Integrated metabolomics and the microbiome reveal the compatibility mechanism of the Suxiao Jiuxin pill in the treatment of stable coronary artery disease

Abstract Background The Suxiao Jiuxin pill (SJP) is a Chinese patent medicine that is used for the treatment of stable coronary artery disease (SCAD). However, the compatibility mechanism of SJP in treating of SCAD is still unclear. This study aimed to elucidate the serum metabolic profiles of patients with SCAD treated with SJP and to decipher the compatibility mechanism of its effective components, Chuanxiong Rhizoma and borneol. Methods We employed metabolomics to assess the serum metabolic profiles of SCAD patients before and after treatment with SJP through metabolomics. Additionally, the compatibility mechanism of the multicomponent pairing of Chuanxiong Rhizoma and borneol was explored using metabolomics and 16S rRNA sequencing. Results Our findings indicate that SJP significantly modulates lipid metabolism in SCAD patients, with particular impacts on glycerophospholipids and fatty acyls. Coadministration of Chuanxiong Rhizoma and borneol in mice demonstrated that borneol increases the absorption of the active components of Chuanxiong Rhizoma into the blood in a dose-dependent manner. This effect correlated with the dose-dependent enrichment of A. muciniphila and its role in modulating host lipid metabolism (glycerophospholipids and fatty acyls). Moreover, the combination of A. muciniphila and Chuanxiong Rhizoma also significantly promoted the absorption of the active components of Chuanxiong Rhizoma into the blood and affected host lipid metabolism (glycerophospholipids and fatty acyls). Conclusion This study is the first to demonstrate a link between SJP treatment in SCAD patients and improved lipid metabolism. Borneol enriches A. muciniphila in a dose-dependent manner, thereby regulating host lipid metabolism and facilitating the absorption of the active components of Chuanxiong Rhizoma into the blood.