Similar articles

Abstract: Objective: To investigate the therapeutic effects and mechanisms of Salvia miltiorrhizae (Danshen) in the treatment of severe acute pancreatitis (SAP)- or obstructive jaundice (OJ)-induced heart injury. Methods: A total of 288 rats were used for SAP- (n=108) and OJ-associated (n=180) experiments. The rats were randomly divided into sham-operated, model control, and Salvia miltiorrhizae-treated groups. According to the difference of time points after operation, SAP rats in each group were subdivided into 3, 6 and 12 h subgroups (n=12), whereas OJ rats were subdivided into 7, 14, 21, and 28 d subgroups (n=15). At the corresponding time points after operation, the mortality rates of the rats, the contents of endotoxin and phospholipase A₂ (PLA₂) in blood, and pathological changes of the hearts were investigated. Results: The numbers of dead SAP and OJ rats in the treated groups declined as compared with those in the model control group, but not significantly (P>0.05). The contents of endotoxin (at 6 and 12 h in SAP rats and on 7, 14, 21, and 28 d in OJ rats, respectively) and PLA₂ (at 6 and 12 h in SAP rats and on 28 d in OJ rats, respectively) in the treated group were significantly lower than those in the model control group (P<0.01 and P<0.001, respectively). Besides, myocardial pathological injuries were mitigated in SAP and OJ rats. Conclusion: In this study, we found that Salvia miltiorrhizae improved myocardial pathological changes, reduced the content of PLA₂ in blood, and decreased the mortality rates of SAP and OJ rats, exerting protective effects on the hearts of the rats.

[1] Aho, H.J., 1980. Experimental pancreatitis in the rats: sodium taurocholate-induced acute hemorrhagic pancreatitis. Scand. J. Gastroenterol., 15(4):411-416.

[2] Assimakopoulos, S.F., Mavrakis, A.G., Grintzalis, K., Papapostolou, I., Zervoudakis, G., Konstantinou, D., Chroni, E., Vagianos, C.E., Georgiou, C., 2008. Superoxide radical formation in diverse organs of rats with experimentally induced obstructive jaundice. Redox Rep., 13(4):179-184.

[3] Celebi, F., Ozturk, G., Kizilkaya, M., 2008. The effects of combined use of glutamine and growth hormone on the bacterial translocation associated with obstructive jaundice. Saud. Med. J., 29(7):989-993.

[4] de Windt, L.J., Willems, J., Roemen, T.H., Coumans, W.A., Reneman, R.S., van der Vusse, G.J., van Bilsen, M., 2001. Ischemic-reperfused isolated working mouse hearts: membrane damage and type IIA phospholipase A2. Am. J. Physiol. Heart Circ. Physiol., 280(6):H2572-H2580.

[5] Fuentes-Orozco, C., Cervantes-Guevara, G., Muciño-Hernández, I., López-Ortega, A., Ambriz-González, G., Gutiérrez-de-la-Rosa, J.L., Gómez-Herrera, E., Hermosillo-Sandoval, J.M., González-Ojeda, A., 2008. L-alanyl-L-glutamine-supplemented parenteral nutrition decreases infectious morbidity rate in patients with severe acute pancreatitis. JPEN J. Parenteral Enteral Nutr., 32(4):403-411.

[6] Garcea, G., Jackson, B., Pattenden, C.J., Sutton, C.D., Neal, C.P., Dennison, A.R., Berry, D.P., 2006. Early warning scores predict outcome in acute pancreatitis. J. Gastrointest. Surg., 10(7):1008-1015.

[7] Geisler, F., Algül, H., Riemann, M., Schmid, R.M., 2005. Questioning current concepts in acute pancreatitis: endotoxin contamination of porcine pancreatic elastase is responsible for experimental pancreatitis-associated distant organ failure. J. Immunol., 174(10):6431-6439.

[8] Gencay, C., Kilicoglu, S.S., Kismet, K., Kilicoglu, B., Erel, S., Muratoglu, S., Sunay, A.E., Erdemli, E., Akkus, M.A., 2008. Effect of honey on bacterial translocation and intestinal morphology in obstructive jaundice. World J. Gastroenterol., 14(21):3410-3415.

[9] Granger, J., Remick, D., 2005. Acute pancreatitis: models, markers, and mediators. Shock, 24:45-51.

