Abstract
Methods The targets of antineoplastic drugs with cardiotoxicity were obtained from the National Center for Biotechnology Information (NCBI) database, China national knowledge infrastructure (CNKI) database, and Swiss Target Prediction platform. Then, the cardiotoxicity-related targets were derived from the Gene Cards, Disgenet, OMIM, and DrugBank databases, as well as the drug of current clinical guidelines. The targets both in these two sets were regarded as potential targets to alleviate ADIC. Then, candidate compounds and herbs were matched via Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform. Cytoscape3.7.1 was used to set up the target-compound-herb network. Molecular docking between core targets and compounds was performed with AutodockVina1.1.2. The rules of herbs were summarized by analyzing their property, flavor, and channel tropism. Results Twenty-one potential targets, 332 candidate compounds, and 400 kinds of herbs were obtained. Five core targets including potassium voltage-gated channel subfamily H member 2 (KCNH2), cyclin-dependent kinase 1 (CDK1), matrix metalloproteinase 2 (MMP2), mitogen-activated protein kinase1 (MAPK1), and tumor protein p53 (TP53) and 29 core compounds (beta-sitosterol, quercetin, kaempferol, etc.) were collected. Five core herbs (Yanhusuo, Gouteng, Huangbai, Lianqiao, and Gancao) were identified. Also, the TCM against ADIC were mainly bitter and acrid in taste, warm in property, and distributed to the liver and lung meridians. Conclusion TCM against ADIC has great potential. Our study provides a new method and ideas for clinical applications of integrated Chinese and western medicine in treating ADIC.
Highlights
Background and AimAntineoplastic drug-induced cardiotoxicity (ADIC) becomes the second leading cause of death for tumor survivors after tumor recurrence and metastasis, and there may be great room for development in the future of traditional Chinese medicine (TCM)
Reports have demonstrated that Xinmailong injection is effective for the treatment of cardiotoxicity caused by sequential chemotherapy of trastuzumab and anthracyclines in breast cancer, which could effectively improve the clinical symptoms of patients, attenuate myocardial injury, reduce blood viscosity, and inhibit expressions of serum IL-6 and TNF-α [10]
Considering that the parameters provided by the Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform is predicted by the computer, part of the data may be inconsistent with the actual situation, and the deleted compounds were checked one by one to supplement the relevant active compounds after the initial screening. e revised compounds were regarded as candidate compounds
Summary
Since the 1970s, there have been reports of cardiotoxic reactions caused by anthracyclines [1]. Reports have demonstrated that Xinmailong injection is effective for the treatment of cardiotoxicity caused by sequential chemotherapy of trastuzumab and anthracyclines in breast cancer, which could effectively improve the clinical symptoms of patients, attenuate myocardial injury, reduce blood viscosity, and inhibit expressions of serum IL-6 and TNF-α [10]. Erefore, it is of great value to further explore Chinese herbs medicine against cardiac toxicity caused by antineoplastic drugs and to develop related preparations. We systematically predicted and analyzed the complex relationship between the target, compound and TCM, initially discussed the material basis and general rules, which could provide ideas and theoretical basis for the follow-up selection of TCM, theoretical discussion, new drug development, and clinical integration of traditional Chinese and Western medicine.
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