Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenyang, Liaoning, 110016, People's Republic of China.
The Third Outpatient Department, General Hospital of Northern Theater Command, 49 Beiling Road, Shenyang, Liaoning, 110032, People's Republic of China.
Apoptosis. 2023 Apr;28(3-4):607-626. doi: 10.1007/s10495-023-01814-8. Epub 2023 Jan 28.
Ferroptosis contributes to the pathogenesis of atrial fibrillation (AF), although the mechanisms are still largely uncovered. The current study was designed to explore the pharmacological effects of icariin against ethanol-induced atrial remodeling, if any, and the mechanisms involved with a focus on SIRT1 signaling. Excessive ethanol-treated animals were administered with Ferrostatin-1, Erastin or icariin to evaluate the potential effects of icariin or ferroptosis. Then, the underling mechanisms was further explored in the in vitro experiments using HL-1 atrial myocytes. Excessive ethanol administration caused significant atrial damage as evidenced by increased susceptibility to AF, altered atrial conduction pattern, atrial enlargement, and enhanced fibrotic markers. These detrimental effects were reversed by Ferrostatin-1 or icariin treatment, while Erastin co-administration markedly abolished the beneficial actions conferred by icariin. Mechanistically, ethanol-treated atria exhibited markedly up-regulated pro-ferroptotic protein (PTGS2, ACSL4, P53) and suppressed anti-ferroptotic molecules (GPX4, FTH1). Icariin treatment inhibited ethanol-induced atrial ferroptosis by reducing atrial mitochondrial damage, ROS accumulation and iron overload. Interestingly, the in vivo and in vitro data showed that icariin activated atrial SIRT1-Nrf-2-HO-1 signaling pathway, while EX527 not only reversed these effects, but also abolished the therapeutic effects of icariin. Moreover, the stimulatory effects on GPX4, SLC7A11 and the suppressive effects on ACSL4, P53 conferred by icariin were blunted by EX527 treatment. These data demonstrate that ferroptosis plays a causative role in the pathogenesis of ethanol-induced atrial remodeling and susceptibility to AF. Icariin protects against atrial damage by inhibiting ferroptosis via SIRT1 signaling. Its role as a prophylactic/therapeutic drug deserves further clinical study.
铁死亡导致心房颤动(AF)的发病机制,尽管其机制在很大程度上仍未被揭示。本研究旨在探讨淫羊藿苷对乙醇诱导的心房重构的药理作用,如果有的话,并探讨其机制,重点关注 SIRT1 信号。过量乙醇处理的动物给予 Ferrostat in-1、Erastin 或淫羊藿苷,以评估淫羊藿苷或铁死亡的潜在作用。然后,在体外实验中使用 HL-1 心房肌细胞进一步探讨其潜在机制。过量乙醇给药导致明显的心房损伤,表现为 AF 易感性增加、心房传导模式改变、心房扩大和纤维化标志物增强。Ferrostat in-1 或淫羊藿苷治疗可逆转这些有害作用,而 Erastin 共同给药则显著消除了淫羊藿苷带来的有益作用。从机制上讲,乙醇处理的心房表现出明显上调的促铁死亡蛋白(PTGS2、ACSL4、P53)和抑制抗铁死亡分子(GPX4、FTH1)。淫羊藿苷通过减少心房线粒体损伤、ROS 积累和铁过载来抑制乙醇诱导的心房铁死亡。有趣的是,体内和体外数据表明,淫羊藿苷激活了心房 SIRT1-Nrf-2-HO-1 信号通路,而 EX527 不仅逆转了这些作用,还消除了淫羊藿苷的治疗作用。此外,EX527 处理减弱了淫羊藿苷对 GPX4、SLC7A11 的刺激作用和对 ACSL4、P53 的抑制作用。这些数据表明,铁死亡在乙醇诱导的心房重构和 AF 易感性发病机制中起因果作用。淫羊藿苷通过 SIRT1 信号抑制铁死亡来保护心房免受损伤。它作为一种预防/治疗药物的作用值得进一步的临床研究。
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