A Preclinical Systematic Review and Meta-Analysis of Astragaloside IV for Myocardial Ischemia/Reperfusion Injury

Abstract

Astragaloside IV (AS-IV), the major pharmacological extract from Astragalus membranaceus Bunge, possesses a variety of biological activities in the cardiovascular systems. Here, we aimed to evaluate preclinical evidence and possible mechanism of AS-IV for animal models of myocardial ischemia/reperfusion (I/R) injury. Studies of AS-IV in animal models with myocardial I/R injury were identified from 6 databases from inception to May, 2018. The methodological quality was assessed by using CAMARADES 10-item checklist. All the data were analyzed using Rev-Man 5.3 software. As a result, 22 studies with 484 animals were identified. The quality score of studies ranged from 3 to 6 points. Meta-analyses showed AS-IV can significantly decrease the myocardial infarct size and left ventricular ejection fraction, and increase shortening fraction compared with control group (P < 0.01). Significant decreasing of cardiac enzymes and cardiac troponin and increasing of decline degree in ST-segment were reported in one study each (P < 0.05). Additionally, the possible mechanisms of AS-IV for myocardial I/R injury are promoting angiogenesis, improving the circulation, antioxidant, anti-inflammatory and anti-apoptosis. Thus, AS-IV is a potential cardioprotective candidate for further clinical trials of myocardial infarction.

Astragaloside IV protects human cardiomyocytes from hypoxia/reoxygenation injury by regulating miR-101a

“…In addition, AS/IV could reduce the number of apoptotic cardiomyocytes with H/R [30]. A meta-analysis showed AS/IV significantly reduced myocardial infarction area and protected heart function in mice compared to the control group [31]. Another similar report also indicated that AS/IV could improve myocardial H/R in rats by suppressing calcium-sensing receptormediated apoptotic signaling pathways [32].…”

Astragaloside-IV protects H9C2(2-1) cardiomyocytes from high glucose-induced injury via miR-34a-mediated autophagy pathway

“…AS-IV increases the production of nitric oxide (NO) by activating the PI3K/Akt pathway in H9C2 cells and inactivating glycogen synthase kinase 3b (GSK-3b) through the NO/cGMP/PKG signalling pathway to prevent the mitochondrial permeability transition pore (mPTP) from opening and reperfusion injury and reduce myocardial injury [43]. AS-IV has many cardiovascular protective effects, including anti-inflammation, anti-virus, anti-oxidation, inhibition of intracellular calcium overload and foam cell formation, and protection of endothelial cells [4]. In addition, it has protective effects on diabetic nephropathy by inhibiting activation of the MEK1/2-ERK1/2-RSK2 signalling pathway [44].…”

“…AS-IV has been reported to show antioxidative stress properties, and to affect immune modulation, including anti-viral and anti-inflammatory effects [1][2][3]. AS-IV has various mechanisms to protect the myocardium, including an antioxidant and free radical removal function [4]. Astragalus has a detoxification and muscle regeneration role in the treatment of long-term muscle ulcers, indicating that astragalus functions as a scavenger in tissue and organ repair and regeneration.…”

Clinical and Preclinical Systematic Review of Panax ginseng C. A. Mey and Its Compounds for Fatigue

“…In addition, the efficacy and mechanisms of PGC in fatigue animal models have not been systematically evaluated yet. Systematic review of animal researches is indispensable in the process of drug development and elucidation of the physiological and pathological mechanisms (Zheng et al, 2018). Preclinical research is the key to convert preclinical data into clinical data.…”