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Network pharmacology combined with in vivo experiments to explore the molecular mechanism of Jiawei Erzhi pill (加味二至丸) protects against atherosclerosis by inhibiting ferroptosis
Received date: 2024-10-12
Accepted date: 2025-01-25
Online published: 2025-11-24
Supported by
Mechanism of Modified Erzhi Pills Up-regulating Adiponectin to Improve the Anti-vasoconstriction Function of Active Perivascular Fat in Menopausal Rats(81373799)
OBJECTIVE: To elucidate the possible mechanism of Jiawei Erzhi pill (加味二至丸, JWEZP) in the treatment of atherosclerosis (AS).
METHODS: The chemical constituents of JWEZP were identified using ultra-performance liquid chromatography-mass spectrometry. A high-fat diet (HFD) was used to establish AS models in ApoE-/- mice. The ApoE-/- mice were randomly divided into the Model (normal saline), Simvastatin (normal saline), Low-dose JWEZP, Medium-dose JWEZP and High-dose JWEZP groups (n = 15), and C57BL/6 mice on a normal diet were used as the control group. Mice were treated with JWEZP at different doses (3.9, 7.8, 15.6 g·kg?1·d?1) or with simvastatin (2.6 mg·kg?1·d?1) for ten weeks. The inhibitory effects of JWEZP on AS were assessed by measuring serum lipid levels and changes in atherosclerotic plaques, lipid peroxidation and ferroptosis. Common targets and key regulatory pathways of JWEZP-mediated inhibition of ferroptosis were predicted using network pharmacology and verified using real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting.
RESULTS: We identified 46 active compounds in JWEZP. Mice in the JWEZP group had lower body weights and serum cholesterol levels compared to HFD mice. The results of Hematoxylin-Eosin and Oil Red O staining showed that JWEZP alleviated AS. Masson staining showed that JWEZP improved the stability of atherosclerotic plaques. In addition, JWEZP-treated mice had lower levels of reactive oxygen species (ROS) in thoracic aortic tissue according to ROS fluorescence staining. The ELISA results showed that JWEZP decreased the levels of iron, lipid peroxide, malondialdehyde and nicotinamide adenine dinucleotide phosphate and increased the levels of glutathione (GSH) and GSH-PX in the thoracic aortic tissues of mice. The expression of glutathione peroxidase 4 in the thoracic aorta of mice in the JWEZP group was upregulated in the results of the immunofluorescence assay. Network pharmacology results indicated that the action mechanisms of JWEZP-mediated inhibition of ferroptosis were closely related to the p53, mitogen-activated protein kinase (MAPK), and phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (Akt) signaling pathways. RT-qPCR and Western blotting results demonstrated that JWEZP inhibited the p53 and MAPK pathways, and activated the PI3K/Akt pathway to regulate ferroptosis.
CONCLUSION: JWEZP improved AS by inhibiting ferroptosis. The study provides a scientific basis for further research and validation of JWEZP as a potential therapeutic for AS.
Key words: atherosclerosis; ferroptosis; network pharmacology; Jiawei Erzhi pill
Guiping MA , Ran CHEN , Junlong LI , Le SUN , Shiping HU , Yiyi ZHANG , Chuangxiong HONG . Network pharmacology combined with in vivo experiments to explore the molecular mechanism of Jiawei Erzhi pill (加味二至丸) protects against atherosclerosis by inhibiting ferroptosis[J]. Journal of Traditional Chinese Medicine, 2025 , 45(6) : 1330 -1341 . DOI: 10.19852/j.cnki.jtcm.2025.06.012
| 1. | Conte SM, Vale, PR. Peripheral arterial disease. Heart Lung Circ 2018; 27: 427-32. |
| 2. | Emini Veseli B, Perrotta P, De Meyer GRA, et al. Animal models of atherosclerosis. Eur J Pharmacol 2017; 816: 3-13. |
| 3. | Moore KJ, Tabas I. Macrophages in the pathogenesis of atherosclerosis. Cell 2011; 145: 341-55. |
| 4. | Zhong S, Li L, Shen X, et al. An update on lipid oxidation and inflammation in cardiovascular diseases. Free Radic Biol Med 2019; 144: 266-78. |
| 5. | Shibata T, Shimizu K, Hirano K, et al. Adductome-based identification of biomarkers for lipid peroxidation. J Biol Chem 2017; 292: 8223-35. |
