Miao medicine Jinshanxiaoke granules alleviates MASLD via Ampk/Ppar-α and Pi3k/Akt-mediated restoration of hepatic lipid homeostasis

Ethnopharmacological relevance: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common progressive condition associated with chronic liver diseases caused by lipid dyshomeostasis, which has become a global pandemic. The incomplete understanding of its mechanisms has resulted in a lack of clinically effective therapeutic options. Miao medicine Jinshanxiaoke Granules (JXKG), a formula used for treating metabolic disorders, is rooted in the traditional Chinese medicine theory of "dampness-heat stasis". However, its specific efficacy and underlying mechanism against MASLD have yet to be elucidated.

Aim of the study: This study aimed to evaluate the therapeutic efficacy of JXKG against MASLD by identifying its active constituents and elucidating the pertinent molecular mechanisms.

Materials and methods: In this study, UPLC-MS/MS was employed to analyze the chemical composition of JXKG. A high-fat diet (HFD) was used to induce MASLD in C57BL/6 mice over a 12-week period. We evaluated JXKG's efficacy against MASLD by measuring body weight, liver index, histopathology, lipid profiles, serum biochemical parameters, and pro-inflammatory cytokine levels. Mechanistically, serum metabolomics, transcriptomics, network pharmacology, molecular docking, and western blotting were conducted. Furthermore, OA-stimulated HepG2 cells were utilized to evaluate the impact of JXKG-containing serum (JXKGs) and key ingredients on hepatic lipid homeostasis.

Results: Eight active ingredients of JXKG, entering the bloodstream, were identified and quantified from JXKGs. JXKG administration effectively ameliorated HFD-induced MASLD in mice via measuring body weight, liver index, pathological analysis (H&E/Oil Red O), hepatic function, and lipid profiles (including TG, TC, and lipoproteins). JXKG elevated Insulin sensitivity and glucose tolerance while concurrently reducing the levels of inflammatory mediators (IL-6 and TNFα) and lipotoxic substances (LPCs and LPEs) in the serum of MASLD mice. In addition, network pharmacology analysis and transcriptomic results revealed that JXKG ameliorated MASLD in mice by regulating lipid dyshomeostasis, which was related to the modulation of the AMPK/Ppar-α and PI3K/Akt signaling pathways. Western blot showed that JXKG up-regulated the related fatty acid β-oxidation proteins (Ppar-α and Cpt-1) by activating AMPK, while reducing the levels of p-Pi3k and p-Akt proteins, which inhibit the Srebp-1c-mediated de novo lipogenesis. Notably, JXKGs recapitulated the in vivo outcomes in OA-induced HepG2 cells, ameliorating steatosis via modulation of the AMPK/Ppar-α and PI3K/Akt signaling pathways.

Conclusion: These results indicated that JXKG can effectively ameliorate HFD-induced MASLD. Mechanistically, JXKG simultaneously modulated the AMPK/Ppar-α and PI3K/Akt signaling pathways to restore metabolic homeostasis, thereby exerting a therapeutic effect on MASLD.