Abstract
   Hyperlipidemia is a metabolic disorder characterized by abnormal lipid
   metabolism, resulting in lipid accumulation in the plasma. According to
   reports, medicinal and edible plants can reduce the risk of metabolic
   diseases such as hyperlipidemia. This study investigates the effects
   and mechanisms of Astragalus membranaceus extract (AME), Hippophae
   rhamnoides L. extract (HRE), and Taraxacum mongolicum Hand. Mazz
   extract (TME) on hyperlipidemia. Active compounds and potential gene
   targets of AME, HRE, and TME were screened using LC-MS and TCMSP
   databases, and hyperlipidemia targets were detected from the OMIM and
   DisGeNet databases. A drug-target pathway disease network was
   constructed through protein interactions, GO enrichment, and KEGG
   pathway analysis. Finally, the lipid-lowering effects of three extracts
   were validated through in vitro HepG2 cell and in vivo animal
   experiments. The results show that LC-MS and network pharmacology
   methodologies identified 41 compounds and 140 targets. KEGG analysis
   indicated that the PI3K-Akt and MAPK signaling pathways significantly
   treat hyperlipidemia with AHT. In vitro experiments have shown that AHT
   is composed of a ratio of AME:HRE:TME = 3:1:2. HepG2 cell and animal
   experiments revealed that AHT exhibits strong lipid-lowering and
   antioxidant properties, significantly regulating the levels of total
   cholesterol (TC), triglycerides (TG), high-density lipoprotein
   cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),
   superoxide dismutase (SOD), and total antioxidant capacity (T-AOC). It
   is worth noting that AHT can effectively downregulate the protein
   expression levels of p-AKT/AKT and p-PI3K/PI3K and upregulate the
   protein expression levels of p-AMPK/AMPK and SIRT1, verifying the
   results predicted by network pharmacology. This study presents a novel
   approach to utilizing these natural plant extracts as safe and
   effective treatments for hyperlipidemia.
   Keywords: hyperlipidemia, network pharmacology, plant extracts, HepG2,
   antioxidant
1. Introduction
   Hyperlipidemia (HLP) is a metabolic disorder caused by abnormal lipid
   metabolism or transport, resulting in one or more lipids in the plasma
   being higher than the normal range [[34]1]. Its characteristics are an
   increase in total cholesterol (TC), triglycerides (TGs), and
   low-density lipoprotein cholesterol (LDL-C) levels or a decrease in
   circulating high-density lipoprotein cholesterol (HDL-C) levels
   [[35]2]. Hyperlipidemia is recognized as a significant risk factor for
   nonalcoholic fatty liver disease, atherosclerosis, diabetes, and
   various other metabolic disorders [[36]3]. Currently, statins are the
   primary treatment for hyperlipidemia. While they act quickly, long-term
   use may result in side effects, including a single treatment mechanism,
   liver and kidney complications, and muscle-related issues [[37]4].
   Consequently, developing a treatment plan with good efficacy and
   minimal side effects has become a research hotspot in recent years.
   Medicinal and edible plants contain a variety of natural active
   ingredients. In comparison to traditional chemically synthesized drugs,
   traditional Chinese medicine, which boasts extensive experience in
   pharmacotherapy, is noted for its reduced adverse reactions and more
   pronounced long-term effects [[38]5,[39]6]. Previous studies have
   indicated that medicinal and edible plants mainly treat hyperlipidemia
   by improving blood lipids, antioxidation, and regulating gut microbiota
   [[40]7,[41]8,[42]9]. Astragalus membranaceus, Hippophae rhamnoides L.,
   and Taraxacum mongolicum Hand. Mazz are typical medicinal and edible
   plants rich in active ingredients such as flavonoids, saponins,
   polysaccharides, and triterpenes. They have the characteristics of
   lowering blood lipids, lowering blood sugar, regulating immunity,
   antioxidation, and being anti-inflammatory. Multiple studies have
   demonstrated that Astragalus membranaceus, Hippophae rhamnoides L., and
   Taraxacum mongolicum Hand. Mazz can inhibit cholesterol synthesis and
   regulate lipid metabolism [[43]10,[44]11,[45]12]. They demonstrate
   significant potential in the treatment of hyperlipidemia and metabolic
   disorders. In recent years, due to the advancement of databases related
   to drugs and diseases, research in the field of bioinformatics has
   become increasingly popular. Network pharmacology has become widely
   used in studying medicinal and edible plants, which can construct
   networks and interactions related to drugs, targets, diseases, and
   pathways. Network pharmacology can conduct in-depth analysis and
   explore the pharmacological mechanisms of various active ingredients
   and targets in medicinal and edible plants [[46]13]. Therefore, network
   pharmacology can be used to further elucidate the chemical composition
   and mechanism of the three extracts’ lipid-lowering effects.
   This study initially identified the active ingredients of three
   extracts through liquid chromatography–mass spectrometry (LC-MS).
   Subsequently, network pharmacology was employed to predict the
   lipid-lowering mechanisms associated with these active ingredients,
   utilizing databases to construct an interaction network relevant to the
   three extracts’ treatment of hyperlipidemia. The potential
   lipid-lowering mechanisms of the three extracts were validated through
   assays conducted on HepG2 cells. Finally, a hyperlipidemia mouse model
   was established to assess the lipid-lowering efficacy of the three
   extracts. This research offers a novel strategy for the prevention and
   treatment of hyperlipidemia.
2. Materials and Methods
2.1. Chemicals and Reagents
   Astragalus membranaceus extract (AME), Hippophae rhamnoides L. extract
   (HRE), and Taraxacum mongolicum Hand. Mazz extract (TME) were purchased
   from Xi’an Ruihe Biotechnology Co., Ltd. (Xi’an, China). The MTT cell
   proliferation and cytotoxicity assay kit and BCA protein quantification
   kit were purchased from Beyotime Biotechnology Co., Ltd. (Shanghai,
   China), while the total cholesterol (TC), triglycerides (TGs),
   low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein
   cholesterol (HDL-C), aspartate aminotransferase (AST), alanine
   aminotransferase (ALT), superoxide dismutase (SOD), and total
   antioxidant capacity (T-AOC) assay kits were purchased from Nanjing
   Jiancheng Bioengineering Research Institute (Nanjing, China). Oleic
   acid and simvastatin were purchased from MACKUN Biotech (Shanghai,
   China).
2.2. LC-MS Analysis Conditions
   AHT powder was measured using liquid chromatography (Vanquish, Thermo,
   Waltham, MA, USA) and mass spectrometry (Orbitrap Exploris 120, Thermo,
   Waltham, MA, USA). Firstly, AHT powder (10 mg) was dissolved in 90%
   methanol (3 mL) and centrifuged (10,000× g, 10 min, 4 °C) to obtain the
   supernatant. Then, 150 μL of supernatant was filtered through a 0.22 μm
   filter membrane into an LC vial for LC-MS analysis.
   The liquid chromatography conditions were as follows: The LC analysis
   was performed on a Vanquish UHPLC System (Thermo Fisher Scientific,
   Waltham, MA, USA). A 2 μL aliquot was injected into a 2.1 × 100 mm, 1.8
   µm column (Waters, Milford, MA, USA) with a flow rate of 0.3 mL/min.
   For LC-ESI (+)-MS analysis, the mobile phases consisted of (A) 0.1%
   formic acid in acetonitrile (v/v) and (B) 0.1% formic acid in water
   (v/v) under the following gradient: 0~1 min, 10% A; 1~5 min, 10~98% A;
   5~6.5 min, 98% A; 6.5~6.6 min, 98~10% A; 6.6~8 min, 10% A. For LC-ESI
   (−)-MS analysis, the mobile phases consisted of (C) acetonitrile and
   (D) ammonium formate (5 mM) under the following gradient: 0~1 min, 10%
   C; 1~5 min, 10~98% C; 5~6.5 min, 98% C; 6.5~6.6 min, 98~10% C; 6.6~8
   min, 10% C.
