Background: Benign prostatic hyperplasia (BPH) is prevalent in elderly males. Although 28 Traditional Chinese Medicine (TCM) prescriptions are approved for BPH, their key quality components and mechanisms remain unclear. Methods: Network pharmacology and molecular docking analyzed 28 prescriptions to identify components. High-performance liquid chromatography (HPLC) quantified these components. Optimized component ratios were validated in BPH cell lines, assessing hormone (PSA, DHT, E2) and inflammatory biomarkers (NO, NOS). Results: Analysis identified 75 active compounds. Twenty-six prescriptions shared a mechanism targeting proteins (eg, TP53, AKT1). Quercetin, luteolin, kaempferol, and β-sitosterol showed stable binding to targets in 17 prescriptions; their contents were quantified across 26 prescriptions. An optimized combination (quercetin: 81 µM, luteolin: 46 µM, kaempferol: 129 µM, β-sitosterol: 82 µM; molar ratio 1:0.6:1.6:1 relative to β-sitosterol) significantly inhibited BPH cell growth by 89.6%. It reduced PSA, DHT, E2 and increased NO, NOS levels. Conclusion: The quercetin, luteolin, kaempferol, and β-sitosterol are key quality components for BPH treatment. Incorporating them at the experimentally determined ratio within safe limits significantly enhances efficacy. Consequently, these findings provide practical insights for refining TCM quality standards, identifying key quality markers, and facilitating the development of new BPH-specific TCM treatments. Future in vivo studies and clinical trials are required to confirm the therapeutic efficacy and safety of this optimized combination.
Xu et al. (Sun,) studied this question.