Abstract Objective Chinese medicine formulae possess the potential for cholestasis treatment. This study aimed to explore the underlying mechanisms of San-Huang-Chai-Zhu formula (SHCZF) against cholestasis. Methods The major chemical compounds of SHCZF were identified by high-performance liquid chromatography. The bioactive compounds and targets of SHCZF, and cholestasis-related targets were obtained from public databases. Intersected targets of SHCZF and cholestasis were visualized by Venn diagram. The protein-protein interaction and compound-target networks were established by Cytoscape according to the STRING database. The biological functions and pathways of potential targets were characterized by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. The biological process-target-pathway network was constructed by Cytoscape. Finally, the interactions between biological compounds and hub target proteins were validated via molecular docking. Results There 7 major chemical compounds in SHCZF. A total of 141 bioactive compounds and 83 potential targets were screened for SHCZF against cholestasis. The process of SHCZF against cholestasis was mainly involved in AGE-RAGE signaling pathway in diabetic complications, fluid shear stress and atherosclerosis, and drug metabolism-cytochrome P450. ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA were the top 10 hub targets. Molecular docking showed that bioactive compounds of SHCZF had a good binding affinity with hub targets. Conclusions This study predicted that the mechanisms of SHCZF against cholestasis mainly involved in AGE-RAGE signaling pathway in diabetic complications, fluid shear stress and atherosclerosis, and drug metabolism-cytochrome P450. Moreover, APOE, AKT1, and TP53 were the critical hub targets for bioactive compounds of SHCZF. Introduction Cholestasis is a common clinical manifestation of liver disease mainly derived from the reduction or obstruction of bile flow [[30]1]. The long-term cholestasis in liver can lead to hepatocyte dysfunctions, thereby causing severe liver diseases such as primary biliary cirrhosis, primary sclerosing cholangitis and secondary sclerosing cholangitis [[31]2]. At present, although some drugs, such as rosiglitazone, obeticholic acid, and ursodeoxycholic acid, have been developed for cholestasis treatment, the therapeutic effect is still limited and may contribute to pruritus, dyslipidemia, and gastrointestinal symptoms [[32]3, [33]4]. Therefore, the discovery of effective drugs for cholestasis treatment is of great significance. Accumulating evidence indicated that Chinese medicines exert beneficial therapeutic effects in liver diseases and cholestasis [[34]5, [35]6]. San-Huang-Chai-Zhu formula (SHCZF) is a Chinese herbal formula, which consists of five herbs, namely, Dahuang (Rhei Radix Et Rhizome), Huangbai (Phellodendri Chinrnsis Cortex), Huangzhizi (Gardeniae Fructus), Chaihu (Radix Bupleuri), and Baizhu (Atractylodes Macrocephala Koidz.). Previous studies indicated that these five herbs all possess the hepatoprotective effect on liver diseases. Cao et al. [[36]7] reported that Dahuang had extensive pharmacological effects in hepatoprotective, anti-inflammatory, anticancer and so on. Huangbai and Huangzhizi were widely used to ameliorate inflammation and hepatotoxicity as a core component of herbal formula [[37]8, [38]9]. Saikosaponins extracted from Chaihu showed valuable pharmacological activities of anti-inflammatory and liver protection [[39]10]. Baizhu in Xiaoyao San formula was also validated its pharmacological effects of hepatoprotection [[40]11]. However, the underlying pharmacological mechanism of SHCZF against cholestasis is still illusive. Network pharmacology is a favorable method to reveal the pharmacological mechanism of Chinese medicine formulae against specific diseases and identify the relevant drugs, targets, and pathways [[41]12–[42]14]. This approach comprehensively investigates the interactions of bioactive ingredients, targets, and diseases, and the relationship are visualized by interaction networks. For instance, by combining the network pharmacology with the pathological examination, Xiaoyaosan decoction was proved the therapeutic effects on alleviating liver fibrosis [[43]15]. The potential biological mechanisms of GegenQinlian decoction also were unveiled to improve insulin resistance in liver, adipose, and muscle