Hederagenin suppresses inflammation-cancer transformation in chronic atrophic gastritis by modulating glycolysis through the mTOR/HIF-1α axis.

Chronic atrophic gastritis (CAG) is a critical precancerous condition with limited therapeutic options to halt its progression toward gastric cancer. Targeting dysregulated metabolism and inflammation-driven transformation represents a promising yet underexplored strategy. Herein, through systematic screening of Jianwei Xiaoyan Granule (JWXYG)-derived compounds via molecular docking and surface plasmon resonance (SPR), we identified hederagenin as a potent and novel mechanistic target of rapamycin (mTOR) binder (Kd = 1.30 μM). In a rat CAG model, hederagenin administration resulted in marked histological and biochemical improvements. Histopathological evaluation revealed that hederagenin effectively restored gastric mucosal architecture, significantly attenuated characteristic glandular atrophy, and reduced the extent of intestinal metaplasia, a key precancerous lesion. Concurrently, serum analysis demonstrated that hederagenin treatment normalized critical biomarker levels, including a significant reduction in gastrin-17 (G-17) and the pro-inflammatory cytokine interleukin-6 (IL-6), alongside a notable increase in the levels of pepsinogen I (PG I) and pepsinogen II (PG II). Functionally, hederagenin exhibited potent anti-tumor properties in vitro by significantly suppressing the proliferation, migration, and invasion capabilities of premalignant gastric epithelial cells. Mechanistically, transcriptomic analyses revealed that hederagenin targeted cancer-associated metabolic reprogramming through the mTOR/hypoxia-inducible factor-1α (mTOR/HIF-1α) signaling axis. Experimental validation further confirmed that hederagenin significantly suppressed the mTOR/HIF-1α pathway. Additionally, it downregulated the expression of key rate-limiting glycolytic enzymes, including hexokinase II (HK II), pyruvate kinase M2 (PKM2), enolase 1 (ENO1), and lactate dehydrogenase A (LDHA), thereby attenuating glycolytic flux, a hallmark metabolic adaptation in precancerous lesions. Importantly, mTOR knockdown abolished hederagenin-mediated LDHA suppression and compromised its therapeutic efficacy, validating mTOR as an essential target. Our findings demonstrated that hederagenin could inhibit inflammation-cancer transformation in CAG via regulation of glycolysis through the mTOR/HIF-1α pathway, which provided new candidate compounds for regulating the transformation of CAG into cancer.