Antipyretic Mechanism Exploration of HuanglianShangqing Pill Based on Metabolomics and Network Pharmacology

HuanglianShangqing pill (HLSQ), a well-known traditional Chinese medicine (TCM), has been used to treat fever in China for a long time. Our previous study had demonstrated that a total of 45 prototype components of HLSQ could be absorbed into the plasma of rats after intragastric administration. However, the detailed mechanisms related to the antipyretic effects of HLSQ were still unclear.In the present work, urinary metabolomics coupled with network pharmacology were employed to evaluate the mechanisms of HLSQ in the treatment of fever compared with ibuprofen (IBU) and paracetamol (APAP).In pyrexia rats, a total of 11 potential metabolites and a disturbed TCA cycle were found. The metabolic regulation effects of HLSQ on fever rats were similar to APAP and could make the TCA cycle disorder return to normal by reducing citrate, β-hydroxybutyrate, succinate. In addition, HLSQ could adjust the intestinal microbial disorder and inhibit inflammatory factors, including IL6, TNF, VEGFA, TP53, STAT3, etc. There were 40 components acting on fever targets in HLSQ; among them, luteolin, apigenin, ursolic acid, kaempferol, wogonin, daidzein, baicalein, emodin, berberine, and oroxylin A were the main active compounds of HLSQ in the treatment of fever.The antipyretic mechanisms of HLSQ are inhibition of inflammatory factors, action on the TCA cycle, and regulation of gut microbiota.