Anti-apoptotic effects and mechanisms of salvianolic acid A on cardiomyocytes in ischemia-reperfusion injury
Wei Qian1*, Zilong Wang2*, Tongda Xu3 and Dongye Li1
1Institute of Cardiovascular Disease Research, Xuzhou Medical University, Jiangsu Province, 2Department of Cardiology of Affiliated Zhongshan Hospital of Fudan University, Qingpu branch, Shanghai Municipality and 3Department of Cardiology of Affiliated Hospital of Xuzhou Medical University, Jiangsu Province, P.R. China
*The first two authors contributed equally
Offprint requests to: Dongye Li, Institute of Cardiovascular Disease Research, Xuzhou Medical University, Jiangsu Province, P.R. China. e-mail: dongyeli@xzhmu.edu.cn
Summary. Prompt myocardial reperfusion during acute myocardial infarction by fibrinolytic therapy, percutaneous coronary intervention, or coronary artery bypass grafting limits the affected area and improves prognosis. However, reperfusion itself can cause cardiomyocyte damage and decrease treatment efficacy. No treatments that effectively prevent myocardial ischemia/reperfusion (I/R) injury are currently available, and are therefore the focus of ongoing research. Salvianolic acid A (SAA), the active ingredient of the traditional Chinese herbal remedy Salvia miltiorrhiza, has anti-thrombotic activity, anti-inflammatory, and anti-cancer activity; regulates blood lipids and provides hepatic and neural protection. Recent studies demonstrated that SAA inhibits cardiomyocyte apoptosis in response to I/R by the PI3K/Akt, GSK-3β, JNK, and ERK1/2 pathways, and by JNK-ERK1/2 crosstalk. The mechanisms for SAA attenuating cardiomyocytes apoptosis during I/R injury through the P38 MAPK, caspase, JAK/STAT, NF-κB and LOX-1 signaling pathways need further illustration. There may be potential crosstalks between PI3K/Akt and JNK, and Akt/GSK-3β and ERK1/2 in the process of SAA against I/R-incuced cardiomyocytes apoptosis. This review summarizes the recent evidence of the anti-apoptotic effects and mechanisms of SAA against myocardial I/R injury and discusses the basis of potential clinical applications of SAA. Histol Histopathol 34, 223-231 (2019)
Key words: Salvianolic acid A (SAA), Ischemia/reperfusion (I/R), Cardiomyocyte, Mechanism, Apoptosis
DOI: 10.14670/HH-18-048