AUTHOR=Liu Yi , Cui Xin , Xi Junyu , Xie Yanming 

TITLE=Clinical efficacy evaluation and potential mechanism prediction on Pudilan Xiaoyan oral liquid in treatment of mumps in children based on meta-analysis, network pharmacology, and molecular docking

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.956219

DOI=10.3389/fphar.2022.956219

ISSN=1663-9812

ABSTRACT=Background: Mumps is a disease caused by virus that can lead to serious complications, so it's harmful. Pudilan Xiaoyan Oral Liquid (PXOL) is used in treating children's mumps. To assess the effects and safety of PXOL on relieving symptoms of children's mumps and investigate the mechanisms, we did a meta-analysis of randomized controlled trials (RCT) and a network pharmacology analysis.   
Methods: This study searched databases for RCTs  comparing PXOL and antiviral drug combination treatment to antiviral drug alone treatment. The main outcomes  were effective rate and duration of 5 symptoms of children’s mumps. We assessed pooled data by using fix-effect or random-effect model and illustrated as risk difference (RD) or standardized mean difference (SMD) with a 95% confidence interval (CI) by utilizing Stata 15. In network pharmacology, we collected active components of PXOL and mumps’ targets, constructed a ‘drug-component-target’ network and a protein-protein interaction network by using Cytoscape  for screening the core components and targets. We ran GO and KEGG analysis targets and performed molecular docking between core components and targets.
Results: 12 studies were included  (N = 1307 participants). Compared with antiviral drug treatments, combination treatment with PXOL and antiviral drug yielded higher effective rates (OR = 5.94), shorter duration of fever (SMD = -1.05), headache (SMD = -0.69), parotid gland swelling (SMD = -1.30), parotid gland pain (SMD = -2.53), and loss of appetite (SMD = -0.56) respectively and fewer side effects reported. 11 core components like quercetin, isoetin and 7 core targets like ALB and IL6 were obtained. Besides, potential pathways include cytokine-cytokine receptor interaction, etc. Molecular docking results showed that most of the core components and core targets can form stable structures. Among them,  isoetin, quercetin, luteolin and HSPOAA, ESR1, ALB have the best affinities.   
Conclusion: Combined use of PXOL and antiviral drugs can effectively improve the efficacy of children's mumps, and alleviate symptoms quickly. This efficacy may be related to the anti-inflammatory and antiviral mechanisms by which PXOL acts through multiple components, multiple targets, and multiple pathways. These results remain to be confirmed by further studies.