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上海中医药大学附属岳阳中西医结合医院心病科(上海 200080)
于雅馨,女,硕士研究生,主要从事中医药防治心血管疾病临床及基础研究工作
沈雁,主任医师,硕士研究生导师;E-mail:sheny26@126.com
收稿日期:2024-10-15,
纸质出版日期:2025-06-10
移动端阅览
于雅馨,沈雁,曹玉,等.益胃升阳汤加味对射血分数保留的心力衰竭小鼠心肌纤维化的作用[J].上海中医药杂志,2025,59(6):22-27.
YU Yaxin,SHEN Yan,CAO Yu,et al.Effect of Modified Yiwei Shengyang Decoction on myocardial fibrosis in heart failure with preserved ejection fraction mice[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(6):22-27.
于雅馨,沈雁,曹玉,等.益胃升阳汤加味对射血分数保留的心力衰竭小鼠心肌纤维化的作用[J].上海中医药杂志,2025,59(6):22-27. DOI: 10.16305/j.1007-1334.2025.z20241015002.
YU Yaxin,SHEN Yan,CAO Yu,et al.Effect of Modified Yiwei Shengyang Decoction on myocardial fibrosis in heart failure with preserved ejection fraction mice[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(6):22-27. DOI: 10.16305/j.1007-1334.2025.z20241015002.
目的
2
观察益胃升阳汤加味对射血分数保留的心力衰竭(HFpEF)的疗效及其对心肌纤维化的改善作用。
方法
2
采用高脂饮食(HFD)和
N
-硝基-
L
-精氨酸甲酯盐酸盐(
L
-NAME)共同干预构建小鼠HFpEF模型,将C57BL/6小鼠随机分为5组,即空白组(BC)、模型组(MC)、沙库巴曲缬沙坦组(AC)、益胃升阳汤加味组(YSD)及益胃升阳汤加味双倍剂量组(YSD-H)。对各组小鼠进行超声心动图分析,评估益胃升阳汤加味对HFpEF小鼠心脏结构及功能的影响。采用游泳力竭实验评估小鼠运动耐量,马松(Masson)染色法及麦胚凝集素(WGA)染色法分析心脏组织的病理改变,酶联免疫吸附测定(ELISA)法检测脑利尿钠肽(BNP)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)评估心功能及纤维化程度,免疫组织化学染色法及Western blot法检测环化GMP-AMP合酶(cGAS)及干扰素基因刺激剂(STING)通路蛋白表达情况。
结果
2
与MC小鼠相比,经益胃升阳汤加味干预后小鼠心肌舒张功能恢复(
P
<
0.05),游泳时间增加(
P
<
0.05),Masson染色法显示相对胶原面积减少(
P
<
0.05),WGA染色法显示相对心肌细胞横截面积减小(
P
<
0.05),BNP、TIMP-1及MMP-9表达量降低(
P
<
0.05),cGAS、STING蛋白表达量下调(
P
<
0.05)。
结论
2
益胃升阳汤加味可有效减轻HFpEF小鼠心肌纤维化、心肌细胞肥大,提升心功能,抑制cGAS-STING表达,对HFpEF具有治疗作用。
Objective
2
To investigate the efficacy of Modified Yiwei Shengyang Decoction (MYSD) on heart failure with preserved ejection fraction (HFpEF) and its ability to improve myocardial fibrosis.
Methods
2
C57BL/6 mice were used to establish an HFpEF model by administering a high-fat diet (HFD) combined with
N
-nitro-
L
-arginine methyl ester (
L
-NAME). The mice were randomly assigned into five groups: blank control group (BC), model group (MC), sacubitril/valsartan treatment group (AC), MYSD treatment group (YSD), and double-dose MYSD treatment group (YSD-H). Echocardiographic assessments were performed to investigate the impact of MYSD on both structural and functional parameters in the hearts of HFpEF mice. A swimming endurance test was conducted to evaluate exercise tolerance in the mice. Masson's trichrome (Masson) staining and wheat germ agglutinin (WGA) staining were employed to analyze pathological alterations in cardiac tissues. Brain natriuretic peptide (BNP), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were detected using enzyme-linked immunosorbent assay (ELISA) to evaluate cardiac function and fibrosis. Immunohistochemical staining and Western blot were used to detect the expression levels of cyclic GMP-AMP synthase (cGAS) and proteins involved in the stimulator of interferon genes (STING) pathway.
Results
2
After intervention with MYSD compared with MC mice: The myocardial diastolic function of the mice was restored (
P
<
0.05); Swimming time increased (
P
<
0.05); Masson staining showed decreased relative collagen area (
P
<
0.05); WGA staining revealed a reduced relative cross-sectional area of myocardial cells (
P
<
0.05); Expression of BNP, TIMP-1, and MMP-9 decreased (
P
<
0.05); cGAS and STING protein expression was downregulated (
P
<
0.05).
Conclusion
2
MYSD significantly mitigates cardiac fibrosis and myocardial hypertrophy while enhancing heart function in HFpEF mouse models; it also suppresses cGAS and STING expression, indicating its therapeutic effect on HFpEF.
黄玉梅 , 陈建康 . 射血分数保留的心力衰竭研究进展 [J]. 创伤与急诊电子杂志 , 2024 , 12 ( 1 ): 74 - 84 .
周京敏 , 王华 , 黎励文 . 射血分数保留的心力衰竭诊断与治疗中国专家共识2023 [J]. 中国循环杂志 , 2023 , 38 ( 4 ): 375 - 393 .
