Search Results (1,939)

Pedunculoside (PE), a primary bioactive constituent of the traditional Chinese medicines (TCM) Ilex chinensis (Sijiqing) and Ilex rotunda (Jiubiying), has garnered growing interest for its broad pharmacological profile. This review synthesizes literature from 1999 to 2026, highlighting anti-inflammatory, cardioprotective, lipid-regulating, neuroprotective, and antitumor activities of PE. By modulating key signaling cascades, including NF-κB, MAPK, NLRP3, and Nrf2/HO-1, PE disrupts the interconnected “inflammation–oxidative stress–cell death” network, conferring multi-organ protection. These findings position PE as a key material basis underlying the Qing Re Jie Du properties of its parent herbs, while rationalizing their distinct clinical applications: Sijiqing for resolving swelling and blood stasis, and Jiubiying for promoting diuresis and alleviating pain. PE exhibits multi-target potential, directly or indirectly engaging proteins such as GATA6, TRAF6, and ACSL4, thereby contributing to formulation synergy. Despite its promise as a TCM-derived lead compound, PE research remains transitional, constrained by undefined direct molecular targets, limited pharmacokinetic data, and insufficient long-term safety profiling. Future efforts should integrate chemical biology and multi-omics to validate target engagement, systematically characterize pharmacokinetics and toxicology, and decode formulation synergy to accelerate clinical translation. Full article

Background: The extent of coronary artery disease (CAD) is a major determinant of prognosis in patients with myocardial infarction (MI). While structured exercise is known to be cardioprotective, the association between habitual daily physical activity and angiographic CAD extension remains insufficiently characterized. Methods: In this prospective observational study, 269 patients were hospitalized with acute MI underwent coronary angiography. Habitual daily physical activity during the four weeks preceding admission was assessed using 10-point self-reported daily preadmission effort questions to help the patients to report a final effort score. CAD extension was classified as single-, double- or triple-vessel disease. Differences in daily effort across CAD categories were evaluated using the Kruskal–Wallis test. Independent predictors of CAD extension were identified using ordinal logistic regression adjusted for age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia and body mass index. Results: Daily preadmission effort decreased progressively with increasing CAD severity (mean scores: 7.44 in single-vessel, 4.93 in double-vessel and 3.69 in triple-vessel disease; p < 0.0001). In multivariable ordinal logistic regression analysis, older age, hypertension, diabetes mellitus and hyperlipidemia were independently associated with greater CAD extension. Higher daily preadmission effort was strongly and independently associated with lower CAD severity; each one-point increase in effort score was associated with a 46% reduction in the odds of more extensive CAD (odds ratio 0.54, 95% confidence interval 0.45–0.64; p < 0.0001). Conclusions: Greater habitual daily physical activity prior to myocardial infarction is independently associated with less extensive coronary artery disease. Assessment of daily preadmission effort may provide clinically useful information regarding coronary disease burden and highlights the potential importance of everyday physical activity in cardiovascular prevention. These findings should be interpreted with caution given the use of a non-validated, self-reported measure of physical activity and the observational study design. Full article

