1. Introduction
Bacterial co-infected pneumonia is an acute inflammatory reaction of the lungs caused by bacteria, especially by Gram-negative bacteria, which causes severe organic lesions in the lungs and exacerbates respiratory distress in the organism [
1,
2].
Klebsiella pneumoniae and
Escherichia coli are widely present in the external environment and often accompany co-infections, and they are common opportunistic pathogenic bacteria causing pneumonia and other symptoms in animals and humans [
3]. Antibiotics are commonly used to treat co-infections of
Klebsiella pneumoniae and
Escherichia coli, but studies have shown that the emergence of antibiotic resistance has become increasingly serious. The natural evolution of antibacterial resistance genes in
Klebsiella pneumoniae and
Escherichia coli have been reported be present in chromosomes, plasmids, or transposons and generate intrinsic antibiotic resistance through the following mechanisms: enzymatic antibiotic inactivation and modification, porin loss, enhanced antibiotic efflux pump expression and biofilm development [
4,
5]. Therefore, the sustainable discovery and development of new antibiotics and alternative therapeutic strategies are urgently needed [
6].
Thalictrum delavayi Franch. (
T. delavayi) is an important member of the buttercup family (
Ranunculaceae) and contains abundant alkaloids such as dimeric benzylisoquinoline alkaloids (thalidelavines A–E) and isoquinoline alkaloids (2,3,9,10-dimethylenedioxy-8-oxoprotoberberine and 2,3,9,10-dimethylenedioxy-1,8-dihydroxyprotoberberine). It has been used in traditional Chinese medicine, especially in Tibetan areas, for thousands of years [
7,
8]. Relevant studies have shown that alkaloids have important antibacterial, antioxidant, antitumor and blood glucose-lowering roles [
9,
10,
11]. Furthermore, alkaloids have anti-inflammatory effects, decreasing the expression of pro-inflammatory factors and increasing the expression of anti-inflammatory factors [
12,
13]. Notably, alkaloids have demonstrated good bacteriostatic activity similar to that of commonly used antimicrobial agents, suggesting the potential to replace antibiotics and the discovery of novel anti-inflammatory drugs [
14].
In this study, the total alkaloids from T. delavayi were first extracted, purified and quantified by response surface methodology (RSM), macroporous absorption resin and high-performance liquid chromatography (HPLC), respectively. Subsequently, bacterial counts of Klebsiella pneumoniae and Escherichia coli; white blood cell counts; the classification of inflammatory cells in bronchoalveolar lavage fluid (BALF); and the contents of IL-4, IL-6, TNF-α, CRP and PCT in the serum were determined in a Klebsiella pneumoniae–Escherichia coli co-infection mouse model to elucidate the therapeutic potential of the total alkaloids from T. delavayi, providing experimental data support for the treatment of pulmonary infection caused by Klebsiella pneumoniae and Escherichia coli.
2. Material and Methods
2.1. Plant Material, Bacterial Strains and Animals
Whole T. delavayi plants were collected from Hailougou Glacier Park, Luding County, Ganzi Tibetan Autonomous Region, Sichuan Province, China, in August 2017 and were identified by associate professor Chaoxi Chen of Southwest Minzu University. The voucher specimens were kept at the College of Animal and Veterinary Sciences of Southwest Minzu University (voucher specimen number: SWUN-Ran-2017-0042). Specifically, the whole dry plant was ground using an analytical batch mill, and the uniform granulometry of the herbal powder was ensured. Four alkaloid compound standards (berberine, thalicarpine, tetrandrine and jatrorrhizine) were purchased from Shanghai Yuanye Bio-Technology Co., Ltd. (Shanghai, China).
The clinical isolates of Klebsiella pneumoniae (strain number: FY164, resistant to doxycycline) and Escherichia coli (strain number: DC123, resistant to sulfamethoxazole) were isolated from dead yaks with pulmonary infections in October 2017 and were preserved at the Laboratory of Veterinary Pharmacology and Toxicology of Southwest Minzu University.
Female and male KM mice (18–22 g) were purchased from Chengdu Dossy Experimental Animals Co., Ltd. (Chengdu, China). The animal experiment was approved by the Institutional Animal Care and Use Committee of Southwest Minzu University. The subjects were allowed 7 days for acclimatization, and clean drinking water and commercial pelleted feed were freely provided during the experiments.
2.2. ELISA Kits and Chemical Reagents
Enzyme-linked immunosorbent assay (ELISA) kits for IL-4, IL-6,TNF-α, PCT and CRP were purchased from Nanjing Jiancheng Bioengineering Institute (Nanjing, China). Ethanol and all the other chemical reagents used in this study were of analytical grade or HPLC grade.