[10] Guo, J.W., Liu, Y.H., Wang, Y., 2001. Acute pancreatitis complicated with heart injury—pancreatic-cardiac syndrome. Clinical Medicine of China, 17(10):761 (in Chinese).

[11] Han, M., 1999. Clinical evaluation of compound Salvia miltiorrhizae injection in improving the prognosis of acute pancreatitis. Chinese Journal of Gastroenterology and Hepatology, 12(2):166 (in Chinese).

[12] Ju, Y.L., Shi, C.X., Fang, C.F., 2003. Effects of inflammatory mediators on heart damage of acute pancreatitis in cats. Chinese Journal of Surgery of Integrated Traditional and Western Medicine, 9(2):77-79 (in Chinese).

[13] Li, X.G., Liu, Q.G., Pan, C.E., Ma, Q.Y., Zhang, M., 2002. Relationship between NO, MDA and ET in liver tissues and liver injury caused by obstructive jaundice and the protective effect of Danshen on liver. Journal of Xi'an Medical University, 23(2):158-161 (in Chinese).

[14] Lytras, D., Manes, K., Triantopoulou, C., Paraskeva, C., Delis, S., Avgerinos, C., Dervenis, C., 2008. Persistent early organ failure: defining the high-risk group of patients with severe acute pancreatitis? Pancreas., 36(3):249-254.

[15] Morioka, C., Uemura, M., Matsuyama, T., Matsumoto, M., Kato, S., Ishikawa, M., Ishizashi, H., Fujimoto, M., Sawai, M., Yoshida, M., et al., 2008. Plasma ADAMTS13 activity parallels the APACHE II score, reflecting an early prognostic indicator for patients with severe acute pancreatitis. Scand. J. Gastroenterol., 26:1-10.

[16] Motoyoshi, M., Sugiyama, M., Atomi, Y., Kimura, W., Nagawa, H., 2006. Effect of a selective thromboxane A2 synthetase inhibitor on the systemic changes induced by circulating pancreatic phospholipase A2. J. Gastroenterol., 41(11):1094-1098.

[17] Muñoz-Castañeda, J.R., Túnez, I., Herencia, C., Ranchal, I., González, R., Ramírez, L.M., Arjona, A., Barcos, M., Espejo, I., Cruz, A., et al., 2008. Melatonin exerts a more potent effect than S-adenosyl-l-methionine against iron metabolism disturbances, oxidative stress and tissue injury induced by obstructive jaundice in rats. Chem. Biol. Interact., 174(2):79-87.

[18] Peng, B., Du, J., Jia, Q., Qiao, A., Wu, Y., Liu, X., Qiang, Q., 2001. The effect of Salvia miltiorrhiza and shengmai on inflammatory mediator and renal function of post-operative patients with obstructive jaundice. J. West Chin. Univ. Med. Sci., 32(4):587-589 (in Chinese).

[19] Rau, B.M., Bothe, A., Kron, M., Beger, H.G., 2006. Role of early multisystem organ failure as major risk factor for pancreatic infections and death in severe acute pancreatitis. Clin. Gastroenterol. Hepatol., 4(8):1053-1061.

[20] Tsuyuguchi, T., Takada, T., Miyazaki, M., Miyakawa, S., Tsukada, K., Nagino, M., Kondo, S., Furuse, J., Saito, H., Suyama, M., et al., 2008. Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas. Journal of Hepato-Biliary-Pancreatic Surgery, 15(1):69-73.

[21] Wang, Z.Y., Gong, P., Bao, Q., 2002. Heart injury in obstructive jaundice and its prevention. Journal of Digestive Surgery, 1(4):293-295 (in Chinese).

[22] Yang, C.X., 1997. Advances in pharmacological research of tanshinol. Chinese Pharmacological Bulletin, 13:298 (in Chinese).

[23] Yang, X.J., Liang, J., Tian, S.Z., Xu, S.Y., 2005. Experimental study on effect of Salvia militiorrhiza injection on intestinal mucosa blood flow and bacterial translocation in rats with acute pancreatitis. Chinese Journal of Integrated Traditional and Western Medicine in Intentire Critical Care, 12(4):245-247 (in Chinese).

