The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification

JI Xiao Ning LIU Zhao Ping ZHANG Chao Zheng CHEN Min LIANG Jiang LU Jiang ZHANG Lei

JI Xiao Ning, LIU Zhao Ping, ZHANG Chao Zheng, CHEN Min, LIANG Jiang, LU Jiang, ZHANG Lei. The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification[J]. Biomedical and Environmental Sciences, 2024, 37(1): 42-53. doi: 10.3967/bes2024.005
Citation: JI Xiao Ning, LIU Zhao Ping, ZHANG Chao Zheng, CHEN Min, LIANG Jiang, LU Jiang, ZHANG Lei. The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification[J]. Biomedical and Environmental Sciences, 2024, 37(1): 42-53. doi: 10.3967/bes2024.005

doi: 10.3967/bes2024.005

The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification

Funds: This research was funded by China’s National Key R&D Programmers for “Hi-Tech Winter Olympics” Special Project [2020YFF0305001].
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    Author Bio:

    JI Xiao Ning, female, born in 1993, PhD Candidate, majoring in homology of medicine and food

    Corresponding author: LU Jiang, Professor, PhD, E-mail: lujiang_cfsa1234@126.comZHANG Lei, Professor, PhD, Tel: 86-10-52165560, E-mail: zhanglei@cfsa.net.cn
  • There are no conflicts to declare.
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    There are no conflicts to declare.
    注释:
    1) CONFLICTS OF INTEREST:
  • S1.  Venn diagram of Fructus Lycii/exercise-induced fatigue related targets.

    Figure  1.  Compound-targets network. GQ1, Sitosterol alpha1; GQ2, Cycloartenol; GQ3, Mandenol; GQ4, Ethyl linolenate; GQ5, LAN; GQ6, Stigmasterol; GQ7, Beta-sitosterol; GQ8, (-)-Hyoscyamine; GQ9, Campesterol; GQ10, Cyanin; GQ11, 24-methylidenelophenol; GQ12, Daucosterol qt; GQ13, Glycitein; GQ14, CLR; GQ15, 14b-pregnane; GQ16, 24-ethylcholesta-5,22-dienol; GQ17, Fucosterol; GQ18, 31-norlanosterol; GQ19, 4,24-methyllophenol; GQ20, Lophenol; GGQ21, 4alpha,14alpha,24-trimethylcholesta-8,24-dienol; GQ22, 4alpha,24-dimethylcholesta-7,24-dienol; GQ23, 4alpha-methyl-24-ethylcholesta-7,24-dienol; GQ24, 6-Fluoroindole-7-Dehydrocholesterol; GQ25, 7-O-methylluteolin-6-C-beta-glucoside_qt; GQ26, Atropine; GQ27, Physcion-8-O-beta-D-gentiobioside; GQ28, Lanost-8-en-3beta-ol; GQ29, Obtusifoliol; GQ30, Quercetin.

    Figure  2.  Enrichment analysis. (A) GO enrichment analysis; (B) KEGG enrichment analysis. BP, biological process; CC, cellular component; MF, molecular function. P < 0.05.

    Figure  3.  Compound-targets-pathways network. GQ1, Sitosterol alpha1; GQ2, Cycloartenol; GQ3, Mandenol; GQ4, Ethyl linolenate; GQ5, LAN; GQ6, Stigmasterol; GQ7, Beta-sitosterol; GQ8, (-)-Hyoscyamine; GQ9, Campesterol; GQ10, Cyanin; GQ11, 24-methylidenelophenol; GQ12, Daucosterol_qt; GQ13, Glycitein; GQ14, CLR; GQ15, 14b-pregnane; GQ16, 24-ethylcholesta-5,22-dienol; GQ17, Fucosterol; GQ18, 31-norlanosterol; GQ19, 4,24-methyllophenol; GQ20, Lophenol; GGQ21, 4alpha,14alpha,24-trimethylcholesta-8,24-dienol; GQ22, 4alpha,24-dimethylcholesta-7,24-dienol; GQ23, 4alpha-methyl-24-ethylcholesta-7,24-dienol; GQ24, 6-Fluoroindole-7-Dehydrocholesterol; GQ25, 7-O-Methylluteolin-6-C-beta-glucoside_qt; GQ26, Atropine; GQ27, Physcion-8-O-beta-D-gentiobioside; GQ28, Lanost-8-en-3beta-ol; GQ29, Obtusifoliol; GQ30, Quercetin.

    S2.  CCK-8 assay of cell viability.

    Figure  4.  The effect of quercetin on glucose uptake, ROS generation, and mitochondria function in C2C12 cells. The 2-NBDG (A), CellRox (B), TMRM (C), and MitoTracker (D) probes were detected by a high content imaging analysis system; Left panel: representative images. Data presented were from three biological replicates; Scale bar size: 50 μm; *P < 0.05; **P < 0.01.

    Figure  5.  Protein expression of MAPK and PI3K-AKT signaling pathways. (A) MAPK signaling pathways, the protein expression of p-P38 MAPK, p-MAPK, and p-JNK was detected by a high content imaging analysis system; (B) PI3K-AKT signaling pathway, p-PI3K and p-AKT was detected by a high content imaging analysis system; Left panel: representative images. Data presented were from three biological replicates; Scale bar size: 50 μm; *P < 0.05; **P < 0.01.

    S3.  Flow diagram of the study selection. Supplementary Figure S3 showed that a total of 441 relevant literature sources were identified through the search strategy. After removing 145 duplicate articles, the titles and abstracts of the remaining papers were screened to exclude those that were not related to Fructus Lycii and exercise-induced fatigue. And then, we reviewed 51 articles with full texts and 15 randomized controlled trials (RCTs) involving animals were included in the final analysis.

    S4.  Forest plot of s standardized mean differences in exhausted time between Fructus Lycii and placebo. Weights have been calculated using random effects model. Degree of heterogeneity in the pooled estimates is represented at I2 statistic. SMD, standardized mean difference; Chi2, Chi-square test; df, degrees of freedom; I2, I-squared statistic; Z, Z-test; CI, confidence interval; H, high-dose intervention in each study; M, median-dose intervention in each study; L, low-dose intervention in each study. The exhausted time was the primary outcome. There was significant heterogeneity among the 14 studies (I2 = 78%, P < 0.01) and therefore a random effect model was used as shown in the Supplementary Figure S4. Meta-analysis of 14 studies showed significant effects of Fructus Lycii on increasing the time to exhaustion compared with control groups (SMD 1.5; 95% CI 1.08 to 1.92; P < 0.01).

    S1.   Potential active components of Fructus Lycii

    Molecule ID Molecule name OB (%) DL
    MOL001323 Sitosterol alpha1 43.2813 0.78354
    MOL003578 Cycloartenol 38.6857 0.78093
    MOL001494 Mandenol 41.9962 0.19321
    MOL001495 Ethyl linolenate 46.101 0.19716
    MOL001979 LAN 42.1192 0.74787
    MOL000449 Stigmasterol 43.8299 0.75665
    MOL000358 beta-sitosterol 36.9139 0.75123
    MOL005406 atropine 45.9706 0.19328
    MOL005438 campesterol 37.5768 0.71488
    MOL006209 cyanin 47.4209 0.75918
    MOL007449 24-methylidenelophenol 44.1926 0.7533
    MOL008173 daucosterol_qt 36.9139 0.75316
    MOL008400 glycitein 50.4789 0.23826
    MOL010234 delta-Carotene 31.8009 0.54639
    MOL000953 CLR 37.8739 0.67677
    MOL009604 14b-pregnane 34.7792 0.33723
    MOL009612 (24R)-4alpha-Methyl-24-ethylcholesta-7,25-dien-3beta-ylacetate 46.3575 0.8398
    MOL009615 24-Methylenecycloartan-3beta,21-diol 37.3173 0.79751
    MOL009617 24-ethylcholest-22-enol 37.0945 0.7511
    MOL009618 24-ethylcholesta-5,22-dienol 43.8299 0.75636
    MOL009620 24-methyl-31-norlanost-9(11)-enol 37.9997 0.75092
    MOL009621 24-methylenelanost-8-enol 42.3682 0.76769
    MOL009622 Fucosterol 43.7764 0.75668
    MOL009631 31-Norcyclolaudenol 38.6821 0.81391
    MOL009633 31-norlanost-9(11)-enol 38.3539 0.7249
    MOL009634 31-norlanosterol 42.2046 0.73012
    MOL009635 4,24-methyllophenol 37.8347 0.74999
    MOL009639 Lophenol 38.1294 0.714
    MOL009640 4alpha,14alpha,24-trimethylcholesta-8,24-dienol 38.9099 0.75772
    MOL009641 4alpha,24-dimethylcholesta-7,24-dienol 42.653 0.75297
    MOL009642 4alpha-methyl-24-ethylcholesta-7,24-dienol 42.2951 0.78304
    MOL009644 6-Fluoroindole-7-Dehydrocholesterol 43.726 0.72224
    MOL009646 7-O-Methylluteolin-6-C-beta-glucoside_qt 40.7737 0.30497
    MOL009650 Atropine 42.159 0.19299
    MOL009651 Cryptoxanthin monoepoxide 46.9537 0.56103
    MOL009653 Cycloeucalenol 39.7265 0.79446
    MOL009656 (E,E)-1-ethyl octadeca-3,13-dienoate 41.9962 0.19364
    MOL009660 methyl (1R,4aS,7R,7aS)-4a,7-dihydroxy-7-methyl-1-[(2S,3R,4S,5S,6R)-3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-1,5,6,7a-tetrahydrocyclopenta[d]pyran-4-carboxylate 39.4285 0.46558
    MOL009662 Lantadene A 38.6794 0.57405
    MOL009664 Physalin A 91.7065 0.27207
    MOL009665 Physcion-8-O-beta-D-gentiobioside 43.9036 0.62426
    MOL009677 lanost-8-en-3beta-ol 34.2263 0.74036
    MOL009678 lanost-8-enol 34.2263 0.74167
    MOL009681 Obtusifoliol 42.552 0.7565
    MOL000098 quercetin 46.4333 0.27525
      Note. DL, Drug Like Index; OB, Oral Bioavailability.
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    S2.   Information of intersection target of components and exercise-induced fatigue

