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Herbal medicines provide regulation against iron overload in cardiovascular diseases: Informing future applications
Jia Liu1, Liangyan Deng1, Liping Qu1
1State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, PR China.
Insights
Iron overload impacts cardiovascular diseases (CVD) by promoting ferroptosis. Herbal medicines, particularly flavonoids, show promise in chelating iron and protecting against CVD by modulating key cellular pathways.
Area of Science:
- Cardiovascular Research
- Nutritional Science
- Pharmacology
Background:
- Iron is vital for cardiomyocytes, but overload or deficiency significantly impacts cardiovascular diseases (CVD).
- Iron overload contributes to doxorubicin (DOX) cardiomyopathy, atherosclerosis, and myocardial ischemia-reperfusion injury (MI/RI) via lipid peroxide production.
- Iron overload-induced cell death is a potential mechanism for ferroptosis, a specific form of regulated cell death.
Purpose of the Study:
- To outline iron metabolism and ferroptosis in cardiomyocytes.
- To review herbal medicines and extracts for preventing iron overload in CVD.
Main Methods:
- Systematic literature search across major scientific databases (ScienceDirect, PubMed, Google Scholar, Web of Science).
- Inclusion of data from Chinese databases (CNKI, WanFang), classic books, and clinical reports.
- Analysis of collected information on iron metabolism, ferroptosis, and herbal interventions in CVD.
Main Results:
- Various herbal medicines, including Chinese herbal prescriptions (e.g., Salvia miltiorrhiza injection, Gegen Qinlian decoction) and extracts (flavonoids, terpenoids, polyphenols), demonstrate therapeutic potential.
- Flavonoids are highlighted for their potent iron-chelating properties.
- Herbal medicines modulate Nrf2, AMPK, and KAT5/GPX4 signaling pathways to reduce iron overload and lipid peroxidation in CVD.
Conclusions:
- Herbal medicines offer cardiovascular protection by modulating iron overload and ferroptosis.
- These natural compounds serve as promising templates for developing strategies to prevent iron overload in CVD.
Ethnopharmacological Relevance:
Iron is an essential micronutrient for maintaining physiological activities, especially for highly active cardiomyocytes. Inappropriate iron overload or deficiency has a significant impact on the incidence and severity of cardiovascular diseases (CVD). Iron overload exerts potentially deleterious effects on doxorubicin (DOX) cardiomyopathy, atherosclerosis, and myocardial ischemia-reperfusion injury (MI/RI) by participating in lipid peroxides production. Notably, iron overload-associated cell death has been defined as a possible mechanism for ferroptosis. At present, some traditional herbal medicines and extracts have been included in the study of regulating iron overload and the subsequent therapeutic effect on CVD.
Aim Of The Study:
To give an outline of iron metabolism and ferroptosis in cardiomyocytes and to focus on herbal medicines and extracts to prevent iron overload in CVD.
Materials And Methods:
Literature information was systematically collected from ScienceDirect, PubMed, Google Scholar, Web of Science, China National Knowledge Infrastructure, WanFang data, as well as classic books and clinical reports.
Results:
After understanding the mechanism of iron overload on CVD, this paper reviews the therapeutic function of various herbal medicines in eliminating iron overload in CVD. These include Chinese herbal compound prescriptions (Salvia miltiorrhiza injection, Gegen Qinlian decoction, Tongxinluo, Banxia-Houpu decoction), plant extracts, phenylpropanoids, flavonoids, terpenoids, and polyphenols. Among them, flavonoids are considered to be the most promising compounds because of their prominent iron chelation. Mechanically, these herbal medicines act on the Nrf2 signaling pathway, AMPK signaling pathway, and KAT5/GPX4 signaling pathway, thereby attenuating iron overload and lipid peroxidation in CVD.
Conclusion:
Our review provides up-to-date information on herbal medicines that exert cardiovascular protective effects by modulating iron overload and ferroptosis. These herbal medicines hold promise as a template for preventing iron overload in CVD.
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