Background: The purpose of this study was to investigate the myocardial protective effect of Xuebijing (XBJ) injection in isolated donor heart preservation based on autophagy and NLRP3 inflammatory pathway, and to provide clues for improving the quality of donor heart preservation in the clinic.
Methods: Fourteen Guangxi Bama miniature pigs were randomly divided into two groups to establish the isolated heart perfusion model of extracorporeal membrane oxygenation (ECMO): (1) normal saline group (NS group): 50 mL normal saline was added to the perfusion solution; and (2) Xuebijing injection group (XBJ group): 10 mL of XBJ was added to the perfusate. Both groups were continuously pumped with 5 mL/h for 8 hours. Hemodynamic changes, inflammatory reaction, and myocardial enzyme levels were observed at five different time points. Western blot and real-time quantitative polymerase chain reaction (RT-qPCR) were used to detect the expression of autophagy markers and the NLRP3 signaling pathway related factors mRNA in myocardial tissue. Hematoxylin and eosin (H&E) staining and transmission electron microscopy were used to observe the pathomorphology and ultrastructure of the myocardium.
Results: There was no significant difference in perfusion pressure, heart rate, perfusion flow, and PH value between the two groups. The degree of myocardial tissue injury in the XBJ group was lighter, and the levels of myocardial enzymes, serum inflammatory factors were lower. The mRNA expression levels of beclin-1 and LC3 in the XBJ group were higher than those in the saline group, and the mRNA expression levels of NLRP3, Caspase-1, and ASC were lower.
Conclusions: Xuebijing injection can effectively improve the level of autophagy, reduce the activation and release of NLRP3 inflammasome, and slow down the inflammatory response, which has a certain myocardial protection effect.
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