<p>Sepsis, marked by hyperinflammation and subsequent immunosuppression, lacks effective phase-specific therapies. Although anisodamine hydrobromide (Ani HBr) reduced 28-day mortality in our prior trial, its mechanisms remained unclear. Here, we integrated network pharmacology, machine learning, immunological profiling, molecular simulations, and single-cell transcriptomics to elucidate Ani HBr’s multi-target actions. Among 30 cross-species targets, ELANE and CCL5 emerged as core regulators via protein interaction networks, survival modeling (AUC: 0.72–0.95), and statistical significance (p &lt; 0.05). Ani HBr inhibited ELANE-driven NET formation (HR = 1.176), associated with immunosuppression and endothelial damage, while enhancing CCL5-related cytotoxic T-cell recruitment (HR = 0.810). Docking and dynamics simulations showed Ani HBr binds ELANE’s catalytic cleft, suggesting direct inhibition of its enzymatic activity, and interacts stably with CCL5 at potential receptor-binding interfaces, indicating a modulatory role. Single-cell analysis revealed ELANE upregulation in CCI-phase neutrophils and widespread yet stage-specific CCL5 expression. These findings support Ani HBr as a phase-tailored agent that targets ELANE in early hyperinflammation while preserving CCL5-mediated immunity. The ELANE/CCL5 prognostic model offers a framework for precision immunotherapy in sepsis.</p>

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Integrative network pharmacology and multi-omics reveal anisodamine hydrobromide’s multi-target mechanisms in sepsis

  • Ying Chen,
  • Danlei Weng,
  • Wei Shi,
  • Shuxing Wei,
  • Wenqing Ji,
  • Xiya Wang,
  • Yali Xu,
  • Xiaoman Wang,
  • Xue Mei,
  • Shubin Guo

摘要

Sepsis, marked by hyperinflammation and subsequent immunosuppression, lacks effective phase-specific therapies. Although anisodamine hydrobromide (Ani HBr) reduced 28-day mortality in our prior trial, its mechanisms remained unclear. Here, we integrated network pharmacology, machine learning, immunological profiling, molecular simulations, and single-cell transcriptomics to elucidate Ani HBr’s multi-target actions. Among 30 cross-species targets, ELANE and CCL5 emerged as core regulators via protein interaction networks, survival modeling (AUC: 0.72–0.95), and statistical significance (p < 0.05). Ani HBr inhibited ELANE-driven NET formation (HR = 1.176), associated with immunosuppression and endothelial damage, while enhancing CCL5-related cytotoxic T-cell recruitment (HR = 0.810). Docking and dynamics simulations showed Ani HBr binds ELANE’s catalytic cleft, suggesting direct inhibition of its enzymatic activity, and interacts stably with CCL5 at potential receptor-binding interfaces, indicating a modulatory role. Single-cell analysis revealed ELANE upregulation in CCI-phase neutrophils and widespread yet stage-specific CCL5 expression. These findings support Ani HBr as a phase-tailored agent that targets ELANE in early hyperinflammation while preserving CCL5-mediated immunity. The ELANE/CCL5 prognostic model offers a framework for precision immunotherapy in sepsis.