Research Progress of Traditional Chinese Medicine in Treatment of Myocardial fibrosis

Abstract

Effective drugs for the treatment of myocardial fibrosis (MF) are lacking. Traditional Chinese medicine (TCM) has garnered increasing attention in recent years for the prevention and treatment of myocardial fibrosis. This Article describes the pathogenesis of myocardial fibrosis from the modern medicine, along with the research progress. Reports suggest that Chinese medicine may play a role in ameliorating myocardial fibrosis through different regulatory mechanisms such as reduction of inflammatory reaction and oxidative stress, inhibition of cardiac fibroblast activation, reduction in extracellular matrix, renin-angiotensin-aldosterone system regulation, transforming growth Factor-β1 (TGF-β1) expression downregulation, TGF-β1/Smad signalling pathway regulation, and microRNA expression regulation. Therefore, traditional Chinese medicine serves as a valuable source of candidate drugs for exploration of the mechanism of occurrence and development, along with clinical prevention and treatment of MF.

Galangin: A food‐derived flavonoid with therapeutic potential against a wide spectrum of diseases

“…In addition, galangin could reduce bleomycin‐induced inflammatory cell activation such as CD4 + CD69+, CD8 + CD69 + T cells and dendritic cells, thereby reducing inflammatory cells in lung tissue of mice (Wang et al, 2020). Furthermore, myocardial fibrosis is one of the main manifestations of myocardial remodeling, which can lead to heart failure and death (Ren et al, 2022). Thangaiyan et al reported that pretreatment with galangin decreased heart rate, lipid peroxidation and upregulated the blood pressure in ISO‐induced rats.…”

Drugs for treating myocardial fibrosis

“…First, danshinone has been suggested to reverse the increase in the levels of collagen type 1 (Col1), collagen type 3 (Col3) and α-smooth muscle actin (α-SMA) in HF rats induced by ligation of the left anterior descending branch (LAD) of the coronary artery through upregulating miR-205-3p, miR-29b, or miR-618 ( Yang et al, 2023 ). Second, MF is achieved by downregulating the TGF-β/SMAD2/3 signaling pathway ( Ren et al, 2022 ).…”

“…Other TCMs, such as curcumin, earthworms and ginsenoside, have therapeutic effects on MF ( Yu et al, 2019 ; Lai et al, 2015 ; Wang et al, 2021 ). Curcumin decreases cardiac fibrogenesis by activating SIRT1, increasing Nrf2, and increasing NADPH oxidase subunits ( Sadoughi et al, 2021 ; Ren et al, 2022 ). Earthworms can inhibit MF by inhibiting the levels of MF-related proteins in H9c2 cells ( Huang et al, 2019 ).…”

“…MF is the response mechanism of myocardial injury. Its main pathological features are the proliferation and activation of cardiac fibroblasts (CFs) ( Cheng et al, 2023 ), the deposition of extracellular matrix (ECM), the formation of scar tissue, a decrease in tissue compliance and a decline in cardiac function ( Ren et al, 2022 ). MF is not only the pathological reaction of cardiovascular diseases including myocardial infarction, myocardial ischemia and sudden cardiac death, but also the risk factor for their further deterioration ( Talman and Ruskoaho, 2016 ; Ambrose, 2006 ; Torrisi et al, 2020 ) ( Figure 1 ).…”

“…Further study is needed to elucidate the molecular mechanisms underlying the prevention and treatment of MF by TCM ( Zhang et al, 2023 ). Clinically, a unified TCM syndrome differentiation system is also lacking because symptoms and manifestations vary with each individual ( Ren et al, 2022 ). In addition, the production of TCM needs stricter and more standard regulation and quality control to improve the quality, purity and potency of TCM drugs.…”