To investigate the protective effect of Dahuang Xuanming Powder Granules (大黄玄明粉) on intestinal barrier injury induced by pancreatitis through phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/nuclear factor kappa B (NF-κB).

By injection of 0.2 mL of a 5% (w/v, 50 mg/mL) sodium taurocholate solution to induce a Sprague-Dawley (SD) rat model with severe acute pancreatitis (SAP). The experiment was divided into sham operation group, SAP-induced intestinal barrier injury group (model group) and Dahuang Xuanming Powder Granules group. Intestinal barrier injury was assessed by scanning electron microscopy, hematoxylin and eosin staining and pathological scoring. The levels of pancreatitis biomarkers (amylase and lipase), oxidative stress markers [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidases (GPx) and malondialdehyde (MDA)] and inflammatory markers [tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and IL-10] in serum or intestinal tissue were measured. The expressions of phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/nuclear factor kappa-B (NF-κB) signaling pathway-related proteins were detected by Western blotting. 16 S rRNA sequencing was used to measure the composition of gut microbiota in feces.

The activity of serum amylase and lipase in the model group was higher than that in the control group. The activity of serum amylase and lipase in Dahuang Xuanming Powder Granules group was lower than that in the model group. Compared with that in the control group, the number of intestinal villi in the model group decreased. The activity of serum amylase and lipase in the model group was higher than that in the control group. The activity of serum amylase and lipase in Dahuang Xuanming Powder Granules group was lower than that in the model group. Compared with that of the control group, the number of intestinal villi in the model group decreased and was damaged, while the treatment of Dahuang Xuanming Powder Granules prevented the reduction of the number of intestinal villi. In addition, Dahuang Xuanming Powder Granules increased the activity of the levels of serum SOD, CAT and GSPx, and decreased the serum MDA levels. Compared with the model group, Dahuang Xuanming Powder Granules reduced the protein levels of Toll like receptor 4 (TRL4), p-PI3K, p-AKT and p-NF-κB. Compared with the model group, Dahuang Xuanming Powder Granules reduced the levels of serum TNF-α, IL-1β and IL-6, but significantly increased serum IL-10 levels. In addition, Dahuang Xuanming Powder Granules increased the proportion of Lactobacillus and Prevotella in the model group, and reduced the proportion of Helicobacter pylori and Escherichia-Shigella.

By inactivating oxidants and inflammatory signals and improving intestinal microbiota, Dahuang Xuanming Powder Granules ultimately improve SAP-induced intestinal barrier injury in the rats.