Mechanism and molecular basis of huanglian decoction in regulating the immune microenvironment of colorectal adenocarcinoma

This study combined network pharmacology, TCGA multi-omics, immune infiltration analysis, and single-cell transcriptome data to systematically elucidate the mechanism by which Huanglian Decoction regulates the immune microenvironment of colorectal adenocarcinoma, and constructed a target gene-based prognostic risk model. A total of 59 core targets (such as MMP1 and MMP3) were screened. Results showed that the high-risk group was enriched with M2-type macrophages and Tregs, forming an immunosuppressive phenotype and the low-risk group was dominated by CD8+ T cells and M1-type macrophages, showing immune activation. Single-cell analysis (GSE277905) further revealed that core targets were specifically enriched in fibroblasts, while B cells were at the hub in cell communication. This model demonstrated stable prognostic stratification ability both within TCGA and external GEO datasets (both P<0.05). These suggest that Huanglian Decoction may synergistically reverse the immunosuppressive microenvironment through multiple targets, and its target model can provide new evidence for precise stratification and individualized treatment of colorectal adenocarcinoma.