Keywords
olibanum and myrrha - acute soft tissue injury - network pharmacology
Introduction
Acute soft tissue injury (ASTI) is a kind of trauma syndrome caused by direct or indirect
violent injury of various malformations, which is a common orthopedic disease.[1] It is mostly manifested as local edema, muscle fiber rupture, pain, and dysfunction
of soft tissues (ligaments, fascia, tendons, synovium, muscles, fat, nerves and blood
vessels around the joint capsule, etc.).[2] ASTI belongs to the category of “acute tendon injury” in traditional Chinese medicine
(TCM). It is caused by external forces damaging qi and blood from outside and inside,
qi stagnation and blood stasis, and obstructing the meridians, resulting in pain,
swelling, local blue and purple, and activity disorder.[3] Nowadays, with the continuous development of medicine, there are many methods in
TCM and Western medicine to treat ASTI. The conservative treatment of western medicine
and the application of new technology complement each other. TCM treatment of ASTI
is based on the basic treatment principles of orthopaedic and traumatology, including
equal emphasis on muscles and bones, internal and external treatment, and phased use
of medicine, forming the multi-method and reference treatment methods of TCM, such
as internal and external treatment, acupuncture, and manipulation.[4]
Olibanum and myrrha are compatible with TCM commonly used in the treatment of ASTI.
Olibanum and myrrha belong to herbs for promoting blood circulation and removing blood
stasis. Olibanum is spicy, bitter, and warm, promoting blood circulation and calming
pain, reducing swelling and developing muscle. Myrrha is good at removing blood stasis
and regulating blood, and the two must be used together to promote the functions of
zang-fu organs, meridians, and collaterals.[5] Network pharmacology is a multidisciplinary discipline that explains the relationship
between herbs and diseases from a molecular perspective as well as a systematic and
holistic perspective and shows the systematic pharmacological mechanism of herbs.[6] Network pharmacology studies herbs from the perspective of “multi-component, multi-target
and multi-approach,” which is consistent with the holistic concept of TCM and the
treatment concept of syndrome differentiation.[7] Many studies have found that olibanum and myrrha have significant efficacy in the
treatment of ASTI. This paper used network pharmacology to identify the main active
components and core targets of olibanum and myrrha in the treatment of ASTI and further
analyze the molecular mechanism of its treatment of ASTI.
Methods
Olibanum and Myrrha Search for Active Ingredients
Using the traditional Chinese medicine systems pharmacology database and analysis
platform (TCMSP) database (http://tcmspw.com/tcmsp.php), we searched for “olibanum” and “Myrrha” fully effective components.
Screening of Active Ingredients and Collection of Potential Targets
Oral availability ≥30% and drug-like property ≥0.18 were used to screen the active
ingredients and their protein targets. Protein targets were then standardized in the
Uniprot Protein Database (https://www.uniprot.org/).
Identification of Targets Associated with Acute Soft Tissue Injury
Keywords related to ASTI, “acute soft tissue injury,” “acute closed soft tissue injury,”
“acute non-open soft tissue injury,” etc., were used to collect disease-related targets
from GeneCards database (http://www.genecards.org/) and OMIM database (https://omim.org/). ASTI targets were obtained by combining and deleting duplicate values.
Protein–Protein Interaction Network Construction
The intersection of olibanum and myrrha targets with targets related to ASTI was plotted,
and a Venn diagram was drawn. Intersection targets were submitted to String11.5 database
(https://www.string-db.org/) and protein–protein interaction (PPI) network was constructed. “Homo sapiens” was
selected as biological species, the minimum interaction score was set as “ > 0.9,”
the nodes of network disconnection were hidden, and the other settings were kept as
default settings to obtain the PPI network. The potential core targets can be obtained
by the degree of connectivity.
Gene Ontology Pathway Enrichment Analysis and KEGG Pathway Enrichment Analysis
To explore the role of target proteins of olibanum and myrrha in gene function and
find the core pathway of olibanum and myrrha in ASTI, this study used Metascape database
(https://metascape.org/) to conduct enrichment analysis of gene ontology (GO) analysis and Kyoto Encyclopedia
of Genes and Genomes (KEGG) pathway for core targets. Microscopic letter cloud platform
(http://www.bioinformatics.com.cn/) was used for visualization processing results.
Construction of Composition–Target–Disease Network Diagrams
The active ingredients and screened core targets were uploaded to Cytoscape 3.8.2
software to generate “component–target–disease network map.” The built-in tool CytoScape3.8.2
was used to analyze network topological parameters of active components and targets
and identify core targets and main active components according to relevant parameters.