   Mass spectrometric detection of metabolites was performed on Orbitrap
   Exploris 120 (Thermo Fisher Scientific, Waltham, MA, USA) with an ESI
   ion source. Simultaneous MS1 and MS/MS acquisition were used. The
   parameters were as follows: sheath gas pressure, 40 arb; aux gas flow,
   10 arb; spray voltage, 3.50 kV and −2.50 kV for ESI (+) and ESI (−),
   respectively; capillary temperature, 325 °C; MS1 range, m/z 100–1000.
   A quantitative list of substances was obtained using the R XCMS
   software (V3.12.0) package for peak detection, peak filtering, and peak
   alignment processing. Normalizing the total peak area was used to
   achieve data correction and eliminate systematic errors. The substance
   identification process uses the Human Metabolome Database (HMDB),
   LipidMaps, McCloud, and KEGG databases for retrieval and comparison.
   The molecular weight of metabolites was determined. The molecular
   formula was predicted based on the mass-to-charge ratio of parent ions
   in primary mass spectrometry and information on added ions, and then
   matched with a database. Meanwhile, fragment ions from secondary
   spectra were utilized for secondary qualitative identification of
   metabolites [[47]14,[48]15].
2.3. AHT Chemical Composition Screening and Target Prediction
   From the Traditional Chinese Medicine System Pharmacology Analysis
   Platform (TCMSP), ([49]http://lsp.nwu.edu.cn/tcmsp.php, accessed on 20
   July 2024). The database used Huangqi, Shaji, and Pugongying as
   keywords, and the filtering criteria were set to OB ≥ 30% and DL ≥
   0.18. Through the UniProt database ([50]https://sparql.uniprot.org/,
   accessed on 20 July 2024), all targets are standardized
   [[51]16,[52]17].
2.4. Prediction of Targets for Hyperlipidemia
   Potential targets related to hyperlipidemia have been identified from
   Genecards ([53]https://www.Genecards.org/, accessed on 22 July 2024),
   the DisGeNet database ([54]https://www.disgenet.org/, accessed on 18
   July 2024), and Online Mendelian Inheritance in Man (OMIM,
   [55]https://www.genecards.org/, accessed on 18 July 2024). After
   eliminating duplicate targets, potential targets related to HLP were
   obtained [[56]18,[57]19].
2.5. Construction of Drug Target Network and Pathways
   Firstly, in order to obtain common targets for compounds and diseases,
   Venny 2.1.0 was used ([58]https://bioinfogp.cnb.csic.es/tools/venny/,
   accessed on 23 July 2024) to perform filtering. Common targets imported
   into Cytoscape 3.9.1 software to construct a drug–target disease
   network. The interacting targets were mapped to the STRING database
   ([59]https://string-db.org/, accessed on 23 July 2024). After
   visualization using Cytoscape 3.9.1 software, the protein–protein
   interaction (PPI) network was obtained and filtered based on
   intermediate centrality (BC), compact centrality (CC), degree
   centrality (DC), eigenvector centrality (EC), local average
   connectivity (LAC), and network centrality (NC), with values greater
   than or equal to twice the median. After deleting duplicate targets,
   the core targets were merged to obtain 140 common targets, which were
   imported into the DAVID database ([60]https://david.ncifcrf.gov/,
   accessed on 24 July 2024). They were used for gene ontology (GO) and
   Kyoto Encyclopedia of Genes and Genomes (KEGGs) analysis to explore the
   biological processes and signaling pathways involved in treating
   hyperlipidemia in AHT [[61]20,[62]21,[63]22].
2.6. Pancreatic Lipase Inhibition Test and Combined Index Analysis
   Ten mg of pancreatic lipase (PL) was accurately weighed and dissolved
   in 10 mL Tris HCl buffer, resulting in a 1.0 mg/mL PL solution. A
   volume of 8.44 μL of NPB liquid was accurately transferred, and 4 mL of
   acetonitrile was added to obtain a 12 mmol/L NPB solution, which was
   used as a substrate. The sample, PL solution, and 4-nitrophenylbutyrate
   were added to a 96-well plate and reacted at 37 °C for 2 h. The
   absorbance was measured at 405 nm [[64]23,[65]24]. The formula for
   calculating the pancreatic lipase inhibition rate is:
   [MATH:
   Inhibition rate <
   mo>(%)=(A1−A2)−
   (A3−A4)A1−A2×100 :MATH]
   A[1] is the absorbance value of the blank group; A[2] is the absorbance
   value of the blank control group; A[3] is the absorbance value of the
   sample group; and A[4] is the absorbance value of the sample control
   group.
   The Chou Talalay method, also known as the combination index method
   (CI), is widely used for quantitative evaluation of the interactions
   between multiple drug formulations [[66]25]. Using the Chou and Talalay
   formulas, calculate the effects of each extract alone and in
   combination.
   [MATH: fafu=(DDm)m :MATH]
   D: Dose, D[m]: the dose that produces moderate effects, f[a]: the
   practical portion of the dose, m: the coefficient of the dose–response
   curve.
   The data analysis and calculation formula for the combination drug
   index (CI) is as follows:
   [MATH: CI=D1<
   msub>DX1+D2<
   msub>DX2 :MATH]
   D[1] and D[2] are the effective concentrations when the drug
   combination inhibition rate is 50%, while D[X1] and D[X2] are effective
   when the drug is used alone with an inhibition rate of 50%. The CI
   values of the complex in each group were calculated using the
   combination index calculation formula and CompuSyn program to analyze
   the effects of the three extracts combined [[67]26,[68]27].
2.7. Cell Culture and MTT Assay
   HepG2 cells were derived from the cell bank of the Chinese Academy of
   Sciences (Shanghai, China); DMEM was used (adding 10% fetal bovine
   serum and 1% penicillin and streptomycin); and the cells were cultured
   in a humidified incubator at 37 ℃ and 5% CO[2], and the medium was
   changed every two to three days. When the cell density reached over
   80%, trypsin was used for subculture [[69]28]. HepG2 cells were
   detected for cell proliferation using an MTT assay. The cells were
   seeded at a density of 5 × 10^3 cells/well into a 96-well plate for 24
   h and then replaced with standard culture medium containing different
   concentrations (0, 10, 50, 100, 200, and 500 μM) of HRE, AME, TME, and
   AHT for 24 h. Then, 10 μL of MTT solution were added and the cells were
   incubated for 4 h. Afterward, 150 μL of dimethyl sulfoxide was added to
   each well and the absorbance value was measured at 490 nm using a
   microplate reader (Tecan Infinite 200 Pro, Shanghai, China)
   [[70]17,[71]29].
2.8. Establishment of High-Fat Model and Administration Regimen
   Cells were seeded at a density of 5 × 10^5 cells/well in a 12-well
   culture plate and cultured for 24 h. They were then exposed to oleic
   acid (0.5 mM) for 24 h to induce a high-fat model. The treatment group
   was cultured with 100 μM HRE, 200 μM AME, 100 μM TME, and AHT (AME:
   HRE: TME = 3:1:2) for 24 h.
2.9. Oil Red O Staining
   HepG2 cells in each well were washed gently with PBS 3 times and then
   rinsed quickly with 60% isopropanol for 20 s. The cells were stained
   with Oil Red O in the dark at room temperature (25 °C) for 20 min.
   Then, the staining solution was discarded and the cells were rinsed 5
   times with distilled water, each for 1 min per well. In addition, 100%
   isopropanol (1 mL) was added to each well and stirred at room
   temperature (25 °C) for 10 min [[72]30].
