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Journal of Pharmaceutical Analysis logoLink to Journal of Pharmaceutical Analysis
. 2019 May 15;10(1):35–48. doi: 10.1016/j.jpha.2019.05.003

Rapid identification of chemical profile in Gandou decoction by UPLC-Q-TOF-MSE coupled with novel informatics UNIFI platform

Li Xu a, Yi Liu a,c, Hongfei Wu b, Huan Wu b, Xiaochuang Liu b, An Zhou a,b,
PMCID: PMC7037531  PMID: 32123598

Abstract

Gandou decoction (GDD), a well-known traditional Chinese medicine (TCM) formula, has been widely used for decades to treat Wilson's disease (WD) in China due to its remarkable clinical effects. However, the chemical constituents of GDD still remain unclear because of their complexity. In this work, a reliable and sensitive strategy based on ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MSE) and UNIFI informatics platform was applied to investigate the chemical components in GDD. In total, 96 compounds including anthraquinones, alkaloids, protostane triterpenoids, flavonoids, triterpenoid saponins, tannins, curcuminoids, etc, were identified or tentatively characterized from GDD by comparing their retention time, accurate mass within 5 ppm error and MSE fragmentation patterns. Among them, eleven compounds were confirmed unambiguously with reference standards. Representative compounds in different chemical structure types were analyzed in fragmentation patterns and characteristic ions. Moreover, to better understand the chemical contribution of individual herbs to the whole decoction, the corresponding each herb in GDD was also detected. This study developed a rapid method for characterizing the chemical constituents in GDD, which could not only be used for chemical standardization and quality control, but also be helpful for further research of GDD in vivo.

Keywords: Gandou decoction, UPLC-Q-TOF-MSE, UNIFI informatics platform, Chemical constituents

1. Introduction

Traditional Chinese medicines (TCM) have been extensively used for the prevention and treatment of complex and chronic diseases in China [1,2]. TCM formulae, combination of medicinal plants or animal materials, collectively exert therapeutic actions by complex interactions among multiple components from different herbal medicines. Based on TCM theories, these constituents in formulae could play a multi-target, synergistic and harmless therapeutic role [3]. As the components in TCM are rather complicated, it is difficult to separate and identify multiple chemical constituents. Therefore, developing a rapid and reliable method for elucidating the composition of TCM is necessary.

Wilson's disease (WD), also known as hepatolenticular degeneration, is an autosomal recessive genetic disorder of copper metabolism caused by ATP7B gene mutation [4,5]. Excessive copper accumulation in patients suffering from WD leads to liver disease, neurological disorder, K-F rings, and osteoporosis [6]. Currently, there are several chelating agents such as d-penicillamine, dimercaptosuccinic acid, trientine, and tetrathiomolybdate for medical therapy [7]. Although Western conventional medications are highly effective, prevalent, and low-priced, a number of side effects have been observed with chelation therapy [8]. Gandou decoction (GDD), a classical TCM formula, has been used in clinics to treat WD for decades in China [9,10]. It is composed of six crude drugs, i.e., Rheum palmatum L. (Da-Huang), Coptis chinensis Franch. (Huang-Lian), Curcuma longa L. (Jiang-Huang), Lysimachia christinae Hance (Jin-Qian-Cao), Alisma orientale (Sam.) Juzep. (Ze-Xie) and Panax notoginseng (Burk.) F. H. Chen (San-Qi). The clinical studies have been proven that GDD can promote urinary copper excretion, ameliorate liver function and improve the patient's clinical symptoms [7,11]. Furthermore, GDD appears to be safe, effective, and well tolerated and has fewer adverse effects than Western conventional medications [12]. In our previous studies, we investigated the therapeutic effect and serum metabolic profiling of GDD in copper-laden rats. It was found that GDD could reduce the hepatic copper accumulation, and improve liver pathological characteristics by restoring the impaired lipid metabolism, amino metabolism and glucose metabolism [13]. However, due to multi-component systems of TCM, the chemical constituents of GDD still remain unclear. Therefore, a systematic chemical profiling research of GDD is in an urgent need.

In recent years, UPLC-Q-TOF-MSE (where E represents collision energy) has provided a powerful approach for the efficient separation and structural characterization of TCM with the advantage of its high resolution, sensitivity and accuracy [14]. Q-TOF-MSE capable of simultaneously acquiring accurate mass precursor ion in MS full scan and fragment ions in MSE high-energy scan increased the credibility of analysis results [15,16]. Additionally, UNIFI software from Waters Corporation is a versatile and automated data processing platform. The software incorporates scientific library into a streamlined workflow to integrate data acquisition, library searching, MS fragment matching and report generation, which alleviates the workload from massive MS data and realizes rapid analysis of chemical components [17]. This high throughput strategy was innovatively used for screening and identification of chemical components in herbal medicines [18,19] and TCM formulae [20]. In the present study, an integrative strategy based on UPLC-Q-TOF-MSE coupled with UNIFI informatics platform has been applied to reveal the chemical profile of GDD. The aim of this study is to develop an analytical method for elucidating the material basis of GDD and provide valuable information for the quality control and in vivo analysis.

2. Material and methods

2.1. Materials and reagents

Rheum palmatum L., Coptis chinensis Franch., Curcuma longa L., Lysimachia christinae Hance, Alisma orientale (Sam.) Juzep. and Panax notoginseng (Burk.) F. H. Chen were purchased from Beijing Tongrentang Co., Ltd. (Hefei, China) and authenticated by Doctor Rongchun Han (College of Pharmacy, Anhui University of Chinese Medicine, Hefei, China). All voucher specimens were deposited at the authors' laboratory. The reference standards, including berberine hydrochloride, physcion, emodin, alisol B 23-acetate, quercetin and notoginsenoside R1, were obtained from the National Institutes for Food and Drug Control (Beijing, China). Chrysophanol, rhein, aloe-emodin and kaempferide were obtained from Beina Chuanglian Biotechnology Research Institute (Beijing, China). Curcumin was isolated in our laboratory with a purity of more than 98% by HPLC, and its structure and molecular weigh have been identified by using several spectral analyses and MS, respectively. Acetonitrile and methanol (LC-MS grade) were purchased from TEDIA (Fairfield, USA). Formic acid was obtained from Tianjin Guangfu Fine Chemical Research Institute (Tianjin, China). Ultrapure water was purified using a Milli-Q water purification system (Millipore, Billerica, MA, USA).

