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 multi-target approach has been considered a promising therapeutic strategy. For assessing the underlying complex mechanisms of action, a novel approach has been developed on the example of a complex natural product, a fixed combination of nine herbal extracts [1]. This approach is now applied to another natural product (NP, code name STW 5-N) consisting from standardized extracts of lemon balm leaves, caraway fruits, peppermint leaves, bitter candytuft total plant, chamomile flowers and liquorice roots, which has been proven effective in a multitude of clinical and preclinical studies.

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

Methods All data on the combination NP and its components were retrieved. Study results were sorted according to respective etiologic mechanisms related to FGDs, and multi-step clustering was conducted to reduce data complexity, followed by a classification according to the strength of the effects and a visualization in the form of 2D histograms/heatmaps.

Results The evaluation of the data shows that NP is active on multiple etiologic factors, especially with a strong anti-inflammatory and mucosa protecting action, besides effects on hyper- and hypomotility, acidity, and hypersensitivity. The clustering by multiple steps allowed the conclusion that all components are involved in these actions, with the heatmaps allowing an overview of the highly complex body of data within one figure.

Discussion and conclusion Multi step clustering allows the visualization of complex data sets on the multi-target action of medicines, especially those with a complex composition, as has been shown earlier [1]. For NP, it makes the allocation of the prominent anti-inflammatory, mucosa protective and calming effects to its different components manageable and allows their visualization within the context of its overall action in FGDs, so giving support to its clinical use especially with the focus on long lasting gastrointestinal symptoms.

Publication History

Article published online:
07 September 2021

• Reference

• 1 Abdel-Aziz et al.. 2017; Planta Med 83: 1130-1140.