Limb lymphedema:network pharmacology and molecular docking analysis of core drug mechanisms in traditional Chinese medicine treatment

Mi Baolai; Liu Yufei; Yang Qiaoli; Kang Yanlan; Yuan Liang; Cao Jianchun

doi:10.12307/2026.740

Abstract：BACKGROUND:Limb lymphedema lacks a specific treatment in modern medicine,and the efficacy of existing drugs is limited.Traditional Chinese medicine (TCM)has a profound accumulation in the treatment of edema,and ancient texts contain a wealth of prescription experience.However,the differences in the views of various schools of thought have led to the dispersal of formulas,and their mechanisms of action are not yet understood.In particular,there is a lack of systematic investigation of the treatment pattern of TCM formulas in ancient books. OBJECTIVE:Based on the cloud platform of ancient and modern medical cases and CytoScape,to analyze the medication patterns of Chinese medical texts for the treatment of limb lymphedema,and to explore the mechanism of action of core drugs through network pharmacology and molecular docking. METHODS:We collected the edema-reducing TCM formulas for the treatment of limb lymphedema in the database of"imedbooks"as of May 1,2024,and screened the core drugs that met the criteria.The components and targets of the core drugs were obtained by TCMSP,and the disease targets were screened by GeneCards,TTD,and OMIM.The drug-component-target network and protein-protein interactions network were constructed,and the Gene Ontology/Kyoto Encyclopedia of Genes and Genomes enrichment analysis was performed by Metascape and verified by molecular docking. RESULTS AND CONCLUSION:Finally,223 formulas(containing 355 Chinese herbal medicines)were included,and the core drug combination was identified by pairing and complex network analysis:dried tangerine peel-Poria cocos-Betel nut-Atractylodis Macrocephalae-Mucuna pruriens.Network pharmacological analysis showed that the core targets(e.g.,tumor protein 53,non-receptor tyrosine kinase,protein kinase B1)were enriched in the pathways of phosphatidylinositol 3-kinase-protein kinase B,mitogen-activated protein kinase,hypoxia-inducible factor 1,and cancer-related pathways.Molecular docking verified the strong binding activity of 3′,5,7-trihydroxy-4-methoxyflavone and brewer's sterol with non-receptor tyrosine kinase and protein kinase B1.The study suggests that this core combination may treat limb lymphedema by modulating non-receptor tyrosine kinase,protein kinase B1 and the above pathways.