tissue by network pharmacology analysis [[44]16]. Therefore, network pharmacology is a commendable approach for exploring the underlying mechanisms of SHCZF against cholestasis. In this article, the underlying mechanisms of SHCZF against cholestasis were uncovered by identifying bioactive compounds and potential target genes. Moreover, the interactions between major bioactive compounds and hub target proteins were validated by molecular docking. This study provides an essential foundation for further experimental investigations and clinical application of SHCZF against cholestasis. Methods Main ingredients analysis of SHCZF SHCZF was prepared by mixing five herbs (Dahuang, Huangbai, Huangzhizi, Chaihu, and Baizhu) in the ratio of 4:4:3:3:4. The extract of SHCZF was obtained by adding 10 times the amount of water, soaking for 30 min, and boiling for 1.5 h. After filtering out the liquid, samples were added 8 times the amount of water and decocted for 0.5 h after boiling. Then, the obtained extract was concentrated into 2 g/mL for high-performance liquid chromatography (HPLC) determination. Samples were analyzed using a LC-20AT HPLC system (Shimadzu, Japan) and separated using an Extend-C18 column (250 mm × 4.6 mm, 5 μm) (Agilent, CA, USA) with a mobile phase consisting of 0.1% phosphoric acid (A) and acetonitrile (B). The elution gradient was as follows: 0–10 min with 90% A and 10% B, 10–20 min with 30% A and 30% B, 20–30 min with 40% A and 60% B, 30–53 min with 30% A and 70% B, 53–54 min with 90% A and 10% B, and 59 min controller stop. The molecular structures of these seven compounds of SHCZF were downloaded from ZINC ([45]https://zinc15.docking.org/) [[46]17]. Screening for bioactive ingredients and targets of SHCZF All ingredients from 5 herbs of SHCZF were retrieved from the traditional Chinese medicine integrated database (TCMID, [47]http://www.megabionet.org/tcmid/) [[48]18], the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP, [49]https://old.tcmsp-e.com/tcmsp.php) [[50]19], and herb ingredients’ targets (HIT, [51]http://lifecenter.sgst.cn/hit/) database [[52]20]. Totally, 227 compounds were obtained after eliminating those compounds without targets. In addition, Search tool for interacting chemicals (STITCH, [53]http://stitch.embl.de/) database [[54]21] and the above data sources were used to retrieve targets associated with 227 compounds from SHCZF with a setting of minimum required interaction score = 0.400 in STITCH. A total of 5216 targets was collected and the Gene ID of these targets was normalized by National Center for Biotechnology Information (NCBI) database ([55]https://www.ncbi.nlm.nih.gov/). Drug-likeness calculation of SHCZF compounds The 227 compounds of SHCZF were screened by drug-likeness evaluation. The assessment of drug-likeness properties is mainly determined by absorption, distribution, metabolism, and elimination (ADME) features of compounds [[56]22]. The quantitative estimate of drug-likeness (QED) value is an important parameter to assess ADME characteristics. In this work, we calculated QED value described by Bickerton [[57]23] to screen pharmaceutically active compounds in SHCZF. The equation of QED calculation was shown as follows: [MATH: QED=exp(1ni=1< /mn>nlndi) :MATH] In this equation, desirability functions (d) were obtained by integrating 8 physicochemical properties of compounds, including molecular weight (MW), the number of hydrogen bond acceptors (HBAs), the number of hydrogen bond donors (HBDs), the octanol-water partition coefficient (ALogP), the number of rotatable bonds (ROTBs), the number of aromatic rings (AROMs), molecular polar surface area (PSA), and the number of structural alerts (ALERTS). Compounds in SHCZF with QED ≥ 0.2 referring to the DrugBank database ([58]https://go.drugbank.com/) were included for following analyses. Target selection of active compounds in SHCZF To precisely define compound-target interaction, the enrichment scoring algorithm based on a binomial statistical model was used to screen core targets of compounds [[59]24, [60]25]. The target that interacts with most of active compounds can be considered as a core target of SHCZF. The probability of being a core target was calculated as follows: [MATH: Pi(Xk)=m=knCnm(p)m(1< mo>−p)nm :MATH] where, n is the total number of compounds in SHCZF, p is the ratio of the average number of compounds simultaneously