Wang Yumeng, Shou Xintian, Fan Zongjing, Cui Jie, Xue Donghua, Wu Yang
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Cardiovascular, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Pharmacol. 2022 May 20;13:847748. doi: 10.3389/fphar.2022.847748. eCollection 2022.
Phytoestrogens are a class of natural compounds that have structural similarities to estrogens. They have been identified to confer potent cardioprotective effects in experimental myocardial ischemia-reperfusion injury (MIRI) animal models. We aimed to investigate the effect of PE on MIRI and its intrinsic mechanisms. A systematic search was conducted to identify PEs that have been validated in animal studies or clinical studies as effective against MIRI. Then, we collected studies that met inclusion and exclusion criteria from January 2016 to September 2021. The SYRCLE's RoB tool was used to evaluate the quality. Data were analyzed by STATA 16.0 software. The search yielded 18 phytoestrogens effective against heart disease. They are genistein, quercetin, biochanin A, formononetin, daidzein, kaempferol, icariin, puerarin, rutin, notoginsenoside R1, tanshinone IIA, ginsenoside Rb1, ginsenoside Rb3, ginsenoside Rg1, ginsenoside Re, resveratrol, polydatin, and bakuchiol. Then, a total of 20 studies from 17 articles with a total of 355 animals were included in this meta-analysis. The results show that PE significantly reduced the myocardial infarct size in MIRI animals compared with the control group ( < 0.001). PE treatment significantly reduced the creatine kinase level ( < 0.001) and cTnI level ( < 0.001), increased left ventricular ejection fraction ( < 0.001) and left ventricular fractional shortening ( < 0.001) in MIRI animals. In addition, PE also exerts a significant heart rate lowering effect ( < 0.001). Preclinical evidence suggests that PE can be multi-targeted for cardioprotective effects in MIRI. More large animal studies and clinical research are still needed in the future to further confirm its role in MIRI.
植物雌激素是一类与雌激素结构相似的天然化合物。在实验性心肌缺血再灌注损伤（MIRI）动物模型中，已证实它们具有强大的心脏保护作用。我们旨在研究植物雌激素对MIRI的影响及其内在机制。通过系统检索，以确定在动物研究或临床研究中已被验证对MIRI有效的植物雌激素。然后，我们收集了2016年1月至2021年9月期间符合纳入和排除标准的研究。使用SYRCLE的RoB工具评估质量。数据采用STATA 16.0软件进行分析。检索结果显示有18种植物雌激素对心脏病有效。它们分别是染料木黄酮、槲皮素、鹰嘴豆芽素A、芒柄花黄素、大豆苷元、山奈酚、淫羊藿苷、葛根素、芦丁、三七皂苷R1、丹参酮IIA、人参皂苷Rb1、人参皂苷Rb3、人参皂苷Rg1、人参皂苷Re、白藜芦醇、虎杖苷和补骨脂酚。然后，本荟萃分析共纳入了来自17篇文章的20项研究，共计355只动物。结果表明，与对照组相比，植物雌激素显著降低了MIRI动物的心肌梗死面积（<0.001）。植物雌激素治疗显著降低了MIRI动物的肌酸激酶水平（<0.001）和肌钙蛋白I水平（<0.001），提高了左心室射血分数（<0.001）和左心室缩短分数（<0.001）。此外，植物雌激素还具有显著的降低心率作用（<0.001）。临床前证据表明，植物雌激素在MIRI中可通过多靶点发挥心脏保护作用。未来仍需要更多的大型动物研究和临床研究来进一步证实其在MIRI中的作用。