Molecular Docking Verification
PDB database (https://www.rcsb.org/pages/search_features) was used to download the key targets of PDB structure, downloading and removing
stasis in TCMSP database gave birth to a new capsule MOL2 structure of active ingredients.
AutoDock Vina 1.1.2 was used to dock the molecule and target. If the binding energy
was less than 0, there was binding activity between ligand and receptor. If the binding
energy was less than −5 kcal·mol−1, the docking was good. Finally, Pymol 2.2.0 was used to visualize the results.
Results
Acquisition of Active Components and Targets of Olibanum and Myrrha
A total of 403 active ingredients of olibanum and myrrha were collected by TCMSP,
including 127 olibanum and 276 myrrh. A total of 36 active ingredients of olibanum
and myrrh were obtained by ADME screening, including 5 olibanum and 31 myrrh, as shown
in [Table 1]. There were 11 targets for olibanum and 175 targets for myrrh. A total of 186 targets
for olibanum and myrrh were obtained after combination.
Table 1
Olibanum and myrrha information on active ingredients
Source
|
MOLID
|
Effective constituent
|
OB/%
|
DL
|
Olibanum
|
MOL001215
|
Tirucallol
|
42.12
|
0.75
|
Olibanum
|
MOL001241
|
O-acetyl-α-boswellic acid
|
42.73
|
0.7
|
Olibanum
|
MOL001243
|
3α-Hydroxy-olean-12-en-24-oic-acid
|
39.32
|
0.75
|
Olibanum
|
MOL001255
|
Boswellic acid
|
39.55
|
0.75
|
Olibanum
|
MOL001295
|
Phyllocladene
|
33.4
|
0.27
|
Myrrha
|
MOL001001
|
Quercetin-3-O-β-D-glucuronide
|
30.66
|
0.74
|
Myrrha
|
MOL001002
|
Ellagic acid
|
43.06
|
0.43
|
Myrrha
|
MOL001004
|
Pelargonidin
|
37.99
|
0.21
|
Myrrha
|
MOL001006
|
Poriferasta-7,22E-dien-3β-ol
|
42.98
|
0.76
|
Myrrha
|
MOL001009
|
Guggulsterol-VI
|
54.72
|
0.43
|
Myrrha
|
MOL001013
|
Mansumbinoic acid
|
48.1
|
0.32
|
Myrrha
|
MOL001026
|
Myrrhanol C
|
39.96
|
0.58
|
Myrrha
|
MOL001028
|
(8R)-3-Oxo-8-hydroxy-polypoda -13E,17E,21-triene
|
44.83
|
0.59
|
Myrrha
|
MOL001029
|
Myrrhanones B
|
34.39
|
0.67
|
Myrrha
|
MOL001031
|
Epimansumbinol
|
61.81
|
0.4
|
Myrrha
|
MOL001033
|
Diayangambin
|
63.84
|
0.81
|
Myrrha
|
MOL001040
|
(2R)-5,7-Dihydroxy-2-(4-hydroxyphenyl)chroman-4-one
|
42.36
|
0.21
|
Myrrha
|
MOL001045
|
(13E,17E,21E)-8-Hydroxypolypodo-13,17,21-trien-3-one
|
44.34
|
0.58
|
Myrrha
|
MOL001046
|
(13E,17E,21E)-Polypodo-13,17,21-triene-3,18-diol
|
39.96
|
0.58
|
Myrrha
|
MOL001049
|
16-Hydroperoxymansumbin-13(17)-en-3β-ol
|
41.05
|
0.49
|
Myrrha
|
MOL001052
|
Mansumbin-13(17)-en- 3,16-dione
|
41.78
|
0.45
|
Myrrha
|
MOL001061
|
(16S, 20R)-Dihydroxydammar-24-en-3-one
|
37.34
|
0.78
|
Myrrha
|
MOL001062
|
15α-Hydroxymansumbinone
|
37.51
|
0.44
|
Myrrha
|
MOL001063
|
28-Acetoxy-15α-hydroxymansumbinone
|
41.85
|
0.67
|
Myrrha
|
MOL001095
|
Isofouquierone
|
40.95
|
0.78
|
Myrrha
|
MOL001126
|
[(5aS,8aR,9R)-8-oxo-9-(3,4,5-trimethoxyphenyl)-5,5a,6,9-tetrahydroisobenzofurano[6,5-f][1,3]benzodioxol-8a-yl]
acetate
|
44.08
|
0.9
|
Myrrha
|
MOL001131
|
phellamurin_qt
|
56.6
|
0.39
|
Myrrha
|
MOL001138
|
(3R,20S)-3,20-Dihydroxydammar- 24-ene
|
37.49
|
0.75
|
Myrrha
|
MOL001156
|
3-Methoxyfuranoguaia-9- en-8-one
|
35.15
|
0.18
|
Myrrha
|
MOL001175
|
Guggulsterone
|
42.45
|
0.44
|
Myrrha
|
MOL000358
|
β-sitosterol
|
36.91
|
0.75
|
Myrrha
|
MOL000449
|
Stigmasterol
|
43.83
|
0.76
|
Myrrha
|
MOL000490
|
Petunidin
|
30.05
|
0.31
|
Myrrha
|
MOL000098
|
Quercetin
|
46.43
|
0.28
|
Myrrha
|
MOL000988
|
4,17(20)-(cis)-pregnadiene-3,16-dione
|
51.42
|
0.48
|
Myrrha
|
MOL000996
|
Guggulsterol IV
|
33.59
|
0.74
|
Abbreviations: DL, drug-like property; OB, oral availability.
