Protective Effect and Mechanism of Shengmai Formula in Ultrafine Particle Matter-Mediated Atherosclerosis and Myocardial Ischemic Injury

Abstract Background : Long-term exposure to ultrafine particulate matter (UFPM) has been shown to enhance the development of atherosclerosis and impair myocardial function, leading to myocardial infarction (MI). The Shengmai (SM) formula is a kind of traditional Chinese medicine for cardiovascular diseases, which has been used in clinic for thousands of years. It is composed of Red ginseng, dwarf lilyturf tuber (Ophiopogon japonicus), and Chinese magnolia vine fruit and has been reported to improve myocardial ischemia and combat oxidative stress (OS) injury. The aim of this study was to explore the protective role of SM and the mechanism by which it acts against UFPM-induced cardiovascular injury. This study is expected to provide a basis for the development of potential adaptive signature of SM in the prevention of atherosclerotic cardiovascular disease (ASCVD) and premature death from global air pollution exposure. Results : Pretreatment with SM reduced plaque vulnerability, improved cardiac systolic function, decreased the OS response, and attenuated UFPM-induced reactive oxygen species production and mitochondrial damage. In addition, mice pretreated with SM showed a smaller MI area. In vitro data further demonstrated that compared with the UFPM group, pretreatment with SM significantly increased the expression of nuclear factor erythroid 2-related factor2 (Nrf2) and HO-1, and to some extent protected the antioxidant defense system. Conclusion : These results indicate that SM can inhibit the OS reaction in myocardial infarction mice, avoid cardiovascular injury induced by UFPM in atherosclerosis (AS)+MI mice, and improve cardiac function. Furthermore, the Keap1-Nrf2/HO-1 antioxidant signaling pathways might be involved during these processes. It is suggested that SM has a potential protective effect on the ASCVD population with prolonged exposure to excess particulate matter concentration.