2.3. Extraction and Purification of the Total Alkaloids from T. delavayi
To obtain the maximal yield of total alkaloids from T. delavayi, a Box–Behnken design (BBD) was applied to optimize the reaction conditions, which included hydrochloric acid volume fraction, solid–liquid ratio and sonication time. Based on the results of the single-factor test, the BBD was created using Design-Expert software version 12.0 to produce a model for optimizing the total alkaloid component of T. delavayi.
2.3.1. Single-Factor Testing
Crude total alkaloids were extracted using dilute hydrochloric acid (0.2%, 0.4%, 0.6%, 0.8%, 1%) with various solid-to-liquid ratios (1:4, 1:6, 1:8, 1:10 and 1:12) and sonication times (20 min, 30 min, 40 min, 50 min and 60 min). The ground powder (20 g) was added to a 500 mL flask; then, a given volume of diluted hydrochloric acid was added to the flask and sonicated at 50 °C for a given time. The solution was separated and dried in a vacuum freeze-dryer. Finally, the dried crude total alkaloids were ground into fine particles, and a 0.15 g/mL solution was prepared.
A spectrophotometric method was used for the determination of total alkaloids based on the reaction with Bromocresol Green [
15]. A standard curve of berberine was prepared through a series of calibration standards (10, 20, 30, 40 and 50 μg/mL). Briefly, a 0.5 mL solution was added to a 25 mL flask; subsequently, 3.0 mL of 0.04% Bromocresol Green and 4 mL of phosphate buffer (pH 4.0, adjusted to a pH of 0.2 M sodium phosphate with 0.1 mol/L citric acid in equal volumes) were added. Finally, 10 mL of chloroform was added, and the mixture was vigorously shaken for 2 min before standing for 30 min. Then, the lower chloroform layer was removed, and OD values at were detected413 nm.
2.3.2. Response Surface Methodology (RSM)
A three-level, three-factor Box–Behnken-design methodology was undertaken in accordance with a previous study [
16]. Three factors—the hydrochloric acid volume fraction (A), solid–liquid ratio (B) and sonication time (C)—were selected as independent variables, and the yield of berberine (Y) was set as the response variable. Variables were fixed at three levels, namely, low (−1), midpoint (0) and high (+1), with A (−1) being 0.4%, 0.6% and 0.8%; B being 1:8, 1:10 and 1:12 g·mL
−1; and C being 40, 50 and 60 min, respectively (
Table 1). To protect the compounds from degradation, the extraction temperature was maintained at 50 °C for the entirety of the experiment.
A total of seventeen independent experiments were carried out in randomized order and are shown in
Table 1. Extraction runs were performed according to the order established, and the polynomial equation was used to fit the experimental data of the variables. The statistical significance of terms in the REs was verified via an ANOVA (analysis of variance). Statistically non-significant terms (
p > 0.05) were excluded, and only the experimental data were fitted to significant parameters (
p < 0.05). A coefficient of determination (R
2) value of close to 1 in this model denotes excellent prediction efficiency, and adjusted R
2 (Adj.R
2) values were also estimated to test the model’s accuracy. Both the
F-value and lack-of-fit (LOF) returned a probability of 0.05 in the regression model. Finally, the responses observed in the regression models were graphically represented as contour plots and three-dimensional plots.
To validate the model, the experimental data were compared to the predicted data. The optimal extraction conditions for the maximum yield of berberine were then validated. Model validation was performed by extracting the yield of berberine under optimal conditions per the analytical procedure followed in the experimental runs.
2.3.3. Purification of Total Alkaloids from T. delavayi
Macroporous absorption resin was used for the removal of impurities from the total alkaloids of T. delavayi because of its advantages of having low cost, strong adsorption and high selectivity. In this study, D101 macroporous absorption resin was selected for the purification of total alkaloids from T. delavayi. The following optimal conditions for the purification of total alkaloids from T. delavayi were determined: 50 mg/mL ethanol concentration and 1.5 BV·h−1 flow rate for both adsorption and desorption using volumes of 2 and 3 BV, respectively.
2.4. Chromatographic Determination of the Total Alkaloids from T. delavayi
After purification, the total alkaloid content of
T. delavayi was determined via high-performance liquid chromatography (HPLC) [
17]. Alkaloid compounds were separated using a reversed-phase Waters C
18 column (BEH C
18, 1.7 μm, 2.1 mm, 150 mm), and HPLC-PDA chromatograms were recorded at an excitation wavelength of 254 nm. The following mobile phases were employed for elution: (i) water acidified with 0.1% phosphoric acid (Solvent A) and (ii) acetonitrile (Solvent B). A 27 min gradient elution at 40 °C and a flow rate of 0.8 mL/min were applied. The mobile phase and gradient elution procedures are listed in
Table 2.
