Multi-target mechanisms of Banxia Baizhu Tianma Decoction against MASH in a methionine-choline deficient mouse model: insights from a Multi-Omics Investigation.

This study aims to systematically evaluate the therapeutic effects of the classic Chinese herbal formula Banxia Baizhu Tianma Decoction (BBTD) on a methionine-choline-deficient (MCD) diet-induced mouse model of metabolic dysfunction-associated steatohepatitis (MASH), and to elucidate its underlying mechanisms through multi-omics techniques. The chemical profile of the BBTD water decoction was comprehensively characterized using ultra-high-performance liquid chromatography-high-resolution mass spectrometry (UHPLC-HRMS). C57BL/6J mice were randomly divided into five groups: normal control group (MCS), model group (MCD), BBTD low-dosage and high-dosage groups (BBTD-L/H), and obeticholic acid (OCA) as a positive control. Therapeutic effect was assessed through biochemistry analysis, histopathological examination of liver (H&E, Oil Red O, Sirius Red staining), and immunohistochemistry analysis. Liver transcriptomics identified key altered pathways, and qRT-PCR and western blotting validated the expression of genes and proteins involved in linoleic acid/arachidonic acid metabolism and the MAPK signaling pathway. Gut microbiota composition was examined by 16S rRNA sequencing along with targeted metabolomic profiling of fecal short-chain fatty acids (SCFAs). Immunofluorescence analysis was used to evaluated the expression of colonic tight junction proteins. A total of 106 compounds were identified from BBTD, spanning more than ten structural classes such as glycosides, flavonoids, organic acids, and triterpenoids. In an MCD diet-induced mouse model of MASH, BBTD administration markedly ameliorated hepatic pathological features. Specifically, it lowered serum levels of ALT, AST, and TBil, lowered hepatic TG content, alleviated hepatocyte steatosis, inflammatory cell infiltration, and collagen deposition. Notably, BBTD exhibited superior anti-fibrotic activity compared to the positive control drug OCA. Mechanistic studies revealed that BBTD exerts hepatoprotective effect via multiple pathways modulation. Transcriptomic analysis demonstrated that BBTD significantly reversed MCD-induced gene expression alternation, with significant enrichment in linoleic acid metabolism and MAPK signaling pathways. Further validation revealed that BBTD not only up-regulated the expression of the fatty acid desaturase FADS2, thereby enhancing the conversion of linoleic acid to γ-linolenic acid, but also re-balanced the arachidonic acid metabolism. This was evidenced by the up-regulation of anti-inflammatory mediators (e.g., EETs, EPA/DHA) and down-regulation of pro-inflammatory mediators (e.g., HETEs), alongside the suppressed expression of COX-2 and ALOX5. Moreover, BBTD dose-dependently inhibited the phosphorylation of key MAPK pathway proteins (p-ERK, p-JNK, p-p38) and down-regulated the downstream early response genes (c-Jun, c-Fos). Regarding intestinal effects, BBTD remodeled the gut microbiota composition, enriching beneficial SCFAs-producing genera such as Faecalibacterium and Roseburia, while reducing pro-inflammatory genera like Turicibacter. Consequently, this shift was accompanied by the increased fecal levels of beneficial SCFAs including butyrate and propionate, enhanced intestinal physical barrier function by up-regulating the expression of colonic tight junction proteins (Occludin, ZO-1, Claudin), and reduced local inflammatory cytokine levels. This study demonstrates that BBTD effectively alleviates MCD-induced MASH in mice via a multicomponent, multitarget mechanism. BBTD simultaneously modulates hepatic and intestinal functions: in the liver, BBTD improves lipid metabolism and suppresses the MAPK-driven inflammatory pathway; in the gut, BBTD remodels the gut microbiota, enhances short-chain fatty acids production, and reinforces the intestinal barrier. From the perspective of the gut-liver axis, this research systematically elucidates that integrated multi-target mechanisms underlying the efficacy of BBTD against MASH and provides a scientific basis for the modernization of traditional Chinese herbal formulae.