Acquisition of Targets Associated with Acute Soft Tissue Injury
The search results of disease-related targets of ASTI were as follows: 4,448 from
GeneCards database and 207 from OMIM database, excluding repeated targets, a total
of 4,600 ASTI-related targets.
Results of Intersection Target Screening and Protein–Protein Interaction Network Construction
The intersection of the active ingredient targets of screened olibanum and myrrha
and the targets of ASTI diseases was obtained by drawing Venn diagram,[8] and 148 common targets of olibanum and myrrha on the active ingredient, ASTI, were
obtained, as shown in [Fig. 1]. Then, the intersection targets were submitted to STRING11.5 platform, and the PPI
network diagram of olibanum and myrrha targets was obtained, as shown in [Fig. 2]. PPI Network map had 158 nodes with 585 edges, and the average node degree was 7.41.
According to the connection degree, the core genes of PPI network were JUN, TP53,
AKT1, MAPK1, RELA, etc.
Fig. 1
Olibanum and myrrha targets at the intersection of ASTI. Notes: O–M represents olibanum and myrrha; ASTI represents acute soft tissue injury.
Fig. 2 PPI network diagram.
Gene Ontology Pathway Enrichment and KEGG Pathway Enrichment Analysis Results
Metascape gene annotation and analysis resource platform were used to conduct GO pathway
enrichment analysis and KEGG pathway enrichment analysis for 148 targets, and micro-bioinformatics
cloud platform was used to visually process the enrichment analysis results, as shown
in [Fig. 3]. GO pathway enrichment analysis set the basic screening conditions for biological
process, cell component, and molecular function enrichment analysis, and screened
the top 20 enrichment analysis results in each group. The results showed that the
function of multiple targets was closely related to the treatment of ASTI. The main
biological processes involved in olibanum and myrrha include reaction to exogenous
stimulation, cell reaction to organic ring compounds, reaction to injury, reaction
to lipolysaccharides, etc. The results of cell component analysis mainly included
membrane raft, plasma membrane protein complex, dendrite, transcription regulatory
complex, etc. The results of molecular function analysis mainly included transcription
factor binding, nuclear receptor activity, protein domain-specific binding, protein
kinase binding, and so on. A total of 334 pathways were obtained from KEGG pathway
enrichment analysis, indicating that the main pathways of olibanum and myrrha in the
treatment of ASTI include cancer pathway and AGE-RAGE signaling pathway in diabetic
complications, as shown in [Fig. 4].
Fig. 3 GO pathway enrichment analysis.
Fig. 4 KEGG pathway enrichment analysis.
Construction of Component–Target–Pathway Network Diagram
Thirty-six active components of olibanum and myrrha and 148 common targets of olibanum
and myrrha and ASTI were uploaded to Cytoscape3.8.2 software to construct a “component-target-pathway
network diagram,” as shown in [Fig. 5]. NetworkAnalyzer (built-in tool of CytoScape3.8.2) was used to analyze the network
topology parameters of olibanum and myrrha for the treatment of ASTI, and the core
components and core targets were obtained. The results showed that the connection
degree of quercetin, the main component of olibanum and myrrha, in the treatment of
ASTI was 123%, the middle degree was 0.5789 and the density was 0.6078. The connection
degree of β -sitosterol was 26, the intermediate degree was 0.0753, and the compact
degree was 0.3949. The degree of connection, medium, and compactness of stigmasterol
were 21, 0.0756, and 0.3816, respectively. β -sitosterol and stigmasterol were also
predicted to play an important role in the treatment of ASTI with olibanum and myrrha,
as shown in [Table 2]. Among the target analysis results, PGR ranked first in terms of connectivity 19,
mediality 0.051, and tightness 0.3406. It was predicted that PGR was the core target
of olibanum and myrrha for the treatment of ASTI. NCOA2, PTGS2, PRKCA, NR3C2, PRKCB,
MAPK1, AKT1, RXRA, RELA also played an important role in the treatment of olibanum
and myrrha in ASTI, as shown in [Table 3].