2.10. Determination of Lipid-Lowering Levels in HepG2 Cells by AHT
   Cells were seeded at a density of 5 × 10^5 cells/well in a 12-well
   culture plate and cultured for 24 h. Except for the NC group, which was
   added to the standard culture medium, all other groups were added to
   the culture medium containing OA. The treatment group was added with
   AME at a concentration of 200 μM, HRE, and TME at a concentration of
   100 μM, and AHT for 24 h to evaluate their lipid-lowering effects on
   cells. The cell culture medium was removed, and the cells were washed
   three times with PBS before being lysed. The levels of TC, TG, HDL-C,
   and LDL-C were measured according to the instructions of the reagent
   kit. The protein concentrations of each group were measured using the
   BCA protein quantification kit.
2.11. Western Blot Analysis
   Cells were seeded at a density of 1 × 10^6 cells/well in a 6-well
   culture plate and cultured for 24 h. All other groups were added to the
   standard culture medium except for the NC group, which was added to the
   culture medium containing OA. The treatment group was added with 100 μM
   HRE, 200 μM AME, and 100 μM TME and AHT for 24 h, respectively, and
   Western blotting was performed for testing. The Western blotting method
   is described below.
   Cells were lysed in RIPA buffer (Beyotime, Shanghai, China) containing
   1% PMSF for 10 min, then centrifuged at 4 °C and 12,000× g for 10 min.
   Protein quantification was performed using the BCA protein assay kit
   (Beyotime, Shanghai, China). The protein sample was boiled at 100 °C
   for 10 min and then separated by 10% SDS-PAGE. It was transferred to a
   PVDF Western blotting membrane (Biotopped, Beijing, China) and then
   blocked with 5% skim milk powder (Biosharp, Hefei, China) at room
   temperature (RT) for 2 h. The membrane was washed three times with TBST
   buffer (Biotopped, Beijing, China). The primary antibody was incubated
   overnight at 4 °C, and the membrane was washed three times with TBST
   and then incubated with the secondary antibody goat anti-rabbit
   (ABclonal, AS014, WB: 1:2000). An ECL chemiluminescence detection kit
   (ABclonal, Wuhan, China) was used for protein detection, a gel imager
   (Tanon 5200, Shanghai, China) was used for image capture, and image J
   software (Version 1.46r) was used to analyze the gray value. β—actin
   rabbit (ABclonal, AC038, WB: 1:20,000) was used as an endogenous
   control. The selected primary antibodies were: PI3 kinase p85 alpha
   rabbit pAb (ABclonal, A11526, WB: 1:500), AKT1 rabbit mAb (ABclonal,
   A17909, WB: 1:1000), phospho-AKT1-S129 rabbit pAb (ABclonal, AP1272,
   WB: 1:200), phospho-PI3K (ABclonal, AP0854, WB: 1:500), AMPKα1 rabbit
   pAb (ABclonal, AP1229, WB: 1:2000), phospho-AMPKα1 rabbit pAb
   (ABclonal, AP0871, WB: 1:2000), SIRT1 rabbit pAb (ABclonal, A11267, WB:
   1:2000).
2.12. Animal Experiments
   Eight-week-old male KM mice weighing 32 ± 2 g were purchased from
   Qingdao Petford White Mouse Breeding Professional Cooperative (Qingdao,
   China). The certificate number is SCXK (Lu) 2019-00003. All mice were
   free to eat and drink, with a 12 h/12 h light–dark cycle. All animal
   procedures were conducted by the National Research Council’s
   “Guidelines for the Care and Use of Experimental Animals” and were
   approved by the Ethics Committee of Northeast Forestry University
   (NEFU2024-011) [[73]31].
   After adaptive feeding for 1 w, KM mice were randomly divided into 6
   groups based on body weight, namely normal control (NC), model control
   (MC), positive control (PC), low-dose administration (LD), medium-dose
   administration (MD), and high-dose administration (HD), with 8 mice in
   each group. NC was given standard feed, while the other groups were
   given high-fat feed for 8 w. NC and MC were given saline by gavage, the
   PC group was given 10 mg/kg simvastatin by gavage, and the LD group was
   given 41.25 mg/kg AME, 13.75 mg/kg HRE, and 27.5 mg/kg TME by gavage.
   MD was orally administered 82.5 mg/kg AME, 27.5 mg/kg HRE, and 55 mg/kg
   TME, while HD was orally administered 165 mg/kg AME, 110 mg/kg HRE, and
   55 mg/kg TME for 8 w. Food intake was measured daily, and the weight of
   each mouse was measured weekly. After the experiment, blood was
   collected from the eyeballs of anesthetized mice.
2.13. Determination of Serum Biochemical Indicators
   Mouse blood was centrifuged at 3000× g for 15 min to obtain mouse
   serum. The levels of TC, TG, LDL-C, HDL-C, AST, ALT, SOD, and T-AOC
   were measured in serum according to the instructions of the kit
   [[74]32].
2.14. Statistical Analysis
   All experiments were conducted in at least three parallel experiments,
   and the results were reported as mean ± standard deviation. Statistical
   analysis was conducted using GraphPad Prism 9.5, and ****, ***, **, *
   and ns represent p < 0.0001, p < 0.001, p < 0.01, p < 0.05, and p >
   0.05, respectively.
3. Results
3.1. Analysis of AHT Active Ingredients
   Firstly, the active ingredients of AHT were identified, and a total of
   1539 metabolites were detected by LC-MS. These metabolites include a
   series of compounds such as flavonoids, polyphenols, terpenes, and
   alkaloids. Then, 1539 compounds were identified and analyzed through
   the TCMSP database. Setting oral bioavailability (OB) ≥ 30% and
   drug-like (DL) ≥ 0.18, 41 compounds were obtained, as shown in
   [75]Table 1, including bioactive ingredients such as luteolin,
   quercetin, isorhamnetin, and kaempferol. Next, a qualitative analysis
   of AHT was conducted, summarizing the retention time, m/z, molecular
   formula, and error (ppm) of 41 compounds ([76]Table 2). In addition,
   the total ion chromatogram (TIC) of AHT in positive and negative ion
   modes was labeled based on the retention time of the compounds
   ([77]Figure 1).
Table 1.
   Active ingredients of AME, HRE, and TME.
   No. Name                     Molecule ID Molecule Name        OB (%) DL
   1   Luteolin                 MOL000006   Luteolin             36.16  0.25
   2   Quercetin                MOL000098   Quercetin            46.43  0.28
   3   Isorhamnetin             MOL000354   Isorhamnetin         49.6   0.31
   4   Kaempferol               MOL000422   Kaempferol           41.88  0.24
   5   Phaseollidin             MOL000457   Phaseollidin         52.04  0.53
   6   Cholesterol              MOL000953   CLR                  37.87  0.68
   7   Ellagic acid             MOL001002   Ellagic acid         43.06  0.43
   8   Pelargonidin             MOL001004   Pelargonidin         37.99  0.21
   9   Dihydrochelerythrine     MOL001461   Dihydrochelerythrine 32.73  0.81
   10  Dihydrosanguinarine      MOL001463   Dihydrosanguinarine  59.31  0.86
   11  Sanguinarine             MOL001474   Sanguinarine         37.81  0.86
   12  Chelerythrine            MOL001478   Toddaline            25.99  0.81
   13  Scopolamine              MOL001554   Scopolamine          67.97  0.27
   14  (+)-Sesamin              MOL001558   Sesamin              56.55  0.83
   15  Acacetin                 MOL001689   Acacetin             34.97  0.24
   16  Diphyllin                MOL001699   Diphyllin            36.23  0.75
   17  Podofilox                MOL001714   Podophyllotoxin      59.94  0.86
   18  Linarin                  MOL001790   Linarin              39.84  0.71
   19  Scopolin                 MOL002218   Scopolin             56.45  0.39
   20  Hesperetin               MOL002341   Hesperetin           70.31  0.27
   21  Medicarpin               MOL002565   Medicarpin           49.22  0.34
   22  Baicalein                MOL002714   Baicalein            33.52  0.21
   23  Melilotoside             MOL004101   Melilotoside         36.85  0.26
   24  Corydaline               MOL004195   CORYDALINE           65.84  0.68
   25  Kaempferide              MOL004564   Kaempferid           73.41  0.27
   26  Glabranin                MOL004910   Glabranin            52.9   0.31
   27  Artemetin                MOL005229   Artemetin            49.55  0.48
   28  Arachidonic acid         MOL005320   Arachidonate         45.57  0.2
   29  Citromitin               MOL005815   Citromitin           86.9   0.51
   30  Papaverine               MOL006980   Papaverine           64.04  0.38
   31  Codeine                  MOL006982   Codeine              45.48  0.56
   32  Cirsimaritin             MOL007274   Skrofulein           30.35  0.3
   33  Artemisinin              MOL007424   Artemisinin          49.88  0.31
   34  Corynoline               MOL008636   Corynoline           30.53  0.85
   35  Camptothecin             MOL009830   EHD                  61.04  0.81
   36  Leucocyanidin            MOL010489   Resivit              30.84  0.27
   37  Estrone                  MOL010921   Estrone              53.56  0.32
   38  Lobelanine               MOL012208   Lobelanine           54.13  0.32
   39  Uridine 5’-monophosphate MOL012820   5’-Uridylic acid     40.25  0.2
   40  Fustin                   MOL013296   Fustin               50.91  0.24
   41  Garbanzol                MOL013305   Garbanzol            83.67  0.21
   [78]Open in a new tab
Table 2.
