Tibetan medicine Bawei Chenxiang Wan attenuates chronic mountain sickness by targeting the AKT/FOXO3a/CAT axis to inhibit oxidative stress.

Bawei Chenxiang Wan (BWCX) is a classical Tibetan medicinal formula originating from the canonical Tibetan medical text The Four Tantras. It is traditionally used to activate qi circulation, nourish the heart, tranquilize the mind and enhance intelligence. It has been applied for over a thousand yea...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Ethnopharmacology Vol. 364
Autores principales: Li, Xiaoya, Zhang, Shujing, Qiu, Yuehua, Wang, Yuyan, Hou, Jianchen, Ji, Xuenian, Ge, Fei, Zhang, Xin, Sun, Qingqing, Song, Haochong, Ciwang, Renzeng, Luo, Yamin, Tao, Xiaohua
Formato: research Journal Article
Publicado: Elsevier B.V. Jun2026
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192483378&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 192483378
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        03788741
        3MS
      jtl: Journal of Ethnopharmacology
      issn: 03788741
      maglogo: N
    pubinfo:
      dt: Jun2026
      vid: 364
      pid: 1004
      pub: Elsevier B.V.
    artinfo:
      ui:
        192483378
        192483378
        192483378
        10.1016/j.jep.2026.121481
        192483378
      ppct: 1
      formats:
      tig:
        atl: Tibetan medicine Bawei Chenxiang Wan attenuates chronic mountain sickness by targeting the AKT/FOXO3a/CAT axis to inhibit oxidative stress.
      aug:
        au:
          Li, Xiaoya
          Zhang, Shujing
          Qiu, Yuehua
          Wang, Yuyan
          Hou, Jianchen
          Ji, Xuenian
          Ge, Fei
          Zhang, Xin
          Sun, Qingqing
          Song, Haochong
          Ciwang, Renzeng
          Luo, Yamin
          Tao, Xiaohua
        affil: College of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China
      sug:
        subj:
          Medicine, Tibetan
          Altitude Sickness Prevention and Control
          Oxidative Stress Drug Effects
          Signal Transduction Drug Effects
          Transferases Metabolism
          Transcription Factors Metabolism
          Catalase Metabolism
          Drugs, Chinese Herbal Pharmacodynamics
          Mice
          Animal Studies
          Models, Biological
          Liquid Chromatography-Mass Spectrometry
          Network Pharmacology
          Random Forest
          Molecular Docking Simulation
          Malondialdehyde Blood
          Superoxide Dismutase Blood
          Glutathione Peroxidase Blood
          Energy Metabolism
          Enzyme-Linked Immunosorbent Assay
          Reverse Transcriptase Polymerase Chain Reaction
          Blotting, Western
      ab: Bawei Chenxiang Wan (BWCX) is a classical Tibetan medicinal formula originating from the canonical Tibetan medical text The Four Tantras. It is traditionally used to activate qi circulation, nourish the heart, tranquilize the mind and enhance intelligence. It has been applied for over a thousand years on the Qinghai–Tibet Plateau to treat cardio-cerebral hypoxic syndromes such as high-altitude (HA) adverse qi flow and mental trance, which are attributed to an imbalance among the three humors (rlung, mkhris-pa, and bad-kan). The traditional applications of BWCX closely align with the clinical manifestations of modern Chronic Mountain Sickness (CMS). However, its effective components and mechanisms of action anti-CMS remain unclear. This study aims to systematically elucidate the material basis of BWCX anti-CMS and its underlying mechanism of cardio-cerebral protection through the regulation of oxidative stress. Chemical constituents of BWCX were characterized by UHPLC-MS. To identify core therapeutic targets, we employed network pharmacology and analyzed CMS patient transcriptomes (GSE145774, GSE103940) by combining weighted gene co-expression network analysis (WGCNA) with the random forest (RF) algorithm. Molecular docking was used to validate interactions between active components and predicted targets. A physiologically relevant CMS model was established by exposing 60 mice to a natural HA environment (Lhasa, 3650 m) for 8 weeks. Hematological parameters were measured; oxidative stress markers (malondialdehyde [MDA], Catalase [CAT], Total Superoxide Dismutase [T-SOD], glutathione peroxidase [GSH-Px], total antioxidant capacity [T-AOC]) and energy metabolism (adenosine triphosphate [ATP]) in cardiac tissues were assessed by ELISA; and the expression of core targets was analyzed using RT-qPCR and Western blot to verify the regulatory effect of BWCX on the AKT1/FOXO3a/CAT signaling axis, and the binding situation of FOXO3a to the promoter region of CAT was analyzed using ChIP-qPCR to verify the regulatory relationship of FOXO3a on CAT. A total of 78 chemical components were identified, including 18-β-glycyrrhetinic acid, β-asarone and quassin. Integrative bioinformatics analysis pinpointed AKT1, FOXO3 and CAT as core targets of BWCX anti-CMS, with significant enrichment in oxidative stress-related pathways. Molecular docking results showed that the binding energies of costunolide with AKT1, FOXO3a, CAT and ESR2 were −9.5, −8.8, −11.1 and −9.9 kcal/mol, respectively; while those of 18-β-glycyrrhetinic acid with the above targets were −9.1, −8.2, −10.2 and −9.2 kcal/mol, respectively, indicating their strong potential for target binding. Animal experiments demonstrated that BWCX intervention significantly reversed CMS-induced hematological abnormalities [increased red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT) and platelets (PLT)], ameliorated cardiac oxidative stress (reduced MDA; elevated T-AOC, T-SOD, GSH-Px, CAT, ATP), and corrected the dysregulated molecular expression: it suppressed the upregulation of AKT1 mRNA/protein and p-AKT1/AKT1 ratio, while restoring the downregulated mRNA/protein expression of FOXO3a and CAT and the p-FOXO3a/FOXO3a ratio in cardiac and hippocampal tissues (P < 0.05). RT-qPCR analysis of AKT1, FOXO3a, and CAT mRNA expression in vitro revealed trends consistent with those observed in the in vivo experiments. It was also verified that significant enrichment of FOXO3a was detected in the CAT promoter region under hypoxic stress (P < 0.05). FOXO3a binds to the CAT promoter in H9C2 cells, thereby confirming that CAT is a direct transcriptional target of FOXO3a. This study provides the first evidence that BWCX alleviates CMS-induced cardio-cerebral hypoxic injury by modulating the AKT1/FOXO3a/CAT signaling axis, thereby rebalancing oxidative stress and improving hemorheology. These findings provide a modern pharmacological interpretation of its traditional cardiocerebral protective effect, offer a paradigm for ethnomedicine research modernization, and lay a scientific foundation for its clinical application and quality control. [Display omitted] • The AKT1/FOXO3a/CAT axis has been identified as the pivotal pathway mediating the therapeutic effects of BWCX against CMS. • Reveals the dual function of CAT upregulation in CMS as both a transcriptional target and a systemic repair effector. • Establishes a research paradigm integrating clinical data, computational prediction, and validation in a CMS model.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N