1.Exploration of Pulmonary Vascular Remodeling Improvement in Rats at Different Stages of Chronic Obstructive Pulmonary Disease by Qibai Pingfei Capsules Based on TLR4/NF-κB Signaling Pathway
Lu ZHANG ; Li FANG ; Shuyu XU ; Xue LIANG ; Jie ZHU ; Xiangli TONG ; Zegeng LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):48-56
ObjectiveTo investigate the improvement effect of Qibai Pingfei capsules on pulmonary vascular remodeling in rats at different stages of chronic obstructive pulmonary disease (COPD) and to analyze its possible mechanism of action. MethodsMale Sprague-Dawley (SD) rats were randomly divided into a normal group, an early COPD model group, an advanced COPD model group, an early-intervention high-dose group, a late-intervention high-dose group, an early-intervention low-dose group, a late-intervention low-dose group, an early-intervention pyrrolidine dithiocarbamate (PDTC) group, and a late-intervention PDTC group, with 15 rats in each group. A rat model of early COPD was constructed by using cigarette smoke combined with airway infusion using lipopolysaccharide(LPS), and a rat model of advanced COPD was constructed by using airway infusion with LPS, cigarette smoke, and hypoxia. All groups except the normal group were given LPS airway drops on days 1 and 14 of the experiment, smoked for 1 h per day, and administered the drug once a day for 40 weeks from day 15 onward. In the high- and low-dose groups, rats were given 1 g·kg-1 and 250 mg·kg-1 Qibai Pingfei capsules, respectively by gavage, and in PDTC groups, rats were given 100 mg·kg-1 of PDTC by intraperitoneal injection. The advanced COPD model group underwent 6 h of hypoxia per day in weeks 5-6. Lung function and mean pulmonary artery pressure were tested in rats. Morphologic changes in lung tissues were detected by hematoxylin-eosin(HE)staining. Collagen deposition in lung tissues was examined by Masson staining, and the levels of inflammatory factors including interleukin-1β(IL-1β), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)in lung tissues were detected by enzyme-linked immunosorbent assay (ELISA). The number of inflammatory cells in the alveolar lavage fluid of rats in each group was detected by Giemsa staining, and the protein expression of Toll-like receptor 4(TLR4), myeloid differentiation factor 88(MyD88), nuclear factor-κB(NF-κB), TNF-α, vascular endothelial-cadherin(VE-cadherin), α-smooth muscle actin(α-SMA), and platelet endothelial cell adhesion molecule-1(CD31) was detected by Western blot in the lung tissues of rats. ResultsCompared with the normal group, the model group showed significantly decreased forced expiratory volume in 0.3 s (FEV0.3), forced vital capacity (FVC), and FEV0.3/FVC ratio related to lung function (P<0.05), thickening of pulmonary vasculature, increased collagen deposition in the lungs, and enhanced mean pulmonary arterial pressure and expression levels of IL-6, IL-1β, and TNF-α (P<0.05). Additionally, the model group also exhibited increased numbers of macrophages, lymphocytes, and neutrophils (P<0.05), significantly higher protein expression of TLR4, MyD88, NF-κB, TNF-α, and α-SMA (P<0.05), and significantly lower protein expression of VE-cadherin and CD31 (P<0.05). Lung function was significantly improved in the Qibai Pingfei capsules groups compared with the model group (P<0.05), with mean pulmonary arterial pressure reduced and pulmonary vascular thickening and collagen deposition in the lungs ameliorated. The Qibai Pingfei capsules groups also showed reduced expression levels of IL-6, IL-1β, and TNF-α (P<0.05) and decreased numbers of macrophages, lymphocytes, and neutrophils (P<0.05), as well as reduced protein expression of TLR4, MyD88, NF-κB, TNF-α, and α-SMA (P<0.05) and elevated protein expression of VE-cadherin and CD31 (P<0.05) in rat lung tissues. ConclusionQibai Pingfei capsules inhibits inflammatory response and endothelial-to-mesenchymal transition probably by regulating the TLR4/NF-κB signaling pathway, thus improving pulmonary vascular remodeling in COPD model rats and showing therapeutic effects in the early stage of COPD.