2.2. Standards and sample preparation

GDD consisted of six ingredients, including Rheum palmatum L. (20.0 g), Coptis chinensis Franch (20.0 g), Curcuma longa L. (20.0 g), Lysimachia christinae Hance (24.0 g), Alisma orientale (Sam.) Juzep. (24.0 g) and Panax notoginseng (Burk.) F. H. Chen (3.0 g). They were mixed together and immersed in 0.8 L distilled water (1:8, w/v) for 0.5 h. Afterwards, they were decocted twice by extracting and refluxing for 1 h each time. Finally, the two extractions were combined and concentrated to 1.0 g crude drug per milliliter, and then the solution was freeze-dried and stored in a vacuum desiccator before use. The accurately weighed 1.0 g freeze-dried powder was dispersed in 30 mL methanol and ultrasonicated in a water bath for 30 min to prepare solutions. The individual preparation of six herbs was carried out according to the same procedures as that of GDD. An aliquot of 5 μL filtrate was injected into the UPLC-Q-TOF-MSE system for analysis after filtered through 0.22 μm filter membrane.

11 reference standards were dissolved in methanol. Before qualitative analysis, they were mixed together to make reasonable concentration and filtered through 0.22 μm filter membrane.

2.3. Chromatography and mass spectrometry conditions

Chromatographic analysis was performed using a Waters Acquity™ UPLC system (Waters Corporation, Milford, USA). Chromatographic separation was carried out at 30 °C, using an Agilent Eclipse Plus C18 RRHD column (2.1 mm × 100 mm, 1.8 μm) with mobile phases A (0.1% formic acid in water) and B (acetonitrile). The flow rate was set at 0.3 mL/min. The gradient profile was as follows: 0–1 min, 10%–10% B; 1–4 min, 10%–20% B; 4–10 min, 20%–30% B; 10–15 min, 30%–40% B; 15–18 min, 40%–50% B; 18–23 min, 50%–75% B; 23–25 min, 75%–85% B; 25–27 min, 85%–100% B.

Mass spectrometric detection was carried out on Waters Xevo G2 Q-TOF mass spectrometer (Waters Corporation, Milford, USA) equipped with an ESI source. The full scan data were acquired from 50 to 1200 Da, using a capillary voltage of 3.0 kV for positive ion mode and −2.5 kV for negative ion mode, sampling cone voltage of 40 V for positive ion mode and 50 V for negative ion mode, extraction cone voltage of 4.0 V, source temperature of 120 °C (ESI+) or 110 °C (ESI), cone gas flow of 50 L/h, desolvation gas (N2) flow of 600 L/h and desolvation gas temperature of 350 °C. The collision voltage was set as 6.0 eV for low-energy scan and 20–80 eV for high-energy scan. Data were centroided and mass was corrected during acquisition using an external reference (Lock-Spray™) consisting of a 200 pg/mL solution of leucineenk ephalin infused at a flow rate of 10 μL/min via a lockspray interface, generating a realtime reference ion of [M+H]+ (m/z 556.2771) in positive ion mode and [M−H] (m/z 554.2615) in negative ion mode to ensure accurate MS analysis. All data collected in centroid mode were obtained and used to calculate the accurate mass and composition of relative target ions with MassLynx™ V4.1 software (Waters).

2.4. Establishment of a chemical compounds library of GDD

The systematic information on chemical compounds isolated from the six individual herbs in GDD was collected and sorted out by retrieving databases such as China Journals of Full-text database (CNKI), Medline, PubMed, Web of Science and ChemSpider. A self-building library of chemical compounds was established by UNIFI software, including compound name, molecular formula, chemical structure, and accurate molecular mass. Among them, the information of 356 compounds is listed in Table S1.

2.5. Data analysis by UNIFI platform

All MS data analysis was processed on the platform of UNIFI software. Minimum peak area of 200 was set for 2D peak detection. The peaks intensity of high energy over 80 counts and the peak intensity of low energy over 200 counts were the selected parameters in 3D peak detection. A margin of error up to 5 ppm for identified compounds was allowed and the matching compounds would be generated predicted fragments from structure. We selected positive adducts including H+, Na+ and negative adducts containing HCOO and H. They were allowed cross adduct combinations.

3. Results and discussion

3.1. Identification and characterization of chemical compounds

The high resolution MS data of GDD were quickly acquired by UPLC-Q-TOF-MSE method. The base peak intensity (BPI) chromatograms of GDD in positive and negative ion modes are depicted in Fig. 1. The UNIFI screening platform was utilized to process and analyze the MS data, and then automatically matched the fragment information. After further manual verification, a total of 96 compounds were identified or tentatively characterized in GDD, including 21 anthraquinones, 14 alkaloids, 17 protostane triterpenoids, 10 flavonoids, 8 triterpenoid saponins, 10 tannins, 4 curcuminoids and 12 others. The detailed MS information of these components is summarized in Table 1. Meanwhile, the chemical structures were confirmed based on accurate mass, MSE data and related literatures. The structures of main chemical constituents in GDD are shown in Fig. 2.

Fig. 1.

Fig. 1

The base peak intensity (BPI) chromatograms of GDD from UPLC-Q-TOF-MSE analysis. (A) Negative scan; (B) Positive scan.

Table 1.

Identification of chemical constituents of GDD by UPLC-Q-TOF-MSE.

