Mechanisms underlying the synergistic effects of chuanxiong combined with Chishao on treating acute lung injury based on network pharmacology and molecular docking combined with preclinical evaluation

Ethnopharmacological relevance: The herb pair of Chuanxiong Rhizome (Ligusticum chuanxiong Hort., Chuanxiong in Chinese, CX) and Paeoniae Radix Rubra (Paeonia lactiflora Pall. Or Paeonia veitchii Lynch, Chishao in Chinese, CS) is a famous blood activating and stasis resolving pair that is often found in traditional Chinese medicine (TCM) formulas for the treatment of acute lung injury (ALI). However, the relationship of CX-CS herb pair to ALI and its underlying mechanisms are unclear. Aim of the study: The study explored the effect and mechanisms of CX-CS herb pair in LPS induced ALI by network pharmacology and molecular docking combined with preclinical evaluation. Materials and methods: The related targets of the active compounds of CX-CS herb pair in regulating ALI were screened by network pharmacology. PPI was constructed and the potential pathways were investigated by GO and KEGG. The contribution of each active ingredient of CX-CS herb pair to ALI were calculated by networkbased efficacy. The interactions between potential targets and active ingredients were evaluated by molecular docking. LPS stimulated RAW264.7 cells and mice model experiments were adopted to verify the effect of CX-CS herb pair on ALI. Results: A total of 25 compounds and 193 targets were identified in the CX-CS herb pair, of which 19 compounds and 64 targets were associated with ALI, and six compounds including baicalin, ellagic acid, baicalein, betasitosterol, paeoniflorin and ferulic acid accounted for 93.12% of the total combination index for ALI prevention. The CX-CS herbal pair against ALI was associated with PI3K/AKT and MAPK signaling pathways by GO and KEGG analysis. The screened active compounds showed good affinity for TNF, MAPK, and AKT by molecular docking. In vitro and in vivo tests showed that CX combined with CS synergistically inhibited LPS-induced ALI at 1:3, suppressed the release of TNF-alpha, IL-1 beta and IL-6, inhibited the accumulation of ROS, as well as regulated the content of SOD, MDA and GSH. Meanwhile, the herb pair was effective in inhibiting the expression of p38, ERK, I kappa B alpha, p65, caspase 3, PARP, and up-regulating the levels of AKT and Bcl-2/Bax. Conclusions: Our study confirmed the synergistic effect of CX-CS herb pair on the prevention of ALI by inhibiting inflammation, oxidative stress, and apoptosis through MAPK/NF-kappa B and PI3K/AKT signaling pathways.