Qingyi Decoction Alleviates Alcoholic Pancreatitis by Improving Glycerolipid Homeostasis via the AMPK/SREBP-1c/PPARα Pathway.

Background: Alcoholic pancreatitis (AP) is one of the most common types of acute pancreatitis, which is commonly accompanied by lipid metabolism disorders. Qingyi Decoction (QYD) is a traditional Chinese medicine formula for the treatment of acute and chronic pancreatitis in clinical. However, previous studies have mostly focused on its efficacy in biliary pancreatitis, leaving its efficacy and mechanistic underpinnings in AP largely unexplored and unreported. Methods: The mice with the AP model were established by intraperitoneal injections of a mixture of OA (150 mg/kg) and EtOH (1.35 g/kg) to evaluate the protective efficacy of QYD. The serum amylase, lipase, and pancreatic tissue myeloperoxidase (MPO) levels combined with histopathological analysis were used to evaluate the efficacy. Then, the differential lipids species associated with QYD treatment in improving AP were explored by a comprehensive lipidomics platform. Finally, the underlying mechanisms involving AMPK-mediated SREBP-1c/FASN and PPARα/CPT1A signaling pathways were systematically examined using Western blot and RT-qPCR techniques to determine both protein and mRNA expression levels. Results: QYD administration significant reduced the serum levels of amylase and lipase as well as MPO activity in pancreatic tissue, and alleviated pancreatic tissue hispathological damage in AP mice. Additionally, QYD regulated the metabolism of lipids such as TAG, DAG and FFA, whose mechanism is closely associated with activation of AMPKα, leading to the concurrent suppression of downstream mediators in lipid synthesis (SREBP-1c, ACC1, and FASN) and enhancement of factors involved fatty acids β-oxidation (PPARα and CPT1A) at both proteins and mRNAs levels, respectively. Conclusion: The study demonstrates that QYD could protect AP through improving lipid metabolism disorder via AMPK-mediated SREBP-1c/FASN and PPARα/CPT1A axis, which not only expands the clinical indications of QYD but also provides a novel therapeutic strategy and theoretical basis for the clinical treatment and drug development of AP.