|Year : 2013 | Volume
| Issue : 5 | Page : 483-489
Panaxquin quefolium diolsaponins dose-dependently inhibits the proliferation of vascular smooth muscle cells by downregulating proto-oncogene expression
Zhihao Wang1, Yingkai Wang2, Xuezhong Zhao3
1 Department of Emergency, The Bethune First Hospital of Jilin University, Changchun 130021, China
2 Department of Gastroenterology, The Bethune First Hospital of Jilin University, Changchun 130021, China
3 Department of Cardiovascular Medicine, The Bethune First Hospital of Jilin University, Changchun 130021, China
|Date of Submission||03-Jan-2013|
|Date of Decision||09-Feb-2013|
|Date of Acceptance||12-Jul-2013|
|Date of Web Publication||6-Sep-2013|
Department of Cardiovascular Medicine, The Bethune First Hospital of Jilin University, Changchun 130021
Source of Support: The Scientific and Technological Project of Traditional Chinese Medicine from Jilin Province Administration of Traditional Chinese Medicine (Grant No. 2004-096), People's Republic of China, Conflict of Interest: None
Objectives: Panax quinquefolium saponins (PQS) potentially prevent atherosclerosis in vivo. The proliferation of vascular smooth muscle cells (VSMCs) plays an important role in coronary heart disease and restenosis after percutaneous coronary intervention. Here, we investigated the potential effect of Panax quinquefolium diolsaponins (PQDS), a subtype of PQS, on angiotensin II (AngII)-induced VSMC proliferation.
Materials and Methods: Isolated rat VSMCs were identified by immunocytochemical analysis. Cell proliferation was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The cell cycle and proliferation index were analyzed using flow cytometry. The messenger ribonucleic acid (mRNA) expression of proto-oncogenes was evaluated using reverse transcription polymerase chain reaction.
Results: Over 98% of cultured VSMCs were immunopositive for anti-α-smooth muscle actin. AngII promoted cell proliferation, whereas PQDS significantly suppressed VSMC growth in a dose-dependent manner. Moreover, PQDS suppressed AngII-induced proliferation of VSMCs by arresting the Gap 0/Gap 1 phase. Down-regulated mRNA expressions of proto-oncogenes occurred after PQDS application.
Conclusions: Our study demonstrates that PQDS may reduce AngII-stimulated VSMC proliferation by suppressing the expression of proto-oncogenes. These results may provide insights for the development of novel traditional Chinese medicines to prevent atherosclerosis.
Keywords: Angiotensin II, Panax quinquefolium diolsaponins, proliferation, proto-oncogene, vascular smooth muscle cells
|How to cite this article:|
Wang Z, Wang Y, Zhao X. Panaxquin quefolium diolsaponins dose-dependently inhibits the proliferation of vascular smooth muscle cells by downregulating proto-oncogene expression. Indian J Pharmacol 2013;45:483-9
|How to cite this URL:|
Wang Z, Wang Y, Zhao X. Panaxquin quefolium diolsaponins dose-dependently inhibits the proliferation of vascular smooth muscle cells by downregulating proto-oncogene expression. Indian J Pharmacol [serial online] 2013 [cited 2019 Jun 26];45:483-9. Available from: http://www.ijp-online.com/text.asp?2013/45/5/483/117772
| » Introduction|| |
Atherosclerosis, which potentially results in severe coronary heart disease and myocardial infarction, has emerged as a major life-threatening complication and cause of death in developed countries. Percutaneous coronary intervention (PCI) is recognized as an effective and safe form of treatment for single and multivessel coronary atherosclerotic disease. However, following coronary intervention, restenosis (i.e., a reoccurrence in the narrowing of blood vessels) remains an unsolved, yet important, clinical problem.  It has been generally accepted that the proliferation of abnormal vascular smooth muscle cells (VSMCs) is one of the most prominent features in the development of atherosclerosis and may contribute to restenosis after PCI. Therefore, after coronary intervention, the inhibition of VSMC proliferation may provide an effective alternative therapy.
