Manpixiao Decoction Halted the Malignant Transformation of Precancerous Lesions of Gastric Cancer: From Network Prediction to In-Vivo Verification

Yuan Li; Tao Li; Jiena Chen; Haocheng Zheng; Yicong Li; Fuhao Chu; Sici Wang; Ping Li; Jie Lin; Zeqi Su; Xia Ding

doi:10.3389/fphar.2022.927731

Manpixiao Decoction Halted the Malignant Transformation of Precancerous Lesions of Gastric Cancer: From Network Prediction to In-Vivo Verification

Front Pharmacol. 2022 Aug 5:13:927731. doi: 10.3389/fphar.2022.927731. eCollection 2022.

Authors

Yuan Li^{1

2

3}, Tao Li⁴, Jiena Chen², Haocheng Zheng², Yicong Li⁵, Fuhao Chu^{2

3

6}, Sici Wang⁴, Ping Li⁴, Jie Lin², Zeqi Su⁷, Xia Ding^{2

3}

Affiliations

¹ National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China.
² School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
³ Research Center for Spleen and Stomach Diseases of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
⁴ Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
⁵ Oncology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
⁶ Institute of Regulatory Science for Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
⁷ Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

Abstract

Manpixiao decoction (MPX), a traditional Chinese medicine formula, is mainly used to improve the gastric mucosal pathology and stomach discomfort in patients with gastric precancerous lesions. Precancerous lesion of gastric cancer (PLGC) refers to intestinal metaplasia and/or dysplasia based on gastric mucosal atrophy. Effective prevention and treatment of PLGC is of great significance to reduce the incidence of gastric cancer. Because of the complexity of the etiology and pathogenesis of PLGC, there is no unified and effective treatment plan in western medicine. In recent years, traditional Chinese medicine has shown obvious advantages in the treatment of PLGC and the prevention of its further progression to gastric cancer, relying on its multi-approach and multi-target comprehensive intervention characteristics. This study is designed to examine the protective effect of MPX against PLGC and further to reveal the engaged mechanism via integrating network pharmacology and in vivo experimental evidence. Network pharmacology results demonstrated that inflammation, immune responses, and angiogenesis might be associated with the efficacy of MPX in the treatment of PLGC, in which the PI3K-Akt, cellular senescence, P53 and protein processing in endoplasmic reticulum were involved. Then, we established a rat model of PLGC using a combination of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), sodium salicylate, irregular fasting, and ranitidine, and observed the effects after MPX treatment. Our result showed that MPX improved the pathological condition of gastric mucosa in PLGC rats and reduced the incidence of gastric cancer. Next, the analysis of serum inflammatory cytokines showed that MPX reduced the inflammation-related cytokines (such as IL-1α, IL-7, CSF-1, and CSF-3) in the serum. Additionally, MPX also had a regulation effect on the "protein/protein phosphorylation-signaling pathway" network in the core region of the PLGC rats. It is showed that MPX can inhibit the phosphorylation of PI3K-AKT, and downregulates the EGFR, β-catenin, and N-cadherin protein levels. These results indicate that MPX halted the PLGC progression through inhibiting EGFR-PI3K-AKT related epithelial-mesenchymal transition process.

Keywords: Carcinogenesis; Manpixiao; PI3K-AKT; dysplasia; epithelial-mesenchymal transition (EMT); traditional Chinese medicine.