Rivaroxaban Combined with Atorvastatin Inhibits Acute Pulmonary Embolism by Promoting the Expression of NRF2/NQO1.

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiovascular Drugs and Therapy Pub Date : 2024-12-01 Epub Date: 2023-06-15 DOI:10.1007/s10557-023-07479-4
Yang Chen, Cuncun Fan, Jinkun Wang, Mingming Jiang
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引用次数: 0

Abstract

Background: Atorvastatin and direct oral factor Xa inhibitors (for instance, rivaroxaban) are co-administrated in patients with atrial fibrillation. However, no studies have been conducted on the function of these two agents in acute pulmonary embolism (APE). Therefore, we investigated the effects of rivaroxaban + atorvastatin in rats with APE and explored the underlying mechanisms.

Methods: Patients with APE were enrolled, and rats with APE were generated for different regimens. The mean pulmonary arterial pressure (mPAP), heart rate, and PaO2 of APE patients and rats were measured. The plasma levels of oxidative stress- and inflammation-related factors were measured, and the expression of platelet activation markers (CD63 and CD62P) was detected. The proteins targeted by rivaroxaban and atorvastatin, the targets associated with APE, and the genes aberrantly expressed in rats with APE were intersected to obtain candidate factors.

Results: Rivaroxaban + atorvastatin reduced mPAP and increased PaO2 in patients and rats with APE. Rivaroxaban + atorvastatin repressed oxidative stress, inflammatory levels, and platelet activation during APE. NRF2 and NQO1 were increased in the lung of rats treated with rivaroxaban + atorvastatin. The therapeutic effect of the combination on APE rats was suppressed after NRF2 downregulation. NRF2 promoted the NQO1 transcription. NQO1 eliminated the inhibitory effect of sh-NRF2 on the combined therapy.

Conclusion: The alleviating effect of rivaroxaban + atorvastatin administration against APE correlates with NRF2/NQO1 expression.

Abstract Image

利伐沙班联合阿托伐他汀通过促进NRF2/NQO1的表达抑制急性肺栓塞。
背景:阿托伐他汀和直接口服Xa因子抑制剂(如利伐沙班)联合应用于房颤患者。然而,尚未有关于这两种药物在急性肺栓塞(APE)中的作用的研究。因此,我们研究了利伐沙班+阿托伐他汀对APE大鼠的影响,并探讨了其潜在机制。方法:纳入APE患者,生成不同方案的APE大鼠。测定APE患者和大鼠的平均肺动脉压(mPAP)、心率和PaO2。检测血浆中氧化应激和炎症相关因子的水平,检测血小板活化标志物(CD63和CD62P)的表达。将利伐沙班和阿托伐他汀靶向的蛋白、与APE相关的靶点以及APE大鼠中异常表达的基因进行交叉,获得候选因子。结果:利伐沙班+阿托伐他汀降低了APE患者和大鼠的mPAP,增加了PaO2。利伐沙班+阿托伐他汀可抑制APE期间的氧化应激、炎症水平和血小板活化。利伐沙班+阿托伐他汀组大鼠肺组织NRF2和NQO1升高。NRF2下调后,联合用药对APE大鼠的治疗效果受到抑制。NRF2促进NQO1转录。NQO1消除了sh-NRF2对联合治疗的抑制作用。结论:利伐沙班+阿托伐他汀对APE的缓解作用与NRF2/NQO1的表达有关。
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来源期刊
Cardiovascular Drugs and Therapy
Cardiovascular Drugs and Therapy 医学-心血管系统
CiteScore
8.30
自引率
0.00%
发文量
110
审稿时长
4.5 months
期刊介绍: Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.
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