Angiotensin II (AngII) is an important component of the renin-angiotensin system, which has been demonstrated to regulate the growth of VSMCs.  It has been reported that AngII is able to stimulate VSMC proliferation by promoting the incorporation of 3 H-thymidine at concentrations ranging from 10−9 mol/L to 10−6 mol/L.  Moreover, growth has been observed to be significantly stimulated when 10−8 -10−6 mol/L of AngII is applied. These observations have been confirmed in subsequent studies,  resulting in AngII being widely administered to induce VSMC proliferation. AngII stimulates the growth and migration of VSMCs in vitro, through the induction of autocrine growth factors. In addition, the continuous administration of AngII promotes the proliferation of VSMC in the arterial wall of injured rats in vivo.  Cell proliferation is controlled by the cell cycle, which comprises four phases: Gap 1 (G 1 ), S (synthesis), Gap 2 (G 2 ) and M (mitosis). In comparison, cells in the Gap 0 (G 0 ) phase are in a quiescent state and do not divide.  Moreover, pro-oncogenes, such as c-myc and c-fos, have been shown to regulate the growth of VSMCs.  The activation of proto-oncogenes may contribute to AngII-induced VSMC proliferation as the exposure of rat VSMCs to AngII has been found to result in the sequential activation of c-myc and platelet-derived growth factor A-chain messenger ribonucleic acid (mRNA) expression.
A range of pharmacological therapies have been used to suppress the migration and proliferation of VSMCs, including calcium channel antagonists, β-blockers angiotensin converting enzyme inhibitor, rapamycin, taxol and probucol. , However, there remains a paucity of information about the safety of these drugs as studies on their effects have primarily conducted in vitro. , Traditional Chinese medicine has been demonstrated to be safe and effective at treating various human diseases, possibly due to the use of multiple ingredients that act on multiple-target sites. ,, However, the effect of traditional Chinese medicine on the suppression of VSMC growth remains unclear. Panax quinquefolium saponins (PQS), which is extracted from the roots, stems and leaves of the North American variety of ginseng (Panax quinquefolium), has been proposed to protect low density lipoproteins from oxidation and may have a potential role in preventing atherosclerosis in vivo. PQS mainly consists of Panax quinquefolium diolsaponins (PQDS) and Pana xquinquefolium tritolsaponins. It has been reported that PQDS has an anti-myocardial ischemic effect on mice. This effect is achieved by decreasing crown arterial resistance and cardiac oxygen consumption and promoting the 86 Rb utilization rate. As a result, the blood flow capacity of the cardiac muscle increases, the oxygen consumption capacity of the cardiac muscle reduces, myocardial infarction size diminishes and the activity of creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) in blood serum decreases. ,, However, the effect of PQDS on VSMC proliferation requires investigation.
In the present study, we evaluate the effect of PQDS on VSMC proliferation induced by stimulating AngII.  Within this context, diltiazem (Dil), a calcium channel antagonist, which has been reported to inhibit VSMC proliferation,  was used as a standard drug. Cell proliferation was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. The cell cycle and proliferation index (PI) were analyzed using flow cytometry. The mRNA expression of proto-oncogenes (c-myc, c-fos and c-jun) was assessed using a reverse transcription polymerase chain reaction (RT-PCR). Based on our observations, we determined whether PQDS reduces AngII-induced VSMC proliferation by suppressing the expression of proto-oncogenes (c-myc, c-fos and c-jun). The results are intended to provide a theoretical basis for the clinical application of PQDS in preventing atherosclerosis following coronary intervention.
| » Materials and Methods|| |
RPMI 1640 culture medium and fetal bovine serum (FBS) were purchased from Gibco Co., USA. Rabbit anti-α-smooth muscle actin (α-SMA) antibody was obtained from Lab Vision Corp., USA. An anti-rabbit streptavidin-peroxidase kit and a DAB kit were obtained from Zhongshan Golden Bridge Biotechnology Co. Ltd., Beijing, China. All other reagents and chemicals were purchased from Sigma (St. Louis, MO, USA).