    ID Molecule name Target name Gene name
    GQ1 Sitosterol alpha1 Progesterone receptor PGR
    GQ1 Sitosterol alpha1 Prostaglandin G/H synthase 2 PTGS2
    GQ1 Sitosterol alpha1 Mineralocorticoid receptor NR3C2
    GQ2 Cycloartenol Mineralocorticoid receptor NR3C2
    GQ3 Mandenol Prostaglandin G/H synthase 1 PTGS1
    GQ3 Mandenol Prostaglandin G/H synthase 2 PTGS2
    GQ4 Ethyl linolenate Prostaglandin G/H synthase 1 PTGS1
    GQ5 LAN Progesterone receptor PGR
    GQ5 LAN Mineralocorticoid receptor NR3C2
    GQ6 Stigmasterol Progesterone receptor PGR
    GQ6 Stigmasterol Mineralocorticoid receptor NR3C2
    GQ6 Stigmasterol Ig gamma-1 chain C region IGHG1
    GQ6 Stigmasterol Retinoic acid receptor RXR-alpha RXRA
    GQ6 Stigmasterol Prostaglandin G/H synthase 1 PTGS1
    GQ6 Stigmasterol Prostaglandin G/H synthase 2 PTGS2
    GQ6 Stigmasterol Alpha-2A adrenergic receptor ADRA2A
    GQ6 Stigmasterol Sodium-dependent noradrenaline transporter SLC6A2
    GQ6 Stigmasterol Sodium-dependent dopamine transporter SLC6A3
    GQ6 Stigmasterol Beta-2 adrenergic receptor ADRB2
    GQ6 Stigmasterol Aldose reductase AKR1B1
    GQ6 Stigmasterol Urokinase-type plasminogen activator PLAU
    GQ6 Stigmasterol Leukotriene A-4 hydrolase LTA4H
    GQ6 Stigmasterol Amine oxidase [flavin-containing] B MAOB
    GQ6 Stigmasterol Amine oxidase [flavin-containing] A MAOA
    GQ6 Stigmasterol Muscarinic acetylcholine receptor M3 CHRM3
    GQ6 Stigmasterol Beta-1 adrenergic receptor ADRB1
    GQ6 Stigmasterol Sodium channel protein type 5 subunit alpha SCN5A
    GQ6 Stigmasterol 5-hydroxytryptamine 2A receptor HTR2A
    GQ6 Stigmasterol Gamma-aminobutyric-acid receptor subunit alpha-3 GABRA3
    GQ6 Stigmasterol Muscarinic acetylcholine receptor M2 CHRM2
    GQ6 Stigmasterol Alpha-1B adrenergic receptor ADRA1B
    GQ6 Stigmasterol Neuronal acetylcholine receptor subunit alpha-7 CHRNA7
    GQ7 beta-sitosterol Progesterone receptor PGR
    GQ7 beta-sitosterol Prostaglandin G/H synthase 1 PTGS1
    GQ7 beta-sitosterol Prostaglandin G/H synthase 2 PTGS2
    GQ7 beta-sitosterol Heat shock protein HSP 90-alpha HSP90AA1
    GQ7 beta-sitosterol Potassium voltage-gated channel subfamily H member 2 KCNH2
    GQ7 beta-sitosterol D(1A) dopamine receptor DRD1
    GQ7 beta-sitosterol Muscarinic acetylcholine receptor M3 CHRM3
    GQ7 beta-sitosterol Sodium channel protein type 5 subunit alpha SCN5A
    GQ7 beta-sitosterol cGMP-inhibited 3',5'-cyclic phosphodiesterase A PDE3A
    GQ7 beta-sitosterol 5-hydroxytryptamine 2A receptor HTR2A
    GQ7 beta-sitosterol Gamma-aminobutyric-acid receptor subunit alpha-5 GABRA5
    GQ7 beta-sitosterol Gamma-aminobutyric-acid receptor subunit alpha-3 GABRA3
    GQ7 beta-sitosterol Muscarinic acetylcholine receptor M2 CHRM2
    GQ7 beta-sitosterol Alpha-1B adrenergic receptor ADRA1B
    GQ7 beta-sitosterol Beta-2 adrenergic receptor ADRB2
    GQ7 beta-sitosterol Neuronal acetylcholine receptor subunit alpha-2 CHRNA2
    GQ7 beta-sitosterol Sodium-dependent serotonin transporter SLC6A4
    GQ7 beta-sitosterol Mu-type opioid receptor OPRM1
    GQ7 beta-sitosterol Neuronal acetylcholine receptor subunit alpha-7 CHRNA7
    GQ7 beta-sitosterol Apoptosis regulator Bcl-2 BCL2
    GQ7 beta-sitosterol Apoptosis regulator BAX BAX
    GQ7 beta-sitosterol Caspase-9 CASP9
    GQ7 beta-sitosterol Transcription factor AP-1 JUN
    GQ7 beta-sitosterol Caspase-3 CASP3
    GQ7 beta-sitosterol Caspase-8 CASP8
    GQ7 beta-sitosterol Protein kinase C alpha type PRKCA
    GQ7 beta-sitosterol Transforming growth factor beta-1 TGFB1
    GQ7 beta-sitosterol Serum paraoxonase/arylesterase 1 PON1
    GQ7 beta-sitosterol Microtubule-associated protein 2 MAP2
    GQ8 (-)-Hyoscyamine D(1A) dopamine receptor DRD1
    GQ8 (-)-Hyoscyamine Muscarinic acetylcholine receptor M3 CHRM3
    GQ8 (-)-Hyoscyamine Beta-1 adrenergic receptor ADRB1
    GQ8 (-)-Hyoscyamine Alpha-2A adrenergic receptor ADRA2A
    GQ8 (-)-Hyoscyamine Alpha-2C adrenergic receptor ADRA2C
    GQ8 (-)-Hyoscyamine Delta-type opioid receptor OPRD1
    GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 2A receptor HTR2A
    GQ8 (-)-Hyoscyamine Sodium-dependent noradrenaline transporter SLC6A2
    GQ8 (-)-Hyoscyamine Muscarinic acetylcholine receptor M2 CHRM2
    GQ8 (-)-Hyoscyamine Alpha-2B adrenergic receptor ADRA2B
    GQ8 (-)-Hyoscyamine Alpha-1B adrenergic receptor ADRA1B
    GQ8 (-)-Hyoscyamine Sodium-dependent dopamine transporter SLC6A3
    GQ8 (-)-Hyoscyamine Beta-2 adrenergic receptor ADRB2
    GQ8 (-)-Hyoscyamine Sodium-dependent serotonin transporter SLC6A4
    GQ8 (-)-Hyoscyamine D(2) dopamine receptor DRD5
    GQ8 (-)-Hyoscyamine Mu-type opioid receptor OPRM1
    GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 1B receptor HTR1B
    GQ8 (-)-Hyoscyamine Histamine H1 receptor HRH1
    GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 1A receptor HTR1A
    GQ9 campesterol Progesterone receptor PGR
    GQ10 cyanin Prostaglandin G/H synthase 2 PTGS2
    GQ10 cyanin Heat shock protein HSP 90-alpha HSP90AA1
    GQ11 24-methylidenelophenol Progesterone receptor PGR
    GQ11 24-methylidenelophenol Mineralocorticoid receptor NR3C2
    GQ12 daucosterol_qt Progesterone receptor PGR
    GQ13 glycitein Prostaglandin G/H synthase 1 PTGS1
    GQ13 glycitein Estrogen receptor ESR1
    GQ13 glycitein Androgen receptor AR
    GQ13 glycitein Peroxisome proliferator-activated receptor gamma PPARG
    GQ13 glycitein Prostaglandin G/H synthase 2 PTGS2
    GQ13 glycitein Retinoic acid receptor RXR-alpha RXRA
    GQ13 glycitein cGMP-inhibited 3',5'-cyclic phosphodiesterase A PDE3A
    GQ13 glycitein Estrogen receptor beta ESR2
    GQ13 glycitein Mitogen-activated protein kinase 14 MAPK14
    GQ13 glycitein Heat shock protein HSP 90-alpha HSP90AA1
    GQ13 glycitein Trypsin-1 PRSS1
    GQ13 glycitein Cyclin-A2 CCNA2
    GQ13 glycitein Nitric oxide synthase, inducible NOS2
    GQ13 glycitein Collagenase 3 MMP13
    GQ13 glycitein Neutrophil collagenase MMP8
    GQ14 CLR Progesterone receptor PGR
    GQ14 CLR Mineralocorticoid receptor NR3C2
    GQ15 14b-pregnane Prostaglandin G/H synthase 2 PTGS2
    GQ15 14b-pregnane Progesterone receptor PGR
    GQ16 24-ethylcholesta-5,22-dienol Progesterone receptor PGR
    GQ16 24-ethylcholesta-5,22-dienol Mineralocorticoid receptor NR3C2
    GQ17 Fucosterol Progesterone receptor PGR
    GQ17 Fucosterol Mineralocorticoid receptor NR3C2
    GQ18 31-norlanosterol Progesterone receptor PGR
    GQ18 31-norlanosterol Mineralocorticoid receptor NR3C2
    GQ19 4,24-methyllophenol Progesterone receptor PGR
    GQ20 Lophenol Progesterone receptor PGR
    GQ21 4alpha,14alpha,24-trimethylcholesta-8,24-dienol Progesterone receptor PGR
    GQ22 4alpha,24-dimethylcholesta-7,24-dienol Progesterone receptor PGR
    GQ22 4alpha,24-dimethylcholesta-7,24-dienol Mineralocorticoid receptor NR3C2
    GQ23 4alpha-methyl-24-ethylcholesta-7,24-dienol Progesterone receptor PGR
    GQ24 6-Fluoroindole-7-Dehydrocholesterol Progesterone receptor PGR
    GQ24 6-Fluoroindole-7-Dehydrocholesterol Mineralocorticoid receptor NR3C2
    GQ24 6-Fluoroindole-7-Dehydrocholesterol Glucocorticoid receptor NR3C1
    GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt Prostaglandin G/H synthase 2 PTGS2
    GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt DNA topoisomerase 2-alpha TOP2A
    GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt Heat shock protein HSP 90-alpha HSP90AA1
    GQ26 Atropine D(1A) dopamine receptor DRD1
    GQ26 Atropine Muscarinic acetylcholine receptor M3 CHRM3
    GQ26 Atropine D(1B) dopamine receptor DRD5
    GQ26 Atropine Beta-1 adrenergic receptor ADRB1
    GQ26 Atropine Sodium channel protein type 5 subunit alpha SCN5A
    GQ26 Atropine Alpha-2A adrenergic receptor ADRA2A
    GQ26 Atropine 5-hydroxytryptamine 1A receptor HTR1A
    GQ26 Atropine Alpha-2C adrenergic receptor ADRA2C
    GQ26 Atropine Delta-type opioid receptor OPRD1
    GQ26 Atropine Histamine H1 receptor HRH1
    GQ26 Atropine 5-hydroxytryptamine 2A receptor HTR2A
    GQ26 Atropine Sodium-dependent noradrenaline transporter SLC6A2
    GQ26 Atropine Muscarinic acetylcholine receptor M2 CHRM2
    GQ26 Atropine Alpha-2B adrenergic receptor ADRA2B
    GQ26 Atropine Alpha-1B adrenergic receptor ADRA1B
    GQ26 Atropine Sodium-dependent dopamine transporter SLC6A3
    GQ26 Atropine Beta-2 adrenergic receptor ADRB2
    GQ26 Atropine Sodium-dependent serotonin transporter SLC6A4
    GQ26 Atropine D(2) dopamine receptor DRD5
    GQ26 Atropine Mu-type opioid receptor OPRM1
    GQ26 Atropine 5-hydroxytryptamine 1B receptor HTR1B
    GQ27 Physcion-8-O-beta-D-gentiobioside DNA topoisomerase 2-alpha TOP2A
    GQ28 lanost-8-en-3beta-ol Progesterone receptor PGR
    GQ28 lanost-8-en-3beta-ol Mineralocorticoid receptor NR3C2
    GQ29 Obtusifoliol Progesterone receptor PGR
    GQ29 Obtusifoliol Mineralocorticoid receptor NR3C2
    GQ30 quercetin Prostaglandin G/H synthase 1 PTGS1
    GQ30 quercetin Androgen receptor AR
    GQ30 quercetin Peroxisome proliferator-activated receptor gamma PPARG
    GQ30 quercetin Prostaglandin G/H synthase 2 PTGS2
    GQ30 quercetin Heat shock protein HSP 90-alpha HSP90AA1
    GQ30 quercetin Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit gamma isoform PIK3CG
    GQ30 quercetin Dipeptidyl peptidase 4 DPP4
    GQ30 quercetin Aldose reductase AKR1B1
    GQ30 quercetin Trypsin-1 PRSS1
    GQ30 quercetin DNA topoisomerase 2-alpha TOP2A
    GQ30 quercetin Prothrombin F2
    GQ30 quercetin Potassium voltage-gated channel subfamily H member 2 KCNH2
    GQ30 quercetin Sodium channel protein type 5 subunit alpha SCN5A
    GQ30 quercetin Coagulation factor X F10
    GQ30 quercetin Beta-2 adrenergic receptor ADRB2
    GQ30 quercetin Stromelysin-1 MMP3
    GQ30 quercetin Coagulation factor VII F7
    GQ30 quercetin Nitric-oxide synthase, endothelial NOS3
    GQ30 quercetin Retinoic acid receptor RXR-alpha RXRA
    GQ30 quercetin Acetylcholinesterase ACHE
    GQ30 quercetin Amine oxidase [flavin-containing] B MAOB
    GQ30 quercetin Transcription factor p65 RELA
    GQ30 quercetin Epidermal growth factor receptor EGFR
    GQ30 quercetin RAC-alpha serine/threonine-protein kinase AKT1
    GQ30 quercetin G1/S-specific cyclin-D1 CCND1
    GQ30 quercetin Apoptosis regulator Bcl-2 BCL2
    GQ30 quercetin Bcl-2-like protein 1 BCL2L1
    GQ30 quercetin Proto-oncogene c-Fos FOS
    GQ30 quercetin Cyclin-dependent kinase inhibitor 1 CDKN1A
    GQ30 quercetin Apoptosis regulator BAX BAX
    GQ30 quercetin Caspase-9 CASP9
    GQ30 quercetin Urokinase-type plasminogen activator PLAU
    GQ30 quercetin 72 kDa type IV collagenase MMP2
    GQ30 quercetin Matrix metalloproteinase-9 MMP9
    GQ30 quercetin Mitogen-activated protein kinase 1 MAPK1
    GQ30 quercetin Interleukin-10 IL10
    GQ30 quercetin Retinoblastoma-associated protein RB1
    GQ30 quercetin Tumor necrosis factor TNF
    GQ30 quercetin Transcription factor AP-1 JUN
    GQ30 quercetin Interleukin-6 IL6
    GQ30 quercetin Caspase-3 CASP3
    GQ30 quercetin Cellular tumor antigen p53 TP53
    GQ30 quercetin NF-kappa-B inhibitor alpha NFKBIA
    GQ30 quercetin Xanthine dehydrogenase/oxidase XDH
    GQ30 quercetin Caspase-8 CASP8
    GQ30 quercetin RAF proto-oncogene serine/threonine-protein kinase RAF1
    GQ30 quercetin Superoxide dismutase [Cu-Zn] SOD1
    GQ30 quercetin Protein kinase C alpha type PRKCA
    GQ30 quercetin Interstitial collagenase MMP1
    GQ30 quercetin Hypoxia-inducible factor 1-alpha HIF1A
    GQ30 quercetin Signal transducer and activator of transcription 1-alpha/beta STAT1
    GQ30 quercetin Cell division control protein 2 homolog CDK1
    GQ30 quercetin Peroxisome proliferator-activated receptor gamma PPARG
    GQ30 quercetin Heme oxygenase 1 HMOX1
    GQ30 quercetin Cytochrome P450 3A4 CYP3A4
    GQ30 quercetin Caveolin-1 CAV1
    GQ30 quercetin Myc proto-oncogene protein MYC
    GQ30 quercetin Tissue factor F3
    GQ30 quercetin Gap junction alpha-1 protein GJA1
    GQ30 quercetin Cytochrome P450 1A1 CYP1A1
    GQ30 quercetin Intercellular adhesion molecule 1 ICAM1
    GQ30 quercetin Interleukin-1 beta IL1B
    GQ30 quercetin Small inducible cytokine A2 CCL2
    GQ30 quercetin E-selectin SELE
    GQ30 quercetin Vascular cell adhesion protein 1 VCAM1
    GQ30 quercetin Prostaglandin E2 receptor, EP3 subtype PTGER3
    GQ30 quercetin Interleukin-8 CXCL8
    GQ30 quercetin Nitric oxide synthase, endothelial NOS3
    GQ30 quercetin Heat shock protein beta-1 HSPB1
    GQ30 quercetin Transforming growth factor beta-1 TGFB1
    GQ30 quercetin Maltase-glucoamylase, intestinal MGAM
    GQ30 quercetin Interleukin-2 IL2
    GQ30 quercetin Cytochrome P450 1B1 CYP1B1
    GQ30 quercetin Tissue-type plasminogen activator PLAT
    GQ30 quercetin Thrombomodulin THBD
    GQ30 quercetin Plasminogen activator inhibitor 1 SERPINE1
    GQ30 quercetin Interferon gamma IFNG
    GQ30 quercetin Arachidonate 5-lipoxygenase ALOX5
    GQ30 quercetin Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase and dual-specificity protein phosphatase PTEN PTEN
    GQ30 quercetin Interleukin-1 alpha IL1A
    GQ30 quercetin Myeloperoxidase MPO
    GQ30 quercetin DNA topoisomerase 2-alpha TOP2A
    GQ30 quercetin Neutrophil cytosol factor 1 NCF1
    GQ30 quercetin Nuclear factor erythroid 2-related factor 2 NFE2L2
    GQ30 quercetin NAD(P)H dehydrogenase [quinone] 1 NQO1
    GQ30 quercetin Poly [ADP-ribose] polymerase 1 PARP1
    GQ30 quercetin Aryl hydrocarbon receptor AHR
    GQ30 quercetin Solute carrier family 2, facilitated glucose transporter member 4 SLC2A4
    GQ30 quercetin Collagen alpha-1(III) chain COL3A1
    GQ30 quercetin C-X-C motif chemokine 11 CXCL11
    GQ30 quercetin C-X-C motif chemokine 2 CXCL2
    GQ30 quercetin Serine/threonine-protein kinase Chk2 CHEK2
    GQ30 quercetin Insulin receptor INSR
    GQ30 quercetin Peroxisome proliferator-activated receptor alpha PPARA
    GQ30 quercetin Peroxisome proliferator-activated receptor delta PPARD
    GQ30 quercetin C-reactive protein CRP
    GQ30 quercetin C-X-C motif chemokine 10 CXCL10
    GQ30 quercetin Inhibitor of nuclear factor kappa-B kinase subunit alpha CHUK
    GQ30 quercetin Osteopontin SPP1
    GQ30 quercetin Runt-related transcription factor 2 RUNX2
    GQ30 quercetin Ras association domain-containing protein 1 RASSF1
    GQ30 quercetin Cathepsin D CTSD
    GQ30 quercetin Insulin-like growth factor-binding protein 3 IGFBP3
    GQ30 quercetin Insulin-like growth factor II IGF2
    GQ30 quercetin CD40 ligand CD40LG
    GQ30 quercetin Receptor tyrosine-protein kinase erbB-3 ERBB3
    GQ30 quercetin Serum paraoxonase/arylesterase 1 PON1
    GQ30 quercetin Type I iodothyronine deiodinase DIO1
    GQ30 quercetin Ras GTPase-activating protein 1 RASA1
    GQ30 quercetin Glutathione S-transferase Mu 1 GSTM1
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    S6.   Methodological quality assessment of the studies included

    Quality score criterionPeer-reviewed publication Control of temperature Random allocation to treatment or controlBlinded induction of modelBlinded assessment of outcomeUse of anesthetic without significant intrinsic neuroprotective activityAppropriate animal model Sample size calculationCompliance with animal welfare regulationsStatement of potential conflict of interestsTotal
    Yang 2019 (30)00100010103
    Cao 2018 (17)00100010103
    Ji et al. 2011 (18)11100110106
    Ding et al. 2001 (29)10100010104
    Qin et al. 2009 (27)10100010104
    Hu et al. 2008 (21)11100010105
    Liu et al. 2011 (19)10100010104
    Yi et al. 2010 (26)10100010104
    Wang et al. 2002 (24)10100010104
    Liu 2019 (22)01100010104
    Yang et al. 2018 (20)11100010105
    Ma 2019 (23)10100010104
    Niu et al. 1994 (25)10100010104
    Wu et al. 2008 (9)11100010105
    Wang et al. 2017 (28)10100010104
      Note. As showed in Supplementary Table S6, the quality score of the included studies ranged from 3 to 5 and the average quality score was 4.2 points. All studies randomly allocated animals to the control group and the treatment group, adopted appropriate animal models and compliance with animal welfare regulations. However, the method of blinded induction of model and blinded assessment of outcome were not involved in those included studies. In addition, there was no statement of potential conflict of interests in those articles.
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    S7.   Meta-analysis for each sub-outcome measure

    Outcome Meta-analysis of outcome Test of heterogeneity Model used
    SMD 95% CI P I2 P
    Blood lactates −1.58 −1.58 to −0.97 < 0.01 80% < 0.01 Random-effects
    Muscle glycogen 0.85 0.04 to 1.67 < 0.01 76% < 0.01 Random-effects
    Liver glycogen 0.91 0.40 to 1.41 < 0.01 60% < 0.01 Random-effects
    SOD 1.30 0.45 to 2.14 < 0.01 78% < 0.01 Random-effects
    MAD −0.84 −1.18 to −0.05 < 0.01 32% 0.18 Fixed-effects
      Note. SMD, standardized mean difference; I2, I-squared statistic; CI, confidence interval; SOD, superoxide dismutase; MAD, malondialdehyde.
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    S3.   Information of targets of exercise-induced fatigue

