Zhao Liyun, Jin Lili, Luo Yuanyuan, Wang Ling, Li Yinghong, Xian Shaoxiang, Zhao Fengli
Department of Critical Care Medicine, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China.
Department of Internal Medicine-Cardiovascular, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China.
Ann Transl Med. 2022 May;10(10):597. doi: 10.21037/atm-22-836.
Cardiac dysfunction frequently occurs after sepsis and septic shock and contributes to multiple organ failure. Shenfu injection, a well-known Chinese medicine formulation, has recently been demonstrated to possess potential cardio-protective effects, although its effect and mechanism in sepsis-induced myocardial dysfunction remains unclear.
To investigate whether Shenfu injection could alleviate myocardial injury and improve cardiac function, a model of sepsis was induced by cecal ligation and puncture (CLP) surgery in C57BL/6 mice. Cardiac function, inflammatory factors, and apoptosis were evaluated in the myocardium.
Our results showed that the survival and left ventricular function markedly declined when exposed to CLP compared with the sham procedure. In contrast, Shenfu injection lowered mortality and prevented CLP from triggering left ventricular dysfunction. Moreover, mice treated with Shenfu injection exhibited noticeably decreased myocardial inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, and monocytechemoattractantprotein-1 (MCP-1)] and reduced apoptotic myocardiocytes death compared with mice that had CLP. The activation of myocardial NF-кB detected in septic mice was suppressed by the presence of Shenfu injection, as evidenced by decreased nuclear translocation of the NF-кB p65 subunit. Moreover, Shenfu injection also prevented sepsis-caused decreases in myocardial phospho-Akt and phospho-GSK-3β in septic mice.
These data suggest that administration of Shenfu injection attenuates cardiac dysfunction, protects against inflammatory injury, and reduces apoptosis of myocardiocytes during sepsis by activating the AKT/GSK-3β pathway.
脓毒症和脓毒性休克后常发生心脏功能障碍，并导致多器官功能衰竭。参附注射液是一种著名的中药制剂，最近已被证明具有潜在的心脏保护作用，但其在脓毒症诱导的心肌功能障碍中的作用及机制仍不清楚。
为研究参附注射液是否能减轻心肌损伤并改善心脏功能，采用盲肠结扎穿刺（CLP）手术在C57BL/6小鼠中诱导脓毒症模型。对心肌的心脏功能、炎症因子和细胞凋亡进行评估。
我们的结果显示，与假手术组相比，暴露于CLP时生存率和左心室功能明显下降。相比之下，参附注射液降低了死亡率，并防止CLP引发左心室功能障碍。此外，与接受CLP的小鼠相比，接受参附注射液治疗的小鼠心肌炎性细胞因子[肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1β、IL-6和单核细胞趋化蛋白-1（MCP-1）]明显减少，凋亡心肌细胞死亡减少。参附注射液的存在抑制了脓毒症小鼠中检测到的心肌NF-κB的激活，NF-κB p65亚基的核转位减少证明了这一点。此外，参附注射液还防止了脓毒症小鼠中脓毒症引起的心肌磷酸化Akt和磷酸化GSK-3β降低。
这些数据表明，在脓毒症期间，给予参附注射液可减轻心脏功能障碍，防止炎症损伤，并通过激活AKT/GSK-3β途径减少心肌细胞凋亡。
