Computational pharmacological comparison of Salvia miltiorrhiza and Panax notoginseng used in the therapy of cardiovascular diseases

The herb pair comprising Salvia miltiorrhiza (SM) and Panax notoginseng (PN) has been used as a classical formula for cardiovascular diseases (CVDs) in China and in western countries. However, the pharmacology of SM and PN in this herb pair has not been fully elucidated. The aim of this study was to compare the mechanisms of SM and PN at the molecular level for the treatment of CVDs. We used a systems pharmacology approach, integrating ligand clustering, chemical space, docking simulation and network analysis, to investigate these two herbal medicines. The compounds in SM were attached to clusters 2, 3, 5, 6, 8 and 9, while the compounds in PN were attached to clusters 1, 2, 4, 5, 6, 7, 8 and 10. The distributions of chemical space between the compounds from SM and PN were discrete, with the existence of small portions of overlap, and the majority of the compounds did not violate 'Lipinski's rule of five'. Docking indicated that the average number of targets correlated with each compound in SM and PN were 5.0 and 3.6, respectively. The minority nodes in the SM and PN drug-target networks possessed common values of betweenness centrality, closeness centrality, topological coefficients and shortest path length. Furthermore, network analyses revealed that SM and PN exerted different modes of action between compounds and targets. These results suggest that the method of computational pharmacology is able to intuitively trace out the similarities and differences of two herbs and their interaction with targets from the molecular level, and that the combination of two herbs may extend their activities in different potential multidrug combination therapies for CVDs.

SMND-309, a novel derivative of salvianolic acid B, protects rat brains ischemia and reperfusion injury by targeting the JAK2/STAT3 pathway

SMND-309 is a novel derivative of salvianolic acid B, and has shown protective effects against rat cortical neuron damage in vitro and in vivo. However the molecular mechanisms through which SMND-309 affords this protection are unclear. The present study aimed to investigate the mechanisms associated with the protective activities of SMND-309 in a cerebral ischemia and reperfusion injury rat model. In this study, we used AG490, a specific inhibitor of the signaling pathway involving the Janus Kinase 2 (JAK2)/Signal Transducers and Activators of Transcription 3 (STAT3) signaling molecules and suramin, a potent inhibitor of vascular endothelial growth factor (VEGF), to investigate the mechanisms of SMND-309. The cerebral ischemia and reperfusion injury model was induced by performing middle cerebral artery occlusion (MCAO) in the rats. SMND-309 mitigated the effects of ischemia and reperfusion injury on brain by decreasing the infract volume, improving neurological function, increasing the survival of neurons and promoting angiogenesis by increasing the levels of erythropoietin (EPO), erythropoietin receptor (EPOR), phosphorylated JAK2 (P-JAK2), phosphorylated STAT3 (P-STAT3), VEGF and VEGF receptor 2 (Flk-1) in the brain. Our results suggest that SMND-309 provides significant neuroprotective effects against cerebral ischemia and reperfusion injury. The mechanisms of this protection may be attributed to the increased VEGF expression occurring from the JAK2/STAT3 pathway, activated by the increased EPO/EPOR expression in the brain.

Salvia miltiorrhiza reduces expression of aquaporin 2 in kidney tissue of cirrhotic rats

AIM: To detect the expression of aquaporin 2 (AQP2) in kidney tissue of rats with BDL-induced cirrhosis and to observe the effect of treatment with salvia miltiorrhiza on AQP2 expression in this animal model.

METHODS: Seventy SD rats were randomly divided into sham operation group and model group. To induce biliary cirrhosis, SD rats underwent double ligation and sectioning of the common bile duct (BDL). Animals in the model group were sacrificed at weeks 1, 2, 3 and 4. At week 5, the model group was divided into two groups: treatment group and control group. Rats in the treatment group were treated with salvia miltiorrhiza, while those in the control group was treated with vehicle. Liver histopathological changes were evaluated by hematoxylin and eosin (H&E) staining and Masson's trichrome staining. Kidney histopathological changes were evaluated by H&E staining. Immunohistochemistry was employed to investigate the expression of AQP2 in kidney tissue of cirrhotic rats.

RESULTS: With the progression of hepatic cirrhosis, the expression of AQP2 increased gradually. The optical density (OD) of renal AQP2 at weeks 1 to 4 was significantly higher in the model group than in the sham operation group (cortex: 0.4703 ± 0.0313, 0.4832 ± 0.0212, 0.5081 ± 0.0417, 0.6802 ± 0.0531 vs 0.4197 ± 0.0295; medulla: 0.4320 ± 0.0237, 0.4724 ± 0.0284, 0.4796 ± 0.0451, 0.5187 ± 0.0612 vs 0.4139 ± 0.0152; all P < 0.05). The expression of AQP2 in the control group was higher than that in the treatment group. The OD of renal AQP2 in the control group was significantly higher than that in the treatment group (cortex: 0.5536 ± 0.0476 vs 0.4233 ± 0.0521; medulla: 0.4764 ± 0.0536 vs 0.4158 ± 0.0413, both P < 0.05).

