Abstract
Purpose: To study the potential therapeutic effects of salvianolic acid A (Sal A) on thromboangiitis obliterans (TAO).
 Methods: An in vitro model of TAO-mimicking endothelial cell damage was established by incubating ECV304 cells with H2O2. An in vivo model of TAO rats was developed via injection of sodium laurate. After treatment with varying doses of Sal A, TAO symptoms were monitored over time and compared. The effects of Sal A on oxidative stress, pyroptosis, inflammation, and thrombosis were assessed using biochemical assays, enzyme-linked immunosorbent assay (ELISA), western blot, and histopathology.
 Results: Sal A significantly alleviated the inhibition of cell viability induced by H2O2 (p < 0.05). The H2O2-induced increases in levels of ROS, IL-1β, and IL-18 in ECV304 cells were significantly decreased by Sal A (p < 0.05). Moreover, Sal A alleviated TAO symptoms in rats. The enhanced levels of IL-1β, IL-18, NLRP3, and active Caspase-1 observed in TAO rats were reduced by Sal A in vivo (p < 0.05). Moreover, Sal A significantly reduced the size of thrombus in TAO rats. In addition, upregulated levels of ROS were significantly inhibited by Sal A (p < 0.05).
 Conclusion: Sal A exerts significant therapeutic effects on TAO. This provides mechanistic insights into the clinical effects of RSMA on TAO patients, which might be beneficial in the development of effective drugs against TAO in the future.
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