Abstract Network pharmacology has become a widely used approach for deciphering multi-component, multi-target mechanisms of traditional Chinese medicine (TCM). Here we introduce TCMCard, a high-confidence digital infrastructure built on a Multi-Dimensional Evidence Integration (MDEI) framework. The framework integrates experimental activity data from authoritative chemical databases, literature-derived evidence, and structure-based similarity inference. Preprocessing steps include chemical structure normalization, species-specific filtering, and target quality scoring. Applied to conventional interaction datasets, this pipeline leads to the removal of over 60% of low-confidence noise. TCMCard supports network pharmacology exploration through an interactive visualization platform, and module analysis identifies functionally relevant communities that offer insights into the synergistic actions of TCM formulas. Overall, TCMCard may help move the field beyond simple data aggregation toward evidence-informed curation and quality-driven analysis. As an interactive and publicly accessible platform, it reveals an organized backbone within complex interaction networks, offering a more reliable basis for understanding multi-component synergy in TCM.

Network pharmacology has emerged as a pivotal approach for deciphering the complex “multi-component, multi-target” mechanisms underlying traditional Chinese medicine (TCM). However, despite extensive research efforts, a comprehensive and intelligent automated analytical framework remains elusive. Large language model (LLM)-based intelligent agent systems demonstrate robust capabilities in semantic understanding, logical inference, and task orchestration. In this study, we present the first LLM-powered multi-agent system specifically designed for network pharmacology and herbal medicine research, namely TCM-Agent. The system demonstrates core capabilities including autonomous knowledge reasoning, data analysis, interactive visualization, as well as literature retrieval and validation. Benchmark evaluations across 100 validated TCM studies demonstrated that the TCM-Agent demonstrated competitive performance in answer accuracy, literature retrieval precision, and computational efficiency. Crucially, the TCM-Agent system exhibited robust and high performance across evaluated foundation model platforms (DeepSeek-v3, Qwen-plus, and GLM-4-plus). Furthermore, no significant differences were observed across the various foundation model platforms, indicating the system’s adaptability and stability when integrated with different LLM. These findings establish TCM-Agent as a robust system that provides an advanced framework, facilitating standardization, intelligent transformation, and evidence-based methodologies in network pharmacology and herbal medicine research. Consequently, TCM-Agent enhances the intelligent analysis of TCM formulas, aids in bioactive compound discovery, and establishes foundational infrastructure for next-generation network pharmacology, thereby advancing research in the field.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used in patients with chronic kidney disease (CKD), but existing evidence regarding their efficacy and safety remains inconsistent. To evaluate the cardiorenal outcomes and adverse effects of GLP-1 RAs in this population, we conducted a systematic review and meta-analysis of randomized controlled trials from PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science up to December 2024. Nine trials involving 21,717 patients, the vast majority of whom had T2DM, were included. GLP-1RAs treatment for CKD was associated with decreasing the incidence of major adverse kidney events (MAKE; RR, 0.84; 95% CI, 0.76-0.94) and major adverse cardiac and cerebrovascular events (MACE; RR, 0.84; 95% CI, 0.72-0.97), reducing all-cause mortality (RR, 0.83; 95% CI, 0.76-0.90) and albuminuria level (SMD, -1.22; 95% CI, -1.53 - 0.90). Gastrointestinal events associated with GLP-1 RA treatments including nausea (RR, 4.14; 95% CI, 2.70-6.33), vomiting (RR, 3.05; 95% CI, 1.88-4.97), diarrhea (RR, 2.65; 95% CI, 1.76-3.98), and dyspepsia (RR, 3.79; 95% CI, 1.02-14.12) have garnered significant attention. In conclusion, administration of GLP-1RAs treatment demonstrates excellent cardiorenal protective effects in CKD, primarily in patients with co-existing T2DM, though with notable gastrointestinal concerns.