SORIMACHI H , BURKHOFF D , VERBRUGGE F H , et al . Obesity, venous capacitance, and venous compliance in heart failure with preserved ejection fraction [J]. Eur J Heart Fail , 2021 , 23 ( 10 ): 1648 - 1658 .
VERBRUGGE F H , OMOTE K , REDDY Y N V , et al . Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality [J]. Eur Heart J , 2022 , 43 ( 20 ): 1941 - 1951 .
KOSIBOROD M N , VERMA S , BORLAUG B A , et al . Effects of semaglutide on symptoms, function, and quality of life in patients with heart failure with preserved ejection fraction and obesity: A prespecified analysis of the STEP-HFpEF trial [J]. Circulation , 2024 , 149 ( 3 ): 204 - 216 .
WITHAAR C , MEEMS L M G , MARKOUSIS-MAVROGENIS G , et al . The effects of liraglutide and dapagliflozin on cardiac function and structure in a multi-hit mouse model of heart failure with preserved ejection fraction [J]. Cardiovasc Res , 2021 , 117 ( 9 ): 2108 - 2124 .
KO T , NOMURA S , YAMADA S , et al . Cardiac fibroblasts regulate the development of heart failure via Htra3-TGF-β-IGFBP7 axis [J]. Nat Commun , 2022 , 13 ( 1 ): 3275 .
YANG B , LARSON D F , RANGER-MOORE J . Biphasic change of tau (τ) in mice as arterial load acutely increased with phenylephrine injection [J]. PLoS One , 2013 , 8 ( 4 ): e60580 .
HU D , CUI Y X , WU M Y , et al . Cytosolic DNA sensor cGAS plays an essential pathogenetic role in pressure overload-induced heart failure [J]. Am J Physiol Heart Circ Physiol , 2020 , 318 ( 6 ): H1525 - H1537 .
RECH L , ABDELLATIF M , PÖTTLER M , et al . Small molecule STING inhibition improves myocardial infarction remodeling [J]. Life Sci , 2022 , 291 : 120263 .
LIU Z , WANG M , WANG X , et al . XBP1 deficiensy promotes hepatocyte pyroptosis by impairing mitophagy to activate mtDNA-cGAS-STING signaling in macrophages during acute liver injury [J]. Redox Biol , 2022 , 52 : 102305 .
MAO Y , LUO W , ZHANG L , et al . STING-IRF3 triggers endothelial inflammation in response to free fatty acid-induced mitochondrial damage in diet-induced obesity [J]. Arterioscler Thromb Vasc Biol , 2017 , 37 ( 5 ): 920 - 929 .
AN C , SUN F , LIU C , et al . IQGAP1 promotes mitochondrial damage and activation of the mtDNA sensor cGAS-STING pathway to induce endothelial cell pyroptosis leading to atherosclerosis [J]. Int Immunopharmacol , 2023 , 123 : 110795 .
曹玉 , 周永明 , 何梦铧 , 等 . 基于线粒体功能障碍探讨阳和汤治疗射血分数保留心力衰竭机制 [J]. 中医学报 , 2024 , 39 ( 10 ): 2060 - 2063 .
国家药典委员会 . 中华人民共和国药典(2020年版):一部 [M]. 北京 : 中国医药科技出版社 , 2020 .
SCHIATTARELLA G G , ALTAMIRANO F , TONG D , et al . Nitrosative stress drives heart failure with preserved ejection fraction [J]. Nature , 2019 , 568 ( 7752 ): 351 - 356 .
汤家铭 , 陈民利 . 医学实验动物学 [M]. 北京 : 中国中医药出版社 , 2012 .
ARMSTRONG P W , LAM C S P , ANSTROM K J , et al . Effect of vericiguat vs placebo on quality of life in patients with heart failure and preserved ejection fraction: the VITALITY-HFpEF randomized clinical trial [J]. JAMA , 2020 , 324 ( 15 ): 1512 - 1521 .
RAMAN S V , CHANDRASHEKHAR Y . Myocardial fibrosis: A viable imaging target in diastolic dysfunction and heart failure? [J]. JACC Cardiovasc Imaging , 2023 , 16 ( 6 ): 870 - 872 .
KREMASTIOTIS G , HANDA I , JACKSON C , et al . Disparate effects of MMP and TIMP modulation on coronary atherosclerosis and associated myocardial fibrosis [J]. Sci Rep , 2021 , 11 ( 1 ): 23081 .
CAO J W , DUAN S Y , ZHANG H X , et al . Zinc deficiency promoted fibrosis via ROS and TIMP/MMPs in the myocardium of mice [J]. Biol Trace Elem Res , 2020 , 196 ( 1 ): 145 - 152 .
DE MARCO C , CLAGGETT B L , DE DENUS S , et al . Impact of diabetes on serum biomarkers in heart failure with preserved ejection fraction: insights from the TOPCAT trial [J]. Esc Heart Fail , 2021 , 8 ( 2 ): 1130 - 1138 .
LOZHKIN A , VENDROV A E , RAMOS-MONDRAGÓN R , et al . Mitochondrial oxidative stress contributes to diastolic dysfunction through impaired mitochondrial dynamics [J]. Redox Biol , 2022 , 57 : 102474 .
JIANG A , LIU J , WANG Y , et al . cGAS-STING singaling pathway promotes hypoxia-induced renal fibrosis by regulating PFKFB3-mediated glycolysis [J]. Free Radic Biol Med , 2023 , 208 : 516 - 529 .
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