Fig. 5
Component–target–pathway network diagram. Notes: circle is the pathway; diamond is the active component; rectangle is the target;
the larger the node area and darker the color, the more important the node is.
Table 2
Characteristic parameters of main active ingredient network nodes of olibanum and
myrrha
MOLID
|
Name
|
Degree
|
Betweenness centrality
|
Closeness centrality
|
MOL000098
|
quercetin
|
123
|
0.578911968
|
0.607784431
|
MOL000358
|
β-sitosterol
|
26
|
0.075295448
|
0.394941634
|
MOL000449
|
Stigmasterol
|
21
|
0.075554792
|
0.381578947
|
MOL001002
|
ellagic acid
|
15
|
0.015257533
|
0.365107914
|
MOL001004
|
pelargonidin
|
13
|
0.030286544
|
0.367753623
|
MOL001156
|
3-methoxyfuranoguaia-9- en-8-one
|
11
|
0.011790874
|
0.354895105
|
MOL001126
|
[(5aS,8aR,9R)-8-oxo-9-(3,4,5-trimethoxyphenyl)-5,5a,6,9-tetrahydroisobenzofurano[6,5-f][1,3]benzodioxol-8a-yl]
acetate
|
11
|
0.016820228
|
0.340604027
|
MOL000490
|
petunidin
|
7
|
0.004221262
|
0.351211073
|
MOL001138
|
(3R,20S)-3,20-dihydroxydammar- 24-ene
|
6
|
0.003297119
|
0.333881579
|
MOL001131
|
phellamurin_qt
|
6
|
0.007189137
|
0.346416382
|
Table 3
Node characteristic parameters of core target network of olibanum and myrrha
The core target
|
Degree
|
Betweenness centrality
|
Closeness centrality
|
The core target
|
Degree
|
Betweenness centrality
|
Closeness centrality
|
PGR
|
19
|
0.050982856
|
0.340604027
|
PRKCB
|
14
|
0.017169956
|
0.435622318
|
NCOA2
|
19
|
0.071779148
|
0.472093023
|
MAPK1
|
13
|
0.010768025
|
0.422916667
|
PTGS2
|
19
|
0.072324782
|
0.476525822
|
AKT1
|
12
|
0.010603844
|
0.422916667
|
PRKCA
|
15
|
0.024305536
|
0.445175439
|
RXRA
|
12
|
0.042261508
|
0.453125
|
NR3C2
|
15
|
0.027280353
|
0.295918367
|
RELA
|
12
|
0.006806169
|
0.415983607
|
Molecular Docking Verification Results
The active components of olibanum and myrrha obtained by analysis were quercetin and
β-sitosterol, and the core targets of molecular docking were PGR, NCOA2, and PTGS2.
The results showed that the binding energy between each active ingredient and the
core target was less than −5kcal·mol−1, and all had strong binding activity, as shown in [Table 4]. Finally, the molecular docking results were visualized, as shown in [Fig. 6].
Table 4
Molecular docking of core components and targets of Quyushengxin capsule
Component
|
PGR
|
NCOA2
|
PTGS2
|
kcal·mol−1
|
kcal·mol−1
|
kcal·mol−1
|
Quercetin
|
−9.1
|
−6.8
|
−9.7
|
Beta-sitosterol
|
−11.5
|
−7.5
|
−9.1
|
Fig. 6 Molecular docking verification.
Discussion
ASTI is the soft tissue injury of motor system caused by many acute injury factors.
Its therapeutic principles have been developed over the years through observation
and experimentation. In the principle of ICE (ice, compression, and elevation of the
injured site), ICE can relieve pain in the acute stage of ASTI. Studies have found
that ICE can improve pain threshold and pain tolerance and significantly reduce nerve
transmission speed.[9] Compression bandaging reduces swelling, limits the amount of edema caused by fluid
leaking into the tissue from damaged capillaries, controls inflammatory exudation
and reduces fibrin, thereby reducing scar tissue production, and helps control the
osmotic pressure of tissue fluid in the injured area. Elevation of the injured site
reduces pressure on local blood vessels, increases the drainage of inflammatory exudate
through lymphatic vessels, and reduces and limits edema and its associated complications.
RICE principles (rest, ice, compression, and elevation) add “Rest” to the ICE principle.