BACKGROUND:Diabetic nephropathy (DN) is a major complication that arises from diabetes. Curcumin, a bioactive compound with antioxidant properties, has been shown to modulate multiple cellular pathways and thereby mitigate tissue damage. AIM:To explore the influence of curcumin on high glucose-triggered apoptosis in renal tubular epithelial cells. METHODS:Sprague-Dawley rats were divided into control, diabetic, and curcumin treatment groups (n = 10/group). Renal function markers (neutrophil gelatinase-associated lipocalin, KIM-1, and urinary albumin) were assessed, and renal tissues were analyzed using histopathology, TUNEL assays, and immunohistochemistry. Renal tubular epithelial cells were cultured under normal (5.5 mmol/L) or high glucose (30 mmol/L) conditions, with or without curcumin. Apoptosis, reactive oxygen species (ROS) levels, and Nrf2/heme oxygenase-1 (HO-1) signaling pathway markers were evaluated using flow cytometry, quantitative polymerase chain reaction, and immunohistochemistry. RESULTS:Curcumin improved renal function markers and reduced renal tubular apoptosis in diabetic rats. In vitro, it suppressed high glucose-induced apoptosis and ROS production, while activating the Nrf2/HO-1 antioxidant pathway (upregulated Nrf2 and HO-1 expression, and downregulated Keap1) and modulating the Bcl-2/Bax apoptotic balance (downregulated Bax and upregulated Bcl-2), demonstrating sequential protection against oxidative stress followed by apoptosis inhibition. CONCLUSION:Curcumin protects against high glucose-induced renal tubular epithelial apoptosis by enhancing Nrf2/HO-1 signaling to reduce oxidative stress and apoptosis, indicating its therapeutic potential for DN.

ETHNOPHARMACOLOGICAL RELEVANCE:Fufang Biejia Ruangan Tablets (FFBJ), a traditional Chinese medicine, has long been used in the management of fibrosis, demonstrating notable efficacy and safety. However, the bioactive components of FFBJ and their mechanisms of action remain poorly understood. AIM OF THE STUDY:To identify the core bioactive components of FFBJ and elucidate their mechanisms of action against renal fibrosis. MATERIALS AND METHODS:The constituents of FFBJ were characterised using high-performance liquid chromatography-High-resolution mass spectrometry (HPLC-HRMS). A multi-tiered strategy integrating pharmacokinetic evaluation, ADMET predictions, molecular docking, and efficacy assessments (MTT/Sirius-Red assays) identified five core bioactive compounds. The synergistic ratios of these compounds were optimised using the Box-Behnken design. In vitro, TGF-β1-stimulated NRK49F cells were treated with FFBJ-COF, a compound composed optimised formula from FFBJ, at low (half-medium dose), medium (30 μM taxifolin, 7.732 μM turtle-shell heptapeptide [OC1], 13.623 μM quercetin, 13 μM curcumenol, and 3.3 μM hederagenin), or high (double-medium dose) concentrations. In vivo, mice with unilateral ureteral obstruction (UUO) were treated with FFBJ-COF via gavage at low (half-medium dose), medium (64.85 mg/kg/d taxifolin, 30.30 mg/kg/d turtle-shell heptapeptide [OC1], 29.25 mg/kg/d quercetin, 21.83 mg/kg/d curcumenol, and 10.07 mg/kg/d hederagenin), or high (1.5-fold medium dose) levels. Polyacrylamide hydrogels (1-20 kPa) were employed to mimic fibrotic-matrix stiffness. Co-immunoprecipitation and western blotting were used to investigate the regulation of integrin αVβ1 binding and the downstream FAK/RhoA/MRTF-A signalling. RESULTS:HPLC-HRMS analysis revealed 76 components. FFBJ-COF, comprising curcumenol, hederagenin, taxifolin, quercetin, and OC1, was formulated based on efficacy screening and ratio optimization. FFBJ-COF treatment attenuated renal injury and fibrosis by reducing fibroblast activation and extracellular matrix (ECM) deposition in both in vivo and in vitro model. Mechanistic studies showed that ECM stiffness activated fibroblasts, which was inhibited by FFBJ-COF. Co-immunoprecipitation demonstrated that matrix stiffness enhanced the binding of integrin αVβ1, whereas FFBJ-COF suppressed this interaction and inhibited the downstream FAK/RhoA/MRTF-A signalling pathway. CONCLUSION:FFBJ-COF was identified as the core bioactive fraction of FFBJ. FFBJ-COF exerts anti-fibrotic effects by inhibiting integrin αVβ1 binding, thereby suppressing the FAK/RhoA/MRTF-A signalling and disrupting the positive feedback loop between ECM stiffness and fibrosis. These findings highlight the potential of FFBJ as a novel therapeutic agent for renal fibrosis.

