和环丙沙星通过分子间弱键诱导形成自组装超分子体系有关; 进一步利用铜绿假单胞菌评价其药物分子互作生物效应(抑菌活性), 发现双黄连、绿原酸、新绿原酸与环丙沙星互作后对铜绿假单胞菌的抑菌能力均显著降低; 通过分子对接研究发现, 其抑菌能力降低与药物分子在铜绿假单胞菌DNA旋转酶B亚单位(DNA gyrase B, GyrB) 有相同结合位点而产生竞争性结合密切相关。本研究从分子自组装角度, 揭示了双黄连及其主要成分绿原酸、新绿原酸与环丙沙星存在分子间互作且会导致抑菌能力降低, 为双黄连与环丙沙星临床联合用药合理性评价提供了参考依据。

双黄连注射液  /  环丙沙星注射液  /  自组装体系  /  分子互作  /  抑菌能力

The combination of Shuanghuanglian injection (SHLI) and ciprofloxacin injection (CIPI) is frequently prescribed in clinical practice, but the basis for the combination is weak. In this study, isothermal titration calorimetry and ultraviolet-visible absorption spectrometry were applied to identify the molecular interactions of SHLI and its main components, chlorogenic acid and neochlorogenic acid with CIPI. Scanning electron microscopy, Fourier-transform infrared spectroscopy, and cold-spray ionization mass spectrometry were performed to confirm that this molecular interaction was related to the formation of self-assembled supramolecular systems induced by chlorogenic acid and neochlorogenic acid with CIPI through weak intermolecular bonds. The antibacterial activity toward Pseudomonas aeruginosa (P. aeruginosa) was evaluated via molecular interactions, and the inhibitory ability of SHLI, chlorogenic acid and neochlorogenic acid against P. aeruginosa was significantly reduced after interaction with CIPI. A molecular docking study demonstrated that the reduced antibacterial ability was closely related to the competitive binding of drug molecules to the same binding site of the DNA gyrase B (GyrB) subunit of P. aeruginosa. The present study uncovered the intermolecular interactions of SHLI and its main components chlorogenic acid and neochlorogenic acid with CIPI from the perspective of molecular self-assembly and contribute to the reduction of its antibacterial ability, providing a basis for the clinical combination of SHLI and CIPI.

Shuanghuanglian injection  /  ciprofloxacin injection  /  self-assembly  /  molecular interaction  /  antibacterial effect
