To explore the mechanism of mastic and myrrh in the treatment of painful diabetic peripheral neuropathy (PDN) using network pharmacological method. The active ingredients of frankincense and myrrha and their related targets were retrieved from the Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), and the gene names were converted using Uniprot protein database. GeneCards, NCBI and OMIM databases were used to search the targets of painful diabetic peripheral neuropathy, and VENNY2.1.0 was used to obtain the intersection targets. Based on the intersection targets, protein interaction analysis, GO cell function and KEGG signaling pathway enrichment analysis were used to analyze the mechanism of mastic and myrrha in the treatment of painful diabetic peripheral neuropathy (PDN). Eight mastic compounds and 11 targets were found. There were 45 bioactive components and 184 targets in myrrh. There were 2265 PDN related genes and 123 common targets of drugs and diseases. Protein network interaction revealed Recombinant Nitric Oxide Synthase 2 (NOS2), factor II (F2) and Recombinant Prostaglandin Endoperoxide Synthase 2 (PTGS2), Dipeptidyl peptidase-4 (DPP4), Recombinant Protease, Serine 1 (PRSS1), estrogen receptor1 (ESR1) and other targets may be the key targets of frankincense and myrrh in the treatment of PDN. GO enrichment analysis included 320 items, involving cellular reactive oxygen species metabolism, response to lipopolysaccharide, epithelial cell proliferation, etc. KEGG enrichment analysis identified 166 signaling pathways, among which the AGE-RAGE signaling pathway in diabetic complications, lipid and atherosclerosis, fluid shear stress and atherosclerosis were the possible pathways of mastic and myrrha in the treatment of PDN.

Cheng Du, Zhang Xiao, Guo Yijia, Yang Jingfeng. A network-based pharmacologic investigation of the mechanism of action of frankincense-myrrh in the treatment of painful diabetic peripheral neuropathy. Frontiers in Medical Science Research (2023) Vol. 5, Issue 10: 82-91. https://doi.org/10.25236/FMSR.2023.051012.

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