Abstract
ObjectiveEndometriosis is a common benign disease in women of reproductive age. Qu’s formula (QUF) is a patented Chinese herbal medicine for treating endometriosis that has been proven to be effective in treating and preventing the recurrence of endometriosis. This study is aimed to discover its molecular mechanism and to explore the potential drug targets.MethodsA QUF target and endometriosis-related gene set was identified by the Traditional Chinese Medicine Systems Pharmacology (TCMSP) and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM) databases and five disease-gene databases. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed, and a protein–protein interaction (PPI) network was established to discover the potential mechanism. MalaCards was searched for targets and signaling pathways related to endometriosis, and the search results were also used to identify the key factors in QUF. Molecular docking was performed to visualize the interactions between the effective molecules and proteins encoded by critical genes. Cell experiments and molecular dynamics (MD) simulations were used to further validate the therapeutic effects of the active compounds in QUF on endometriosis.ResultsA compound-target network with 117 nodes (94 genes and 23 active compounds) and 224 edges was generated. The results of GO and KEGG analyses indicated that QUF could act by regulating the immune response, apoptosis and proliferation, oxidative stress, and angiogenesis. VEGFA, CXCL8, CCL2, IL1B and PTGS2 were selected for molecular docking analysis from two critical subnetworks with high correlation scores in MalaCards, and the active compounds of QUF had binding potential and high affinity for them. The mRNA expression levels of CCL2, IL1B and PTGS2 significantly decreased after treatment with quercetin. MD simulations showed that the combinations of quercetin and these proteins were relatively stable.ConclusionThe network pharmacological strategy integrates molecular docking to unravel the molecular mechanism by which QUF protects against endometriosis. Our findings not only confirm the clinical effectiveness of QUF but also provide a foundation for further experimental study.
Highlights
Endometriosis is a common gynecological disease characterized by the presence of endometrial-like tissue outside the uterus [1]
The results of Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses indicated that Qu’s formula (QUF) could act by regulating the immune response, apoptosis and proliferation, oxidative stress, and angiogenesis
The network pharmacological strategy integrates molecular docking to unravel the molecular mechanism by which QUF protects against endometriosis
Summary
Endometriosis is a common gynecological disease characterized by the presence of endometrial-like tissue outside the uterus [1]. This estrogen-dependent, benign, inflammatory disease can cause dysmenorrhea, dyspareunia, chronic pain, and infertility [2]. Approximately 50% of women with endometriosis have recurrent symptoms over 5 years [6]. Traditional Chinese medicine (TCM) has been widely used to treat gynecological diseases for centuries. Guizhi Fuling Wan (GZFLW) is a classical prescription for endometriosis treatment in TCM [7]. A recent network pharmacology analysis indicated that GZFLW can treat endometriosis through multiple mechanisms [8]. Animal experiments have shown that GZFLW can attenuate endometriosis in rats by immunological regulation and induction of apoptosis [9,10]
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