南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (8): 1835-1849.doi: 10.12122/j.issn.1673-4254.2026.08.11

• • 上一篇    

芍药苷靶向EZH2/CCNE1调控细胞周期与炎症微环境改善乳腺癌化疗期癌因性疲乏

李壮1(), 石欢2,3,4, 陈洁婷2,3,4, 梁欲琪2,3,4, 吴迎朝2,4, 左谦2,3,4, 陈前军1,2,3,4()   

  1. 1.广州中医药大学第二临床医学院,广东 广州 510405
    2.广州中医药大学第二附属医院,中医证候全国重点实验室,广东 广州 510120
    3.广东省中医院乳腺科,广东 广州 510120
    4.广东省中医药科学院,广东 广州 510120
  • 收稿日期:2026-01-05 出版日期:2026-08-20 发布日期:2026-08-01
  • 通讯作者: 陈前军 E-mail:lz2942853517@163.com;cqj55@163.com
  • 作者简介:李 壮,在读博士研究生,E-mail: lz2942853517@163.com
  • 基金资助:
    国家自然科学基金(82474504);广州市科技计划项目(2023B1212060063);广州市科技计划项目(2023KT15485);国家中医药综合改革示范区(广东省)联合科技项目(GZY-KJS-GD-2025-002);中医湿证国家重点实验室自主项目(QZ2023ZZ13);中医湿证国家重点实验室自主项目(SKLKY2025C0001);中医湿证国家重点实验室自主项目(SKLKY2026C0002);羊城中医药创新人才团队建设项目(2026RC002);中国基层卫生保健基金会项目(KYJJ20240509);广州中医药大学固本工程中西医结合学科群提质扩容项目(A1-2601-26-415-111Z220)

Paeoniflorin alleviates cancer-related fatigue during chemotherapy for breast cancer by targeting EZH2/CCNE1 to regulate cell cycle and inflammatory microenvironment

Zhuang LI1(), Huan SHI2,3,4, Jieting CHEN2,3,4, Yuqi LIANG2,3,4, Yingchao WU2,4, Qian ZUO2,3,4, Qianjun CHEN1,2,3,4()   

  1. 1.Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
    2.State Key Laboratory of Traditional Chinese Medicine Syndrome, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
    3.Department of Breast, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
    4.Guangdong Academy of Traditional Chinese Medicine, Guangzhou 510120, China
  • Received:2026-01-05 Online:2026-08-20 Published:2026-08-01
  • Contact: Qianjun CHEN E-mail:lz2942853517@163.com;cqj55@163.com
  • Supported by:
    National Natural Science Foundation of China(82474504)

摘要:

目的 通过机器学习方法、整合药理学及体外实验探讨白芍干预乳腺癌化疗期癌因性疲乏(CRF)的潜在分子机制及关键药效物质基础。 方法 从TCMSP、SwissTargetPrediction等数据库筛选白芍的活性成分及靶点,并利用Genecards和OMIM获取疾病靶点。结合GEO数据集(GSE41112),运用Limma包筛选化疗与非化疗组的差异表达核心基因。创新性地引入4种机器学习算法:随机森林(RF)、支持向量机(SVM)、极端梯度提升(XGBoost)和广义线性模型(GLM),筛选最具诊断价值的关键特征基因,并构建Nomogram预测模型。利用Kaplan-Meier Plotter和HPA数据库进行生存分析与免疫组化验证。进一步构建IL-17诱导的Py230乳腺癌细胞CRF模型,通过CCK-8、qRT-PCR、Western blotting和免疫荧光技术验证白芍主要活性成分芍药苷对核心靶点的调控作用。 结果 共筛选得到芍药苷、白芍苷及山奈酚等13个活性成分及475个药物靶点,与疾病差异基因映射后获得65个核心交集基因。富集分析显示主要涉及MAPK信号级联、昼夜节律调节及细胞周期等生物过程。免疫浸润分析表明,核心基因与CD8+T细胞、巨噬细胞等免疫细胞丰度显著相关。在4种机器学习模型中,支持向量机模型性能最佳,筛选出PSMB8、EZH2、CCNE1、PSEN2、CDK1为关键特征基因。基于此构建的Nomogram模型C-index=0.911,校准曲线及决策曲线分析均显示其具有良好的准确性与临床净获益。分子对接证实白芍核心成分与关键靶点具有较强的结合能。生存分析显示,EZH2和CCNE1的高表达与乳腺癌患者不良预后显著相关(P<0.05)。体外实验证实,化疗药物上调癌细胞中EZH2和CCNE1的mRNA和蛋白水平表达,而芍药苷能显著逆转这一病理改变(P<0.05),其效果与阳性抑制剂相当。 结论 白芍可能通过其活性成分芍药苷,靶向抑制EZH2和CCNE1的异常表达,调节细胞周期与炎症微环境,从而发挥缓解乳腺癌CRF的减毒增效作用。

关键词: 白芍, 乳腺癌, 化疗期癌因性疲乏, 整合药理学, 机器学习

Abstract:

Objective To explore the molecular mechanisms and key pharmacodynamic basis of Baishao for alleviating cancer-related fatigue (CRF) during chemotherapy for breast cancer. Methods Bioinformatics analyses were used to explore the active ingredients and potential targets of Baishao, CRF-related targets, and the differentially expressed core genes between chemotherapy and non-chemotherapy groups. Four machine learning algorithms (Random Forest, SVM, XGBoost, and GLM) were used to screen the key feature genes to construct a diagnostic nomogram model with subsequent survival and immunohistochemical analyses using Kaplan-Meier Plotter and HPA databases. In an IL-17-induced Py230 breast cancer cell model of CRF, the regulatory effects of paeoniflorin (a major active ingredient of Baishao) on the core targets were validated using CCK-8 assay, qRT-PCR, Western blotting, and immunofluorescence staining. Results Thirteen active ingredients (including paeoniflorin, albiflorin, and kaempferol) and 475 drug targets of Baishao were identified, yielding 65 core intersection genes enriched in the MAPK signaling cascade, circadian rhythm, and cell cycle regulation and showing significant correlations with immune cells. The SVM model demonstrated the best diagnostic performance and identified PSMB8, EZH2, CCNE1, PSEN2, and CDK1 as the key feature genes. The SVM-based nomogram achieved a C-index of 0.911, showing excellent calibration and clinical net benefit. Molecular docking confirmed strong binding affinities between the core ingredients of Baishao and the key targets. Survival analysis linked high EZH2 and CCNE1 expressions to poor breast cancer prognosis. In IL-17-induced Py230 cells, chemotherapy resulted in significant upregulation of EZH2 and CCNE1 expressions, which were effectively reversed by paeoniflorin treatment with an efficacy comparable to specific positive inhibitors. Conclusion Paeoniflorin alleviates chemotherapy-induced CRF in breast cancer by targeting and inhibiting abnormal expressions of EZH2 and CCNE1 to regulate cell cycle and inflammatory microenvironment, highlighting the therapeutic potential of Baishao for attenuating toxicity and enhancing efficacy of chemotherapy.

Key words: Baishao, breast cancer, cancer-related fatigue during chemotherapy, integrative pharmacology, machine learning