AIMS:Diabetic cardiomyopathy (DCM) is a common complication of diabetes mellitus and frequently progresses to heart failure. Although the deubiquitinase OTUB1 has demonstrated protective effects in DCM, the upstream regulatory mechanisms governing its expression and their influence on mitochondrial function remain unclear. METHODS:We used a short-term insulinopenic diabetic mouse model supplemented with exogenous protein C (PC) to investigate the role of activated protein C (aPC) in regulating OTUB1 during early-stage DCM. A thrombomodulin-mutant (TMPro/Pro) mouse model, which limits endogenous PC activation, was employed to assess long-term effects. Additionally, a microRNA miR-493-5p sponge was delivered via recombinant adeno-associated virus (rAAV) to evaluate the therapeutic potential of miR-493-5p inhibition. RESULTS:Exogenous PC supplementation preserved cardiac function and restored OTUB1 protein levels in early-stage DCM without affecting Otub1 mRNA expression. In contrast, TMPro/Pro mice exhibited exacerbated cardiac dysfunction and reduced OTUB1 protein abundance. Mechanistically, we identified miR-493-5p as a direct translational repressor of OTUB1, which was upregulated in diabetic hearts and downregulated by aPC through endothelial protein C receptor-protease-activated receptor 1 signaling. Both in vitro and in vivo experiments confirmed that miR-493-5p impairs OTUB1-mediated mitochondrial function, resulting in cardiomyocyte apoptosis. Inhibition of miR-493-5p via rAAV-sponge delivery restored OTUB1 levels, improved mitochondrial morphology, and significantly enhanced cardiac function in diabetic mice. CONCLUSION:Our findings identify the aPC/miR-493-5p/OTUB1 axis as a critical regulatory pathway in DCM pathogenesis. Targeting this axis may represent a promising therapeutic strategy for preserving mitochondrial integrity and preventing diabetic cardiac dysfunction.

Objective To identify the active components in Maimendong decoction (MMDD) against pulmonary fibrosis (PF) and validate their molecular effects in vitro, while focusing on the role of methylophiopogonanone B in regulating fibrosis. Methods Data on MMDD components and targets were gathered from databases including BATMAN-TCM and PubMed, whereas the PF gene data were sourced from GeneCards, OMIM, and TTD. Shared targets were determined using the STRING database, and molecular docking was used to analyze the essential molecules associated with fibrosis. To simulate PF conditions, human embryonic lung fibroblasts (HPF) and A549 cells were exposed to transforming growth factor-β1 (TGF-β1). Various assays were used to determine the effects of MMDD and methylophiopogonanone B on signaling pathways, apoptosis, and epithelial–mesenchymal transition. Results We identified 11 active components from MMDD extracts that targeted 511 shared proteins associated with PF, revealing 10 key targets in network analysis. Gene ontology analysis indicated that processes and pathways such as apoptosis regulation and PI3K/Akt signaling were involved. In vitro experiments revealed that MMDD downregulated the expression of α-smooth muscle actin (α-SMA), collagen type I (COL-I), and collagen type III and regulated Bcl-2/Bax signaling pathways to promote apoptosis. The flow cytometry apoptosis assay revealed that MMDD promoted the TGF-β1-induced apoptosis of myofibroblasts. The primary active ingredient in MMDD, methylophiopogonanone B, reduced α-SMA, COL-I, and PI3K/Akt/mTOR-related protein levels in TGF-β1-treated HPF cells, decreased Bcl-2 and cleaved caspase 3, and increased Bax. Moreover, methylophiopogonanone B increased E-cadherin levels and reduced α-SMA, fibronectin, N-cadherin, vimentin, and snail in TGF-β1-treated A549 cells. Conclusion Methylophiopogonanone B demonstrated the potential to treat PF by inducing myofibroblast apoptosis and inhibiting EMT. However, despite encouraging initial results, further clinical research is warranted to verify the safety and efficacy of methylophiopogonanone B in the management of PF.

