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中药补气活血延缓糖尿病心肌病进展。

Chinese Medicine Supplementing Qi and Activating Blood Circulation Relieves the Progression of Diabetic Cardiomyopathy.

机构信息

Department of Traditional Chinese Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, P.R. China

National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, P.R. China

出版信息

Endocr Metab Immune Disord Drug Targets. 2024;24(1):163-171. doi: 10.2174/1871530323666230501151924.

Abstract

BACKGROUND

Diabetic cardiomyopathy (DCM) is the leading cause of diabetic death as the final occurrence of heart failure and arrhythmia. Traditional Chinese medicine is usually used to treat various diseases including diabetes.

OBJECTIVE

This study sought to investigate the effects of Traditional Chinese medicine supplementing Qi and activating blood circulation (SAC) in DCM.

METHODS

After the construction of the DCM model by streptozotocin (STZ) injection and high glucose/fat diet feeding, rats were administered intragastrically with SAC. Then, cardiac systolic/diastolic function was evaluated by detecting left ventricular systolic pressure (LVSP), maximal rate of left ventricular pressure rise (+LVdp/dtmax), and fall (-LVdp/dtmax), heart rate (HR), left ventricular ejection fraction (EF), LV fractional shortening (FS) and left ventricular end-diastolic pressure (LVEDP). Masson’s and TUNEL staining were used to assess fibrosis and cardiomyocyte apoptosis.

RESULTS

DCM rats exhibited impaired cardiac systolic/diastolic function manifested by decreasing LVSP, + LVdp/dtmax, -LVdp/dtmax, HR, EF and FS, and increasing LVEDP. Intriguingly, traditional Chinese medicine SAC alleviated the above-mentioned symptoms, indicating a potential role in improving cardiac function. Masson’s staining substantiated that SAC antagonized the increased collagen deposition and interstitial fibrosis area and the elevations in protein expression of fibrosis-related collagen I and fibronectin in heart tissues of DCM rats. Furthermore, TUNEL staining confirmed that traditional Chinese medicine SAC also attenuated cardiomyocyte apoptosis in DCM rats. Mechanically, DCM rats showed the aberrant activation of the TGF-β/Smad signaling, which was inhibited after SAC.

CONCLUSION

SAC may exert cardiac protective efficacy in DCM rats via the TGF-β/Smad signaling, indicating a new promising therapeutic approach for DCM.

摘要

背景

糖尿病心肌病(DCM)是心力衰竭和心律失常最终发生的糖尿病死亡的主要原因。中药通常用于治疗包括糖尿病在内的各种疾病。

目的

本研究旨在探讨中药益气活血(SAC)对 DCM 的作用。

方法

采用链脲佐菌素(STZ)注射和高糖/高脂饮食喂养构建 DCM 模型后,大鼠给予 SAC 灌胃。然后,通过检测左心室收缩压(LVSP)、左心室压力上升最大速率(+LVdp/dtmax)、下降最大速率(-LVdp/dtmax)、心率(HR)、左心室射血分数(EF)、左心室短轴缩短率(FS)和左心室舒张末期压(LVEDP)来评估心脏的收缩/舒张功能。Masson 和 TUNEL 染色用于评估纤维化和心肌细胞凋亡。

结果

DCM 大鼠表现出心脏收缩/舒张功能受损,表现为 LVSP、+LVdp/dtmax、-LVdp/dtmax、HR、EF 和 FS 降低,LVEDP 升高。有趣的是,中药 SAC 缓解了上述症状,表明其在改善心脏功能方面具有潜在作用。Masson 染色证实,SAC 拮抗了 DCM 大鼠心脏组织中胶原沉积和间质纤维化面积的增加以及纤维化相关胶原 I 和纤维连接蛋白蛋白表达的升高。此外,TUNEL 染色证实,中药 SAC 还减轻了 DCM 大鼠的心肌细胞凋亡。在机制上,DCM 大鼠表现出 TGF-β/Smad 信号的异常激活,而 SAC 后该信号被抑制。

结论

SAC 可能通过 TGF-β/Smad 信号通路对 DCM 大鼠发挥心脏保护作用,为 DCM 提供了一种新的有前途的治疗方法。

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