| 6. | Hammad SM, Twal WO, Barth JL, et al. Oxidized LDL immune complexes and oxidized LDL differentially affect the expression of genes involved with inflammation and survival in human U937 monocytic cells. Atherosclerosis 2009; 202: 394-404. |
| 7. | Dixon SJ, Lemberg KM, Lamprecht MR, et al. Ferroptosis: an iron-dependent form of nonapoptotic cell death. Cell 2012; 149: 1060-72. |
| 8. | Latunde-Dada GO. Ferroptosis: role of lipid peroxidation, iron and ferritinophagy. Biochim Biophys Acta Gen Subj 2017; 1861: 1893-900. |
| 9. | Stockwell BR, Friedmann Angeli JP, Bayir H, et al. Ferroptosis: a regulated cell death nexus linking metabolism, redox biology, and disease. Cell 2017; 171: 273-85. |
| 10. | Bai T, Li MX, Liu YF, Qiao ZT, Wang ZW. Inhibition of ferroptosis alleviates atherosclerosis through attenuating lipid peroxidation and endothelial dysfunction in mouse aortic endothelial cell. Free Radic Biol Med 2020; 160: 92-102. |
| 11. | Sullivan JL. Iron in arterial plaque: modifiable risk factor for atherosclerosis. Biochim Biophys Acta 2009; 1790: 718-23. |
| 12. | Lei W, Shen F, Chang N, et al. Chemical proteomics reveals ligustilide targets SMAD3, inhibiting collagen synthesis in aortic endothelial cells. Chin Chem Lett 2021; 32: 190-3. |
| 13. | Zuo JY, Park C, Doschak M, L?benberg R. Are the release characteristics of Erzhi pills in line with Traditional Chinese Medicine theory? A quantitative study. J Integr Med 2021; 19: 50-5. |
| 14. | Huang S, Mu F, Li F, et al. A network-based approach to explore the mechanism and bioactive compounds of Erzhi pill against metabolic dysfunction-associated fatty liver disease. J Diabetes Res 2020; 2020: 1-15. |
| 15. | Peng M, Xia T, Zhong Y, et al. Integrative pharmacology reveals the mechanisms of Erzhi pill, a traditional Chinese formulation, against diabetic cardiomyopathy. J Ethnopharmacol 2022; 296: 115474. |
| 16. | Xia J, Hu J, Zhang R, et al. Icariin exhibits protective effects on cisplatin-induced cardiotoxicity via ROS-mediated oxidative stress injury in vivo and in vitro. Phytomedicine 2022; 104: 154331. |
| 17. | Huwait EA, Saddeek SY, Al-Massabi RF, Almowallad SJ, Pushparaj PN, Kalamegam G. Antiatherogenic effects of quercetin in the THP-1 macrophage model in vitro, with insights into its signaling mechanisms using in silico analysis. Front Pharmacol 2021; 12: 698138. |
| 18. | Li H, Xiao L, He H, et al. Quercetin attenuates atherosclerotic inflammation by inhibiting galectin-3-NLRP 3 signaling pathway. Mol Nutr Food Res 2021; 65: e2000746. |
| 19. | Zhang Y, Xu D, Huang P, et al. Essential role of protein kinase C betaI in icariin-mediated protection against atherosclerosis. J Pharm Pharmacol 2021; 73: 1169-79. |
| 20. | Zeng Y, Xiong Y, Yang T, et al. Icariin and its metabolites as potential protective phytochemicals against cardiovascular disease: from effects to molecular mechanisms. Biomed Pharmacother 2022; 147: 112642. |
| 21. | Luo H, Zhang R. Icariin enhances cell survival in lipopolysaccharide-induced synoviocytes by suppressing ferroptosis via the Xc-/GPX4 axis. Exp Ther Med 2021; 21: 72. |
| 22. | Liu X, Ma Y, Luo L, et al. Dihydroquercetin suppresses cigarette smoke induced ferroptosis in the pathogenesis of chronic obstructive pulmonary disease by activating Nrf2-mediated pathway. Phytomedicine 2022; 96: 153894. |
| 23. | Wang ZX, Ma J, Li XY, et al. Quercetin induces p53-independent cancer cell death through lysosome activation by the transcription factor EB and reactive oxygen species-dependent ferroptosis. Br J Pharmacol 2021; 178: 1133-48. |
| 24. | Fang Y, Liu J, Xin L, et al. Radix Salvia miltiorrhiza for ankylosing spondylitis: determining potential inflammatory molecular targets and mechanism using network pharmacology. Biomed Res Int 2022; 2022: 1-13. |
| 25. | Xu X, Zhang W, Huang C, et al. A novel chemometric method for the prediction of human oral bioavailability. Int J Mol Sci 2012; 13: 6964-82. |
| 26. | Jia CY, Li JY, Hao GF, Yang GF. A drug-likeness toolbox facilitates ADMET study in drug discovery. Drug Discov Today 2020; 25: 248-58. |