Extracellular vesicles (EVs) are lipid bilayer-enclosed nanoparticles that mediate intercellular communication and hold significant promise as therapeutic agents, drug delivery vehicles, and biomarkers. This review systematically explores the bidirectional interplay between EVs and Traditional Chinese Medicine (TCM). We first summarize the unique bioactivity and therapeutic potential of Chinese herbal medicine-derived EVs (CHM-EVs), which retain plant-specific components and demonstrate anti-inflammatory, antioxidant, and tissue-protective effects. We critically expand the scope beyond the prevailing discourse on EVs' intrinsic mechanisms to investigate two significant emerging paradigms We examine EVs as innovative delivery platforms for TCM bioactive compounds, demonstrating how EVs enhance solubility, stability, and targeted delivery of challenging components to amplify therapeutic efficacy. Concurrently, we explore how TCM itself modulates endogenous EVs. Active ingredients within TCM formulations exert therapeutic effects by regulating host EV biogenesis, secretion, cargo composition, and bioactivity, as evidenced in diseases ranging from nephropathy to inflammation. We further evaluate challenges in CHM-EVs standardization (isolation, characterization, nomenclature), biosafety, and clinical translation. By integrating these perspectives, this review provides a panoramic overview of how EVs bridge TCM theory with modern mechanistic research, offering innovative strategies for advancing TCM modernization and EV-based therapeutics.

Background Accumulating evidence suggests that metabolic disorders, including type 2 diabetes mellitus (T2DM), can be treated with traditional Chinese medicine formulas, such as the Gegen Qinlian decoction (GQD). This study elucidates the mechanisms by which gut microbes mediate the anti-diabetic effects of GQD.Methods We conducted a double-blind randomized clinical trial involving 120 untreated participants with T2DM. During the 12-week intervention, anthropometric measurements and diabetic traits were recorded every 4 weeks. Fecal microbiota and serum metabolites were measured before and after the intervention using 16S rDNA sequencing, liquid chromatography-mass spectrometry, and Bio-Plex panels.Results Anti-diabetic effects were observed in the GQD group in the human trial. Specifically, glycated hemoglobin, fasting plasma glucose, and two-hour postprandial blood glucose levels were significantly lower in the GQD group than in the placebo group. Additionally, Faecalibacterium was significantly enriched in the GQD group, and the short-chain fatty acid levels were higher and the serum inflammation-associated marker levels were lower in the GQD group compared to the placebo group. Moreover, Faecalibacterium abundance negatively correlated with the levels of serum hemoglobin, fasting plasma glucose, and pro-inflammatory cytokines. Finally, the diabetes-alleviating effect of Faecalibacterium was confirmed by oral administration of Faecalibacterium prausnitzii (DSMZ 17677) in T2DM mouse model.Conclusions GQD improved type 2 diabetes primarily by modulating the abundance of Faecalibacterium in the gut microbiota, alleviating metabolic disorders and the inflammatory state.Trial registration Registry No. ChiCTR-IOR-15006626. Graphical Abstract

Ethnopharmacological relevance Chai Shao Jie Yu Granules (CSJY) is a renowned and time-honored formula employed in clinical practice for the management of various conditions, notably depression. Depression, a prevalent psychiatric disorder, poses challenges with limited effective treatment options. Traditional herbal medicines have garnered increasing attention in the realm of combating depression, being perceived as safer alternatives to pharmacotherapy. Aim of the study To explore the effects and mechanisms of CSJY in chronic unpredictable mild stress (CUMS)-induced depression. Materials and methods Rat models of CUMS-induced depression were established, and the rats were randomly allocated into six groups: Control, CUMS, CUMS + Paroxetine (PX), CUMS + CSJY-L, CUMS + CSJY-M, and CUMS + CSJY-H. Throughout the study, the rats' body weight was monitored. Depression-related behaviors were assessed using the sucrose preference test (SPT) and open field test (OFT). High-performance liquid chromatography-mass spectrometry (HPLC-MS) measured monoamine neurotransmitters in the rat cortex and hippocampus. We measured adrenocorticotropic hormone (ACTH), corticosterone (CORT), and corticotropin-release hormone (CRH) levels in rat serum. Additionally, network pharmacology was employed to predict relevant molecular targets and potential mechanisms, followed by in vivo validation. Western blot analysis was conducted to evaluate the protein levels of 5-hydroxytryptamine/serotonin receptor 1A (5-HT1A) and Glutamate (Glu)-related proteins, such as p-GluA1, GluA1, p-GluN1, GluN1, p-GluN2A and GluN2A in the hippocampus. Results In behavioral assessments, CUMS rats exhibited depressive behaviors, which were ameliorated by CSJY or PX treatment. Moreover, CSJY or PX treatment increased serotonin (5-HT) levels. It reduced the kynurenine/tryptophan (KYN/TRP) and gamma-aminobutyric acid/glutamate (GABA/Glu) in the hippocampus and cortex, as well as reduced serum levels of ACTH, CORT and CRH. Furthermore, CSJY or PX administration enhanced the decreased expression of p-GluN1/GluN1 while upregulating 5-HT1A and p-GluA1/GluA1 levels in the CUMS group. Conclusion CSJY demonstrated the ability to alleviate depressive behaviors in CUMS-induced depression rats, potentially through the inhibition of the hypothalamic-pituitary-adrenal (HPA) axis, modulation of monoamine neurotransmitters, and glutamatergic neurons. These findings suggest that CSJY could serve as a promising treatment option for depression.