    DegreeNameNeighborhood connectivity
    117MAPK115.31624
    98AKT116.81633
    84RAF115.54762
    77RELA19.09091
    68TNF16.77941
    66PRKCA15.04545
    62MAPK1416.27419
    57JUN19.52632
    54CHUK20.48148
    52BAX19.34615
    52IL619.55769
    51TP5319.23529
    50NFKBIA20.4
    48EGFR17.8125
    47CCND118.76596
    46CASP321.08696
    46FOS20.28261
    45IL1B18.93333
    44BCL220.56818
    42CDKN1A19.33333
    38CASP822.10526
    37CASP921.48649
    36TGFB119.75
    35MYC20.45714
    34CXCL821.73529
    32IFNG18.5625
    30PGR6.625
    30PTGS218.43333
    30STAT122.1
    29BCL2L121.2069
    26RB123
    26PTEN20.80769
    23INSR15.65217
    22IL1017.18182
    22IL1A21.04545
    21IL220.33333
    20HSP90AA123.8
    19RXRA24.36842
    19NOS322.33333
    18NOS217.61111
    18CCL225.5
    17MMP927.76471
    17ICAM123.70588
    15NR3C23.714286
    15CXCL223.86667
    14ADRB223.57143
    14ADRB114.85714
    14HIF1A23.78571
    14CD40LG18.71429
    13CHRM315.92308
    13DRD114.53846
    13PPARG25.16667
    13CCNA219.23077
    13PIK3CG22.84615
    13CXCL1024.46154
    12MMP228.16667
    12NCF124.75
    11MAOB18.45455
    11GSTM126.45455
    10PTGS121.3
    10SLC6A313.2
    10MAOA9.6
    10CHRM219.6
    10ADRA1B17
    10VCAM127.6
    10PPARA25.3
    9HTR2A18.11111
    9CHRNA719.66667
    9ESR121.44444
    9F228.44444
    9SOD122.55556
    9MMP132.66667
    9CDK123.44444
    9CYP1A124.44444
    9CYP1B122.44444
    9SERPINE126
    8PLAU29.5
    8GABRA313.125
    8ESR220.5
    8MMP333.375
    8SELE31.5
    8NFE2L235.375
    8SLC2A422.125
    8ERBB329.625
    7GABRA511.71429
    7DRD518.16667
    7HMOX137.71429
    7CYP3A422.85714
    7PTGER336
    7COL3A128.42857
    7SPP128.85714
    7RASSF132
    7CTSD29.28571
    7IGF237.57143
    6PDE3A14.66667
    6OPRM119.5
    6HTR1B17
    6HTR1A17
    6AR38
    6PRSS129.66667
    6CAV131.83333
    6PLAT32.66667
    6ALOX526.83333
    5ADRA2A20.4
    5SCN5A38
    5SLC6A417.2
    5OPRD118.8
    5HRH117.4
    5TOP2A31
    5MPO30.2
    5NQO145.8
    5PARP134
    5AHR36.4
    5CXCL1133
    5CHEK235.2
    5PPARD36.4
    5IGFBP334.2
    4SLC6A216.5
    4ADRA2C19.75
    4ADRA2B19.75
    4MMP1317.25
    4HSPB138.75
    4THBD43.25
    4RASA137
    3XDH38.66667
    3F348
    3RUNX245.66667
    2AKR1B165
    2LTA4H14
    2KCNH268
    2CHRNA227
    2PON168
    2NR3C114
    2DPP455.5
    2F1058
    2F758
    2ACHE59
    2GJA158.5
    2DIO160.5
    1IGHG123
    1MAP229
    1MMP815
    1MGAM107
    1CRP107
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    S4.   Information of pathways of exercise-induced fatigue

    Pathway Description Degree Neighborhood connectivity
    hsa05200 Pathways in cancer 51 35.80392
    hsa05417 Lipid and atherosclerosis 37 41.48649
    hsa05418 Fluid shear stress and atherosclerosis 29 35.62069
    hsa04933 AGE-RAGE signaling pathway in diabetic complications 28 44.89286
    hsa05207 Chemical carcinogenesis - receptor activation 28 39.89286
    hsa05161 Hepatitis B 27 56.66667
    hsa05167 Kaposi sarcoma-associated herpesvirus infection 27 52.66667
    hsa04151 PI3K-Akt signaling pathway 27 46.33333
    hsa05163 Human cytomegalovirus infection 26 57
    hsa04080 Neuroactive ligand-receptor interaction 25 15.12
    hsa04657 IL-17 signaling pathway 24 46.25
    hsa04668 TNF signaling pathway 23 49.73913
    hsa05160 Hepatitis C 23 55.30435
    hsa05164 Influenza A 23 54.52174
    hsa05169 Epstein-Barr virus infection 23 52.47826
    hsa05166 Human T-cell leukemia virus 1 infection 23 52.91304
    hsa04010 MAPK signaling pathway 23 54.6087
    hsa05205 Proteoglycans in cancer 22 49.04545
    hsa05208 Chemical carcinogenesis - reactive oxygen species 22 45.72727
    hsa05022 Pathways of neurodegeneration - multiple diseases 22 51.18182
    hsa05215 Prostate cancer 21 50.66667
    hsa05142 Chagas disease 21 54.85714
    hsa05145 Toxoplasmosis 21 51.85714
    hsa04218 Cellular senescence 21 49.90476
    hsa05152 Tuberculosis 21 56.42857
    hsa05171 Coronavirus disease - COVID-19 21 51.52381
    hsa05132 Salmonella infection 21 61.42857
    hsa05162 Measles 20 54.7
    hsa05225 Hepatocellular carcinoma 20 49.65
    hsa05165 Human papillomavirus infection 20 57.6
    hsa05222 Small cell lung cancer 19 51.52632
    hsa04926 Relaxin signaling pathway 19 53.89474
    hsa04210 Apoptosis 19 60.94737
    hsa04932 Non-alcoholic fatty liver disease 19 52.36842
    hsa05202 Transcriptional misregulation in cancer 19 35.05263
    hsa05170 Human immunodeficiency virus 1 infection 19 64.84211
    hsa05206 MicroRNAs in cancer 19 46.84211
    hsa01522 Endocrine resistance 18 56.55556
    hsa04620 Toll-like receptor signaling pathway 18 58.38889
    hsa04659 Th17 cell differentiation 18 51.94444
    hsa04621 NOD-like receptor signaling pathway 18 56
    hsa04024 cAMP signaling pathway 18 45.5
    hsa05010 Alzheimer disease 18 57.16667
    hsa05168 Herpes simplex virus 1 infection 18 56.61111
    hsa05140 Leishmaniasis 17 54.23529
    hsa04625 C-type lectin receptor signaling pathway 17 64.88235
    hsa04380 Osteoclast differentiation 17 59.76471
    hsa04915 Estrogen signaling pathway 17 47.82353
    hsa05224 Breast cancer 17 56.94118
    hsa05130 Pathogenic Escherichia coli infection 17 61.29412
    hsa05415 Diabetic cardiomyopathy 17 40.11765
    hsa04020 Calcium signaling pathway 17 27.41176
    hsa05212 Pancreatic cancer 16 64.125
    hsa05210 Colorectal cancer 16 64.875
    hsa04064 NF-kappa B signaling pathway 16 43.625
    hsa04066 HIF-1 signaling pathway 16 53.9375
    hsa05135 Yersinia infection 16 63.6875
    hsa05131 Shigellosis 16 67.75
    hsa04115 p53 signaling pathway 15 42.53333
    hsa05220 Chronic myeloid leukemia 15 66.4
    hsa05235 PD-L1 expression and PD-1 checkpoint pathway in cancer 15 66.2
    hsa05323 Rheumatoid arthritis 15 43.8
    hsa05146 Amoebiasis 15 48
    hsa04660 T cell receptor signaling pathway 15 66.66667
    hsa04071 Sphingolipid signaling pathway 15 64.86667
    hsa04068 FoxO signaling pathway 15 61.13333
    hsa04936 Alcoholic liver disease 15 59.6
    hsa04022 cGMP-PKG signaling pathway 15 40.86667
    hsa04062 Chemokine signaling pathway 15 54.53333
    hsa04060 Cytokine-cytokine receptor interaction 15 39.66667
    hsa05219 Bladder cancer 14 51.92857
    hsa05223 Non-small cell lung cancer 14 63.71429
    hsa05133 Pertussis 14 61.71429
    hsa04726 Serotonergic synapse 14 43.14286
    hsa04919 Thyroid hormone signaling pathway 14 57.64286
    hsa05226 Gastric cancer 14 64.07143
    hsa04630 JAK-STAT signaling pathway 14 55.85714
    hsa05203 Viral carcinogenesis 14 58.78571
    hsa05144 Malaria 13 42.61538
    hsa01524 Platinum drug resistance 13 59
    hsa04014 Ras signaling pathway 13 62.46154
    hsa05020 Prion disease 13 55.84615
    hsa05213 Endometrial cancer 12 69.58333
    hsa05321 Inflammatory bowel disease 12 55
    hsa05214 Glioma 12 71.25
    hsa01521 EGFR tyrosine kinase inhibitor resistance 12 68.5
    hsa04921 Oxytocin signaling pathway 12 63.83333
    hsa04510 Focal adhesion 12 66.5
    hsa05012 Parkinson disease 12 39.5
    hsa05134 Legionellosis 11 60
    hsa05221 Acute myeloid leukemia 11 66.63636
    hsa04917 Prolactin signaling pathway 11 70.54545
    hsa05218 Melanoma 11 71.72727
    hsa04658 Th1 and Th2 cell differentiation 11 67.63636
    hsa04928 Parathyroid hormone synthesis, secretion and action 11 61
    hsa04931 Insulin resistance 11 57.09091
    hsa04725 Cholinergic synapse 11 56
    hsa04722 Neurotrophin signaling pathway 11 80.90909
    hsa04371 Apelin signaling pathway 11 55.90909
    hsa04261 Adrenergic signaling in cardiomyocytes 11 58.27273
    hsa04217 Necroptosis 11 50.36364
    hsa05014 Amyotrophic lateral sclerosis 11 55.81818
    hsa05143 African trypanosomiasis 10 51.8
    hsa04370 VEGF signaling pathway 10 71.4
    hsa05120 Epithelial cell signaling in Helicobacter pylori infection 10 64.1
    hsa04012 ErbB signaling pathway 10 75.3
    hsa04540 Gap junction 10 56
    hsa04061 Viral protein interaction with cytokine and cytokine receptor 10 44.6
    hsa04110 Cell cycle 10 46.2
    hsa04728 Dopaminergic synapse 10 52
    hsa04072 Phospholipase D signaling pathway 10 69
    hsa05216 Thyroid cancer 9 63.66667
    hsa04920 Adipocytokine signaling pathway 9 64.66667
    hsa04622 RIG-I-like receptor signaling pathway 9 66
    hsa05230 Central carbon metabolism in cancer 9 74.55556
    hsa04662 B cell receptor signaling pathway 9 86.77778
    hsa04610 Complement and coagulation cascades 9 26.77778
    hsa05231 Choline metabolism in cancer 9 80.88889
    hsa04914 Progesterone-mediated oocyte maturation 9 69.44444
    hsa04935 Growth hormone synthesis, secretion and action 9 78.44444
    hsa04611 Platelet activation 9 59.11111
    hsa04140 Autophagy - animal 9 68.55556
    hsa04150 mTOR signaling pathway 9 81.55556
    hsa04613 Neutrophil extracellular trap formation 9 79.88889
    hsa04923 Regulation of lipolysis in adipocytes 8 49.25
    hsa05416 Viral myocarditis 8 50.375
    hsa04664 Fc epsilon RI signaling pathway 8 87.375
    hsa05211 Renal cell carcinoma 8 80.75
    hsa05031 Amphetamine addiction 8 51.375
    hsa04912 GnRH signaling pathway 8 80.5
    hsa04670 Leukocyte transendothelial migration 8 49.25
    hsa04650 Natural killer cell mediated cytotoxicity 8 78.5
    hsa04015 Rap1 signaling pathway 8 87
    hsa05016 Huntington disease 8 55.375
    hsa04215 Apoptosis - multiple species 7 63.42857
    hsa05332 Graft-versus-host disease 7 62.57143
    hsa05030 Cocaine addiction 7 53.71429
    hsa04623 Cytosolic DNA-sensing pathway 7 69.85714
    hsa04929 GnRH secretion 7 82.57143
    hsa04211 Longevity regulating pathway 7 73
    hsa05032 Morphine addiction 7 43.42857
    hsa04152 AMPK signaling pathway 7 57
    hsa04723 Retrograde endocannabinoid signaling 7 69.71429
    hsa04934 Cushing syndrome 7 69
    hsa04310 Wnt signaling pathway 7 65.57143
    hsa05034 Alcoholism 7 63.28571
    hsa04810 Regulation of actin cytoskeleton 7 68.42857
    hsa01523 Antifolate resistance 6 82.33333
    hsa05330 Allograft rejection 6 59.16667
    hsa04940 Type I diabetes mellitus 6 64.33333
    hsa04672 Intestinal immune network for IgA production 6 57.16667
    hsa04913 Ovarian steroidogenesis 6 45.83333
    hsa05204 Chemical carcinogenesis - DNA adducts 6 44
    hsa04137 Mitophagy - animal 6 71
    hsa03320 PPAR signaling pathway 6 42.16667
    hsa04742 Taste transduction 6 39.66667
    hsa04970 Salivary secretion 6 52.5
    hsa04350 TGF-beta signaling pathway 6 81
    hsa04666 Fc gamma R-mediated phagocytosis 6 95.83333
    hsa04750 Inflammatory mediator regulation of TRP channels 6 64.16667
    hsa04114 Oocyte meiosis 6 69.33333
    hsa04910 Insulin signaling pathway 6 88
    hsa04550 Signaling pathways regulating pluripotency of stem cells 6 99
    hsa04390 Hippo signaling pathway 6 55.33333
    hsa04960 Aldosterone-regulated sodium reabsorption 5 83.6
    hsa00380 Tryptophan metabolism 5 47.4
    hsa04930 Type II diabetes mellitus 5 82.8
    hsa00330 Arginine and proline metabolism 5 51
    hsa00590 Arachidonic acid metabolism 5 49.2
    hsa00982 Drug metabolism - cytochrome P450 5 47.4
    hsa00980 Metabolism of xenobiotics by cytochrome P450 5 46.8
    hsa00983 Drug metabolism - other enzymes 5 44.8
    hsa04640 Hematopoietic cell lineage 5 77
    hsa04270 Vascular smooth muscle contraction 5 95
    hsa05322 Systemic lupus erythematosus 5 66.8
    hsa04514 Cell adhesion molecules 5 49.4
    hsa04141 Protein processing in endoplasmic reticulum 5 64.4
    hsa04360 Axon guidance 5 93.8
    hsa05310 Asthma 4 75.5
    hsa05033 Nicotine addiction 4 55.5
    hsa05320 Autoimmune thyroid disease 4 63.75
    hsa04730 Long-term depression 4 116.25
    hsa00140 Steroid hormone biosynthesis 4 55.75
    hsa04213 Longevity regulating pathway - multiple species 4 82
    hsa05217 Basal cell carcinoma 4 85.75
    hsa04720 Long-term potentiation 4 116.25
    hsa04924 Renin secretion 4 58
    hsa04520 Adherens junction 4 96.5
    hsa04612 Antigen processing and presentation 4 79.5
    hsa04721 Synaptic vesicle cycle 4 54.25
    hsa04146 Peroxisome 4 57
    hsa04727 GABAergic synapse 4 69.75
    hsa05410 Hypertrophic cardiomyopathy 4 88.5
    hsa05414 Dilated cardiomyopathy 4 79
    hsa04713 Circadian entrainment 4 106.75
    hsa04916 Melanogenesis 4 116.25
    hsa04972 Pancreatic secretion 4 70.75
    hsa04974 Protein digestion and absorption 4 53.25
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    S5.   Summary of studies included in the systematic review