Cell Culture and Drug Treatment
Cell culture was conducted following previously described methods. , Briefly, primary VSMCs were obtained from the aortic media of male Sprague-Dawley rats (120-150 g) using the tissue explant technique. Tissue blocks were maintained in the culture medium until VSMCs migrated and became approximately 80% confluent. VSMCs were subsequently transferred to a new culture dish and maintained in RPMI 1,640 medium supplemented with 10% FBS in a humidified 37°C, 5% CO 2 incubator. Subcultures in passages 3-6 were used for identification by using immunocytochemical analysis with a rabbit anti-α-SMA antibody. Experiments were conducted using VSMCs in passages 4 and 10. To stimulate the proliferation of VSMCs, 10−7 mol/L AngII was added to the culture medium. For PQDS treatment, various concentrations (25, 50 or 100 mg/L) of PQDS or 0.1 μmol/L Dil were applied, accompanied with 10−7 mol/L Ang II.  This study was approved by the ethics committee of the Bethune First Hospital of Jilin University.
Determination of Cell Proliferation
To evaluate cell proliferation, a MTT assay was performed as described previously. , VSMCs were seeded onto a 96-well plate at a density of 10 3 -10 4 cells/well, 24 h prior to drug treatment. At 48 h after drug incubation, 20 μL of MTT (5 mg/mL) was added to each well. After a further 4 h of incubation at 37°C, the medium was removed and 150 mL dimethyl sulfoxide was added to each well to resuspend the MTT metabolic product. The absorbance of the dissolved formazan was measured at 490 nm (A490) using a scanning microplate spectrophotometer (DG-3022A, Huadong Electron Tube Factory, Shanghai, China).
Flow Cytometry Analysis
Cell cycle and proliferation was analyzed using flow cytometry analysis , using FACS Aria (BD Bioscience, San Jose, CA, USA). Briefly, cells were arrested in the G 0 phase through 24 h of serum-free medium incubation. After 48 h of drug treatment, cells were collected by centrifugation and fixed in pre-cooled, 70% ethanol for a further 18 h. Subsequently, the cells were adjusted to a density of 1 cells/mL × 10 6 cells/mL and stained with propidiumiodide at 37°C. At 30 min after incubation, PI-labeled cells were analyzed using flow cytometry. Cell cycle analysis was performed using ModFit Lt3.0 (BD Becton, Dickinson and Company, New Jersey, USA) software. The PI was calculated using the formula: PI = (S + G 2 /M)/(G 0 /G 1 + S + G 2 /M).
The mRNA level of the proto-oncogenes (c-myc, c-fos and c-jun) was examined using RT-PCR on a TC-312 thermal cycler (Techne, Duxford, Cambridge, United Kingdom). Total RNA was extracted using conventional technology and RNA purification was determined by using a spectrophotometer. Subsequently, total RNA was retrotranscribed into double-chained complementary deoxyribonucleic acid (DNA) and used for PCR amplification with the specific primers for the indicated genes [Table 1]. The thermocycling conditions were 95°C for 15 min, followed by 30 cycles at 94°C for 45 s, 55°C for 30 s, 72°C for 60 s and a 10 min final extension step at 72 °C. The amplified products were stored at 4°C until use. The PCR products were confirmed by 2% agarose gel electrophoresis and a gel imaging system was used for gray-scale analysis. The integrated optical density of the target gene/glyceraldehyde 3-phosphate dehydrogenase (GAPDH) was recorded.