李江玲, 刘爽, 谢以清, 龙江兰, 王真真, 王爱婷, 马强, 鄢丹. 基于自组装体系研究双黄连主要成分与环丙沙星的分子互作. 药学学报, 2022 , 57 (8) : 2445 -2452 . DOI: 10.16438/j.0513-4870.2022-0696
Jiang-ling LI, Shuang LIU, Yi-qing XIE, Jiang-lan LONG, Zhen-zhen WANG, Ai-ting WANG, Qiang MA, Dan YAN. Molecular interactions between the main components of Shuanghuanglian injection and ciprofloxacin injection based on self-assembly[J]. Acta Pharmaceutica Sinica, 2022 , 57 (8) : 2445 -2452 . DOI: 10.16438/j.0513-4870.2022-0696
药物相互作用(drug-drug interaction, DDI) 在临床真实世界普遍存在, 已受到国家药品监督管理局和业界广泛关注[1, 2]。双黄连注射液(双黄连) 由金银花、黄芩、连翘组成, 具有清热解毒、清宣风热的功效, 临床上常用于治疗呼吸道感染性疾病[3]。其主要成分绿原酸是《中国药典》收载的双黄连制剂质量标准的质控成分[4]。环丙沙星注射液(环丙沙星) 是喹诺酮类抗菌药物, 具有广谱的抗菌作用而广泛应用于临床[5]。在临床真实世界中, 双黄连与环丙沙星联合用药治疗感染的情况时有发生[6], 但二者联合用药的DDI评价研究薄弱[7]
自组装是将系统从无序的单元组合成有序、高度排列结构的过程, 通过非共价相互作用, 它赋予了结构体独特的性质[8]。近年来, 超分子自组装技术取得了长足的进步[9], 已引起越来越多的学者关注。研究表明, 弱键诱导形成的自组装超分子体系是中药配伍的物质基础[10, 11]。因此, 本研究猜想联合用药分子互作引发的DDI可能与超分子自组装体系有关。具体地, 从超分子自组装和生物活性角度出发, 采用等温滴定量热技术和紫外光谱提示双黄连及其主要成分绿原酸、新绿原酸与环丙沙星的分子互作, 采用扫描电镜、红外光谱和冷喷雾电离质谱技术对药物分子互作形成的超分子体系进行确证, 进一步通过铜绿假单胞菌模型评估其药物分子互作的生物效应, 以期为临床联合用药(分子互作) 合理性评价研究提供参考。
药品与试剂    双黄连(批号: 2001013, 1 mL相当于1 g生药), 河南福森药业有限公司; 环丙沙星(批号: 3141481), 广州南新制药有限公司; 0.9%氯化钠注射液(0.9% NaCl, 批号: 200927), 佛山双鹤药业有限责任公司; 绿原酸(批号: MUST-21070910) 和新绿原酸(批号: MUST-21030108), 成都曼思特生物科技有限公司, 纯度大于98%; 铜绿假单胞菌(Pseudomonas aeruginosa, BNCC337005), 商城北纳创联生物科技有限公司; MH肉汤Ⅱ (阳离子调节, 批号: LA6740) 和二甲基亚砜(DMSO, 批号: D8370), 北京索莱宝科技有限公司。
仪器    NANO ITC LV等温滴定量热仪(美国TA公司); SYNERGY H1多功能微孔板检测仪(美国BioTek Instruments公司); SU8020场发射扫描电子显微镜(日本日立公司); Nicolet iS50傅里叶变换红外光谱仪和Q-Exactive高分辨质谱仪(美国Thermo Fisher Scientific公司); LRH-250生化培养箱(上海一恒科学仪器有限公司)。
等温滴定量热(isothermal titration calorimetry, ITC) 检测    量取双黄连、环丙沙星适量, 参照临床给药剂量分别以超纯水稀释至所需浓度[12], 绿原酸、新绿原酸均以5% DMSO溶解并稀释, 即得供试品溶液。以双黄连、绿原酸、新绿原酸溶液分别滴定环丙沙星溶液, 温度为25 ℃, 搅拌速率为300 r·min-1, 连续滴定25滴。滴定结束后, 在数据采集软件Nano Analyze中输入实验样品浓度, 即可得溶液混合时的热力学参数吉布斯自由能ΔG、焓变ΔH和熵变ΔS
紫外光谱检测    将双黄连、环丙沙星稀释液等比例混合, 绿原酸、新绿原酸溶液分别与环丙沙星稀释液等比例混合, 即得混合溶液。设置酶标仪的检测波长为240~500 nm, 以0.9% NaCl、1% DMSO作为空白溶剂, 进行全波长扫描。
场发射扫描电子显微镜观察    取绿原酸、新绿原酸、环丙沙星及绿原酸-环丙沙星、新绿原酸-环丙沙星混合溶液适量滴于硅片上, 室温自然干燥, 喷金处理后置于场发射扫描电子显微镜下, 工作电压5.0 kV, 拍照并观察绿原酸、新绿原酸与环丙沙星反应后的微观形貌。