interacting with the same target in the total target of SHCZF compounds, and P[i] (X ≥ k) represents the probability of a target gene (i) simultaneously interacting with more than k active compounds. The investigated target with P < 0.01 can be regarded as a core target for SHCZF compounds. Screening of targets associated with cholestasis The cholestasis-related targets were retrieved from the GeneCards database ([61]https://www.genecards.org/) [[62]26, [63]27], the online mendelian inheritance in man (OMIM, [64]https://www.omim.org/) database [[65]28], and the DisGeNET database ([66]https://www.disgenet.org/home/) [[67]29]. Accordingly, 56, 28, and 420 cholestasis-related targets were collected from GeneCards, OMIM, and DisGeNET databases, respectively. A total of 449 targets was obtained after removing duplicates ([68]S1 Table). Construction of protein-protein interaction (PPI) network and compound-target (C-T) network The intersection targets of SHCZF and cholestasis were visualized by a Venn diagram. PPI network of common target proteins was established and analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) dataset ([69]https://string-db.org) [[70]30], where each node in the network represented a target, and the node with higher degree means the more important target in the network. The C-T network of SHCZF against cholestasis was constructed using Cytoscape (v3.8.2) [[71]31]. Biological function enrichment analyses In order to further explore the biological functions of SHCZF acting on cholestasis, core targets were integrated for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses [[72]32]. GO enrichment analysis included molecular function (MF), biological process (BP), and cellular component (CC) analyses according to the GO database. KEGG enrichment analysis were performed according to the KEGG database. A hypergeometric distribution model was used to assess whether the core target genes were significantly related to specific GO terms and KEGG pathways [[73]33], showed as follows: [MATH: P=1i=0k1< mrow>(Mi)( NMni)(< mtable>Nn ) :MATH] where, N is the total number of genes, M is the number of genes annotated in GO and KEGG databases, n is the number of investigated target genes of SHCZF, and k is the number of intersection genes of SHCZF and annotated genes. P-values that corrected by the Bonferroni method reflected the relevance between potential targets and GO terms or KEGG pathways. GO terms and KEGG pathways with P-value < 0.01 were considered as significant relevance. Bubble charts and histograms were drawn based on the cluster profiler package R 3.15.4. Construction of a target-pathway network for SHCZF against cholestasis To elucidate the pharmacological mechanism of SHCZF in cholestasis treatment, Cytoscape was used to construct a BP-target-pathway network. The degree, betweenness and centeredness of potential target were calculated by a CytoHubba plugin [[74]34]. The core targets, top 15 KEGG pathways, and top 15 BPs were included in the network. Targets with flesh-colored circles, pathways with green circles, and BPs with purple circles were presented as nodes, and the interactions between nodes were expressed as edges. Molecular docking Molecular docking was conducted to validate the interactions between bioactive compounds and target proteins of SHCZF against cholestasis. The top 10 hub target proteins were selected for molecular docking and used for PPI network construction by a CytoHubba plugin in Ctytoscape. The 3D structures of target proteins were obtained from Protein Data Bank (PDB, [75]https://www.rcsb.org/) [[76]35]. After deleting water molecules using PyMol (v2.3.0) [[77]36], the obtained protein structures were imported into AutoDockTools (v1.5.6) to construct mating pocket of molecular docking. Molecular docking with bioactive compounds was performed using AutoDock Vina (v1.1.2) [[78]37] based on the data collected above. Results Major ingredients in SHCZF HPLC was performed to identify the major chemical compounds in SHCZF. Seven main compounds of SHCZF were obtained, including chrysophanol, emodin, physcion, rhein, aloe-emodin, berberine chloride, gardenoside ([79]S1A–S1G Fig). The chemical structures of these 7 compounds were shown in [80]Table 1. Table 1. Chemical structures of 7 major compounds of San-Huang-Chai-Zhu formula (SHCZF). Synonyms Cas Molecular Formula Chrysophanol 481-74-3 