Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges

Myocardial fibrosis (MF) involves the activation and excessive proliferation of cardiac fibroblasts (CFs) in the extracellular matrix, leading to increased collagen expression that impairs cardiac function. Currently, there are no effective pharmacological treatments for MF. Traditional Chinese Medi...

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Main Authors: Qianrong Li, Chunzhen Ren, Bing Jiang, Xuehan Wang, Chunling Wang, Xiaodong Zhi, Linchan Li, Xiaoying Guo, Xinke Zhao, Yingdong Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1554696/full
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author Qianrong Li
Qianrong Li
Qianrong Li
Chunzhen Ren
Chunzhen Ren
Chunzhen Ren
Bing Jiang
Bing Jiang
Bing Jiang
Xuehan Wang
Xuehan Wang
Xuehan Wang
Chunling Wang
Chunling Wang
Chunling Wang
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Linchan Li
Linchan Li
Linchan Li
Linchan Li
Xiaoying Guo
Xiaoying Guo
Xiaoying Guo
Xinke Zhao
Xinke Zhao
Xinke Zhao
Xinke Zhao
Yingdong Li
Yingdong Li
Yingdong Li
author_facet Qianrong Li
Qianrong Li
Qianrong Li
Chunzhen Ren
Chunzhen Ren
Chunzhen Ren
Bing Jiang
Bing Jiang
Bing Jiang
Xuehan Wang
Xuehan Wang
Xuehan Wang
Chunling Wang
Chunling Wang
Chunling Wang
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Linchan Li
Linchan Li
Linchan Li
Linchan Li
Xiaoying Guo
Xiaoying Guo
Xiaoying Guo
Xinke Zhao
Xinke Zhao
Xinke Zhao
Xinke Zhao
Yingdong Li
Yingdong Li
Yingdong Li
author_sort Qianrong Li
collection DOAJ
description Myocardial fibrosis (MF) involves the activation and excessive proliferation of cardiac fibroblasts (CFs) in the extracellular matrix, leading to increased collagen expression that impairs cardiac function. Currently, there are no effective pharmacological treatments for MF. Traditional Chinese Medicine (TCM), particularly Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma], has gained attention for its potential in treating MF. Recent studies indicate significant therapeutic effects of its active metabolites, supporting its use in MF treatment and positioning it as a promising candidate for drug development. Aim of the review: This article reviews the research and mechanisms of S. miltiorrhiza’s effective metabolites and preparations in treating MF, providing a reference for future clinical treatments. A systematic literature search was conducted in PubMed, Web of Science, CNKI, and Google Scholar (January 2000–October 2024) using keywords: “myocardial fibrosis,” “cardiac fibrosis,” “Salvia miltiorrhiza Bunge,” “extract,” and “botanical drug.” Results: The active metabolites of S. miltiorrhiza and its metabolite preparations exert anti-fibrotic effects through pleiotropic mechanisms, including suppression of ventricular remodeling, modulation of autophagy, inhibition of oxidative stress and cardiomyocyte apoptosis, and regulation of extracellular matrix homeostasis and immune-inflammatory responses. Conclusion: Research indicates that S. miltiorrhiza is beneficial for managing MF, but further studies are needed to identify its chemical metabolites and regulatory mechanisms. Large-scale, multi-center clinical trials are also necessary to assess treatment safety. This review offers insights for developing new anti-MF pharmacotherapies.
