Article

Different network pharmacology mechanisms of Danshen-based Fangjis in the treatment of stable angina

Authors: Guo-xia ZHANG1, Ying-ying ZHANG2,3, Xiao-xu ZHANG4, Peng-qian WANG5, Jun LIU3, Qiong LIU3, Zhong WANG3
1 Luohu District Traditional Chinese Medicine Hospital, Shenzhen 518000, China
2 Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
3 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
4 Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China
5 Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
Corresponding to: Zhong WANG: zhonw@vip.sina.com,
DOI: 10.1038/aps.2017.191
Received: 17 June 2017
Accepted: 26 November 2017
Advance online: 8 February 2018

Abstract

Abstract
Danshen (Salvia miltiorrhiza) preparations such as Danhong injection, Danshen injection, Salvianolate injection, compound Danshen injection and Sodium Tanshinone IIA Sulfonate (STS) injection are widely used in China to treat stable angina (angina pectoris) caused by coronary heart disease. In this study we compared the network pharmacological mechanisms of the 5 Danshen preparations. Following a literature search performed in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) database, China Biology Medicine (CBM) database, China Conference Paper Database, Wanfang Database, VIP Database and Conference Proceedings Citation Index (through January 2015), 444 randomized controlled trial publications detailing the use of the 5 Danshen-based injections for treating stable angina were identified, and their combined data were analyzed using a network meta-analysis. All of the 5 Danshen-based preparations were effective in treating stable angina with clinical improvement rates of 72.4%–91.6% and electrocardiogram (ECG) improvement rates of 54.5%–71.6%. According to both clinical improvement and ECG improvement, the 5 Danshen-based preparations were ranked as follows: Danhong injection > Salvianolate injection > STS injection > compound Danshen injection > Danshen injection. There were no significant differences among the safety profiles of the 5 Danshen preparations. The meta-analysis results were further examined using a network pharmacology approach and functional enrichment analysis, which revealed that Danshen and Danhong injections affected 4 and 15 signaling pathways, respectively, and that the 4 signaling pathways affected by Danshen were a subset of those influenced by Danhong. Therefore, Danhong injection affected some unique signaling pathways that might regulate lipoprotein metabolism, oxidation, and inflammation, and protect vascular endothelia, reflecting the multi-component and multi-target characteristics of this traditional formula and its strengths in treating complex diseases.
Keywords: stable angina (angina pectoris); coronary heart disease; Danshen preparations; network meta-analysis; network pharmacology; comparative effectiveness; Fangji

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