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Background <p>Ventricular remodeling is a key pathological feature of chronic heart failure (CHF). Following myocardial infarction (MI), impaired macrophage efferocytosis sustains cardiac inflammation, disrupts tissue repair, and accelerates adverse remodeling and dysfunction. Qishen Granules (QSG) is a classical traditional Chinese medicine formulation used in the clinical treatment of heart failure. However, its regulatory effects on efferocytosis in resident cardiac macrophages (RCMs) remain unclear.</p> Purpose <p>This study aimed to elucidate the molecular mechanisms by which QSG regulates Legumain-mediated efferocytosis in RCMs and to identify the key bioactive compounds.</p> Methods <p>A mouse model of post-MI heart failure was established via ligation of the left anterior descending coronary artery. The therapeutic effects of QSG were evaluated in isolated RCMs obtained using magnetic-activated cell sorting. Mechanistic investigations were conducted using transcriptomic analysis, network pharmacology, live-cell imaging, and siRNA-mediated gene silencing. In addition, UPLC-Q-Exactive MS, molecular docking, and molecular dynamics simulations were employed to systematically study the active compounds of QSG.</p> Results <p>QSG treatment restored the population of RCMs and enhanced their efferocytic capacity in CHF, thereby reducing cardiomyocyte apoptosis, promoting inflammatory resolution, and improving ventricular structure and function. Mechanistically, QSG upregulated Legumain expression and activated the Arg1/Rac1 signaling axis to facilitate cytoskeletal remodeling and enhance phagocytic efficiency. Further analyses identified tanshinone IIA, neocryptotanshinone and calycosin as the core bioactive compounds of QSG. All three compounds upregulated Legumain expression and exhibited stable binding affinity toward Legumain.</p> Conclusion <p>QSG restores efferocytic capacity in RCMs by targeting the Legumain/Arg1/Rac1 signaling axis, thereby attenuating adverse ventricular remodeling in CHF.</p>

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Qishen Granules attenuate adverse ventricular remodeling in chronic heart failure by promoting Legumain/Arg1/Rac1-mediated efferocytosis of resident cardiac macrophages

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Meijiao Tao,
  • Shixuan Min,
  • Jiali Liu,
  • Huishi Xiao,
  • Tong Xiao,
  • Sisi Liang,
  • Xin Liu,
  • Jun Wang,
  • Yulin Ouyang,
  • Ruijia Wen,
  • Lei Wang,
  • Wei Wang,
  • Yao Zhang,
  • Chun Li

摘要

Background

Ventricular remodeling is a key pathological feature of chronic heart failure (CHF). Following myocardial infarction (MI), impaired macrophage efferocytosis sustains cardiac inflammation, disrupts tissue repair, and accelerates adverse remodeling and dysfunction. Qishen Granules (QSG) is a classical traditional Chinese medicine formulation used in the clinical treatment of heart failure. However, its regulatory effects on efferocytosis in resident cardiac macrophages (RCMs) remain unclear.

Purpose

This study aimed to elucidate the molecular mechanisms by which QSG regulates Legumain-mediated efferocytosis in RCMs and to identify the key bioactive compounds.

Methods

A mouse model of post-MI heart failure was established via ligation of the left anterior descending coronary artery. The therapeutic effects of QSG were evaluated in isolated RCMs obtained using magnetic-activated cell sorting. Mechanistic investigations were conducted using transcriptomic analysis, network pharmacology, live-cell imaging, and siRNA-mediated gene silencing. In addition, UPLC-Q-Exactive MS, molecular docking, and molecular dynamics simulations were employed to systematically study the active compounds of QSG.

Results

QSG treatment restored the population of RCMs and enhanced their efferocytic capacity in CHF, thereby reducing cardiomyocyte apoptosis, promoting inflammatory resolution, and improving ventricular structure and function. Mechanistically, QSG upregulated Legumain expression and activated the Arg1/Rac1 signaling axis to facilitate cytoskeletal remodeling and enhance phagocytic efficiency. Further analyses identified tanshinone IIA, neocryptotanshinone and calycosin as the core bioactive compounds of QSG. All three compounds upregulated Legumain expression and exhibited stable binding affinity toward Legumain.

Conclusion

QSG restores efferocytic capacity in RCMs by targeting the Legumain/Arg1/Rac1 signaling axis, thereby attenuating adverse ventricular remodeling in CHF.