    StudyInformation of aninmalsType of Fructus LyciiIntervention vs. controlTime of interventionOutcome measures used
    Yang 2019Kunming mice, weighing 12–22 g, half-male and half-female, SPFDecoction of Fructus Lycii3 mg/(g∙d) (n = 10) vs. 6 mg/(g∙d) (n = 10) vs. Placebo (distilled water 0.02 mL/(g∙d), n = 10)30 daysMDA, ROS, SOD, CAT, GSH-Px
    Cao 2018Kunming mice, weighing 18–22 g, half-male and half-female, SPFDecoction of Fructus Lycii
    3 mg/(g∙d) (n = 10) vs. 6 mg/(g∙d) (n = 10) vs. Placebo (distilled water 0.02 mL/(g∙d), n = 10)30 daysThe time of exhaustive swimming, blood glucose, muscle glycogen and liver glycogen, BUN and lactic acid
    Ji et al 2011Eight-week-old Wistar rats, weighing 220 ± 23.19 g, femaleDecoction of Fructus LyciiDecoction of Fructus Lycii (n = 8) vs. Placebo (n = 8)30 daysThe time of exhaustive swimming, SOD, MAD
    Ding et al 2001Kunming mice, weighing 20–24 g, maleDecoction of Fructus LyciiDecoction of Fructus Lycii (n = 10) vs. Placebo (n = 10)2 weeksThe time of exhaustive swimming, SOD, MAD
    Qin et al 2009miceExtract of Fructus Lycii5 mg/(g∙d) (n = 10) vs. 10 mg/(g∙d) (n = 10) vs. 20 mg/(g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)2 weeksThe time of exhaustive swimming
    Hu et al 2008Kunming mice, weighing 18–22 g, femaleRaw juice of Fructus Lycii10 mL/(kg∙d) (n = 10) vs. 20 mL/(kg∙d) (n = 10) vs. 30 mL/(kg∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)3 weeksThe time of exhaustive swimming, and liver glycogen,BUN
    Liu et al 2011Kunming mice, weighing 24 ± 5 g, femaleDecoction of Fructus Lycii5 mg/(g∙d) (n = 10) vs. Placebo (Equivalent distilled water, n = 10)10 daysThe time of exhaustive swimming
    Yi et al 2010Kunming mice, weighing 24 ± 5 g, half-male and half-femaleDecoction of Fructus Lycii5 mg/(g∙d) (n = 10) vs. 2.5 mg/(g∙d) (n = 10) vs. Placebo(Equivalent running water, n = 10)2 weeksThe time of exhaustive swimming
    Wang et al 2002Kunming mice, weighing 20 ± 2 g, male and femaleDecoction of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. 0.1 mL/10 (g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)1 weekThe time of exhaustive swimming
    Liu 2019Kunming mice, 6 week, maleExtract of Fructus Lycii0.3 mg/(g∙d) (n = 10) vs. 0.6 mg/(g∙d) (n = 10) vs. 0.9 mg/(g∙d) (n = 10) vs. Placebo (n = 10)2 weeksThe time of exhaustive swimming, muscle glycogen and liver glycogen, BUN and lactic acid, SOD, MDA
    Yang et al 2018Kunming mice, weighing 18–22 g, male, SPFExtract of Fructus Lycii0.5 mg/(g∙d) (n = 10) vs. 1 mg/g/d (n = 10) vs. 1.5 mg/(g∙d) (n = 10) vs. Placebo (n = 10)30 daysThe time of exhaustive swimming, muscle glycogen and liver glycogen, BUN and lactic acid
    Ma 2019Rats, SPFFruit of Fructus Lycii0.5g/(kg∙d) (n = 10) vs. 3g/(kg∙d) (n = 15) vs. Placebo (5 mL/kg saline, n = 15)6 weeksThe time of exhaustive swimming
    Niu et al. 1994Kunming mice, weighing 18–24 g, half-male and half-female, SPFDecoction of Fructus Lycii5g/(kg∙d) (n = 10) vs. 2.5/(kg∙d) (n = 10) vs. Placebo (Equivalent running water, n = 10)2 weeksThe time of exhaustive swimming, blood glucose, and lactic acid
    Wu et al. 2008Kunming mice, 3 week, weighing 18–22 g,femaleRaw juice of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. 0.25 mL/10 (g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)3 weeksThe time of exhaustive swimming, BUN and lactic acid
    Wang et al. 2017Kunming mice, weighing 60–80 g, femaleExtract of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. Placebo (n = 10)3 weeksThe time of exhaustive swimming
      Note. MDA, malondialdehyde; ROS, reactive oxygen species; SOD, superoxide dismutase; CAT, catalase; GSH-Px, glutathione peroxidase; BUN, blood urea nitrogen. A total 15 RCTs studies included, the information in detail were showed in the Supplementary Table S5. The exhaustive time, which the main parameter of anti-exercise-fatigue ability, were assessed in 14 articles. blood lactate (included in 6 articles) and BUN (included in 5 articles) were the main product of exercise metabolism and important marker for the evaluation of exercise fatigue. As the important energy source, muscle glycogen was included in 2 articles and liver glycogen in 3 articles. SOD (in 3 articles) and MAD (in 4 articles) also were the important outcomes included in our study. Based on the placebo group, the experimental group received decoction of Fructus Lycii (8 articles), extract of Fructus Lycii (4 articles), raw juice of Fructus Lycii (2 articles) and fruit of Fructus Lycii (1 article). Treatment duration ranged from 10 to 42 days.
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  • 收稿日期:  2023-06-07
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  • 刊出日期:  2024-01-20

The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification

doi: 10.3967/bes2024.005
    基金项目:  This research was funded by China’s National Key R&D Programmers for “Hi-Tech Winter Olympics” Special Project [2020YFF0305001].
    作者简介:

    JI Xiao Ning, female, born in 1993, PhD Candidate, majoring in homology of medicine and food

    通讯作者: LU Jiang, Professor, PhD, E-mail: lujiang_cfsa1234@126.comZHANG Lei, Professor, PhD, Tel: 86-10-52165560, E-mail: zhanglei@cfsa.net.cn
注释:
1) CONFLICTS OF INTEREST:

English Abstract

JI Xiao Ning, LIU Zhao Ping, ZHANG Chao Zheng, CHEN Min, LIANG Jiang, LU Jiang, ZHANG Lei. The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification[J]. Biomedical and Environmental Sciences, 2024, 37(1): 42-53. doi: 10.3967/bes2024.005
Citation: JI Xiao Ning, LIU Zhao Ping, ZHANG Chao Zheng, CHEN Min, LIANG Jiang, LU Jiang, ZHANG Lei. The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification[J]. Biomedical and Environmental Sciences, 2024, 37(1): 42-53. doi: 10.3967/bes2024.005
    • Exercise-induced fatigue is a complex biological phenomenon that significantly impairs athletic performance and health. It is characterized by the inability to sustain a given level of physical activity or maintain a specific exercise intensity, resulting in sluggishness, poor coordination, insensitivity, memory impairment, and difficulty in concentrating. In addition, long-term fatigue has been associated with diseases, such as weakened immunity and cardiovascular diseases. The onset of fatigue is related to several factors, including energy depletion, accumulation of metabolites, oxidative stress, disruption of muscle calcium homeostasis, and central nervous system fatigue[1]. The current research indicates that the major mechanisms for alleviating exercise-induced fatigue involve enhancing energy substrate availability through increased glycogen synthesis, clearing fatigue-causing metabolites, improving mitochondrial function, regulating calcium homeostasis, inhibiting inflammatory responses, regulating neurotransmitters, and maintaining muscle proteins[2]. Several signal transduction pathways mainly MAPK, P13K-AKT, mTOR, AMPK, and NF-κB signaling pathways might be essential elements in the short- and long-term adaptations of the skeletal muscle to exercise-induced fatigue. The current study suggests that an aberrant MAPK signaling pathway impeding muscle regeneration may disrupt biochemical and metabolic processes in muscles, eventually leading to fatigue[3,4]. Additionally, studies have also shown that activation of the PI3K/AKT signaling pathway and increased glucose uptake through the glucose transporter GLUT4 is an effective way to increase energy supply and utilization in muscles[5]. Further research on the complex molecular events underlying fatigue will provide new insights into interventions and countermeasures to enhance exercise performance.

      Exercise fatigue is inevitable for professional athletes engaged in competitive sports and individuals who engage in regular exercise. Delaying the onset of exercise fatigue is crucial for improving physical performance, optimizing training outcomes, and reducing the risk of sports injuries. Numerous sports supplements are employed to reduce exercise fatigue and enhance exercise capacity. However, some of these supplements may pose potential health risks, such as gastrointestinal distress caused by sodium bicarbonate. Therefore, it is essential to identify anti-fatigue components or formulations with definite efficacy and fewer adverse effects. Traditional medicines, foods, and naturally active components such as Radix Rehmanniae preparata, Ginseng, and Astragalus membranaceus have been used effectively as healthcare products to relieve exercise fatigue[6,7]. The Homology of Medicine and Food, a special food category in China, can be used in both food and medicine. Compared to medicines, they possess more potent nutritional properties and are primarily used as tonics, which are characterized by a mild flavor and gentle nature. They are known to promote recovery, rehabilitation, and overall health. Fructus lycii (goji berry), a medicinal and food product, is usually preserved and consumed in its dried fruit form. Fructus lycii contains multiple active components, including polysaccharides, carotenoids, flavonoids, and phenolics[8]. Studies have confirmed that Fructus lycii has significant effects on the regulation of immune function, apoptosis, blood lipids, and blood glucose, as well as its anti-tumors, anti-aging, and anti-fatty liver disease properties[9]. Lately, researchers have begun to explore its potential to delay fatigue and enhance athletic performance[10]. Fructus lycii is a complex mixture containing multiple compounds that act on various targets; however, the active compounds and their mechanisms of action remain unclear. Network pharmacology, an emerging branch of pharmacology, provides a means to scrutinize the synergistic effects of multiple components and targets, particularly useful for investigating the potential mechanism of traditional Chinese medicine (TCM) in disease treatment[11].

      We hypothesized that the presence of multiple active components of Fructus lycii and their associated mechanisms may contribute to the alleviation of exercise fatigue. Therefore, the main purpose of this study was to explore the complex interplay between Fructus lycii and exercise fatigue using network pharmacology. Subsequently, in vitro assays were performed on C2C12 cells to validate the effects and mechanisms of the representative components of Fructus lycii predicted by network analysis to improve exercise fatigue.

    • The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) was used to identify the major chemical components and their potential targets (accessed November 22, 2022). Relevant active compounds were screened for oral bioavailability (OB) ≥ 30%[12] and drug like index (DL) ≥ 0.18 of component[13]. In this study, the predicted targets of the main components of Fructus lycii were retrieved from TCMSP. The target protein was mapped to its corresponding gene name using the UniProt human database.

    • The corresponding targets of disease related to fatigue were retrieved from the Therapeutic Target Database (TTD), Online Mendelian Inheritance in Man (OMIM), Drug bank and Gene card using the exercise fatigue-related search terms including “exercise fatigue” “physical fatigue” “fatigue” and “exercise capacity” (accessed on November 22, 2022).

      The intersection targets of compounds and disease were considered potential targets of Fructus lycii in the treatment of exercise fatigue, as represented by the Venn diagram in Supplementary Figure S1, available in www.besjournal.com.

      Figure S1.  Venn diagram of Fructus Lycii/exercise-induced fatigue related targets.

    • The intersection targets of the main components of Fructus lycii and exercise fatigue were imported into the Metascape database (http://metascape.org/gp/index.html). The Gene Ontology (GO) enrichment analysis included three aspects: biological process (BP), molecular function (MF), and cellular component (CC) (accessed November 28, 2022). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was used for target pathway enrichment (accessed November 28, 2022). GO enrichment and KEGG pathway analyses were carried out with P < 0.05 as the screening condition. Finally, the top 10 GO terms and the top 20 KEGG terms were screened with the lowest P value and represented as visual graphs using R 4.1.1 software or Bioinformatics (http://www.bioinformatics.com.cn).

    • The “Network Analyzer” function of Cytoscape 3.8.2 was used to calculate the network parameters of each node, protein, gene, active component, or pathway. The effective active compounds and their corresponding intersection targets of exercise fatigue were imported into Cystoscope 3.8.2, to construct an active compound-target network. The intersection targets, effective active compounds, and KEGG pathway enrichment in the Metascape database (P < 0.05) were imported into Cystoscope 3.8.2, to construct an active compound-targets-pathways network. The “degree” value represents the number of one node associated with the other nodes in the network. The larger the degree value, the more important the node is in the network, and the more likely it is to become a core node.

    • Skeletal muscle C2C12 cells (Pythonbio) were cultured in Dulbecco’s modified Eagle medium (DMEM) supplemented with 10% FBS (Gibco) and 1% penicillin-streptomycin (Gibco). At 90% confluence, the medium was changed to DMEM plus 2% horse serum (Gibco) and 1% penicillin-streptomycin for 6 days to induce C2C12 cells to differentiate into myotube cells, two days after the medium switch. The cells were cultured at 37 °C in a controlled humidified 5% CO2 atmosphere.

    • C2C12 myotubes were seeded in 96-well plates at a density of 10,000 cells per well and incubated overnight. The cells were treated with various concentrations (7.8125–1,000 μmol/L) of quercetin for 24 h. Cell proliferation was measured using the Cell Counting Kit-8 (CCK-8) assay (Dojindo Molecular Technologies, Kumamoto, Japan) by adding 10 μL CCK-8 reagent to each well after incubating at 37 °C for 1 h. Optical density (OD) was measured at 450 nm using a plate reader (BioTek, Synergy 4).

    • C2C12 myotubes were washed with phosphate buffer (PBS) and incubated in serum-free DMEM (Gibco) containing FBS for 4 h. After fasting, the cells were treated with 2-(N-(7-Nitrobenz-2-oxa-1,3-diazol-4-yl)Amino)-2-Deoxyglucose (2-NBDG) (ThermoFisher Science) at a concentration of 400 μm at 37 °C for 30 min[14]. The cells were washed twice with PBS and counterstained with Hoechst 33,342 for nucleic acid staining. The mean stained area was analyzed using Image Xpress software (Molecular Devices, San Jose, CA, USA).

    • After treatment, C2C12 myotubes were cultured with 100 μmol/L tert-butyl hydroperoxide (TBHP) as an ROS inducer for 30 min before labeling with CellRox Green reagent (ThermoFisher Science)[14]. Then, the cells were stained with CellRox Green reagent for 30 min at 37 °C. The subsequent procedure was similar to that described previously.

    • Mitochondrial membrane potential and mitochondrial mass were measured using the Image-iT™ TMRM reagent (ThermoFisher Scientific) and MitoTracker™ Green FM (Thermo Fisher Scientific), respectively, according to the manufacturer’s instructions[15]. Cells were washed twice with PBS, then loaded with TMRM staining or MitoTracker and Hoechst 33342 at 37 °C avoiding light for 30 min. The subsequent procedure was similar to that described previously.

    • C2C12 cells were fixed with fixative buffer (eBioscienceTM Fixation: Fixation/Permeabilization = 1:3) from the eBioscience™ Foxp3 (ThermoFisher Science) at 18–22 °C for 30 min. The cells were then washed twice with the permeabilization buffer. The cells were then incubated with the following primary antibodies: p-p38 MAPK (1:200, CST), p-MAPK (Erk1/2, 1:200, CST), p-PI3K (1:200, Affinity), p-AKT (1:400, CST), and p-JNK (1:200, CST) at 18–22 °C for 30 min. After washing twice with PBS, the cells were probed with the following secondary antibodies: Anti-mouse IgG or Anti-rabbit IgG (1:1,000, CST) for 1 h at 18–22 °C. After washing twice, the cells were stained with Hoechst 33,342 for 5 min, and the mean stained area was assessed using Image Xpress software[16].

    • The results are expressed as mean and standard deviation (SD). Statistical analyses were performed using GraphPad Prism 7.0 (GraphPad Software Inc., San Diego, CA, USA). Differences were analyzed using one-way analysis of variance (ANOVA), followed by Fisher’s least significant difference (LSD) multiple comparisons. Statistical significance was considered at P-values less than 0.05.

    • A total of 188 chemical components of Fructus lycii were identified, of which 45 had OB > 30% and DL > 0.18. After eliminating the duplicate targets, 45 components had 188 potential targets. The results are presented in Supplementary Table S1, available in www.besjournal.com.