   The compound composition in AHT determined by LC-MS.
   Peak No. Proposed Compound RT/s Precursor m/z Error (ppm) Formula
   1 Luteolin 290 285.0761 2.606 C[15]H[10]O[6]
   2 Quercetin 287 303.0498 0.420 C[15]H[10]O[7]
   3 Isorhamnetin 303.7 315.0515 1.512 C[16]H[12]O[7]
   4 Kaempferol 282 285.0391 4.770 C[15]H[10]O[6]
   5 Phaseollidin 224 325.1379 17.003 C[20]H[20]O[4]
   6 CLR 412.7 369.3588 19.607 C[27]H[46]O
   7 Ellagic acid 116.6 324.9999 13.574 C[14]H[6]O[8]
   8 Pelargonidin 57.5 543.1263 4.175 C[15]H[11]O[5]
   9 Dihydrochelerythrine 63.8 332.1285 1.169 C[21]H[19]NO[4]
   10 Dihydrosanguinarine 48.1 665.1907 3.352 C[20]H[15]NO[4]
   11 Sanguinarine 116.9 289.1103 1.990 C[20]H[14]NO[4]
   12 Toddaline 83.9 332.1315 10.197 C[21]H[18]NO[4]
   13 Scopolamine 301.9 285.1163 10.784 C[17]H[21]NO[4]
   14 Sesamin 48.5 337.1115 13.218 C[20]H[18]O[6]
   15 Acacetin 336.1 283.0606 2.098 C[16]H[12]O[5]
   16 Diphyllin 46.8 381.0936 8.594 C[21]H[16]O[7]
   17 Podophyllotoxin 58.8 829.2688 1.687 C[22]H[22]O[8]
   18 Linarin 240.2 653.184 17.888 C[28]H[32]O[14]
   19 Scopolin 81.8 335.0758 4.287 C[16]H[18]O[9]
   20 Hesperetin 241.6 301.071 2.518 C[16]H[14]O[6]
   21 Medicarpin 240.9 254.0728 11.289 C[16]H[14]O[4]
   22 Baicalein 297.6 269.0448 2.767 C[15]H[10]O[5]
   23 Melilotoside 81.8 371.0968 4.221 C[15]H[18]O[8]
   24 CORYDALINE 226.1 387.2221 14.781 C[22]H[27]NO[4]
   25 Kaempferid 302.1 299.0567 1.977 C[16]H[12]O[6]
   26 Glabranin 385.4 369.1471 4.907 C[20]H[20]O[4]
   27 Artemetin 61.3 345.1367 9.972 C[20]H[20]O[8]
   28 Arachidonate 447.9 303.2351 7.121 C[20]H[32]O[2]
   29 Citromitin 206.6 405.1339 18.738 C[21]H[24]O[8]
   30 Papaverine 66.5 322.127 4.678 C[20]H[21]NO[4]
   31 Codeine 219.3 300.1587 2.372 C[18]H[21]NO[3]
   32 Skrofulein 252 359.073 11.803 C[17]H[14]O[6]
   33 Artemisinin 260.9 343.1382 4.764 C[15]H[22]O[5]
   34 Corynoline 254.3 350.1458 3.569 C[21]H[21]NO[5]
   35 EHD 260.3 330.2363 11.189 C[20]H[1]6N[2]O[4]
   36 Resivit 267.9 288.0443 14.498 C[15]H[14]O[7]
   37 Estrone 292.4 269.079 10.881 C[18]H[22]O[2]
   38 Lobelanine 276 336.1978 5.963 C[22]H[25]NO[2]
   39 5’-Uridylic acid 41.1 323.0274 3.682 C[9]H[13]N[2]O[9]P
   40 Fustin 326.2 333.0473 15.279 C[15]H[12]O[6]
   41 Garbanzol 252.4 273.0805 17.407 C[15]H[12]O[5]
   [79]Open in a new tab
Figure 1.
   [80]Figure 1
   [81]Open in a new tab
   Total ion chromatogram in positive and negative ion modes. Ionic
   chromatograms of AME, HRE, and TME in positive-ion mode (A–C). Ionic
   chromatograms of AME, HRE, and TME in negative-ion mode (D–F). The
   numbers in [82]Figure 1 represent the substances in [83]Table 2.
3.2. Potential Target Prediction of AHT and HLP
   Firstly, the TCMSP database filtering criteria (OB ≥ 30%, DL ≥ 0.18)
   was set, a total of 256 potential targets of compounds in AHT were
   searched for, and all potential targets with the “Homo sapiens” species
   were standardized using the UniProt database to obtain [84]Table S1.
   The potential targets related to hyperlipidemia were obtained from the
   Genecards database and Drugbank database. After eliminating duplicate
   targets, 1571 potential targets related to HLP were obtained ([85]Table
   S2).
3.3. Target Network Construction for AHT and HLP
   Firstly, the common targets of AHT and HLP were screened using Venny
   2.1.0, resulting in 140 common targets ([86]Figure 2A, [87]Table S3).
   These targets are potential targets for AHT treatment of HLP. The above
   targets were imported into Cytoscape 3.9.1 software to construct a
   drug–target disease network. There are 181 nodes and 546 edges in
   [88]Figure 2B, and the size of the nodes in the figure is related to
   the degree centralities (DCs) value. The 40 compounds of AHT are
   represented by red squares; green circles represent common targets; and
   blue triangles represent AHT. The results show that quercetin,
   kaempferol, luteolin, baicalein, isorhamnetin, acacetin, medicarpin,
   phaseollidin, papaverine, and dihydrochelerythrine ranked in the top
   ten in terms of DC values, suggesting that they are key compounds.
Figure 2.
   [89]Figure 2
   [90]Open in a new tab
   Network pharmacology analysis of AHT treatment for hyperlipidemia. (A)
   Common targets of AHT and HLP. (B) AHT compound target network diagram.
   (C) Analysis of protein–protein interaction networks with 140 common
   targets. (D) PPI network diagram of common targets. (E) Core target PPI
   network diagram (node size and color depth indicate the high or low DC
   value).
