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Yiqi-Yangyin recipe attenuates myocardial ischemia-reperfusion injury in diabetic rats by activation of ERK/Nrf2/HO-1 pathway
Authors:CHAI Song-bo  SI Fu-chun  WANG Zhen-tao  ZHANG Shu-juan  LIU Shun-yu
Institution:1. Department of Cardiology, Second Affiliated Hospital of Henan University of Traditional Chinese Medicine/Henan Hospital of Traditional Chinese Medicine, Zhengzhou 450002, China; 2. Henan University of Traditional Chinese Medicine, Zhengzhou 450046, China
Abstract:AIM: To explore the effect of Yiqi-Yangyin recipe on myocardial ischemia-reperfusion injury (MIRI) in rats with diabetes mellitus (DM) and the possible mechanism. METHODS: The rats were divided into normal group (control group), DM sham operation (DM-S) group, DM+MIRI group, low-, medium-and high-dose Yiqi-Yang-yin recipe (TL, TM and TH) groups (7.5, 15 and 30 g/kg decoction of Yiqi-Yangyin recipe by gavage), and Nrf2 inhibitor (bardoxolone methyl) group (30 mg/kg bardoxolone methyl by intragastric administration). The gavage volume was 1 mL/kg. There were 15 rats in each group, and they were administered continuously for 7 d. The tail vein blood was collec-ted after the last administration to detect the blood sugar and lipid levels in the rats. The serum levels of cardiac troponin I (cTnI), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-10 were measured by ELISA. Echocardiography was used to detect the changes of cardiac function in the rats after blood collection. After cardiac function test, the rats were sacrificed to obtain cardiac tissues, and the volume changes of myocardial infarction were assessed by triphenylte-trazole chloride staining. The histopathological changes of myocardium was observed by HE staining. The cardiomyocyte apoptosis was determined by TUNEL assay. The protein levels of phosphorylated extracellular signal-regulated kinase (p-ERK), nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the myocardium were determined by Western blot. The myocardial activity of superoxide dismutase (SOD) was measured by nitro blue tetrazolium method, the content of malondialdehyde (MDA) was tested by thiobarbituric acid method, and the production of reactive oxygen species (ROS) was analyzed by iron ion reduction method. RESULTS: Compared with control group, the levels of fasting blood glucose (FBG), total cholesterol (TC) and triglyceride (TG) in DM-S group and DM+MIRI group were significantly elevated, while the level of high-density lipoprotein cholesterol (HDL-C) was significantly lowered (P<0.05). Compared with DM-S group and DM+MIRI group, the levels of FBG, TC, TG in TL, TM, TH and bardoxolone methyl groups were significantly decreased, while HDL-C level was significantly increased (P<0.05). Compared with control group and DM-S group, heart rate (HR) and left ventricular end-diastolic pressure (LVEDP) were increased in DM+MIRI group, mean arterial pressure (MAP), left ventricular systolic pressure (LVSP) and left ventricular ejection fraction (LVEF) were decreased, serum levels of cTnI, TNF-α, IL-1β and IL-10 were increased, the myocardial infarction volume percentage was increased, the myocardial cell breakage and necrosis were increased, the myocardial cell apoptotic rate was increased, the protein levels of p-ERK1/2, Nrf2 and HO-1 were decreased, MDA and ROS levels were increased, and the activity of SOD was decreased (P<0.05). Compared with DM+MIRI group, HR and LVEDP were decreased in TL, TM, TH and bardoxolone methyl groups, MAP, LVSP and LVEF were increased, the serum levels of cTnI, TNF-α, IL-1β and IL-10 were decreased, the myocardial infarction volume percentage was decreased, myocardial cell breakage and necrosis were decreased, myocardial cell apoptotic rate was decreased, the protein levels of p-ERK1/2, Nrf2 and HO-1 were increased, the MDA and ROS levels were decreased, and the activity of SOD was increased (P<0.05). CONCLUSION: Yiqi-Yangyin recipe protects the myocardial tissue of DM+MIRI rats from injury and reduces the oxidative stress level, which may be achieved by activating ERK/Nrf2/HO-1 pathway.
Keywords:Diabetes mellitus  Myocardial ischemia-reperfusion injury  Yiqi-Yangyin recipe  ERK/Nrf2/HO-1 signaling pathway  Oxidative stress  
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