红外光谱检测    取绿原酸、新绿原酸、环丙沙星溶液及绿原酸-环丙沙星、新绿原酸-环丙沙星混合溶液适量, 冻干, 备用。称取绿原酸、新绿原酸、环丙沙星及绿原酸-环丙沙星、新绿原酸-环丙沙星结合体粉末适量, 与无水溴化钾粉末研磨均匀, 并压制成片状。傅里叶变换红外光谱仪的波数范围为4 000~1 000 cm-1, 光谱分辨率为4 cm-1, 空气为背景。光谱软件(OMNIC 8.2) 记录和存储红外光谱。采用AutoDock Vina 1.1.2进行绿原酸、新绿原酸与环丙沙星的平面分子对接, 佐证红外光谱的结果。
冷喷雾电离质谱(cold-spray ionization mass spectrometry, CSI-MS) 检测    精密称取绿原酸和新绿原酸适量, 分别以甲醇溶解并稀释后与环丙沙星以1∶5浓度混合均匀, 即得混合溶液。电喷雾离子源为正离子模式; 辅助气加热器温度25 ℃; 辅助气流速0.667 L·min-1; 将通过冷凝装置的氮气接入质谱代替原鞘气; 喷雾电压3.7 kV; 透镜电压55 V; 毛细管电压50 V; 进样方式为针泵进样; 进样量为200 μL。
最低抑菌浓度(minimal inhibitory concentration, MIC) 测定    采用微量肉汤稀释法测定双黄连及其主要成分绿原酸、新绿原酸及环丙沙星对Pseudomonas aeruginosa (P. aeruginosa) 的抑菌活性。倍比稀释配制双黄连、绿原酸、新绿原酸和环丙沙星溶液。96孔板每孔分别加入200 μL药物溶液和20 μL菌悬液(1×105 CFU·mL-1), 37 ℃培养16 h。采用酶标仪于600 nm处测定其吸收度A。实验重复3次。按照公式抑制率(%) = [1-(A样品-A溶剂) / (A空白菌-A溶剂)] × 100%计算MIC, MIC为抑制率 > 80%的最低浓度[13]
体外联合抑菌实验    采用棋盘稀释法测定双黄连及其主要成分绿原酸、新绿原酸与环丙沙星联用对P. aeruginosa的抑菌效应。将双黄连、绿原酸、新绿原酸、环丙沙星分别配备成2~1/4MIC浓度待用。按照棋盘法设计, 分别将双黄连、绿原酸、新绿原酸与环丙沙星组合加入96孔板中, 每种溶液各100 μL, 每孔再加入20 μL菌悬液(1×105 CFU·mL-1)。将上述96孔板置于37 ℃孵育16 h, 读取结果并记录联合用药时的MIC。每种组合重复3次。采用部分抑菌浓度指数(fractional inhibitory concentration index, FICI) 判定联合抑菌效果。FIC = MIC甲药联用 / MIC甲药单用 + MIC乙药联用 / MIC乙药单用。评价标准: FICI ≤ 0.5为协同作用; 0.5 < FICI ≤ 1为相加作用; 1 < FICI ≤ 2为无关作用; FICI > 2为拮抗作用。
分子对接    PDB数据库(https://www.rcsb.org/) 下载DNA旋转酶B亚单位(DNA gyrase B, GyrB) 晶体PDB (PDB ID: 1KZN) 文件, PubChem数据库(https://www.ncbi.nlm.nih.gov/pccompound/) 下载绿原酸、新绿原酸和环丙沙星SDF文件。AutoDock Tools 1.5.6优化蛋白和小分子结构, 利用软件AutoDock Vina 1.1.2进行分子对接。
应用ITC技术表征双黄连及其主要成分与环丙沙星的分子互作。双黄连及主要成分绿原酸、新绿原酸滴定环丙沙星的相容性与反应活性谱如图 1所示。从反应活性图谱可见, 双黄连及主要成分绿原酸、新绿原酸滴定环丙沙星均为放热过程, 且放热明显。由图中热力学参数可见, 双黄连及其主要成分绿原酸、新绿原酸与环丙沙星的反应均为自发反应(ΔG < 0), 且滴定过程中|ΔH| > TS|。因此, 推断两种溶液混合以焓驱动反应为主, 即发生了化学反应[14]。结果提示, 双黄连及其主要成分绿原酸、新绿原酸与环丙沙星均存在分子互作。
双黄连与环丙沙星混合前后的紫外吸收光谱见图 2A。双黄连的特征吸收峰出现在276、316 nm处, 环丙沙星的特征吸收峰出现在276 nm处, 其混合体系兼具二者的特征峰, 且混合体系中双黄连、环丙沙星的吸光度明显升高。绿原酸、新绿原酸与环丙沙星混合前后的紫外吸收光谱见图 2B。绿原酸、新绿原酸的特征吸收峰出现在324 nm处, 环丙沙星的特征吸收峰出现在276 nm处。绿原酸、新绿原酸分别与环丙沙星混合后, 均出现吸光度明显升高, 部分最大吸收波长增加(如图 2B箭头所示)。由此推测, 双黄连及其主要成分绿原酸、新绿原酸与环丙沙星可能存在因分子互作引发的电子云重排[10]
