Integrating Serum Pharmacochemistry With Network Pharmacology to Elucidate the Mechanism of Wushen Decoction in the Prevention and Treatment of Lower Extremity Erysipelas.

Lower extremity erysipelas (LEE), a frequently seen skin and soft tissue infection caused predominantly by streptococci, usually presents with fever, erythema and pain. Wushen Decoction (WSD), a Compound traditional Chinese medicine, has been used historically to treat LEE, though its exact mechanism of action remains unclear. In this study, we explored the therapeutic mechanisms of WSD in treating LEE by employing a combination of serum pharmacochemistry, network pharmacology, and molecular docking techniques. Initially, using UPLC-Q-Exactive Orbitrap-MS/MS, 39 candidate active compounds in the serum of rats treated with WSD were identified. Subsequently, network pharmacology analysis identified 35 overlapping targets between LEE and the active components, and 23 related signaling pathways. Further analysis and molecular docking studies have confirmed that the key active components (rutin, hyperoside and luteoloside) possess potential for effective therapeutic effects with the core targets (PTGS 2 and TNF). Furthermore, in vitro experiments demonstrated that WSD significantly downregulated the expression of PTGS 2 and TNF, thereby validating the network pharmacology findings and providing insights into the potential mechanisms. Results suggested that WSD may exert its therapeutic effects on LEE by modulating the TNF and NF-kappa B signaling pathway, offering a promising approach for the prevention and treatment of LEE.