3.4. Construction of PPI Network
   Common targets were imported into the STRING 11.0 database for PPI
   network analysis ([91]Figure 2C). There were a total of 139 nodes and
   395 edges, with an average node degree of 5.68. Import the cross
   targets obtained through STRING database analysis into Cytoscape 3.9.1
   software to obtain the PPI network diagram for AHT treatment of HLP. As
   shown in [92]Figure 2D, the larger the degree value, the darker the
   color and the larger the area of the gene target, indicating that the
   target has a more significant influence in the PPI network. In
   addition, the target’s BC, CC, DC, EC, LAC, and NC values were obtained
   through network topology analysis in Cytoscape 3.9.1 software. By
   screening and removing duplicate targets from the first six targets in
   each item, 15 key targets were obtained ([93]Figure 2E and [94]Table
   3), namely TP53, PPARG, ESR1, TNF, CCL2, AKT1, RELA, MAPK1, IL6, CXCL8,
   IL1A, IL4, IL10, IL1B, and IFNG. We speculate that they may be key
   targets for treating HPL.
Table 3.
   Prediction of key targets for AHT treatment of HPL.
   NO. Symbol ID Protein Name Pathways
   1 TP53 Tumor protein p53 hsa05417, hsa04010, hsa04151
   2 PPARG Peroxisome proliferator-activated receptor gamma hsa05417
   3 ESR1 Estrogen receptor hsa05207
   4 TNF Tumor necrosis factor hsa05417, hsa04933, hsa04010
   5 CCL2 C-C motif chemokine 2 hsa05417, hsa04933, hsa05418
   6 AKT1 Potassium channel AKT1 hsa05417, hsa04933, hsa04010, hsa04151
   7 RELA Transcription factor p65 hsa05417, hsa04933, hsa04010, hsa04151
   8 MAPK1 Mitogen-activated protein kinase 1 hsa05417, hsa04933,
   hsa04010, hsa04151
   9 IL6 Interleukin-6 hsa05417, hsa04933, hsa04151
   10 CXCL8 Interleukin-8 hsa05417, hsa04933
   11 IL1A Interleukin-1 alpha hsa04933, hsa04010, hsa05418
   12 IL4 Interleukin-4 hsa04151
   13 IL10 Interleukin-10 -
   14 IL1B Interleukin-1 beta hsa05417, hsa04933, hsa04010
   15 IFNG Interferon gamma hsa05418
   [95]Open in a new tab
3.5. Enrichment Analysis of GO and KEGG Pathways
   To explore the potential therapeutic mechanism of AHT for
   hyperlipidemia we imported the overlapping genes of AHT and HLP into
   the DAVID database for GO and KEGG pathway enrichment analysis.
   Firstly, visual analysis was conducted on biological progress (BP),
   cellular components (CC), and molecular functions (MF). the top 10
   enriched GO terms were identified separately (p-Value < 0.05) and the
   key targets were analyzed ([96]Figure 3A). The results show that in BP,
   the targets of AHT were associated with response to lipolysis (GO:
   0032496) and cellular response to lipolysis (GO: 0071222). In MF, the
   target of AHT was associated with steroid binding (GO: 0005496). In CC,
   the targets of AHT were associated with membrane raft (GO: 0045121),
   protein-containing complex (GO: 0032991), and transcription regulator
   complex (GO: 0005667). The GO enrichment analysis results indicated
   that compounds in AHT can exert therapeutic effects on hyperlipidemia
   from lipopolysaccharides, inflammatory factors, and protein regulation.
   The false discovery rate (FDR) was used as the X-axis; the size of the
   dots represented the number of targets in different pathways, and dots
   of different colors represented the p-values of different pathways. The
   darker the red color, the higher the significance. As shown in
   [97]Figure 3B, enrichment analysis was performed on the top 20
   signaling pathways for AHT treatment of hyperlipidemia. It was found
   that AHT mainly occurs through lipids and atherosclerosis, the AGE–RAGE
   signaling pathway in diabetic complications, and the inflammatory
   pathway, MAPK signaling pathway, and PI3K-Akt signaling pathway play a
   role. [98]Table 4 presents detailed information on the top 10 signaling
   pathways and their corresponding targets. Moreover, the target and
   signaling pathway were visualized in [99]Figure 3C. The above 10
   pathways connected with relevant key targets and compounds to form a
   compound–target–signaling pathway network. It included 140 nodes and
   657 edges ([100]Figure 3D). A significant correlation was indicated
   between key signaling pathways and the main compounds of AHT. The core
   compounds included quercetin (MOL000098, edge count = 67), luteolin
   (MOL000006, edge count = 31), kaempferol (MOL000422, edge count = 27),
   and baicalein (MOL002714, edge count = 18).
Figure 3.
   [101]Figure 3
   [102]Open in a new tab
   Network pharmacology pathway analysis of AHT treatment for HLP. (A) GO
   enrichment analysis. (B) The top 20 KEGG enrichment pathways. (C) KEGG
   chord diagram, it indicated the top 10 pathways and their corresponding
   targets; the different colors of the graphics represent different
   signal pathways. (D) Compound–target–pathway–disease network diagram.
Table 4.
   Annotation of the top 10 KEGG pathways.
   ID Description p-Value Gene ID Count
   hsa05200 Pathways in cancer 29.15 GSK3B, CXCL8, PTEN, CASP9, CASP8,
   CCND1, MYC, CASP3, AKT1, NCOA1, CHUK, PRKCB, MMP1, MMP2, FOS, MMP9, AR,
   IFNG, BIRC5, PPARG, RAF1, TP53, PPARD, PTGS2, HIF1A, EGFR, RELA, RXRB,
   MAPK8, RXRA, ERBB2, E2F1, HMOX1, MAPK1, RXRG, TGFB1, NOS2, CDKN2A, EGF,
   STAT1, IGF2, ESR1, ESR2, IL2, VEGFA, MAPK10, IL4, IL6, CDK4, BCL2,
   MDM2, BAX, NFE2L2 53
   hsa05417 Lipid and atherosclerosis 30.27 GSK3B, CXCL8, TNF, CXCL2,
   RELA, ICAM1, CASP9, RXRB, PPP3CA, MAPK8, CASP8, CYP2B6, RXRA, CASP3,
   CCL2, AKT1, MAPK1, OLR1, RXRG, VCAM1, CHUK, MMP1, NOS3, MMP3, NFATC1,
   FOS, MAPK14, SELE, MMP9, MAPK10, IL6, CD40LG, IL1B, CYP1A1, BCL2, BAX,
   PPARG, TP53, NFE2L2 39
   hsa04933 AGE-RAGE signaling pathway in diabetic complications 31.05
   CXCL8, SERPINE1, TNF, RELA, ICAM1, THBD, MAPK8, CCND1, CASP3, CCL2,
   AKT1, MAPK1, TGFB1, VCAM1, PRKCB, NOS3, STAT1, MMP2, NFATC1, MAPK14,
   SELE, F3, VEGFA, MAPK10, IL1A, COL3A1, IL6, CDK4, IL1B, BCL2, BAX 31
   hsa05167 Kaposi sarcoma-associated herpesvirus infection 20.65 GSK3B,
   CXCL8, PTGS2, HIF1A, CXCL2, RELA, PIK3CG, ICAM1, CASP9, PPP3CA, MAPK8,
   CASP8, CCND1, MYC, CASP3, E2F1, AKT1, MAPK1, CHUK, STAT1, NFATC1, FOS,
   MAPK14, VEGFA, MAPK10, IL6, CDK4, BAX, RAF1, TP53 30
   hsa05207 Chemical carcinogenesis—receptor activation 19.50 NR1I3,
   ADRB1, AHR, ADRB2, CYP3A4, RELA, EGFR, RXRB, CYP2B6, RXRA, CCND1, MYC,
   E2F1, AKT1, MAPK1, RXRG, UGT1A1, PRKCB, EGF, FOS, ESR1, ESR2, VEGFA,
   AR, CYP1A1, BCL2, BIRC5, PGR, RAF1, PPARA 30
   hsa05163 Human cytomegalovirus infection 17.81 GSK3B, CXCL8, PTGS2,
   TNF, RELA, EGFR, CASP9, PPP3CA, CASP8, CCND1, MYC, CASP3, E2F1, CCL2,
   AKT1, MAPK1, CHUK, CDKN2A, PRKCB, NFATC1, MAPK14, VEGFA, IL6, CDK4,
   IL1B, MDM2, BAX, RAF1, TP53 29
   hsa04010 MAPK signaling pathway 12.69 HSPB1, TNF, RELA, EGFR, PPP3CA,
   MAPK8, MYC, CASP3, ERBB2, AKT1, MAPK1, TGFB1, CHUK, PRKCB, EGF, INSR,
   IGF2, NFATC1, FOS, MAPK14, VEGFA, MAPK10, IL1A, RASA1, IL1B, RAF1, TP53
   27
   hsa04151 PI3K-Akt signaling pathway 10.81 GSK3B, PTEN, RELA, EGFR,
   PIK3CG, CASP9, RXRA, CCND1, MYC, ERBB2, SPP1, AKT1, MAPK1, CHUK, EGF,
   NOS3, INSR, IGF2, IL2, VEGFA, IL4, IL6, CDK4, BCL2, MDM2, RAF1, TP53 27
   hsa05418 Fluid shear stress and atherosclerosis 19.75 PLAT, TNF, RELA,
   ICAM1, THBD, MAPK8, CCL2, AKT1, HMOX1, VCAM1, CHUK, NOS3, CAV1, MMP2,
   FOS, MAPK14, SELE, MMP9, VEGFA, MAPK10, IL1A, IFNG, IL1B, BCL2, TP53,
   NFE2L2 26
   hsa05161 Hepatitis B 18.15 CXCL8, TNF, RELA, CASP9, MAPK8, CASP8, MYC,
   CASP3, E2F1, AKT1, MAPK1, TGFB1, CHUK, PRKCB, STAT1, NFATC1, FOS,
   MAPK14, MMP9, MAPK10, IL6, BCL2, BAX, BIRC5, RAF1, TP53 26
   [103]Open in a new tab
3.6. Determination of AHT Compounding Ratio
   An orthogonal experiment was conducted to determine the optimal
   blending ratio of AME, HRE, and TME. According to the theoretical
   analysis of the k value, the optimal combination is A[3]H[1]T[2], which
   meant the ratio of AME, HRE, and TME was 3:1:2. To verify this ratio,
   the pancreatic lipase inhibition rate was 97.74 ± 0.62% ([104]Table 5).
