Treatment with Sheng-Mai-San Reduces Myocardial Infarct Size Through Activation of Protein Kinase C and Opening of Mitochondrial KATP Channel

Wang, Ningyuan; Minatoguchi, Shinya; Uno, Yoshihiro; Arai, M.; Hashimoto, Kazuaki; Hashimoto, Yasuko; Yamaguchi, Kazushige; Fukuda, Kazunori; Akao, Seigo; Fujiwara, Hisayoshi

doi:10.1142/s0192415x01000381

Cited by 6 publications

(6 citation statements)

References 11 publications

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“…Another study indicated that Xue-Fu-Zhu-Yu-Tang inhibits ischemic myocardial apoptosis, most likely through a sensitization agent that inhibits SIRT1 (silent mating type information regulation 2 homolog-1) apoptosis pathways [ 16 ]. Sheng-Mai-San could reduce myocardial infarct size through activation of protein kinase C, opening of the mitochondrial KATP channel, and reducing oxidative damage [ 17 – 19 ]. Dan Shen has antioxidant effects, inhibits smooth-muscle-cell proliferation, and protects against vascular atherosclerotic lesions by circulating ROS suppression via the PKC/p44/42 MAPK-dependent pathway [ 20 – 25 ].…”

Section: Discussionmentioning

confidence: 99%

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

Hung

Tseng

et al. 2015

PLoS ONE

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ObjectiveCombinations of Chinese herbal products (CHPs) are widely used for ischemic heart disease (IHD) in Taiwan. We analyzed the usage and frequency of CHPs prescribed for patients with IHD.MethodsA nationwide population-based cross-sectional study was conducted, 53531 patients from a random sample of one million in the National Health Insurance Research Database (NHIRD) from 2000 to 2010 were enrolled. Descriptive statistics, the multiple logistic regression method and Poisson regression analysis were employed to estimate the adjusted odds ratios (aORs) and adjusted risk ratios (aRRs) for utilization of CHPs.ResultsThe mean age of traditional Chinese medicine (TCM) nonusers was significantly higher than that of TCM users. Zhi-Gan-Cao-Tang (24.85%) was the most commonly prescribed formula CHPs, followed by Xue-Fu-Zhu-Yu-Tang (16.53%) and Sheng-Mai-San (16.00%). The most commonly prescribed single CHPs were Dan Shen (29.30%), Yu Jin (7.44%), and Ge Gen (6.03%). After multivariate adjustment, patients with IHD younger than 29 years had 2.62 times higher odds to use TCM than those 60 years or older. Residents living in Central Taiwan, having hyperlipidemia or cardiac dysrhythmias also have higher odds to use TCM. On the contrary, those who were males, who had diabetes mellitus (DM), hypertension, stroke, myocardial infarction (MI) were less likely to use TCM.ConclusionsZhi-Gan-Cao-Tang and Dan Shen are the most commonly prescribed CHPs for IHD in Taiwan. Our results should be taken into account by physicians when devising individualized therapy for IHD. Further large-scale, randomized clinical trials are warranted in order to determine the effectiveness and safety of these herbal medicines.

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Section: Discussionmentioning

confidence: 99%

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

Hung

Tseng

et al. 2015

PLoS ONE

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“…145: 722-7227. doi: 10.1016/j.jep.2012.11.036 Hausenloy, D.J., and Yellon, D.M. 2007 Wu et al, 2011;Xia et al, 2011 Aged rats IR P ginseng ↓infarct size, ↑LV funcƟon ↑Akt/eNOS, Sirt1 and Sirt3, ↓Erk/caspase 7 Luo et al, 2015 Guinea pig IR Korean red ginseng ↑funcƟon Antioxidant, anti-inflammatory Aravinthan et al, 2015 Rabbit IR Shreng-mai-san ↓infarct size ↑PKC, ↑mKATP Wang et al, 2001 Mouse IR Compound K ↓infarct size ↑Akt-eNOS pathway Tsutsumi et al, 2011 Rat Iso treatment Korean red ginseng ↓injury, ↑LV funcƟon Antioxidant Lim et al, 2013 Porcine Iso treatment Korean red ginseng ↓injury, ↑LV funcƟon Antioxidant Lim et al, 2014 D r a f t…”

Section: Discussionmentioning

confidence: 99%

“…Li et al (1996) have postulated that the presence of lignan-enriched extract of Fructus schisandrae accounts for the beneficial effects of Sheng-Mai-San although others have implicated the ginsenoside content of this formulation as a basis for cardioprotection, at least in a mouse model of isoproterenol-induced cardiac injury . Sheng-Mai-San has also been shown to reduce infarct size in rabbits when administered up to three days prior to infarction, with no benefit observed with acute treatment (Wang et al 2001). The benefit was proposed to be mediated by activation of protein kinase C and opening of mitochondrial ATP-sensitive potassium channels primarily attributable to the presence of ginsenosides and lignans as the primary active ingredients in this formulation (Wang et al 2001).…”