Statistical package for the Social Sciences 10 (Statistical package for the Social Sciences company, Chicago, USA) software and expressed as ± s. Statistical significance was assessed using one-way analysis of variance followed by Student-Newman-Keuls test. The significance level was set at P < 0.05.
| » Results|| |
Primary Culture and Identification of VSMCs
At 3 and 5 d following in vitro culture, the initial migration of VSMCs in the tissue sections was observed. Excessive proliferation occurred with prolonged culture time. As examined by the inverted phase contrast microscope, these cells exhibited a typical, spindle-shaped morphology and a multilayered hill-and-valley growth pattern. The longitudinal axis of the cells ran in a direction that was perpendicular to the tissue margins. Bipolar cells were commonly observed to have a diffuse cytoplasm and round or mitotic nuclei. After 10 d of in vitro culture, a proportion of the cells were aligned in parallel to one another, with an overlapping growth pattern being detected in some regions. Immunostaining for α-SMA identified over 98% of cells as VSMCs. In addition, enhanced immunoactivity of α-SMA was predominately observed in the cytoplasm of the VSMCs with limited nuclear labeling [Figure 1].
|Figure 1: Identification of VSMCs using immunocytochemical analysis. Over 98% of cells were α-SMA-immunopositive, confirming the high purification of cultured VSMCs|
Click here to view
PQDS Inhibited AngII-induced Cell Proliferation
AngII has been widely used to stimulate the proliferation of VSMCs, both in vitro and in vivo.  Cell viability and proliferation was determined using MTT assays. Consistent with previous reports, 48 h of 10−7 mol/L AngII incubation promoted the remarkable growth of VSMCs [Figure 2], P < 0.05 compared to the control]. The standard drug Dil (0.1 μM) caused a major decrease in the growth rate of AngII-stimulated VSMCs (P < 0.05 compared to the AngII treatment group). In addition, the application of 50 or 100 mg/L of PQDS significantly reduced the growth rate of VSMCs stimulated by AngII (P < 0.05 compared to the AngII treatment group). The low PQDS treatment dose (25 mg/L) induced a slight reduction in cell proliferation, but no significant difference was observed (P > 0.05 compared to the AngII treatment group). No significant difference was observed between the Dil and PQDS treatment groups (P > 0.05). These results indicate that PQDS is able to suppress AngII-induced VSMC proliferation in a dose-dependent manner.
|Figure 2: Cell proliferation after a 48 h incubation period using MTT assays. VSMCs were incubated with 10-7 mol/L AngII, with or without the application of PQDS (25, 50, and 100 mg/L). The x-axis represents PQDS dose (mg/L); the y-axis represents MTT optical density (OD). A concentration of 0.1 μM Diltiazem (Dil) was used was used as the standard drug. #P < 0.05 compared to the control group; *P < 0.05 compared to the AngII treatment group|
Click here to view
Effect of PQDS on the Cell Cycle and PI of VSMCs
Flow cytometric analysis was performed to explore whether the PQDS inhibits cell proliferation by arresting the G 0 /G 1 phase in VSMCs. As shown in [Figure 3]a-f, the number of cells in the G 0 /G 1 phase decreased following treatment with 10−7 mol/L AngII (67.11 ± 2.56% vs. control 77.57 ± 1.75%, P < 0.05). Meanwhile, AngII elevated the number of cells and PI in the S and G 2 /M phases [Figure 3]g and h. This result indicates that AngII promotes the transition from the G 0 /G 1 phase to the S phase during the cell cycle progression in VSMCs. In addition, the administration of different PQDS concentrations noticeably elevated the number of cells in the G 0 /G 1 phase (P < 0.05 compared to the AngII group). The application of 50 and 100 mg/L AngII significantly reduced the percentage of cells in the G 2 /M phase (P < 0.05 compared to the AngII group). In contrast, the application of 25 mg/L AngII slightly decreased the number of cells in the G 2 /M phase (P > 0.05). Consistent with the MTT results, the effect of PQDS on G 0 /G 1 arrest appeared to be dose-dependent as higher concentrations of PQDS (50 or 100 mg/L) more strongly inhibited VSMC proliferation. In addition, 0.1 μmol/L Dil elevated the number of cells in the G 0 /G 1 phase (P < 0.05) and reduced the percentage of cells in the G 2 /M phase (P < 0.05), indicating that Dil inhibited growth. Different concentrations of both Dil and PQDS suppressed the AngII-stimulated PI [Figure 3]h.