2.Association of MICA gene polymorphisms and SNP loci with susceptibility to rosacea.
Xiangli YIN ; Quan ZHU ; Ji LI ; Yizhou ZOU ; Qizhi LUO
Journal of Central South University(Medical Sciences) 2025;50(3):319-330
OBJECTIVES:
The major histocompatibility complex class I chain-related gene A (MICA), a component of the human leukocyte antigen (HLA) gene complex, is involved in the pathogenesis of various diseases including cancers and autoimmune disorders. Rosacea, a chronic inflammatory skin disease with a complex pathogenesis, potentially influenced by genetic and autoimmune factors. This study aims to investigate the relationship among MICA gene polymorphisms, single nucleotide polymorphisms (SNPs), and susceptibility to rosacea, thereby offering new insights into the disease mechanism.
METHODS:
Peripheral blood DNA samples were collected from 84 patients with rosacea (rosacea group) and 223 healthy volunteers (control group) who visited the Dermatology Outpatient Department of Xiangya Hospital of Central South University between November 2017 and November 2019. MICA genotyping was performed using polymerase chain reaction-sequencing-based typing (PCR-SBT) and the next-generation sequencing (NGS), and the accuracy of the 2 methods was compared. The frequency distributions of MICA alleles between the 2 groups were analyzed. Amino acid clustering and SNP site analyses were conducted to identify haplotype-linked SNPs and to classify MICA polymorphic variants. Distribution differences of these classifications between groups were also examined.
RESULTS:
Blood tests in rosacea patients showed mildly elevated, with no significant changes in lymphocyte counts. Both PCR-SBT and NGS accurately identified MICA alleles. The most common alleles in the rosacea group were MICA*010:01, MICA*008:04, and MICA*019:01. The frequencies of MICA*002:01 and MICA*027 were significantly lower in the rosacea group compared to controls (6.55% vs 18.16% and 1.19% vs 5.38%, respectively), while and MICA*010:01 were significantly higher (7.74% vs 3.36% and 31.55% vs 18.61%, respectively; all P<0.05). Five short tandem repeat (STR) alleles were identified. Frequencies of MICA-A4 and MICA-A9 were lower in the rosacea group than in the control group (16.07% vs 23.32% and 7.74% vs 17.26%, respectively), whereas MICA-A6 was higher (10.12% vs 4.03%; all P<0.05). Clustering and SNP analysis identified 6 linked SNP sites, classifying MICA variants into Type I (C36+M129+K173+G206+W210+S215) and Type II (Y36+V129+E173+S206+R210+T215). Type I MICA variants were significantly associated with rosacea susceptibility.
CONCLUSIONS
MICA gene polymorphisms are associated with susceptibility to rosacea, and there are 6 linked SNP sites within the MICA gene. Based on this, MICA polymorphic variants are classified into Type I and Type II, with Type I being more closely associated with disease development of rosacea.
Humans
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Polymorphism, Single Nucleotide
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Histocompatibility Antigens Class I/genetics*
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Rosacea/genetics*
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Genetic Predisposition to Disease/genetics*
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Female
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Male
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Adult
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Middle Aged
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Genotype
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Alleles
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Gene Frequency
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Haplotypes
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Case-Control Studies
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Aged
;
High-Throughput Nucleotide Sequencing
3.A retrospective analysis of the clinical characteristics of 63 patients with vestibular neuritis.
