Chinese herbal medicine and active ingredients for diabetic cardiomyopathy: molecular mechanisms regulating endoplasmic reticulum stress
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Published on: April 18, 2025
Lianjun Ao1, Zhengtao Chen2, Jiacheng Yin1
1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Insights
Chinese herbal medicine shows promise in treating diabetic cardiomyopathy (DCM) by targeting endoplasmic reticulum stress (ERS). These natural compounds can alleviate heart damage and improve patient outcomes.
Area of Science:
- Cardiovascular Research
- Pharmacology
- Traditional Chinese Medicine
Background:
- Diabetic cardiomyopathy (DCM) is a serious complication of diabetes, leading to heart failure and reduced survival.
- Endoplasmic reticulum stress (ERS) is a key factor in DCM pathogenesis, causing cardiomyocyte apoptosis, insulin resistance, and fibrosis.
- Targeting ERS presents a novel therapeutic strategy for DCM.
Purpose of the Study:
- To review the mechanisms of Chinese herbal medicine and active ingredients in modulating ERS for DCM treatment.
- To summarize the potential of these natural compounds in improving myocardial structure and function.
Main Methods:
- Literature search of PubMed, Web of Science, CNKI, and Wanfang databases.
- Analysis of studies on phytochemicals targeting ERS pathways in DCM.
- Keywords: "diabetic cardiomyopathy" and "endoplasmic reticulum stress".
Main Results:
- Chinese herbs and ingredients regulate ERS via IRE1, ATF6, and PERK pathways.
- These interventions reduce cardiomyocyte apoptosis, myocardial fibrosis, and hypertrophy in DCM.
- Demonstrated improvement in DCM clinical outcomes.
Conclusions:
- Chinese herbal medicine offers potential as a therapeutic approach for DCM by targeting ERS.
- Natural compounds can serve as drug candidates for DCM treatment.
- Further research into traditional Chinese medicine for ERS regulation in DCM is warranted.
Abstract:
Background: Diabetic cardiomyopathy (DCM) is one of the serious microvascular complications of diabetes mellitus. It is often associated with clinical manifestations such as arrhythmias and heart failure, and significantly reduces the quality of life and years of survival of patients. Endoplasmic reticulum stress (ERS) is the removal of unfolded and misfolded proteins and is an important mechanism for the maintenance of cellular homeostasis. ERS plays an important role in the pathogenesis of DCM by causing cardiomyocyte apoptosis, insulin resistance, calcium imbalance, myocardial hypertrophy and fibrosis. Targeting ERS is a new direction in the treatment of DCM. A large number of studies have shown that Chinese herbal medicine and active ingredients can significantly improve the clinical outcome of DCM patients through intervention in ERS and effects on myocardial structure and function, which has become one of the hot research directions. Purpose: The aim of this review is to elucidate and summarize the roles and mechanisms of Chinese herbal medicine and active ingredients that have the potential to modulate endoplasmic reticulum stress, thereby contributing to better management of DCM. Methods: Databases such as PubMed, Web of Science, China National Knowledge Internet, and Wanfang Data Knowledge Service Platform were used to search, analyze, and collect literature, in order to review the mechanisms by which phytochemicals inhibit the progression of DCM by targeting the ERS and its key signaling pathways. Keywords used included "diabetic cardiomyopathy" and "endoplasmic reticulum stress." Results: This review found that Chinese herbs and their active ingredients can regulate ERS through IRE1, ATF6, and PERK pathways to reduce cardiomyocyte apoptosis, ameliorate myocardial fibrosis, and attenuate myocardial hypertrophy for the treatment of DCM. Conclusion: A comprehensive source of information on potential ERS inhibitors is provided in this review. The analysis of the literature suggests that Chinese herbal medicine and its active ingredients can be used as potential drug candidates for the treatment of DCM. In short, we cannot ignore the role of traditional Chinese medicine in regulating ERS and treating DCM, and look forward to more research and new drugs to come.