|Figure 3: Effect of PQDS on the cell cycle and proliferation index of VSMCs. (a-f) are the representative data of the cell cycle analysis for (a) the control, (b) Ang II, (c) Ang II+PQDS (25 mg/L), (d) Ang II+PQDS (50 mg/L), (e) Ang II+PQDS (100 mg/L), and (f) Ang II+diltiazem (0.1 μM), determined by flow cytometry. The number of cells in the G0/G1 phase, the S phase (DNA synthesis phase), and the G2/M-phase (mitosis) are shown. (g) The percentage of cells in each phase using flow cytometry. The x-axis represents the doses of drugs. (h) The proliferation index of cells after PQDS or diltiazem treatment. The x-axis represents the drug doses used. #P< 0.05 compared to the control group; *P < 0.05 compared to the AngII treatment group; ^ P < 0.05 compared to the diltiazem treatment group|
Click here to view
Effect of PQDS on the mRNA Level of Proto-oncogenes (c-myc, c-fos and c-jun)
Proto-oncogenes c-myc, c-fos and c-jun may be involved in the mechanism by which PQDS modulates the reduction of AngII-induced cell proliferation in VSMCs. To test this hypothesis, RT-PCR was carried out with specific primers for c-myc, c-fos, c-jun and the GAPDH gene. Enhanced mRNA expression of each proto-oncogene was detected after 48 h of 10−7 mol/L AngII treatment [Figure 4]. A 0.1 μM concentration of Dil caused a noticeable decrease in the levels of these proto-oncogenes (P < 0.05 compared to the AngII group). Treatment with 25, 50 and 100 mg/L PQDS noticeably reduced c-myc and c-jun levels (P < 0.05 compared to the AngII group). Treatment with 25 mg/L PQDS caused a slight decrease in c-fos expression (P > 0.05 compared to the AngII group), while 50 and 100 mg/L PQDS significantly reduced c-fos levels (P < 0.05 compared to the AngII group). Hence, PQDS caused the mRNA expression of c-myc, c-fos and c-jun to be down-regulated in a dose-dependent manner. The results imply that PQDS may reduce AngII-induced VSMC proliferation by inactivating proto-oncogenes.
|Figure 4: PQDS reduced the mRNA level of proto-oncogenes. (a) The expression of proto-oncogenes (c-myc, c-fos, and c-jun) was evaluated by RT-PCR. Total RNA was extracted from cultured VSMCs at 48 h after treatment (for PCR amplification primers see Table 1). (b) The mRNA level of proto-oncogenes was quantified relative to the GAPDH level. The x-axis represents the drug doses used. Data was quantified from three independent experiments. #P < 0.05 compared to the control group; *P < 0.05 compared to the AngII treatment group; ^P < 0.05 compared to the diltiazem treatment group|
Click here to view
| » Discussion|| |
The abnormal proliferation and migration of VSMCs is a key event in the development of atherosclerosis and may contribute to restenosis following PCI. Consequently, the inhibition of VSMCs proliferation represents an important therapeutic strategy for preventing these diseases. Endothelial cells exert a large influence on VSMCs by releasing both contracting and relaxing factors, in addition to their ability to synthesize a large number of molecules that influence the growth of VSMCs. Hence, the progression of disease may be suppressed by understanding the underlying mechanism of VSMC proliferation, facilitating the development of drugs to prevent VSMC growth. Existing studies show that traditional Chinese medicines have limited adverse and/or toxic effects in the therapy of atherosclerosis, indicating advantages for their development.
