Hyperoside as a promising multi-target candidate for neovascular age-related macular degeneration. mechanisms involving Wnt/β-catenin signaling, oxidative stress, and inflammation suppression.

Abstract

Background: Neovascular age-related macular degeneration (nAMD), which is primarily characterized by choroidal neovascularization (CNV), encounters limitations with current therapeutic approaches, including treatment resistance and the burden of frequent injections, highlighting the need for exploring novel effective therapeutic agents and their mechanisms for nAMD management. Oxidative stress and inflammation are core pathogenic drivers of CNV in nAMD, and hyperoside (HYP)-a major flavonoid from Cuscuta chinensis, exhibits potent antioxidant and anti-inflammatory activities. These properties position HYP as a promising candidate for addressing the unmet treatment needs of nAMD and warrant further investigation into its mechanism of action in CNV modulation.

Purpose: This study aimed to explore the therapeutic potential of HYP-the main active component of the traditional Chinese herb Cuscuta chinensis Lam., and to elucidate its underlying molecular mechanisms in treating nAMD.

Study design: A combined in vivo and in vitro experimental strategy was adopted to systematically evaluate the therapeutic efficacy of HYP against nAMD and dissect the mechanistic basis of its action on CNV progression.

Methods: This study adopted a multi-dimensional research approach: network pharmacology was first used to predict HYP's multi-target potential in regulating inflammation, oxidative stress, and vascular endothelial growth factor (VEGF) signaling; a murine model of laser-induced CNV was established to evaluate HYP's effects on CNV lesion area, retinal/choroidal damage, and inflammatory infiltration; reactive oxygen species (ROS) levels were detected, the expression of endogenous antioxidant enzymes (Cat, Nqo1, Sod2), Vegf, pro-inflammatory cytokines (Il-1β, Ccl2, Il-6, Tnf-α), and Wnt pathway-related genes (Myc, Plcb2, Rspo1, Wnt7a/7b, Ctnnb1) and protein (β-catenin); lipopolysaccharide (LPS)-stimulated ARPE-19 cells were used to corroborate HYP's antioxidant, anti-inflammatory effects, and Wnt pathway inhibition; molecular docking was employed to analyze the interaction between HYP and β-catenin; pharmacokinetic analysis was conducted to assess HYP's distribution in ocular tissues; and integrated transcriptomic analysis (RNA-seq) and Gene Expression Omnibus (GEO) database data analyses were performed to confirm the role of the Wnt pathway in human AMD and its correlation with intraocular inflammation.

Results: Network pharmacology predicted that HYP has multi-target potential against inflammation, oxidative stress, and VEGF signaling; in the murine laser-induced CNV model, HYP treatment significantly reduced CNV lesion area, alleviated retinal/chorioretinal damage, and attenuated inflammatory infiltration; mechanistically, HYP effectively scavenged ROS, significantly upregulated the expression of endogenous antioxidant enzymes (Cat, Nqo1, Sod2), and downregulated the expression of Vegf, pro-inflammatory cytokines (Il-1β, Ccl2, Il-6, Tnf-α), key Wnt pathway genes (Myc, Plcb2, Rspo1, Wnt7a/7b, Ctnnb1), and the Wnt pathway's signature protein β-catenin; HYP's antioxidant, anti-inflammatory effects, and Wnt pathway inhibition were corroborated in LPS-stimulated ARPE-19 cells; molecular docking suggested a direct interaction between HYP and β-catenin; pharmacokinetic analysis showed favorable ocular distribution of HYP, supporting its biological relevance; and integrated transcriptomic and GEO data analyses confirmed the involvement of the Wnt pathway in human AMD and its correlation with intraocular inflammation.

Conclusion: Collectively, the findings demonstrate that HYP ameliorates CNV in nAMD through a concerted inhibition of oxidative stress, inflammation, and angiogenesis, primarily by suppressing Wnt/β-catenin signaling, which positions HYP as a promising multi-target candidate for the development of novel nAMD therapies.