Shexiang Baoxin Pill, Derived From the Traditional Chinese Medicine, Provides Protective Roles Against Cardiovascular Diseases

Abstract

Shexiang Baoxin Pill (SBP), derived from the traditional Chinese medicine, has been broadly applied for the treatment of cardiovascular diseases including coronary heart disease, heart failure, and hypertension in East Asia for decades. Emerging pharmacological studies have revealed that SBP displays pleiotropic roles in protecting the cardiovascular system, as seen by the promotion of angiogenesis, amelioration of inflammation, improvement of endothelium dysfunction, mitigation of dyslipidemia, repression of vascular smooth muscle cell proliferation, and migration and restraint of cardiac remodeling. In terms of clinical practice, the clinical trials and meta-analyses have proved the efficacy and safety of SBP. In this review, we, for the first time, systematically summarize the cardioprotective effects and underlying mechanisms of SBP and provide novel insights into future research directions of SBP based on the experimental and clinical perspectives.

Keywords: Shexiang Baoxin Pill; angiogenesis; cardiac remodeling; cardiovascular disease; traditional Chinese medicine.

FIGURE 1

The components included in Shexiang Baoxin Pills and the related Chinese patent medicine. (A) The morphology of seven raw medicinal materials which compose Shexiang Baoxin Pills. (B) The relevant patent medicine of Shexiang Baoxin Pills manufactured by Shanghai Hutchison Pharmaceuticals, which have been used in clinical practice for several years. The picture of this patent medicine has been permitted to be presented in the manuscript by Shanghai Hutchison Pharmaceuticals.

FIGURE 2

The therapeutic roles by which Shexiang Baoxin Pills protect against cardiovascular diseases. SBP, Shexiang Baoxin Pill; VEGF, vascular endothelial growth factor; EPC, endothelial progenitor cell; eNOS, endothelial nitric oxide synthase; NO, nitric oxide; PPAR, peroxisome proliferator-activated receptor; AMPK, AMP-activated protein kinase; PGC-1α, peroxisome proliferator-activated receptor gamma coactivator 1-α; SOD, superoxide dismutase; MDA, malondialdehyde; ET-1, endothelin-1; α-SMA, α-smooth muscle actin; SM-MHC, smooth muscle myosin heavy chain; MMP-9, matrix metalloprotein 9; TIMP-1, tissue inhibitor of metalloproteinase 1; PRA, plasma rein activity; AT2R, angiotensin II type 2 receptor.