Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China.
Department of Acupuncture, Qinhuai District Hospital of Traditional Chinese Medicine, Nanjing 210000, China.
Chin J Nat Med. 2022 Sep;20(9):679-690. doi: 10.1016/S1875-5364(22)60172-9.
Deep venous thrombosis (DVT) poses a major challenge to public health worldwide. Endothelial cell injury evokes inflammatory and oxidative responses that contribute to thrombus formation. Tea polyphenol (TP) in the form of epigallocatechin-3-gallate (EGCG) has anti-inflammatory and oxidative effect that may ameliorate DVT. However, the precise mechanism remains incompletely understood. The current study was designed to investigate the anti-DVT mechanism of EGCG in combination with warfarin (an oral anticoagulant). Rabbits were randomly divided into five groups. A DVT model of rats was established through ligation of the inferior vena cava (IVC) and left common iliac vein, and the animals were orally administered with EGCG, warfarin, or vehicle for seven days. In vitro studies included pretreatment of human umbilical vein endothelial cells (HUVECs) with different concentrations of EGCG for 2 h before exposure to hydrogen peroxide. Thrombus weight and length were examined. Histopathological changes were observed by hematoxylin-eosin staining. Blood samples were collected for detecting coagulation function, including thrombin and prothrombin times, activated partial thromboplastin time, and fibrinogen levels. Protein expression in thrombosed IVCs and HUVECs was evaluated by Western blot, immunohistochemical analysis, and/or immunofluorescence staining. RT-qPCR was used to determine the levels of AGTR-1 and VEGF mRNA in IVCs and HUVECs. The viability of HUVECs was examined by CCK-8 assay. Flow cytometry was performed to detect cell apoptosis and ROS generation was assessed by 2',7'-dichlorofluorescein diacetate reagent. In vitro and invivo studies showed that EGCG combined with warfarin significantly reduced thrombus weight and length, and apoptosis in HUVECs. Our findings indicated that the combination of EGCG and warfarin protects HUVECs from oxidative stress and prevents apoptosis. However, HIF-1α silencing weakened these effects, which indicated that HIF-1α may participate in DVT. Furthermore, HIF-1α silencing significantly up-regulated cell apoptosis and ROS generation, and enhanced VEGF expression and the activation of the PI3K/AKT and ERK1/2 signaling pathways. In conclusion, our results indicate that EGCG combined with warfarin modifies HIF-1α and VEGF to prevent DVT in rabbits through anti-inflammation via the PI3K/AKT and ERK1/2 signaling pathways.
深静脉血栓形成(DVT)是全球公共卫生面临的主要挑战。内皮细胞损伤会引起炎症和氧化反应,导致血栓形成。表没食子儿茶素没食子酸酯(EGCG)形式的茶多酚具有抗炎和抗氧化作用,可能改善 DVT。然而,其确切机制尚不完全清楚。本研究旨在探讨 EGCG 联合华法林(一种口服抗凝剂)抗 DVT 的机制。兔子被随机分为五组。通过结扎下腔静脉(IVC)和左髂总静脉建立大鼠 DVT 模型,动物连续 7 天口服 EGCG、华法林或载体。体外研究包括用不同浓度的 EGCG 预处理人脐静脉内皮细胞(HUVEC) 2 小时,然后暴露于过氧化氢。检查血栓重量和长度。通过苏木精-伊红染色观察组织病理学变化。收集血液样本检测凝血功能,包括凝血酶和凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原水平。通过 Western blot、免疫组化分析和/或免疫荧光染色评估血栓形成的 IVC 和 HUVEC 中的蛋白表达。通过 RT-qPCR 确定 IVC 和 HUVEC 中 AGTR-1 和 VEGF mRNA 的水平。通过 CCK-8 测定法检查 HUVEC 的活力。通过流式细胞术检测细胞凋亡,通过 2',7'-二氯荧光素二乙酸酯试剂检测 ROS 生成。体外和体内研究表明,EGCG 联合华法林可显著降低 HUVEC 血栓重量和长度以及凋亡。我们的研究结果表明,EGCG 联合华法林可保护 HUVEC 免受氧化应激并防止凋亡。然而,HIF-1α 沉默削弱了这些作用,这表明 HIF-1α 可能参与 DVT。此外,HIF-1α 沉默显著增加细胞凋亡和 ROS 生成,并增强 VEGF 表达和 PI3K/AKT 和 ERK1/2 信号通路的激活。总之,我们的结果表明,EGCG 联合华法林通过 PI3K/AKT 和 ERK1/2 信号通路通过抗炎作用调节 HIF-1α 和 VEGF,从而预防兔 DVT。