Premna microphylla Turcz. reshapes nutritional metabolism via the Simulator of the Human Intestinal Microbial Ecosystem model

doi:10.4251/wjgo.v18.i6.119130

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Jun 15, 2026; 18(6): 119130
Published online Jun 15, 2026. doi: 10.4251/wjgo.v18.i6.119130

Premna microphylla Turcz. reshapes nutritional metabolism via the Simulator of the Human Intestinal Microbial Ecosystem model

Hui-Di Zhu, Chang Xu, Sheng-Hong Guan, Yu-Ming Lou, Kan-Kai Zhu, Run-Feng Lin, Hai-Long Jin, Shuo Chai, Xiao-Yong Zhang, Xiao-Sun Liu, Jing-Kui Tian

Hui-Di Zhu, Yu-Ming Lou, Kan-Kai Zhu, Hai-Long Jin, Xiao-Sun Liu, Department of Gastrointestinal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China

Chang Xu, Sheng-Hong Guan, Run-Feng Lin, Shuo Chai, Xiao-Yong Zhang, Jing-Kui Tian, Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou 310000, Zhejiang Province, China

Co-first authors: Hui-Di Zhu and Chang Xu.

Co-corresponding authors: Xiao-Sun Liu and Jing-Kui Tian.

Author contributions: Zhu HD and Xu C contribute equally to this study as co-first authors; Liu XS and Tian JK contribute equally to this study as co-corresponding authors; Zhu HD was responsible for writing – review & editing, writing – original draft, and methodology; Xu C was responsible for conceptualization, formal analysis, and data curation; Guan SH was responsible for project administration and investigation; Lou YM was responsible for resources and project administration; Zhu KK was responsible for software; Lin RF was responsible for writing – review & editing; Jin HL was responsible for validation; Chai S was responsible for software; Zhang XY was responsible for visualization; Liu XS was responsible for writing – review & editing; Tian JK was responsible for funding acquisition; all authors have read and approved the final version to be published.

AI contribution statement: We used DeepSeek to assist with language polishing. Any portion of the manuscript was not generated by AI. AI was only used to help with language polishing and translation. AI was not used in experimental design or result analysis. All figures were created using graphic software, rather than being generated by AI.

Supported by Joint Traditional Chinese Medicine Science & Technology Projects of National Demonstration Zones for Comprehensive Traditional Chinese Medicine Reform, No. ZY-KJS-ZJ-2025-052 and No. GZY-KJS-ZJ-2025-036; and Key Research & Development Plan of Zhejiang Province, No. 2025C02171.

Institutional review board statement: The study was approved by the Clinical Research Ethics Committee of the First Affiliated Hospital, College of Medicine, Zhejiang University School of Medicine (Approval No. 20231014).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors report no conflicts of interest.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.

Data sharing statement: No additional data are available.

Corresponding author: Xiao-Sun Liu, Professor, Department of Gastrointestinal Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 366 Wutong Road, Hangzhou 310000, Zhejiang Province, China. xiaosunliu@zju.edu.cn

Received: January 20, 2026
Revised: February 10, 2026
Accepted: March 12, 2026
Published online: June 15, 2026
Processing time: 141 Days and 1.5 Hours

Abstract

BACKGROUND

Gastric cancer (GC) remains a leading cause of cancer mortality worldwide. Despite improved survival with surgery combined with chemotherapy and immunotherapy, these treatments frequently induce gastrointestinal mucosal injury and disrupt intestinal microecological homeostasis, resulting in severe dysbiosis. Premna microphylla Turcz. (PMT), a traditional medicinal and edible herb, exhibits anti-inflammatory and immunomodulatory properties. However, the metabolism of PMT bioactive components in a compromised intestinal microenvironment and their roles in microecology-mediated intestinal repair remain poorly understood.

AIM

To establish a Simulator of the Human Intestinal Microbial Ecosystem (SHIME) model for explicitly elucidating the segment-specific metabolism of PMT.

METHODS

Using the SHIME model, this study simulated the absorption of PMT in GC patients undergoing chemotherapy and immunotherapy, aiming to clarify its active components' intestinal recovery mechanism and nutritional intervention value.

RESULTS

Components of PMT were converted into small-molecule phenolic acids by microbiota. Their absorption and metabolism showed heterogeneity and dynamics across intestinal segments, e.g., flavonoid glycosides are activated rapidly in the small intestine, while hydrophobic terpenes are retained in the colon. The shifted primary absorption site in the intervention group (e.g., epicatechin from the small intestine in the control group to the colon in the treatment group) suggests that dysbiosis may reshape drug absorption pathways, providing a theoretical basis for natural nutrient-based nutritional strategies for cancer patients.

CONCLUSION

The SHIME model revealed PMT’s metabolism-repair dual pathway in chemotherapy and immunotherapy-damaged intestines, laying a theoretical foundation for its targeted nutritional rehabilitation strategies for cancer patients’ intestinal microecology.

Keywords: Gastric cancer; Chemotherapy combined with immunotherapy; Nutritional bioactivity; Simulator of the Human Intestinal Microbial Ecosystem; Premna microphylla Turcz

Core Tip: This study established an intestinal microbial ecosystem (Simulator of the Human Intestinal Microbial Ecosystem) model to uncover the differential absorption and metabolism profiles of Premna microphylla Turcz. (PMT) across various intestinal segments. We demonstrated that chemotherapy-induced gut microbiota dysbiosis leads to a shift in the primary absorption site of active ingredients toward the colon. These findings not only provide a scientific basis for developing novel strategies to improve cancer patient prognosis but also lay a solid theoretical foundation for utilizing PMT as a low-toxicity therapeutic agent.