Low levels of high-density lipoprotein cholesterol (HDL-C) are strongly associated with increased cardiovascular risk. However, under various pathological conditions, high-density lipoprotein (HDL) particles may undergo structural and functional modifications, leading to a progressive loss of antioxidant capacity and a shift from a cardioprotective to a proatherogenic phenotype. In this cross-sectional study, we investigated differences in HDL particle distribution and antioxidant function between individuals with elevated lipoprotein(a) [Lp(a)] levels (≥30 mg/dL) and those with low Lp(a) levels (<10 mg/dL). Serum low-density lipoprotein (LDL) and HDL subfractions were analyzed in twenty subjects with high Lp(a) and ten low-Lp(a) controls using non-denaturing polyacrylamide gel electrophoresis (PAGE, Lipoprint system). Enzymatic activities of paraoxonase-1 (PON1) and HDL-associated lipoprotein-associated phospholipase A₂ (HDL-Lp-PLA₂) were measured. Electrophoretic analysis revealed a significant increase in small HDL (S-HDL) in the high-Lp(a) group compared to the controls (34.1 ± 13.2% vs. 21.5 ± 2.7%, p = 0.01), alongside a reduction in large HDL (L-HDL) (19.6 ± 9.9% vs. 33.4 ± 3.8%, p < 0.001). Furthermore, the high Lp(a) group exhibited significantly lower HDL-PON1 activity (55 ± 12 vs. 67 ± 7 U/mL, p < 0.001) and HDL-Lp-PLA₂ activity (2.6 ± 1.0 vs. 3.6 ± 1.2 nmol/min/mL, p < 0.02) compared with the controls. These findings suggest that markedly elevated Lp(a) levels are associated with a shift toward a more proatherogenic HDL subfraction profile and impaired antioxidant functionality, which may reflect mechanisms linked to increased atherosclerotic cardiovascular disease (ASCVD) risk. Full article

Background/Objectives: This study aimed to clarify the cardioprotective effects of combined empagliflozin and sacubitril/valsartan therapy in an experimental rat model of heart failure (HF). The main research question was whether dual treatment provides greater functional and molecular benefit than either monotherapy, with particular emphasis on oxidative stress, inflammation, apoptosis, and JAK2/STAT3 signaling. Methods: HF was induced in rats by 7-day isoproterenol administration and confirmed four weeks later by echocardiographic evidence of reduced ejection fraction (<55%). The animals were then assigned to healthy control, untreated HF, empagliflozin, sacubitril/valsartan, and combined empagliflozin/sacubitril/valsartan groups. Following four weeks of treatment, ex vivo cardiac function was evaluated using the Langendorff technique. Serum cardiospecific markers and natriuretic peptides were measured by ELISA. Oxidative stress parameters were determined in coronary venous effluent, while myocardial gene expression of selected (anti)oxidative, (anti)inflammatory, (anti)apoptotic, and signaling markers was assessed by RT-PCR. Myocardial collagen content was evaluated using Picrosirius red staining. Results: HF rats exhibited impaired ex vivo myocardial function, elevated cardiac injury markers, increased oxidative stress, upregulation of pro-inflammatory and pro-apoptotic genes, activation of JAK2/STAT3 signaling, and increased myocardial collagen content. Both monotherapies produced partial benefit. In contrast, combined treatment achieved the most pronounced improvement in contractile performance, attenuated oxidative stress more consistently, reduced expression of TNF-α, IL-1β, IL-6, IL-17, Bax, CASP-3, and CASP-9, favorably modulated JAK2, STAT3, mTOR, and PPARγ expression, and decreased myocardial collagen content. Conclusions: Dual empagliflozin and sacubitril/valsartan therapy exerted broader cardioprotective effects than either monotherapy, likely through coordinated antioxidant, anti-inflammatory, anti-apoptotic, and signaling-related mechanisms. Full article

The gut–heart axis plays a role in cardiac injury due to the disruption of barriers, endotoxemia, and inflammatory signaling; yet, it is not clear whether sodium butyrate (SB) is capable of alleviating isoprenaline-induced myocardial injury through coordinated intestinal, microbial, and metabolic restoration. This study used male Sprague-Dawley rats, which were grouped into control, control + SB, isoprenaline (ISO)-induced myocardial injury, and ISO + SB groups. We evaluated cardiac biomarkers of injury, oxidative stress, histopathologic, intestinal barrier (16S rRNA sequencing), and serum metabolomics (LC-MS). SB treatment decreased serum cardiac troponin I, creatine kinase-MB, and lactate dehydrogenase; relieved oxidative stress; and lowered myocardial necrosis and fibrosis. It re-established colonic architecture, upregulated the expression of ZO-1 (zonula occludens-1) and claudin-1, and reduced endotoxin in the bloodstream. SB also prevented the production of proinflammatory cytokines such as TNF-α, IL-6, and IL-1β; cardiac TLR4; IκBα degradation; and NF-κB p 65 phosphorylation. In addition, SB altered the gut microbiota in favor of beneficial commensals, including Ligilactobacillus and Bifidobacterium, and reduced Desulfovibrio. It normalized key circulating metabolites and enriched cardiometabolic pathways, and the patterns of correlation suggested the coordinated remodeling of the microbiome–metabolome. These findings reveal that SB prevents myocardial injury caused by ISO through strengthening gut barrier protection, alleviating endotoxemia, inhibiting TLR4/NF-κB, and remodeling the microbiome–metabolome axis, indicating its potential for use as a gut-targeted cardioprotective intervention. Full article