| 27. | Jiang L, Kon N, Li T, et al. Ferroptosis as a p53-mediated activity during tumour suppression. Nature 2015; 520: 57-62. |
| 28. | Kobayashi M, Suhara T, Baba Y, Kawasaki NK, Higa JK, Matsui T. Pathological roles of iron in cardiovascular disease. Curr Drug Targets 2018; 19: 1068-76. |
| 29. | Ayala A, Mu?oz M, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxid Med Cell Longev 2014; 2014: 360438. |
| 30. | Gianazza E, Brioschi M, Martinez Fernandez A, et al. Lipid peroxidation in atherosclerotic cardiovascular diseases. Antioxid Redox Signal 2021; 34: 49-98. |
| 31. | Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodial Int 2017; 21 Suppl 1: S6-S20. |
| 32. | Wunderer F, Traeger L, Sigurslid HH, et al. The role of hepcidin and iron homeostasis in atherosclerosis. Pharmacol Res 2020; 153: 104664. |
| 33. | Seibt TM, Proneth B, Conrad M. Role of GPX4 in ferroptosis and its pharmacological implication. Free Radic Biol Med 2019; 133: 144-52. |
| 34. | Luo TT, Lu Y, Yan SK, Xiao X, Rong XL, Guo J. Network pharmacology in research of Chinese medicine formula: methodology, application and prospective. Chin J Integr Med 2020; 26: 72-80. |
| 35. | Bi Z, Zhang W, Yan X. Anti-inflammatory and immunoregulatory effects of icariin and icaritin. Biomed Pharmacother 2022; 151: 113180. |
| 36. | Chen Y, Gan Y, Yu J, Ye X, Yu W. Key ingredients in Verbena officinalis and determination of their anti-atherosclerotic effect using a computer-aided drug design approach. Front Plant Sci 2023; 14: 1154266. |
| 37. | Luo G, Xiang L, Xiao L. Quercetin alleviates atherosclerosis by suppressing oxidized LDL-induced senescence in plaque macrophage via inhibiting the p38MAPK/p16 pathway. J Nutr Biochem 2023; 116: 109314. |
| 38. | Wang IC, Lin JH, Lee WS, Liu CH, Lin TY, Yang KT. Baicalein and luteolin inhibit ischemia/ reperfusion-induced ferroptosis in rat cardiomyocytes. Int J Cardiol 2023; 375: 74-86. |
| 39. | Wang SJ, Li D, Ou Y, et al. Acetylation is crucial for p53-mediated ferroptosis and tumor suppression. Cell Rep 2016; 17: 366-73. |
| 40. | Yang WS, SriRamaratnam R, Welsch ME, et al. Regulation of ferroptotic cancer cell death by GPX4. Cell 2014; 156: 317-31. |
| 41. | Lagares MH, Silva KSF, Barbosa AM, et al. Analysis of p53 gene polymorphism (codon 72) in symptomatic patients with atherosclerosis. Genet Mol Res 2017; 16: 1-10. |
| 42. | Iwabayashi M, Taniyama Y, Sanada F, et al. Inhibition of Lp(a)-induced functional impairment of endothelial cells and endothelial progenitor cells by hepatocyte growth factor. Biochem Biophys Res Commun 2012; 423: 79-84. |
| 43. | Konstorum A, Tesfay L, Paul BT, Torti FM, Laubenbacher RC, Torti SV. Systems biology of ferroptosis: a modeling approach. J Theor Biol 2020; 493: 110222. |
| 44. | Wang Y, Zhao Y, Ye T, Yang L, Shen Y, Li H. Ferroptosis signaling and regulators in atherosclerosis. Front Cell Dev Biol 2021; 9: 809457. |
| 45. | Funauchi Y, Tanikawa C, Yi Lo PH, et al. Regulation of iron homeostasis by the p53-ISCU pathway. Sci Rep 2015; 5: 16497. |
| 46. | Zhang F, Wang W, Tsuji Y, Torti SV, Torti FM. Post-transcriptional modulation of iron homeostasis during p53-dependent growth arrest. J Biol Chem 2008; 283: 33911-8. |
| 47. | Chen WX, Zhang Y, Wang ZX, et al. Dapagliflozin alleviates myocardial ischemia/reperfusion injury by reducing ferroptosis MAPK signaling inhibition. Front Pharmacol 2023; 14: 1078205. |
| 48. | Sarmiento-Salinas FL, Perez-Gonzalez A, Acosta-Casique A, et al. Reactive oxygen species: role in carcinogenesis, cancer cell signaling and tumor progression. Life Sci 2021; 284: 119942. |
| 49. | Son Y, Kim S, Chung HT, Pae HO. Reactive oxygen species in the activation of MAP kinases. Methods Enzymol 2013; 528: 27-48. |
| 50. | Liu R, Sun Y, Di D, Zhang X, Zhu B, Wu H. PI3K/AKT/SERBP-1 pathway regulates Alisma orientalis beverage treatment of atherosclerosis in APOE-/- high-fat diet mice. Pharm Biol 2023; 61: 473-87. |
| 51. | Li J, Jiang J, Chen Y, Lu WQ. KLF 2 inhibits colorectal cancer progression and metastasis by inducing ferroptosis via the PI3K/AKT signaling pathway. J Pathol Clin Res 2023; 9: 423-35. |
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