ETHNOPHARMACOLOGICAL RELEVANCE:Mai Men Dong decoction (MMDD), a traditional Chinese medicine formula, is relevant to ethnopharmacology due to its constituents and therapeutic properties. The formula contains herbs like Ophiopogon japonicus (Thunb.) Ker Gawl., Pinellia ternata (Thunb.) Makino, Panax ginseng C.A.Mey, Glycyrrhiza uralensis Fisch, and Ziziphus jujuba Mill, Oryza sativa L., which have been used for centuries in Chinese medicine. These herbs provide a comprehensive approach to treating respiratory conditions by addressing dryness, cough, and phlegm. Ethnopharmacological studies have explored the scientific basis of these herbs and identified active compounds that contribute to their medicinal effects. The traditional usage of MMDD by different ethnic groups reflects their knowledge and experiences. Examining this formula contributes to the understanding and development of ethnopharmacology.AIM OF THE STUDY:In the case of pulmonary fibrosis (PF), treating it can be challenging due to the limited treatment options available. This study aimed to assess the potential of MMDD as a treatment for PF by targeting macrophages and the PI3K/Akt/FOXO3a signaling pathway.MATERIALS AND METHODS:In a mouse model of PF, we investigated the effects of MMDD on inflammation, fibrosis, and M2 macrophage infiltration in lung tissue. Additionally, we examined the modulation of pro-fibrotic factors and key proteins in the PI3K/Akt/FOXO3a pathway. In vitro experiments involved inducing M2-type macrophages and assessing the impact of MMDD on fibroblast activation and the PI3K/Akt/FOXO3a pathway.RESULTS:Results demonstrated that MMDD improved weight, reduced inflammation, and inhibited M2 macrophage infiltration in mouse lung tissue. It downregulated pro-fibrotic factors, such as TGF-β1 and PDGF-RB, as well as markers of fibroblast activation. MMDD also exhibited regulatory effects on key proteins in the PI3K/Akt/FOXO3a signaling pathway.CONCLUSIONS:MMDD inhibited M2 macrophage polarization and released profibrotic factors that inhibited pulmonary fibrosis. As a result, the PI3K/Akt/FOXO3a signaling pathway is suppressed. MMDD is proving to be a successful treatment for PF. However, further research is needed to validate its effectiveness in clinical practice.

Objective: To explore the mechanism of the Peiyuan Jieyu formula in treating depression by assessing its impact on a lipopolysaccharide-induced (LPS-induced) depression mouse model. Methods: We created a mouse model of depression by exposing mice that had previously received chronic stress to intraperitoneal LPS injections. The mice were divided into the following groups: control, model, fluoxetine, Tiansi Yin, Sini powder, and low-, medium-, and high-dose Peiyuan Jieyu formula groups. Forced swim and tail suspension tests were used to assess the efficacy of the depression (despair) model, and weight gain rates were also measured. Furthermore, serum levels of various depression and inflammation-associated molecules, including tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), tryptophan, 5-hydroxytryptamine, kynurenine (KYN), and kynurenic acid (KA) were assessed. Furthermore, the expression levels of ionic calcium-binding adaptor molecule-1 (IBA-1) and indoleamine 2,3-dioxygenase (IDO) mRNA in hippocampal microglia were measured. Results: The model group displayed greater despair-associated immobility, which was shortened in response to various doses of Peiyuan Jieyu formula. Furthermore, formula administration significantly reduced serum TNF-α levels and hippocampal IDO mRNA expression. The high formula dose also reduced IFN-γ and IBA-1 levels, the latter was also decreased in response to the medium formula dose. However, the low formula dose reduced serum KYN level and KYN/tryptophan (TRP) and KYN/KA ratios. Conclusion: The Peiyuan Jieyu formula holds immense potential in treating depression in a mouse model, potentially inhibiting inflammation and improving TRP-KYN metabolic disorders.