Background: The gut microbiota and its metabolite short-chain fatty acids (SCFAs) regulate host physiology, but whether butyrate, a key SCFA, protects against myocardial injury via the gut–heart axis remains unclear. Objectives: This study aimed to investigate the cardioprotective effect of butyrate in a rat model of isoproterenol (ISO)-induced myocardial injury and to explore its underlying gut–heart mechanism. Methods: In this experimental study, male Sprague-Dawley rats received intragastric butyrate pre-treatment followed by ISO injection to induce myocardial injury. Cardiac function, myocardial remodeling, gut–heart homeostasis, intestinal barrier integrity, and the expression of Tas2r, GPR41/43, and NLRP3 pyroptosis pathway components were assessed. Results: Butyrate pre-treatment significantly restored cardiac function (LVEF increased by 19.67 units; 95% CI, 11.17–28.16; p < 0.001) and ameliorated electrophysiological abnormalities (QTc shortened by 63.21 ms; 95% CI, 45.45–80.97; p < 0.0001). Mechanistically, butyrate suppressed aberrant myocardial Tas2r signaling (Tas2r137 reduced by 1.06 units; 95% CI, 0.37–1.74; p < 0.01), upregulated GPR41/43, inhibited NLRP3 inflammasome activation (NLRP3 reduced by 1.23 units; 95% CI, 0.13–2.33; p < 0.05), and repaired intestinal barrier integrity, thereby reducing bacterial translocation and secondary injury. Conclusions: Butyrate ameliorates ISO-induced myocardial injury through a simultaneous gut–heart mechanism, acting on both the cardiac Tas2r137/GPR41/43-NLRP3 pathway and intestinal barrier protection. These findings identify butyrate as a key functional molecule in gut–heart crosstalk and suggest its potential as a therapeutic agent for myocardial injury. Full article