In the present study, AngII was used to stimulate the proliferation of VSMCs. Cell viability and proliferation was determined using MTT assays, from which it was found that the dose-dependent application of PQDS reduced the growth rate of VSMCs stimulated by AngII [Figure 2]. Moreover, PQDS was found to inhibit VSMC proliferation, arresting development in the G 0 /G 1 phase. In contrast, the administration of different concentrations of PQDS noticeably elevated the number of cells in the G 0 / G 1 phase in a dose-dependent manner [Figure 3]. In general, abnormal VSMC function may induce myocardial ischemia.  A previous study showed that PQDS has an anti-myocardial ischemic effect, with the ability to decrease crown arterial resistance, increase cardiac muscle blood current capacity, reduce the oxygen consumption capacity of cardiac muscle, diminish myocardial infarction size and decrease the activities of CPK and LDH in blood serum.  Therefore, PQDS may suppress VSMC proliferation, protect against the impairment of coronary circulation and consequently, prevent myocardial ischemia.
It has been demonstrated that extracellular stimuli may initiate the rapid transcriptional activation of various genes, which have been classed together under the rubric of immediate early response genes (IEGs). IEGs mediate a complex cascade of mechanisms, linking membrane stimulation to long-term alterations in cellular phenotype. Accumulating evidence shows that some of these genes, termed proto-oncogenes, serve as key control switches in the regulation of cell growth. For example, c-myc is involved in the G 0 /G 1 transition from quiescence to proliferation and is required for continuous cellular mitogenesis. The nuclear protein fos, which specifically binds to chromosomal DNA, is involved in regulating DNA replication and transcription. The c-jun gene is activated early in response to growth-promoting agents in a wide variety of cell types. Existing research has also detected the up-regulation of mRNA levels for c-myc and c-fos in VSMCs after AngII stimulation. In the current study, the mRNA expression of c-myc, c-fos and c-jun was promoted after 48 h of 10−7 mol/L AngII treatment [Figure 4]. Of note, PQDS caused the downregulation of mRNA expression for proto-oncogenes in a dose-dependent manner, implying that PQDS may reduce AngII-induced VSMC proliferation by suppressing the activities of proto-oncogenes. In this study, we observed that PQDS efficiently suppressed AngII-induced VSMC proliferation after 48 h incubation. Calcium has been reported to mediate cell proliferation and the generation of cell matrices, which represent a common pathway involved in bioactive peptide-regulated cell proliferation. , Intracellular calcium becomes elevated during the mitogenetic process, following induction by growth factors. In addition, a voltage-gated calcium channel contributes to growth factor-induced cell proliferation.  Previous studies have indicated that certain panaxa diolsaponins (i.e., Rb1, Rb2, Rb3, Rc and Rd) may block the calcium channel. , As Rb1, Rb2, Rb3 and Rd are the main components of PQDS,  it is possible that PQDS may act as a calcium channel inhibitor, suppressing VSMC proliferation by blocking calcium influx after AngII stimulation. By using a whole-cell patch clamp, Zhang et al. found that panaxa diolsaponin Rb1 reduces the L-type calcium channel current in ischemic cardiomyocytes, without influencing the maximum activated voltage and reverse potential.  This experiment indicates that Rb1 may decrease the concentration of calcium in the cytoplasm by inhibiting Ca 2+ influx. In addition, PQS has been observed to suppress high K + levels induced by elevated [Ca 2+ ] I; hence, PQS may inhibit the entry of calcium into cells by a voltage-dependent Ca 2+ channel. 