Qi WANG ; Gendi YIN ; Shuqi ZHANG ; Qiling HUANG ; Lingwei LI ; Zhicheng LI ; Xiangli ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(1):19-23
Objective:To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology, Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University, from October 2012 to December 2022 were recruited. All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis. Clinical data and the results of pure tone audiometry, electrocochleogram, video electronystagmogram, caloric test, cervical vestibuloevoked myogenic potential(cVEMP), ocular vestibuloevoked myogenic potential(oVEMP), video head impulse test(vHIT) was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group. The differences of blood indexs and lipid metabolism indexes between the two groups were compared. Results:In patients with vestibular neuritis, 50 out of 63 patients presented normal threshold in pure tone audiometry, 8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss, 56 out of 63 cases completed the electrocochleogram, of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4, 5 cases had monaural amplitude ratio ≥0.4. Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all. The ratio of patients completed cVEMP, oVEMP and vHIT were 46 cases, 22 cases and 30 cases, respectively. 17 out of 63 cases completed all the four vestibular function tests. According to these tests, 49 patients could determine the extent of injury,including 27 cases with unilateral superior vestibular nerve injury, 21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury. There were significant differences in neutrophil value(P<0.001), lymphocyte value(P<0.005), neutrophil/lymphocyte ratio(P<0.001) and apolipoprotein A1(P<0.001) between patient group and control group. Inflammatory markers were risk factors for patients with vestibular neuritis. The OR values of neutrophil value and blood neutrophil/lymphocyte ratio were 1.81(1.38-2.37, P<0.001) and 2.11(1.41-3.16, P<0.001), respectively. Apolipoprotein A1 was a protective factor for patients with vestibular neuritis, and the OR value was 0.004(0.001-0.042, P<0.001). Conclusion:Electrocochleogram could be used in vestibular neuritis patients with normal pure tone threshold to test whether there is hidden hearing loss in these patients. Neutrophil value, lymphocyte value, neutrophil/lymphocyte ratio and apolipoprotein A1 were correlated with vestibular neuritis. The Neutrophil value and neutrophil/lymphocyte ratio were risk factors for morbidity.
Humans
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Vestibular Neuronitis/physiopathology*
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Retrospective Studies
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Female
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Male
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Audiometry, Pure-Tone
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Hearing Loss, Sensorineural/physiopathology*
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Middle Aged
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Adult
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Vestibular Function Tests
;
Vestibular Evoked Myogenic Potentials
;
Aged
4.Discovery of bioactive polycyclic polyprenylated acylphloroglucinol from Hypericum patulum that protects against hepatic ischemia/reperfusion injury.
Bo TAO ; Xiangli ZHAO ; Zhengyi SHI ; Jie LI ; Yulin DUAN ; Xiaosheng TAN ; Gang CHEN ; Changxing QI ; Yonghui ZHANG
Chinese Journal of Natural Medicines (English Ed.) 2025;23(9):1104-1110
Hepatic ischemia/reperfusion injury (IRI) remains a critical complication contributing to graft dysfunction following liver surgery. As part of an ongoing search for hepatoprotective natural products, five previously unreported homoadamantane-type polycyclic polyprenylated acylphloroglucinols (PPAPs), named hyperhomanoons A-E (1-5), and one known analog, hypersampsone O (6), were isolated from Hypericum patulum. Among these, compound 6 demonstrated potent protective effects against CoCl₂-induced hypoxic injury in hepatocytes. Furthermore, in a murine model of hepatic IRI induced by vascular occlusion, pretreatment with 6 markedly alleviated liver damage and reduced hepatocyte apoptosis. This study is the first to identify PPAPs as promising scaffolds for the development of therapeutic agents targeting hepatic IRI, underscoring their potential as lead compounds in drug discovery efforts for ischemic liver diseases.
