Lulu Wu,1,* Haoyou Xu,2 Hui Xia,1 Lilin Peng,1 Lulu Qin,1 Qian Gong,3,4 Min Zhao,2 Zhibing Wu,5 Yuanqi Zhao,2 Zequan Zheng2,6,* 

1The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 2The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 3The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 4Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 5The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 6Doctoral Candidates with the Same Academic Level of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zequan Zheng, Email DoctorCheng@gzucm.edu.cn Yuanqi Zhao, Email zyq2022@gzucm.edu.cn

Background: Multiple sclerosis (MS) is one of the leading causes of disability among young people, and the immune imbalance between T helper cell 17 (Th17) and regulatory T cells (Tregs) plays a crucial role in its pathogenesis. Currently, MS treatment relies significantly on immunosuppressive drugs or glucocorticoids, which often have side effects and limitations in efficacy. Sheng-Jiang powder (SJP), a traditional Chinese medicine formula, has demonstrated anti-inflammatory effects and may offer a novel therapeutic option for MS.
Aim: This study aimed to investigate the therapeutic efficacy and underlying mechanism of SJP in myelin oligodendrocyte glycoprotein 35– 55 (MOG35-55)-induced experimental autoimmune encephalomyelitis (EAE) mice.
Methods: The efficacy of SJP was assessed using the MOG35-55-induced EAE model. Disease severity was monitored based on the clinical symptoms, body weight, and pathological damage. Furthermore, Th17/Treg balance in the peripheral and central immune systems was assessed. Metabolomic analysis was performed to detect differential metabolites in serum, and the effects of fatty acids on the lipoxygenase (LOX) metabolic pathway were investigated.
Results: SJP alleviated MOG35-55-induced EAE symptoms and histological damage, restored the peripheral Th17/Treg immune balance, decreased pro-inflammatory cytokine levels, and increased anti-inflammatory cytokine levels. SJP intervention also influenced omega-3 polyunsaturated fatty acid (PUFA) metabolism and absorption in EAE mice, promoting an anti-inflammatory process associated with 12/15-lipoxygenase(12/15-LOX) upregulation and 5-lipoxygenase(5-LOX) downregulation.
Conclusion: This study suggests that SJP is a viable treatment option for MS, and traditional Chinese medicine therapies for autoimmune diseases will continue to be developed.

Keywords: Shengjiang powder, multiple sclerosis, Th17/Treg, metabolomics, fatty acids metabolism