We found that PQDS could suppress the proliferation of VSMC induced by AngII at 48 h after incubation. However, the proliferation inhibition of PQDS after 36 h, 72 h or longer-term incubation has not yet been determined. Moreover, the proliferation inhibition of PQDS at the dose of 100 mg/L was better than the dose of 50 mg/L and 25 mg/L. Future study will be continued to evaluate the best dose and incubation time of PQDS treatment. In addition, the involvement of apoptosis-related genes (such as bax, p53 and fas) in the suppression of PQDS-mediated growth requires further clarification. In conclusion, this study provides a theoretical basis for the clinical application of PQDS in preventing atherosclerosis.
| » Acknowledgments|| |
This research was supported by the Scientific and Technological Project of Traditional Chinese Medicine from Jilin Province Administration of Traditional Chinese Medicine (Grant No. 2004-096), People's Republic of China.
| » References|| |
|1.||Nakatani M, Takeyama Y, Shibata M, Yorozuya M, Suzuki H, Koba S, et al. Mechanisms of restenosis after coronary intervention: Difference between plain old balloon angioplasty and stenting. Cardiovasc Pathol 2003;12:40-8. |
|2.||Yang X, Zhu MJ, Sreejayan N, Ren J, Du M. Angiotensin II promotes smooth muscle cell proliferation and migration through release of heparin-binding epidermal growth factor and activation of EGF-receptor pathway. Mol Cells 2005;20:263-70. |
|3.||Rossi F, Bertone C, Petricca S, Santiemma V. Adrenomedullin antagonizes angiotensin II-stimulated proliferation of human aortic smooth muscle cells. Peptides 2006;27:2935-41. |
|4.||Zhang Y, Gao P, Wang X, Zhang Z, Zhu D. Effect of angiotensin II on the proliferation of vascular smooth muscle cells. Chin J Pathophysiol 2000;16:1007. |
|5.||Boehm M, Nabel EG. The cell cycle and cardiovascular diseases. Prog Cell Cycle Res 2003;5:19-30. |
|6.||Cody RJ. The integrated effects of angiotensin II. Am J Cardiol 1997;79:9-11. |
|7.||Blagosklonny MV, Darzynkiewicz Z, Halicka HD, Pozarowski P, Demidenko ZN, Barry JJ, et al. Paclitaxel induces primary and postmitotic G1 arrest in human arterial smooth muscle cells. Cell Cycle 2004;3:1050-6. |
|8.||Liu X, Shen J, Zhan R, Wang X, Wang X, Zhang Z, et al. Proteomic analysis of homocysteine induced proliferation of cultured neonatal rat vascular smooth muscle cells. Biochim Biophys Acta 2009;1794:177-84. |
|9.||Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: A comparative overview. Evid Based Complement Alternat Med 2005;2:465-73. |
|10.||Cohen I, Tagliaferri M, Tripathy D. Traditional Chinese medicine in the treatment of breast cancer. Semin Oncol 2002;29:563-74. |
|11.||Chan K. Progress in traditional Chinese medicine. Trends Pharmacol Sci 1995;16:182-7. |
|12.||Li J, Huang M, Teoh H, Man RY. Panax quinquefolium saponins protects low density lipoproteins from oxidation. Life Sci 1999;64:53-62. |
|13.||Wu S, Sui D, Yu X, Lu Z, Zhao X. Antimyocardial ischemic effects of Panax quinquefolium 20 s-protopanaxdiol saponins (PQDS) and its mechanism. Chin Pharm J 2002;37:100-3. |
|14.||Liu SY, Sui DY, Yu XF, Lu ZZ, Wang L. Effects of Panax quinquefolium 20s-protopanaxdiol saponins on the hemodynamics and cardial oxygen metabolism in dogs with acute myocardial infarction. Chin Pharm J 2001;36:25-9. |
|15.||Zhai LJ, Yu XF, Qu SC, Sui DY. Effect of Panax quinquefolium 20s-protopanaxdiolsaponins on the nutritional blood flow of myocardium in mice. Ginseng Research 2004;16:2-4. |