Rest reduces the metabolic demands of the injured tissue, thereby avoiding an increase
in blood flow. Rest avoids increased stress on injured tissue and reduces the breakdown
of fibrin bonds, the first element of the repair process.[10] PRICE principle (protection, rest, ice, compression, and elevation) can reduce secondary
injury. “Protection” principle is added to RICE principle. PRICE principle carries
out the concept of rehabilitation of ASTI in quiescent treatment to the end. Studies
have found that PRICE principle can reduce microvascular blood flow and down-regulate
intramural tissue perfusion after injury.[11] With the vigorous development of modern sports rehabilitation technology, the latest
concepts such as early rehabilitation therapy and personalized rehabilitation formulation
have also emerged[12]. Functional therapy and progressive mechanical loading therapy have emerged, followed
by “optimal loading” to replace the rest principle, resulting in the emergence of
POLICE principle.[13] With the continuous development and change of doctor–patient relationship and the
increasingly clear doctor–patient cooperation, the PEACE & LOVE principle (PEACE:
protection, elevation, avoid anti-inflammatory modalities, compression, educate; LOVE:
load, optimism, vascularization, exercise) highlights the importance of educating
patients and dealing with social and psychological factors to promote recovery and
for the first time proposes that the premature use of anti-inflammatory drugs should
be avoided to achieve the purpose of inflammation repair.[14]
With the development of society, ASTI has become an increasingly frequent accidental
injury in people's fast-paced life and work, and its influence on people's work and
life is increasing year by year. With the continuous progress of medical technology
and people's increasing attention to their own health, there are more and more methods
of treating ASTI with Chinese and Western medicine. Internal and external treatment
of TCM, modern Chinese medicine for external use, oral medicine of Western medicine,
physical therapy, regenerative medicine, etc., all achieve local detumescence, analgesic,
anti-inflammatory, and even systemic recuperation of ASTI under the action of various
principles. Jiang et al[15] established the ASTI model of hammer-hit male SD rats, and the experiment showed
that Qingre Huoxue Jiedu decoction could treat ASTI by reducing the levels of inflammatory
factors such as TNF-α, IL-6, PGE2, and IL-1β in muscle tissue, regulating Mir-26B-5P/COX2
axis and inhibiting the inflammatory response. Olibanum and myrrha are the main components
of XuanHuang ointment, which have a significant curative effect on various bone injury
diseases, including ASTI.[16]
[17] Experiments have proved that Xuanhuang ointment can significantly reduce the levels
of IL-6, IL-1β, TNF-α, and PGE2 in animal injured tissues and also reduce hemorheological
indicators. It is important to enhance and improve the immune function of experimental
animals, protect the immune organs, so as to achieve the purpose of anti-inflammatory
analgesia, increase the immunity of the body, and treat ASTI.[18]
[19]
[20]
Olibanum and myrrha have been used for a long time in the treatment of ASTI such as
glinting, twisting, tumbling and injury, and are compatible with Qili Powder,[21] Jiufen Powder,[22] Huoluoxiao Ling Dan.[23] Using the method of network pharmacology, starting from the material basis of olibanum
and myrrha, this study discusses the molecular mechanism of olibanum and myrrha in
the treatment of ASTI, and provides a certain theoretical basis for the follow-up
study of olibanum and myrrha in the treatment of ASTI. After analysis, the main active
ingredient of olibanum and myrrha in the treatment of ASTI was predicted to be quercetin.
Various studies have shown that quercetin has the functions of anti-oxidation, anti-cancer,
hypoglycemic, anti-inflammatory, antihypertensive, antiviral, anti-oxidation, lipid
regulation, cardiovascular protection, and bone protection.[24] PGR is a core target of olibanum and myrrha in the treatment of ASTI. The pathway
prediction of olibanum and myrrha in the treatment of ASTI may be related to cancer
pathway and AGE-RAGE signaling pathway in diabetic complications.
The results showed that the compound regulatory targets of olibanum and myrrha were
complex, and the target intervention biological processes and signal pathways were
diverse, which fully reflected the characteristics of olibanum and myrrh on multi-target
and multi-pathway interaction. The results suggest the possibility and feasibility
of regulating important targets in the network to regulate the entire network, which
provides a scientific basis for the clinical application of olibanum and myrrha in
the treatment of ASTI and also provides a new direction for exploring the potential
mechanism of olibanum and myrrha. However, this paper only predicted the active components,
target, and pathway information of olibanum and myrrha in the treatment of ASTI from
the perspective of network pharmacology, without the support of relevant clinical
trial research. Subsequent studies should also complete the related research content
of olibanum and myrrha in the treatment of ASTI from the basic and clinical aspects.