Background: Myocardial ischemia/reperfusion injury (MIRI) remains a major limitation to effective cardioprotection. Chikusetsusaponin IVa (CS-IVa) has shown promising cardioprotective activity; however, its pharmacokinetic behavior and exposure–response relationship under MIRI pathological conditions remain insufficiently characterized. This study aimed to evaluate the disease-state-related pharmacokinetics of CS-IVa in MIRI rats and to explore its concentration–effect relationship using a revised descriptive PK framework. Methods: A rat MIRI model was established by ligation and reperfusion of the left anterior descending coronary artery. The cardioprotective effects of CS-IVa were evaluated using echocardiography, hemodynamic parameters, myocardial infarct size, histopathological examination, and biochemical markers of myocardial injury and oxidative stress. Plasma CS-IVa concentrations were quantified by UHPLC-MS/MS over 0–24 h after administration. Non-compartmental pharmacokinetic parameters were statistically compared between normal and MIRI rats. To address model reliability and parameter identifiability, candidate PK models with different structural assumptions and weighting schemes were systematically re-evaluated. The selected descriptive PK model was further assessed using the leave-one-rat-out robustness analysis. An exploratory exposure–response analysis was performed using CK-MB as the longitudinal PD endpoint, and a Ke0 sensitivity analysis was conducted to evaluate the robustness of the downstream effect-compartment interpretation. Data-driven models were retained only as supplementary exploratory predictive analyses. Results: CS-IVa improved cardiac function; reduced myocardial infarct size; attenuated histopathological injury; decreased serum CK-MB, cTnI, LDH and plasma MDA levels; and restored SOD activity in MIRI rats. In normal rats, systemic exposure to CS-IVa increased with dose escalation. Compared with normal rats at 15 mg/kg, MIRI rats showed markedly altered pharmacokinetic behavior, including reduced C_max and AUC, delayed T_max, shortened apparent half-life, and increased apparent volume of distribution. After systematic model re-evaluation, a one-compartment model with first-order absorption, no lag time, and unweighted fitting was selected as the revised working descriptive PK model, providing a better balance between model fit, parameter stability, and parsimony. The leave-one-rat-out analysis supported the robustness of this revised model. The exploratory concentration–effect analysis revealed a temporal dissociation between plasma CS-IVa exposure and CK-MB response, suggesting a delayed pharmacodynamic response. Ke0 sensitivity analysis indicated that effect-compartment-based PD fitting was sensitive to Ke0 selection; accordingly, the exposure–response analysis is interpreted as exploratory rather than as a definitive mechanistic PK/PD model. Conclusions: CS-IVa exerted cardioprotective effects in MIRI rats, while MIRI markedly altered its overall pharmacokinetic behavior. The revised analysis supports disease-state-related PK changes and an exploratory exposure–response delay between plasma CS-IVa exposure and CK-MB response. These findings provide a pharmacokinetic basis for understanding CS-IVa under MIRI pathological conditions; however, further studies incorporating individual-level PD endpoints, tissue distribution data, and clinically relevant formulations are needed before translational dosing recommendations can be made. Full article

Sirtuin 1 (SIRT1), a nicotinamide adenine dinucleotide (NAD⁺)-dependent class III histone deacetylase, functions as a central metabolic sensor and stress-responsive regulator in the cardiovascular system. Unlike its well-characterized role in atherosclerosis, SIRT1 exerts multifaceted protective effects directly on cardiac tissue. This review synthesizes recent advances in understanding SIRT1-mediated cardioprotection across a spectrum of heart diseases, including myocardial ischemia/reperfusion (I/R) injury, heart failure (HF), diabetic cardiomyopathy (DCM), cardiac hypertrophy, aging-related cardiac dysfunction and circadian rhythm disruption. Mechanistically, SIRT1 orchestrates antioxidant defense through nuclear factor erythroid 2-related factor 2 (Nrf2) and Forkhead box O (FoxO) transcription factors activation, suppresses inflammatory signaling via nuclear factor kappa B (NF-κB) deacetylation, inhibits apoptosis by targeting p53, promotes autophagic flux and mitophagy, regulates mitochondrial biogenesis through peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), and controls ferroptosis via the Nrf2/glutathione peroxidase 4 (GPX4) axis. Preclinical studies demonstrate that natural compounds (resveratrol, quercetin, curcumin, ginsenosides, tanshinone IIA, bergenin, swietenine) and synthetic SIRT1 activators (SRT1720, anilinopyridine derivatives) attenuate cardiac injury and improve function. Moreover, SIRT1 serves as a prognostic biomarker in HF and diabetic patients. However, context-dependent dual roles, where excessive SIRT1 expression may be detrimental, underscore the need for precise modulation. Challenges remain in achieving cardiac-specific targeting, optimizing NAD⁺ availability, and translating preclinical findings into clinical practice. Future research should integrate multi-omics approaches, single-cell transcriptomics, and precision medicine strategies to unlock the therapeutic potential of SIRT1 in cardiac diseases. Full article