No. tR (min) Idenfitication Neutral mass
(Da)
Formular Observed neutral
mass (Da)
Experimental mass (m/z) Error
(ppm)
MS and MSE data (+ or −) (m/z) Source
1 0.98 Gallic acid-O-glc 332.0743 C13H16O10 332.0743 331.0669 -0.5 331.0669[M−H]
169.0141[M−H-Glc]
a
2 1.05 Gallic acid 170.0215 C7H6O5 170.0214 169.0141 -0.8 169.0141[M−H]
125.0244[M−H-CO2]
a
3 1.39 Progallin A 198.0528 C9H10O5 198.0528 197.0455 -0.7 197.0455[M−H]
124.0455[M−H-2CH2-COOH]
a
4 1.50 (+)-Catechin-5-O-β-D-glc 452.1319 C21H24O11 452.1318 451.1245 -0.7 451.1245[M−H]
289.0717[M−H-Glc]
a
5 1.71 Procyanidin B 578.1424 C30H26O12 578.1432 577.1359 1.4 577.1359[M−H]
425.0873[M–H-C7H4O4]
407.0763[M–H-C7H4O4-H2O]
289.0712[M−H-catechin]
a
6 2.71 Chlorogenic acid 354.0951 C16H18O9 354.0962 353.0889 3.1 353.0889[M−H]
191.0899[M-C9H6O3]
b,d
7 2.82 (-)-Epicatechin 290.0790 C15H14O6 290.0797 289.0724 2.3 289.0724[M−H]
245.0821[M−H-CO2]
a
8 3.16 Isocorydine 341.1627 C20H23NO4 341.1628 342.1707 0.1 342.1707[M+H]+
296.1132[M+H-CH3-CH3O]+
b
9 3.19 Procyanidin B-O-gallate 730.1534 C37H30O16 730.1544 729.1471 1.3 729.1471[M−H]
577.1350[M−H-gallate]
a
10 3.20 Magnoflorine 342.1705 C20H24NO4 342.1730 342.1701 -1.2 342.1701[M]+
297.1123[M-(CH3)2NH]+
282.0876[M-(CH3)2NH-CH3]+
265.0861[M-(CH3)2NH-CH3OH]+
237.0908[M-(CH3)2NH-CH3OH-CO]+
b
11 3.42 Isoboldine 327.1471 C19H21NO4 327.1479 328.1552 2.7 328.1552[M+H]+
297.1123[M+H-CH3O]+
b
12 3.79 Isovitexin 432.1056 C21H20O10 432.1065 477.1047 1.8 477.1047[M+HCOO]
431.0982[M−H]
311.0567[M−H-CO2-C3H8O2]
d
13 4.75 Tetradehydroscoulerine 322.1079 C19H16NO4 322.1055 322.1052 -6.6 322.1052[M]+
307.0839[M-CH3]+
279.0511[M-CH3-CO]+
b
14 4.79 Procyanidin B-5,3,3'-di-O
-gallate
882.1643 C44H34O20 882.1685 881.1612 4.8 881.1612[M−H]
729.1471[M−H-gallate]
711.0735[M−H-gallate-H2O]
559.1341[M−H-2gallate-H2O]
a
15 4.86 Emodin-8-O-β-D-glc 432.1056 C21H20O10 432.1065 431.0992 1.9 431.0992[M−H]
269.0461[M−H-Glc]
241.0493[M−H-Glc-CO] 225.0554[M−H-Glc-CO-O]
a
16 4.88 Rutin 610.1534 C27H30O16 610.1555 609.1483 3.6 609.1483[M−H]
463.0815[M−H-Rha]
301.0487[M−H-Rha-Glc]
a,d
17 5.09 Rhein-1-O-β-D-glc 446.0849 C21H18O11 446.0860 445.0787 2.4 445.0787[M−H]
283.0256[M−H-Glc]
239.0356[M−H-Glc-CO2]
211.0403[M−H-Glc-CO2-CO]
a
18 5.11 Isolindleyin or lindleyin 478.1475 C23H26O11 478.1483 477.1410 1.7 477.1410[M−H]
313.0552[M−H-C10H12O2]
169.0145[M−H-C16H20O6]
d
19 5.14 (+)-Catechin-3-O-gallate 442.0900 C22H18O10 442.0910 441.0838
2.4 441.0838[M−H]
289.0722[M−H-C7H4O4]
165.1245[M−H-C14H12O6]
a
20 5.20 Ferulic acid-O-β-D-glc 356.1107 C16H20O9 356.1113 355.1040 1.5 355.1040[M−H]
193.1033[M−H-Glc]
d
21 5.25 Isoquercitrin 464.0955 C21H20O12 464.0972 463.0899 3.7 463.0899[M−H]
301.0038[M−H-C6H10O5]
d
22 5.45 Isolindleyin or lindleyin 478.1475 C23H26O11 478.1482 477.1408 1.6 477.1408[M−H]
313.0551[M−H-C10H12O2]
169.0144[M−H-C16H20O6]
a
23 5.61 Kaempferol-3-O-rutinoside 594.1585 C27H30O15 594.1599 593.1521 1.6 593.1521[M−H]
447.1591[M−H-Rha]
285.0832[M−H-Rha-Glc]
d
24 5.65 Resveratrol-4'-O-β-D-(2''-O-galloyl)-glc 542.1424 C27H26O12 542.1431 541.1333 1.2 541.1333[M−H]
313.0555[M−H-Res-H2O]
a
25 5.70 Sennoside C or D 848.2164 C42H40O19 848.2177 847.2104 1.5 847.2104[M−H]
685.1557[M−H-Glc]
a
26 5.89 Tetrahydropalmatine 355.1784 C21H25NO4 355.1792 356.1865 2.4 356.1865[M+H]+
192.1019[M+H-C10H12O2]+
b
27 6.24 Sennoside A or B 862.1956 C42H38O20 862.1981 861.1908 2.8 861.1908[M−H]
699.1358[M−H-Glc]
655.1880[M−H-Glc-CO2]
386.1002[M−H-Glc-CO2-C15H9O5]
a
28 6.36 Homoorientin 448.1006 C21H20O11 448.1000 447.0927 -1.2 447.0927[M−H] d
29 6.52 Thalifendine 322.1079 C19H16NO4 322.1069 322.1082 -0.4 322.1082[M]+
279.0889[M-CH3-CO]+
b
30 6.94 Hesperetin-5-O-glc 464.1319 C22H24O11 464.1313 463.1240 1.5 463.1240[M−H]
301.1131[M−H-Glc]
d
31 7.01 Coptisine 320.0923 C19H14NO4 320.0921 320.0921 0.6 320.0921[M]+
292.0970[M-CO]+
b
32 7.08 Rhein-8-O-β-D-(6"-O-acetyl)-glc 488.0955 C23H20O12 488.0949 487.0876 1.5 487.0876[M−H]
283.0246[M−H-acetyl-Glc] 239.0347[M−H-acetyl-Glc-CO2]
a
33 7.15 Jatrorrhizine 338.1392 C20H20NO4 338.1384 338.1384 2.4 338.1384[M]+
322.0997[M-CH3-H]+
308.1309[M-2CH3]+
b
34 7.35 Epiberberine 336.1236 C20H18NO4 336.1250 336.1250 -4.2 336.1250[M]+
320.0935[M-CH3-H]+
292.1314[M-CH3-H-CO]+
b
35 7.47 Aloe emodin-8-O-β-D-glc 432.1056 C21H20O10 432.1068 431.0992 0.8 431.0992[M−H]
269.0385[M−H-Glc]
225.0562[M−H-Glc-CO2]
a
36 7.48 Tetrahydroberberine 339.1471 C20H21NO4 339.1466 340.1544 -1.4 340.1544[M+H]+
176.0705[M+H-C10H12O2]+
b
37g 7.72 Notoginsenoside R1 932.5345 C47H80O18 932.5372 977.5354 2.8 977.5354[M+HCOO]
931.5297[M−H]
799.4856[M−H-Xyl]
637.4314[M−H-Xyl-Glc]
475.3782[M−H-Xyl-2Glc]
f
38 8.09 Worenine 334.1079 C20H16NO4 334.1080 334.1080 -0.3 334.1080[M]+
320.1093[M-CH2]+
318.1092[M-CH2-2H]+
292.0969[M-CH2-CO]+
b
39g 8.46 Berberine 336.1236 C20H18NO4 336.1230 336.1231 1.8 336.1231[M]+
321.0983[M-CH3]+
320.0918[M-CH3-H]+
306.0763[M-2CH3]+
292.0969[M-CH3-H-CO]+
278.0813[M-2CH3-CO]+
b
40 8.51 Palmatine 352.1549 C21H22NO4 352.1543 352.1538 -1.7 352.1538[M]+
337.1430[M-CH3]+
336.0983[M-CH3-H]+
322.1068 [M-2CH3]+
308.1275 [M-CH3-H-CO]+
b

