According to epidemiological data released by 2021,451 million adults aged 20 to 79 worldwide have diabetes, of whom 116 million in China have diabetes [14], in Western countries, 30%-50% of people with diabetes have secondary kidney disease [15]. Chronic kidney disease caused by diabetes, called DN, has a large base of patients, and in developed countries, DN has been the main cause of the end-stage renal disease (ESRD) for a long time, and the prognosis is very limmited[16]. At present, western drugs are mainly used in clinical practice, such as ACEI/ARB, but the effect of the simple application is not good. Clinical studies have shown that the combination of Chinese drugs and western drugs can play a better role in the treatment of DN; for example, chuanxiong injection combined with Puli (ACEI) can improve renal function and reduce the level of urine protein better than alone injection[17]. However, although Chinese medicine has a favourable curative effect, it works in the form of multi-component coexistence. Most of the drugs have the problem of unclear specific effective components. Therefore, we seek the main active components of Chinese medicine, and it is necessary to improve the efficiency of drug utilization.
In recent years, the development of Internet pharmacology has promoted the discovery and utilization of the effective components of traditional Chinese medicine and saved the cost of drug research and development to some extent. Based on the method of network pharmacology, the active components of chuanxiong Hort were selected by Lipinski five rules[13, 18] and drug similarity [19]. There are angelica lactone A, ligusticum chuanxiong hort. Naphthalene, Myricetin respectively, 1-palmitic acid-2-linoleic acid-3-olein, conifer ferulate, 1-aldehyde-β-carboline, ligusticum chuanxiong and Chrysophanol; protein interaction analysis using a STRING database in the exploration of the interaction network of core genes in the treatment of DN by chuanxiong, Cytoscape 3.7.2 software was used to optimize the results. The results showed that there was an interaction network between the active components of chuanxiong and DN, in which NR3C1, AR, ESR1, NCOA1, NCOA2 and PGR played a key role in the regulatory network, after GO analysis and KEGG analysis of 15 potential target genes of chuanxiong Hort. regulating DN, the GO results suggest that the genes involved in the regulation of DN by chuanxiong Hort. It is involved in the regulation of cellular response to steroid hormone stimulation, the binding of nuclear receptors to steroid hormone receptors and the regulation of cAMP-dependent protein kinase complexes. Besides, KEGG analysis showed that estrogen signalling pathway, endocrine and other factors-regulated calcium reabsorption and adipocyte adiposis regulation play a role in the regulation of DN. Thus, to find out the sites of interaction and the forms of interaction between the active components and the targets, the key genes and the main active components of chuanxiong hort. After determining the range of the active pocket, we used vina software to predict the molecular docking and select the appropriate binding energy; it was found that the K220, S212, N224, and K2261 groups in NCOA1 protein could interact with the hydrogen bonds of angelica lactone A, palmitic acid-2-linoleic acid-3-glyceryl oleate and Myricetin, the groups of NCOA2 protein A475, R655, D590, N466, D467 and P547 interact with Chrysophanol, chuanxiong naphthafuronolactone, Angelica Sinensis A, 1-palmitic acid-2-linoleic acid-3-glyceryl ester by a hydrogen bond. The above results suggest that there are potential targets of active components of chuanxiong Hort. NCOA1 and NCOA2 have intermolecular interactions with the main active components of chuanxiong Hort.
Clinical and animal studies have shown a link between ESR1 signals activity and DN [20]. Studies have shown that plasma estradiol levels in the kidneys of diabetic patients are reduced, and ESR1 signals are out of whack [21]. Protein tyrosine kinase (PTK) is a kind of kinase that catalyzes the transfer of γ-phosphoric acid from ATP to protein tyrosine residues [22], and can catalyze the phosphorylation of tyrosine residues in a variety of substrate proteins, plays an important role in cell growth, proliferation and differentiation [23]. PTK can be divided into non-receptor type and membrane receptor type according to whether PTK exists in the cell membrane receptor. The P160/steroid receptor coactivators (SRC-1, SRC-2, also known as NCOA1, NCOA2) family products represent the non-receptor type [24, 25], which can regulate a variety of physiological reactions and clinical pathology. This pleiotropy is achieved through its inherent structural complexity, which enables this class of auxiliary regulators to control both nuclear and nonnuclear receptor signals, playing an important role in steroid hormone signaling [26]. The results indicated that the target genes of chuanxiong Hort. can be regulated by cAMP-dependent protein kinase complexes. It is well known that cAMP can activate the expression of Phosphatidylinositol 3-hydroxy kinase (PI3K)[27], it has been suggested that Estrogen can activate PI3K by binding to the ESR1(ER) on the cell membrane and participate in the regulation of Estrogen signalling pathway, which suggests a potential link between the therapy of chuanxiong and the activation of Estrogen signaling[28]. Recent studies have shown that the estrogen signal pathway can affect energy metabolism; KEGG analysis results show that the estrogen signal pathway is involved in the regulation of DN by chuanxiong. Based on the above results, we hypothesized that chuanxiong might participate in the binding of steroid hormone receptors via NCOA1 and NCOA2, thus affecting the activation of an estrogen signalling pathway, regulating energy metabolism and delaying the progression of DN. In this study, the method of network pharmacology was used to systematically analyze the treatment of DN with chuanxiong Hort.
Based on the published literature and the results of molecular docking experiments, we hypothesized that chuanxiong might be involved in the binding of steroid hormone receptors via NCOA1 and NCOA2; it can affect the activation of the estrogen signal pathway, regulate the energy metabolism and delay the progress of DN. It provides a new way for the better clinical application and mechanism research of chuanxiong, and a new method and a new way for the research of traditional Chinese medicine. In this study, the mechanism of action of chuanxiong in the treatment of DN was predicted based on network pharmacological reasoning, and the drug-target interaction was analyzed by molecular docking technique in order to improve the reliability of the target of chuanxiong Hort., the prediction results need to be verified by in vitro and in vivo experiments.