Yuhan Yang, Ziyi Sun, Xiaoning Sun, Jin Zhang, Tong Tong, Xiaoxiao Zhang, Kuiwu Yao
{"title":"Protective effect of salvianolic acid B against myocardial ischemia/reperfusion injury: preclinical systematic evaluation and meta-analysis","authors":"Yuhan Yang, Ziyi Sun, Xiaoning Sun, Jin Zhang, Tong Tong, Xiaoxiao Zhang, Kuiwu Yao","doi":"10.3389/fphar.2024.1452545","DOIUrl":null,"url":null,"abstract":"BackgroundSalvianolic acid B is the most abundant water-soluble component in the traditional Chinese medicine Danshen and can reduce myocardial ischemia-reperfusion (MI/R) injury through multiple targets and pathways. However, the role of SalB in protecting the myocardium from ischemia/reperfusion injury remains unclear.PurposeTo perform a preclinical systematic review and meta-analysis to assess the efficacy of Sal B in an animal model of myocardial infarction/reperfusion (MI/R) and to summarize the potential mechanisms of Sal B against MI/R.MethodsStudies published from inception to March 2024 were systematically searched in PubMed, Web of Science, Embase, China National Knowledge Infrastructure Wanfang, and VIP databases. The methodological quality was determined using the SYRCLE RoB tool. The R software was used to analyze the data. The potential mechanisms are categorized and summarized.Results32 studies containing 732 animals were included. The results of the meta-analysis showed that Sal B reduced myocardial infarct size (<jats:italic>p</jats:italic> &lt; 0.01), and the cardiological indices of CK-MB (<jats:italic>p</jats:italic> &lt; 0.01), CK (<jats:italic>p</jats:italic> &lt; 0.01), LDH (<jats:italic>p</jats:italic> &lt; 0.01), and cTnI (<jats:italic>p</jats:italic> &lt; 0.01) compared to the control group. In addition, Sal B increased cardiac function indices, such as LVFS (<jats:italic>p</jats:italic> &lt; 0.01), -dp/dt max (<jats:italic>p</jats:italic> &lt; 0.01), +dp/dt max (<jats:italic>p</jats:italic> &lt; 0.01), and cardiac output (<jats:italic>p</jats:italic> &lt; 0.01). The protective effects of Sal B on the myocardium after I/R may be mediated by attenuating oxidative stress and inflammation, promoting neovascularization, regulating vascular function, and attenuating cardiac myocyte apoptosis. Publication bias was observed in all the included studies. Further studies are required to elucidate the extent of the cardioprotective effects of SalB and the safety of its use.ConclusionTo the best of our knowledge, this is the first meta-analysis of Sal B in the treatment of MI/R injury, and Sal B demonstrated a positive effect on MI/R injury through the modulation of key pathological indicators and multiple signaling pathways. Further studies are needed to elucidate the extent to which SalB exerts its cardioprotective effects and the safety of its use.Systematic Review Registration<jats:ext-link>https://www.crd.york.ac.uk/PROSPERO/</jats:ext-link>.","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fphar.2024.1452545","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
BackgroundSalvianolic acid B is the most abundant water-soluble component in the traditional Chinese medicine Danshen and can reduce myocardial ischemia-reperfusion (MI/R) injury through multiple targets and pathways. However, the role of SalB in protecting the myocardium from ischemia/reperfusion injury remains unclear.PurposeTo perform a preclinical systematic review and meta-analysis to assess the efficacy of Sal B in an animal model of myocardial infarction/reperfusion (MI/R) and to summarize the potential mechanisms of Sal B against MI/R.MethodsStudies published from inception to March 2024 were systematically searched in PubMed, Web of Science, Embase, China National Knowledge Infrastructure Wanfang, and VIP databases. The methodological quality was determined using the SYRCLE RoB tool. The R software was used to analyze the data. The potential mechanisms are categorized and summarized.Results32 studies containing 732 animals were included. The results of the meta-analysis showed that Sal B reduced myocardial infarct size (p < 0.01), and the cardiological indices of CK-MB (p < 0.01), CK (p < 0.01), LDH (p < 0.01), and cTnI (p < 0.01) compared to the control group. In addition, Sal B increased cardiac function indices, such as LVFS (p < 0.01), -dp/dt max (p < 0.01), +dp/dt max (p < 0.01), and cardiac output (p < 0.01). The protective effects of Sal B on the myocardium after I/R may be mediated by attenuating oxidative stress and inflammation, promoting neovascularization, regulating vascular function, and attenuating cardiac myocyte apoptosis. Publication bias was observed in all the included studies. Further studies are required to elucidate the extent of the cardioprotective effects of SalB and the safety of its use.ConclusionTo the best of our knowledge, this is the first meta-analysis of Sal B in the treatment of MI/R injury, and Sal B demonstrated a positive effect on MI/R injury through the modulation of key pathological indicators and multiple signaling pathways. Further studies are needed to elucidate the extent to which SalB exerts its cardioprotective effects and the safety of its use.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/.
背景丹参酚酸 B 是中药丹参中含量最高的水溶性成分,可通过多种靶点和途径减轻心肌缺血再灌注损伤。目的 进行临床前系统综述和荟萃分析,评估丹参在心肌梗死/再灌注(MI/R)动物模型中的疗效,并总结丹参抗心肌梗死/再灌注的潜在机制。方法 在PubMed、Web of Science、Embase、中国国家知识基础设施万方和VIP数据库中系统检索了从开始到2024年3月发表的研究。使用 SYRCLE RoB 工具确定研究方法的质量。使用 R 软件对数据进行分析。结果共纳入 32 项研究,包含 732 只动物。荟萃分析结果表明,与对照组相比,萨尔乙能缩小心肌梗死面积(p< 0.01),降低CK-MB(p< 0.01)、CK(p< 0.01)、LDH(p< 0.01)和cTnI(p< 0.01)等心脏病学指标。此外,盐 B 还能增加心功能指数,如 LVFS(p < 0.01)、-dp/dt max(p < 0.01)、+dp/dt max(p < 0.01)和心输出量(p < 0.01)。盐 B 对 I/R 后心肌的保护作用可能是通过减轻氧化应激和炎症、促进血管新生、调节血管功能和减轻心肌细胞凋亡来实现的。所有纳入的研究均存在发表偏倚。结论 据我们所知,这是第一份关于 Sal B 治疗 MI/R 损伤的荟萃分析,Sal B 通过调节关键病理指标和多种信号通路对 MI/R 损伤有积极作用。还需要进一步的研究来阐明 Sal B 发挥心脏保护作用的程度及其使用的安全性。系统综述注册https://www.crd.york.ac.uk/PROSPERO/。
期刊介绍:
Frontiers in Pharmacology is a leading journal in its field, publishing rigorously peer-reviewed research across disciplines, including basic and clinical pharmacology, medicinal chemistry, pharmacy and toxicology. Field Chief Editor Heike Wulff at UC Davis is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.