C[15]H[10]O[4] Emodin 518-82-1 C[15]H[10]O[5] Physcion 521-61-9 C[16]H[12]O[5] Rhein 478-43-3 C[15]H[8]O[6] Aloe-emodin 481-72-1 C[15]H[10]O[5] Berberine chloride 633-65-8 C[20]H[18]ClNO[4] Gardenoside 24512-62-7 C[17]H[24]O[11] [81]Open in a new tab Bioactive components and targets of SHCZF QED is a critical indicator to evaluate the drug-likeness of compounds. According to the QED values, 216 drug-likeness components in SHCZF were obtained based on the TCMID, TCMSP, and HIT database. Moreover, 162 active compounds and 457 SHCZF compound-related targets were collected by combining the public databases with a binomial statistical model. There were 19, 40, 34, 93, and 22 bioactive compounds in Dahuang, Huangbai, Huangzhizi, Chaihu, and Baizhu of SHCZF, respectively ([82]S2 Table). Potential targets of SHCZF active compounds for cholestasis treatment According to the GeneCards, OMIM, and DisGeNET databases, a total of 449 cholestasis-related target genes were obtained after eliminating duplicates ([83]S1 Table). The intersection between 457 SHCZF targets and 449 cholestasis-related targets was presented by a Venn diagram. As a result, there were 83 overlapping targets considered as core targets associated with both SHCZF compounds and cholestasis ([84]Fig 1A & [85]Table 2). Furthermore, 83 potential targets were input into the STRING database to construct a PPI network. Nodes and edges in the PPI network represent targets and protein-protein associations, respectively. The PPI network included 83 nodes and 1034 edges. Green and yellow circles in the PPI network stood for 83 potential targets. The degree of targets represents the number of links to nodes, and the target with higher degree can be regarded as the more important target. In this PPI network, the darker green circles mean the targets with higher degree and yellow circles mean less importance. The average node degree of this PPI network was 24.9, and ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA were top 10 targets with high degrees ([86]Fig 1B). Fig 1. The 83 potential targets for San-Huang-Chai-Zhu formula (SHCZF) in cholestasis treatment. [87]Fig 1 [88]Open in a new tab (A) Intersection of SHCZF and cholestasis targets was visualized by Venn diagram. (B) Protein-protein interaction (PPI) network of 83 common targets. Each node represents a common target for SHCZF and cholestasis, and each edge represents the association between two targets. The darker green means the higher degree value, and the average degree is 24.9. Table 2. 83 potential targets of SHCZF against cholestasis. Gene ID Target Name Gene ID Target Name Gene ID Target Name Gene ID Target Name 19 ABCA1 1559 CYP2C9 4846 NOS3 7157 TP53 183 AGT 1565 CYP2D6 4988 OPRM1 7376 NR1H2 207 AKT1 1576 CYP3A4 5122 PCSK1 7412 VCAM1 213 ALB 1581 CYP7A1 5243 ABCB1 8856 NR1I2 216 ALDH1A1 1728 NQO1 5290 PIK3CA 9002 F2RL3 219 ALDH1B1 2099 ESR1 5319 PLA2G1B 9370 ADIPOQ 335 APOA1 2147 F2 5320 PLA2G2A 9429 ABCG2 345 APOC3 2149 F2R 5443 POMC 9970 NR1I3 348 APOE 2539 G6PD 5444 PON1 10062 NR1H3 551 AVP 2641 GCG 5465 PPARA 10891 PPARGC1A 567 B2M 2950 GSTP1 5468 PPARG 23411 SIRT1 570 BAAT 3162 HMOX1 5594 MAPK1 54575 UGT1A10 596 BCL2 3383 ICAM1 5595 MAPK3 54576 UGT1A8 841 CASP8 3480 IGF1R 5599 MAPK8 54577 UGT1A7 847 CAT 3552 IL1A 5603 MAPK13 54578 UGT1A6 885 CCK 3553 IL1B 5970 RELA 54658 UGT1A1 1080 CFTR 3569 IL6 6288 SAA1 54659 UGT1A3 1432 MAPK14 3576 CXCL8 6822 SULT2A1 64240 ABCG5 1544 CYP1A2 4129 MAOB 6863 TAC1 64241 ABCG8 1555 CYP2B6 4313 MMP2 7097 TLR2 94233 OPN4 1557 CYP2C19 4843 NOS2 7124 TNF [89]Open in a new tab Compound-target (C-T) network of SHCZF against cholestasis According to 83 potential targets, 141 SHCZF compounds were identified as the major ingredients acting on cholestasis ([90]Table 3). The interactions between 83 potential targets and 141 SHCZF compounds were exhibited by a C-T network. In the C-T network, red diamonds represented 5 herbs in SHCZF, including Dahuang (Rhei Radix Et Rhizome), Huangzhizi (Gardeniae Fructus), Baizhu (Atractylodes Macrocephala Koidz.), Huangbai (Phellodendri Chinrnsis Cortex), and Chaihu (Radix Bupleuri). Circles with 5 different colors stood for distinct compounds from 5 herbs, among which, there were 17 compounds from Rhei Radix Et Rhizome, 19 from Gardeniae Fructus, 17 from Atractylodes Macrocephala Koidz., 15 from Phellodendri Chinrnsis Cortex, and 49 from Radix Bupleuri. Besides, 24 common compounds were displayed using blue circles. The parallelograms in the network represented 83 potential targets of SHCZF against cholestasis and darker orange indicated higher degree ([91]Fig 2). Table 3. 