Liver fibrosis is a major global health issue, and immune dysregulation is a main contributor. Triptolide is a natural immunosuppressive agent with demonstrated effectiveness in ameliorating liver fibrosis, but whether it exerts anti-liver fibrotic effects via immunoregulation remains obscure. In this study, first, by employing a CCL4-induced liver fibrosis mouse model, we demonstrated that triptolide could alleviate pathological damage to liver tissue and attenuate liver function damaged by CCL4. In addition, triptolide inhibited the expression of liver fibrotic markers such as hydroxyproline, collagen type IV, hyaluronidase, laminin, and procollagen type III, and the protein expression of α-SMA in CCL4-induced liver fibrosis. Second, with the help of network pharmacology, we predicted that triptolide's anti-liver fibrotic effects might occur through the regulation of Th17, Th1, and Th2 cell differentiation, which indicated that triptolide might mitigate liver fibrosis via immunoregulation. Finally, multiplex immunoassays and flow cytometry were adopted to verify this prediction. The results suggested that triptolide could reverse the aberrant expression of inflammatory cytokines caused by CCL4 and regulate the differentiation of Th1, Th2, Th17, and Treg cells. In conclusion, triptolide could attenuate CCL4-induced liver fibrosis by regulating the differentiation of CD4+ T cells. The results obtained in this study extended the application of triptolide and introduced a new mechanism of triptolide's anti-liver fibrotic effects.

Background Acute respiratory distress syndrome (ARDS) is a serious life threatening clinical critical illness. ARDS-related pulmonary fibrosis is a common complication of ARDS. The occurrence of early pulmonary fibrosis indicates a higher incidence and mortality of multiple organ failure. LPS-induced ARDS-related pulmonary fibrosis model in mice was established in this study. And we have explored the anti-pulmonary fibrosis effects and molecular mechanisms of the Citrus Alkaline Extracts (CAE) in vivo and in vitro. Methods Pulmonary fibrosis mouse model and lung epithelial cell injury model were established in this study. H&E, Masson and Sirius Red staining were used to estimate lung tissue damage. Immunohistochemistry and western blotting were used to analyze proteins expression. Protein-protein interaction was observed by Co-Immunoprecipitation. Systemic impact of CAE on signaling pathway was examined by RNA-seq. Results Through H&E, Masson and Sirius Red staining, it was convincingly indicated that therapeutic administration of CAE alleviated lung injury and fibrosis, while pretreated administration of CAE showed weak improvement. In vitro experiments showed that CAE had dual regulation to E-cadherin and N-cadherin, the important indicators of epithelial-mesenchymal transition (EMT). And it was further demonstrated that CAE reversed TGF-β1-induced EMT mainly through Wnt/β-catenin, Stat3/6 and COX2/PGE2 signals. Through RNA-Seq, we discovered important mechanisms by which CAE exerts its therapeutic effect. And network pharmacology analysis demonstrated core potential targets of CAE in EMT. Conclusion Thus, this study provides new therapeutic effects of CAE in anti-fibrosis, and offers potential mechanisms for CAE in LPS-induced pulmonary fibrosis. Graphical Abstract

