Objective:

2

To investigate the main components and potential mechanism of Shuxuening Injection (SXNI) in the treatment of myocardial ischemia-reperfusion injury (MIRI) through network pharmacology and

in vivo

research.

Methods:

2

The Traditional Chinese Medicine Systems Pharmacology (TCMSP) and PharmMapper databases were used to extract and evaluate the effective components of Ginkgo biloba leaves

the main component of SXNI. The Online Mendelian Inheritance in Man (OMIM) and GeneCards databases were searched for disease targets and obtain the drug target and disease target intersections. The active ingredient-target network was built using Cytoscape 3.9.1 software. The STRING database

Metascape online platform

and R language were used to obtain the key targets and signaling pathways of the anti-MIRI effects of SXNI. In order to verify the therapeutic effect of different concentrations of SXNI on MIRI in rats

60 rats were first divided into 5 groups according to random number table method: the sham operation group

the model group

SXNI low-dose (3.68 mg/kg)

medium-dose (7.35 mg/kg)

and high-dose (14.7 mg/kg) groups

with 12 rats in each group. Then

another 60 rats were randomly divided into 5 groups: the sham operation group

the model group

SXNI group (14.7 mg/kg)

SXNI+LY294002 group

and LY294002 group

with 12 rats in each group. The drug was then administered intraperitoneally at body weight for 14 days. The main biological processes were validated using

in vivo

testing. Evans blue/triphenyltetrazolium chloride (TTC) double staining

hematoxylin-eosin (HE) staining

terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay

enzyme-linked immunosorbent assay (ELISA)

and Western blot analysis were used to investigate the efficacy and mechanism of SXNI in MIRI rats.

Results:

2

Eleven core targets and 30 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were selected. Among these

the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) pathway was closely related to SXNI treatment of MIRI.

In vivo

experiments showed that SXNI reduced the myocardial infarction area in the model group

improved rat heart pathological damage

and reduced the cardiomyocyte apoptosis rate (all

P

<

0.01). After SXNI treatment

the p-PI3K/PI3K and p-AKT/AKT ratios as well as B-cell lymphoma-2 (Bcl-2) protein expression in cardiomyocytes were increased

while the Bax and cleaved caspase 3 protein expression levels were decreased (all

P

<

0.05). LY294002 partially reversed the protective effect of SXNI on MIRI.

Conclusion:

2

SXNI protects against MIRI by activating the PI3K/AKT signaling pathway.