Key result
NaoXinTong enhanced atorvastatin-induced plaque stability and ameliorated atorvastatin-induced hepatic side effects, including inflammation and elevated aminotransferases, in apoE-deficient mice.
Why the study?
Does co-treatment with NaoXinTong and atorvastatin improve plaque stability and reduce hepatic side effects compared to atorvastatin alone in apoE-deficient mice on a high-fat diet?
RCT
randomly divided
Does co-treatment with NaoXinTong and atorvastatin improve plaque stability and reduce hepatic side effects compared to atorvastatin alone in apoE-deficient mice on a high-fat diet?
In a preclinical model, NaoXinTong enhanced atorvastatin-induced plaque stability and ameliorated statin-induced hepatic side effects.
NXT may enhance atorvastatin plaque stability and reduce hepatic effects; hypothesis-generating in mice, human trials needed before practice change.
Buchang NaoXinTong (NXT) is a Chinese medicine that has been used for many years for treatment of patients with coronary heart disease (CHD) in China. Statins substantially reduce hypercholesterolemia and CHD mortality and morbidity. However, there is still a lot of CHD patients who do not respond well to statin therapy. Herein, we report the effects of NXT on atorvastatin-inhibited atherosclerosis and atorvastatin-induced hepatic side effects. After 10 weeks of high-fat diet (HFD) feeding, apoE-deficient mice were randomly divided into 4 groups and received the following treatment for another 8 weeks: group 1, HFD; group 2, HFD containing NXT; group 3, HFD containing atorvastatin; and group 4, HFD containing both NXT and atorvastatin. After treatment, serum lipid profiles, atherosclerotic lesions, and hepatic lipid content and inflammation were determined. NXT moderately increased high-density lipoprotein cholesterol levels, although had little effect on atorvastatin-induced reduction of low-density lipoprotein cholesterol levels. Both NXT and atorvastatin reduced en face lesions and sinus lesions of aortic root. In addition, NXT enhanced atorvastatin-induced lesion plaque stability by increasing smooth muscle cell/collagen content and reducing macrophage accumulation and calcification in lesion areas. The co-treatment of NXT and atorvastatin further reduced hepatic triglyceride levels by downregulating acyl-CoA:diacylglycerol acyltransferase 1 while activating hormone-sensitive lipase, adipose triglyceride lipase, and comparative gene identification-58 expression. The AMPKα pathway was also further activated by the co-treatment. More importantly, the liver injuries caused by atorvastatin, such as hepatic inflammation and elevated serum aminotransferase activities, were substantially attenuated by NXT. Therefore, our study demonstrates that NXT enhances atorvastatin-induced plaque stability and ameliorates atorvastatin-induced hepatic side effects.
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Yang et al. (2016) conducted an RCT in Atherosclerosis and atorvastatin-induced hepatic side effects. NaoXinTong (NXT) and atorvastatin co-treatment vs. High-fat diet alone, NXT alone, and atorvastatin alone was evaluated on Serum lipid profiles, atherosclerotic lesions, and hepatic lipid content and inflammation. NaoXinTong enhanced atorvastatin-induced plaque stability and ameliorated atorvastatin-induced hepatic side effects, including inflammation and elevated aminotransferases, in apoE-deficient mice.
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