Analysis and Validation of the Network Pharmacology of the Mechanism of Glycyrrhetinic Acid for the Treatment of High-Altitude Pulmonary Hypertension

Glycyrrhetinic acid (GA) is a pentacyclic triterpene component in Glycyrrhize glabra L, it has demonstrated an inhibitive effect on high-altitude pulmonary hypertension (HAPH), but the molecular action is still not known. We aimed to explore the mechanism of GA for the treatment of HAPH based on network pharmacology and molecular docking method. Cell experiment validation was also conducted. The targets for GA were screened using the Swiss Target Prediction and Batman databases. The HAPH-related targets were obtained using the GeneCards and OMIM databases. The common targets for diseases and drugs were obtained using a Venn diagram. The core targets were screened using the String database. Then, a component-target-disease diagram and protein-protein interaction (PPI) network mutual assistance diagram were developed using Cytoscape3.9.1 software. GO functional and KEGG pathway enrichment analyses were conducted using the Metascape database. Finally, molecular docking of the target and its corresponding active components were performed using Autodock software. A total of 68 common targets for glycyrrhetinic acid high-altitude pulmonary hypertension were screened out. The core targets include PTGS1, MMP1, SERPINA6, and nitric oxide synthase (NOS2), involving PPAR signal pathway, human cytomegalovirus infection, IL-17 signal pathway, proteoglycans in cancer, and other pathways. The molecular docking affinity was -8.4 kcalmol-1 in average, indicating that GA has a good binding stability with key target proteins. In the PDGF-BB-induced PASMC proliferation model, PASMC proliferation and the p-p38, p38, p-ERK1/2, and ERK1/2 protein expression were inhibited. The pharmacological mechanism of GA for the treatment of HAPH was characterized by multi-target and multi pathway. GA may serve as a promising therapeutic candidate for HAPH but still needs further in vivo/in vitro experiment.