Chronic kidney disease (CKD) is a major global health burden associated with substantially increased risks of morbidity and mortality. Cardiovascular disease remains the leading cause of death across all stages of CKD. Over the past few decades, several pharmacologic therapies—including renin–angiotensin system inhibitors, sodium–glucose cotransporter-2 inhibitors, mineralocorticoid receptor antagonists, glucagon-like peptide-1 receptor agonists, and lipid-lowering agents—have demonstrated substantial cardio-nephroprotective benefits and are recommended in international guidelines. However, real-world implementation of these therapies remains incomplete, and emerging evidence highlights important sex-based disparities in prescribing patterns. Although CKD is more prevalent in women worldwide, women with CKD are consistently less likely than men to receive guideline-directed cardioprotective and nephroprotective medications. This treatment gap spans both traditional therapies, such as angiotensin-converting enzyme inhibitors and statins, and newer agents with proven outcome benefits. Women are less likely to initiate treatment, less likely to receive high-intensity or target doses, and less likely to achieve recommended blood pressure and lipid goals. Importantly, the presence of CKD attenuates the usual female survival advantage, and the relative excess cardiovascular risk associated with CKD may be particularly pronounced in women. The under-prescription of cardio-renal therapies in women with CKD reflects a complex interplay of factors. These include older age at presentation, higher reported rates of adverse drug reactions, concerns regarding tolerability and safety in advanced kidney disease, therapeutic inertia, underestimation of cardiovascular risk, and persistent underrepresentation of women in clinical trials. Biological differences in pharmacokinetics and pharmacodynamics, as well as structural and system-level barriers, further contribute to inequities in care. Addressing these disparities requires improved risk recognition, sex-informed prescribing practices, enhanced representation of women in clinical research, and implementation strategies that incorporate sex-disaggregated performance metrics. Reducing treatment gaps is essential to improving cardiovascular and renal outcomes and to achieving equitable, precision-based care for women with CKD. Full article

Isovitexin (ISOV) is an active component identified in the traditional Tibetan medicine Tsantan Sumtang, which is commonly used for treating myocardial ischemia. Although previous studies have suggested the protective effect of ISOV on cardiomyocytes, the in vivo anti-ischemic efficacy and underlying mechanisms of ISOV remain unclear. This study aimed to systematically evaluate the therapeutic effects of ISOV on myocardial ischemia in rats and to elucidate its molecular mechanism of action. An acute myocardial infarction model was established in rats by ligating the left anterior descending branch (LADL) of the coronary artery. The protective effects of ISOV were assessed by measuring infarct size, serum cardiac injury biomarkers, and oxidative stress levels. Chemical proteomics using photoaffinity magnetic beads was employed to identify potential target proteins of ISOV. Molecular docking, pull-down western blotting, and cellular thermal shift assay (CETSA) western blotting were applied to validate the interaction between ISOV and target. Knockdown of the target was used to verify the mechanism of ISOV on anti-myocardial ischemia effect. ISOV treatment significantly reduced myocardial infarct size, decreased serum levels of lactate dehydrogenase (LDH), creatine kinase isoenzymes (CK-MB), malondialdehyde (MDA), and enhanced superoxide dismutase (SOD) activity in myocardial ischemia rats. Furthermore, ISOV improved mitochondrial function, as evidenced by increased ATP content and enhanced activities of mitochondrial complexes I and IV. Chemical proteomics and bioinformatic analysis identified SLC25A4 as a direct target of ISOV. Molecular docking revealed a high-affinity binding (binding energy: −8.3 kcal/mol), which was further confirmed by pull-down assays and CETSA. In SLC25A4-knockdown H9c2 cells under hypoxic conditions, ISOV upregulated SLC25A4 expression, promoted the phosphorylation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) and upregulated the expression of proliferator-activated receptor gamma coactivator-1$\alpha$ (PGC-1$\alpha$). ISOV exerts cardioprotective effects against myocardial ischemia by directly binding to SLC25A4 and activating the AMPK/PGC-1$\alpha$ pathway, highlighting its potential as a therapeutic agent for myocardial ischemia. Full article