      Table S1.  Potential active components of Fructus Lycii

      Molecule ID Molecule name OB (%) DL
      MOL001323 Sitosterol alpha1 43.2813 0.78354
      MOL003578 Cycloartenol 38.6857 0.78093
      MOL001494 Mandenol 41.9962 0.19321
      MOL001495 Ethyl linolenate 46.101 0.19716
      MOL001979 LAN 42.1192 0.74787
      MOL000449 Stigmasterol 43.8299 0.75665
      MOL000358 beta-sitosterol 36.9139 0.75123
      MOL005406 atropine 45.9706 0.19328
      MOL005438 campesterol 37.5768 0.71488
      MOL006209 cyanin 47.4209 0.75918
      MOL007449 24-methylidenelophenol 44.1926 0.7533
      MOL008173 daucosterol_qt 36.9139 0.75316
      MOL008400 glycitein 50.4789 0.23826
      MOL010234 delta-Carotene 31.8009 0.54639
      MOL000953 CLR 37.8739 0.67677
      MOL009604 14b-pregnane 34.7792 0.33723
      MOL009612 (24R)-4alpha-Methyl-24-ethylcholesta-7,25-dien-3beta-ylacetate 46.3575 0.8398
      MOL009615 24-Methylenecycloartan-3beta,21-diol 37.3173 0.79751
      MOL009617 24-ethylcholest-22-enol 37.0945 0.7511
      MOL009618 24-ethylcholesta-5,22-dienol 43.8299 0.75636
      MOL009620 24-methyl-31-norlanost-9(11)-enol 37.9997 0.75092
      MOL009621 24-methylenelanost-8-enol 42.3682 0.76769
      MOL009622 Fucosterol 43.7764 0.75668
      MOL009631 31-Norcyclolaudenol 38.6821 0.81391
      MOL009633 31-norlanost-9(11)-enol 38.3539 0.7249
      MOL009634 31-norlanosterol 42.2046 0.73012
      MOL009635 4,24-methyllophenol 37.8347 0.74999
      MOL009639 Lophenol 38.1294 0.714
      MOL009640 4alpha,14alpha,24-trimethylcholesta-8,24-dienol 38.9099 0.75772
      MOL009641 4alpha,24-dimethylcholesta-7,24-dienol 42.653 0.75297
      MOL009642 4alpha-methyl-24-ethylcholesta-7,24-dienol 42.2951 0.78304
      MOL009644 6-Fluoroindole-7-Dehydrocholesterol 43.726 0.72224
      MOL009646 7-O-Methylluteolin-6-C-beta-glucoside_qt 40.7737 0.30497
      MOL009650 Atropine 42.159 0.19299
      MOL009651 Cryptoxanthin monoepoxide 46.9537 0.56103
      MOL009653 Cycloeucalenol 39.7265 0.79446
      MOL009656 (E,E)-1-ethyl octadeca-3,13-dienoate 41.9962 0.19364
      MOL009660 methyl (1R,4aS,7R,7aS)-4a,7-dihydroxy-7-methyl-1-[(2S,3R,4S,5S,6R)-3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy-1,5,6,7a-tetrahydrocyclopenta[d]pyran-4-carboxylate 39.4285 0.46558
      MOL009662 Lantadene A 38.6794 0.57405
      MOL009664 Physalin A 91.7065 0.27207
      MOL009665 Physcion-8-O-beta-D-gentiobioside 43.9036 0.62426
      MOL009677 lanost-8-en-3beta-ol 34.2263 0.74036
      MOL009678 lanost-8-enol 34.2263 0.74167
      MOL009681 Obtusifoliol 42.552 0.7565
      MOL000098 quercetin 46.4333 0.27525
        Note. DL, Drug Like Index; OB, Oral Bioavailability.
    • There were 6,490 potential targets associated with exercise fatigue in the TTD, OMIM, Drug Bank, and Gene Card databases.

    • By considering the intersection targets of Fructus lycii components associated with exercise fatigue, a total of 144 targets were obtained, as shown in Supplementary Figure S1 and Supplementary Table S2 (available in www.besjournal.com).

      Table S2.  Information of intersection target of components and exercise-induced fatigue

      ID Molecule name Target name Gene name
      GQ1 Sitosterol alpha1 Progesterone receptor PGR
      GQ1 Sitosterol alpha1 Prostaglandin G/H synthase 2 PTGS2
      GQ1 Sitosterol alpha1 Mineralocorticoid receptor NR3C2
      GQ2 Cycloartenol Mineralocorticoid receptor NR3C2
      GQ3 Mandenol Prostaglandin G/H synthase 1 PTGS1
      GQ3 Mandenol Prostaglandin G/H synthase 2 PTGS2
      GQ4 Ethyl linolenate Prostaglandin G/H synthase 1 PTGS1
      GQ5 LAN Progesterone receptor PGR
      GQ5 LAN Mineralocorticoid receptor NR3C2
      GQ6 Stigmasterol Progesterone receptor PGR
      GQ6 Stigmasterol Mineralocorticoid receptor NR3C2
      GQ6 Stigmasterol Ig gamma-1 chain C region IGHG1
      GQ6 Stigmasterol Retinoic acid receptor RXR-alpha RXRA
      GQ6 Stigmasterol Prostaglandin G/H synthase 1 PTGS1
      GQ6 Stigmasterol Prostaglandin G/H synthase 2 PTGS2
      GQ6 Stigmasterol Alpha-2A adrenergic receptor ADRA2A
      GQ6 Stigmasterol Sodium-dependent noradrenaline transporter SLC6A2
      GQ6 Stigmasterol Sodium-dependent dopamine transporter SLC6A3
      GQ6 Stigmasterol Beta-2 adrenergic receptor ADRB2
      GQ6 Stigmasterol Aldose reductase AKR1B1
      GQ6 Stigmasterol Urokinase-type plasminogen activator PLAU
      GQ6 Stigmasterol Leukotriene A-4 hydrolase LTA4H
      GQ6 Stigmasterol Amine oxidase [flavin-containing] B MAOB
      GQ6 Stigmasterol Amine oxidase [flavin-containing] A MAOA
      GQ6 Stigmasterol Muscarinic acetylcholine receptor M3 CHRM3
      GQ6 Stigmasterol Beta-1 adrenergic receptor ADRB1
      GQ6 Stigmasterol Sodium channel protein type 5 subunit alpha SCN5A
      GQ6 Stigmasterol 5-hydroxytryptamine 2A receptor HTR2A
      GQ6 Stigmasterol Gamma-aminobutyric-acid receptor subunit alpha-3 GABRA3
      GQ6 Stigmasterol Muscarinic acetylcholine receptor M2 CHRM2
      GQ6 Stigmasterol Alpha-1B adrenergic receptor ADRA1B
      GQ6 Stigmasterol Neuronal acetylcholine receptor subunit alpha-7 CHRNA7
      GQ7 beta-sitosterol Progesterone receptor PGR
      GQ7 beta-sitosterol Prostaglandin G/H synthase 1 PTGS1
      GQ7 beta-sitosterol Prostaglandin G/H synthase 2 PTGS2
      GQ7 beta-sitosterol Heat shock protein HSP 90-alpha HSP90AA1
      GQ7 beta-sitosterol Potassium voltage-gated channel subfamily H member 2 KCNH2
      GQ7 beta-sitosterol D(1A) dopamine receptor DRD1
      GQ7 beta-sitosterol Muscarinic acetylcholine receptor M3 CHRM3
      GQ7 beta-sitosterol Sodium channel protein type 5 subunit alpha SCN5A
      GQ7 beta-sitosterol cGMP-inhibited 3',5'-cyclic phosphodiesterase A PDE3A
      GQ7 beta-sitosterol 5-hydroxytryptamine 2A receptor HTR2A
      GQ7 beta-sitosterol Gamma-aminobutyric-acid receptor subunit alpha-5 GABRA5
      GQ7 beta-sitosterol Gamma-aminobutyric-acid receptor subunit alpha-3 GABRA3
      GQ7 beta-sitosterol Muscarinic acetylcholine receptor M2 CHRM2
      GQ7 beta-sitosterol Alpha-1B adrenergic receptor ADRA1B
      GQ7 beta-sitosterol Beta-2 adrenergic receptor ADRB2
      GQ7 beta-sitosterol Neuronal acetylcholine receptor subunit alpha-2 CHRNA2
      GQ7 beta-sitosterol Sodium-dependent serotonin transporter SLC6A4
      GQ7 beta-sitosterol Mu-type opioid receptor OPRM1
      GQ7 beta-sitosterol Neuronal acetylcholine receptor subunit alpha-7 CHRNA7
      GQ7 beta-sitosterol Apoptosis regulator Bcl-2 BCL2
      GQ7 beta-sitosterol Apoptosis regulator BAX BAX
      GQ7 beta-sitosterol Caspase-9 CASP9
      GQ7 beta-sitosterol Transcription factor AP-1 JUN
      GQ7 beta-sitosterol Caspase-3 CASP3
      GQ7 beta-sitosterol Caspase-8 CASP8
      GQ7 beta-sitosterol Protein kinase C alpha type PRKCA
      GQ7 beta-sitosterol Transforming growth factor beta-1 TGFB1
      GQ7 beta-sitosterol Serum paraoxonase/arylesterase 1 PON1
      GQ7 beta-sitosterol Microtubule-associated protein 2 MAP2
      GQ8 (-)-Hyoscyamine D(1A) dopamine receptor DRD1
      GQ8 (-)-Hyoscyamine Muscarinic acetylcholine receptor M3 CHRM3
      GQ8 (-)-Hyoscyamine Beta-1 adrenergic receptor ADRB1
      GQ8 (-)-Hyoscyamine Alpha-2A adrenergic receptor ADRA2A
      GQ8 (-)-Hyoscyamine Alpha-2C adrenergic receptor ADRA2C
      GQ8 (-)-Hyoscyamine Delta-type opioid receptor OPRD1
      GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 2A receptor HTR2A
      GQ8 (-)-Hyoscyamine Sodium-dependent noradrenaline transporter SLC6A2
      GQ8 (-)-Hyoscyamine Muscarinic acetylcholine receptor M2 CHRM2
      GQ8 (-)-Hyoscyamine Alpha-2B adrenergic receptor ADRA2B
      GQ8 (-)-Hyoscyamine Alpha-1B adrenergic receptor ADRA1B
      GQ8 (-)-Hyoscyamine Sodium-dependent dopamine transporter SLC6A3
      GQ8 (-)-Hyoscyamine Beta-2 adrenergic receptor ADRB2
      GQ8 (-)-Hyoscyamine Sodium-dependent serotonin transporter SLC6A4
      GQ8 (-)-Hyoscyamine D(2) dopamine receptor DRD5
      GQ8 (-)-Hyoscyamine Mu-type opioid receptor OPRM1
      GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 1B receptor HTR1B
      GQ8 (-)-Hyoscyamine Histamine H1 receptor HRH1
      GQ8 (-)-Hyoscyamine 5-hydroxytryptamine 1A receptor HTR1A
      GQ9 campesterol Progesterone receptor PGR
      GQ10 cyanin Prostaglandin G/H synthase 2 PTGS2
      GQ10 cyanin Heat shock protein HSP 90-alpha HSP90AA1
      GQ11 24-methylidenelophenol Progesterone receptor PGR
      GQ11 24-methylidenelophenol Mineralocorticoid receptor NR3C2
      GQ12 daucosterol_qt Progesterone receptor PGR
      GQ13 glycitein Prostaglandin G/H synthase 1 PTGS1
      GQ13 glycitein Estrogen receptor ESR1
      GQ13 glycitein Androgen receptor AR
      GQ13 glycitein Peroxisome proliferator-activated receptor gamma PPARG
      GQ13 glycitein Prostaglandin G/H synthase 2 PTGS2
      GQ13 glycitein Retinoic acid receptor RXR-alpha RXRA
      GQ13 glycitein cGMP-inhibited 3',5'-cyclic phosphodiesterase A PDE3A
      GQ13 glycitein Estrogen receptor beta ESR2
      GQ13 glycitein Mitogen-activated protein kinase 14 MAPK14
      GQ13 glycitein Heat shock protein HSP 90-alpha HSP90AA1
      GQ13 glycitein Trypsin-1 PRSS1
      GQ13 glycitein Cyclin-A2 CCNA2
      GQ13 glycitein Nitric oxide synthase, inducible NOS2
      GQ13 glycitein Collagenase 3 MMP13
      GQ13 glycitein Neutrophil collagenase MMP8
      GQ14 CLR Progesterone receptor PGR
      GQ14 CLR Mineralocorticoid receptor NR3C2
      GQ15 14b-pregnane Prostaglandin G/H synthase 2 PTGS2
      GQ15 14b-pregnane Progesterone receptor PGR
      GQ16 24-ethylcholesta-5,22-dienol Progesterone receptor PGR
      GQ16 24-ethylcholesta-5,22-dienol Mineralocorticoid receptor NR3C2
      GQ17 Fucosterol Progesterone receptor PGR
      GQ17 Fucosterol Mineralocorticoid receptor NR3C2
      GQ18 31-norlanosterol Progesterone receptor PGR
      GQ18 31-norlanosterol Mineralocorticoid receptor NR3C2
      GQ19 4,24-methyllophenol Progesterone receptor PGR
      GQ20 Lophenol Progesterone receptor PGR
      GQ21 4alpha,14alpha,24-trimethylcholesta-8,24-dienol Progesterone receptor PGR
      GQ22 4alpha,24-dimethylcholesta-7,24-dienol Progesterone receptor PGR
      GQ22 4alpha,24-dimethylcholesta-7,24-dienol Mineralocorticoid receptor NR3C2
      GQ23 4alpha-methyl-24-ethylcholesta-7,24-dienol Progesterone receptor PGR
      GQ24 6-Fluoroindole-7-Dehydrocholesterol Progesterone receptor PGR
      GQ24 6-Fluoroindole-7-Dehydrocholesterol Mineralocorticoid receptor NR3C2
      GQ24 6-Fluoroindole-7-Dehydrocholesterol Glucocorticoid receptor NR3C1
      GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt Prostaglandin G/H synthase 2 PTGS2
      GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt DNA topoisomerase 2-alpha TOP2A
      GQ25 7-O-Methylluteolin-6-C-beta-glucoside_qt Heat shock protein HSP 90-alpha HSP90AA1
      GQ26 Atropine D(1A) dopamine receptor DRD1
      GQ26 Atropine Muscarinic acetylcholine receptor M3 CHRM3
      GQ26 Atropine D(1B) dopamine receptor DRD5
      GQ26 Atropine Beta-1 adrenergic receptor ADRB1
      GQ26 Atropine Sodium channel protein type 5 subunit alpha SCN5A
      GQ26 Atropine Alpha-2A adrenergic receptor ADRA2A
      GQ26 Atropine 5-hydroxytryptamine 1A receptor HTR1A
      GQ26 Atropine Alpha-2C adrenergic receptor ADRA2C
      GQ26 Atropine Delta-type opioid receptor OPRD1
      GQ26 Atropine Histamine H1 receptor HRH1
      GQ26 Atropine 5-hydroxytryptamine 2A receptor HTR2A
      GQ26 Atropine Sodium-dependent noradrenaline transporter SLC6A2
      GQ26 Atropine Muscarinic acetylcholine receptor M2 CHRM2
      GQ26 Atropine Alpha-2B adrenergic receptor ADRA2B
      GQ26 Atropine Alpha-1B adrenergic receptor ADRA1B
      GQ26 Atropine Sodium-dependent dopamine transporter SLC6A3
      GQ26 Atropine Beta-2 adrenergic receptor ADRB2
      GQ26 Atropine Sodium-dependent serotonin transporter SLC6A4
      GQ26 Atropine D(2) dopamine receptor DRD5
      GQ26 Atropine Mu-type opioid receptor OPRM1
      GQ26 Atropine 5-hydroxytryptamine 1B receptor HTR1B
      GQ27 Physcion-8-O-beta-D-gentiobioside DNA topoisomerase 2-alpha TOP2A
      GQ28 lanost-8-en-3beta-ol Progesterone receptor PGR
      GQ28 lanost-8-en-3beta-ol Mineralocorticoid receptor NR3C2
      GQ29 Obtusifoliol Progesterone receptor PGR
      GQ29 Obtusifoliol Mineralocorticoid receptor NR3C2
      GQ30 quercetin Prostaglandin G/H synthase 1 PTGS1
      GQ30 quercetin Androgen receptor AR
      GQ30 quercetin Peroxisome proliferator-activated receptor gamma PPARG
      GQ30 quercetin Prostaglandin G/H synthase 2 PTGS2
      GQ30 quercetin Heat shock protein HSP 90-alpha HSP90AA1
      GQ30 quercetin Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit gamma isoform PIK3CG
      GQ30 quercetin Dipeptidyl peptidase 4 DPP4
      GQ30 quercetin Aldose reductase AKR1B1
      GQ30 quercetin Trypsin-1 PRSS1
      GQ30 quercetin DNA topoisomerase 2-alpha TOP2A
      GQ30 quercetin Prothrombin F2
      GQ30 quercetin Potassium voltage-gated channel subfamily H member 2 KCNH2
      GQ30 quercetin Sodium channel protein type 5 subunit alpha SCN5A
      GQ30 quercetin Coagulation factor X F10
      GQ30 quercetin Beta-2 adrenergic receptor ADRB2
      GQ30 quercetin Stromelysin-1 MMP3
      GQ30 quercetin Coagulation factor VII F7
      GQ30 quercetin Nitric-oxide synthase, endothelial NOS3
      GQ30 quercetin Retinoic acid receptor RXR-alpha RXRA
      GQ30 quercetin Acetylcholinesterase ACHE
      GQ30 quercetin Amine oxidase [flavin-containing] B MAOB
      GQ30 quercetin Transcription factor p65 RELA
      GQ30 quercetin Epidermal growth factor receptor EGFR
      GQ30 quercetin RAC-alpha serine/threonine-protein kinase AKT1
      GQ30 quercetin G1/S-specific cyclin-D1 CCND1
      GQ30 quercetin Apoptosis regulator Bcl-2 BCL2
      GQ30 quercetin Bcl-2-like protein 1 BCL2L1
      GQ30 quercetin Proto-oncogene c-Fos FOS
      GQ30 quercetin Cyclin-dependent kinase inhibitor 1 CDKN1A
      GQ30 quercetin Apoptosis regulator BAX BAX
      GQ30 quercetin Caspase-9 CASP9
      GQ30 quercetin Urokinase-type plasminogen activator PLAU
      GQ30 quercetin 72 kDa type IV collagenase MMP2
      GQ30 quercetin Matrix metalloproteinase-9 MMP9
      GQ30 quercetin Mitogen-activated protein kinase 1 MAPK1
      GQ30 quercetin Interleukin-10 IL10
      GQ30 quercetin Retinoblastoma-associated protein RB1
      GQ30 quercetin Tumor necrosis factor TNF
      GQ30 quercetin Transcription factor AP-1 JUN
      GQ30 quercetin Interleukin-6 IL6
      GQ30 quercetin Caspase-3 CASP3
      GQ30 quercetin Cellular tumor antigen p53 TP53
      GQ30 quercetin NF-kappa-B inhibitor alpha NFKBIA
      GQ30 quercetin Xanthine dehydrogenase/oxidase XDH
      GQ30 quercetin Caspase-8 CASP8
      GQ30 quercetin RAF proto-oncogene serine/threonine-protein kinase RAF1
      GQ30 quercetin Superoxide dismutase [Cu-Zn] SOD1
      GQ30 quercetin Protein kinase C alpha type PRKCA
      GQ30 quercetin Interstitial collagenase MMP1
      GQ30 quercetin Hypoxia-inducible factor 1-alpha HIF1A
      GQ30 quercetin Signal transducer and activator of transcription 1-alpha/beta STAT1
      GQ30 quercetin Cell division control protein 2 homolog CDK1
      GQ30 quercetin Peroxisome proliferator-activated receptor gamma PPARG
      GQ30 quercetin Heme oxygenase 1 HMOX1
      GQ30 quercetin Cytochrome P450 3A4 CYP3A4
      GQ30 quercetin Caveolin-1 CAV1
      GQ30 quercetin Myc proto-oncogene protein MYC
      GQ30 quercetin Tissue factor F3
      GQ30 quercetin Gap junction alpha-1 protein GJA1
      GQ30 quercetin Cytochrome P450 1A1 CYP1A1
      GQ30 quercetin Intercellular adhesion molecule 1 ICAM1
      GQ30 quercetin Interleukin-1 beta IL1B
      GQ30 quercetin Small inducible cytokine A2 CCL2
      GQ30 quercetin E-selectin SELE
      GQ30 quercetin Vascular cell adhesion protein 1 VCAM1
      GQ30 quercetin Prostaglandin E2 receptor, EP3 subtype PTGER3
      GQ30 quercetin Interleukin-8 CXCL8
      GQ30 quercetin Nitric oxide synthase, endothelial NOS3
      GQ30 quercetin Heat shock protein beta-1 HSPB1
      GQ30 quercetin Transforming growth factor beta-1 TGFB1
      GQ30 quercetin Maltase-glucoamylase, intestinal MGAM
      GQ30 quercetin Interleukin-2 IL2
      GQ30 quercetin Cytochrome P450 1B1 CYP1B1
      GQ30 quercetin Tissue-type plasminogen activator PLAT
      GQ30 quercetin Thrombomodulin THBD
      GQ30 quercetin Plasminogen activator inhibitor 1 SERPINE1
      GQ30 quercetin Interferon gamma IFNG
      GQ30 quercetin Arachidonate 5-lipoxygenase ALOX5
      GQ30 quercetin Phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase and dual-specificity protein phosphatase PTEN PTEN
      GQ30 quercetin Interleukin-1 alpha IL1A
      GQ30 quercetin Myeloperoxidase MPO
      GQ30 quercetin DNA topoisomerase 2-alpha TOP2A
      GQ30 quercetin Neutrophil cytosol factor 1 NCF1
      GQ30 quercetin Nuclear factor erythroid 2-related factor 2 NFE2L2
      GQ30 quercetin NAD(P)H dehydrogenase [quinone] 1 NQO1
      GQ30 quercetin Poly [ADP-ribose] polymerase 1 PARP1
      GQ30 quercetin Aryl hydrocarbon receptor AHR
      GQ30 quercetin Solute carrier family 2, facilitated glucose transporter member 4 SLC2A4
      GQ30 quercetin Collagen alpha-1(III) chain COL3A1
      GQ30 quercetin C-X-C motif chemokine 11 CXCL11
      GQ30 quercetin C-X-C motif chemokine 2 CXCL2
      GQ30 quercetin Serine/threonine-protein kinase Chk2 CHEK2
      GQ30 quercetin Insulin receptor INSR
      GQ30 quercetin Peroxisome proliferator-activated receptor alpha PPARA
      GQ30 quercetin Peroxisome proliferator-activated receptor delta PPARD
      GQ30 quercetin C-reactive protein CRP
      GQ30 quercetin C-X-C motif chemokine 10 CXCL10
      GQ30 quercetin Inhibitor of nuclear factor kappa-B kinase subunit alpha CHUK
      GQ30 quercetin Osteopontin SPP1
      GQ30 quercetin Runt-related transcription factor 2 RUNX2
      GQ30 quercetin Ras association domain-containing protein 1 RASSF1
      GQ30 quercetin Cathepsin D CTSD
      GQ30 quercetin Insulin-like growth factor-binding protein 3 IGFBP3
      GQ30 quercetin Insulin-like growth factor II IGF2
      GQ30 quercetin CD40 ligand CD40LG
      GQ30 quercetin Receptor tyrosine-protein kinase erbB-3 ERBB3
      GQ30 quercetin Serum paraoxonase/arylesterase 1 PON1
      GQ30 quercetin Type I iodothyronine deiodinase DIO1
      GQ30 quercetin Ras GTPase-activating protein 1 RASA1
      GQ30 quercetin Glutathione S-transferase Mu 1 GSTM1
    • The 144 potential targets of the components of Fructus lycii associated with exercise fatigue were imported into Cystoscope 3.8.2 to construct an active compound-targets network, as shown in Figure 1. There were 174 nodes, including 30 nodes for chemical components, 144 nodes for targets, and 530 edges for interactions between nodes. Quercetin (degree = 110), β-sitosterol (degree = 29), stigmasterol (degree = 23), 7-O-methylluteolin-6-C-beta-glucoside_qt (degree = 21), atropine (degree = 19), and glycitein (degree = 15) of Fructus lycii were identified as the main active components with an anti-exercise fatigue effect. Quercetin was selected as the representative component for further studies.