141 bioactive compounds of SHCZF against cholestasis. Compound Name QED Compound Name QED (-)-Epicatechin-pentaacetate 0.3317 Istidina 0.4207 (+)-trans-Carveol 0.5719 jatrorrhizine 0.7352 (Z,Z)-farnesol 0.6157 kaempferol 0.6372 vanillin 0.5173 lauric acid 0.3925 2-heptanone 0.5103 l-carvone 0.5247 3,4,5-trihydroxybenzoic acid 0.4656 L-Ile 0.4718 acetic acid 0.4199 limonin 0.4519 adonitol 0.3082 linalool 0.6172 aloe-emodin 0.7330 linolenic acid 0.3326 alpha-humulene 0.4851 L-Limonene 0.4838 alpha-limonene 0.4838 L-Lysin 0.2814 alpha-linolenic acid 0.3326 LPG 0.3562 angelicin 0.4354 Lutein 0.2035 angelicin 0.4670 L-Valin 0.4120 Apocynin 0.6736 L-valine 0.4266 Auraptene 0.4124 MAE 0.4992 Azole 0.4642 menthyl acetate 0.6510 Baicalin 0.3617 Methose 0.3101 berberine 0.6633 Methyl naphthalene 0.5294 berberine 0.8245 methyl palmitate 0.2468 beta-elemene 0.5799 Methyleugenol 0.6599 beta-sitosterol 0.4354 MTL 0.2704 caffeic acid 0.4750 myristic acid 0.4490 caprylic acid 0.5818 naphthalene 0.5114 capsaicin 0.5370 nonanoic acid 0.5775 chrysin 0.8206 obaculactone 0.4519 cinnamic acid 0.6504 Obacunone 0.4784 cis-Carveol 0.5719 o-caffeoylquinic acid 0.2356 citric acid 0.4243 octanoic acid 0.5818 coumarin 0.4124 octanol 0.5480 crocetin 0.5030 oleanolic acid 0.4460 Cyclopentenone 0.4228 oleic acid 0.2030 DBP 0.4752 OYA 0.3958 DEP 0.6925 PAC 0.6684 DIBP 0.6761 paeonol 0.5478 DLA 0.4605 palmatine 0.6613 d-limonene 0.4838 palmitic acid 0.3653 DTY 0.5110 PCR 0.5390 EIC 0.2944 PEA 0.6259 emodin 0.6835 pentadecylic acid 0.4059 esculetin 0.3579 PHA 0.5664 EUG 0.6993 phenylalanine 0.5664 eugenol 0.6955 PHPH 0.5905 farnesol 0.6157 PIT 0.4834 fructose 0.3101 PLO 0.7502 Fumarine 0.7258 poriferast-5-en-3beta-ol 0.4354 Furol 0.4792 Prolinum 0.3867 gallicacid 0.4656 puerarin 0.4049 genipin 0.5093 py 0.4453 geniposide 0.2532 quercetin 0.5064 geraniol 0.6172 rhapontigenin 0.7399 Germacron 0.4329 rhein 0.7375 GLB 0.3046 rottlerin 0.2140 glutamate 0.3835 rutaecarpine 0.6889 guaiacol 0.5771 scoparone 0.5470 guanidine 0.2426 scopoletin 0.5425 Guasol 0.5771 Scopoletol 0.5425 Gulutamine 0.3835 Serotonin 0.6456 Hemo-sol 0.4838 serotonine 0.6456 Heptadekan 0.2688 stearic acid 0.3017 heptanoic acid 0.5128 Stigmasterol 0.4599 Heptanol 0.5465 succinic acid 0.5303 hexanal 0.2939 TDA 0.4900 hexanoic acid 0.5687 tetradecane 0.3217 histidine 0.4184 thymol 0.6510 Hyacinthin 0.4290 trans-2-nonenal 0.3144 IFP 0.3920 tridecanoic acid 0.4900 IPH 0.5172 trihydroxybenzoic acid 0.4656 isoimperatorin 0.4856 UND 0.4133 isoliquiritigenin 0.5824 ursolic acid 0.4433 isorhamnetin 0.6678 [92]Open in a new tab Fig 2. Compound-target (C-T) network of 141 bioactive compounds and 83 potential targets for SHCZF against cholestasis. [93]Fig 2 [94]Open in a new tab There were 229 nodes in the C-T network, including 5 red diamonds for herbs from SHCZF, 83 orange (higher degree) and green (lower degree) parallelograms for potential targets, and 141 circles for bioactive compounds. GO and KEGG enrichment analyses To elaborate the biological functions of 83 potential targets, targets were characterized by GO and KEGG pathway enrichment analyses. In the GO analysis, a total of 1617 GO terms were found, including 91 of MF, 1498 of BP, and 28 of CC (p value < 0.01). The top 15 terms of MF, BP, and CC were ranked according to the adjusted p value and gene count ([95]Fig 3). Lower p value with red color and higher count with bigger circle indicated greater enrichment of GO terms. The bubble chart and histogram showed that MF was significantly enriched in heme binding, tetrapyrrole binding, carboxylic acid binding, receptor agonist activity, and organic acid binding, etc. ([96]Fig 3A and 3B). The main GO terms of BP were related to response to lipopolysaccharide, regulation of lipid localization, cellular response to biotic stimulus, regulation of inflammatory response, and response to oxidative stress, etc. ([97]Fig 3C and 3D). CC were mainly enriched in membrane microdomain, high-density lipoprotein particle, blood microparticle, nuclear transcription factor complex, and RNA polymerase II transcription factor complex, etc. ([98]Fig 3E and 3F). Fig 3. Gene Ontology (GO) enrichment analysis for 83 potential targets