Treatment of polycystic ovary syndrome with QUF7 and mechanism of action: Evidence from network pharmacology analysis that hydroxynaringenin, quercetin, and kaempferol modulate the estrogen receptor gene

This study aims to investigate the clinical effectiveness and underlying pharmacological processes of a patented formulation derived from Chinese herbal medicine (CHM), named Qu's formula 7 (QUF7), in addressing polycystic ovary syndrome (PCOS). A retrospective analysis of clinical data was performed involving 225 patients diagnosed with PCOS. We categorized the subjects into two distinct groups: one receiving combined oral contraceptives (COCs) and the other undergoing QUF7 treatment. After treatment, the menstrual cycles and sex hormone levels of the two groups were evaluated. Moreover, an integrative pharmacology approach was utilized to explore the principal components, cardinal targets, and potential mechanisms associated with the QUF7 prescription in the treatment of PCOS. After treatment, patients in the QUF7 group exhibited a significant alteration in their menstrual periods and a pronounced decrease in blood luteinizing hormone (LH) levels compared to the COCs group (p < 0.05). The analysis of network pharmacology revealed a total of 332 intersecting targets associated with QUF7 and PCOS, and findings from molecular docking analyses indicated that 6-hydroxynaringenin has a robust affinity for estrogen receptor 1 (ESR1). The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis evaluation indicated that the advanced glycation end product (AGE)-AGE receptor (RAGE) and phosphatidylinositol 3-kinase-protein kinase B (PI3K-AKT) signaling pathways are the most probable underlying mechanisms. QUF7 modulates endocrine levels and improves ovulation in PCOS patients and possibly exerts multi-targeted effects by mediating the signaling pathways of AGE-RAGE and PI3K-AKT.