Department of Traditional Chinese Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital Zhengzhou Children's Hospital, Zhengzhou, Henan, China.
Medicine (Baltimore). 2024 Oct 4;103(40):e40023. doi: 10.1097/MD.0000000000040023.
Cough variant asthma (CVA) is a common disease with high incidence among children. Cough is the main clinical symptom and Chinese medicine (CM) has an exact effect on CVA. However, the rules of herb formulation, the pharmacodynamic substances, and the mechanism remained unclear. Therefore, we conducted this article to explore medication rules and molecular mechanism of CM against CVA in children using data mining, network pharmacology, molecular docking, and molecular dynamics simulation. Relevant literatures were collected from China National Knowledge Infrastructure, Chinese Scientific and Technical Journals database, Wanfang database, Pubmed, and Web of science. Excel 2016 was used to extract related data and establish the database for Chinese medical frequency, properties, tastes, and meridian analysis. Association rules were analyzed based on Apriori algorithm using IBM SPSS Modeler 18.0 software and core herb combination was identified. The active ingredients and targets of the core herb combination were acquired form the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. The main targets of CVA were obtained from the GeneCards and Online Mendelian Inheritance in Man database. Core targets were selected by using STRING platform and Cytoscape 3.7.2 software. Metascape platform was utilized to perform gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. The results were verified by molecular docking. SwissADME and pkCSM website were used to analyze the pharmacokinetic profiles and toxicity of key components of the core herb combination. Molecular dynamics simulation was utilized to evaluate the stable of protein-ligand complex. Two hundred seventy-five literatures containing 202 herbs were finally collected. Statistics indicated that these herbs possessed bitter, pungent taste, and warm properties, and belonged to lung meridian. Glycyrrhizae radix et rhizome, Ephedrae herba, and Armeniacae semen amarum were the most frequently used herbs. "Glycyrrhizae radix et rhizoma-ephedrae herba-Armeniacae semen amarum" was the core herb combination with highest support and confidence. Network pharmacology predicted that the main active ingredients, like quercetin, kaempferol, luteolin, etc, might target on RAC-alpha serine/threonine-protein kinase, tumor necrosis factor, interleukin-6, vascular endothelial growth factor A, transcription factor AP-1, interleukin-1 beta, matrix metalloproteinase-9, etc. They played a pivotal role in regulating multiple signaling pathways, such as tumor necrosis factor signaling pathway, IL-17 signaling pathway, and PI3K-Akt signaling pathway. Molecular docking revealed that the key active ingredients were well docked with core targets. The absorption, distribution, metabolism, excretion, and toxicity analysis showed that formononetin, luteolin, naringenin, and quercetin have high gastrointestinal absorption, no AMES toxicity, hepatotoxicity, and skin sensitization. Molecular dynamics simulation revealed that the formononetin-matrix metalloproteinase-9 complex was relatively stable. This article revealed that CM against CVA in children focused on dispelling wind and reducing phlegm, warming lung, and relieving cough. The mechanism of the core herb combination of CM for CVA through muti-components, muti-targets, and muti-pathways.
咳嗽变异性哮喘(CVA)是儿童中发病率较高的常见疾病。咳嗽是其主要的临床症状,中医药对 CVA 具有确切的疗效。然而,中药组方规律、药效物质基础及作用机制仍不明确。因此,我们通过数据挖掘、网络药理学、分子对接和分子动力学模拟,开展了这项研究,以探讨中医药治疗儿童 CVA 的用药规律和分子机制。相关文献均来自中国知网、中国科技期刊数据库、万方数据库、PubMed 和 Web of Science。使用 Excel 2016 提取相关数据并建立中药频次、药性、味、归经分析数据库。采用 IBM SPSS Modeler 18.0 软件中的 Apriori 算法进行关联规则分析,识别核心药对组合。从中药系统药理学数据库与分析平台数据库中获取核心药对组合的活性成分和靶点。从基因数据库和在线孟德尔遗传数据库中获取 CVA 的主要靶点。使用 STRING 平台和 Cytoscape 3.7.2 软件筛选核心靶点。利用 Metascape 平台进行基因本体和京都基因与基因组百科全书富集分析。通过分子对接进行验证。使用 SwissADME 和 pkCSM 网站分析核心药对组合中关键成分的药代动力学特征和毒性。利用分子动力学模拟评价蛋白-配体复合物的稳定性。最终共纳入 275 篇文献,包含 202 味中药。统计结果显示,这些中药多具有苦、辛味,性温,归肺经。甘草、麻黄和苦杏仁是使用频次最高的三味中药。“甘草-麻黄-苦杏仁”是置信度和支持度均最高的核心药对组合。网络药理学预测,槲皮素、山柰酚、木犀草素等主要活性成分可能作用于 RAC-α丝氨酸/苏氨酸蛋白激酶、肿瘤坏死因子、白细胞介素 6、血管内皮生长因子 A、转录因子 AP-1、白细胞介素 1β、基质金属蛋白酶 9 等核心靶点,从而调控肿瘤坏死因子信号通路、IL-17 信号通路和 PI3K-Akt 信号通路等多种信号通路。分子对接显示,关键活性成分与核心靶点结合良好。吸收、分布、代谢、排泄和毒性分析表明,芒柄花素、木犀草素、柚皮苷和槲皮素具有较高的胃肠道吸收性,无 AMES 毒性、肝毒性和皮肤致敏性。分子动力学模拟显示,芒柄花素-基质金属蛋白酶 9 复合物较为稳定。本研究揭示了中医药治疗儿童 CVA 以祛风化痰、温肺止咳为主。其作用机制可能是通过多成分、多靶点、多通路实现的。