Medicinal Herbs can Play Significant Role in Attenuation of Ischemia and Reperfusion Injury

Nature has been a source of medicinal treatments for thousands of years and plant-derived products continue to play an essential role in the primary health care of about 80-85% of the world’s population. Medicinal herbs are widely used in Ayurveda, the Indian System of Medicine and have been observed to possess numerous activities with regard to cardiovascular system viz. antiplatelet, hypolipidemic, anti-inflammatory, hypoglycemic and hypotensive actions. Hence, these herbal extracts traditionally used have been evaluated scientifically in the present study with an aim to define the role of these agents in limiting the deleterious effects of myocardial ischemia and reperfusion (IR) injury by providing scientific data to validate their use as prophylactic approaches or as an adjunct to standard treatment (synthetic compounds employed in conventional treatment protocols) of ischemic heart disease. The efficacy of Withania somnifera (Ws), Curcuma longa (Cl) and Ocimum sanctum (Os), and herbal combination (HCB) including {Ws (50 mg/kg) + Cl (100 mg/kg) + Os (75 mg/kg} to limit injury in the setting of myocardial ischemia and reperfusion was explored in the present study. An open chest left anterior descending coronary artery (LAD) occlusion and reperfusion induced myocardial injury was used as the experimental model. Wistar albino rats were divided into ten groups and orally fed saline once daily (sham, control IR) or medicinal herbs (Ws/Cl/Os/HCB; Ws-IR, Cl-IR/Os-IR/HCB-IR) respectively for 1 month. On the 31st day in the rats of the Control IR and Ws-IR, Cl-IR/Os-IR/HCB-IR groups, LAD was occluded for 45 min, and reperfused for 1 h. Hemodynamic parameters were recorded at preset points and subsequently sacrificed for biochemical, immunohistochemical and pathological studies. In the control IR group, significant ventricular dysfunction, cardiac necrosis, apoptosis; decline in antioxidant status and elevation in lipid peroxidation was observed. Chronic oral treatment with HCB per se for 1 month resulted in significant enhancement of the myocardial endogenous antioxidant enzymes. Pretreatment with Ws, Cl and the herbal combination exerted significant cardioprotective effects in the experimental model of myocardial injury. The most remarkable observation of the present study was that cardioprotective effect exerted by HCB treatment was found to be superior to that shown by singular treatment with individual herbal extracts. The combination of herbal extracts was found to significantly ameliorate the ischemia and reperfusion cardiomyocyte apoptosis, cardiac dysfunction, compromised antioxidant status and histopathologic alterations as compared to control IR group. Cardioprotection by HCB treatment may be attributed to its favorable hemodynamic effects, myocardial adaptogenic properties, and significant antioxidant and antiapoptotic properties. Furthermore, HCB decreased the severity of pathological changes and significantly preserved the myocardial creatinine phosphokinase confirming its myocardial salvaging effects. Results clearly demonstrated the therapeutic potential of the herbal drugs in the treatment of myocardial ischemia and reperfusion injury. If the beneficial effects can be established in-patients, these findings may represent a novel adjunctive therapy of ischemic heart disease and Myocardial Infarction.