2.5. In Vitro Antibacterial Assay
The in vitro antimicrobial activity of the total alkaloidal constituents from
T. delavayi was evaluated against the bacterial strains
Klebsiella pneumoniae (FY164) and
Escherichia coli (DC123). Minimum inhibitory concentrations (MICs) were determined via broth microdilution [
18,
19]. Briefly,
Klebsiella pneumoniae (FY164) and
Escherichia coli (DC123) were incubated at 37 °C for 12 h. Turbidity was adjusted with sterile MH broth to achieve a suspension containing 1.0 × 10
5~1.0 × 10
6 CFU/mL. The total alkaloid content from
T. delavayi was dissolved in distilled water, and a serial dilution technique was used to generate solutions with different concentrations (0.39~100.0 mg/mL). Microplates with bacterial suspensions and serial concentrations of total alkaloids from
T. delavayi were incubated at 37 °C for 16 h. Distilled water and levofloxacin were used as a negative control and positive control, respectively. The lowest concentrations without visible growth were defined as MICs, and the minimal antibacterial density necessary to kill bacteria was used as the minimum bactericidal concentration (MBC). ATCC25922 was used for susceptibility testing as a reference strain.
2.6. Acute Toxicity and Cumulative Toxicity
Acute oral toxicity testing was carried out according to the Chinese Standard GB 15193.3-2014 [
20]. A total of 20 female KM mice were randomly grouped before adaptation for 1 week and were given ad libitum access to food and water during the test. Mice were gavaged with a single dose of 10 g/kg body weight (BW) of total alkaloids from
T. delavayi. Body weight changes and survival rates were monitored daily after administration for 14 days, and histopathology observations of the heart, liver, spleen, lung and kidney were evaluated. Meanwhile, the organ coefficient was calculated by dividing the organ weight by the total body weight.
In the cumulative toxicity test, 20 female KM mice were gavaged with total alkaloids from T. delavayi over a 4-day cycle that featured 1.5-fold dose increments at 1000 mg/kg BW, 1500 mg/kg BW, 2250 mg/kg BW, 3375 mg/kg BW and 5060 mg/kg BW. The experiment lasted for 21 days; body weight and survival rate were monitored, and histopathology observations of heart, liver, spleen, lung and kidney were evaluated. The organ coefficient was calculated as described for the acute oral toxicity test.
2.7. Therapeutic Effect of Total Alkaloids from T. delavayi on Klebsiella pneumoniae–Escherichia coli Mixed Pulmonary Infection
2.7.1. Animal Model and Administration Protocol
A total of 66 female KM mice were weighted, numbered and randomly grouped into six groups, using a random digit table, for one week before adaptation; they were given ad libitum access to food and water. Overnight cultures of Klebsiella pneumoniae and Escherichia coli were rinsed with sterile saline and adjusted to 1.5 × 108 CFU/mL before being equally mixed in a ratio of 1:1 (v/v). With the exception of the control group, 11 mice from each group were administered with the mixed bacterial cultures for 3 days continuously via intranasal instillation. The administration protocol was as follows: levofloxacin was given to the positive control group at a dose of 80 mg/kg BW, and the high-dose group, medium-dose group and low-dose group were administered, by gavage, a dose of 1000 mg/kg BW, 500 mg/kg BW and 250 mg/kg BW, respectively, of total alkaloids from T. delavayi. The model group and control group received sterile saline by gavage. Common clinical conditions were observed and recorded post-treatment.
2.7.2. Mice Dissection and Sample Collection
Mice were euthanized, and organs were collected for pathological observation. Bronchoalveolar lavage fluid (BALF) and blood samples were collected for the enumeration of bacteria and inflammatory biomarker measurement.
2.7.3. Pathological Observation
The histopathological diagnosis of hematoxylin and eosin (H&E)-stained mice tissues was performed by conventional light microscopy.
2.7.4. Bacterial Enumeration, White Blood Cell Counts and Classification of Inflammatory Cells in BALF
The BALF procedure followed a standardized protocol. Except for the control group, 1 mL of sterilized PBS solution was instilled through the working channel, and the procedure was repeated three times. BALF was retrieved and collected for pathogen cultivation and bacterial enumeration on MH agar containing doxycycline (25 mg/mL) and sulfamethoxazole (50 mg/mL), including Klebsiella pneumoniae and Escherichia coli.
White blood cell counts and the classification of inflammatory cells in the BALF of mice were determined using a cell chamber after May–Grunwald–Giemsa staining. White blood cell count and percentages of eosinophils and neutrophils were also calculated.
2.7.5. Detection of Cytokine Concentrations
Blood IL-4, IL-6, TNF-α, CRP and PCT concentrations were measured using ELISA kits in accordance with the procedure provided by the manufacturer.