Reperfusion Injury/prevention & control*
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Animals
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Hypericum/chemistry*
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Phloroglucinol/administration & dosage*
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Mice
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Humans
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Male
;
Liver/blood supply*
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Apoptosis/drug effects*
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Molecular Structure
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Protective Agents/pharmacology*
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Hepatocytes/drug effects*
;
Mice, Inbred C57BL
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Liver Diseases/drug therapy*
5.Wenxiao Powder Alleviates Depression by Promoting Neurogenesis via BDNF/TrkB/ERK/CREB Signaling Pathway
Duo ZHANG ; Xiuhui GUO ; Yucheng LI ; Yunli GAO ; Ming BAI ; Xiangli YAN ; Erping XU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(8):100-108
ObjectiveTo decipher the mechanism of Wenxiao powder in alleviating corticosterone-induced depression-like behaviors in mice. MethodMale ICR mice were randomized into normal, model, paroxetine (20 mg·kg-1), and low- and high-dose (3.27, 6.54 g·kg-1, respectively) Wenxiao powder groups. The mice in normal and model groups received equal volume of saline. Other groups except the normal group were injected with corticosterone subcutaneously 0.5 h after gavage to induce depression. Mice were tested for depression-like behaviors after drug administration. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the corticosterone content in the serum. Nissl staining was performed to observe the damage of hippocampal neurons. Immunofluorescence staining was employed to observe the expression of double cortin (DCX) in the dentate gyrus (DG) of the hippocampus. Western blot was employed to determine the expression of proteins in the brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB)/extracellular signal-regulated kinase (ERK)/cAMP-response element-binding protein (CREB) pathway in the hippocampus. ResultCompared with the normal group, the model group showed decreased sucrose preference rate, increased immobility time in the tail suspension test (P<0.01), and reduced residence time in the central area of the open field and the total movement distance (P<0.05, P<0.01). In addition, the modeling elevated the corticosterone level in the serum (P<0.01), decreased the volume and intensified the nuclear staining of hippocampal neurons in the DG area, reduced the expression of DCX in the DG area, and down-regulated the protein levels of BDNF, phosphorylated (p)-TrkB, p-ERK, and p-CREB in the hippocampus (P<0.05, P<0.01). Compared with the model group, low-dose Wenxiao powder improved the mouse behavivors in the sucrose preference, open field, and tail suspension tests (P<0.05, P<0.01), and high-dose Wenxiao powder improved the behaviors in the sucrose preference and open field tests (P<0.05, P<0.01). In addition, Wenxiao powder lowered the serum corticosterone level (P<0.01) and recovered the structure and morphology of neurons with obvious nuclei and presence of Nissl bodies in the DG area of the hippocampus. Moreover, Wenxiao powder at both doses promoted the expression of DCX in the DG area, and high-dose Wenxiao powder up-regulated the protein levels of BDNF, p-TrkB, p-ERK, and p-CREB in the hippocampus (P<0.05, P<0.01). ConclusionWenxiao powder can alleviate corticosterone-induced depression-like behaviors and promote neurogenesis in mice possibly by activating the BDNF/TrkB/ERK/CREB signaling pathway.
6.Screening of anti-COPD quality biomarkers of Gnaphalium affine
Wanting LIU ; Rong XIE ; Dahuai LIN ; Xiangli YE ; Guohong YAN ; Huang LI
China Pharmacy 2024;35(6):683-688
OBJECTIVE To screen the quality biomarkers of Gnaphalium affine with anti-chronic obstructive pulmonary disease (COPD) effect and determine their contents. METHODS The effective components and targets of “G. affine” with anti- COPD effect were predicted by using network pharmacology as a search criterion. HPLC fingerprints for 10 batches of G. affine were established by using Similarity Evaluation System of TCM Chromatographic Fingerprint (2012 edition); common peak identification and similarity evaluation were conducted; cluster analysis (CA), principal component analysis (PCA), and orthogonal partial least squares-discriminant analysis (OPLS-DA) were performed to screen differential components as quality maker that affected the quality of G. affine using variable importance projection (VIP)>1 as the standard. The same HPLC method was adopted to determine the contents of the differential components in 10 batches of samples. RESULTS A total of 10 flavonoids (such as quercetin, luteolin, and chlorogenic acid) and organic acid components, were identified through network pharmacology search, with 91 targets closely related to anti-COPD. A total of 9 common peaks were identified in 10 batches of samples, with similarity greater than 0.90. Among them, the differential components included chlorogenic acid, caffeic acid, 1,3-O- dicaffeoylquinic acid and apigenin 7-O-β-D-glucopyranoside; S3, S4, S6, S7 and S10 were clustered into one category, S2, S5, S8 and S9 clustered into one category, and S1 clustered into one category. The contents of chlorogenic acid, caffeic acid, 1,3-O- dicaffeoylquinic acid, and apigenin 7-O-β-D-glucopyranoside in 10 batches of G. affine ranged 0.070-7.653, 0.010-0.097, 0.001- 0.036, 0.508-6.627 mg/g, respectively. CONCLUSIONS Chlorogenic acid, caffeic acid, 1,3-O-dicaffeoylquinic acid, apigenin 7- O-β-D-glucopyranoside can serve as the potential quality marker for the anti-COPD effect of G. affine, with the highest content of chlorogenic acid in G. affine produced in Ji’an, Jiangxi province, and the highest content of caffeic acid in G. affine produced in Ji’an, Jiangxi province and Sanming, Fujian province. The contents of the last two components are highest in G. affine produced in Chaoshan, Guangdong province.
