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Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by continuous mucosal inflammation of the colon1, leading to symptoms such as abdominal pain, diarrhea, rectal bleeding, and weight loss2. The incidence of UC has been increasing worldwide, imposing a substantial burden on healthcare systems and significantly impairing patients’ quality of life3. Although the etiology of UC remains incompletely understood, accumulating evidence indicates that dysregulated immune responses, excessive production of inflammatory cytokines, oxidative stress, and metabolic disturbances play central roles in disease pathogenesis4,5.
Current therapeutic strategies for UC mainly include aminosalicylates, corticosteroids, immunosuppressive agents, and biologics targeting inflammatory cytokines6. While these treatments can alleviate symptoms and induce remission, their long-term use is often associated with adverse effects, high costs, and variable therapeutic responses7,8,9. Moreover, a considerable proportion of patients fail to achieve sustained remission, highlighting the need for alternative or complementary therapeutic approaches with improved safety and multi-target efficacy.
Traditional Chinese medicine (TCM) has been widely used for the treatment of gastrointestinal disorders for centuries and is increasingly recognized for its potential benefits in complex inflammatory diseases such as UC10. Unlike single-target therapies, TCM formulas typically exert therapeutic effects through multiple components acting on multiple targets and pathways, which may better address the multifactorial nature of UC11. Clinical and experimental studies have suggested that certain TCM prescriptions can modulate immune responses, suppress inflammation, protect intestinal barrier integrity, and regulate metabolic homeostasis12,13,14,15.
Liangxue Dihuang Decoction (LXDHD) is a classical TCM formula traditionally used to “cool the blood and clear heat” and has been clinically applied for inflammatory and hemorrhagic disorders16. The prescription consists of multiple herbs, including Scutellaria baicalensis, Phellodendron chinense, Rehmannia glutinosa, Paeonia suffruticosa, Paeonia lactiflora, Sanguisorba officinalis, Platycladus orientalis, Saposhnikovia divaricata, Citrus aurantium, Angelica sinensis, and Glycyrrhiza uralensis. Modern pharmacological studies have shown that several constituent herbs and their active compounds possess anti-inflammatory, antioxidant, and immunomodulatory properties17,18,19. However, the overall therapeutic effects and underlying mechanisms of LXDHD in UC have not yet been systematically elucidated.
Network pharmacology has emerged as an effective approach to explore the complex interactions between multi-component herbal formulas and disease-related molecular targets20. By integrating information from multiple databases, network pharmacology can predict potential active compounds, therapeutic targets, and signaling pathways, providing a systems-level understanding of TCM mechanisms21. Nevertheless, network pharmacology primarily relies on database predictions and does not directly reflect in vivo metabolic changes.
Metabolomics, as a powerful tool for profiling global metabolic alterations, offers complementary insights into disease pathophysiology and therapeutic responses22. In UC, metabolomic analyses have revealed significant disturbances in lipid and amino acid metabolism, as well as oxidative stress-related pathways23,24,25. Integrating metabolomics with network pharmacology can help bridge the gap between predicted molecular targets and actual metabolic phenotypes, thereby improving the reliability of mechanistic interpretations.
In the present study, an integrated strategy combining network pharmacology, untargeted metabolomics, and experimental validation was employed to investigate the anti-inflammatory effects and potential mechanisms of LXDHD in a dextran sulfate sodium (DSS)–induced mouse model of UC (Figure 1A). This overall methodological design, integrating in silico predictions with in vivo metabolomic and phenotypic validation, is in accordance with established rigorous research frameworks26. Network pharmacology analysis was used to identify active compounds, potential therapeutic targets, and signaling pathways enriched by LXDHD treatment. Untargeted metabolomics was performed to characterize metabolic alterations induced by UC and their modulation by LXDHD. Furthermore, key findings were validated through in vivo experiments, including assessments of disease activity, histopathological changes, hematological parameters, and inflammatory cytokine levels.
By integrating computational predictions, metabolic profiling, and biological validation, this study aims to provide a comprehensive understanding of the multi-component, multi-target, and multi-pathway mechanisms underlying LXDHD's therapeutic effects in UC. This work not only offers experimental evidence supporting the use of LXDHD as a potential complementary therapy for UC but also provides a methodological framework for investigating the mechanisms of other complex TCM formulas.