of SHCZF against cholestasis. [99]Fig 3 [100]Open in a new tab (A, B) The bubble chart and histogram of top 15 molecular function (MF) enrichment. (C, D) The bubble chart and histogram of top 15 biological process (BP) enrichment. (E, F) The bubble chart and histogram of top 15 cellular component (CC) enrichment. The essential signaling pathways of SHCZF in cholestasis were displayed by KEGG pathway enrichment analysis. A total of 133 pathways were significantly associated with 83 potential targets (p value < 0.01). In addition, the top 15 pathways with low adjust p values and high counts were displayed by the bubble chart and the histogram ([101]Fig 4A and 4B), and listed in [102]Table 4. The results showed that the common signaling pathways mainly focused on the AGE-RAGE signaling pathway in diabetic complications, Toll-like receptor signaling pathway, and TNF signaling pathway, etc. ([103]Fig 4A and 4B). In addition, the interactions among 83 potential targets, top 15 BP terms, and top 15 pathways were visualized by a BP-target-pathway network ([104]Fig 5A). Furthermore, the interactions among top 10 hub targets, namely ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA, were visualized by a PPI network. The network showed 10 target nodes connected by 44 edges with an average degree of 8.8 ([105]Fig 5B). Fig 4. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis for 83 potential targets of SHCZF against cholestasis. [106]Fig 4 [107]Open in a new tab (A) The bubble chart of top 15 KEGG pathways. (B) The histogram of top 15 KEGG pathways. Table 4. Top 15 KEGG pathways for SHCZF against cholestasis. ID Pathway P. adjust Count hsa04933 AGE-RAGE signaling pathway in diabetic complications 7.28E-18 19 hsa05418 Fluid shear stress and atherosclerosis 5.18E-14 18 hsa00982 Drug metabolism—cytochrome P450 2.46E-13 14 hsa05142 Chagas disease (American trypanosomiasis) 1.37E-12 15 hsa00980 Metabolism of xenobiotics by cytochrome P450 1.08E-11 13 hsa04620 Toll-like receptor signaling pathway 2.58E-11 14 hsa04668 TNF signaling pathway 6.29E-11 14 hsa05133 Pertussis 1.40E-10 12 hsa01522 Endocrine resistance 1.50E-10 13 hsa05204 Chemical carcinogenesis 3.32E-10 12 hsa05161 Hepatitis B 4.98E-10 15 hsa00830 Retinol metabolism 4.98E-10 11 hsa05152 Tuberculosis 1.93E-09 15 hsa04625 C-type lectin receptor signaling pathway 3.61E-09 12 hsa04931 Insulin resistance 5.28E-09 12 [108]Open in a new tab Fig 5. BP-target-pathway network and PPI network of top 10 hub genes for SHCZF against cholestasis. [109]Fig 5 [110]Open in a new tab (A) The BP-target-pathway network included 83 potential targets (flesh-colored circles), top 15 BP terms (purple circles), and top 15 KEGG pathways (green circles). (B) PPI network of top 10 hub targets (ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA) for SHCZF against cholestasis. Molecular docking between bioactive compounds and hub targets Molecular docking was performed to validate the interactions between bioactive compounds and hub targets of SHCZF against cholestasis. Seven main compounds of SHCZF, including chrysophanol, emodin, physcion, rhein, aloe-emodin, berberine chloride, and gardenoside, were chosen for molecular docking based on their high contents analyzed by HPLC. Top 10 hub targets, including ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA, were chosen for molecular docking based on network pharmacology. The results presented that the molecular docking affinity of seven active compounds with top 10 hub target proteins were all less than -5 kcal/mol ([111]S3 Table). The strongest binding activity between active compounds and hub target proteins were exhibited in [112]Fig 6. APOE displayed the best binding affinity with berberine chloride (affinity = -10.5 kcal/mol), physcion (affinity = -10 kcal/mol), chrysophanol (affinity = -9.9 kcal/mol), emodin (affinity = -9.8 kcal/mol), and rhein (affinity = -9.8 kcal/mol) ([113]Fig 6A–6E). AKT1 had a strong affinity with berberine chloride (affinity = -10.4 kcal/mol), chrysophanol (affinity = -9.7 kcal/mol), physcion (affinity = -9.7 kcal/mol), and rhein (affinity = -9.7 kcal/mol) ([114]Fig 6F–6I). TP53 bound to emodin with a binding energy of -9.5 kcal/mol ([115]Fig 6J). According to the molecular docking diagrams, the structures of emodin bound to sites of ALA-260 and LYS-268, while rhein interacted with LEU-330 in APOE by hydrogen bond ([116]Fig 6D