Rheum palmatum L.–Prunus persica (L.) Batsch herb pair restores endometrial receptivity in adenomyosis

Meiling Wang, Lin Du, Xianyun Fu, Wenjie Shi, Yirong Su, Lin Z. Li
In: Journal of Traditional Chinese Medical Sciences · 2026 · vol. 13(2) , pp. 254–266 · doi:10.1016/j.jtcms.2026.03.004 · W7138910148
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The Rheum palmatum L.–Prunus persica (L.) Batsch herb pair reversed infertility in an adenomyosis mouse model by restoring endometrial receptivity and normalizing dysregulated glycolytic metabolism.

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Abstract

Objective: To investigate whether herbal pair Rheum palmatum L. (R. palmatum; Da Huang)–Prunus persica (L.) Batsch (P. persica; Tao Ren) (RP) can restore endometrial receptivity and mitigate adenomyosis (AM)-associated infertility by regulating dysregulated glycolytic metabolism. Methods: An AM mouse model was established by pituitary transplantation. Mice receiving RP were divided into the low-dose (RP-L) and high-dose (RP-H) groups based on the RP dose administered. Pregnancy outcomes were assessed based on embryo implantation sites, progesterone levels, and levels of endometrial receptivity markers, including homeobox A10 (Hoxa10), leukemia inhibitory factor (LIF), and integrin beta 3 (Itgβ3). Molecular docking was used to analyze the interactions between the RP components and glycolytic enzymes. Results: AM mice exhibited pathological features of infertility, including reduced implantation sites, suppressed progesterone (P < .001), and downregulated receptivity markers (Hoxa10 and Itgβ3, P < .01; LIF, P < .05), alongside glycolytic dysfunction characterized by depleted glucose (P = .003) and accumulated pyruvate/lactate (both P < .05). RP treatment reversed these defects, restoring embryo implantation (P = .001 for RP-L; P = .013 for RP-H) and upregulating Hoxa10 (P = .001), LIF (P = .04), and Itgβ3 (P = .004). Crucially, RP normalized glycolytic flux, increasing glucose (P = .046) while reducing pyruvate (P = .01) and lactate (P = .003). RP significantly reduced LDH activity in the RP-H group (P = .025) and PK activity in the RP-H (P < .001) and RP-L (P = .007) groups compared to the AM group, with greater suppression than that with gestrinone treatment (LDH, P = .023; PK, P = .003). Molecular docking confirmed strong binding (energy, <−5.0 kcal/mol) between RP components and LDHA/PKM2, primarily via hydrogen bonds. In vitro, RP rescued lactate-impaired trophoblast adhesion (P = .002). Conclusion: RP ameliorated AM-associated infertility by regulating glycolytic metabolism and improving endometrial receptivity.

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Condition tags

adenomyosisinfertility

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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