采用场发射扫描电子显微镜表征绿原酸-环丙沙星、新绿原酸-环丙沙星结合体的微观形貌。结果显示, 绿原酸(图 3A)、新绿原酸(图 3B) 呈不规则的条状结构; 环丙沙星(图 3C) 呈现网状结构。绿原酸-环丙沙星、新绿原酸-环丙沙星结合体的微观形态与单体结构区别较大。绿原酸-环丙沙星(图 3D)、新绿原酸-环丙沙星结合体(图 3E) 中绿原酸、新绿原酸分别与环丙沙星簇和, 呈现均一、有序排布的聚集状结构, 提示绿原酸-环丙沙星、新绿原酸-环丙沙星结合体在分子互作下组装形成了超分子。
绿原酸、新绿原酸与环丙沙星单用及结合体的红外光谱如图 4所示。绿原酸红外图谱在3 350 cm-1处的宽吸收峰, 为苯酚中O-H的振动强吸收峰; 1 686 cm-1为羧酸中C=O的伸缩振动强吸收峰; 1 289 cm-1为羧酸中C-O的伸缩振动强吸收峰(图 4A)。新绿原酸红外图谱在3 335 cm-1处有一个宽吸收峰, 为醇中O-H的振动强吸收峰; 1 686 cm-1归属于羧酸中C=O的伸缩振动强吸收峰; 1 292 cm-1归属于羧酸中C-O的伸缩振动强吸收峰(图 4B)。环丙沙星红外谱图在3 401/3 389 cm-1的吸收峰, 为羧酸中O-H的伸缩振动强吸收峰; 1 641 cm-1吸收峰, 为羧酸中C=O的伸缩振动强吸收峰(图 4A4B)。与绿原酸单用的红外图谱相比, 绿原酸与环丙沙星结合体中, 苯酚中的O-H吸收峰大幅度向高波数偏移; 与新绿原酸单用的红外图谱相比, 新绿原酸与环丙沙星结合体中, 醇中的O-H吸收峰大幅度向高波数偏移, 提示绿原酸、新绿原酸与环丙沙星结合后, 分子间官能团(酚羟基、醇羟基等) 发生互作, 参与组装形成超分子结构。平面分子对接结果显示, 绿原酸的酚羟基(图 4C)、新绿原酸的醇羟基(图 4D) 与环丙沙星的羧基有结合的潜能。即红外光谱与分子对接的结果相佐证。
为了深入探讨双黄连主要成分绿原酸、新绿原酸与环丙沙星分子互作自组装形成的超分子, 分别配制了绿原酸、新绿原酸与环丙沙星的混合体系进行CSI-MS研究。研究发现, 在正离子模式下, 绿原酸、新绿原酸的特征离子均为m/z 355.12 [M+H]+, 环丙沙星的特征离子为m/z 332.14 [M+H]+。绿原酸、新绿原酸与环丙沙星自组装分别形成了绿原酸-环丙沙星(m/z 686.26 [M+H]+) (图 5A)、新绿原酸-环丙沙星加合物(m/z 686.26 [M+H]+) (图 5B)。进一步对比加合物的二级质谱信息, 相应地得到了绿原酸(m/z 355.12 [M+H]+) (图 5C)、新绿原酸(m/z 355.12 [M+H]+) (图 5D)、环丙沙星(m/z 332.14 [M+H]+) (图 5C5D) 的特征峰。由此得出, 绿原酸-环丙沙星、新绿原酸-环丙沙星加合物是通过分子间非共价互作形成, 分子间非共价互作参与自组装形成超分子。
采用微量肉汤稀释法测定双黄连及其主要成分绿原酸、新绿原酸及环丙沙星对P. aeruginosa的MIC值, 发现上述药物在所选浓度下均表现出抑菌活性。双黄连及其主要成分绿原酸、新绿原酸及环丙沙星的MIC值分别为250.00 mg·mL-1、8.22 mg·mL-1、8.00 mg·mL-1和61.04 ng·mL-1。双黄连及其主要成分绿原酸、新绿原酸分别与环丙沙星联用后对P. aeruginosa的MIC及FICI值如表 1所示。与双黄连、绿原酸、新绿原酸单用相比, 其与环丙沙星联用后的MIC值均升高了1个倍比稀释度; 环丙沙星与双黄连联用后, 其MIC值与环丙沙星单用相比升高了1个倍比稀释度; 环丙沙星与绿原酸、新绿原酸联用后, 其MIC值与环丙沙星单用相比降低了2个倍比稀释度。FICI的结果显示, 双黄连及其主要成分绿原酸、新绿原酸与环丙沙星联用后均对P. aeruginosa产生拮抗效应, 提示双黄连及其主要成分绿原酸、新绿原酸与环丙沙星结合体的抑菌活性减弱。
Gyr是II型DNA拓扑异构酶, 催化DNA双链断裂和重新连接从而改变DNA的拓扑结构[15]。GyrB作为Gyr的B亚基, 是抗菌药物研究的重要靶点[16]。通过分子对接探索双黄连主要成分绿原酸、新绿原酸及环丙沙星与GyrB的结合模式, 揭示双黄连及其主要成分绿原酸、新绿原酸与环丙沙星联用后对P. aeruginosa抑菌活性减弱的原因。结果显示, 绿原酸、新绿原酸及环丙沙星与GyrB的活性位点均具有结合活性。绿原酸、环丙沙星均与GyrB的GLY117、ILE90、ALA96形成稳定氢键; 新绿原酸、环丙沙星均与GyrB的ALA96、ILE90形成稳定氢键(图 6)。由此推测双黄连及其主要成分绿原酸、新绿原酸与环丙沙星联用对P. aeruginosa抑菌活性减弱, 可能与其在GyrB上有相同结合位点而产生竞争性结合密切相关。
