Research Progress on Salvia miltiorrhiza Bioactive Components Regulating P-Selectin for Microcirculatory Improvement:...

Severe acute pancreatitis (SAP) is associated with high morbidity and mortality. Microcirculatory dysfunction is a critical pathological event in this process and a primary contributor to organ failure (OF). Despite the pivotal role of P-selectin in mediating the adhesion of activated platelets and leukocytes to the vascular endothelium, a process central to microcirculatory dysfunction, effective therapeutic interventions for SAP remain limited. Salvia miltiorrhiza, a traditional Chinese medicinal (TCM) herb, possesses well-documented pharmacological properties, including anti-inflammatory, anticoagulant, and microcirculation-improving effects. This review synthesizes recent advances in understanding the bioactive components of Salvia miltiorrhiza, which ameliorate microcirculation by modulating P-selectin expression and activity through mechanisms targeting its transcription, translation, or post-translational activation. Given the current lack of direct evidence in the context of SAP, we synthesized extensive findings from studies on cardiovascular, gastrointestinal, and inflammatory diseases, as well as from relevant acute pancreatitis (AP)/SAP models. These collective data demonstrate that Salvia miltiorrhiza effectively inhibits platelet aggregation, attenuates leukocyte adhesion, mitigates endothelial injury, and improves perfusion. Substantial evidence suggests that the bioactive compounds derived from Salvia miltiorrhiza function as effective agents against microcirculatory dysfunction by targeting P-selectin. Leveraging this well-defined mechanistic pathway and the promising therapeutic efficacy observed in AP/SAP models, targeting P-selectin with Salvia miltiorrhiza's bioactive compounds emerges as a compelling novel strategy for SAP-associated microcirculatory dysfunction, laying a groundwork for subsequent validation studies.