Abstract
Background Poststroke depression (PSD) is the most common and serious neuropsychiatric complication occurring after cerebrovascular accidents, seriously endangering human health while also imposing a heavy burden on society. Nevertheless, it is difficult to control disease progression. Gan-Mai-Da-Zao Decoction (GMDZD) is effective for PSD, but its mechanism of action in PSD is unknown. In this study, we explored the mechanism of action of GMDZD in PSD treatment using network pharmacology and molecular docking. Material and methods. We obtained the active components of all drugs and their targets from the public database TCMSP and published articles. Then, we collected PSD-related targets from the GeneCards and OMIM databases. Cytoscape 3.8.2 was applied to construct PPI and composite target disease networks. In parallel, the DAVID database was used to perform GO and KEGG enrichment analyses to determine the biological processes enriched in the treatment-related drugs in vivo. Finally, molecular docking was used to verify the association between the main active ingredients and their targets. Results The network pharmacological analysis of GMDZD in PSD revealed 107 active ingredients with important biological effects, including quercetin, luteolin, kaempferol, naringenin, and isorhamnetin. In total, 203 potential targets for the treatment of this disease were screened, including STAT3, JUN, TNF, TPT53, AKT1, and EGFR. These drugs are widely enriched in a series of signaling pathways, such as TNF, HIF-1, and toll-like receptor. Moreover, molecular docking analysis showed that the core active components were tightly bound to their core targets, further confirming their anti-PSD effects. Conclusion This prospective study was based on the integrated analysis of large data using network pharmacology technology to explore the feasibility of GMDZD for PSD treatment that was successfully validated by molecular docking. It reflects the multicomponent and multitarget characteristics of Chinese medicine and, more importantly, brings hope for the clinical treatment of PSD.
Highlights
Post-stroke depression (PSD) is one of the most common and heavy neuropsychiatric complications after stroke [1, 2], which often starts insidiously, with mild symptoms of malaise and drowsiness in the early stages
This is a prospective study based on the integration and analysis of large data, using the technology of network pharmacology to explore the feasibility of Gan-Mai-Da-Zao decoction for the treatment of PSD, and successfully validated by molecular docking
Through the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP, https://tcmspw.com/tcmsp.php), an authoritative public database that collects a large number of active ingredients, related targets, and pharmacokinetic information [18], we searched for the active ingredients of three Chinese medicines and supplemented them with published literature [19, 20]
Summary
Post-stroke depression (PSD) is one of the most common and heavy neuropsychiatric complications after stroke [1, 2], which often starts insidiously, with mild symptoms of malaise and drowsiness in the early stages. What’s more, if patients with PSD are unable to express their feelings clearly due to language or cognitive impairment, the diagnosis is often compromised and treatment is delayed [3]. This poses a great challenge to clinical work and adds a heavy burden to the society and economy. Due to the lack of timely diagnosis, the adverse effects on cardiovascular function of drugs, and increased risk of bleeding, which leads to unsatisfactory treatment of patients with PSD [9, 10]
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