Xiaoyou decoction suppresses cervical precancerous lesions through the activation of cellular autophagy and the upregulation of p53 expression
Persistent high-risk human papilloma virus (HR-HPV) infection is a key factor in the progression of cervical lesions to cervical cancer. This study explores the molecular mechanisms through which the traditional Chinese medicine Xiaoyou Decoction (XYD) inhibits cervical intraepithelial neoplasia (CIN) lesions, offering new insights into its potential therapeutic application. Network pharmacology analysis was employed to identify the potential active ingredients and key target genes of XYD in treating CIN. Functional enrichment analysis was utilized to pinpoint the critical biological pathways affected by XYD. Clinical randomized trials were performed to evaluate the clinical efficacy of XYD. In vitro experiments were conducted to explore the functional effects and underlying molecular mechanisms of XYD. A total of 209 potential target genes of XYD associated with CIN lesions were identified. In addition, the active ingredients of XYD exhibited a strong association with autophagy-related proteins. Clinical randomized trials demonstrated that XYD treatment effectively alleviated HR-HPV infection, and after a 6-month follow-up, 90.3 % of patients exhibited negative conversion, successfully reversing the progression of CIN lesions. In vitro experiments confirmed that XYD inhibited CIN cell proliferation by activating the autophagy pathway and upregulating p53 protein expression. In conclusion, our study reveals that XYD effectively prevents the persistence of HR-HPV infection and reverses the progression of CIN lesions by activating the autophagy pathway and upregulating p53 expression. These findings provide preliminary insights into the biological effects and specific mechanisms of XYD in CIN, offering a novel perspective for treating persistent HR-HPV infections.