Table 5.
   Pancreatic lipase inhibition rates of AME, HRE, and TME with different
   compounding ratios.
   Group            AME   HRE   TME   Inhibition Rate%
   1                1     1     1     80.71 ± 0.83
   2                1     2     2     79.84 ± 0.80
   3                1     3     3     72.11 ± 1.94
   4                2     1     2     94.25 ± 1.10
   5                2     2     3     86.08 ± 0.86
   6                2     3     1     89.64 ± 1.23
   7                3     1     3     96.72 ± 1.30
   8                3     2     1     95.87 ± 0.25
   9                3     3     2     96.47 ± 0.32
   k[1]             77.55 90.56 88.74
   k[2]             89.99 87.26 90.19
   k[3]             96.35 86.07 84.97
   R                18.80 4.49  5.13
   Best combination A[3]H[1]T[2]
   [105]Open in a new tab
3.7. Combination Index Analysis of AHT, AME, HRE, and TME
   To further determine whether the combination of various extraction
   solutions has a synergistic effect, the dose–response relationship
   between each individual extraction solution and the combination group
   was studied, and the combination index (CI) value of each experimental
   group was calculated based on the principle of medium effect. The CI
   value of less than 1 indicated a synergistic effect between the
   components. As shown in [106]Figure 4A, the CI values of all groups
   were less than 1, indicating that the combination of the three extracts
   showed sound synergistic effects. The CI value of AHT (A[3]H[1]T[2])
   was significantly lower than that of the other groups (p < 0.05),
   indicating that AHT had the best synergistic effect. [107]Figure 4B
   showed that the pancreatic lipase inhibition effect of AHT was superior
   to that of AME, HRE, and TME at various addition ratios. [108]Figure 4C
   illustrates that when the synergistic effect reached 50%, the drug
   activity size was AHT > HRE > TME > AME. The above results indicated
   that the in vitro lipid-lowering effect of AHT was due to the
   combination of a single extract and other ratios.
Figure 4.
   [109]Figure 4
   [110]Open in a new tab
   Combination Index analysis of AHT, AME, HRE, and TME. (A) CI values are
   combined in different proportions. (B) Dose effect curves of AHT, AME,
   HRE, and TME on pancreatic lipase inhibition. (C) Intermediate effect
   diagrams of AHT, AME, HRE, and TME. (n = 3, **** and * represent p <
   0.01 and p < 0.05, respectively).
3.8. The Effects of AHT, AME, HRE, and TME on HepG2 Cell Proliferation and
Oleic Acid Staining
   To verify the lipid-lowering effect of AHT, we chose to establish a
   high-fat blood model using HepG2 cells. Before establishing the model,
   the cytotoxicity of AME, HRE, and TME were first detected by MTT assay.
   As shown in [111]Figure 5A, AME and HRE had a promoting effect on cell
   proliferation at concentrations of 200 μM and 100 μM, while TME had a
   significant promoting effect at concentrations of 50 μM and 100 μM (p >
   0.05). TME at a concentration of 100 μM was selected for the next
   experiment. When the dosage continued to increase, the activity of
   cells was inhibited. Next, the optimal concentrations of AME, HRE, and
   TME were compounded in a ratio of 3:1:2 to obtain the compound extract
   AHT. The lipid-lowering effect of AHT was verified. HepG2 cells were
   induced to produce lipid droplets using 0.5 mM OA, and the lipid
   droplets inside the cells were observed by staining with Oil Red O.
   [112]Figure 5B showed that no obvious lipid droplet staining was
   observed in the NC group, and the cell morphology was good. Red lipid
   droplets were clearly observed within the OA group cells, covering the
   entire cell periphery. After adding AHT, AME, HRE, and TME, a decrease
   in intercellular lipid droplets was observed. The results showed that
   AHT, AME, HRE, and TME could alleviate lipid deposition in HepG2 cells
   to varying degrees.
Figure 5.
   [113]Figure 5
   [114]Open in a new tab
   Effects of AHT, AME, HRE, and TME on HepG2 cell proliferation and oleic
   acid staining. (A) Cytotoxicity assay. (B) Oleic acid staining image.
   (n = 3, ****, ***, **, *, and ns represent p < 0.0001, p < 0.001, p <
   0.01, p < 0.05, and p > 0.05, respectively).
3.9. The Lipid-Lowering Effect of AHT on Oleic Acid-Induced HepG2 Cells
   The HepG2 cell model induced by oleic acid (OA) had been widely used
   for in vitro studies of hyperlipidemia ([115]Figure 6). Compared with
   the NC group, HepG2 cells induced by OA showed significantly increased
   levels of TC, TG, and LDL-C (p < 0.01) and significantly decreased
   levels of HDL-C (p < 0.01). After administration, compared with the OA
   group, the levels of AHT, AME, HRE, and TME decreased by 31.53%,
   21.04%, 22.95%, and 24.88% (p < 0.01) in TC, 30.37%, 14.84%, 14.50%,
   and 18.84% (p < 0.01) in TG, 25.93%, 20.74%, 19.26%, and 23.70% (p <
   0.01) in LDL-C, and 90.10%, 63.37%, 67.33%, and 72.28% (p < 0.01) in
   HDL-C, respectively. It indicated that AHT, AME, HRE, and TME all have
   good lipid-lowering effects, and the lipid-lowering performance of AHT
   after compounding has been further improved.
Figure 6.
   [116]Figure 6
   [117]Open in a new tab
   Determination of AHT lipid-lowering levels. (A) TC. (B) TG. (C) LDL-C.