      Figure 1.  Compound-targets network. GQ1, Sitosterol alpha1; GQ2, Cycloartenol; GQ3, Mandenol; GQ4, Ethyl linolenate; GQ5, LAN; GQ6, Stigmasterol; GQ7, Beta-sitosterol; GQ8, (-)-Hyoscyamine; GQ9, Campesterol; GQ10, Cyanin; GQ11, 24-methylidenelophenol; GQ12, Daucosterol qt; GQ13, Glycitein; GQ14, CLR; GQ15, 14b-pregnane; GQ16, 24-ethylcholesta-5,22-dienol; GQ17, Fucosterol; GQ18, 31-norlanosterol; GQ19, 4,24-methyllophenol; GQ20, Lophenol; GGQ21, 4alpha,14alpha,24-trimethylcholesta-8,24-dienol; GQ22, 4alpha,24-dimethylcholesta-7,24-dienol; GQ23, 4alpha-methyl-24-ethylcholesta-7,24-dienol; GQ24, 6-Fluoroindole-7-Dehydrocholesterol; GQ25, 7-O-methylluteolin-6-C-beta-glucoside_qt; GQ26, Atropine; GQ27, Physcion-8-O-beta-D-gentiobioside; GQ28, Lanost-8-en-3beta-ol; GQ29, Obtusifoliol; GQ30, Quercetin.

    • The Mediascape database was utilized to analyze 144 key targets, and the results of the GO enrichment analysis were divided into three categories: BP, CC, and MF, as shown in Figure 2A. These targets are highly related to cellular components, including the synaptic membrane. Responses to nitrogen compounds, hormones, lipids, and xenobiotic stimuli are primarily involved in biological processes. In addition, G protein-coupled amine receptor activity, transcription co-regulator binding, DNA-binding transcription factor binding, nuclear receptor activity, and ligand-activated transcription factor activity of the molecular function were closely related to these targets.

      Figure 2.  Enrichment analysis. (A) GO enrichment analysis; (B) KEGG enrichment analysis. BP, biological process; CC, cellular component; MF, molecular function. P < 0.05.

      A total of 198 pathways with P < 0.05 were identified, and the top 20 pathways are illustrated as enriched dot bubbles in Figure 2B. The top three pathways were hsa05200 (degree = 50), hsa05417 (degree = 36), and hsa04933 (degree = 27), all of which were highly associated with cancer-, inflammation-, immune-, and apoptosis-related pathways, as revealed by enrichment analysis.

    • To explain the pharmacological mechanism of anti-exercise fatigue in Fructus lycii in detail, a compound-target-pathway network was constructed. As shown in Figure 3 and Supplementary Tables S3S4 (available in www.besjournal.com), there were 198 pathways related to 136 of the 144 key targets and eight targets without pathways. The average degrees of the targets, pathways, and components were 17.35, 12.28, and 8.83, respectively. Based on the double median degree (degree ≥ 18), 39 targets were selected. Targets with the highest degrees were MAPK1 (117), AKT1 (98), RAF1 (84), RELA (77), TNF (68), PRKCA (66), MAPK14 (62), JUN (57), CHUK (54), IL6 (52), and BAX (52). The top signaling pathways included hsa05200 (pathways in cancer), hsa04933 (AGE-RAGE signaling pathway in diabetic complications, degree = 28), hsa04151 (PI3K-Akt signaling pathway, degree = 27), hsa04080 (neuroactive ligand-receptor interaction pathway, degree = 25), hsa04657 (IL-17 signaling pathway, degree = 24), hsa04668 (TNF signaling pathway, degree = 23), hsa05022 (pathways of neurodegeneration - multiple diseases) and hsa04010 (MAPK signaling pathway, degree = 23). Among these, the PI3K-Akt and MAPK signaling pathways are closely related to exercise fatigue[17]. Moreover, most of the core target proteins identified by network pharmacology analysis were associated with the PI3K-Akt and MAPK signaling pathways. Therefore, in the present study, we first focused on the PI3K-Akt and MAPK signaling pathways.

      Figure 3.  Compound-targets-pathways network. GQ1, Sitosterol alpha1; GQ2, Cycloartenol; GQ3, Mandenol; GQ4, Ethyl linolenate; GQ5, LAN; GQ6, Stigmasterol; GQ7, Beta-sitosterol; GQ8, (-)-Hyoscyamine; GQ9, Campesterol; GQ10, Cyanin; GQ11, 24-methylidenelophenol; GQ12, Daucosterol_qt; GQ13, Glycitein; GQ14, CLR; GQ15, 14b-pregnane; GQ16, 24-ethylcholesta-5,22-dienol; GQ17, Fucosterol; GQ18, 31-norlanosterol; GQ19, 4,24-methyllophenol; GQ20, Lophenol; GGQ21, 4alpha,14alpha,24-trimethylcholesta-8,24-dienol; GQ22, 4alpha,24-dimethylcholesta-7,24-dienol; GQ23, 4alpha-methyl-24-ethylcholesta-7,24-dienol; GQ24, 6-Fluoroindole-7-Dehydrocholesterol; GQ25, 7-O-Methylluteolin-6-C-beta-glucoside_qt; GQ26, Atropine; GQ27, Physcion-8-O-beta-D-gentiobioside; GQ28, Lanost-8-en-3beta-ol; GQ29, Obtusifoliol; GQ30, Quercetin.

    • Upon treating C2C12 cells with or without quercetin for 24 h, we observed that quercetin reduced cell viability in a dose-dependent manner, as shown by the CCK-8 assay (Supplementary Figure S2, available in www.besjournal.com). Quercetin at 125 μmol/L reduced the viability of C2C12 cells to approximately 80%. The viability of cells treated with 453.5 μmol/L was 50%, which was defined as inhibitory concentration 50 (IC50) of quercetin. We chose a concentration that was around 1/10 of the IC50 as the highest concentration of quercetin, 50 μmol/L. This concentration exhibited no discernible toxicity and was also consistent with commonly used concentration of quercetin in other related experiments.

      Figure S2.  CCK-8 assay of cell viability.

    • To assess the effect of quercetin treatment on glucose uptake, C2C12 myotubes were treated with different concentrations of quercetin (50, 25, 12.5, 6.25 μmol/L) and then exposed to 2-NBDG, a fluorescently labeled glucose analog. Compared to the control, the glucose uptake of C2C12 myotubes was significantly increased by quercetin (P < 0.01), as shown in Figure 4A.

      Figure 4.  The effect of quercetin on glucose uptake, ROS generation, and mitochondria function in C2C12 cells. The 2-NBDG (A), CellRox (B), TMRM (C), and MitoTracker (D) probes were detected by a high content imaging analysis system; Left panel: representative images. Data presented were from three biological replicates; Scale bar size: 50 μm; *P < 0.05; **P < 0.01.

    • The effects of quercetin on ROS production were analyzed in TBHP-treated C2C12 myotube cells. Quercetin significantly reduced ROS production in a concentration-dependent manner (P < 0.01; Figure 4B).

    • Mitochondrial biogenesis is intricately linked to multiple physiological processes and is a crucial factor influencing skeletal muscle function[18]. In our study, mitochondrial mass and membrane potential were evaluated using MitoTracker and TMRM, respectively. The results showed that quercetin significantly increased the mitochondrial membrane potential and the mean stained area of TMRM-and Mito Tracker-stained mitochondria in a concentration-dependent manner (Figure 4C and Figure 4D).

    • The expression of key targets in the MAPK (p-38 MAPK, p-MAPK, and p-JNK) and PI3K-Akt (p-PI3K and p-AKT) signaling pathways was analyzed based on the results of network pharmacology. The immunofluorescence results (Figure 5A) revealed increased protein expression of p-P38 MAPK, p-MAPK, and p-JNK in the quercetin group compared to the control group. Moreover, the protein levels of p-PI3K and p-AKT markedly increased after quercetin treatment (Figure 5B).

      Figure 5.  Protein expression of MAPK and PI3K-AKT signaling pathways. (A) MAPK signaling pathways, the protein expression of p-P38 MAPK, p-MAPK, and p-JNK was detected by a high content imaging analysis system; (B) PI3K-AKT signaling pathway, p-PI3K and p-AKT was detected by a high content imaging analysis system; Left panel: representative images. Data presented were from three biological replicates; Scale bar size: 50 μm; *P < 0.05; **P < 0.01.

