Abstract
Background “Zheng” (syndrome) is the basic unit and the basis of traditional Chinese medicine (TCM) treatment. In clinical practice, we have been able to improve the survival time and quality of life for patients with rectal cancer through the treatment of “FuZhengXiaoJi” (strengthening the Qi and reducing accumulation). Purpose In this study, we elucidated the core prescriptions for patients with rectal cancer and Qi and blood deficiency syndrome, and we explored the potential mechanisms of the prescriptions using an integrated strategy that coupled data mining with network pharmacology. Methods A Bron–Kerbosch (BK) algorithm was applied to find the core prescriptions. The active ingredients, targets, activated signaling pathways, and biological functions of core prescriptions were analyzed using network pharmacology and directly associated proteins were docked using molecular docking technology to elucidate the multicomponent, multitarget, and inter-related components associated with TCM systematically. Results Data mining identified 3 core prescriptions, and most of the herbs consisted of “FuZhengXiaoJi” Fang. Network pharmacology identified 15 high-degree active ingredients among the 3 core prescriptions and 16 high-degree hub genes linked with both rectal cancer and the 3 core prescriptions. Additional Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of these 16 targets showed that the most significant pathways were MAPK, interleukin-17, tumor necrosis factor (TNF), and vascular endothelial growth factor (VEGF) pathways. From the 16 genes, TGFB1, IL1B, IL10, IL6, PTGS2, and PPARG closely interacted with the tumor microenvironment, and PPARG, MYC, and ERBB2 were closely linked to survival. In molecular docking, quercetin, kaempferol, and lauric acid showed good binding energy to each target. Conclusion Data mining, network pharmacology, and molecular docking may help identify core prescriptions, high-degree ingredients, and high-degree hub genes to apply to diseases and treatments. Furthermore, these studies may help discover hub genes that affect the tumor microenvironment and survival. The combination of these tools may help elucidate the relationship between herbs acting on “Zheng” (syndrome) and diseases, thus expanding the understanding of TCM mechanisms.
Highlights
Rectal cancer is a common type of colorectal cancer (CRC)
Using Gene Ontology (GO) functional analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) functional analysis, Disease Ontology (DO) enrichment analysis, and Reactome enrichment analysis, our findings indicated that the core prescription targets mainly act on tumor apoptosis-related, immune anti-inflammatory effects, and oxidative stress effects. ese functional and enrichment analysis results are consistent with activities involving the IL-17 signaling pathway, tumor necrosis factor (TNF) signaling pathway, glucuronidation, IL-10 signaling, IL-4 and IL-13 signaling, and vascular endothelial growth factor (VEGF) signaling, which may be the most relevant pathways activated by the prescription 1 (P1), prescription 2 (P2), and prescription 3 (P3) prescriptions
We found that P1, P2, and P3 may be potential core prescriptions for patients during the tumor progression and recurrence periods, the chemotherapy period, and the recovery period, respectively
Summary
Rectal cancer is a common type of colorectal cancer (CRC). CRC is the second and fourth most common malignant tumor in the world and in China, respectively (approximately37.6 per 100,000 in 2015) [1, 2], and has a mortality rate of 19.1 per 100,000 [2]. Rectal cancer is a common type of colorectal cancer (CRC). CRC is the second and fourth most common malignant tumor in the world and in China, respectively CRC has become a substantial burden in China, in the more developed provinces [3]. More than 50% of patients with CRC are diagnosed at an advanced stage [4]; according to previous. Evidence-Based Complementary and Alternative Medicine reports, 20%–50% of patients with rectal cancer will eventually develop metastatic disease [5]. The 5-year survival rate of CRC is less than 14%. Effective treatments for CRC include a combination of surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy therapy. Chemotherapeutics have known limitations, such as their substantial adverse effects, including gastrointestinal reactions, mucositis, bone marrow suppression, neurotoxicity, abnormal liver or kidney function, febrile neutropenia, and fatigue [6]. e search for more effective alternative agents with lower toxicity that are able to inhibit the tumor’s metastatic potential is essential [7, 8]
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