[24] Yousaf, M., McCallion, K., Diamond, T., 2003. Management of severe acute pancreatitis. Br. J. Surg., 90(4):407-420.

[25] Zhang, Q., Ni, Q., Cai, D., Zhang, Y., Zhang, N., Hou, L., 2001. Mechanisms of multiple organ damages in acute necrotizing pancreatitis. Chin. Med. J. (Engl.), 114(7): 738-742.

[26] Zhang, X.P., Chen, H.Q., 2006. Studies on etiological factors of hear injury complicating severe acute pancreatitis. Journal of Medical Research, 35(8):90-91 (in Chinese).

[27] Zhang, X.P., Li, Z.J., 2005. Mechanism of Danshen in treatment of acute pancreatitis. World Chinese Journal of Digestology, 13(17):2122-2124 (in Chinese).

[28] Zhang, X.P., Liu, D.R., 2006. Advances in research on the mechanism of Salvia miltiorrhizae in the treatment of obstructive jaundice. Chinese Journal of Surgery of Integrated Traditional and Western Medicine, 12(1):69-70 (in Chinese).

[29] Zhang, X.P., Dai, J., Chen, H.Q., 2006a. Progress in clinical manifestations and mechanisms of heart injury induced by severe acute pancreatitis. World Chinese Journal of Digestology, 14(60):611-617 (in Chinese).

[30] Zhang, X.P., Li, Z.J., Liu, D.R., 2006b. Progress in research into the mechanism of Radix Salviae miltiorrhizae in treatment of acute pancreatitis. Hepatobiliary Pancreat Dis. Int., 5(4):501-504.

[31] Zhang, X.P., Wang, L., Zhang, J., 2007a. Study progress on mechanism of severe acute pancreatitis complicated with hepatic injury. J. Zhejiang Univ. Sci. B, 8(4):228-236.

[32] Zhang, X.P., Zhang, J., Song, Q.L., Chen, H.Q., 2007b. Mechanism of acute pancreatitis complicated with injury of intestinal mucosa barrier. J. Zhejiang Univ. Sci. B, 8(12):888-895.

[33] Zhang, X.P., Ye, Q., Jiang, X.G., Ma, M.L., Zhu, F.B., Zhang, R.P., Cheng, Q.H., 2007c. Preparation method of an ideal model of multiple organ injury of rat with severe acute pancreatitis. World J. Gastroenterol., 13(34):4566-4573.

[34] Zhang, X.P., Tian, H., Chen, H.Q., Chen, L., Wang, Z.W., Wang, K.Y., Yan, W., Li, Y., LI, Q.Y., He, Q., et al., 2007d. The protecting effects and mechanisms of Baicalin and Octreotide on heart injury in rats with SAP. Mediators Inflamm., No. 19469.

[35] Zhang, X.P., Zhang, L., Chen, H.Q., Cheng, Q.H., Lu, B., Ju, T.F., Fang, X., Shen, H.P., 2007e. Study of protecting effects of baicalin and octreotide on heart injury in rats with severe acute pancreatitis. Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care, 14(2):114-118 (in Chinese).

[36] Zhang, X.P., Chen, L., Zhang, J., Tian, H., Zhang, X., Zhou, Y., Wang, Z., Wang, K., 2008a. Effect of Salvia miltiorrhizae on apoptosis and NF-kappaB p65 expression in the liver of rats with severe acute pancreatitis or obstructive jaundice. J. Gastroenterol. Hepatol. [Epub ahead of print].

[37] Zhang, X.P., Cai, Y., Wu, D.J., Zhang, J., Ye, Q., Jiang, X.G., Ma, M.L., Yang, Q.J., Xie, Q., Zhou, Y.F., Yuan, W.Q., Zhou, N.N., He, J., 2008b. Effects of Salvia miltiorrhiza on Intercellular Adhesion Molecule 1 Protein Expression in the Lungs of Rats With Severe Acute Pancreatitis or Obstructive Jaundice. Pancreas [Epub ahead of print].

[38] Zheng, B.R., Shen, W.L., Wen, J., Yang, S.H., Chen, S.Y., 2007. Influence of Radix Salviae miltiorrhizae injection upon NF-κB in rat with severe acute pancreatitis. Chinese Journal of Bases and Clinics in General Surgery, 14(4):392-395 (in Chinese).