Exploration of the Active Components and Mechanisms of Epimedium for the Treatment of Undescended Testis

Zhonglei Deng¹Sirui Zhang¹Haiyang Zhao²Shijia Xu¹Miao Qi¹Tianle Pu¹Hui Wang^1*

• ¹Nanjing Medical University, Nanjing, China
• ²Shanghai University of Traditional Chinese Medicine, Shanghai, China

Background: Undescended Testis, the most common congenital male reproductive disorder in children, demonstrates complex pathogenesis with genetic predisposition.While early surgical intervention (before 18 months) remains standard care, pharmacological options are limited.Purpose: Explore the therapeutic potential of Traditional Chinese medicine for Undescended Testis. Study design: This study employs multiple bioinformatics approaches to search for potential Traditional Chinese Medicines for Undescended Testis treatment and investigate their therapeutic mechanisms. Methods: This study integrated medication regularity analysis, network pharmacology, Mendelian randomization, and molecular docking, with exploration conducted through cellular and animal models. Results: Our analysis identified 27 bioactive Epimedium compounds, with quercetin, kaempferol, and Icariin showing particular promise. Protein interaction networks revealed AKT1, PARP1, and PGR as key targets. Functional enrichment analysis primarily focused on biological processes including response to stress-induced damage (such as reactive oxygen species, chemical toxins, and other stressors), steroid signaling and receptor activation, transmembrane signal transduction, as well as cellular proliferation and apoptosis regulation. Molecular docking demonstrated Yinyanghuo B's strong binding affinity with PARP1 (-7.2 kcal/mol). Mendelian randomization confirmed PARP1 reduction's causal relationship with lower Undescended Testis risk. We constructed animal and cellular heat stress models to simulate Undescended Testis, and subsequent experiments observed significant DNA damage. Thermally stressed TM4 cells showed significant PARP1 upregulation, suggesting its critical role in testicular heat stress response by accelerating DNA damage repair. Conclusion: These findings potentially provide mechanistic evidence supporting Epimedium's traditional use while advancing Traditional Chinese Medicine modernization through contemporary pharmacological validation.