Integration of single-cell sequencing and multi-omics approaches with pharmacological analysis to unveil biomarkers and mechanisms of traditional Chinese medicine in treating heart diseases

Traditional Chinese medicine (TCM) offers a holistic approach to managing cardiovascular diseases (CVDs). However, its complex multi-component and multi-target mechanisms, along with associated biomarkers, are not yet fully understood. This limits its widespread acceptance in precision medicine. This review systematically summarizes and critically evaluates how the integration of single-cell sequencing (SCS), multi-omics technologies (including transcriptomics, proteomics, and metabolomics), and pharmacological analysis is transforming the understanding of TCM’s cardioprotective effects. This review first provides an overview of these technologies and their applications in TCM research. Then, this review synthesizes recent advances showing how this integrative approach successfully identifies novel disease-specific biomarkers (e.g., LAMP3, CD33) and elucidates intricate molecular mechanisms, such as the regulation of ferroptosis, cellular senescence, and mitochondrial function. Furthermore, this review discusses critical challenges in clinical translation, including biomarker validation, herb-drug interactions (HDIs), and the need for large-scale omics data from patient cohorts. Finally, this review outlines future perspectives on leveraging artificial intelligence and prospective clinical trials to bridge the gap between TCM’s traditional wisdom and modern precision cardiology. This review underscores that the synergy of SCS, multi-omics, and pharmacology provides an unprecedented framework to decode TCM, paving the way for its evidence-based, personalized application in heart diseases, including myocardial infarction, heart failure, arrhythmias, and valvular heart diseases.