   (D) HDL-C. (n = 3, ****, ***, **, *, and ns represent p < 0.0001, p <
   0.001, p < 0.01, p < 0.05, and p > 0.05, respectively).
3.10. The Effect of AHT on the Lipid-Lowering Mechanism Induced by Oleic Acid
in HepG2 Cells
   Based on the prediction of lipid-lowering-related proteins by network
   pharmacology, we treated HepG2 cells induced by oleic acid with AHT,
   AME, HRE, and TME and verified the effects of the MAPK signaling
   pathway and the PI3K-Akt signaling pathway on the lipid-lowering
   mechanism of HepG2 cells ([118]Figure 7A). As shown in [119]Figure
   7B,C, the protein expression of AKT, phosphorylated AKT (p-AKT), PI3K,
   and phosphorylated PI3K (p-PI3K) were validated and the relevant
   protein ratios were calculated. It was found that the protein
   expression levels of p-AKT/AKT and p-PI3K/PI3K in HepG2 cells induced
   by oleic acid were significantly reduced after treatment with AHT, AME,
   HRE, and TME (p < 0.05). AHT significantly reduced the phosphorylation
   of AKT and PI3K in HepG2 cells (p < 0.01). As shown in [120]Figure
   7D,E, AHT significantly increased the protein expression levels of
   AMPKα1, phosphorylated AMPKα1, and SIRT1 (p < 0.05). The above results
   indicated that AHT could regulate lipid function and improve lipid
   metabolism balance through the MAPK signaling pathway and the PI3K-Akt
   signaling pathway.
Figure 7.
   [121]Figure 7
   [122]Open in a new tab
   The effect of AHT on critical proteins in the PI3K Akt signaling
   pathway and MAPK signaling pathway. (A) Immunoblot analysis of related
   proteins. (B) The ratio of p-AKT/AKT protein quantification results.
   (C) The ratio of p-PI3K/PI3K protein quantification results. (D) The
   ratio of p-AMPK/AMPK protein quantification results. (E) SIRT1 protein
   quantification results. (n = 3, ****, ***, **, *, and ns represent p <
   0.0001, p < 0.001, p < 0.01, p < 0.05, and p > 0.05, respectively).
3.11. The Effect of AHT on Body Weight, Food Intake, and Organ Index in Mice
   As shown in [123]Figure 8A, there was no significant difference in the
   initial body weight of mice at 0 w (p > 0.05). With the prolongation of
   time, at 2 w, the weight of the MC group fed with a high-fat diet was
   significantly higher than that of the NC group fed with a normal diet
   (p < 0.05). At 4 w, the weight of the MC group was significantly higher
   than that of the HD group (p < 0.01). However, as shown in [124]Figure
   8B, there was no significant difference in food intake among the groups
   fed a high-fat diet (p > 0.05). It indicated that a high-fat diet could
   lead to weight gain in mice, and when AHT was supplemented, it
   prevented weight gain induced by a high-fat diet. But there was no
   significant difference in organ index, indicating that AHT had no
   adverse effects on mice (p > 0.05) ([125]Table 6).
Figure 8.
   [126]Figure 8
   [127]Open in a new tab
   Body weight and food intake of mice. (A) Changes in body weight of mice
   in each group during 8 w. (n = 8, *, ** represent significant and
   extremely significant differences between the MC group and the NC group
   (p < 0.05, p < 0.01); ## represents extremely significant differences
   between the MC group and the HD group (p < 0.05). (B) During the 8 w
   period, the food intake of mice in each group. (n = 3, ****, **, and ns
   represent p < 0.0001, p < 0.01, and p > 0.05, respectively).
Table 6.
   The effect of AHT on organ indices in different groups of mice.
   Group NC MC PC LD MD HD
   Heart (%) 0.693 ± 0.11 0.672 ± 0.11 0.602 ± 0.10 0.707 ± 0.19 0.660 ±
   0.09 0.613 ± 0.10
   Liver (%) 4.554 ± 0.47 4.527 ± 0.35 3.847 ± 1.40 4.750 ± 0.67 4.483 ±
   0.66 4.548 ± 0.74
   Spleen (%) 0.327 ± 0.03 0.309 ± 0.05 0.253 ± 0.06 0.306 ± 0.08 0.282 ±
   0.10 0.321 ± 0.09
   Kidney (%) 1.462 ± 0.18 1.367 ± 0.13 1.357 ± 0.17 1.463 ± 0.19 1.334 ±
   0.23 1.271 ± 0.14
   [128]Open in a new tab
   (n = 8, p > 0.05; there was no significant difference between the
   groups).
3.12. The Effect of AHT on Serum Biochemical Indicators in High-Fat Mice
   Blood lipids, liver damage, and antioxidant levels in mouse serum were
   measured. As shown in [129]Figure 9A–D, compared with the NC group, the
   levels of TC, TG, and LDL-C were significantly increased in the MC
   group, while the level of HDL-C was significantly decreased. The LD
   group, MD group, and HD group all showed varying degrees of
   improvement, with TC, TG, and LDL-C levels in the HD group decreasing
   by 29.01%, 42.98%, and 55.01%, respectively, compared to the MC group
   (p < 0.01), while HDL-C levels increased significantly by 165.85% (p <
   0.0001). AST and ALT are considered indicators for detecting liver
   injury and can verify the damage of hyperlipidemia to the liver of
   mice. As shown in [130]Figure 9E,F, the AST and ALT levels in the HD
   group decreased by 49.19% and 45.23%, respectively, compared to the MC
   group and returned to normal levels. Dysregulation of lipid metabolism
   could lead to the production of large amounts of reactive oxygen
   species in the body, causing oxidative stress. Therefore, we validated
   the antioxidant level and found that the antioxidant capacity of the MC
   group significantly decreased, while the SOD and T-AOC levels of the HD
   group significantly increased by 18.99% and 44.20%, respectively,
   compared to the MC group (p < 0.01) ([131]Figure 9G,H).
Figure 9.
   [132]Figure 9
   [133]Open in a new tab
   Serum indicators. (A) TC. (B) TG. (C) LDL-C. (D) HDL-C. (E) AST. (F)
   ALT. (G) SOD. (H) T-AOC. (n = 3, ****, ***, **, *, and ns represent p <
   0.0001, p < 0.001, p < 0.01, p < 0.05, and p > 0.05, respectively).
4. Discussion
   Long-term high-fat diets will lead to a disorder of lipid metabolism
   and increase the risk of chronic diseases such as obesity,
   hyperlipidemia, and diabetes [[134]33]. Hyperlipidemia is a complex
   disease; the traditional intervention method is taking statins.
   However, these drugs usually have a single site of action, and
   long-term use can cause some toxic side effects. Previous studies have
   found that disturbances in liver lipid metabolism, oxidative stress,
   and chronic inflammation in the body often accompany the occurrence of
   hyperlipidemia [[135]34]. Therefore, using natural plant ingredients
   with multi-target, multi-pathway, natural, safe, and efficient
   characteristics to prevent or intervene in lipid metabolism disorders
   has attracted widespread attention from researchers [[136]35].
   Astragalus membranaceus, Hippophae rhamnoides L., and Taraxacum
   mongolicum Hand. Mazz are traditional edible and medicinal plants with
   a long history of consumption. They have been widely reported to have
   various bioactive functions, such as lowering blood lipids,
   antioxidation, and immune regulation [[137]36,[138]37,[139]38].
   Therefore, this study aimed to explore the lipid-lowering effects,
   targets, and mechanisms of the combined application of Astragalus
   membranaceus extract, Hippophae rhamnoides extract, and dandelion
   extract.