41 8.53 Ginsenoside Rg1 800.4922 C42H72O14 800.4939 845.4921
2.0 845.4921[M+HCOO]
799.4863[M−H]
637.4321[M−H-Glc]
475.3784[M−H-2Glc]
f
42 9.23 Kaempferol 286.0477 C15H10O6 286.0479 285.0406 0.7 285.0406[M−H]
229.0451[M−H-C2O2]
169.0141[M−H-C3O5]
a,d
43g 9.46 Quercetin 302.0427 C15H10O7 302.0432 301.0360 2.0 301.0360[M−H]
151.0451[M−H-C8H6O3]
121.0431[M−H-C8H6O3-CH2O]
107.0162[M−H-C8H6O3-CH2O-CH2]
d
44 9.61 Aloin 418.1264 C21H22O9 418.1267 417.1195 0.8 417.1195[M−H]
255.0666[M−H-Glc]
227.0718[M−H-Glc-CO]
a
45 9.76 Aloe emodin-1-O-β-D-glc 432.1056 C21H20O10 432.1068 431.0995 2.7 431.0995[M−H]
269.0452[M−H-Glc]
225.0562[M−H-Glc-CO2]
a
46 9.91 Aloe emodin-ω-O-β-D-glc 432.1056 C21H20O10 432.1068 431.0995 2.7 431.0995[M−H]
269.0463[M−H-Glc]
225.0560[M−H-Glc-CO2]
a
47 10.09 Chrysophanol-1-O-β-D-glc 416.1107 C21H20O9 416.1118 415.1045 2.6 415.1045[M−H]
253.0515[M−H-Glc]
225.0563[M−H-Glc-CO]
a
48 10.91 Aloe emodin-8-(6"-O-malonyl)-glc 518.1060 C24H22O13 518.1076 517.1003 3.1 517.1003[M−H]
473.1097[M−H-CO2]
269.0463[M−H-malonyl-Glc]
a
49 10.95 Calebin-A 384.1209 C21H20O7 384.1211 429.1193 0.5 429.1193[M+HCOO] c
50 11.16 Naringenin 272.0685 C15H12O5 272.0689 271.0616 1.5 271.0616[M−H]
151.0665[M−H-C8H8O]
d
51 11.25 Aloe emodin-8-O-β-D-(6"-O-acetyl)-glc 474.1162 C23H22O11 474.1169 473.1096 1.5 473.1096[M−H]
269.0451[M−H-acetyl-Glc]
240.0410[M−H-acetyl-Glc-CHO]
a
52 11.77 Physcion-8-O-β-D-glc 446.1213 C22H22O10 446.1219 445.1146 1.3 445.1146[M−H]
283.0617[M−H-Glc]
240.0433[M−H-Glc-CO-CH3]
a
53 11.85 Chysophanol-8-O-β-D-(6"-O-acetyl)-glc 458.1213 C23H22O10 458.1221 457.1148 1.8 457.1148[M−H]
253.0511[M−H-acetyl-Glc]
225.0561[M−H-acetyl-Glc-CO]
a
54 12.18 Notoginsenoside R2 770.4816 C41H70O13 770.4843 815.4825 3.3 815.4825[M+HCOO]
769.4768[M−H]
637.4335[M−H-Xyl]
475.3786[M−H-Xyl-Glc]
f
55 12.53 Ginsenoside Rb1 1108.6029 C54H92O23 1108.6105 1107.5967 6.6 1107.5967[M−H]
945.5469[M−H-Glc]
783.4917[M−H-2Glc]
621.4361[M−H-3Glc]
459.3824[M−H-4Glc]
f
56 12.69 Cyclocurcumin 368.1260 C21H20O6 368.1258 367.1186 -0.4 367.1186[M−H]
175.0401[M−H-C11H12O3]
c
57 12.74 Ginsenoside Rg2 784.4973 C42H72O13 784.4999 829.4982 3.2 829.4982[M+HCOO]
783.4922[M−H]
637.4326[M−H-Rha]
475.3789[M−H-Rha-Glc]
f
58 12.94 Ginsenoside Rh1 638.4394 C36H62O9 638.4414 683.4382 2.9 683.4382[M+HCOO]
637.4321[M−H]
475.3784[M−H-Glc]
f
59 13.18 6-Methyl-rhein 298.0477 C16H10O6 298.0481 297.0408 1.1 297.0408[M−H]
283.0251[M−H-CH2]
239.0358[M−H-CH2-CO2]
a
60 13.21 Physcion-8-O-β-D-(6"-O-acetyl)-glc 488.1319 C24H24O11 488.1323 487.1250 0.8 487.1250[M−H]
283.0615[M−H-acetyl-Glc] 255.0317[M−H-acetyl-Glc-CO]
240.0432[M−H-acetyl-Glc-CO-CH3]
a
61 13.51 Orientalol A 254.1882 C15H26O3 254.1907 299.1889 8.3 299.1889[M+HCOO]
253.1905[M−H]
c
62 14.13 16-Oxo-alisol A 504.3451 C30H48O6 504.3474 505.3223 4.3 505.3223[M+H]+
487.3327[M+H-H2O]+
469.3285[M+H-2H2O]+
451.3318[M+H-3H2O]+
415.2824[M+H-C4H10O2]+
397.2783[M+H-C4H10O2-H2O]+
e
63 14.41 Ginsenoside Rd 946.5501 C48H82O18 946.5581 991.5563 8.0 991.5563[M+HCOO]
945.5563[M−H]
783.4939[M−H-Glc]
621.4398[M−H-2Glc]
459.3851[M−H-3Glc]
f
64g 14.52 Aloe emodin 270.0528 C15H10O5 270.0536 269.0462 3.0 269.0462[M−H]
240.0421[M−H-CHO]
211.0410[M−H-2CHO]
a
65g 15.30 Rhein 284.0321 C15H8O6 284.0332 283.0256 4.0 283.0256[M−H]
239.0356[M−H-CO2]
211.0403[M−H-CO2-CO]
183.0439[M−H-CO2-CO-CO]
a
66 16.01 Notoginsenoside R3 962.5450 C48H82O19 962.5491 961.5418 4.2 961.5418[M−H]
799.4889[M−H-Glc]
637.4360[M−H-2Glc]
475.3817[M−H-3Glc]
f
67 16.70 8-Oxoberberine 351.1107 C20H17NO5 351.1108 352.1181 0.4 352.1181[M+H]+
337.0948[M+H-CH3]+
294.0764[M+H-2CH3-CO]+
b
68 16.72 Alisol I 454.3447 C30H46O3 454.3460 455.3526
2.6 455.3526[M+H]+
383.2943[M+H-C4H8O]+
e
69 17.05 Alisol C 486.3345 C30H46O5 486.3368 487.3418 4.2 487.3418[M+H]+
469.3265[M+H-H2O]+
451.3215[M+H-2H2O]+
415.2841[M+H-C4H8O]+
397.2746[M+H-C4H10O2]+
e
70 17.24 Ar-turmerone 216.1514 C15H20O 216.1516 217.1588 0.7 217.1588[M+H]+
120.0935[M+H-C6H9O]+
92.06212[M+H-C8H13O]+
c
71g 17.34 Kaempferide 300.0634 C16H12O6 300.0628 299.0553 -2.1 299.0553[M−H]
284.0489[M−H-CH3]
d
72 17.46 Bisdemethoxycurcumin 308.1049 C19H16O4 308.1058 307.0984 2.9 307.0984[M−H]
187.0406[M−H-C8H8O]
c
73 17.93 Demethoxycurcumin 338.1154 C20H18O5 338.1161 337.1088 2.0 337.1088[M−H]
217.0508[M−H-C8H8O]
c
74g 18.38 Curcumin 368.1260 C21H20O6 368.1260 367.1192 -0.1 367.1192[M−H]
217.0524[M−H-C9H10O2]
c
75 18.94 Alisol M 23-acetate 488.3502 C30H48O5 488.3497 489.3480 -0.8 489.3480[M+H]+
471.2696[M+H-H2O]+
e

