Background: Qigesan (QGS) is a traditional Chinese herbal medicine used for the treatment of esophageal carcinoma (EC) and possesses anti-cancer properties. However, the mechanism of QGS in the treatment of EC remains unclear. Objectives: This study aimed to investigate the molecular basis of QGS in the treatment of EC and establish a scientific foundation for its application. Methods: This study employed a multifaceted approach-including network pharmacology, molecular docking, and molecular dynamics simulations-to investigate the therapeutic mechanisms of QGS in EC. By leveraging a comprehensive array of databases such as TCMSP, HERB, TTD, OMIM, GeneCards, and DrugBank, we systematically identified potential bioactive components and their corresponding targets related to QGS, as well as targets associated with EC. Results: 271 overlapping targets of QGS and EC were obtained. Network pharmacology analysis identified eight hub targets (TP53, AKT1, IL6, STAT3, TNF, IL1B, EGFR, and CTNNB1) mediating the effects of QGS through dysregulated pathways, including PI3KAkt signaling, apoptosis regulation, AGE-RAGE, and IL-17 signaling. Molecular docking revealed that three QGS-derived compounds-peimisine, salvianolic acid J, and songbeinoneexhibited high binding affinities for multiple hub targets. These compounds concomitantly inhibit the MAPK/NF-κB pathways while activating cell cycle regulation, DNA repair, and apoptosis, suggesting a multi-target therapeutic mechanism against esophageal carcinoma. Discussion: QGS, a TCM formulation, has been extensively applied in the clinical treatment of EC for a long time and has been demonstrated to relieve esophageal obstruction. Nevertheless, the exact active components within QGS and their underlying molecular mechanisms remain elusive. In this study, network pharmacology, molecular docking, and MD simulation were employed to investigate the potential molecular mechanisms by which QGS exerts its therapeutic effects in the treatment of EC. Conclusion: These findings provide a comprehensive elucidation of the multi-component, multi-target therapeutic strategy employed by QGS in the treatment of EC, laying a solid theoretical foundation for subsequent pharmacological development and clinical validation.
Zhang et al. (Mon,) studied this question.