Screening and evaluation of medicine food homology herbal combinations for ameliorating chemotherapy induced ovarian aging under an integrated multi-strategy framework

Abstract Background: Ovarian aging poses a serious threat to women's reproductive health. Medicine food homology (MFH) herbs, owing to their favorable safety profile and suitability for long-term use, have become important interventional resources. However, conventional formula screening relies largely on empirical statistics and lacks mechanistic evidence and a systematic screening strategy. Methods: In this study, we integrated single cell transcriptomic analysis, human use evidence mining, UPLC/Q TOF MS chemical profiling and pretrained protein molecular representation models to establish a multi strategy framework for the discovery of MFH herbal combinations. Single cell transcriptomic datasets related to ovarian aging from the GEO database were analyzed to identify key pathological processes and candidate targets. High-frequency MFH herbs were selected by mining classical prescriptions and clinical literature. By comparing six protein molecular pretrained representation combinations, ESM T5 was identified for compound target affinity prediction and validated by molecular dynamics simulation and surface plasmon resonance (SPR) assays, ultimately identifying the Astragalus ginseng (Huangqi Renshen) herb pair (HXF) as the core candidate. Functional expression validation of key targets was performed, and the efficacy of HXF and the expression of related molecules were verified in a D gal induced KGN granulosa cell senescence model and a cyclophosphamide-induced rat model of diminished ovarian function. Results: Single cell analysis revealed that ovarian aging was characterized by impaired steroidogenesis, enhanced MDK NCL communication between granulosa cells and immune cells, and extracellular matrix remodeling, with CYP19A1, SERPINE1 and MDK as key targets. By further integrating human-use evidence mining and UPLC/Q TOF MS compound annotation, an MFH compound library comprising 712 molecules was established. ESM T5 prediction, molecular dynamics (MD) simulation and SPR assays confirmed that multiple constituents of Astragalus and ginseng exhibited favorable binding activity toward key targets. At the cellular level, knockdown of MDK or SERPINE1 attenuated the senescence phenotype, whereas knockdown of CYP19A1 aggravated it. In vitro and in vivo experiments demonstrated that Astragalus ginseng ameliorated granulosa cell senescence and diminished ovarian function in rats, restored CYP19A1 related steroidogenesis, downregulated inflammation- and matrix remodeling related molecules such as SERPINE1 and IL18, and reduced MDK NCL colocalization signals. Conclusion: This study established a multi-strategy screening framework integrating disease mechanism decoding, human use evidence constraints and pretrained model prediction, and identified Astragalus ginseng as a candidate herb pair for ameliorating ovarian aging. Its effects may be associated with promoting steroidogenesis, suppressing SERPINE1/IL18 related inflammation and matrix remodeling, and modulating MDK NCL signaling. These findings provide a strategic reference for the mechanism oriented discovery of MFH herbal combinations.