Feature Reports: Myocardial Damage

Prevention and treatment of acute radiation⁃induced myocardial injury by the preparation of Abelmoschus manihot (L.) Medik (Jiahua Tablet)

  • Wenli YANG ,
  • Tong BAO ,
  • Xin LIN ,
  • Ruge NIU ,
  • Zhongchi XU ,
  • Yunhe ZHAO
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  • The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu,China

Received date: 2025-04-07

  Online published: 2025-09-05

Abstract

Objective To investigate the protective effects and potential mechanisms of the preparation of Abelmoschus manihot (L.) Medik (Jiahua Tablet) against acute radiation-induced myocardial injury, based on myocardial injury markers (sST2, cTnI) and oxidative stress damage-related indicators (SOD, MDA), and to provide new avenues for the prevention and treatment of radiation-induced heart disease (RIHD). Methods Sixty-nine patients with thoracic malignant tumor who received radiotherapy at the department of radiation oncology in Hospital Affiliated to Nanjing University of Chinese Medicine from December 2023 to November 2024 were enrolled in the study. Participants were randomly divided into control group (n = 38) and observation group (n = 31). The control group received standard radiotherapy in conjunction with conventional medications for RIHD, while the observation group was additionally administered Jiahua Tablet alongside the same regimen. Both groups took medications continuously for 1 month. Changes in serum levels of sST2, cTnI, SOD, and MDA were compared between the two groups 3 days prior to radiotherapy and 7 days after radiological therapy. Results On day 7 post-radiotherapy, the levels of sST2 and cTnI in the control group were highly elevated, showing statistically significant difference (P < 0.01). In contrast, the levels of sST2 and cTnI in the observation group showed only mild elevation, and no statistically significant difference was observed (P > 0.05). Between-group analysis demonstrated that post-treatment sST2 and cTnI levels in the observation group were substantially lower compared to those in the control group, indicating statistically significant difference (P < 0.05). After treatment, SOD level in the control group was considerably lower compared to its pre-treatment level, and marked statistical significance was observed (P < 0.01). SOD level in the observation group demonstrated a downward trend compared to baseline value, indicating no statistical significance(P > 0.05). Between-group analysis demonstrated that post-treatment SOD level in the observation group was substantially elevated compared to that in the control group, indicating a highly significant disparity(P < 0.05). After treatment, MDA level in the control group was considerably higher compared to its pre-treatment level, and a marked statistical significance was observed (P < 0.05), whereas MDA level in the observation group showed only a mild increase compared to baseline value, with no statistically significant difference (P > 0.05).Between-group analysis demonstrated that post-treatment MDA level in the observation group was substantially lower compared to that in the control group, demonstrating a remarkably statistically significant difference (P < 0.01). Conclusion The preparation of Abelmoschus manihot (L.) Medik (Jiahua Tablet) effectively inhibits acute radiation-induced myocardial injury, with its potential mechanism closely linked to the suppression of oxidative stress responses.

Cite this article

Wenli YANG , Tong BAO , Xin LIN , Ruge NIU , Zhongchi XU , Yunhe ZHAO . Prevention and treatment of acute radiation⁃induced myocardial injury by the preparation of Abelmoschus manihot (L.) Medik (Jiahua Tablet)[J]. The Journal of Practical Medicine, 2025 , 41(17) : 2631 -2636 . DOI: 10.3969/j.issn.1006-5725.2025.17.004

