Network Pharmacology Analysis of Traditional Chinese Medicine for Treating Psoriasis: Identifying Core Components, Mechanisms, and Dosing Patterns.

Context: Psoriasis is a chronic, inflammation-mediated skin disease. The use of traditional Chinese medicine (TCM) in the treatment of psoriasis boasts a rich historical tradition. Researchers widely use network pharmacology to reveal the action mechanisms of TCM by establishing an interaction network-drug-component-target-disease.

Objective: The study aimed to use a network pharmacology approach to investigate the interaction between TCM and its targets in psoriasis, aiming to identify core drugs and mechanisms underlying TCM's treatment of common psoriasis and to create a new TCM formula.

Design: The research team performed a retrospective genetic study.

Setting: The study took place in the Dermatology Department at Beijing Wangfu Hospital of Integrative Medicine in Beijing, China.

Participants: Participants were patients that the dermatology clinic had diagnosed with common psoriasis between January 1, 2016 and January 1, 2019.

Outcome Measures: The research team: (1) calculated the frequency of each herb's occurrence; (2) identified the core drugs; (3) determined the core drugs' active ingredients and targets; (4) identified psoriasis' targets; (5) determined the target proteins; (6) identified the top-30, key signaling-set pathways; (7) identified the top 10 biological processes (BPs), cell components (CC), and molecular functions (MF); (8) screened the top-five major active ingredients; and (9) performed molecular docking.

Results: The research team: (1) based on 892 prescriptions from 95 patients, identified 161 herbal medicines, with Lonicerae Japonicae Flos, Herba Portulacae, Radix Gentianae, Bletilla striata, Raw Rehmanniae Radix, Dictamni Cortex, and Forsythia suspensa being core drugs; (2) found 58 active ingredients and 144 effective, target functional genes for the core drugs through network pharmacology screening, with 81 potential targets for psoriasis treatment; the core drugs for treatment may restore the keratin-forming cell function by inhibiting cancer-related pathways, the interleukin-17 (IL-17) signaling pathway, the tumor necrosis factor (TNF) signaling pathway, and the hypoxia-inducible factor-1 (HIF-1) signaling pathway; (3) using molecular docking, revealed high-affinity interactions between the active ingredients primuletin, luteolin, and wogonin and mitogen-activated protein kinase 8 (MAPK8), tumor protein 53 (TP53), and epidermal growth factor receptor (EGFR).

Conclusions: The new TCM formula to be used in the current research team's hospital may act on MAPK8, TP53, and EGFR targets through active ingredients such as primuletin, kaempferol, luteolin, wogonin, and β-sitosterol, which involve several signaling pathways, such as the cancer signaling, TNF signaling pathway, HIF-1 signaling pathway, and endocrine resistance. The research provides a theoretical foundation for the clinical use of the new TCM formula.