Section: Ginsenoside-containing Preparationsmentioning

confidence: 99%

“…Sheng-Mai-San has also been shown to reduce infarct size in rabbits when administered up to three days prior to infarction, with no benefit observed with acute treatment (Wang et al 2001). The benefit was proposed to be mediated by activation of protein kinase C and opening of mitochondrial ATP-sensitive potassium channels primarily attributable to the presence of ginsenosides and lignans as the primary active ingredients in this formulation (Wang et al 2001). Zhao et al (2016) have reported that a Sheng-mai-san derived product, YiXin-Shu, specifically developed for the treatment of ischemic heart disease, attenuates myocardial ischemic and reperfusion injury in hypercholesterolemic mice through a mechanism involving inhibition of myocardial apoptosis by blunting mitochondrial mediated pro-apoptosis pathways, reduction in oxidative stress as well as by upregulating the nuclear LXRα receptor.…”

Section: Ginsenoside-containing Preparationsmentioning

confidence: 99%

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Cardioprotection by ginseng: experimental and clinical evidence and underlying mechanisms

Gan

Karmazyn

2018

Can. J. Physiol. Pharmacol.

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Protection of the ischemic and reperfused myocardium represents a major therapeutic challenge. Translating results from animal studies to the clinical setting has been disappointing, yet the need for effective intervention, particularly to limit heart damage following infarction or surgical procedures such as coronary artery bypass grafting, is substantial. Among the many compounds touted as cardioprotective agents is ginseng, a medicinal herb belonging to the genus Panax, which has been used as a medicinal agent for thousands of years, particularly in Asian societies. The biological actions of ginseng are very complex and reflect composition of many bioactive components, although many of the biological and therapeutic effects of ginseng have been attributed to the presence of steroid-like saponins termed ginsenosides. Both ginseng and many ginsenosides have been shown to exert cardioprotective properties in experimental models. There is also clinical evidence that traditional Chinese medications containing ginseng exert cardioprotective properties, although such clinical evidence is less robust primarily owing to the paucity of large-scale clinical trials. Here, we discuss the experimental and clinical evidence for ginseng, ginsenosides, and ginseng-containing formulations as cardioprotective agents against ischemic and reperfusion injury. We further discuss potential mechanisms, particularly as these relate to antioxidant properties.

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“…CHM injections based on sheng mai san are also widely prescribed. It reduces infarct size via the activation of protein kinase C, opening of the mitochondrial KATP channels, and lowering the concentration of 5-hydroxytryptamine, norepinephrine, methionine-enkephalin, and leucine-enkephalin [10, 11]. …”

Section: Introductionmentioning

confidence: 99%

Add-On Effect of Chinese Herbal Medicine on Mortality in Myocardial Infarction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Chung

Chen

Qin

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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In China, Chinese herbal medicine (CHM) is widely used as an adjunct to biomedicine (BM) in treating myocardial infarction (MI). This meta-analysis of RCTs evaluated the efficacy of combined CHM-BM in the treatment of MI, compared to BM alone. Sixty-five RCTs (12,022 patients) of moderate quality were identified. 6,036 patients were given CHM plus BM, and 5,986 patients used BM only. Combined results showed clear additional effect of CHM-BM treatment in reducing all-cause mortality (relative risk reduction (RRR) = 37%, 95% CI = 28%–45%, I 2 = 0.0%) and mortality of cardiac origin (RRR = 39%, 95% CI = 22%–52%, I 2 = 22.8). Benefits remained after random-effect trim and fill adjustment for publication bias (adjusted RRR for all-cause mortality = 29%, 95% CI = 16%–40%; adjusted RRR for cardiac death = 32%, 95% CI = 15%–46%). CHM is also found to be efficacious in lowering the risk of fatal and nonfatal cardiogenic shock, cardiac arrhythmia, myocardial reinfarction, heart failure, angina, and occurrence of total heart events. In conclusion, addition of CHM is very likely to be able to improve survival of MI patients who are already receiving BM. Further confirmatory evaluation via large blinded randomized trials is warranted.

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Treatment with Sheng-Mai-San Reduces Myocardial Infarct Size Through Activation of Protein Kinase C and Opening of Mitochondrial KATP Channel

Cited by 6 publications

References 11 publications

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

Demographic and Prescribing Patterns of Chinese Herbal Products for Individualized Therapy for Ischemic Heart Disease in Taiwan: Population-Based Study

Cardioprotection by ginseng: experimental and clinical evidence and underlying mechanisms

Add-On Effect of Chinese Herbal Medicine on Mortality in Myocardial Infarction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

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