Chinese Herbal Medicine Analyzed for Its Effectiveness in Treating PCOS

In a recent study from Zhejiang University and Zhejiang GongShang University in Zhejiang, China, scientists analyzed Cang-Fu-Dao-Tan Formula, a Chinese herbal medicine, to determine what makes it effective in treating polycystic ovary syndrome (PCOS). Their findings were published in the Journal of Pharmaceutical and Biomedical Analysis (1).

Group of chinese medicine herbs By banprik - stock.adobe.com

PCOS is a common endocrine disease that can afflict reproductive-age women, characterized by reproductive and metabolic disorders. Specifically, it occurs when ovaries produce irregular amounts of androgens, male sex hormones that usually exist in small amounts in women. This can affect the hormones needed to ovulate, causing ovaries to develop cysts and cause issues with women’s menstrual cycles (2). Symptoms can range from irregular periods and excess body hair to thinning hair and infertility. PCOS can affect between 5–18% of women, with the exact cause of the disease being unclear. Though there have been various proposed pharmaceutical treatments for the condition, their long-term side effects and probably low efficacy have led to a need for alternative treatments.

One alternative medicine that has proven useful in combatting PCOS is Cang-Fu-Dao-Tan Formula (CFDTF), which is a mix of nine Chinese herbs. CFDTF has been found to help PCOS-afflicted women with their glucolipid metabolisms. That said, its effects on glucose metabolism, reproductive hormones, and blood lipids should be examined for adverse effects. While CFDTF was able to relieve mitochondria-dependent apoptosis (cell death) in rats with PCOS, the scientists still think that the interactions between active CFDTF compounds and PCOS therapeutic targets must be systematically analyzed. For this study, the scientists used ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC/Q-TOF-MS), network pharmacology, and molecular experiments to clarify how CFDTF specifically treats PCOS (1).

Using databases like TCSMP and SwissTargetPrediction, the active ingredients in CFDTF were identified. Then, the GeneCards, Disgenet, and Drugbank databases were used to obtain PCOS-related targets. Twenty compounds were identified using UHPLC/Q-TOF-MS, and 136 active CFDTF compounds were detected with the TCMSP database. After removing duplicate results and analyzing key targets with the Drug-component-target (D-C-T) and protein-protein-interaction (PPI) networks, there were 370 targets found to be related to both CFDTF and PCOS. From there, potential mechanisms were found using the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis. Using this, it was discovered that CFDTF mechanisms that work against PCOS were found to be related to the PI3K-Akt, mTOR, and MAPK signaling pathways. Finally, the scientists used molecular docking analysis, molecular dynamics (MD) simulations, and molecular experiments to confirm interactions among active compounds and targets, using their findings to explore potential mechanisms. These in vitro experiments showed that CFDTF positively regulates cell proliferation and inhibits apoptosis levels in PCOS cell models.

The scientists concluded that quercetin, hesperidin, and glycyrrhizin disaccharide are the three most effective compounds within CFDTF that treat PCOS. Additionally, the mechanisms behind these treatments can involve regulating the proliferation and apoptosis of granulosa cells.

References

(1) Hu, W.; Xie, N.; Zhu, H.; Jiang, Y.; Ding, S.; Ye, S.; Zhang, S.; Wang, F.; Qu, F.; Zhou, J. The Effective Compounds and Mechanisms of Cang-Fu-Dao-Tan Formula in Treating Polycystic Ovary Syndrome Based on UPLC/Q-TOF-MS/MS, Network Pharmacology and Molecular Experiments. J. Pharm. Biomed. Anal. 2024, 239, 115867. DOI: https://doi.org/10.1016/j.jpba.2023.115867

(2) Polycystic Ovary Syndrome (PCOS). The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos (accessed 2024-3-12)