Abstract
Introduction The objective of our study is to explore the potential active ingredients and activity of Ginseng and Astragalus decoction (GAD) in the treatment of malignant pleural effusion (MPE) by using network pharmacology and molecular docking technologies. Methods The active ingredients and corresponding targets of Ginseng and Astragalus were extracted from the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. The relevant targets of malignant pleural effusion (MPE) were searched in the disease databases. Overlapping targets of Ginseng and Astragalus and the corresponding targets of MPE were obtained to define the effective target of GAD for the treatment of MPE. The STRING database was applied to construct a predicted protein-protein interaction network for intersected targets. The Cytoscape software was used to screen key targets with a therapeutic potential. Using the Metascape database, we performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes functional enrichment analysis on the targets identified in the study. PyMOL and AutoDock Vina were used to molecularly dock the selected key components to their respective key targets for MPE treatment. Results The core target network revealed 22 main active ingredients, 26 main targets, and 16 signaling pathways in GAD. Molecular docking revealed 6 targets (AKT serine/threonine kinase 1, intercellular adhesion molecule, Jun proto-oncogene, peroxisome proliferator activated receptor gamma, prostaglandin-endoperoxide synthase 2, and tumor necrosis factor) that could partially dock with kaempferol, frutinone A, ginsenoside RH2, formononetin, and quercetin. Conclusions Several components, targets, and signaling pathways of GAD contribute to the treatment of MPE, which suggests a rationale for further investigation on GAD's active molecule and mechanism of action in the clinical application of MPE.
Highlights
Malignant pleural effusion (MPE) is one of the most common adverse consequences of lung cancer in the advanced stages of the disease [1]
Based on the selection criteria (OB ≥ 30% and DL ≥ 0.18), the core active ingredients were further filtered to 22 in Ginseng and 20 in Astragalus, among which kaempferol (KPL) was a compound shared by both drugs (Table 1)
Most malignant pleural effusion (MPE) patients present with systemic symptoms such as inappetence, weight loss, and discomfort because the condition is usually diagnosed at an advanced stage. ere is no clear understanding of how large pleural effusions cause breathing difficulties
Summary
Malignant pleural effusion (MPE) is one of the most common adverse consequences of lung cancer in the advanced stages of the disease [1]. It was reported that MPE is primarily associated with malignant tumors, and lung carcinoma is the most common type [2]. Several types of tumors are associated with less MPE including ovarian and gastrointestinal cancers [3]. Most patients present with signs of advanced cachexia, Evidence-Based Complementary and Alternative Medicine such as weight loss, emaciation, and anemia and symptoms including progressive dyspnea, chest pain, and dry cough. Modern medicine mainly treats MPE with the intrathoracic infusion of chemotherapy drugs, pleurodesis, and pleurocentesis, but the overall efficacy is limited, and treatments are not suitable for advanced and weak elderly patients with poor physical strength [5]
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