7.Stellate Ganglion Block as an Adjunctive Intervention for Chronic Subjective Tinnitus: Efficacy and Predictive Indicators
Zhicheng LI ; Nan CHENG ; Jibin XING ; Jiawang TIAN ; Jianqi ZHAO ; Huajing TIAN ; Jiayi LIN ; Xiangli ZENG
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(2):276-282
ObjectiveTo explore the efficacy and predictive indicators of stellate ganglion block (SGB) as an adjunctive intervention for chronic subjective tinnitus and accumulate experience for the application of SGB in the clinical treatment of tinnitus. MethodsA retrospective review was conducted on the data of chronic subjective tinnitus patients who received SGB intervention, with unsatisfactory outcomes otherwise. Pure tone audiometry (PTA), tinnitus loudness evaluation and Pittsburgh sleep quality index (PSQI) were used. The tinnitus handicap inventory (THI) scores were compared before and after SGB intervention. Correlation analysis and linear regression equations were employed to identify the potential indicators predicting the effectiveness of SGB intervention. Statistical analysis was performed by SPSS 24.0 software. ResultsBy April 2023, a total of 107 patients with chronic subjective tinnitus had undergone SGB intervention, including 67 male and 40 female, with a mean age of (45.32±11.40) years old and an average tinnitus history of (20.32±24.64) months [16 (12~20)]. Only 7 patients (6.54%) quitted the intervention for personal reasons, which demonstrated good compliance with the intervention. No patients experienced adverse reactions such as infection at the injection site, hematoma, nerve injury, local anesthetic intoxication and so on, which revealed good safety. After SGB intervention, THI scores decreased to below 36 points in 77 patients and decrease by 10 points or more in 12 of the remaining patients, with a total effective rate of 89%. A paired sample t-test showed a significant difference in THI scores before and after SGB intervention (t=15.575, P<0.001), indicating good improvement. Pearson correlation analysis suggested that pre-intervention THI scores and subjective tinnitus loudness were significantly positively correlated with the improvement level of THI scores (P<0.05). Further stepwise linear regression analysis found that "pre-intervention THI scores" had statistical significance (P<0.001), with a regression coefficient of 0.308, predicting a 17.4% improvement level in THI scores. ConclusionsDue to its good and safe short-term effects, SGB intervention can be used as a supplementary option for chronic subjective tinnitus when other interventions are not ideal, especially for patients with higher THI scores. However, further research is needed to clarify the long-term efficacy and underlying mechanisms, in order to establish a more solid theoretical basis for SGB intervention in the treatment of subjective tinnitus.
8.Role of Flavonoids in Traditional Chinese Medicine to Improve Cerebral Ischaemia-reperfusion Injury and Its Mechanism: A Review
Lu YUE ; Tianbao ZHOU ; Xiangli YAN ; Mingsan MIAO ; Yan LI ; Ming BAI
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):269-279
Cerebral ischemia-reperfusion injury (CIRI) has a very high incidence, disability, and mortality rates, which seriously affects human life and health. In recent years, modern medicine has made some progress in the diagnosis and treatment of CIRI, but there are still problems such as difficulties in postoperative rehabilitation and adverse drug reactions, and new therapeutic drugs for CIRI are urgently needed. As an important class of active ingredients in traditional Chinese medicine, flavonoids can play antioxidant, apoptosis inhibition, anti-inflammatory, and other pharmacological effects to improve brain tissue damage, which is important for improving the quality of life of CIRI patients and slowing down the aging of the social population. Numerous studies have found that flavonoids in traditional Chinese medicine can regulate cell surface receptors Toll-like receptor 4/nuclear factor-kappaB (TLR4/NF-κB), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), adenylate-activated protein kinase/mammalian target of rapamycin protein (AMPK/mTOR), Ras homologous gene family member A/Rho-associated coiled-coil protein kinase (RhoA/ROCK), nuclear factor E2-associated factor 2/Kelch-like epoxychloropropane-associated protein-1/haemoglobin oxygenase 1 (Nrf2/Keap1/ HO-1), Notch, and other signaling pathways, so as to regulate the transcription and expression of related proteins after CIRI, alleviate brain tissue injury, and improve CIRI. This paper analyzed the relevant literature in China and abroad in recent years, reviewed the mechanism of action and related pathways of flavonoids in traditional Chinese medicine to improve CIRI, and explored the new therapeutic direction of CIRI at the metabolic level, with a view to providing a basis for the further development and application of flavonoids in traditional Chinese medicine.
