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World J Gastroenterol. Dec 21, 2025; 31(47): 113496
Published online Dec 21, 2025. doi: 10.3748/wjg.v31.i47.113496
Saffron and Calculus bovis combination exerts anti-hepatic fibrotic effect in liver fibrosis rats via the mitogen-activated protein kinases pathway
Sheng-Nan Sun, Kun Wang, Ya Xu, Fei Ye, Wei-Na Xia, Zhu-Wei Wang, Fang Liu, Zi-Xuan He, Meng Chen, Qing-Hong Du
Sheng-Nan Sun, Kun Wang, Ya Xu, Wei-Na Xia, Zhu-Wei Wang, Zi-Xuan He, Meng Chen, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
Fei Ye, Shenzhen Longgang District Second People’s Hospital, Shenzhen 518000, Guangdong Province, China
Fang Liu, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 102488, China
Qing-Hong Du, Department of Pathology, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
Co-first authors: Sheng-Nan Sun and Kun Wang.
Author contributions: Sun SN and Wang K made equal contributions as co-first authors; Sun SN, Wang K, Ye F, Xia WN, Wang ZW, Liu F, He ZX, and Chen M contributed to investigation and methodology; Sun SN contributed to conceptualization, validation, visualization, and data curation; Wang K prepared the original draft; Ye F, Xia WN, Wang ZW, Liu F, He ZX, and Chen M contributed to guidance and review of statistical data analysis. All authors agree to be accountable for all aspects of work ensuring integrity and accuracy.
Supported by Tibetan Medicine Administration of Tibet Autonomous Region, No. JJKT2020006; Key Research and Development Project of Tibet Autonomous Region, No. XZ202201ZY0019G; and National Administration of Traditional Chinese Medicine High-level Key Discipline Construction Project, No. zyyzdxk-2023262.
Institutional animal care and use committee statement: This study was approved by the Animal Ethics Committee of Beijing University of Chinese Medicine, No. BUCM-2023041904-2025.
Conflict-of-interest statement: Dr. Du reports a patent “Application of Crocin-I in the preparation of anti-hepatic fibrosis drugs” pending.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: This study involves sensitive animal data. In accordance with the provisions of the approval document issued by the Animal Ethics Committee of Beijing University of Chinese Medicine, the original data must be strictly protected to uphold animal experiment ethics, and full public sharing is not supported temporarily. Researchers who meet the following criteria may obtain the data through a reasonable application process: (1) Having obtained approval from the ethics review committee of their affiliated institution (the approval document must be provided); and (2) Committing that the data will only be used for academic research purposes, not for commercial use, and will be kept strictly confidential. Application method: Contact the corresponding author via email, submit the Data Use Application Letter and relevant supporting materials. Upon approval of the application, the de-identified data will be provided via an encrypted method.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Hong Du, PhD, Professor, Department of Pathology, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No. 11 North Third Ring East Road, Beijing 102488, China. qhdu2005@126.com
Received: August 27, 2025
Revised: October 11, 2025
Accepted: November 11, 2025
Published online: December 21, 2025
Processing time: 114 Days and 19 Hours
Abstract
BACKGROUND

Liver fibrosis is a global health issue that lacks effective treatments. Tibetan medicine, with a long history, has accumulated rich experience in the treatment of chronic liver diseases. The saffron (Saf) and Calculus bovis (Cal b) combination is among the most commonly used medicines in clinical practice in Tibetan medicine for hepatic disease. Its characteristic therapies and drug compatibility provide unique ideas for the treatment of liver fibrosis and have research value and application potential.

AIM

To investigate the efficacy of the Saf-Cal b therapy in treating liver fibrosis and explored its underlying mechanism.

METHODS

We initially established a carbon tetrachloride-induced rat liver fibrosis model to assess Saf-Cal b’s anti-fibrotic effects. Subsequently, we conducted network pharmacology analysis to identify the potential therapeutic targets and pathways of Saf-Cal b in liver fibrosis intervention. Finally, we performed in vivo validation of key regulatory targets.

RESULTS

Saf-Cal b combination therapy exerted superior effects in ameliorating liver fibrosis in model rats compared with Saf or Cal b monotherapy. Through network pharmacology prediction, key targets of the combination were identified. Mechanistic validation revealed that Saf-Cal b inhibited the p38 mitogen-activated protein kinases pathway, which in turn suppressed the transforming growth factor-β/small mother against decapentaplegic pathway. This sequential inhibition led to reduced activation of hepatic stellate cells, a central event in liver fibrosis progression.

CONCLUSION

These findings demonstrate that Saf-Cal b combination therapy is more effective than either monotherapy in alleviating liver fibrosis, with its therapeutic effect mediated through the p38 mitogen-activated protein kinases/transforming growth factor-β/small mother against decapentaplegic signaling axis, providing a potential therapeutic strategy for liver fibrosis.

Keywords: Liver fibrosis; Tibetan medicine; Saffron; Calculus bovis; Mitogen-activated protein kinases pathway

Core Tip: Liver fibrosis, a health issue of global concern, lacks effective treatments. Using Tibetan medicine experience and network pharmacology, this study explored the potential mechanism of the saffron-Calculus bovis combination against liver fibrosis in rats. After CCl4 induction of rats, intragastric intervention was performed, followed by assessments of liver pathology, liver function, inflammation, and hepatic stellate cell activation. The results showed that the combination exerted more significant anti-fibrotic effects compared with single treatment, and it may act by regulating the mitogen-activated protein kinase pathway.