Unveiling XinJia-LuHuang Granules' protective mechanism against atherosclerosis: Integrating network pharmacology, metabolomics, and experimental validation.

Background: Atherosclerosis (AS) is a primary contributor to cardiovascular disease. XinJia-LuHuang Granules (XLG), a formula used in traditional Chinese medicine (TCM), has been employed to treat AS. However, the underlying mechanism through which XLG exerts its effects remains unclear and warrants further investigation.

Purpose: The purposes of this research are to assess the therapeutic effect of XLG on AS and to investigate its potential underlying procedures.

Materials And Methods: Network pharmacology was implemented to recognize XLG's active ingredients, along with their associated targets and pathways involved in the treatment of AS. Metabolomics was employed to detect changes in metabolites following XLG administration. Furthermore, a combined analysis of metabolomics and network pharmacology elucidated the key targets and pathways underlying the therapeutic effects of XLG in AS. The interactions between XLG's active ingredients and their specific targets were evaluated using molecular docking. In addition, an apolipoprotein E knockout (ApoE) mouse model was used to simulate AS. Hematoxylin-Eosin (HE) staining and Oil Red O staining were utilized to assess the extent of pathological changes. An enzyme-linked immunosorbent assay (ELISA) was employed to measure inflammatory responses. The biochemical analyzer was applied to evaluate serum lipid levels in the mice. Immunofluorescence (IF) staining was conducted to measure the expression levels of key proteins in the sphingosine-1-phosphate receptor 1 (S1PR1)-activated phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/endothelial nitric oxide synthase (eNOS) signaling pathway. In cell experiments, the viability of human umbilical vein endothelial cells (HUVECs) was detected using Cell Counting Kit-8 (CCK-8). Western blot (WB) analysis and ELISA were executed to measure the expression levels of proteins in the S1PR1-activated PI3K/Akt/eNOS signaling pathway both before and after the administration of specific inhibitors.

Results: XLG contains 143 active ingredients and 309 potential targets, of which 193 are associated with AS. Metabolomic analysis revealed alterations in lipid substance levels. Combined with molecular docking analysis, it was observed that the principal active ingredients of XLG interact directly with these targets, potentially exerting anti-AS effects through the PI3K/Akt/eNOS signaling pathway. Animal experiments found that XLG reduced blood lipid levels and inflammatory cytokine content in AS mice. Additionally, the expression levels of PI3K, AKT, eNOS, and S1PR1 were significantly upregulated following XLG administration. Furthermore, XLG promoted the proliferation of HUVECs in response to lipopolysaccharide stimulation and improved vascular function through the S1PR1-activated PI3K/Akt/eNOS signaling pathway. Conversely, the therapeutic efficacy of XLG was diminished upon administration of an S1PR1 inhibitor.

Conclusion: Our research indicates that XLG may employ the S1PR1-activated PI3K/Akt/eNOS signaling pathway to produce its anti-AS actions. This research improves our understanding of the underlying mechanism by which XLG treats AS, providing a promising therapeutic approach for managing the condition.