Ethnopharmacological relevance: The incidence of renal fibrosis caused by chronic kidney disease is increasing year by year. Preventing the activation and conversion of kidney-intrinsic fibroblasts to a myofibroblast phenotype is an important target for blocking the development of renal interstitial fibrosis. Our team established a stable renal interstitial fibrosis cell model in the early stage, and the screening results showed that GPs has good anti-fibrosis potential. At this stage, only a few literatures have reported its anti-fibrosis effect, and the mechanism of action is still unclear. Aim of the study: The massive synthesis and secretion of extracellular-matrix (ECM) components by activated fibroblasts in the kidneys causes irreversible renal interstitial fibrosis. Gypenosides (GPs) have been shown to decelerate this process, in which micro RNAs (miRNAs) play an important regulatory role. This study aimed to evaluate the mechanism underlying the suppressive effect of GPs on renal fibrosis. Materials and methods: This study used TGF-& beta;1-stimulated NRK-49F renal cells as an in-vitro model of renal interstitial fibrosis. First, the concentration range of GPs that significantly affects the cytoactive was determined. Then, the anti-fibrotic effects of various concentrations of GPs in the in-vitro model were assessed via immunofluorescence, western blotting, and quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Non-coding-RNA sequencing combined with bioinformatics was used to predict the mechanistic basis of the antifibrotic effect of GPs, and qRT-PCR was used to verify the sequencing results and bioinformatic predictions. The identified relationships of the anti-fibrotic effect of GPs with miR-378a-5p and the PI3K/AKT signaling were evaluated using a miR-NC mimic and the PI3K inhibitor LY294002 as controls, respectively. Results: TGF-& beta;1 stimulation up-regulated & alpha;-SMA, COL1, and COL3 in NRK-49F cells, and this effect was suppressed by GPs. Additionally, TGF-& beta;1 stimulation significantly changed the expression levels of 151 miRNAs, and GPs significantly suppressed the effect of TGF-& beta;1 on the levels of 18 of these miRNAs. Among them, miR-3588 and miR-378a-5p were down-regulated, and miR-135b-5p and miR-3068-5p were up-regulated upon TGF-& beta;1 induction. Of these miRNAs, miR-378a-5p was predicted to target the mRNAs of numerous proteins mainly enriched in the PI3K/AKT signaling pathway. The miRNA transfection experiments with the miR-NC mimic and PI3K inhibitor as controls showed that miR-378a-5p overexpression could suppress the TGF-& beta;1-induced upregulation of & alpha;-SMA, COL1, PI3K, and AKT, including the phosphorylated form (p-AKT). Conclusion: GPs inhibit the PI3K/AKT signaling by up-regulating miR-378a-5p in TGF-& beta;1-stimulated NRK-49F cells and thereby reduce their massive secretion of ECM components. Given that this in-vitro model of renal interstitial fibrosis closely mimics the in-vivo pathogenesis, our results most likely apply to the in-vivo conditions.

目的 探讨不同半夏炮制品体外抗肺纤维化的作用及筛选出的半夏制品对肺纤维化小鼠的干预作用.方法 用10μg/L转化生长因子β1(TGF-β1)诱导人胚肺成纤维细胞系(MRC-5)建立肺纤维化体外模型,经水提生半夏(2.1、4.2、8.4、16.7 g/L)、清半夏(2.1、4.2、8.4、16.7 g/L)、法半夏(2.1、4.2、8.4、16.7 g/L)和姜半夏(2.1、4.2、8.4、16.7 g/L)分别处理48 h后,通过CCK-8法检测细胞活性、天狼星红染色法测定胶原含量进行抗纤维化筛选.用Western blot分析筛选出的生半夏干预MRC-5细胞表达α-平滑肌肌动蛋白(α-SMA)的情况.C57BL/6N小鼠经口腔进行气管滴注博来霉素(2 mg/kg)建立肺纤维化模型,第14天开始灌胃生半夏水提液(2.5、5.0、10.0 g/kg),第28天取肺组织经HE和Masson染色观察,并测定羟脯氨酸(HYP)含量.结果 与对照组比较,TGF-β1诱导后的MRC-5细胞对生半夏(8.4 g/L)的细胞活性抑制作用更敏感(P<0.05),而未经TGF-β1诱导的MRC-5细胞则需要更高浓度的生半夏或清半夏(16.7 g/L)抑制细胞活性(P<0.05).与模型对照组比较,生半夏(8.4、16.7 g/L)能够抑制TGF-β1诱导的胶原合成(P<0.05),清半夏、法半夏、姜半夏各组未见抑制效应.与模型对照组比较,生半夏(2.1、4.2、8.4 g/L)能够抑制TGF-β1诱导的MRC-5细胞中 α-SMA蛋白的表达(P<0.05).生半夏(10 g/kg)能够缓解肺纤维化模型小鼠肺间质中的炎性浸润,恢复肺泡结构,减少胶原沉积,降低肺组织中的HYP含量(P<0.05).结论 生半夏对TGF-β1诱导后的病理性肌成纤维细胞具有活性抑制作用,并能阻止成纤维细胞向肌成纤维细胞分化,抑制其胶原合成,缓解模型小鼠的肺纤维化进展,为临床应用半夏治疗肺纤维化提供新的思路.