Handling of complexity: describing the mechanisms of action of a multi-target therapy in functional GI diseases by multi-step clustering derived heatmaps

Introduction In functional gastrointestinal diseases (FGDs), a multitude of concomitant causes and likewise also targets for therapeutic interventions have been identified [1]. Therefore, a multi-target approach is a promising therapeutic strategy. For assessing the underlying complex mechanisms of action, a novel approach has been developed [2]. This approach is now applied to a clinically proven [3],[4] natural product (NP) consisting from standardized extracts of lemon balm leaves, caraway fruits, peppermint leaves, bitter candytuft total plant, chamomile flowers and liquorice roots.

Aims To analyze and describe its mechanisms of action of NP in relation to different forms and causes of functional GI diseases, an evaluation of the available data is needed.

Methods Studies were retrieved and sorted and a multi-step clustering [2] was conducted to reduce data complexity.

In a further step, results were classified in relative classes according to the strength of the effects and visualized in the form of 2D histograms/heatmaps.

Results The evaluation of the data shows that NP is active in response to multiple etiologic factors involved in FGDs, especially functional dyspepsia and irritable bowel syndrome, like hyper- and hypomotility, acidity, inflammation and hypersensitivity, but also in inflammatory gastrointestinal diseases. The clustering by multiple steps allows the conclusion that all components are, with a respective specific profile of activities, involved in these actions, with the heatmaps allowing an overview of the highly complex body of data within one figure.

Discussion and conclusions Multi step clustering allows the transformation of complex data sets, as had been shown earlier [2]. For NP, it makes the allocation of specific actions to the different components of the medicine manageable and allows their visualization within the context of the overall action of the medicine in FGDs, so also giving support to its clinical use in patients with different gastrointestinal symptoms.

Publication History

Article published online:
08 September 2020

• References

• 1 Allescher. et al. 2006 Phytomedicine 13 SV:2.
• 2 Abdel-Aziz. et al. 2017; Planta Med 83: 1130-1140.
• 3 Roesch W. et al. 2002; Z Gastroenterol 40: 4001-4008
• 4 Madisch A. et al. 2004; Digestion 69: 45-52