Abstract

Viral myocarditis (VMC) is a common cardiac disease, however, there still lacks an effective therapeutic strategy for VMC. Astragalus mongholicus (Fisch.) Bge (AB), a Chinese herb with some functional metabolites, may have some pharmacological effects on VMC. AB ingredients were measured by a full-scan LCQ mass spectrum. We aimed to explore the effects of AB on the VMC children by investigating peripheral Treg cell homeostasis. A total of 68 VMC children were random and evenly assigned into an AG group (received 10-mL AB oral liquid daily), and a CG group (received placebo daily). Peripheral blood mononuclear cells (PBMC) were obtained from peripheral blood and Treg cells were isolated. The levels of miR-146b, miR-155, Treg immunity activity and myocarditis biomarkers were measured in Treg cells. There were four main components (sucrose, calycosin, Astragaloside IV and calycosin-7-glucoside) in AB. The cases sinus tachycardia, frequent premature ventricular contractions, and supraventricular tachycardia were significantly reduced in the AG group (P < 0.05). Meanwhile, the myocardial enzymes and cardiac function indexes were improved in the AG group when compared with the CG group (P < 0.05). The time of electrocardiogram recovery, symptom duration and hospital stay was shorter in the AG group than in the CG group (P < 0.05). The levels of miR-146b and miR-155 were higher in the CG group than in the AG group (P < 0.05). The levels of ROR-γt (retinoic acid receptor-related orphan nuclear receptor gamma), FoxP3 (forkhead transcription factor), IL-10 (interleukin-11) and TGF-β (transforming growth factor beta) were lower in the CG group than in the AG group (P < 0.05). In contrast, the levels of IL-17, IL-21, CK-MB (creatine kinase-MB), cTnI (cardiac troponin I), GrB (granzyme B), sFasL (soluble fas ligand) and caspase-3 were higher in the CG group than in the AG group (P < 0.05). Furthermore, the levels of ROR-γt, FoxP3, IL-10, and TGF-β were positively, whereas the levels of IL-17, IL-21, CK-MB, cTnI, GrB, sFasL and caspase-3 were negatively, associated with the levels of miR-146b and miR-155 (P < 0.05). AB treatment improved cardiac functions, peripheral Treg cell immunity imbalance in the children with VMC by reducing the levels of miR-146b and miR-155.

Highlights

  • Viral myocarditis (VMC) is caused by enterovirus and adenovirus infection, and the incidence shows a rising trend recently

  • We explored the effects of Astragalus mongholicus (Fisch.) Bge (AB) on peripheral Treg cell immunity imbalance in VMC children, and analyzed the relationship between the expression of miR-146b and miR155, and Treg immunity activity and myocarditis biomarkers in the peripheral blood of VMC children

  • HPLC analysis showed that there were four main components in AB according to the results of standards (Figure 1A)

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Summary

Introduction

Viral myocarditis (VMC) is caused by enterovirus and adenovirus infection, and the incidence shows a rising trend recently. Astragalus mongholicus (Fisch.) Bge (AB) is one of the most important traditional Chinese herbs and has some functional metabolites. AB has been reported to prevent and treat inflammation by inhibiting lipopolysaccharide-induced production of TNF-α and IL-8, and suppressing the p38 signaling pathway [1]. Other work showed the antiinflammatory properties of AB [2]. AB polysaccharides can significantly improve serum and liver antioxidant activities and reduce peroxidative lipid levels [3]. Antioxidant and anti-inflammatory treatment is often considered for VMC therapy [4,5,6]. AB may have beneficial and pharmacological effects on VMC.

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