CONCLUSION: The expression of AQP2 is up-regulated in kidney tissue of cirrhotic rats. Salvia miltiorrhiza treatment reduced the expression of AQP2 in kidney tissue of cirrhotic rats.

Role of Salvia miltiorrhiza for Modulation of Th2-derived Cytokines in the Resolution of Inflammation

Background

Salvia miltiorrhiza (SM) has been used to treat inflammatory diseases including edema and arthritis; however, the anti-inflammatory mechanism of SM action remains unresolved.

Methods

The effects of an ethanol extract of SM (ESM) on pro-inflammatory cytokines such as TNF-α, IL-1β, IL-6, and NO, on anti-inflammatory cytokines including IL-4, IL-10, TGF-β, and IL-1Ra have been studied in an attempt to elucidate the anti-inflammatory mechanism in murine macrophages.

Results

ESM inhibited the production of pro-inflammatory cytokines via down-regulation of gene and protein expression whereas it increased the anti-inflammatory cytokines. Furthermore, ESM inhibited the expression of the chemokines, RANTES and CX3CL1, as well as of inflammatory mediators such as TLR-4 and 11β-HSD1.

Conclusion

These results indicated that the regulatory effects of ESM may be mediated though the suppression of pro-inflammatory cytokines as well as the induction of anti-inflammatory cytokines. Consequently, we speculate that ESM has therapeutic potential for inflammation-associated disorders.

Treating oligohydramnios with extract of Salvia miltiorrhiza: A randomized control trial

Objective

To determine whether purified herbal extract of Salvia miltiorrhiza can improve the amniotic fluid volume in pre-term oligohydramnios by improving uteroplacental circulation.

Methods

Forty-three pregnant women with oligohydramnios received a daily intravenous dose of 30 mL of salvia extract mixed with 5% glucose 500 mL. A control group of 41 women received daily 5% glucose 500 mL only. The amniotic fluid index (AFI) was assessed at least twice a week by ultrasonographists who were blinded to the treatment. Both women and fetuses were monitored closely. The change in AFIwas calculated and compared by paired t test within and between groups. The revised recommendations for improving the quality of reports of parallel group randomized trials were used.

Results

After a mean of 7.2 ± 2.7 days’ therapy, ranging from 3 to 18 days, the AFIincreased significantly from a mean of 4.9 ± 2.3 cm to a mean of 7.12 ± 2.36 cm, by a mean of AFI0.18 ± 0.06 cm/day (paired t = 3.62, p < 0.005). In the control group, the AFIincreased from a mean of 5.1 ± 2.4 cm to a mean of 5.5 ± 3.1 cm after a mean of 6.1 ± 3.3 days’ treatment, ranging from 4 to 15 days. The effect of salvia treatment on AFIin the salvia group was significantly greater than in the control group (p < 0.001). No side effects were observed in treated patients.

Conclusion

Salvia miltiorrhiza is an effective Chinese medicine for the treatment of oligohydramnios.

Therapeutic effects of Rhubarb and Salvia miltiorrhiza on severe acute pancreatitis

AIM: To investigate the therapeutic effects of Rhubarb and Salvia miltiorrhiza on severe acute pancreatitis (SAP).

METHODS: Ninety-eight patients with SAP were divided into three groups: control group (group A, n = 21), Salvia miltiorrhiza treatment group (group B, n = 25) and Rhubarb & Salvia miltiorrhiza treatment group (group C, n = 52). All the patients in the 3 groups received the same routine therapy while group B and group C received additional treatment of salvia miltiorrhiza and the combined management of Rhubarb & Salvia miltiorrhiza respectively.

RESULTS: Compared with group A, group C had faster recovery of intestinal gurgling sound (t1) and less important organ injury (t₂), fewer infective positions (t₃), pancreatic pseudocysts (χ²) and significantly decreased hospital days (t4) (t₁ = 2.34, t₂ = 2.17, t₃ = 3.04, χ² = 13.76, t₄ = 3.65, all P < 0.05) and lower mortality. Compared with group A, group B had a significant reduce in organ injury (t = 3.45, P < 0.05), while had no difference in recovery of intestinal gurgling sound, and in the number of infective positions, pancreatic pseudocysts and hospital days. Compared with group B, group C had better recovery of intestinal gurgling sound with significant difference (t = 2.73, P < 0.05).

CONCLUSION: On the basis of routine treatment, combined management of Rhubarb and Salvia miltiorrhiza for treating SAP possesses a significant synergistic action and therapeutic effect.

