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Bioactive components and molecular mechanisms of Salvia miltiorrhiza Bunge in promoting blood circulation to remove blood stasis

Ethnopharmacological relevance: Salvia miltiorrhiza Bunge (SM) is an outstanding herbal medicine with various traditional effects, especially promoting blood circulation to remove blood stasis. It has been widely used for centuries to treat blood stasis syndrome (BSS)-related diseases. BSS is one of the basic pathological syndromes of diseases such as cardiovascular and cerebrovascular diseases in traditional East Asian medicine, which is characterized by disturbance of blood circulation. However, the bioactive components and mechanisms of SM in the treatment of BSS have not been systematically reviewed. Therefore, this article outlines the anti-BSS effects of bioactive components of SM, concentrating on the molecular mechanisms.

Aim of the review: To summarize the bioactive components of SM against BSS and highlight its potential targets and signaling pathways, hoping to provide a modern biomedical perspective to understand the efficacy of SM on enhancing blood circulation to remove blood stasis.

Materials and methods: A comprehensive literature search was performed to retrieve articles published in the last two decades on bioactive components of SM used for BSS treatment from the online electronic medical literature database (PubMed).

Results: Phenolic acids and tanshinones in SM are the main bioactive components in the treatment of BSS, including but not limited to salvianolic acid B, tanshinone IIA, salvianolic acid A, cryptotanshinone, Danshensu, dihydrotanshinone, rosmarinic acid, protocatechuic aldehyde, and caffeic acid. They protect vascular endothelial cells by alleviating oxidative stress and inflammatory damage and regulating of NO/ET-1 levels. They also enhance anticoagulant and fibrinolytic capacity, inhibit platelet activation and aggregation, and dilate blood vessels. Moreover, lowering blood lipids and improving blood rheological properties may be the underlying mechanisms of their anti-BSS. More notably, these compounds play an anti-BSS role by mediating multiple signaling pathways such as Nrf2/HO-1, TLR4/MyD88/NF-κB, PI3K/Akt/eNOS, MAPKs (p38, ERK, and JNK), and Ca2+/K+ channels.

Conclusions: Both phenolic acids and tanshinones in SM may act synergistically to target different signaling pathways to achieve the effect of promoting blood circulation.

 

Comments:

The review article summarizes the bioactive components of Salvia miltiorrhiza Bunge (SM) and their effects on blood stasis syndrome (BSS), a condition characterized by impaired blood circulation. SM has been used in traditional East Asian medicine for centuries to treat BSS-related diseases, particularly cardiovascular and cerebrovascular diseases. The aim of the review is to provide a modern biomedical perspective on the efficacy of SM in enhancing blood circulation and removing blood stasis by identifying the bioactive components and their potential targets and signaling pathways.

The review conducted a comprehensive literature search, focusing on articles published in the last two decades, to gather information on the bioactive components of SM used in the treatment of BSS from the PubMed database.

The main bioactive components identified in SM for treating BSS are phenolic acids and tanshinones. These include salvianolic acid B, tanshinone IIA, salvianolic acid A, cryptotanshinone, Danshensu, dihydrotanshinone, rosmarinic acid, protocatechuic aldehyde, and caffeic acid. These components exert their effects by protecting vascular endothelial cells, reducing oxidative stress and inflammatory damage, and regulating the levels of nitric oxide (NO) and endothelin-1 (ET-1). They also enhance anticoagulant and fibrinolytic capacity, inhibit platelet activation and aggregation, and promote blood vessel dilation. Additionally, they contribute to lowering blood lipid levels and improving blood rheological properties, which are important underlying mechanisms in the treatment of BSS. These bioactive components mediate multiple signaling pathways such as Nrf2/HO-1, TLR4/MyD88/NF-κB, PI3K/Akt/eNOS, MAPKs (p38, ERK, and JNK), and Ca2+/K+ channels to exert their anti-BSS effects.

In conclusion, both phenolic acids and tanshinones in SM work synergistically to target various signaling pathways, promoting blood circulation and alleviating blood stasis. This review provides valuable insights into the bioactive components and molecular mechanisms underlying the therapeutic effects of SM in BSS treatment.

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