    • A meta-analysis was conducted to investigate the effect of Fructus lycii on exercise fatigue. The findings indicated that Fructus lycii extended the duration of exhaustive exercise and stored muscle and liver glycogen reserves while decreasing the levels of BUN and lactic acid (Supplementary Tables S6S7 and Figure S3S4, available in www.besjournal.com). These indicators are important for evaluating exercise fatigue[19,20], suggesting that Fructus lycii might have the potential to improve exercise performance. To further investigate the mechanism and identify the primary components responsible for this effect, we conducted a network pharmacology analysis. Six potential active components in Fructus lycii as predicted by network pharmacology, emerged, with quercetin exhibiting the highest degree of influence. Other key components included β-sitosterol, stigmasterol, 7-O-methylluteolin-6-C-beta-glucoside_qt, atropine, and glycitein. Multiple pathways have been identified to be related to anti-exercise fatigue, including the AGE-RAGE signaling pathway in diabetic complications, PI3K-Akt signaling pathway, neuroactive ligand-receptor interaction pathway, IL-17 signaling pathway, TNF signaling pathway, and MAPK signaling pathway. Furthermore, quercetin, one of the main active components of Fructus lycii[21], and its two signaling pathways (MAPK and PI3K-Akt) closely related to exercise fatigue were investigated in an in vitro study to clarify its function and mechanism.

      Table S6.  Methodological quality assessment of the studies included

      Quality score criterionPeer-reviewed publication Control of temperature Random allocation to treatment or controlBlinded induction of modelBlinded assessment of outcomeUse of anesthetic without significant intrinsic neuroprotective activityAppropriate animal model Sample size calculationCompliance with animal welfare regulationsStatement of potential conflict of interestsTotal
      Yang 2019 (30)00100010103
      Cao 2018 (17)00100010103
      Ji et al. 2011 (18)11100110106
      Ding et al. 2001 (29)10100010104
      Qin et al. 2009 (27)10100010104
      Hu et al. 2008 (21)11100010105
      Liu et al. 2011 (19)10100010104
      Yi et al. 2010 (26)10100010104
      Wang et al. 2002 (24)10100010104
      Liu 2019 (22)01100010104
      Yang et al. 2018 (20)11100010105
      Ma 2019 (23)10100010104
      Niu et al. 1994 (25)10100010104
      Wu et al. 2008 (9)11100010105
      Wang et al. 2017 (28)10100010104
        Note. As showed in Supplementary Table S6, the quality score of the included studies ranged from 3 to 5 and the average quality score was 4.2 points. All studies randomly allocated animals to the control group and the treatment group, adopted appropriate animal models and compliance with animal welfare regulations. However, the method of blinded induction of model and blinded assessment of outcome were not involved in those included studies. In addition, there was no statement of potential conflict of interests in those articles.

      Table S7.  Meta-analysis for each sub-outcome measure

      Outcome Meta-analysis of outcome Test of heterogeneity Model used
      SMD 95% CI P I2 P
      Blood lactates −1.58 −1.58 to −0.97 < 0.01 80% < 0.01 Random-effects
      Muscle glycogen 0.85 0.04 to 1.67 < 0.01 76% < 0.01 Random-effects
      Liver glycogen 0.91 0.40 to 1.41 < 0.01 60% < 0.01 Random-effects
      SOD 1.30 0.45 to 2.14 < 0.01 78% < 0.01 Random-effects
      MAD −0.84 −1.18 to −0.05 < 0.01 32% 0.18 Fixed-effects
        Note. SMD, standardized mean difference; I2, I-squared statistic; CI, confidence interval; SOD, superoxide dismutase; MAD, malondialdehyde.

      Quercetin, a flavonoid, possesses unique biological properties that hold potential for improving mental and physical performance, as well as conferring benefits to overall health and disease resistance. It exhibits anti-inflammatory, antiviral, antioxidant, anticarcinogenic, and psychostimulant activities[22]. Several studies have shown that quercetin inhibits LPS-induced mRNA expression of TNF-α, IL-8 and IL-1α[23]. In addition, quercetin is widely used as a nutritional supplement and phytochemical therapy for the treatment of various diseases, such as diabetes, obesity, and cardiovascular diseases[24]. Recent studies have reported that dietary quercetin supplementation can ameliorate exercise fatigue and enhance performance[25]; however, the underlying mechanism is still unclear. Our study demonstrated that quercetin significantly increased glucose uptake, enhanced mitochondrial function, and decreased ROS levels. Increasing the capacity for glucose uptake and mitochondrial energy production has been suggested as an effective approach to delay exercise fatigue[26,27]. The skeletal muscles play an important role in exercise and energy balance. Recently, increasing evidence has revealed that mitochondria are essential for maintaining energy homeostasis, which is highly correlated with muscle function and energy production, resulting in enhanced exercise performance[28,29]. Excessive ROS production during exercise can impair mitochondrial and nuclear DNA, and induce mitochondrial dysfunction, which appears to be a key issue during exhaustive exercise. Similar to our findings, quercetin improves mitochondrial regeneration, enhances energy metabolism, and improves exercise endurance by regulating mitochondrial gene expression in mouse muscles[30]. In addition, glucose is initially phosphorylated by hexokinase, which traps glucose intracellularly in the skeletal muscle and is then utilized to produce energy[31]. Quercetin may facilitate glucose uptake to exert beneficial effects on maintaining glucose homeostasis. This glucose can be stored as glycogen or utilized to produce energy during exercise. Notably, research has underscored quercetin’s role in elevating insulin-stimulated glucose uptake and coupled with an improved replenishment function, which is conducive to the rapid restoration of muscle glycogen. This synergistic effect serves to improve time-to-exhaustion during exercise[32].

      Previous reports have indicated that the MAPK and PI3K-Akt signaling pathways play crucial roles in various cellular processes, including cell survival, proliferation, differentiation, motility, and apoptosis. Our in vitro experiments revealed that quercetin exerts its biological functions by regulating the MAPK and PI3K-Akt signaling pathways. The MAPK signaling pathway regulates energy metabolism by enhancing mitochondrial function and glucose uptake[33,34]. The glucose transporter GLUT4 is critical for skeletal muscle glucose uptake and the maintenance of whole-body glucose homeostasis. Similarly, black rice extracts were found to stimulate GLUT4 glucose uptake through the activation of PI3K-Akt and MAPK signaling in C2C12 myotubes[5]. Previous studies have shown that activation of the PI3K-Akt and MAPK signaling pathways may help reduce oxidative damage[35,36]. Consistent with our results, ginsenoside Rb1 has also been shown to alleviate fatigue syndrome by reducing skeletal muscle oxidative stress through the activation of the PI3K-Akt pathway[37]. Adaptation and maintenance of the oxidative-antioxidant balance depend heavily on the MAPK signaling pathway. Moreover, the MAPK signaling pathway contributes to antioxidant activity by regulating the levels of SOD, which plays a critical role in anti-fatigue effects[38]. Overall, our findings suggest that quercetin exerts its effects via the PI3K-Akt and MAPK signaling pathways.

      It is also noteworthy that Fructus lycii regulates the inflammatory pathways that are involved in exercise fatigue. Exercise fatigue is often accompanied by increased levels of pro-inflammatory cytokines[39]. It has also been suggested that cytokine release may result in prolonged sickness symptoms or behavioral stillness, which can sometimes be observed in cases of overtraining syndrome in athletes, as well as in a variety of systemic immune and inflammatory conditions. For example, TNF-α, IL-1β, and IL-6 also increased as a result of muscle fatigue[40]. Additionally, post-exercise mobilization of T-lymphocytes, particularly CD4+ and CD8+ lymphocytes, from peripheral lymphoid compartments into the blood has been observed[41]. The IL-17, TNF, and MAPK signaling pathways are the main pathway-linked inflammatory responses, as shown in our study[42]. Studies have suggested that regulating the expression of pro-inflammatory and anti-inflammatory cytokines by regulating signaling pathways involved in anti-inflammatory was an effective way to relieve exercise fatigue[2]. Hence, future research endeavors should focus on extensively investigating Fructus lycii’s potential in combating to exercise fatigue.

      Our study lays the groundwork for potential avenues of deeper exploration into the mechanisms underlying the impacts of Fructus lycii on exercise fatigue. Nonetheless, there exist certain limitations. First, we focused on Fructus lycii and its energy metabolism and antioxidant mechanisms. Moving forward, it is imperative to pay continuous attention to other active ingredients and mechanisms, especially the functions of the inflammatory pathways identified in our study. Second, although we used immunofluorescence staining combined with high-content imaging to display the phosphorylation levels of key target proteins associated with the identified signaling pathways, western blotting can also be used as an auxiliary method to verify the expression and phosphorylation levels of key target proteins. In addition, the mRNA expression should be measured during follow-up. Finally, the study used cultured cells as a model, which does not fully represent in vivo physiological conditions. Therefore, in vivo studies are needed to confirm the anti-fatigue activity of Fructus lycii and its components.

      In summary, we conducted a multi-component, multi-target, and multi-pathway exploration of the anti-exercise-fatigue effects of Fructus lycii. The main active components and possible molecular mechanisms underlying the anti-exercise-fatigue activity of Fructus lycii should be further investigated. Quercetin, a crucial active component in Fructus lycii, was shown to enhance energy metabolism and reduce oxidative stress, thereby delaying exercise fatigue. The PI3K-Akt and MAPK signaling pathways might be involved in this process. These results pave the way for subsequent research endeavors aimed at deeper explorations of the mechanisms underlying the effects of Fructus lycii on exercise fatigue.

      Fructus lycii significantly alleviated exercise fatigue. Six potential active components, including quercetin, sitosterol, stigmasterol, 7-O-methylluteolin-6-C-beta-glucoside_qt, atropine, and glycitein, may contribute to the improvement of exercise fatigue via multiple pathways, including the PI3K-Akt, neuroactive ligand-receptor interaction, IL-17, TNF, and MAPK signaling pathways. Quercetin may play important roles in reducing oxidative stress, boosting glucose uptake, and enhancing mitochondrial function. The underlying mechanism may involve the PI3K-AKT and MAPK signaling pathways.

    • JI Xiao Ning: methodology, formal analysis, validation, investigation, and writing - original draft; LIU Zhao Ping: conceptualization, methodology, writing - review and editing; ZHANG Chao Zheng: formal analysis, investigation, data curation, writing - review and editing; CHEN Min: conceptualization, investigation, writing - review and editing; LIANG Jiang: conceptualization, writing - review and editing. ZHANG Lei: conceptualization, resources, writing - review and editing; LU Jiang: conceptualization, supervision, writing - review and editing, and project administration. All authors have approved the final version of the manuscript submitted for publication.

    • Table S3.  Information of targets of exercise-induced fatigue

      DegreeNameNeighborhood connectivity
      117MAPK115.31624
      98AKT116.81633
      84RAF115.54762
      77RELA19.09091
      68TNF16.77941
      66PRKCA15.04545
      62MAPK1416.27419
      57JUN19.52632
      54CHUK20.48148
      52BAX19.34615
      52IL619.55769
      51TP5319.23529
      50NFKBIA20.4
      48EGFR17.8125
      47CCND118.76596
      46CASP321.08696
      46FOS20.28261
      45IL1B18.93333
      44BCL220.56818
      42CDKN1A19.33333
      38CASP822.10526
      37CASP921.48649
      36TGFB119.75
      35MYC20.45714
      34CXCL821.73529
      32IFNG18.5625
      30PGR6.625
      30PTGS218.43333
      30STAT122.1
      29BCL2L121.2069
      26RB123
      26PTEN20.80769
      23INSR15.65217
      22IL1017.18182
      22IL1A21.04545
      21IL220.33333
      20HSP90AA123.8
      19RXRA24.36842
      19NOS322.33333
      18NOS217.61111
      18CCL225.5
      17MMP927.76471
      17ICAM123.70588
      15NR3C23.714286
      15CXCL223.86667
      14ADRB223.57143
      14ADRB114.85714
      14HIF1A23.78571
      14CD40LG18.71429
      13CHRM315.92308
      13DRD114.53846
      13PPARG25.16667
      13CCNA219.23077
      13PIK3CG22.84615
      13CXCL1024.46154
      12MMP228.16667
      12NCF124.75
      11MAOB18.45455
      11GSTM126.45455
      10PTGS121.3
      10SLC6A313.2
      10MAOA9.6
      10CHRM219.6
      10ADRA1B17
      10VCAM127.6
      10PPARA25.3
      9HTR2A18.11111
      9CHRNA719.66667
      9ESR121.44444
      9F228.44444
      9SOD122.55556
      9MMP132.66667
      9CDK123.44444
      9CYP1A124.44444
      9CYP1B122.44444
      9SERPINE126
      8PLAU29.5
      8GABRA313.125
      8ESR220.5
      8MMP333.375
      8SELE31.5
      8NFE2L235.375
      8SLC2A422.125
      8ERBB329.625
      7GABRA511.71429
      7DRD518.16667
      7HMOX137.71429
      7CYP3A422.85714
      7PTGER336
      7COL3A128.42857
      7SPP128.85714
      7RASSF132
      7CTSD29.28571
      7IGF237.57143
      6PDE3A14.66667
      6OPRM119.5
      6HTR1B17
      6HTR1A17
      6AR38
      6PRSS129.66667
      6CAV131.83333
      6PLAT32.66667
      6ALOX526.83333
      5ADRA2A20.4
      5SCN5A38
      5SLC6A417.2
      5OPRD118.8
      5HRH117.4
      5TOP2A31
      5MPO30.2
      5NQO145.8
      5PARP134
      5AHR36.4
      5CXCL1133
      5CHEK235.2
      5PPARD36.4
      5IGFBP334.2
      4SLC6A216.5
      4ADRA2C19.75
      4ADRA2B19.75
      4MMP1317.25
      4HSPB138.75
      4THBD43.25
      4RASA137
      3XDH38.66667
      3F348
      3RUNX245.66667
      2AKR1B165
      2LTA4H14
      2KCNH268
      2CHRNA227
      2PON168
      2NR3C114
      2DPP455.5
      2F1058
      2F758
      2ACHE59
      2GJA158.5
      2DIO160.5
      1IGHG123
      1MAP229
      1MMP815
      1MGAM107
      1CRP107