and 6E). Berberine chloride bound to sites of ARG-206 and SER-205 in AKT1, while chrysophanol bound to sites of SER-205, LYS-268, and ASN-53 ([117]Fig 6F and 6G). Both physcion and rhein bound to sites of SER-205 and LYS-268 in AKT1 ([118]Fig 6H and 6I). The structure of emodin bound to the site of ASP-65 in TP53 ([119]Fig 6J). Fig 6. Molecular docking of SHCZF compounds and hub target proteins. [120]Fig 6 [121]Open in a new tab (A-E) The binding mode of APOE and berberine chloride, physcion, chrysophanol, emodin, and rhein, respectively. (F-I) The binding mode of AKT1 and berberine chloride, chrysophanol, physcion, and rhein, respectively. (J) The binding mode of TP53 and emodin. Discussion Cholestasis is clinical condition and pathogenic features caused by the impairment of bile flow, which is closely associated with hepatocyte dysfunction and liver diseases [[122]38]. Previous study indicated that SHCZF had the potential for cholestasis treatment, however, the pharmacological mechanisms remain unclear [[123]6]. Our study found that SHCZF possessed 7 major chemical compounds, including chrysophanol, emodin, physcion, rhein, aloe-emodin, berberine chloride, and gardenoside. According to the network pharmacology analysis, 141 bioactive compounds and 83 potential targets of SHCZF against cholestasis were screened. The corresponding biological functions of potential targets were characterized and presented by Go terms and KEGG pathways. Furthermore, the interactions between 7 major bioactive compounds and top 10 hub target proteins were exhibited by molecular docking. SHCZF is a Chinese medicine formula, presenting a hepatoprotective effect on intrahepatic cholestasis [[124]6]. There are five herbs in SHCZF, including Dahuang (Rhei Radix Et Rhizome), Huangbai (Phellodendri Chinrnsis Cortex), Huangzhizi (Gardeniae Fructus), Chaihu (Radix Bupleuri) and Baizhu (Atractylodes Macrocephala Koidz.). Our study identified 7 major chemical compounds in five herbs of SHCZF, including chrysophanol, emodin, physcion, rhein, aloe-emodin, berberine chloride, and gardenoside. Previous studies indicated that these seven compounds have favorable pharmacological properties including anticancer, hepatoprotective, anti-inflammatory, etc. [[125]39–[126]45]. For instance, emodin can suppress liver injury and bile acids secretion, and exert a protective effect on intrahepatic cholestasis [[127]40]. Physcion is a novel liver protective agent by reprogramming the hepatic circadian clock [[128]41]. Rhein may promote bile acid transport and reduce bile acid accumulation in liver [[129]42]. As a result, we speculate that these seven compounds from SHCZF may exert critical effects for SHCZF against cholestasis. Network pharmacology are widely applied in elucidating the biological mechanism of traditional Chinese medicine formula by constructing intricate interaction network based on bioactive compounds, targets, and biological functions [[130]46]. According to the network pharmacology analysis, a total of 141 bioactive compounds and 83 potential targets of SHCZF against cholestasis were collected based on public databases. The interactions among 83 targets were presented by a PPI network containing 83 target nodes connected by 1034 edges with an average node degree of 24.9. Besides, the interactions between 141 bioactive compounds and 83 potential targets were visualized by a C-T network. The top 10 hub targets were ALB, IL6, AKT1, TP53, TNF, MAPK3, APOE, IL1B, PPARG, and PPARA. Of note, most of them is associated with the progression of liver diseases [[131]47–[132]51]. For instance, ALB is a protein produced by liver, which is widely used as a marker for liver diseases [[133]47]. IL6 and TNF are inflammatory biomarkers for cholestatic liver injury [[134]48]. AKT1 and TP53 are closely related to the regulation of liver cancer progression [[135]50, [136]51]. These results suggest that these top 10 hub targets may act as essential roles in SHCZF for cholestasis treatment. In order to further investigate the underlying mechanisms, the biological functions of hub targets were enriched via GO and KEGG analyses. The interactions among 83 potential targets, top 15 related BP terms, and top 15 KEGG pathways were presented by a BP-target-pathway network. Our study showed that these targets were mainly related to the processes of response to molecule of bacterial origin, response