Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12500
Peer-review started: July 23, 2022
First decision: September 26, 2022
Revised: October 9, 2022
Accepted: November 7, 2022
Article in press: November 7, 2022
Published online: December 6, 2022
Helicobacter pylori (H. pylori) is the most important infectious agent and plays an important role in the progression of chronic gastritis and the development of gastric cancer.
To identify efficient therapeutic agents or strategies that can treat H. pylori infection.
We performed literature analysis, experimental validation, and network pharmacology. First, traditional Chinese medicine (TCM) prescriptions for the treatment of H. pylori infection were obtained from the China National Knowledge Infrastructure, China Biology Medicine, China Science and Technology Journal Database, and WanFang databases. In addition, we conducted a relevant search by Reference Citation Analysis (RCA) (https://www.referencecitationanaly
The TCM treatment of H. pylori was mainly based on reinforcing the healthy Qi and eliminating pathogenic factors by simultaneously applying pungent dispersing, bitter descending, cold and warm drugs. The combination of Coptis, Pinellia, and Scutellaria (CPS) was identified as the core drug combination from 207 prescriptions and 168 herbs. This drug combination eradicated H. pylori, alleviated the gastric pathology induced by H. pylori infection, and reduced the expression levels of tumor necrosis factor-α (P = 0.024) and interleukin-1β (P = 0.001). Moreover, a total of 35 compounds and 2807 targets of CPS were identified using online databases. Nine key compounds (tenaxin I, neobaicalein, norwogonin, skullcapflavone II, baicalein, 5,8,2'-trihydroxy-7-methoxyflavone, acacetin, panicolin, and wogonin) and nine hub target proteins (EGFR, PTGS2, STAT3, MAPK3, MAPK8, HSP90AA1, MAPK1, MMP9, and MTOR) were further explored. Seventy-seven signaling pathways were correlated with H. pylori-induced inflammation and carcinogenesis.
In summary, we showed that CPS is the core drug combination for treating H. pylori infection. Animal experiments demonstrated that CPS has bacteriostatic properties and can reduce the release of inflammatory cytokines in the gastric mucosa. Network pharmacology predictions further revealed that CPS showed complex chemical compositions with multi-target and multi-pathway regulatory mechanisms. Although the results derived from network pharmacology are not necessarily comprehensive, they still expand our understanding of CPS for treating H. pylori infection.
Core Tip: Infection with Helicobacter pylori (H. pylori) is associated with severe digestive diseases, while successful eradication of this pathogen is known to prevent the occurrence of peptic ulcer disease and gastric cancer. Traditional Chinese medicine (TCM) has unique advantages for treating H. pylori infection, which can reduce drug resistance and increase the eradication rate of H. pylori. Here, we attempted to identify medication rules, effective materials, and the molecular mechanisms underlying the therapeutic effect of TCM against H. pylori using data mining, in vivo experiment, and network pharmacology. Coptis, Pinellia, and Scutellaria (CPS) were identified as the core drug combination for H. pylori eradication. We evidenced that CPS eradicated H. pylori, alleviated the gastric pathology, and reduced circulating tumor necrosis factor-α and interleukin-1β levels. Nine key compounds and nine hub target proteins were further determined as the key active ingredients and therapeutic targets of CPS against H. pylori, respectively. Altogether, our data strongly suggest that the efficacy of CPS in the treatment of H. pylori is worthy of affirmation.