76g 19.25 Emodin 270.0528 C15H10O5 270.0533 269.0460 1.7 269.0460[M−H]
241.0507[M−H-CO]
225.0559[M−H-CO-O]
a
77 19.54 Bisabolone oxide A 236.1776 C15H24O2 236.1776 237.1850 0.5 237.1850[M+H]+ c
78 19.65 Alisol C 23-acetate 528.3451 C32H48O6 528.3453 529.3535 1.0 529.3535[M+H]+
511.3415[M+H-H2O]+
469.3456[M+H-HAc]+
e
79 19.71 Alisol F 488.3502 C30H48O5 488.3497 511.3391 -1.4 511.3391[M+Na]+
471.2696[M+H-H2O]+
453.2687[M+H-2H2O]+
399.3129[M+H-C4H10O2]+
381.3091[M+H-C4H10O2-H2O]+
e
80 20.04 Alisol L 23-acetate 510.3345 C32H46O5 510.3350 511.3418 1.0 511.3418[M+H]+
451.3201[M+H-HAc]+
397.2739[M+H-C6H10O2]+
e
81 20.59 Procyanidin 594.1373 C30H26O13 594.1382 593.1309 0.8 593.1309[M−H] a
82 21.39 Neoalisol A 488.3502 C30H48O5 488.3505 489.3572 2.5 489.3572[M+H]+
471.3571[M+H-H2O]+
e
83g 21.71 Chrysophanol 254.0579 C15H10O4 254.0579 253.0515 3.3 253.0515[M−H]
225.0545[M−H-CO]
a
84 21.72 16,23-Oxido alisol B 470.3396 C30H46O4 470.3395 493.3287 -0.2 493.3287[M+Na]+
453.3362[M+H-H2O]+
339.2686[M+H-C6H10O2-H2O]+
e
85 22.56 Gingerdione 292.1675 C17H24O4 292.1679 337.1661 1.4 337.1661[M+HCOO]
291.1629[M−H]
c
86g 22.80 Physcion 284.0685 C16H12O5 284.0692 283.0619 2.5 283.0619[M−H]
255.0315[M−H-CO]
240.0359[M−H-CO-CH3]
a
87 22.90 Alisol A 23-acetate 532.3764 C32H52O6 532.3767 555.3749 0.6 555.3749[M+Na]+
515.3516[M+H-H2O]+
383.2797[M+H-C6H12O3-H2O]+
e
88 23.05 11-Deoxy-alisol C 470.3396 C30H46O4 470.3398 471.3380 0.3 471.3380[M+H]+
453.3515[M+H-H2O]+
399.2874[M+H-C4H8O]+
e
89 23.32 Stearic acid 284.2715 C18H36O2 284.2717 283.2645 0.7 283.2645[M−H] d
90 23.54 Alisol A 490.3658 C30H50O5 490.3678 491.3661 3.8 491.3661[M+H]+
473.3515[M+H-H2O]+
455.3621[M+H-2H2O]+
437.3415[M+H-3H2O]+
383.2973[M+H-H2O-C4H10O2]+
e
91 23.79 Alisol B 472.3553 C30H48O4 472.3558 473.3622 -0.7 473.3622[M+H]+
455.3515[M+H-H2O]+
437.3521[M+H-2H2O]+
383.2943[M+H-H2O-C4H8O]+
e
92 23.93 Alisol L 468.3240 C30H44O4 468.3238 469.3310 -0.4 469.3310[M+H]+
451.3188[M+H-H2O]+
397.2745[M+H-C4H8O]+
e
93 24.47 Alisol O 512.3502 C32H48O5 512.3492 513.3581 0.3 513.3581[M+H]+
495.3475[M+H-H2O]+
453.3413[M+H-HAc]+
435.3628[M+H-HAc-H2O]+
e
94 24.65 Linolenic acid 278.2246 C18H30O2 278.2245 277.2164 -1.4 277.2164[M−H] a,d
95 25.28 Alisol A 24-acetate 532.3764 C32H52O6 532.3761 555.3748

