Oren-gedoku-to inhibits calcification of human aortic valve interstitial cells in vitro and aortic valve in spontaneously hypertensive rats in vivo

Despite being the most common adult heart valve disease in developed countries, no medicinal treatment exists for calcific aortic valve stenosis (CAS). We previously demonstrated that tumor necrosis factor (TNF)-α promotes aortic valve calcification (AVC) via the bone morphogenic protein (BMP) 2-alkaline phosphatase (ALP) pathway. In the present study, we aimed to investigate the effects of Kampo, a traditional Japanese herbal medicine, on TNF-α-induced AVC involving CAS progression. We confirmed that Oren-gedoku-to (OGT, 10-100 μg/mL) strongly and dose-relatedly inhibited HAVIC calcification induced by TNF-α (30 ng/mL). OGT significantly inhibited TNF-α-induced BMP2 expression, p65 NF-κB phosphorylation, and ALP activation in HAVICs. Notably, two crude drugs from OGT [Coptis rhizome (CR), and Phellodendron bark (PB)] exhibited inhibitory effects akin to those of OGT. Berberine, mainly contained in CR and PB, also inhibited TNF-α induced HAVIC calcification, BMP2 expression, and p65 NF-κB phosphorylation. Further, OGT significantly prevented accelerated AVC in spontaneously hypertensive rats in vivo. Our results suggest that OGT and its component, berberine, can effectively prevent AVC acceleration both in vitro and in vivo.