      Table S4.  Information of pathways of exercise-induced fatigue

      Pathway Description Degree Neighborhood connectivity
      hsa05200 Pathways in cancer 51 35.80392
      hsa05417 Lipid and atherosclerosis 37 41.48649
      hsa05418 Fluid shear stress and atherosclerosis 29 35.62069
      hsa04933 AGE-RAGE signaling pathway in diabetic complications 28 44.89286
      hsa05207 Chemical carcinogenesis - receptor activation 28 39.89286
      hsa05161 Hepatitis B 27 56.66667
      hsa05167 Kaposi sarcoma-associated herpesvirus infection 27 52.66667
      hsa04151 PI3K-Akt signaling pathway 27 46.33333
      hsa05163 Human cytomegalovirus infection 26 57
      hsa04080 Neuroactive ligand-receptor interaction 25 15.12
      hsa04657 IL-17 signaling pathway 24 46.25
      hsa04668 TNF signaling pathway 23 49.73913
      hsa05160 Hepatitis C 23 55.30435
      hsa05164 Influenza A 23 54.52174
      hsa05169 Epstein-Barr virus infection 23 52.47826
      hsa05166 Human T-cell leukemia virus 1 infection 23 52.91304
      hsa04010 MAPK signaling pathway 23 54.6087
      hsa05205 Proteoglycans in cancer 22 49.04545
      hsa05208 Chemical carcinogenesis - reactive oxygen species 22 45.72727
      hsa05022 Pathways of neurodegeneration - multiple diseases 22 51.18182
      hsa05215 Prostate cancer 21 50.66667
      hsa05142 Chagas disease 21 54.85714
      hsa05145 Toxoplasmosis 21 51.85714
      hsa04218 Cellular senescence 21 49.90476
      hsa05152 Tuberculosis 21 56.42857
      hsa05171 Coronavirus disease - COVID-19 21 51.52381
      hsa05132 Salmonella infection 21 61.42857
      hsa05162 Measles 20 54.7
      hsa05225 Hepatocellular carcinoma 20 49.65
      hsa05165 Human papillomavirus infection 20 57.6
      hsa05222 Small cell lung cancer 19 51.52632
      hsa04926 Relaxin signaling pathway 19 53.89474
      hsa04210 Apoptosis 19 60.94737
      hsa04932 Non-alcoholic fatty liver disease 19 52.36842
      hsa05202 Transcriptional misregulation in cancer 19 35.05263
      hsa05170 Human immunodeficiency virus 1 infection 19 64.84211
      hsa05206 MicroRNAs in cancer 19 46.84211
      hsa01522 Endocrine resistance 18 56.55556
      hsa04620 Toll-like receptor signaling pathway 18 58.38889
      hsa04659 Th17 cell differentiation 18 51.94444
      hsa04621 NOD-like receptor signaling pathway 18 56
      hsa04024 cAMP signaling pathway 18 45.5
      hsa05010 Alzheimer disease 18 57.16667
      hsa05168 Herpes simplex virus 1 infection 18 56.61111
      hsa05140 Leishmaniasis 17 54.23529
      hsa04625 C-type lectin receptor signaling pathway 17 64.88235
      hsa04380 Osteoclast differentiation 17 59.76471
      hsa04915 Estrogen signaling pathway 17 47.82353
      hsa05224 Breast cancer 17 56.94118
      hsa05130 Pathogenic Escherichia coli infection 17 61.29412
      hsa05415 Diabetic cardiomyopathy 17 40.11765
      hsa04020 Calcium signaling pathway 17 27.41176
      hsa05212 Pancreatic cancer 16 64.125
      hsa05210 Colorectal cancer 16 64.875
      hsa04064 NF-kappa B signaling pathway 16 43.625
      hsa04066 HIF-1 signaling pathway 16 53.9375
      hsa05135 Yersinia infection 16 63.6875
      hsa05131 Shigellosis 16 67.75
      hsa04115 p53 signaling pathway 15 42.53333
      hsa05220 Chronic myeloid leukemia 15 66.4
      hsa05235 PD-L1 expression and PD-1 checkpoint pathway in cancer 15 66.2
      hsa05323 Rheumatoid arthritis 15 43.8
      hsa05146 Amoebiasis 15 48
      hsa04660 T cell receptor signaling pathway 15 66.66667
      hsa04071 Sphingolipid signaling pathway 15 64.86667
      hsa04068 FoxO signaling pathway 15 61.13333
      hsa04936 Alcoholic liver disease 15 59.6
      hsa04022 cGMP-PKG signaling pathway 15 40.86667
      hsa04062 Chemokine signaling pathway 15 54.53333
      hsa04060 Cytokine-cytokine receptor interaction 15 39.66667
      hsa05219 Bladder cancer 14 51.92857
      hsa05223 Non-small cell lung cancer 14 63.71429
      hsa05133 Pertussis 14 61.71429
      hsa04726 Serotonergic synapse 14 43.14286
      hsa04919 Thyroid hormone signaling pathway 14 57.64286
      hsa05226 Gastric cancer 14 64.07143
      hsa04630 JAK-STAT signaling pathway 14 55.85714
      hsa05203 Viral carcinogenesis 14 58.78571
      hsa05144 Malaria 13 42.61538
      hsa01524 Platinum drug resistance 13 59
      hsa04014 Ras signaling pathway 13 62.46154
      hsa05020 Prion disease 13 55.84615
      hsa05213 Endometrial cancer 12 69.58333
      hsa05321 Inflammatory bowel disease 12 55
      hsa05214 Glioma 12 71.25
      hsa01521 EGFR tyrosine kinase inhibitor resistance 12 68.5
      hsa04921 Oxytocin signaling pathway 12 63.83333
      hsa04510 Focal adhesion 12 66.5
      hsa05012 Parkinson disease 12 39.5
      hsa05134 Legionellosis 11 60
      hsa05221 Acute myeloid leukemia 11 66.63636
      hsa04917 Prolactin signaling pathway 11 70.54545
      hsa05218 Melanoma 11 71.72727
      hsa04658 Th1 and Th2 cell differentiation 11 67.63636
      hsa04928 Parathyroid hormone synthesis, secretion and action 11 61
      hsa04931 Insulin resistance 11 57.09091
      hsa04725 Cholinergic synapse 11 56
      hsa04722 Neurotrophin signaling pathway 11 80.90909
      hsa04371 Apelin signaling pathway 11 55.90909
      hsa04261 Adrenergic signaling in cardiomyocytes 11 58.27273
      hsa04217 Necroptosis 11 50.36364
      hsa05014 Amyotrophic lateral sclerosis 11 55.81818
      hsa05143 African trypanosomiasis 10 51.8
      hsa04370 VEGF signaling pathway 10 71.4
      hsa05120 Epithelial cell signaling in Helicobacter pylori infection 10 64.1
      hsa04012 ErbB signaling pathway 10 75.3
      hsa04540 Gap junction 10 56
      hsa04061 Viral protein interaction with cytokine and cytokine receptor 10 44.6
      hsa04110 Cell cycle 10 46.2
      hsa04728 Dopaminergic synapse 10 52
      hsa04072 Phospholipase D signaling pathway 10 69
      hsa05216 Thyroid cancer 9 63.66667
      hsa04920 Adipocytokine signaling pathway 9 64.66667
      hsa04622 RIG-I-like receptor signaling pathway 9 66
      hsa05230 Central carbon metabolism in cancer 9 74.55556
      hsa04662 B cell receptor signaling pathway 9 86.77778
      hsa04610 Complement and coagulation cascades 9 26.77778
      hsa05231 Choline metabolism in cancer 9 80.88889
      hsa04914 Progesterone-mediated oocyte maturation 9 69.44444
      hsa04935 Growth hormone synthesis, secretion and action 9 78.44444
      hsa04611 Platelet activation 9 59.11111
      hsa04140 Autophagy - animal 9 68.55556
      hsa04150 mTOR signaling pathway 9 81.55556
      hsa04613 Neutrophil extracellular trap formation 9 79.88889
      hsa04923 Regulation of lipolysis in adipocytes 8 49.25
      hsa05416 Viral myocarditis 8 50.375
      hsa04664 Fc epsilon RI signaling pathway 8 87.375
      hsa05211 Renal cell carcinoma 8 80.75
      hsa05031 Amphetamine addiction 8 51.375
      hsa04912 GnRH signaling pathway 8 80.5
      hsa04670 Leukocyte transendothelial migration 8 49.25
      hsa04650 Natural killer cell mediated cytotoxicity 8 78.5
      hsa04015 Rap1 signaling pathway 8 87
      hsa05016 Huntington disease 8 55.375
      hsa04215 Apoptosis - multiple species 7 63.42857
      hsa05332 Graft-versus-host disease 7 62.57143
      hsa05030 Cocaine addiction 7 53.71429
      hsa04623 Cytosolic DNA-sensing pathway 7 69.85714
      hsa04929 GnRH secretion 7 82.57143
      hsa04211 Longevity regulating pathway 7 73
      hsa05032 Morphine addiction 7 43.42857
      hsa04152 AMPK signaling pathway 7 57
      hsa04723 Retrograde endocannabinoid signaling 7 69.71429
      hsa04934 Cushing syndrome 7 69
      hsa04310 Wnt signaling pathway 7 65.57143
      hsa05034 Alcoholism 7 63.28571
      hsa04810 Regulation of actin cytoskeleton 7 68.42857
      hsa01523 Antifolate resistance 6 82.33333
      hsa05330 Allograft rejection 6 59.16667
      hsa04940 Type I diabetes mellitus 6 64.33333
      hsa04672 Intestinal immune network for IgA production 6 57.16667
      hsa04913 Ovarian steroidogenesis 6 45.83333
      hsa05204 Chemical carcinogenesis - DNA adducts 6 44
      hsa04137 Mitophagy - animal 6 71
      hsa03320 PPAR signaling pathway 6 42.16667
      hsa04742 Taste transduction 6 39.66667
      hsa04970 Salivary secretion 6 52.5
      hsa04350 TGF-beta signaling pathway 6 81
      hsa04666 Fc gamma R-mediated phagocytosis 6 95.83333
      hsa04750 Inflammatory mediator regulation of TRP channels 6 64.16667
      hsa04114 Oocyte meiosis 6 69.33333
      hsa04910 Insulin signaling pathway 6 88
      hsa04550 Signaling pathways regulating pluripotency of stem cells 6 99
      hsa04390 Hippo signaling pathway 6 55.33333
      hsa04960 Aldosterone-regulated sodium reabsorption 5 83.6
      hsa00380 Tryptophan metabolism 5 47.4
      hsa04930 Type II diabetes mellitus 5 82.8
      hsa00330 Arginine and proline metabolism 5 51
      hsa00590 Arachidonic acid metabolism 5 49.2
      hsa00982 Drug metabolism - cytochrome P450 5 47.4
      hsa00980 Metabolism of xenobiotics by cytochrome P450 5 46.8
      hsa00983 Drug metabolism - other enzymes 5 44.8
      hsa04640 Hematopoietic cell lineage 5 77
      hsa04270 Vascular smooth muscle contraction 5 95
      hsa05322 Systemic lupus erythematosus 5 66.8
      hsa04514 Cell adhesion molecules 5 49.4
      hsa04141 Protein processing in endoplasmic reticulum 5 64.4
      hsa04360 Axon guidance 5 93.8
      hsa05310 Asthma 4 75.5
      hsa05033 Nicotine addiction 4 55.5
      hsa05320 Autoimmune thyroid disease 4 63.75
      hsa04730 Long-term depression 4 116.25
      hsa00140 Steroid hormone biosynthesis 4 55.75
      hsa04213 Longevity regulating pathway - multiple species 4 82
      hsa05217 Basal cell carcinoma 4 85.75
      hsa04720 Long-term potentiation 4 116.25
      hsa04924 Renin secretion 4 58
      hsa04520 Adherens junction 4 96.5
      hsa04612 Antigen processing and presentation 4 79.5
      hsa04721 Synaptic vesicle cycle 4 54.25
      hsa04146 Peroxisome 4 57
      hsa04727 GABAergic synapse 4 69.75
      hsa05410 Hypertrophic cardiomyopathy 4 88.5
      hsa05414 Dilated cardiomyopathy 4 79
      hsa04713 Circadian entrainment 4 106.75
      hsa04916 Melanogenesis 4 116.25
      hsa04972 Pancreatic secretion 4 70.75
      hsa04974 Protein digestion and absorption 4 53.25

      Table S5.  Summary of studies included in the systematic review

      StudyInformation of aninmalsType of Fructus LyciiIntervention vs. controlTime of interventionOutcome measures used
      Yang 2019Kunming mice, weighing 12–22 g, half-male and half-female, SPFDecoction of Fructus Lycii3 mg/(g∙d) (n = 10) vs. 6 mg/(g∙d) (n = 10) vs. Placebo (distilled water 0.02 mL/(g∙d), n = 10)30 daysMDA, ROS, SOD, CAT, GSH-Px
      Cao 2018Kunming mice, weighing 18–22 g, half-male and half-female, SPFDecoction of Fructus Lycii
      3 mg/(g∙d) (n = 10) vs. 6 mg/(g∙d) (n = 10) vs. Placebo (distilled water 0.02 mL/(g∙d), n = 10)30 daysThe time of exhaustive swimming, blood glucose, muscle glycogen and liver glycogen, BUN and lactic acid
      Ji et al 2011Eight-week-old Wistar rats, weighing 220 ± 23.19 g, femaleDecoction of Fructus LyciiDecoction of Fructus Lycii (n = 8) vs. Placebo (n = 8)30 daysThe time of exhaustive swimming, SOD, MAD
      Ding et al 2001Kunming mice, weighing 20–24 g, maleDecoction of Fructus LyciiDecoction of Fructus Lycii (n = 10) vs. Placebo (n = 10)2 weeksThe time of exhaustive swimming, SOD, MAD
      Qin et al 2009miceExtract of Fructus Lycii5 mg/(g∙d) (n = 10) vs. 10 mg/(g∙d) (n = 10) vs. 20 mg/(g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)2 weeksThe time of exhaustive swimming
      Hu et al 2008Kunming mice, weighing 18–22 g, femaleRaw juice of Fructus Lycii10 mL/(kg∙d) (n = 10) vs. 20 mL/(kg∙d) (n = 10) vs. 30 mL/(kg∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)3 weeksThe time of exhaustive swimming, and liver glycogen,BUN
      Liu et al 2011Kunming mice, weighing 24 ± 5 g, femaleDecoction of Fructus Lycii5 mg/(g∙d) (n = 10) vs. Placebo (Equivalent distilled water, n = 10)10 daysThe time of exhaustive swimming
      Yi et al 2010Kunming mice, weighing 24 ± 5 g, half-male and half-femaleDecoction of Fructus Lycii5 mg/(g∙d) (n = 10) vs. 2.5 mg/(g∙d) (n = 10) vs. Placebo(Equivalent running water, n = 10)2 weeksThe time of exhaustive swimming
      Wang et al 2002Kunming mice, weighing 20 ± 2 g, male and femaleDecoction of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. 0.1 mL/10 (g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)1 weekThe time of exhaustive swimming
      Liu 2019Kunming mice, 6 week, maleExtract of Fructus Lycii0.3 mg/(g∙d) (n = 10) vs. 0.6 mg/(g∙d) (n = 10) vs. 0.9 mg/(g∙d) (n = 10) vs. Placebo (n = 10)2 weeksThe time of exhaustive swimming, muscle glycogen and liver glycogen, BUN and lactic acid, SOD, MDA
      Yang et al 2018Kunming mice, weighing 18–22 g, male, SPFExtract of Fructus Lycii0.5 mg/(g∙d) (n = 10) vs. 1 mg/g/d (n = 10) vs. 1.5 mg/(g∙d) (n = 10) vs. Placebo (n = 10)30 daysThe time of exhaustive swimming, muscle glycogen and liver glycogen, BUN and lactic acid
      Ma 2019Rats, SPFFruit of Fructus Lycii0.5g/(kg∙d) (n = 10) vs. 3g/(kg∙d) (n = 15) vs. Placebo (5 mL/kg saline, n = 15)6 weeksThe time of exhaustive swimming
      Niu et al. 1994Kunming mice, weighing 18–24 g, half-male and half-female, SPFDecoction of Fructus Lycii5g/(kg∙d) (n = 10) vs. 2.5/(kg∙d) (n = 10) vs. Placebo (Equivalent running water, n = 10)2 weeksThe time of exhaustive swimming, blood glucose, and lactic acid
      Wu et al. 2008Kunming mice, 3 week, weighing 18–22 g,femaleRaw juice of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. 0.25 mL/10 (g∙d) (n = 10) vs. Placebo (Equivalent saline, n = 10)3 weeksThe time of exhaustive swimming, BUN and lactic acid
      Wang et al. 2017Kunming mice, weighing 60–80 g, femaleExtract of Fructus Lycii0.2 mL/10 (g∙d) (n = 10) vs. Placebo (n = 10)3 weeksThe time of exhaustive swimming
        Note. MDA, malondialdehyde; ROS, reactive oxygen species; SOD, superoxide dismutase; CAT, catalase; GSH-Px, glutathione peroxidase; BUN, blood urea nitrogen. A total 15 RCTs studies included, the information in detail were showed in the Supplementary Table S5. The exhaustive time, which the main parameter of anti-exercise-fatigue ability, were assessed in 14 articles. blood lactate (included in 6 articles) and BUN (included in 5 articles) were the main product of exercise metabolism and important marker for the evaluation of exercise fatigue. As the important energy source, muscle glycogen was included in 2 articles and liver glycogen in 3 articles. SOD (in 3 articles) and MAD (in 4 articles) also were the important outcomes included in our study. Based on the placebo group, the experimental group received decoction of Fructus Lycii (8 articles), extract of Fructus Lycii (4 articles), raw juice of Fructus Lycii (2 articles) and fruit of Fructus Lycii (1 article). Treatment duration ranged from 10 to 42 days.

      Figure S3.  Flow diagram of the study selection. Supplementary Figure S3 showed that a total of 441 relevant literature sources were identified through the search strategy. After removing 145 duplicate articles, the titles and abstracts of the remaining papers were screened to exclude those that were not related to Fructus Lycii and exercise-induced fatigue. And then, we reviewed 51 articles with full texts and 15 randomized controlled trials (RCTs) involving animals were included in the final analysis.

      Figure S4.  Forest plot of s standardized mean differences in exhausted time between Fructus Lycii and placebo. Weights have been calculated using random effects model. Degree of heterogeneity in the pooled estimates is represented at I2 statistic. SMD, standardized mean difference; Chi2, Chi-square test; df, degrees of freedom; I2, I-squared statistic; Z, Z-test; CI, confidence interval; H, high-dose intervention in each study; M, median-dose intervention in each study; L, low-dose intervention in each study. The exhausted time was the primary outcome. There was significant heterogeneity among the 14 studies (I2 = 78%, P < 0.01) and therefore a random effect model was used as shown in the Supplementary Figure S4. Meta-analysis of 14 studies showed significant effects of Fructus Lycii on increasing the time to exhaustion compared with control groups (SMD 1.5; 95% CI 1.08 to 1.92; P < 0.01).

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