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spelling doaj-art-a56cc79eebee4abbbb2fbd99e1986d872025-08-20T02:10:53ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.15546961554696Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challengesQianrong Li0Qianrong Li1Qianrong Li2Chunzhen Ren3Chunzhen Ren4Chunzhen Ren5Bing Jiang6Bing Jiang7Bing Jiang8Xuehan Wang9Xuehan Wang10Xuehan Wang11Chunling Wang12Chunling Wang13Chunling Wang14Xiaodong Zhi15Xiaodong Zhi16Xiaodong Zhi17Xiaodong Zhi18Linchan Li19Linchan Li20Linchan Li21Linchan Li22Xiaoying Guo23Xiaoying Guo24Xiaoying Guo25Xinke Zhao26Xinke Zhao27Xinke Zhao28Xinke Zhao29Yingdong Li30Yingdong Li31Yingdong Li32School of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaThe First Clinical Medical College, Lanzhou University, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaAffiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaOncology Department, Shaanxi Provincial Hospital of Chinese Medicine, Xi’an, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaAffiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, ChinaCollege of Integrated Traditional Chinese and Western Medicine, Gansu Province Key Laboratory of Chinese Medicine for the Prevention and Treatment of Chronic Diseases, Gansu University of Chinese Medicine, Lanzhou, ChinaKey Clinical Specialty of the National Health Commission of the People’s Republic of China, Key Specialized Cardiovascular Laboratory National Administration of Traditional Chinese Medicine, Lanzhou, ChinaMyocardial fibrosis (MF) involves the activation and excessive proliferation of cardiac fibroblasts (CFs) in the extracellular matrix, leading to increased collagen expression that impairs cardiac function. Currently, there are no effective pharmacological treatments for MF. Traditional Chinese Medicine (TCM), particularly Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma], has gained attention for its potential in treating MF. Recent studies indicate significant therapeutic effects of its active metabolites, supporting its use in MF treatment and positioning it as a promising candidate for drug development. Aim of the review: This article reviews the research and mechanisms of S. miltiorrhiza’s effective metabolites and preparations in treating MF, providing a reference for future clinical treatments. A systematic literature search was conducted in PubMed, Web of Science, CNKI, and Google Scholar (January 2000–October 2024) using keywords: “myocardial fibrosis,” “cardiac fibrosis,” “Salvia miltiorrhiza Bunge,” “extract,” and “botanical drug.” Results: The active metabolites of S. miltiorrhiza and its metabolite preparations exert anti-fibrotic effects through pleiotropic mechanisms, including suppression of ventricular remodeling, modulation of autophagy, inhibition of oxidative stress and cardiomyocyte apoptosis, and regulation of extracellular matrix homeostasis and immune-inflammatory responses. Conclusion: Research indicates that S. miltiorrhiza is beneficial for managing MF, but further studies are needed to identify its chemical metabolites and regulatory mechanisms. Large-scale, multi-center clinical trials are also necessary to assess treatment safety. This review offers insights for developing new anti-MF pharmacotherapies.https://www.frontiersin.org/articles/10.3389/fphar.2025.1554696/fullnatural medicine Salvia miltiorrhiza BungeMFadvancements in researchmetabolitespharmacological mechanism
spellingShingle Qianrong Li
Qianrong Li
Qianrong Li
Chunzhen Ren
Chunzhen Ren
Chunzhen Ren
Bing Jiang
Bing Jiang
Bing Jiang
Xuehan Wang
Xuehan Wang
Xuehan Wang
Chunling Wang
Chunling Wang
Chunling Wang
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Xiaodong Zhi
Linchan Li
Linchan Li
Linchan Li
Linchan Li
Xiaoying Guo
Xiaoying Guo
Xiaoying Guo
Xinke Zhao
Xinke Zhao
Xinke Zhao
Xinke Zhao
Yingdong Li
Yingdong Li
Yingdong Li
Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
Frontiers in Pharmacology
natural medicine Salvia miltiorrhiza Bunge
MF
advancements in research
metabolites
pharmacological mechanism
title Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
title_full Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
title_fullStr Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
title_full_unstemmed Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
title_short Salvia miltiorrhiza Bunge root in the treatment of myocardial fibrosis: research progress and challenges
title_sort salvia miltiorrhiza bunge root in the treatment of myocardial fibrosis research progress and challenges
topic natural medicine Salvia miltiorrhiza Bunge
MF
advancements in research
metabolites
pharmacological mechanism
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1554696/full
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