Analysis of the Mechanism of Action of Kushen in the Treatment of Tuberculosis Based on Network Pharmacology.

Context
Drug-resistant tuberculosis (TB), especially multidrug-resistant TB, has continued to increase and pan-drug-resistant TB and even fully drug-resistant TB have emerged, bringing great challenges to the treatment of TB. Development of new, safe, and effective antituberculosis drugs is an urgent need.


Objective
The study intended to evaluate the use of the network pharmacology method to comprehensively and systematically analyze the network relationship of Kushen's main components, targets, and signaling pathways, aiming to provide new ideas and clues for an in-depth study of the mechanism of Kushen's main components in the treatment of pulmonary TB.


Design
The research team performed a Network pharmacology analysis.


Setting
The study took place in the Department of Respiratory and Critical Care Medicine at the Third People's Hospital of Yichang City in Yichang, Hubei, China.


Outcome Measures
The research team: (1) screened Kushen's active ingredients and related targets using the Traditional Chinese Medicine System Pharmacology (TCMSP) database and analysis platform; (2) used the GeneCards database and the Online Mendelian Inheritance in Man (OMIM) database to search for disease targets, (3) connected the active ingredient's targets to the disease targets to obtain predictive targets for Kushen to act against TB, (4) used the STRING database to construct a protein-protein interaction (PPI) network map, (5) used the Database for Annotation, Visualization and Integrated Discovery (DAVID) to subject the intersecting genes to gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, and (6) used the TCMSP and Protein Data Bank (PDB) databases to dock the active ingredients with target-protein molecules.


Results
The research team found 45 active ingredients for Kushen and 177 target-protein genes related to active ingredients. The PPI network map of the Kushen-TB targets and found that the top 10 targets of Kushen were: (1) mitogen-activated protein kinase 8 (MAPK8); (2) protein kinase B (AKT1); (3) MAPK1, (4) estrogen receptor 1 (ESR1), (5) rel avian reticuloendotheliosis viral oncogene homolog A (RELA), (6) interleukin-6 (IL6), (7) MYC proto-oncogene, basic helix-loop-helix (bHLH) transcription factor MYC), (8) retinoid X receptor alpha (RXRA), (9) FOS proto-oncogene activator protein 1 (AP-1) transcription factor subunit (FOS), and (10) JUN proto-oncogene AP-1 transcription factor subunit (JUN). The KEGG analysis suggested that Kushen can intervene in TB through the hypoxia-inducible factor 1 (HIF-1) signaling pathway.


Conclusions
The network pharmacology analysis showed that Kushen's active ingredients can play a role in the treatment of TB through the HIF-1 signaling pathway.