Abstract
Endometriosis is a common benign disease in women of reproductive age. It has been defined as a disorder characterized by inflammation, compromised immunity, hormone dependence, and neuroangiogenesis. Unfortunately, the mechanisms of endometriosis have not yet been fully elucidated, and available treatment methods are currently limited. The discovery of new therapeutic drugs and improvements in existing treatment schemes remain the focus of research initiatives. Chinese medicine can improve the symptoms associated with endometriosis. Many Chinese herbal medicines could exert antiendometriosis effects via comprehensive interactions with multiple targets. However, these interactions have not been defined. This study used association rule mining and systems pharmacology to discover a method by which potential antiendometriosis herbs can be investigated. We analyzed various combinations and mechanisms of action of medicinal herbs to establish molecular networks showing interactions with multiple targets. The results showed that endometriosis treatment in Chinese medicine is mainly based on methods of supplementation with blood-activating herbs and strengthening qi. Furthermore, we used network pharmacology to analyze the main herbs that facilitate the decoding of multiscale mechanisms of the herbal compounds. We found that Chinese medicine could affect the development of endometriosis by regulating inflammation, immunity, angiogenesis, and other clusters of processes identified by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. The antiendometriosis effect of Chinese medicine occurs mainly through nervous system–associated pathways, such as the serotonergic synapse, the neurotrophin signaling pathway, and dopaminergic synapse, among others, to reduce pain. Chinese medicine could also regulate VEGF signaling, toll-like reporter signaling, NF-κB signaling, MAPK signaling, PI3K-Akt signaling, and the HIF-1 signaling pathway, among others. Synergies often exist in herb pairs and herbal prescriptions. In conclusion, we identified some important targets, target pairs, and regulatory networks, using bioinformatics and data mining. The combination of data mining and network pharmacology may offer an efficient method for drug discovery and development from herbal medicines.
Highlights
Endometriosis is a common benign condition in women of reproductive age, which is characterized by inflammation, compromised immunity, hormone dependence, and neuroangiogenesis, etc. (Rogers et al, 2009)
We have studied the prescriptions of Chinese medicine for endometriosis through literature monographs
The mechanism of Traditional Chinese Medicine (TCM) in the treatment of endometriosis is realized through functional modules, such as inhibiting inflammation, enhancing the immune response, regulating angiogenesis-related pathways, inhibiting the epithelialmesenchymal transition, and inducing apoptosis
Summary
Endometriosis is a common benign condition in women of reproductive age, which is characterized by inflammation, compromised immunity, hormone dependence, and neuroangiogenesis, etc. (Rogers et al, 2009). In addition to surgical treatment, conventional drug therapies includes nonsteroidal anti-inflammatory drugs (NSAIDs) and other drugs, such as androgens, aromatase inhibitors, selective progesterone receptor modulators, oral contraceptives, and gonadotropin releasing hormone (GnRH) agonists (Mihalyi et al, 2006; Dunselman et al, 2014; Legendre et al, 2018). These drugs play a certain therapeutic role, the main effect is only to relieve symptoms, delay recurrence, and bring certain side effects. We urgently need to summarize the rules for the administration of Chinese medicine and analyze the mechanism of action of the herbs, in order to provide the Abbreviations: ADMET, absorption, distribution, metabolism, excretion and toxicity; BP, biological process; BSS, blood stasis syndrome; CC, cellular component; DEGs, differentially expressed genes; DL, drug-likeness; EMT, epithelial-to-mesenchymal transition; GO, Gene Ontology; KEGG, Kyoto Encyclopedia of Genes and Genomes; MCODE, molecular complex detection; MF, molecular function; OB, oral bioavailability; OMIM, Online Mendelian Inheritance in Man; PPI, protein-protein interactions; RCSB PDB, Research Collaboratory for Structural Bioinformatics Protein Data Bank; TCMSP, Traditional Chinese Medicine Systems Pharmacology; TTD, Therapeutic Target Database; UHPLC-QTOFMS, ultrahigh-performance liquid chromatography tandem quadruple time of flight mass spectrometry
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