1.5 555.3748[M+Na]+
515.3516[M+H-H2O]+
497.3472[M+H-2H2O]+
383.2797[M+H-C6H12O3-H2O]+
e
96g 25.38 Alisol B 23-acetate 514.3658 C32H50O5 514.3661 537.3554 0.5 537.3554[M+Na]+
515.3735[M+H]+
497.3629[M+H-H2O]+
479.3508[M+H-2H2O]+
437.3415[M+H-H2O-HAc]+
383.2688[M+H-C6H12O3]+
e

Glc: glucose; Rha: rhamnose; Xyl: xylose; Res: resveratrol.

a

Rheum palmatum L.

b

Coptis chinensis Franch.

c

Curcuma longa L.

d

Lysimachia christinae Hance.

e

Alisma orientale (Sam.) Juzep.

f

Panax notoginseng (Burk.) F. H. Chen.

g

Identified by comparison with reference standards.

Fig. 2.

Fig. 2

Chemical structures of compounds identified in GDD.

3.2. Analysis of GDD by UPLC-Q-TOF-MSE

3.2.1. Anthraquinones

21 anthraquinones were detected from GDD and were also the major bioactive constituents of Rheum palmatum L. In this study, 6 free anthraquinones, 13 anthraquinone glycosides and 2 anthrones were determined based on MS database-matching. Anthraquinones have a characteristic fragmentation behavior with successive or simultaneous losses of CO, OH, CH3 and CO2 [21,22]. Peaks 64, 65, 76, 83 and 86 were exactly identified as aloe emodin, rhein, emodin, chrysophanol and physcion by comparing retention time and fragmentation patterns with reference standards. Rhein, the main anthraquinone in GDD, was used to characterize the fragmentation pathways (Fig. 3). Rhein showed quasi-molecular ion [M−H] at m/z 283.0256 in negative ion mode, and yielded fragment ions at m/z 239.0356 and 211.0403 by losses of CO2 and CO, respectively. And then, the ion at m/z 211.0403 could further lose one molecule of CO to generate ion at m/z 183.0439. Aloe emodin and emodin were isomers with the same [M−H] ion at m/z 269. In high energy MSE spectra, emodin revealed [M−H-CO] ion at m/z 241.0507 and [M−H-CO-O] ion at m/z 225.0559, while aloe emodin could be differentiated by the characteristic ion [M−H-CHO] at m/z 240.0421. Physcion showed [M−H] ion at m/z 283.0619, and the obvious fragments ions at m/z 255.0315 [M−H-CO] and 240.0359 [M−H-CO-CH3] were further obtained. Chrysophanol showed [M−H] ion at m/z 253.0515, only one product ion at m/z 225.0545 [M−H-CO].

Fig. 3.

Fig. 3

The MS spectra and fragmentation pathway of rhein in negative ion mode.

For anthraquinone glycosides, aglycone ions were identified based on the MS fragmentation behaviors of free anthraquinones. Peak 47 exhibited [M−H] ion at m/z 415.1045, which generated an [M−H-162Da] ion at m/z 253.0515 by eliminating the glucose residue. The further loss of CO was in accordance with the characteristic ion at m/z 225.0563 of chrysophanol. Thus, peak 47 was assigned as chrysophanol-1-O-β-D-glc. Based on these fragmentation patterns, peaks 15, 17, 32, 35, 44, 45, 46, 47, 48, 51, 52, 53, and 60 were inferred as anthraquinones glycosides. In addition, anthrones are an important type of anthraquinone. Sennosides usually gave a significant ion at m/z 386 which originated from C-10−C-10′ cleavage. Peak 27 showed [M−H] ion at m/z 861.1908, which first produced ions at m/z 699.1358 and 655.1880 by sequential loss of terminal glucose residue and CO2, followed by the cleavage of C-10 and C-10′ forming [M−H-Glc-CO2-C15H9O5] ion at m/z 386.1002. Its structure was identified as sennoside A or B. These two isomers were not distinguished from each other only by their MS spectra. Similarly, peak 25 displayed the same fragmentation patterns as peak 27, so it was presumed as sennoside C or D.

3.2.2. Alkaloids

A total of 14 alkaloids were identified in positive ion mode and came from Coptis chinensis Franch, including protoberberine alkaloids, apomorphine alkaloids, and tetrahydroprotoberberine alkaloids. As reported in the literature, the neutral losses like the methyl radical (CH3∙), hydrogen radical (H∙) and CO are the main fragment patterns of protoberberine alkaloids due to the successive cleavage of substituted methoxyl or methylenedioxyl groups on the A- and D-rings [23]. Peak 39 was unequivocally identified as berberine by contrast with a reference standard. The MS spectrum and possible fragmentation pathways of berberine are depicted in Fig. 4. Taking berberine as an example, it produced fragment ions at m/z 321.0983 [M-CH3]+, 320.0918 [M-CH3-H]+, 306.0763 [M-2CH3]+, 292.0969 [M-CH3-H-CO]+ and 278.0813 [M-2CH3-CO]+. Peak 40 showed [M]+ ion at m/z 352.1538 and yielded characteristic ions at m/z 337.1430 [M-CH3]+, 336.0983 [M-CH3-H]+, 322.1068 [M-2CH3]+ and 308.1275 [M-CH3-H-CO]+, which indicated that it was presumed as palmatine. Likewise, the other peaks 31, 33, 34, 38 and 67 could be tentatively identified as coptisine, jatrorrhizine, epiberberine, worenine and 8-oxoberberine, respectively.

Fig. 4.

Fig. 4

The MS spectra and fragmentation pathway of berberine in positive ion mode.

Peak 10 gave [M]+ ion at m/z 342.1701 with a molecular formula C20H24NO4. The predominant ions appeared at m/z 297.1123 [M-(CH3)2NH]+, 282.0876 [M-(CH3)2NH-CH3]+, 265.0861 [M-(CH3)2NH-CH3OH]+, and 237.0908 [M-(CH3)2NH-CH3OH-CO]+, which is consistent with the common structure of apomorphine alkaloids. Thus, peak 10 was considered as magnoflorine. Analogously, peaks 8 and 11 were deemed as isocorydine and isoboldine. Additionally, the tetrahydroprotoberberine alkaloids have retro-Diels-Alder (RDA) reaction, resulting in the cleavage of the terminal chain, such as -CH3. Peak 26 gave a protonated ion at m/z 356.1865. The fragment ions at m/z 192.1019 and 165.0893 were attributed to RDA cleavage at C- and B-rings. By further loss of a methyl radical, two obtained ions generated characteristic ions at m/z 177.0774 and 150.0663, respectively. Therefore, peak 26 was tentatively identified as tetrahydropalmatine.

