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| Programmed cell death: key targets and multidimensional modulation strategies of traditional Chinese medicine for prevention and treatment of myocardial fibrosis |
| Hits 35 Download times 10 Received:May 16, 2026 |
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| DOI
10.11656/j.issn.1673-9043.2026.09.14 |
| Key Words
myocardial fibrosis;programmed cell death;traditional Chinese medicine monomer;extracellular matrix;ventricular remodeling |
| Author Name | Affiliation | E-mail | | HE Sisi | Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China | | | WANG Yuyao | Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China | | | ZHANG Yingying | Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China | | | LI Hua | Innovative Institute of Chinese Medicine and Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China | | | WANG Taiyi | Institute of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
Key Laboratory of Traditional Chinese Medicine Classic Theory, Ministry of Education, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
Shandong Provincial Key Laboratory of Innovation and Applied Research of Basic Theories of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China | wangtaiyi@sdutcm.edu.cn |
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| Abstract
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| Myocardial fibrosis（MF） is a common pathological basis for various cardiovascular diseases，characterized by excessive deposition of extracellular matrix（ECM） proteins，such as type I and type III collagen，in the myocardial interstitium. This results in myocardial stiffness，decreased compliance，ventricular remodeling，and heart failure. Aberrant activation of programmed cell death（PCD），including apoptosis，pyroptosis，necroptosis，and ferroptosis，serves as a core initiator of myocardial injury，inflammatory amplification，and fibrotic progression. The crosstalk among these pathways forms a death regulatory network，which is a key reason for the irreversibility of chronic fibrosis. Traditional Chinese medicine（TCM） monomers exhibit unique advantages against MF due to their multi-target and cross-pathway regulatory properties. They can precisely intervene in key nodes of the PCD network，inhibit abnormal cardiomyocyte death，alleviate inflammation，block fibroblast activation，and reduce excessive collagen deposition. This paper systematically reviews the regulatory mechanisms of PCD subtypes in myocardial fibrosis，summarizes the intervention effects and molecular pathways of TCM monomers targeting the PCD network，and clarifies the multi-pathway modulatory intervention strategies of TCM. Furthermore，we propose that network pharmacology and targeting the PCD regulatory network will be the core directions for future research on anti-fibrotic therapy of TCM，providing a theoretical basis and new insights for the modernization of traditional Chinese medicine and the development of new anti-fibrotic drugs. |
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