Integrative multi-omics and network analysis identify potential targets of Chaihu Shugan Xiaozheng Formula in breast cancer

BACKGROUND: Breast cancer (BC) is linked to emotional stress and neuroendocrine-immune dysregulation. Chaihu Shugan Xiaozheng Formula (CSXF) shows clinical efficacy in BC with depressive symptoms, yet its mechanisms remain unclear. This study aims to investigate the therapeutic effects of CSXF in modulating neuroendocrine-immune networks and tumor-related pathways in BC. METHODS: The bioactive compounds of CSXF were screened using the TCMSP database. Target genes that intersected with differentially expressed genes associated with BC from the TCGA-BRCA dataset were analyzed. Prognostic signatures were constructed through Cox and LASSO regression models. Multi-omics profiling included immune infiltration, pathway enrichment, molecular docking, and RT-qPCR validation in BC tissue samples. RESULTS: Five core targets formed a prognostic model with high predictive accuracy. High-risk patients exhibited elevated mortality independent of age/NM stage. Oxidative phosphorylation activation and myeloid-derived suppressor cell infiltration correlated with CD14 overexpression in high-risk groups. RT-qPCR confirmed tumor-specific downregulation of CD14, PPARG, and CHRM1 in BC tissues. CONCLUSIONS: CSXF treats BC via multi-target modulation of neuroendocrine-immune and tumor pathways, providing prognostic biomarkers and mechanistic insights.