Serum proteomic, peptidomic and metabolomic profiles in myasthenia gravis patients during treatment with Qiangji Jianli Fang

High-throughput proteomic, peptidomic and metabolomic techniques were applied to investigate serum samples from 21 healthy individuals and 47 MG patients before and after QJF treatment via two-dimensional gel electrophoresis, matrix-assisted laser desorption/ionization time of flight mass spectrometry and liquid chromatography Fourier transform mass spectrometry, respectively.After QJF treatment, the expression levels of peptides m/z 1865.019, 2021.128 and 1211.668 of complement C3f increased (P？=？0.004, P？=？0.001 and P？=？0.043, respectively), while that of peptide m/z 1739.931 of component C4b decreased (P？=？0.043), in the serum of MG patients. The levels of γ-aminobutyric acid (P？=？0.000) and coenzyme Q4 (P？=？0.000) resumed their normal states.QJF could inhibit the activity of the complement system and restore the normal levels of metabolites.Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder, with an incidence rate of 3–30/1,000,000 people per year [1]. MG patients can produce autoantibodies, such as anti-acetylcholine receptor antibody (AChRAb) and anti-muscle-specific receptor tyrosine kinase antibody (MuSKAb) through their own immune system to prevent muscle contraction, and cause muscle weakness and fatigue [2]. Genetic factors play an important role in MG [3]. In addition, infection with viruses or bacteria, such as poliovirus and Escherichia coli, may be involved in the pathogenesis of MG [4,5]. Anticholinesterase drugs, non-specific immunosuppressants, thymectomy and plasmapheresis are the main therapeutic approaches to MG [6-8]. However, the above treatments have some serious side effects, such as cardiac arrhythmia, osteoporosis and hypotension, and can not inhibit the relapse of patients’ symptoms and achieve complete remission [9]. Alternative treatments with higher efficacy and fewer side effects are required.Chinese medicine (CM) has been practiced for many diseases, including cancer, cardiovascular disease, inflammation and Parkin