Gelanxinning capsule improves coronary microvascular dysfunction by inhibiting inflammation and restoring endothelial...

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Biochemistry

Background:

• Coronary artery disease (CAD) can involve coronary microvascular dysfunction (CMD), a condition whose treatment is not fully understood.
• Gelanxinning capsule (GXSC), a traditional Chinese medicine composed of Pueraria lobata, hawthorn extract, and gypenosides, is used for CAD but its effect on CMD is unknown.

Purpose of the Study:

• To investigate the therapeutic efficacy of GXSC in improving CMD in CAD patients.
• To elucidate the underlying mechanisms of GXSC's action on inflammation and endothelial function in CMD.

Main Methods:

• A single-center, randomized controlled trial involving 78 CAD patients diagnosed via coronary angiography (CAG).
• Measurements included index of microcirculatory resistance (IMR) and coronary flow reserve (CFR) via CAG and SPECT.
• ELISA was used to quantify biomarkers of inflammation, endothelial function, and microvascular function before and after two months of treatment.

Main Results:

• GXSC treatment significantly decreased proinflammatory markers (NLRP3, IL-1) and increased anti-inflammatory adropin.
• Endothelial function markers (syndecan 1, syndecan 4, heparan sulfates) were downregulated, while vascular protective SIRT1 was upregulated with GXSC.
• Coronary microvascular function markers (endocan, suPAR, GDF-15) were significantly reduced in the GXSC group.

Conclusions:

• GXSC demonstrates a therapeutic effect on CMD in CAD patients by inhibiting inflammation and restoring endothelial function.
• GXSC may serve as an effective treatment option for CAD patients experiencing angina due to CMD, particularly those without obstructive epicardial coronary arteries.