Allicin Hanning Blood Myocardial Ischemia Gas Signaling Molecules And Microcirculation

Background: Coronary heart disease(CHD) angina pectoris and acute myocardial infarction(AMI) are the most frequent myocardial ischemia disease in clinic.They all belong to the syndrome of blood stasis category in TCM. Blood stasis due to cold coagulation is the frequent type of syndrome in TCM. The prophase research indicate that garlicin can interfere in CHD angina pectoris in several morbility component element and has the character of the traditional Chinese drug effects on multitarget point. It has satisfactory protection on ischemia myocardium especially in the therapeutic action on cold syndrome surpass pyretic syndrome. This concordance to successive dynasties record and indicate that garlicin possess the function of warming and activating meridian to promote blood flow.Garlicin has the therapeutic action of treating Myocardial ischemia of blood stasis due to cold coagulation (MIBSCC).Aim: Disscuss the garlicin functions to regulate gaseous signaling molecule and to improve microcirculation. Reveal therapeutic mechanism of garlicin to MIBSCC in patho-physiology and pharmacology mechanism by warming and activating meridian to promote blood flow. Survey the microcirculation of patients with syndrome of blood stasis and patients with MIBSCC.Methods: This study consist of three portions: theoretical discuss, expetimental research and clinical research.(1)Theoretical discuss: According to the study purpose, theory approach was carried out from three aspects: study on the pattern and treatment of MIBSCC; study on gaseous signaling molecule and promoting blood circulation to removing blood stasis; and study on integrated traditional and western medicine of coronary artery microcirculation disturbance.(2)Empirical research:â‘ First,we established integrated disease and syndrome rat model of MIBSCC adopting interrupt cold stress repeatedly and Pit. Synthesis evaluation was done from the following aspects to determine the animal model's establishment: the state of rat, body temperature, microcirculation evaluated by tongue and ear StO2, ECG, biochemical indicator of the blood and myocardium pathology.â‘¡On the bases of these, garlicin's role on MIBSCC in common physiological index (syndrome, body temperature and ECG), biochemical indicator (FT3,FT4,TSH,cTnT,MDA and SOD), vasomotion bioactive peptide (CGRP and ET) and myocardium pathology were observed.â‘¢The regulating mechanism of garlicin on MIBSCC by gaseous signaling molecule were researched from the influence of garlicin to gaseous signaling molecule NO, NOS and H2S as well as myocardium eNOS and ET-1 mRNA expression.â‘£The influence of garlicin on microcirculation of MIBSCC were researched from visible light StO2, vascular endothelial cell Caveolin-1, CD34 and heart muscle capillary ultrastructure.(3)Clinical research:â‘ Through the healthy adult screening, the normal value of visual light StO2 in tongue and face were obtained. The visual light StO2 in tongue and face of ptients with syndrome of blood stasis were detected pretherapy and post-treatment. By this way, clinical research on microcirculation function was done.â‘¡To patients in acute stage of AMI after emergency PCI or thrombolysis treatment to evaluating myocardial microcirculation and surveying the myocardial microcirculation characteristic on MIBSCC by ultrasoundcardiogram and MCE examination.Results:(1)Each model evaluation index above-mentioned support the establishment of rat MIBSCC model.The model is correspond to the TCM theory.(2)Garlicin can improve common index, biochemical indicator, vasomotion bioactive peptide regulation and myocardial pathology of MIBSCC.(3)In the aspect of gaseous signaling molecule regulation mechanism, low dose garlicin can up-regulate eNOS mRNA expression obviously, promote the synthesis of eNOS, elevate the contents of NOS and NO in rat myocardium tissue significantlly, degrade the H2S synthase contents in myocardium tissue.(4)In microcirculation aspects, middle and low dose garlicin can significantlly improve the MIBSCC rat's StO2 of ear,tongue and heart, middle dose garlicin can lower the Caveolin-1 and raise CD34 expression notablely, lessen the pathological changes degree of myocardium ultrastructure and improve microcirculation.(5)Clinical research indicate that visible light StO2 lowest in the face and highest in oral lips. Lingual surface StO2 is the highest in each regional of the tongue. StO2 in each part above-mentioned increased obviously after treated by activating blood circulation to dissipate blood stasis medicine.(6)MIBSCC patients response more obvious to echocardiography stress test and the k value in ischemic region significantlly less than the other syndrome.Conclusions:(1)The method of MIBSCC animal model by interrupting and repeatedly cold stress connected with Pit correspond to TCM syndrome character. (2)Garlicin can aim directly at MIBSCC multitude morbidity link, and protect ischemia myocardium in many ways through regulating gaseous signaling molecule and improve microcirculation.The middle and low dose of garlicin produce the best effect.(3)The determination of StO2 with visual light is a new index quantitative assessment tissue microcirculation function.(4)The research of AMI patients detected by MCE indicate that the myocardial microcirculation of MIBSCC patients had aggravate tendency compared with non MIBSCC patients.(5) According to differentiation of symptoms and signs, the utilization of garlicin can get its best effect.