3.2.3. Protostane triterpenoids

17 protostane triterpenoids in GDD originated from Alisma orientale (Sam.) Juzep. Protostane triterpenoids showed [M+H]+ ion, adduct [M+Na]+ ion in positive ion mode and all possess a tetracyclic carbon skeleton. During the collision-induced dissociation (CID) process, the hydrogen rearrangement at C-23-OH resulting in C-23−C-24 bond dissociation was proposed as a characteristic CID fragmentation pathway, which can be used to further distinguish certain positional isomers containing the acetyl unit at the C-23 or C-24 position [23,24]. Such compounds usually occurred successive losses of H2O, acetic acid group (HAc, 60 Da) and other complex groups such as C4H8O (72 Da), C4H10O2 (90 Da) and C6H12O3 (132 Da). Peaks 96 was exactly identified as alisol B 23-acetate based on retention time and fragment behavior of reference standard. The high energy MSE spectra and the proposed fragment pathway of alisol B 23-acetate are depicted in Fig. 5. Alisol B 23-acetate showed [M+H]+ and [M+Na]+ ions at m/z 515.3735 and 537.3554, which underwent several dehydrations or deacetylations to form fragment ions at m/z 497.3629 [M + H-H2O]+, 479.3508 [M + H-2H2O]+, and 437.3415 [M + H-H2O-HAc]+, and then dissociation of the C-23−C-24 bond and loss of H2O gave rise to [M + H-C6H12O3]+ ion at m/z 383.2688. Peaks 87, 91, and 95 showed the similar fragmentation behavior to alisol B 23-acetate, and were identified as alisol A 23-actetate, alisol B, and alisol A 24-actetate, respectively.

Fig. 5.

Fig. 5

The MS spectra and fragmentation pathway of alisol B 23-acetate in positive ion mode.

Peak 92 had a protonated ion [M+H]+ at m/z 469.3310 with a molecular formula of C30H44O4, and formed characteristic ions at 451.3188 [M + H-H2O]+ and m/z 397.2745 [M + H-C4H8O]+ through 23-OH dehydration and C-23−C-24 dissociation. Thus, it was assigned as Alisol L. Owing to similar cleavage patterns by loss of C4H8O, peaks 69 and 88 were deduced to be alisol C and 11-deoxy-Alisol C, respectively. Peak 62 exhibited [M+H]+ ion at m/z 505.3223. Three typical dehydration ions at m/z 487.3327, 469.3285 and 451.3318 were generated from the hydroxyl groups. The dissociation of the C-23−C-24 bond via hydrogen rearrangement at C-23-OH produced diagnostic ion at m/z 415.2824 [M + H-C4H10O2]+, with further loss of H2O generating an ion at m/z 397.2783 [M + H-C4H10O2-H2O]+, so peak 62 was tentatively identified as 16-oxo-alisol A. Peak 90, 14Da less than that of 16-oxo-alisol A and similar to 16-oxo-alisol A, was further confirmed as alisol A.

3.2.4. Flavonoids

Ten flavones and their glycosides have been screened and identified in GDD using the UNIFI workflow. It is well known that the main MS behavior of flavone aglycones was RDA fragmentation pathway and losses of small molecules and/or radicals like CH3, CO and CO2 [25]. For flavones glycosides, the cleavage at glycosidic linkages could happen in both positive and negative ion modes, and 162 Da (Glc), 146 Da (Rha) and 308 Da (rutinoside) were the characteristic neutral loss of flavonoid-O-glycosides. The fragment ions with low m/z were the same as that of their aglycones. Among them, peaks 43 and 71 were ascertained to be quercetin and kaempferide by contrast with reference standards. Here we took quercetin and kaempferide as examples to describe the fragment patterns of these components. Quercetin displayed a deprotonated ion at m/z 301.0360 with a molecular formula of C15H10O7, and the ions at m/z 151.0451 [M−H-C8H6O3], 121.0431 [M−H-C8H6O3-CH2O] and 107.0162 [M−H-C8H6O3-CH2O-CH2] resulted from RDA cleavage. Kaempferide, with the parent ion [M−H] at m/z 299.0553, exhibited a diagnostic ion [M−H-CH3] at m/z 284.0489 and RDA cleavage ion at m/z 151.0055.

Peak 42 presented [M−H] ion at m/z 285.0406, which was 14 Da less than that of kaempferide, showing the similar fragment pathways as kaempferide. It was presumed as kaempferol. Peak 23 displayed [M−H] ion at m/z 593.1521 and produced predominant fragment ions at 447.1591 [M−H-Rha], 285.0832 [M−H-Rha-Glc] due to successive losses of glycoside fragments. Meanwhile, the ion at m/z 285.0832 further generated the characteristic ions identical to those of kaempferol, so the structure of this compound was considered as kaempferol-3-O-rutinoside. Analogously, peaks 16 and 30 were identified as rutin and hesperetin-5-O-glc, respectively.

3.2.5. Triterpenoid saponins

Eight triterpenoid saponins were detected from Panax notoginseng (Burk.) F. H. Chen in negative ion mode. These compounds offered the intense deprotonated ion [M−H] and adduct ion [M + HCOO]. The primary fragmentation pattern of triterpenoid saponins was the successive losses of glycosidic unit at the site of C-20, C-3 or C-6 of ginsenosides until the formation of [Aglycon−H] ions. The species and amount of glycosyl groups were observed from MS data, in which the mass differences of 162Da, 132Da and 146Da indicated the presence of glucose (Glc), xylose (Xyl), and rhamnose (Rha), respectively [26]. Peak 37 was definitely identified as notoginsenoside R1 with a reference standard. To facilitate characterization of these ginsenosides, the MS fragmentation pattern of notoginsenoside R1 is investigated in detail (Fig. 6). Notoginsenoside R1 gave [M−H] ion at m/z 931.5297 and [M + HCOO] ion at m/z 977.5354, along with three major fragment ions at m/z 799.4856 [M−H-Xyl], 637.4314 [M−H-Xyl-Glc], and 475.3782 [M−H-Xyl-2Glc] observed in high energy MSE spectra. Peak 55 showed deprotonated ion [M−H] at m/z 1107.5967 with a molecular formula of C54H92O23. The fragment ion at m/z 459.3824 [M−H-4Glc] represented glycosidic cleavage by loss of four glucose residues. Hence, it was tentatively characterized as ginsenoside Rb1.