2.8. Statistical Analysis
The experimental data were preprocessed using Microsoft Excel. The data were statistically analyzed and processed by SPSS20.0 and Origin2021. Contour plots and surface 3D graphs were obtained using Design-Expert software version 12.0.
4. Discussion
The optimization of extraction parameters via response surface methodology (RSM) has become a common methodological approach to producing reliable determinations. In this study, RSM was used to optimize the extraction of total alkaloids from
T. delavayi. The optimal conditions for the production of total alkaloids were as follows: a hydrochloric acid volume fraction of 0.8%, a solid–liquid ratio of 1:12 and a sonication time of 54 min. Under the optimal conditions, the experimental yield of total alkaloids was 2.46%, in agreement with the predicted value; this indicates that RSM is suitable for optimizing the extraction process through analyzing influential factors and the interaction of said factors [
22]. To optimize the extraction of total alkaloids from
T. delavayi, a single-factor experiment design was carried out to investigate the effect of a given factor on a given response, according to previous studies [
23]. The determination of total alkaloid content in
T. delavayi was achieved through the acid dye colorimetric method, which has the advantages of low instrumentation cost, reasonable sensitivity, high accuracy and easy execution [
24,
25].
Impurity removal is commonly used for the purification of Chinese herbal medicines [
26]. In this study, D101 macroporous absorption resin was used for purification, and the four major alkaloid components of total alkaloids from
T. delavayi were identified via high-performance liquid chromatography. In this study, four of these alkaloids (thalicarpine, jatrorrhizine, tetrandrine and berberine) were detected qualitatively and quantitatively. When the extracts were subjected to HPLC, and in comparison to standards, four peaks were observed, and retention times were recorded to calculate the concentration of alkaloids. The optimal extraction method presented four peaks quite similar to those of the standard and almost the same retention time, indicating that the alkaloid composition of extracts used in the study contained thalicarpine, jatrorrhizine, tetrandrine and berberine. Based on toxicity testing, our results show that the total alkaloids from
T. delavayi are safe, even in high doses (1000 mg/kg BW).
The irrational use of antibacterial agents has led to genetic mutations and the development of drug resistance in many pathogenic bacteria [
27]. Natural plant components have positive impacts on health, and many medicinal plant natural products are a major source of substances used in traditional and modern medicine [
28,
29]. The MIC is a key indicator that can be used to evaluate antibacterial activity. In this study, total alkaloids from
T. delavayi were found to have good in vitro antibacterial activity against
Klebsiella pneumoniae and
Escherichia coli, presenting inhibitory activity at concentrations of 12.5 mg/mL and 6.25 mg/mL, respectively.
In recent years, bacterial infections have become a more significant threat to humans and animals, a situation exacerbated by increasing antibiotic resistance [
30]. Animal models have contributed substantially to unravelling the physiopathology of infections, such as pathogenic and nonpathogenic
Escherichia coli [
31,
32]. A mixed bacterial pulmonary infection model was established in this study, and results of bacterial counts in BALF showed that the number of bacteria decreased, thereby verifying that total alkaloids from
T. delavayi had an inhibitory effect on
Klebsiella pneumoniae and
Escherichia coli. The extent of lung damage was significantly improved, indicating that the total alkaloids of
T. delavayi had a potential therapeutic effect on the mixed pulmonary infection caused by
Klebsiella pneumoniae and
Escherichia coli. Furthermore, animal testing showed that total alkaloids from
T. delavayi effectively improved clinical symptoms in bacterial infectious pneumonia, which was consistent with the previous studies [
33,
34].
TNF-α, a multifunctional cytokine associated with inflammatory diseases, is released by a variety of immune cells and induces the production of IL-4 and IL-6 [
35,
36]. Mixed infections can cause inflammatory responses and the increased presence of inflammatory cytokines in the lungs, thus further accelerating pulmonary congestion and parenchymal abnormalities [
35,
37]. In this study, TNF-α, IL-4 and IL-6 were significantly increased in mice with bacterial infections, while organ damage and pro-inflammatory factors were significantly reduced after treatment with total alkaloids from
T. delavayi; the high-dose group in our study showed the most significant improvement, thanks to the ameliorative effect of total alkaloids from
T. delavayi on mice with mixed
Klebsiella pneumoniae and
Escherichia coli infection.
PCT and CRP have been used as new approaches to identifying different types of infections to avoid the abuse and misuse of antibiotics during the diagnosis of bacterial infections. In the present study, CRP and PCT increased to a significant degree in the model group, and the serum PCT and CRP levels were significantly reduced after the administration of total alkaloids from T. delavayi, indicating that total alkaloids from T. delavayi have potential therapeutic utility in pulmonary infection caused by Klebsiella pneumoniae and Escherichia coli.