The increased tendency for anemia in traditional Chinese medicine deficient body constitution is associated with the gut microbiome

Yuanjun Liang; Yang Chen; Yanzhao Lin; Wei Huang; Qinwei Qiu; Chen Sun; Jiamin Yuan; Ning Xu; Xinyan Chen; Fuping Xu; Xiaoxiao Shang; Yusheng Deng; Yanmin Liu; Fei Tan; Chunxiang He; Jiasheng Li; Qinqin Deng; Xiaoxuan Zhang; Huahua Guan; Yongzhu Liang; Xiaodong Fang; Xuanting Jiang; Lijuan Han; Li Huang; Zhimin Yang

doi:10.3389/fnut.2024.1359644

The increased tendency for anemia in traditional Chinese medicine deficient body constitution is associated with the gut microbiome

Front Nutr. 2024 Sep 18:11:1359644. doi: 10.3389/fnut.2024.1359644. eCollection 2024.

Authors

Yuanjun Liang^#^{1

2}, Yang Chen^#^{1

2}, Yanzhao Lin^#^{1

2}, Wei Huang^{1

2}, Qinwei Qiu^{1

2}, Chen Sun^{1

2}, Jiamin Yuan^{1

2}, Ning Xu², Xinyan Chen^{1

2}, Fuping Xu^{1

2}, Xiaoxiao Shang^{1

2}, Yusheng Deng^{1

2}, Yanmin Liu^{1

2}, Fei Tan^{1

2}, Chunxiang He^{1

2}, Jiasheng Li², Qinqin Deng², Xiaoxuan Zhang^{1

2}, Huahua Guan^{1

2}, Yongzhu Liang³, Xiaodong Fang^{1

2}, Xuanting Jiang⁴, Lijuan Han⁴, Li Huang^{1

2}, Zhimin Yang^{1

2}

Affiliations

¹ State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
² Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
³ Zhuhai Branch of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China.
⁴ Department of Scientific Research, Kangmeihuada GeneTech Co., Ltd., Shenzhen, China.

^# Contributed equally.

Abstract

Background: Constitution is a valuable part of traditional Chinese medicine theory; it is defined as the internal foundation for the occurrence, development, transformation and outcome of diseases, and has its characteristic gut microbiota. Previous study showed that deficiency constitution was related to lower Hb counts. However, no research has examined how alterations in the gut microbiome induced by deficiency constitution may increase the tendency for anemia.

Methods: We used a multiomics strategy to identify and quantify taxonomies and compounds found under deficient constitution individuals and further explore the possible pathological factors that affect red blood cell indices.

Results: ① People with deficient constitution showed lower hemoglobin (Hb), more Firmicutes, less Bacteroidetes, and higher α diversity. ② We identified Escherichia coli, Clostridium bolteae, Ruminococcus gnavus, Streptococcus parasanguinis and Flavonifractor plautii as potential biomarkers of deficient constitution. ③ Slackia piriformis, Clostridium_sp_L2_50 and Bacteroides plebeius were enriched in balanced-constitution individuals, and Parabacteroides goldsteinii was the key bacterial marker of balanced constitution. ④ Flavonifractor plautii may be a protective factor against the tendency for anemia among deficient individuals. ⑤ Ruminococcus gnavus may be the shared microbe base of deficiency constitution-related the tendency for anemia. ⑥ The microorganism abundance of the anaerobic phenotype was lower in deficient constitution group. ⑦ Alterations in the microbiome of deficient-constitution individuals were associated with worse health status and a greater risk of anemia, involving intestinal barrier function, metabolism and immune responses, regulated by short-chain fatty acids and bile acid production.

Conclusion: The composition of the gut microbiome was altered in people with deficient constitution, which may explain their poor health status and tendency toward anemia.

Keywords: anemia; deficient constitution; gut microbiome; serum metabolomics; traditional Chinese medicine constitution.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was funded by the State Key Laboratory of Dampness Syndrome of Chinese Medicine (No. SZ2021ZZ31/SZ2021ZZ32/No.SZ2021ZZ3002), the Specific Fund of State Key Laboratory of Dampness Syndrome of Chinese Medicine (No. SZ2021ZZ28), Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No: ZYYCXTD-C-202001), National Natural Science Foundation of China (No. 82004234), the Science and Technology Planning Project of Guangdong Province (No. 2020B1111100005).