Regulatory Effects of Zhenxin Formula in Treating Doxorubicin-Induced Heart Failure: Network Pharmacology and Animal Experimental Verification.

OBJECTIVE: This study aimed to elucidate the mechanisms underlying the protective effects of Zhenxin Formula (ZXF) against doxorubicin (Dox)-induced HF through the integration of network pharmacology, phospho-antibody array analysis, and experimental validation. METHODS: The active components and potential targets of ZXF were identified via the Traditional Chinese Medicine Systems Pharmacology (TCMSP) platform, while HF-associated target genes were retrieved from the OMIM, Genecards, and TTD databases. Protein-protein interaction (PPI) networks and compound-disease target networks were constructed using Cytoscape 3.7.2, with functional annotations performed through GO enrichment and KEGG pathway analyses using R software. Experimental validation involved the establishment of a Dox-induced HF model via intraperitoneal injection, with ZXF's therapeutic effects evaluated using cardiac ultrasound, morphological staining, and Western blot analysis. Additionally, a phospho-antibody array was utilized to screen over 300 molecules across 16 canonical signaling pathways in ZXF-treated HF models, with Western blot analysis confirming the specific pathways implicated in ZXF's therapeutic effects. RESULTS: Network pharmacology analysis identified 56 potential active ingredients in ZXF, 47 of which were associated with HF-related targets. AKT1 emerged as the target most strongly correlated with HF improvement. In vivo, ZXF significantly enhanced cardiac function and mitigated myocardial fibrosis and cardiomyocyte apoptosis. Phospho-antibody array analysis revealed that 16 phosphorylated proteins were upregulated and 3 downregulated in the Dox-treated group. ZXF intervention resulted in the upregulation of 10 phosphorylated proteins and downregulation of 5. Comparative analysis highlighted PDK1-Phospho and FOXO1/3/4-Phospho as pivotal phosphorylated proteins mediating ZXF's cardioprotective effects. Western blot analysis confirmed that ZXF enhanced phosphorylation levels of PI3K, PDK1, AKT, and FOXO1 in the Dox-induced HF model. CONCLUSION: This study, employing network pharmacology, phospho-antibody array analysis, and experimental validation, demonstrates that ZXF ameliorates cardiac dysfunction and suppresses myocardial apoptosis in Dox-induced HF through modulation of the PI3K/PDK1/AKT/FOXO1 signaling pathway.