How can traditional Chinese medicine enhance the efficacy of antibiotics in the treatment of MRSA-infected pneumonia: an experimental study on the combination of Reyanning mixture and linezolid

• Published in: Journal of ethnopharmacology 2024-12, Vol.340, p.119221, Article 119221
• Main Authors: Dou, Minhang, Huang, Jiayi, Li, Pengyue, Chen, Wanling, Wang, Xinran, Yang, Tianzi, Fan, Xiaoyu, Zhang, Xinyu, Lu, Yang, Bai, Jie, Du, Shouying
• Format: Article
• Language: English
• Subjects: Combination therapy; Linezolid; Lung inflammation; Methicillin-resistant Staphylococcus aureus; Pneumonia; Reyanning mixture
• ISSN: 0378-8741; 1872-7573; 1872-7573
• DOI: 10.1016/j.jep.2024.119221

The Reyanning Mixture (RYN) is a Chinese patent medicine widely used in the treatment of respiratory inflammatory diseases in China and has potential in the treatment of bacteria-infected pneumonia. The present study aimed to demonstrate the therapeutic potential of RYN in combination with linezolid for the treatment of MRSA-infected pneumonia and to explore the mechanisms of action and active components. The pharmacodynamics of RYN alone and in combination with linezolid was investigated in a rat model of MRSA-induced pneumonia. Transcriptomics, ELISA, western blot and qRT-PCR were used to explore and verify the pharmacological mechanism of the anti-inflammatory effect of RYN. UPLC-MS and molecular docking were used to explore the anti-inflammatory components of RYN for the treatment of MRSA-infected pneumonia. In vivo, RYN reduced lung injury and inflammation in patients with pneumonia. In particular, the combination of RYN and linezolid enhanced the therapeutic effect compared to that of either treatment alone. Further research suggests that the synergistic therapeutic effect of the combination may be related to the inhibition of the inflammatory response by RYN and the enhancement of linezolid inhibition and clearance of MRSA in lung tissues by RYN. RYN plays an anti-inflammatory role in MRSA-infected pneumonia by inhibiting the TLR2/NF-κB/NLRP3 pathway, with 7 active components that may play a dominant role. These results indicate that RYN may serve as an adjuvant drug to antibiotics for the treatment of MRSA-associated pneumonia. Exploration of its active components and mechanisms is conducive to the clinical application and quality improvement of RYN. More importantly, this study showed that the synergistic therapeutic effect of the combination of traditional Chinese medicine and antibiotics may be a valuable therapeutic strategy. [Display omitted] •We first investigated the effects of the Reyanning mixture applied alone and in combination•with linezolid in a rat model of pneumonia caused by MRSA infection. The combination of Reyanning mixture and linezolid can produce a synergistic therapeutic effect, which shows important clinical significance.•Reyanning mixture can significantly improve the antibacterial effect of linezolid against•MRSA in vivo. Reyanning mixture can also play an anti-inflammatory role in pneumonia caused by MRSA infection.•Reyanning mixture exerts an anti-inflammatory effect through the TLR2/NF-κB/NLRP3•pathway, which is mainly