9.Lymphoma risk in the treatment of Crohn's disease with four biologi-cal agents:a real world analysis of post-marketing surveillance data
Yao SONG ; Chen PAN ; Xiaohong ZHAO ; Hongge YANG ; Ze LI ; Xiangli CUI
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(7):768-774
AIM:To determine the link between infliximab,adalimumab,vedolizumab,ustekinumab and risk of lymphoma in order to provide reference for the safety of clinical application.METHODS:Dis-proportionality analysis and Bayesian analysis were used in data mining to screen the suspected lym-phoma after the use of four biological agents based on the FAERS data from October 2012 to June 2023.The fatality and hospitalization rates of this four biological agents associated lymphoma were also investigated.RESULTS:Totally 705 cases of four biological agents associated lymphoma were collected.Four biological agents associated lymphoma appeared to influent more young pa-tients and middle-aged patients than elderly pa-tients(25.11%vs.22.41%vs.12.2%).There were slightly more male than females(42.84%vs.35.60%).Infliximab has the highest reporting odds ratio[ROR3.40,95%CI=(3.03,3.82)],proportional ratio[PRR3.38,95%CI=(3.01,3.79)],information component(IC1.14,IC-2SD=1.02)and empirical Bayes geometric mean(EBGM2.21,EBGM05=2.01).Significant difference in the fatality rate and hospi-talization rate among four biological agents were not found.CONCLUSION:Infliximab showed a strongest lymphoma association than the other three biological agents.Lymphoma risk should be vigilant when using infliximab.
10.Feasibility study on the use of peripheral blood differentially expressed genes for objective classification of chronic subjective tinnitus: a case study on high-frequency tinnitus
Zhicheng LI ; Bixing FANG ; Jin XIE ; Xinyi WANG ; Jingshi ZHOU ; Xiangli ZENG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(7):727-734
Objective:To explore the feasibility of constructing an objective tinnitus subtype model based on peripheral blood differentially expressed genes (DEGs) using a combination of Weighted Gene Co-expression Network Analysis (WGCNA) and Random Forest algorithm (RF).Methods:From October 2019 to June 2020, peripheral blood DEGs were obtained from 37 patients (from the Third Affiliated Hospital of Sun Yat-sen University)with chronic subjective high-frequency tinnitus (21 unbothersome type, 16 bothersome type) and 20 healthy volunteers through high-throughput sequencing. WGCNA was used to construct gene modules with different expression patterns and analyze their relationships with tinnitus characteristics. Subsequently, RF was employed to build subtype models, which were evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, and F1-score.Results:A total of 12 351 intergroup DEGs were divided into 9 gene modules. Among them, MEblue, MEgreen, and MEbrown showed significant negative correlations with the healthy volunteer group, while MEpink showed a significant positive correlation with the tinnitus distress group. The "Tinnitus vs. Normal" and "Compensatory vs. Decompensatory" subtype models, based on MEblue and MEpink respectively, both had AUCs greater than 0.80, accuracies above 90%, and F1-scores above 0.90, indicating good performance.Conclusions:Peripheral blood DEGs are potential biological indicators for objective classification of subjective tinnitus. The combined application of WGCNA and the Random Forest algorithm should be a viable approach to constructing an objective tinnitus subtype model. However, further exploration and refinement are needed to validate the model′s generalizability, cross-dataset performance, and algorithm optimization.

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