Abstract
Cardio-cerebrovascular diseases, as a major cause of health loss all over the world, contribute to an important part of the global burden of disease. A large number of traditional Chinese medicines have been proved effective both clinically and in pharmacological investigations, with the acceleration of the modernization of Chinese medicine. Sinomenine is the main active constituent of sinomenium acutum and has been generally used in therapies of rheumatoid arthritis and neuralgia. Varieties of pharmacological effects of sinomenine in cardio-cerebrovascular system have been discovered recently, suggesting an inspiring application prospect of sinomenine in cardio-cerebrovascular diseases. Sinomenine may retard the progression of atherosclerosis by attenuating endothelial inflammation, regulating immune cells function, and inhibiting the proliferation of vascular smooth muscle cells. Sinomenine also alleviates chronic cardiac allograft rejection relying on its anti-inflammatory and anti-hyperplastic activities and suppresses autoimmune myocarditis by immunosuppression. Prevention of myocardial or cerebral ischemia-reperfusion injury by sinomenine is associated with its modulation of cardiomyocyte death, inflammation, calcium overload, and oxidative stress. The regulatory effects on vasodilation and electrophysiology make sinomenine a promising drug to treat hypertension and arrhythmia. Here, in this review, we will illustrate the pharmacological activities of sinomenine in cardio-cerebrovascular system and elaborate the underlying mechanisms, as well as give an overview of the potential therapeutic roles of sinomenine in cardio-cerebrovascular diseases, trying to provide clues and bases for its clinical usage.
Highlights
Sinomenine is an alkaloid isolated from the root and stem of Sinomenium acutum Rehder et Wilson or Sinomenium acutum var. cinereum., and is the main active chemical component of these traditional Chinese medicine which used to treat rheumatism and neuralgia for centuries [1,2,3,4]
As the effectiveness of Chinese medicine in clinical treatments has been recognized gradually around the world, investigations on the specific role of sinomenine in cardio-cerebrovascular diseases are increasing, especially inspired by the fact that inflammatory responses and immune activation are involved in many pathological processes in cardio-cerebrovascular diseases, such as atherosclerosis, as well as cerebral and myocardial ischemia-reperfusion injury (IRI) [14,15,16,17]
It has been realized that sinomenine treatment could be beneficial to many cardio-cerebrovascular diseases, including atherosclerosis, cerebral or myocardial IRI, cardiac allograft rejection, autoimmune myocarditis, hypertension, and arrhythmia
Summary
Sinomenine is an alkaloid isolated from the root and stem of Sinomenium acutum Rehder et Wilson or Sinomenium acutum var. cinereum., and is the main active chemical component of these traditional Chinese medicine which used to treat rheumatism and neuralgia for centuries [1,2,3,4]. Since sinomenine is purified in the 1920s, Sinomenine and Cardio-Cerebrovascular Diseases many other pharmacological properties and therapeutic efficacies of this alkaloid have been discovered and investigated, including promotion of histamine release, mild sedative and analgesic effects, treatment of ankylosing spondylitis, and protection against cardio-cerebrovascular diseases, etc. As the effectiveness of Chinese medicine in clinical treatments has been recognized gradually around the world, investigations on the specific role of sinomenine in cardio-cerebrovascular diseases are increasing, especially inspired by the fact that inflammatory responses and immune activation are involved in many pathological processes in cardio-cerebrovascular diseases, such as atherosclerosis, as well as cerebral and myocardial ischemia-reperfusion injury (IRI) [14,15,16,17]. We will systematically summarize and expound the role of sinomenine in cardiocerebrovascular diseases based on its pharmacological effects and therapeutic potentials, aiming to give enlightenments for clinical applications of sinomenine
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