Network Pharmacology and Experimental Assessment to Explore the Pharmacological Mechanism of Qimai Feiluoping Decoction Against Pulmonary Fibrosis

Abstract

Pulmonary fibrosis (PF) is one of the pathologic changes in COVID-19 patients in convalescence, and it is also a potential long-term sequela in severe COVID-19 patients. Qimai Feiluoping decoction (QM) is a traditional Chinese medicine formula recommended in the Chinese national medical program for COVID-19 convalescent patients, and PF is one of its indications. Through clinical observation, QM was found to improve the clinical symptoms and pulmonary function and reduce the degree of PF of COVID-19 convalescent patients. To further explore the pharmacological mechanisms and possible active components of QM in anti-PF effect, UHPLC/Q-TOF-MS was used to analyze the composition of the QM extract and the active components that can be absorbed into the blood, leading to the identification of 56 chemical compounds and 10 active components. Then, network pharmacology was used to predict the potential mechanisms and targets of QM; it predicted that QM exerts its anti-PF effects via the regulation of the epithelial–mesenchymal transition (EMT), extracellular matrix (ECM) degradation, and TGF-β signaling pathway. Finally, TGF-β1–induced A549 cells were used to verify and explore the pharmacological effects of QM and found that QM could inhibit the proliferation of TGF-β1–induced A549 cells, attenuate EMT, and promote ECM degradation by inhibiting the TGF-β/Smad3 pathway.

Therapeutic Effect of Astragali Radix Extract Injection Combined with Bone Marrow Mesenchymal Stem Cells in Bleomycin-Induced Pulmonary Fibrotic Rats

“…The Qimai feiluoping decoction is another TCM compound for treating PF associated with COVID-19 by supplementing Qi, nourishing Yin, and activating blood circulation. Pharmacological networks have predicted that Qimai feiluoping decoction exerts anti-PF effects via regulation of the epithelial-mesenchymal transition, extracellular matrix degradation, and TGF- β signaling pathway, and this has been verified in vitro [ 31 ]. Pharmacological networks have also found that Chinese herbs such as Curcuma Radix [ 32 ], Houttuynia cordata [ 33 ], Schisandra [ 34 ], and Astragalus can regulate PF via the TGF- β , PI3K/Akt, MAPK, and STAT3 signaling pathways.…”

Wenfei Buqi Tongluo Formula Against Bleomycin-Induced Pulmonary Fibrosis by Inhibiting TGF-β/Smad3 Pathway

“…The voucher specimens were deposited at the Jilin Ginseng Academy, Changchun University of Chinese Medicine. According to the preparation processing as traditional use, the standard procedure from Chinese Pharmacopoeia (2020 edition), and previous studies (Huang Q. et al, 2018;Yang et al, 2021), all drugs were blended, mixed, and extracted by 2,000 ml of distilled water (the drug solvent ration of this formula is 9.0) at 100 °C for 30 min, which was repeated three times to obtain the aqueous extract of WBT formula. After centrifugation, the supernatant was dried under a vacuum to produce a powdery extract with the drug-extract ratio of 22.47% (obtained 48 g of powdery extract from 214 g of raw materials).…”

“…As previous described (Zuo et al, 2019;Yang et al, 2021) data were conducted using UNIFI ™ 1.9.3.0 software (Waters, Milford, USA).…”

The role of traditional Chinese medicine in the prevention and treatment of coronavirus disease 2019

“…Through the clinical study of “the three syndromes and six Chinese patent medicine” during the recovery phase of COVID-19, it was found that Chinese patent medicines such as Jinshuibao Capsule, Shengmai Yin, Ludangshen Oral Liquid, Xiangsha Liujun Pill, and Shumian Capsule can improve cardiopulmonary dysfunction, digestive dysfunction, and sleep and emotional dysfunction of convalescent patients [ 6 , 7 ]. In addition, our clinical study also showed that Qimai Feiluoping Decoction could significantly promote the absorption of interstitial inflammation and pulmonary fibrosis in patients with severe/critical disease in the convalescent stage, and preliminarily explored its antifibrosis mechanism from the pharmacological level [ 8 ]. The profound practice of TCM in the fight against COVID-19 has proven its unique role and advantages, fully verifying its effectiveness and scientific nature.…”