Background/Objectives: Clinical application of Doxorubicin (Doxo) is limited by cardiotoxicity, a process strongly associated with an interplay between oxidative stress and inflammatory signaling, particularly Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation and Nucleotide oligomerization domain-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome engagement. Identifying strategies capable of mitigating these interconnected pathways is of critical importance in cardio-oncology. Simvastatin (SIM) is a promising option since it modulates oxidative stress, inflammation, and cell death through its pleiotropic effects, so this study aimed to evaluate whether SIM attenuates Doxo-induced inflammatory responses. Methods: Human Cardiomyocyte (HCM) cells were pre-treated with SIM (10 µM) for 4 h and then co-exposed to SIM and Doxo (1 µM) for 20 h. Cytofluorimetric analysis was used to evaluate inducible nitric oxide synthase (iNOS), Connexin 43 (Cx43), and Cx43 phosphorylated at Serine 368 (p^S368Cx43) levels. Real-time qPCR was performed to evaluate iNOS gene expression, while Nitric oxide (NO) release was evaluated by spectrophotometric analysis. Interleukin (IL)-1β, IL-18, IL-6, tumor necrosis factor alpha (TNF-α) production, and NLRP3 levels were evaluated by means of ELISA assay. Expression levels of inhibitor of nuclear factor kappa B alpha (IκB-α), Caspase-1, and Gasdermin D (GSDMD) were evaluated by Western Blot analysis. Nuclear translocation of NF-κB was evaluated by immunofluorescence assay. Results: In our experimental model, SIM significantly (p < 0.01) reduced Doxo-induced nitrite release, as well as iNOS gene expression (p < 0.05) and protein levels (p < 0.01). SIM also markedly attenuated Doxo-induced NF-κB signaling, pro-inflammatory cytokines production (TNF-α and IL-6, p < 0.01), and inflammosome-related responses (cleaved caspase-1, IL-1β, N-terminal domain of GSDMD), and NLRP3 expression p < 0.05). Additionally, SIM significantly attenuated the overexpression of Cx43 and its phosphorylated form (p^S368Cx43), which are responsible for impairing intercellular communication and electrical coupling in cardiomyocytes and contribute to arrhythmias and conduction abnormalities characteristic of acute Doxo-induced cardiotoxicity. Conclusions: Overall, these findings demonstrate that SIM exerts a multifaceted cardioprotective effect against Doxo-induced injury, thereby targeting interconnected inflammatory and pro-arrhythmic pathways implicated in Doxo cardiotoxicity. Full article

Grape pomace extract (GPE) from Vitis vinifera L. cv. Aglianico is rich in polyphenols with recognized cardioprotective properties, yet its direct electrophysiological effects on spontaneous cardiac activity have not been previously investigated. Here, we examined the chronotropic effects of GPE using two complementary models: HL-1 cardiomyocytes, assessed by whole-cell patch-clamp and intracellular Ca²⁺ imaging, and the Drosophila melanogaster larval heart tube, evaluated by optical recording. In HL-1 cells, chronic treatment with 25 µg/mL GPE for 48 h significantly reduced potential spontaneous action frequency and selectively prolonged the diastolic depolarization phase without altering action potential morphology, depolarization-activated currents, or cytosolic Ca²⁺ homeostasis. GPE reduced the hyperpolarization-activated funny current (I_f) density without shifting its voltage dependence. GPE-treated cells retained cAMP sensitivity, as both isoproterenol and intracellular 8-Br-cAMP significantly increased I_f amplitude, while ELISA quantification confirmed that global cAMP levels were unaffected by GPE. In Drosophila larvae, a cAMP-independent myogenic preparation, GPE administered in the diet significantly reduced heart rate. These findings demonstrate that Aglianico GPE exerts a negative chronotropic effect through a mechanism that reduces functional I_f density without altering cAMP availability or HCN channel voltage dependence, and reveal a cAMP-independent component of action conserved across phylogenetically distant species. Full article

