Department of Traditional Chinese Medicine External Treatment Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
College of Acupuncture, Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
PeerJ. 2024 Aug 16;12:e17885. doi: 10.7717/peerj.17885. eCollection 2024.
Myocardial ischemia-reperfusion injury (MIRI) refers to severe damage to the ischemic myocardium following the restoration of blood flow, and it is a major complication of reperfusion therapy for myocardial infarction. Notably, drugs such as metoprolol have been utilized to reduce ischemia-reperfusion injury. Tanshinone IIA is a major constituent extracted from Bunge. Recently, tanshinone IIA has been studied extensively in animal models for controlling MIRI. Therefore, we conducted a meta-analysis on the application of tanshinone IIA in rat models with MIRI to evaluate the therapeutic effects of tanshinone IIA.
A comprehensive search was conducted across PubMed, Web of Science, Embase, the Cochrane Library, the China National Knowledge Infrastructure database, the Wanfang database, and the Chinese Scientific Journal Database to gather studies on tanshinone IIA intervention in rat models with MIRI.We employed SYRCLE's risk of bias tool to assess study quality. The primary outcome indicators were superoxide dismutase (SOD) and malondialdehyde (MDA). Myocardial infarction area was a secondary outcome indicator. This study was registered at PROSPERO (registration number CRD 42022344447).
According to the inclusion and exclusion criteria, 15 eligible studies were selected from 295 initially identified studies. In rat models with MIRI, tanshinone IIA significantly increased SOD levels while reducing MDA levels and myocardial infarction area. Moreover, the duration of myocardial ischemia influenced the effectiveness of tanshinone IIA. However, additional high-quality research studies are needed to establish the efficacy and definitive guidelines for the use of tanshinone IIA. Animal studies demonstrated that tanshinone IIA exerted a significant therapeutic effect when the ischemia duration was less than 40 minutes. Tanshinone IIA was found to be more effective when administered via intravenous, intraperitoneal, and intragastric routes at doses above 5 mg/kg. Additionally, treatment with tanshinone IIA at all stages-prior to myocardial ischemia, after ischemia but before reperfusion, prior to ischemia and after reperfusion, and after reperfusion-showed satisfactory results.
Tanshinone IIA enhanced SOD activity and reduced MDA levels, thereby ameliorating oxidative stress damage during MIRI. Additionally, it reduced the myocardial infarction area, indicating its effectiveness in mitigating MIRI-induced damage in rats and demonstrating a myocardial protective effect. These findings contribute valuable insights for developing MIRI treatment strategies.
心肌缺血再灌注损伤（MIRI）是指缺血心肌在血流恢复后的严重损伤，是心肌梗死再灌注治疗的主要并发症。值得注意的是，美托洛尔等药物已被用于减少缺血再灌注损伤。丹参酮 IIA 是从 丹参中提取的主要成分。最近，丹参酮 IIA 在动物模型中被广泛研究用于控制 MIRI。因此，我们对丹参酮 IIA 在 MIRI 大鼠模型中的应用进行了荟萃分析，以评估丹参酮 IIA 的治疗效果。
通过全面检索 PubMed、Web of Science、Embase、Cochrane 图书馆、中国知网、万方数据库和中国科学引文数据库，收集丹参酮 IIA 干预 MIRI 大鼠模型的研究。我们采用 SYRCLE 的偏倚风险工具评估研究质量。主要结局指标为超氧化物歧化酶（SOD）和丙二醛（MDA）。心肌梗死面积为次要结局指标。本研究在 PROSPERO（注册号 CRD 42022344447）上进行了注册。
根据纳入和排除标准，从最初确定的 295 项研究中选择了 15 项符合条件的研究。在 MIRI 大鼠模型中，丹参酮 IIA 显著提高 SOD 水平，同时降低 MDA 水平和心肌梗死面积。此外，心肌缺血持续时间影响丹参酮 IIA 的疗效。然而，需要更多高质量的研究来确定丹参酮 IIA 的疗效和使用指南。动物研究表明，当缺血持续时间小于 40 分钟时，丹参酮 IIA 发挥显著的治疗作用。当剂量大于 5mg/kg 时，丹参酮 IIA 通过静脉、腹腔和胃内途径给药更有效。此外，在心肌缺血前、缺血后再灌注前、缺血后再灌注前和再灌注后各个阶段给予丹参酮 IIA 治疗均取得了满意的效果。
丹参酮 IIA 增强 SOD 活性，降低 MDA 水平，从而减轻 MIRI 过程中的氧化应激损伤。此外，它还减少了心肌梗死面积，表明其在减轻大鼠 MIRI 损伤方面的有效性，并显示出心肌保护作用。这些发现为开发 MIRI 治疗策略提供了有价值的见解。