Extracellular ATP-induced NO production and its dependence on membrane Ca2+ flux in Salvia miltiorrhiza hairy roots

Extracellular ATP (eATP) is a novel signalling agent, and nitric oxide (NO) is a well-established signal molecule with diverse functions in plant growth and development. This study characterizes NO production induced by exogenous ATP and examines its relationship with other important signalling agents, Ca(2+) and H(2)O(2) in Salvia miltiorrhiza hairy root culture. Exogenous ATP was applied at 10-500 microM to the hairy root cultures and stimulated NO production was detectable within 30 min. The NO level increased with ATP dose from 10-100 microM but decreased from 100-200 muM or higher. The ATP-induced NO production was mimicked by a non-hydrolysable ATP analogue ATPgammaS, but only weakly by ADP, AMP or adenosine. The ATP-induced NO production was blocked by Ca(2+) antagonists, but not affected by a protein kinase inhibitor. ATP also induced H(2)O(2) production, which was dependent on both Ca(2+) and protein kinases, and also on NO biosynthesis. On the other hand, ATP induced a rapid increase in the intracellular Ca(2+) level, which was dependent on NO but not H(2)O(2). The results suggest that NO is implicated in ATP-induced responses and signal transduction in plant cells, and ATP signalling is closely related to Ca(2+) and ROS signalling.

Influence of Salvia miltiorrhiza on the changes of plasma endothelin and P-selectin in patients with acute pancreatitis

AIM: To explore the changes of plasma endothelin and P-selectin as well as the effects of Salvia miltiorrhiza (SM) in patients with acute pancreatitis (AP).

METHODS: A total of 82 patients with acute pancreatitis were divided into group A (n = 40) and B (n = 42), treated with general method and SM, respectively. Anther 20 normal individuals were used as normal controls. The levels of plasma endothelin (ET) and P-selectin were measured by radioimmunoassay.

RESULTS: The levels of ET and P-selectin in patients with severe acute pancreatitis (SAP) were significantly higher than those in the cases with mild acute pancreatitis (MAP) and normal controls (ET: 147.56 ± 10.65 ng/L vs 85.13 ± 9.47, 52.27 ± 6.23 ng/L, P < 0.01; P-selectin: 85.32 ± 6.21 µg/L vs 30.01 ± 4.82, 10.26 ± 2.57 µg/L, P < 0.01), and the levels of ET and P-selectin were positively correlated in SAP (r = 0.705, P < 0.01). After treatment, the levels of ET and P-selectin in group B were obviously decreased as compared with those before treatment (ET: 69.77 ± 7.65 ng/L vs 100.54 ± 11.41 ng/L, P < 0.01; P-selectin: 4.07 ± 4.75 µg/L vs 54.52 ± 9.79 µg/L, P < 0.01). The average in-hospital time of group B was distinctly shorter than that of group A (9.76 ± 1.77 d vs 14.27 ± 2.55 d, P < 0.01).

CONCLUSION: Endothelin and P-selectin may be involved in the pathogenesis of AP, and SM is effective in the treatment of AP.

Effects of salvia miltiorrhiza injection on coagulation function of decompensated liver cirrhosis

AIM: To evaluate the effect of salvia miltiorrhiza (SM) injection on the coagulation function of patients with decompensated liver cirrhosis.

METHODS: A total of 40 patients with decompensated liver cirrhosis were randomly and averagely divided into SM group and controls group. Besides comprehensive treatment, the patients in SM group also received SM injection for 2 wk. The indexes, including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB) level were examined before and after treatment. Moreover, bleeding complication was observed in the two groups.

RESULTS: Before treatment, the values of PT, APTT and TT, and the level of FIB were 17.2 ± 5.9 s, 50.3 ± 5.1 s, 21.5 ± 2.5 s, 1.7 ± 1.2 g/L in control group, and 17.5 ± 5.7 s, 50.1 ± 5.8 s, 21.3 ± 2.7 s, 1.7 ± 1.0 g/L in SM group, respectively. After treatment, the above markers were 15.8 ± 5.0 s, 47.2 ± 5.3 s, 19.2 ± 2.1 s, 1.8 ± 1.3 g/L in control group, and 14.5 ± 4.0 s, 44.2 ± 5.6 s, 17.2 ± 2.4 s, 2.0 ± 1.5 g/L in SM group, respectively. There were significant differences before and after treatment both in control group and SM group (P < 0.05), and furthermore, marked differences also existed between the two groups after treatment (P < 0.05). The incidence rate of bleeding complication was notably lower in SM group than that in control group (25% vs 50%, P < 0.05).

CONCLUSION: SM injection can improve the coagulation function and lower the rate of bleeding complication in patients with decompensated liver cirrhosis.