|16.||Voisard R, Koschnick S, Baur R, Vogel U, Mattfeldt T, Hemmer W, et al. High-dose diltiazem prevents migration and proliferation of vascular smooth muscle cells in various in-vitro models of human coronary restenosis. Coron Artery Dis 1997;8:189-201. |
|17.||Campbell JH, Kocher O, Skalli O, Gabbiani G, Campbell GR. Cytodifferentiation and expression of alpha-smooth muscle actin mRNA and protein during primary culture of aortic smooth muscle cells. Correlation with cell density and proliferative state. Arteriosclerosis 1989;9:633-43. |
|18.||Yang Z, Cheng B, Song J, Wan Y, Wang Q, Cheng B, et al. Estrogen accelerates G1 to S phase transition and induces a G2/M phase-predominant apoptosis in synthetic vascular smooth muscle cells. Int J Cardiol 2007;118:381-8. |
|19.||Cheng JF, Ni GH, Chen MF, Li YJ, Wang YJ, Wang CL, et al. Involvement of profilin-1 in angiotensin II-induced vascular smooth muscle cell proliferation. Vascul Pharmacol 2011;55:34-41. |
|20.||Yoon JW, Cho BJ, Park HS, Kang SM, Choi SH, Jang HC, et al. Differential effects of trimetazidine on vascular smooth muscle cell and endothelial cell in response to carotid artery balloon injury in diabetic rats. Int J Cardiol 2013;167:126-33. |
|21.||Chan KC, Wang CJ, Ho HH, Chen HM, Huang CN. Simvastatin inhibits cell cycle progression in glucose-stimulated proliferation of aortic vascular smooth muscle cells by up-regulating cyclin dependent kinase inhibitors and p53. Pharmacol Res 2008;58:247-56. |
|22.||Shimokawa H, Yasuda S. Myocardial ischemia: Current concepts and future perspectives. J Cardiol 2008;52:67-78. |
|23.||Hattori Y, Kakishita H, Akimoto K, Matsumura M, Kasai K. Glycated serum albumin-induced vascular smooth muscle cell proliferation through activation of the mitogen-activated protein kinase/extracellular signal-regulated kinase pathway by protein kinase C. Biochem Biophys Res Commun 2001;281:891-6. |
|24.||Watanabe T, Pakala R, Katagiri T, Benedict CR. Monocyte chemotactic protein 1 amplifies serotonin-induced vascular smooth muscle cell proliferation. J Vasc Res 2001;38:341-9. |
|25.||Sasaki E, Nozawa Y, Miyoshi K, Kanda A, Yamasaki Y, Miyake H, et al. TAS-301 blocks receptor-operated calcium influx and inhibits rat vascular smooth muscle cell proliferation induced by basic fibroblast growth factor and platelet-derived growth factor. Jpn J Pharmacol 2000;84:252-8. |
|26.||Yang SJ, Chen X, Li H. Effect of Panax quinquefolium diolsaponins Rb3 on the hemodynamics and calcium channel activity in rat. Chin Pharm Bull 1995;11:39-40. |
|27.||Zhong GG, Sun CW, Li YY, Qi H, Zhao CY, Jiang Y, et al. Calcium channel blockade and anti-free-radical actions of panaxadiol saponins Rb1, Rb2, Rb3, Rc, and Rd. Zhongguo Yao Li Xue Bao 1995;16:255-60. |
|28.||Sui DY, Yu XF, Qu SC, Lu ZZ, Wang L, Chen MQ. Protective effect of Panax quinquefolium 20s-proto-panaxdiolsaponins on acute myocardial infarction in dogs. Zhongguo Zhong Yao Za Zhi 2001;26:416-9. |
|29.||Zhang W, Li L, Zhao C, Li X, Zhao M, Zhong G. Effects of panaxadiol saponins monomer Rb1 on action potential and L-type calcium channel in ischemic cardiomyocytes. J Jilin Univ 2007;33:978-81. |
|30.||Guan L, Yi X, Yang S, Lv Y. The effect of saponins extracted from the stem and leaves of Panax quinquefolium on Ca2+ entry at rat myocardial cells. Pharmacol Clin Chin Mater Med 2004;20:8-9. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]