Fig. 6.

Fig. 6

The MS spectra and fragmentation pathway of notoginsenoside R1 in negative ion mode.

Peak 41 displayed [M−H] and [M + HCOO] ions at m/z 799.4863 and 845.4921, respectively, and produced fragment ion at m/z 475.3784 by loss of two glucose residues. Thus, it was tentatively assigned to be ginsenoside Rg1. Peak 54 showed deprotonated ion at m/z 769.4768. The fragment ions at m/z 637.4335 [M−H-Xyl] and 475.3786 [M−H-Xyl-Glc] corresponded to successive neutral losses of xylose residue and glucose residue, indicating that peak 54 was notoginsenoside R2. Peak 57 gave [M−H] at m/z 783.4922, which further fragmented into m/z 637.4326 [M−H-Rha] and m/z 475.3789 [M−H-Rha-Glc], so their fragment ions suggested that it was ginsenoside Rg2. According to the cleavage of glycosidic linkages discussed above, peaks 58, 63 and 66 were tentatively identified as ginsenoside Rh1, ginsenoside Rd, and notoginsenoside R3, respectively.

3.2.6. Others

Four curcuminoids were recognized as the major active components in Curcuma longa L. Peak 74 was unambiguously identified as curcumin by comparison with a reference standard. Curcumin was taken as an example, which gave precursor ion at m/z 367.1192 [M−H] and diagnostic ion at m/z 217.0524 [M−H-C9H10O2] in negative ion mode. Analogously, peaks 56, 72 and 73 were identified as cyclocurcumin, bisdemethoxycurcumin and demethoxycurcumin, respectively. The fragmentation behaviors were in accordance with those previously reported in the literature [27].

In addition, there are small amounts of tannins in GDD, of which 10 components were identified as tannins or acylglucosides by comparing with the data in library. Peak 2 showed [M−H] ion at m/z 169.0141 as base peak, and fragment ion of m/z 125.0244 corresponding to the loss of CO2 residues. So it was tentatively identified as gallic acid. Peak 5 gave [M−H] ion at m/z 577.1359 with a molecule formula of C30H26O12, which yielded characteristic ions at m/z 425.0873 [M−H-C7H4O4], 407.0763 [M−H-C7H4O4-H2O] and 289.0712 [M−H-catechin]. Thus, it was tentatively deduced to be procyanidin B. Peak 9 exhibited [M−H] ion at m/z 729.1471 and fragment ion at m/z 577.1350 [M−H-gallate], suggesting that it had an additional gallate than procyanidin B. It was tentatively identified as procyanidin B-O-gallate. Based on the similar fragment pattern, peaks 1, 4 and 19 were determined as gallic acid-O-glc, (+)-catechin-5-O-β-D-glc and (+)-catechin-3-O-gallate by matching the data in library, respectively.

3.3. Contribution of individual herbs to GDD

The established method was subsequently applied to analyze individual herbal decoctions by UPLC-Q-TOF-MSE, and the relative sources of 96 compounds were also correspondingly confirmed. In summary, 37 components were from Rheum palmatum L., 15 components were from Coptis chinensis Franch., 9 components came from Curcuma longa L., 15 components were from Lysimachia christinae Hance, 17 components were from Alisma orientale (Sam.) Juzep. and 8 triterpenoid saponins were from Panax notoginseng (Burk.) F. H. Chen. The BPI chromatograms of six individual herbs in positive and negative ion modes are shown in Fig. 7. But each individual herb undoubtedly contributed to chemical components in GDD. Therefore, different sources and multiple types of pharmacodynamic components can exert better therapeutic effect through synergism or complementation.

Fig. 7.

Fig. 7

The base peak intensity (BPI) chromatograms of six individual herbs in positive (A) and negative (B) ion modes. DH = Rheum palmatum L., HL = Coptis chinensis Franch., JH = Curcuma longa L., JQC = Lysimachia christinae Hance, ZX = Alisma orientale (Sam.) Juzep. and SQ = Panax notoginseng (Burk.) F. H. Chen.

4. Conclusion

In this study, an integrative strategy based on UPLC-Q-TOF-MSE coupled with UNIFI informatics platform was applied for chemical profile analysis of GDD. To the best of our knowledge, it was the first time to reveal the constituents in GDD comprehensively. By comparison with retention time, accurate mass, fragmentation behavior, a total of 96 compounds were identified or tentatively characterized from GDD, including anthraquinones, alkaloids, protostane triterpenoids, flavonoids, triterpenoid saponins, tannins, curcuminoids and other compounds. Additionally, the ESI-MS fragmentation patterns of representative compounds in different chemical structure types were investigated. Most of the high response constitutions in individual herbs were also detected in GDD. This approach provided a rapid method for high throughput screening and characterization of constituents, and would be available in other TCM formulae analysis. What is more, the results could supply valuable information for the quality control and further study of GDD in vivo.

Moreover, we found that most of the compounds have abundant phenolic hydroxyl, especially the anthraquinones, curcumin and flavonoids. The structures of these compounds tend to be easily chelated by copper ions. Therefore, it is speculated that natural small molecules in GDD that could selectively chelate copper are able to form stable complexes to promote copper excretion. These molecules with properties would serve as a promising alternative to current treatments. This work has great guiding significance in further research and application of GDD in clinical treatment.

Acknowledgments

This research was supported by the National Natural Science Foundation of China (No: 81872976, 81873038, 81303245), Key Project of the National Science Fund of Anhui Province (No: KJ2016A398), Key Project Foundation of Oversea Visiting and Research for the Excellent Young and Middle-aged Faculties in Universities of Anhui Province (No: gxgwfx2018042), and Primary Research & Development Plan of Anhui Province (No: 201904a07020051).

Footnotes

Peer review under responsibility of Xi’an Jiaotong University.

Appendix A

Supplementary data to this article can be found online at https://doi.org/10.1016/j.jpha.2019.05.003.

Conflicts of interest

The authors declare that there are no conflicts of interest.

Appendix A. Supplementary data

The following is the Supplementary data to this article:

Multimedia component 1
mmc1.docx (34.7KB, docx)

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