中西药注射剂联合用药临床上通常慎用或禁用, 但“一前一后”序贯给药并导致疗效降低的现象却时有发生[17]。本研究正是基于临床上存在双黄连与环丙沙星联合用药治疗感染的情况下而开展的。在发现双黄连及其主要成分绿原酸、新绿原酸与环丙沙星存在分子互作表型的基础上, 以扫描电镜观察形貌, 确认绿原酸、新绿原酸与环丙沙星通过分子互作自组装形成了超分子体系; 采用红外光谱和冷喷雾电离质谱技术对超分子进行表征, 发现官能团非共价相互作用参与超分子体系的组装; 进一步, 基于抑菌活性试验发现双黄连及其主要成分绿原酸、新绿原酸与环丙沙星联合用药后对P. aeruginosa的抑菌活性显著弱于单用。这一重要发现与文献[18, 19]报道临床上不支持双黄连、清开灵等含绿原酸类成分的中药注射剂与环丙沙星联合用药的结论相吻合。由此提示, 双黄连与环丙沙星在临床联合用药时, 应考虑调整给药时间间隔, 避免因“一前一后”序贯给药在体内发生分子互作而引起疗效降低。本研究建立的超分子互作表征-抑菌活性评价序贯分析策略, 对分析临床多药联合用药合理性具有潜在应用价值。
除了上述分析临床多药联合用药合理性的技术手段之外, 药物混合后pH、渗透压、不溶性微粒、药代动力学、药效动力学、安全性指标等也是常用的表征技术。但这些技术在面对临床上纷繁复杂的多药联合用药合理性评价时, 还需要考虑与临床相关性、检测通量、剂量比例、反应体系、评估指标(阈值)、共性特征提抽等问题。本研究尝试以双黄连与环丙沙星联合用药相互作用评价为例, 探讨“源于临床-证于试验-归于临床”的研究路径[20]。即从临床真实世界切入, 发现双黄连与环丙沙星存在“一前一后”用药并引发疗效降低的现象; 通过超分子自组装表征技术和抑菌活性评价, 建立了序贯分析方法; 再回归临床并拓展相关文献报道进一步佐证研究策略与方法的可行性。随着可能面临更多的药物联合用药(包括不同给药途径、不同给药剂量和时间等) 庞大的数据量, 可广泛收集临床多中心的实际用药案例、疗效评价信息, 结合国内外药物互作公共资源库信息, 从药物成分的分子结构、活性基团、结合靶点等角度切入, 运用GINI基尼不纯度、互信息等人工智能手段捕获共性特征, 借助深度学习、迁移学习等技术构建基于交叉学科的临床联合用药合理性智能评价体系[21], 这对构建临床联合用药相互作用评价是一种值得期待的发展方向。
作者贡献: 李江玲负责实验研究、数据分析及文章撰写; 刘爽和谢以清协助完成实验; 龙江兰和王真真负责文章修改; 王爱婷、马强和鄢丹负责指导实验与文章修改。
利益冲突: 所有作者均声明不存在利益冲突。
  • 国家自然科学基金重点项目(82130112)
  • 北京市医院管理中心“登峰”计划专项(DFL20190702)
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2022年第57卷第8期
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doi: 10.16438/j.0513-4870.2022-0696
  • 接收时间:2022-06-06
  • 首发时间:2025-12-23
  • 出版时间:2022-08-12
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  • 收稿日期:2022-06-06
  • 修回日期:2022-06-22
基金
国家自然科学基金重点项目(82130112)
北京市医院管理中心“登峰”计划专项(DFL20190702)
作者信息
    1.成都中医药大学药学院, 四川 成都 611137
    2.首都医科大学附属北京友谊医院, 北京 100050
    3.北京市临床药学研究所, 北京 100050
    4.中国检验检疫科学研究院, 北京 100176

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*王爱婷, Tel: 86-10-63139318, E-mail: ;
马强, Tel: 86-10-53897463, E-mail:
鄢丹, Tel: 86-10-63139318, E-mail:
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2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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