PMC:7247521 / 40380-47856 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7247521","sourcedb":"PMC","sourceid":"7247521","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7247521","text":"4 Discussion\nNovel coronavirus (2019-nCov) infection is characterized by lung and immune system damage. Severe infection can lead to acute respiratory distress syndrome (ARDS) and septicemia, and eventually lead to death [2]. In addition, a number of patients presented multi-organ damage and dysfunction [28]. However, there are no specific drugs or vaccine for the treatment of the COVID-19. This reason may partly be that a single targeted drug cannot cure a complex disease with complex biological networks [29]. Despite the lack of strong evidence-based medicine, TCM has a good potential to complement the medical service for COVID-19, including reverting radiological changes, and shortening fever duration and hospital stay. [30]. It is observed that the total effective rate of QFPD in the treatment of pneumonia patients infected by novel coronavirus is more than 90 % [31]. Therefore, we explored the mechanism of QFPD against COVID-19 by systems pharmacology, and provided a combination strategy to explore the functional units in QFPD from a holistic perspective.\nTo our knowledge, this is the first study to explore the mechanisms of QFPD for COVID based on intra-functional units. In this study, GO enrichment analysis showed that the common GO terms of MSXG, SGMH, XCH, WLS and Others targets were significant enriched in oxidoreductase activity, lipid metabolic process, lipid binding, small molecule metabolic process, and homeostatic process etc., suggesting QFPD may exert anti-viral activity through metabolic function. In agreement with these results, a recent research has found that lipid metabolic reprograming plays an important role in virus replication, which may be an appealing and applicable target for antiviral therapy [32]. KEGG analysis showed that in addition to lipid metabolism-related pathways, endocrine system pathways were also significantly enriched in more than four formulae, including PPAR signaling pathway and adipocytokine signaling pathway. A recent study has showed that the host can exert anti-inflammatory functions to inhibit excessive inflammatory damage through PPAR signaling pathway after H1N1 infection, thus keeping homeostasis of metabolism and development [33]. In addition, other common terms were significant enriched in more than two formulae, such as immune system process, endoplasmic reticulum, cell-cell signaling, calcium signaling pathway, vascular smooth muscle contraction, inflammatory mediator regulation of TRP channels, cardiac muscle contraction, etc. Therefore, the multi-pathway and multi-target results of our intra functional unit of QFPD not only showed a new useful method for studying TCM, but may demonstrate the rationality of TCM compatibility. Moreover, TCMATCOV platform was used to validate these results. Interestingly, all the five FUs of QFPD showed higher disturbance score than negative control (BXTM), indicating that MSXG, SGMH, XCH, WLS and Others may protect COVID-19 independently, and target 8 specifically expressed drug-attacked nodes (Cdc20, Ido1, Ifng, Il10, Il6, Ptger4, Spi1, Tnf) which were related to the bacterial and viral responses, cytokine, immune system, signaling transduction, etc.\nCurrently, a number of studies have showed that 2019-nCov can cause multiple organs dysfunction, including liver [34], pancreas [35], kidney [36], throat and rectum [37], which may be the reason that a wide distribution of ACE2 across these tissues [38]. In agreement with these results, we found that ACE2 was highly expressed in terminal ileum, testis, adipose visceral omentum, heart left ventricle, kidney cortex and thyroid, etc., and QFPD has only 15.33 % common targets with 2019-nCov, pneumonia and ACE2 related genes. These results indicate that the effective treatment of QFPD for COVID-19 may be through a holistic treatment. Moreover, TTD analysis further displayed that QFPD targets were significantly enriched in many COVID-19 related disease, such as chronic inflammatory diseases, asthma, inflammatory bowel disease, chronic obstructive pulmonary disease, intrahepatic cholestasis, chronic ileitis, etc.\nIt is known that ADMETox prediction is an important part in evaluating if a drug can be toxic or can be absorbed during drug development process [39]. In our study, ADMETox evaluation shows that 20 compounds passed the stringent lead-like criteria (250 ≤ MW≤350 \u0026 XLOGP ≤ 3.5 \u0026 Number of rotatable bonds≤7) [40] and in silico drug-likeness test, and showed high gastrointestinal absorption. Moreover, predicted toxicity evaluation showed that the median lethal dose (LD50) of all these ingredients was above 1600 mg/kg, thus may suggesting safety and efficacy of QFPD. Combined with molecular docking results, 4 specific ingredients (M3, S1, X2 and O2) and 5 common ingredients (MS1, MX16, SX1, WO1 and XO1) of QFPD might be promising leading compounds with good molecular docking score for 2019-nCov structure and non-structure proteins, revealing that QFPD treated COVID-19 by multi-component synergy. However, these newly monomer components should provide a further research.\nIt has been reported that host cellular microRNAs (miRNAs) are involved in the regulation of virus infection [41]. A previous study discovered that significantly up-regulated MIR301 and down-regulated MIR183/130B were found in H1N1 patients [42]. Consistent with these results, we found that MIR183 and MIR130A/B/301 are related to four functional units of QFPD, indicating these microRNAs may exert anti−COVID-19 activity through QFPD. In addition, CDKs have played a role in the efficient replication of various viruses, including human HIV-1, papillomaviruses, human cytomegalovirus (HCMV), herpes simplex virus (HSV) type 1 and HSV-2 [43,44]. In agreement with these results, we found that CDK7 was predicted to enriched in the five formulae, suggesting that QFPD may regulate replication of COVID-19 viruses via CDK7 mediated cell cycle and RNA polymerase II transcription. Recently, a previous study showed that LXR known to regulate cholesterol homeostasis during inflammation were differentially regulated during H1N1 influenza virus infection [45]. Based on our results that LXR was associated with MSXG, SGMH, XCH, WLS targets, we speculated that QFPD can regulate metabolic and pro-inflammatory processes to counter COVID-19 virus infection.\nIn summary, QFPD is effective in the treatment of COVID-19. However, some shortcomings in our study include lack of an in-depth study of predictive monomers and key targets and pathways, thus need further validation in vivo and in vitro. And the TCMATCOV platform uses SARS disease network, which is different from the COVID-19 disease network, and COVID-19-related cytokines are related to severe COVID-19 disease, so the results of platform analysis more reflect the potential efficacy of severe stage. Nevertheless, this study confirms that network pharmacology can help explore the mechanism of QFPD on the treatment of COVID-19 with time- and cost-saving. Moreover, based on our new FUNP analysis, we reveal that QFPD treat COVID-19 by a holistic treatment and multi-component synergy, and are further demonstrated by formula perturbation analysis. In addition, this study provides possible candidate monomers of QFPD and related miRNAs, kinases and TFs with potential therapeutic effect on COVID-19. This will hopefully provide evidence and new insights for further researches on the treatment of COVID-19 using 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