Published online Nov 15, 2023. doi: 10.4239/wjd.v14.i11.1672
Peer-review started: August 23, 2023
First decision: September 14, 2023
Revised: September 25, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 15, 2023
Processing time: 78 Days and 17.2 Hours
The prognosis of diabetes nephropathy is poor. Its pathological changes are chronic progressive damage. The clinical symptoms appear late. Once there is persistent proteinuria, its renal function will inevitably decline and develop into end-stage renal failure, causing a huge health burden.
We executed experimental validations to furnish a novel reference method for the treatment of DN.
This study employed network pharmacology and molecular docking methods to predict the mechanism by which glycyrrhetinic acid (GA) treats DN, subsequently validating these predictions through experimental means.
Utilizing comprehensive databases such as PharmMapper, TCMSP, GeneCards, OMIM, and TTD, we meticulously searched for targets associated with both the drug GA and the disease DN. Subsequently, we identified common targets by taking their intersections. The pivotal target-pathway relationships were elucidated through a protein-protein interaction network analysis. Furthermore, we conducted Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses to gain deeper insights. Molecular docking studies were performed employing GA constituents to provide a comprehensive understanding of potential interactions.
In summary, GA appears to modulate the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway, resulting in the inhibition of HK-2 cell proliferation and a reduction in HK-2 cell apoptosis. It also induces a G2/M phase cell cycle arrest while upregulating glycogen synthase kinase-3 and p-AKT expression, and downregulating AKT, PI3K, and p-PI3K proteins. These actions potentially involve the reactivation or restoration of the impaired PI3K/AKT pathway in the presence of hyperglycemia, thereby affording protection to renal parenchymal cells.
This study found 186 therapeutic targets for DN with GA, and GA may act on DN through the PI3K/AKT signaling pathway. The results of in vitro cell experiments indicate that GA inhibits the proliferation of HK2 cells, blocks the cell cycle in the G2/M phase, and reduces the apoptosis of HK2 cells. GA can activate or restore the activity of the PI3K/AKT pathway damaged under high glucose conditions, thereby protecting inherent kidney cells.
We plan to conduct genetic testing using high-throughput validation techniques. Gene silencing or overexpression experiments targeting the core genes will be employed to verify whether the predicted targets serve as viable drug targets. Additionally, we will perform pathway validation by employing transcriptional and translational inhibitors targeting upstream and downstream signaling proteins. Furthermore, experimental techniques including the assessment of transcription factors and DNA binding through dual luciferase assays and chromatin immunoprecipitation will be utilized to delve deeper into the therapeutic mechanism of GA in the context of DN.