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the management of type 2 diabetes mellitus (T2DM) by providing robust glycemic control alongside significant cardioprotective and renoprotective benefits. This review synthesizes current mechanistic, preclinical, and clinical evidence regarding the impact of GLP-1RAs on retinal microvasculature and summarizes the current clinical evidence of GLP-1RA-induced retinal complications. GLP-1RAs exert pleiotropic effects on the retinal microvasculature, offering protection by amelioration of endothelial function, reduction in oxidative stress, inflammation, microvascular remodeling, and preservation of the blood–retinal barrier (BRB). Despite these mechanistic advantages, emerging clinical data have raised concerns regarding potential retinal adverse events associated with GLP-1RA therapy. Observational studies and pharmacovigilance analyses have suggested possible associations with non-arteritic anterior ischemic optic neuropathy (NAION), diabetic macular edema (DME), vitreous hemorrhage, retinal detachment, macular hole formation, and progression of diabetic retinopathy (DR), particularly in the context of semaglutide use. Most evidence comes from retrospective studies or secondary endpoints, limiting causal inference. Retinal complications associated with GLP-1RAs remain heterogeneous and inconclusive, requiring careful evaluation of potential risks across diverse patient populations. Future research should conduct large, randomized trials with standardized ocular endpoints, detailed imaging, and stratified analyses to clarify GLP-1RA retinal safety. Full article

Sulforaphane, a bioactive isothiocyanate found abundantly in cruciferous vegetables, has attracted significant attention for its chemopreventive and therapeutic potential, particularly in cancer. There is now an abundance of peer-reviewed research documenting true synergies between sulforaphane and (a) cancer treatment drugs, (b) pharmaceuticals in development but not yet on the market or in the regulatory pipeline, (c) other phytochemicals, and (d) proprietary mixtures such as leaf extracts and other botanicals, as well as evidence that some cell lines resistant to various cancer drugs become more susceptible when treated with sulforaphane. Most of the published studies demonstrate evidence for synergy in cancer, including cancers of the bladder, blood, brain, breast, colon, esophagus, liver, lung, ovaries, prostate, and skin, where reducing drug dosages could yield substantial patient benefits. Importantly, non-cancer indications have also been reported, such as mitigation of cardiac toxicity, inflammation, obesity, and pain (including antihyperalgesic and antinociceptive effects). Synergistic effects are most often demonstrated in cell line models, with many studies providing robust mechanistic evidence, and some employing the gold-standard Chou–Talalay method for quantifying synergy. Current evidence on the synergistic interactions of sulforaphane with both phytochemicals and pharmaceuticals highlights underlying mechanisms such as modulation of oxidative stress, inflammation, apoptosis, and epigenetic regulation, suggesting significant clinical and therapeutic implications. By providing a comprehensive overview of sulforaphane synergies in both cancer and non-cancer contexts, we aim to inform future research and support the development of integrated therapeutic strategies. Full article

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, making the search for new therapeutic strategies to prevent or mitigate cardiac damage mandatory. Essential oils, long used in traditional medicine, contain terpenoids as their most prominent constituents, and these molecules have emerged as promising cardioprotective agents. The review compiles 45 articles investigating the effects of plant-derived terpenoids on cardiovascular health. Evidence shows that their therapeutic properties rely on their antioxidant, anti-inflammatory, anti-apoptotic, anti-remodeling, antiarrhythmic, antihypertensive, anti-atherosclerotic, antidiabetic and antimicrobial actions. These effects result from the modulation of molecular pathways altered during cardiovascular diseases, resulting in oxidative stress, inflammation, cell death, fibrosis, ion channel dysregulation, alteration of lipid metabolism and glucose homeostasis. Key mechanisms of terpenes healing properties include activation of endogenous antioxidant defense—mainly via Nrf2-, inhibition of NLRP3 inflammosome-mediated pyroptosis and reduction in lipid oxidation involved in atherosclerotic plaque formation. Their therapeutic potential is reinforced by low toxicity profiles and broad botanical availability. However, challenges related to their translation to therapeutic practice remain unresolved, such as low bioavailability, limited yield and scarce results in human in vitro models. Future research should focus on nano- and micro-delivery systems, biotechnological production strategies and the use of human induced pluripotent stem cell-derived cardiomyocytes. Despite these limitations, terpenes represent valuable templates for developing more potent and clinically viable therapeutic agents. Further studies of this family are encouraged due to its promising ability to treat cardiovascular disorders. Full article