The potential of herbal drugs to treat heart failure: The roles of Sirt1/AMPK

Area of Science:

• Cardiology
• Molecular Biology
• Pharmacology

Background:

• Heart failure (HF) is a major cause of morbidity and mortality, significantly impacting patient health and incurring substantial socio-economic costs.
• Pathological mechanisms of HF include oxidative stress, apoptosis, altered cardiac energy metabolism, and disrupted autophagy.
• Sirtuin 1 (Sirt1) and AMP-activated protein kinase (AMPK) are key regulators of cellular processes implicated in cardiac health.

Purpose of the Study:

• To summarize the synergistic roles of Sirt1 and AMPK in cardiac function.
• To identify traditional Chinese medicines (TCMs) that modulate the Sirt1/AMPK pathway for cardioprotection.
• To provide a foundation for developing novel therapeutic strategies for HF and cardiovascular diseases (CVDs).

Main Methods:

• Literature review focusing on the molecular mechanisms of Sirt1 and AMPK in the heart.
• Analysis of studies investigating TCMs with cardioprotective effects related to the Sirt1/AMPK pathway.
• Synthesis of information on shared targets regulated by Sirt1 and AMPK, including PGC-1α, p38 MAPK, PPARs, and mTOR.

Main Results:

• Sirt1 and AMPK exhibit overlapping functions in regulating cardiac pathological processes.
• These pathways influence key targets involved in energy metabolism, mitochondrial biogenesis, and cellular stress responses.
• Several TCMs demonstrate potential to activate or inhibit Sirt1 and AMPK, suggesting therapeutic utility.

Conclusions:

• The Sirt1/AMPK pathway is a critical regulator of cardiac homeostasis and a promising target for HF treatment.
• Modulation of this pathway by TCMs offers a potential avenue for novel cardioprotective therapies.
• Further research into Sirt1/AMPK activators and inhibitors derived from TCMs could lead to effective treatments for HF and other CVDs.