to nutrient levels, response to lipopolysaccharide, etc. A previous study also found that patients with cholestasis presented a lack of response to bacterial infections [[137]52]. These results suggested that these targets may be involved in the regulation of SHCZF against cholestasis via moderating these biological processes. In addition, the top 15 KEGG pathways related to hub targets were AGE-RAGE signaling pathway in diabetic complications, fluid shear stress and atherosclerosis, drug metabolism-cytochrome P450, TNF signaling pathway, insulin resistance, etc. According to previous statistic, the pathways of AGE-RAGE signaling pathway in diabetic complications, fluid shear stress and atherosclerosis, and insulin resistance were also enriched in non-alcoholic fatty liver and involved in the regulation of liver function [[138]53]. Xue et al. [[139]54] found that Da-Huang-Xiao-Shi decoction could upregulate the expression of the metabolic enzyme cytochrome P450 in chronic cholestasis. Our previous study suggested that TNF signaling pathway may be the important mechanism for SHCZF against cholestasis [[140]6]. Overall, the above pathways may be closed relevant to SHCZF against cholestasis. The binding force of a drug with target proteins is a pivotal index for assessing its mechanistic action on diseases [[141]55]. The binding models between 7 SHCZF compounds and 10 hub target proteins were visualized by molecular docking. The results showed that chrysophanol, physcion, rhein, aloe-emodin, and berberine chloride had a strong affinity with APOE and AKT1. Emodin had a strong affinity with APOE, AKT1, and TP53. The structures of emodin and rhein bound to sites of SER-278 and LEU-330 in APOE, respectively. The structure of berberine chloride bound to sites of ARG-206 and SER-205 in AKT1, while chrysophanol bound to sites of SER-205, LYS-268, and ASN-53. Both physcion and rhein bound to sites of SER-205 and LYS-268 in AKT1. The structure of emodin bound to the site of ASP-65 in TP53. Differences in the binding sites may affect the ability of SHCZF compounds to bind target proteins, thereby exerting regulatory effects on cholestasis. In conclusion, the interactions of 141 bioactive compounds and 83 potential targets of SHCZF against cholestasis were characterized by network pharmacology analysis. These targets may be closely related to the biological processes of response to molecule of bacterial origin, response to nutrient levels, response to lipopolysaccharide, etc., and involved in the pathways of AGE-RAGE signaling pathway in diabetic complications, fluid shear stress and atherosclerosis, drug metabolism-cytochrome P450, TNF signaling pathway, insulin resistance, etc. Molecular docking validated the binding of 7 active compounds and top 10 hub target proteins. Chrysophanol, physcion, rhein, aloe-emodin, and berberine chloride had a strong affinity with APOE and AKT1, and emodin had a strong affinity with APOE, AKT1, and TP53. This study provides essential clues to further explore the underlying mechanisms of SHCZF against cholestasis. However, in vivo or in vitro experiments are needed to be performed for validating the mechanisms of SHCZF against cholestasis through moderating above hub targets and pathways. Supporting information S1 Fig. High Performance Liquid Chromatography (HPLC) chromatograms of 7 major chemical compounds in SHCZF. (A) Chrysophanol. (B) Emodin. (C) Physcion. (D) Rhein. (E) Aloe-emodin. (F) Berberine chloride. (G) Gardenoside. (PDF) [142]Click here for additional data file.^ (188.2KB, pdf) S1 Table. Cholestasis-related targets from public databases. (XLSX) [143]Click here for additional data file.^ (18.3KB, xlsx) S2 Table. 162 active compounds and 457 corresponding targets of SHCZF. (XLSX) [144]Click here for additional data file.^ (23.2KB, xlsx) S3 Table. Molecular docking of seven bioactive compounds and top 10 targets. (DOCX) [145]Click here for additional data file.^ (17KB, docx) Data Availability All relevant data are within the paper and its [146]Supporting Information files. Funding Statement This work was supported by Zhejiang science and technology research fund [No. 2014C33238] and Zhejiang science and technology research fund of traditional Chinese medicine [No.2020ZB158], funder play the role of conception and design of the research, analysis and interpretation of data and revision of manuscript. References