   We first identified the main compounds in Astragalus membranaceus
   extract, Hippophae rhamnoides L. extract, and Taraxacum mongolicum
   Hand. Mazz extract using LC-MS and identified 1539 compounds. Research
   has confirmed that compound plants have better regulatory effects on
   lipid metabolism/diseases than single plants. Previous studies have
   shown that AME, HRE, and TME all have lipid-lowering activity, but
   their potential mechanisms for preventing hyperlipidemia have yet to be
   fully explored. Further research is needed to verify their mechanisms
   of action, such as key compounds, targets, and mechanisms. Therefore,
   network pharmacology was used to predict the targets and signaling
   pathways of the combined intervention of AME, HRE, and TME in
   hyperlipidemia. A total of 41 compounds and 140 potential targets for
   treating hyperlipidemia were detected. Fifteen core targets, including
   TP53, PPARG, ESR1, AKT1, RELA, and MAPK1, were identified through PPI
   analysis. Key compounds such as quercetin, luteolin, kaempferol, and
   baicalein were identified through compound target pathway analysis.
   These key compounds and core targets may be key factors in treating
   hyperlipidemia. Research has shown that the main component of the
   polyphenol-rich extract from Allium cepa and Gynostemma pentaphyllum is
   quercetin, demonstrating that quercetin can achieve therapeutic effects
   on hyperlipidemia through LOX1-PI3K AKT eNOS [[140]39,[141]40]. In
   addition, Astragalus membranaceus can regulate lipid metabolism by
   downregulating AKT1 and upregulating ESR1 [[142]41]. These results are
   similar to our research findings [[143]42]. The results of KEGG
   enrichment analysis indicate that AHT may regulate hyperlipidemia
   through lipids and atherosclerosis, MAPK signaling pathway, and
   PI3K-Akt signaling pathway.
   To verify the predictive results of network pharmacology, AME, HRE, and
   TME were combined to obtain AHT. The lipid-lowering ability,
   antioxidant capacity, and mechanism of action of AHT were validated by
   establishing oleic acid-induced HepG2 cell models and high-fat
   diet-induced hyperlipidemia mouse models. The results showed that AHT
   can regulate lipid function, alleviate oxidative stress, and have an
   excellent lipid-lowering effect through the MAPK and PI3K-Akt signaling
   pathways. Research shows that the PI3K-Akt signaling pathway can
   participate in atherosclerosis activity and improve glucose and lipid
   metabolism in mice [[144]43,[145]44]. In this study, AHT can regulate
   the PI3K-Akt signaling pathway and activate the expression of SIRT1
   protein. SIRT1, as a dependent acylase, is involved in lipid metabolism
   disorders such as hyperlipidemia, which reduces the protein expression
   level of SITR1 [[146]45]. The SIRT1/AMPK pathway can regulate lipid
   content, increase mitochondrial fatty acid oxidation, and promote lipid
   breakdown and energy metabolism. In Zheng et al.’s study [[147]46],
   SDF-PPs effectively reversed the decrease in p-AMPK/AMPK and inhibited
   the activity of acetyl CoA carboxylase 1 (ACC1). Our research also
   found that AMPK phosphorylation was enhanced in HepG2 cells treated
   with AHT. Previous reports have shown that α-ketoglutarate (AKG)
   activates AMPK protein in liver cells in dyslipidemia, enhancing its
   phosphorylation. After AMPK phosphorylation enhancement, it can inhibit
   the increase in TC and TG and oxidative stress induced by palmitic acid
   in HepG2 cells [[148]47]. Our results also found a significant decrease
   in TC, TG, and LDL-C levels in cells after AHT intervention, as well as
   a significant increase in HDL-C levels. It indicates that AHT regulates
   the lipid breakdown ability in liver cells by activating the MAPK and
   PI3K-Akt signaling pathways, inhibiting TC and TG accumulation in HepG2
   cells and mice. The above results indicate that AHT can enhance the
   regulatory ability of liver cells toward lipid metabolism and their
   resistance to oxidative stress. To further evaluate the lipid-lowering
   effect of AHT, we established a high-fat mouse model using a high-fat
   diet. After 8 weeks of AHT intervention, we found that the levels of
   TC, TG, and LDL-C in the HD group were significantly reduced, HDL-C
   levels were significantly increased, AST and ALT activities were
   decreased, and SOD and T-AOC levels were increased
   [[149]7,[150]48,[151]49]. These results indicate that AHT can improve
   lipid metabolism disorders in high-fat mice by increasing the body’s
   antioxidant levels and reducing liver damage. In summary, we validated
   the targets and pathways predicted by network pharmacology through cell
   and animal experiments. We found that AHT can improve hyperlipidemia
   and regulate lipid metabolism by regulating the MAPK and PI3K-Akt
   signaling pathways.
5. Conclusions
   In this work, network pharmacology was used to predict and analyze the
   potential mechanisms of bioactive compounds in AME, HRE, and TME for
   treating hyperlipidemia, and the lipid-lowering mechanism of AHT was
   explored through in vitro and in vivo experiments. The research results
   indicate that compounds in AHT, such as quercetin, luteolin,
   kaempferol, and baicalein, might affect hyperlipidemia by targeting
   core targets such as TP53, PPARG, ESR1, AKT1, RELA, MAPK1, as well as
   by acting on the PI3K-Akt and MAPK signaling pathways. In vitro and in
   vivo experiments showed that AHT could reduce TC, TG, and LDL-C levels,
   increase HDL-C levels, reduce liver injury, and enhance the body’s
   antioxidant capacity. Most importantly, AHT could improve
   hyperlipidemia by affecting the expression of proteins related to the
   PI3K-Akt and MAPK signaling pathways. In summary, these findings
   provide a new strategy for AHT to serve as a safe and efficient
   resource for improving lipid metabolism disorders such as
   hyperlipidemia.
List of Abbreviations
   ALT Alanine aminotransferase
   AST Aspartate aminotransferase
   AME Astragalus membranaceus extract
   AHT Astragalus membranaceus extract: Hippophae rhamnoides L. extract:
   Taraxacum mongolicum Hand. Mazz extract = 3:1:2
   HDL-C High-density lipoprotein cholesterol
   HRE Hippophae rhamnoides L. extract
   LC-MS Liquid chromatography–mass spectrometry
   LDL-C Low-density lipoprotein cholesterol
   OMIM Online Mendelian Inheritance in Man
   PPI Protein–protein interaction
   SOD Superoxide dismutase
   TME Taraxacum mongolicum Hand. Mazz extract
   TCMSP Traditional Chinese Medicine System Pharmacology Analysis
   Platform
   T-AOC Total antioxidant capacity
   TC Total cholesterol
   TG Triglycerides
   [152]Open in a new tab
Supplementary Materials
   The following supporting information can be downloaded at:
   [153]https://www.mdpi.com/article/10.3390/foods13172795/s1, Table S1:
   Drug targets, Table S2: Target of hyperlipidemia, Table S3: Targets of
   drugs and diseases.
   [154]foods-13-02795-s001.zip^ (63.8KB, zip)
Author Contributions
   Investigation, J.L.; formal analysis, Y.A. and Z.C.; conceptualization,
   Y.B.; methodology, X.Y. and M.J.; writing—original draft, X.Y. and
   M.J.; writing—review and editing, X.Y. and M.J.; resources, Y.B.;
   funding acquisition, Y.B. All authors have read and agreed to the
   published version of the manuscript.
Institutional Review Board Statement
   The animal research protocol has been approved by the Science and
   Technology Ethics Committee of Northeast Forestry University
   (NEFU2024-011) for research involving animals.
Informed Consent Statement
   Not applicable.
Data Availability Statement
   The original contributions presented in the study are included in the
   article and [155]Supplementary Materials, further inquiries can be
   directed to the corresponding author.
Conflicts of Interest
   The authors declare no conflicts of interest.
Funding Statement
   This research was funded by Heilongjiang Province Key Research and
   Development Project (JD2023SJ08), National Key Research and Development
   Program Project (2022YFD1600500), Heilongjiang Province Discipline
   Collaborative Innovation Project (Zxkxt220100002).
Footnotes
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References