References

[1] CHIARA L, MAURIZIO M, ELISA C, et al. Cardiologic long-term follow-up of patients treated with chest radiotherapy: When and how?[J]. Front Cardiovasc Med,2021,8:671001. doi:10.3389/fcvm.2021.671001
[2] CAO X, WEN P, FU Y, et al. Radiation induces apoptosis primarily through the intrinsic pathway in mammalian cells[J]. Cell Signal, 2019, 62: 109337. doi:10.1016/j.cellsig.2019.06.002
[3] BELZILE-DUGAS E, EISENBERG M J. Radiation-Induced Cardiovascular Disease:Review of an Underrecognized Pathology [J]. J Am Heart Assoc, 2021, 10:e021686. doi:10.1161/jaha.121.021686
[4] GUSTAVSSON A, OSTERMAN B, CAVALLIN S. A systematic over viewof radiation therapy effects in Hodgkin's lymphoma[J].Acta On-cologica, 2003,42(5/6):605-619. doi:10.1080/02841860310014435
[5] GIRAUD P, COSSET J M. Radiation toxicity to the heart: Physiopathologyand clinical data[J]. Bull Cancer, 2004,91():147-153.
[6] BANFILL K, GIULIANI M, AZNAR M, et al. Cardiac toxicity of thoracic radiotherapy: Existing evidence and future directions[J]. J Thorac Oncol, 2020, 16(2): 216-227. doi:10.1016/j.jtho.2020.11.002
[7] 王军,武亚晶. 放射性心脏损伤研究进展—基础篇[J]. 中华放射肿瘤学杂志,2019,28(10): 721-727.
[8] 张长林,王兆强,张东友. 中药抗辐射作用的研究概况[J]. 中国中西医结合影像学杂志,2006,4(5):377-378.
[9] XU Z, WANG Y, YANG W, et al. Total extracts from Abelmoschus manihot (L.) alleviate radiation-induced cardiomyocyte ferroptosis via regulating redox imbalances mediated by the NOX4/xCT/GPX4 axis[J]. J Ethnopharmacol, 2024, 334: 118582. doi:10.1016/j.jep.2024.118582
[10] 王喜明,张艳霞,余海彬,等. 阿托伐他汀预处理对大鼠心肌缺血再灌注损伤的保护作用[J]. 中华实验外科杂志,2017,34(5):804-806.
[11] SARKOZY M, VARGA Z, GASPAR R, et al. Pathomechanisms and therapeutic opportunities in radiation?induced heart disease: From bench to bedside [J]. Clin Res Cardiol, 2021, 110:507-531. doi:10.1007/s00392-021-01809-y
[12] RAMADAN R, BAATOUT S, LEYBAERT L, et al.The role of connexin proteins and their channels in radiation?induced atherosclerosis[J]. Cell Mol Life Sci, 2021, 78(7):3087-3103. doi:10.1007/s00018-020-03716-3
[13] SLEZAK J, KURA B, RAVINGEROVA T, et al. Mechanisms of cardiac radiation injury and potential preventive approaches[J]. Can J Physiol Pharmacol, 2015, 93(9): 737-753. doi:10.1139/cjpp-2015-0006
[14] AZZAM E I, JAY-GERIN J P, PAIN D. Ionizing radiation-induced metabolic oxidative stress and prolonged cell injury[J].Cancer Lett,2012,327(1/2):48-60. doi:10.1016/j.canlet.2011.12.012
[15] ZHANG P, YANG P, HONG L, et al. Oxidative Stress in Radiation-Induced Cardiotoxicity [J]. Oxid Med Cell Longev, 2020, 2020:3579143. doi:10.1155/2020/3579143
[16] ZHANG P, YANG P, HONG L, et al. Oxidative stress in radiation-induced cardiotoxicity[J]. Oxid Med Cell Longev,2020,2020:3579143. doi:10.1155/2020/3579143
[17] 陶学娇,卢均坤,陈嘉辉,等. FIB-4、sST2水平与心力衰竭及其严重程度的相关性分析[J]. 新医学,2023,54(8):569-573.
[18] BRAUNWALD E. Heart failure[J]. JACC: Heart Fai,2013,1(1):1-20. doi:10.1016/j.jchf.2012.10.002
[19] REED G W, HORR S, YOUNG L, et al. Associations between cardiac troponin, mechanism of myocardial injury, and long-term mortality after noncardiac vascular surgery[J]. J Am Heart Assoc,2017,6(6):e005672. doi:10.1161/jaha.117.005672
[20] BEESLEY S J, WEBER G, SARGE T, et al. Septic cardiomyopathy [J]. Critical Care Med, 2018,46(4):625-634. doi:10.1097/ccm.0000000000002851
[21] 孙路轩,党晓平,孙子健. 低温诱导的RBM3对各器官缺血再灌注损伤研究进展[J]. 新医学, 2024,55(4):260-264.
[22] MORO C, JOUAN M G, RAKOTOVAO A, et al. Delayed expression of cytokines after reperfused myocardial infarction: Possible trigger for cardiac dysfunction and ventricular remodeling[J].Am J Physiol Heart Circ Physiol,2007,293(5):H3014-H3019. doi:10.1152/ajpheart.00797.2007
[23] VALKO M, RHODES C J, MONCOL J, et al. Free radicals, metals and antioxidants in oxidative stress-induced cancer[J]. Chem Biol Interact, 2006,160(1):1-40. doi:10.1016/j.cbi.2005.12.009
[24] EBADI M, GOVITRAPONG P, SHARMA S, et al. Ubiquinone (coenzyme q10) and mitochondria in oxidative stress of parkinson's disease[J]. Biol Signals Recept, 2001,10(3/4):224-253. doi:10.1159/000046889
[25] 顾静,付力文,韩晓斐,等. 基于miR-134-5p/BDNF/Akt信号通路探讨辐射致大鼠心肌细胞凋亡的相关机制[J]. 海军军医大学学报, 2024,45(11):1352-1361.
[26] 刘阳,高世乐,胡宗涛. 放射性心脏损伤机制及其防治的研究进展[J]. 安徽医药,2016,20(10):1813-1817.
[27] 吕东岭. 黄蜀葵花总黄酮对缺血性损伤的保护机制研究[D]. 南京:南京中医药大学, 2016.
[28] 孙增红,张莎,王丽娃,等. 黄蜀葵花提取物中总黄酮与总多酚含量测定及体外抑菌与抗氧化活性研究[J]. 化学与生物工程,2024,41(2):26-32.
[29] 缪晓帆,李思洋,林欣. 基于网络药理学和分子对接验证技术探讨黄蜀葵花防治造影剂肾损伤的作用机制[J]. 现代中西医结合杂志,2024,33(15):2133-2140.
[30] LV D, CHENG X, TANG L, et al. The cardioprotective effect of total flavonoids on myocardial ischemia/reperfusion in rats Biomedicine [J]. Biomed Pharmacother, 2017, 88 :277-284. doi:10.1016/j.biopha.2017.01.060
[31] ZHANG K, HE X, ZHOU Y, et al. Atorvastatin Ameliorates Radiation-Induced Cardiac Fibrosis in Rats [J]. Radiat Res, 2015, 184(6): 611-620. doi:10.1667/rr14075.1
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