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ArticleCardiovascular drugs and therapy2026

Shenfu Injection Inhibits Cardiac Fibroblast Activation and Improves Myocardial Fibrosis by Down-regulating M1 Macrophage-Derived Exosomal miR-155-5p.

Fei Wang, Siyuan Hu, Lin Li, Kun Lian, Junyu Zhang, Xinchun Li, Ge Fang, Zhixi Hu

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Article in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Fei WangDepartment of Traditional Chinese Medicine, the First Affiliated Hospital of University of South China, Hengyang, Hunan, China.
Siyuan HuSchool of Sports Art, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Lin LiProvincial Key Laboratory of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Kun LianPost-Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Junyu ZhangPost-Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China.
Xinchun LiHunan University of Chinese Medicine Integrated Chinese Medicine Affiliated Hospital, Changsha, Hunan, China.
Ge FangSchool of Traditional Chinese Medicine, Hunan Traditional Chinese Medical College, Zhuzhou, Hunan, China.
Zhixi HuProvincial Key Laboratory of Traditional Chinese Medicine Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan, China. 003405@hnucm.edu.cn.

Funding

The National Natural Science Foundation of China 82574922the National Natural Science Foundation of Hunan 2025JJ60522
6 · The paper itself

Abstract

purposeMyocardial fibrosis is a key pathological feature of heart failure (HF) linked to aberrant macrophage polarization. Although the traditional Chinese medicine Shenfu injection (SFI) clinically improves HF and has been found to inhibit M1 macrophage polarization and fibrosis, its mechanisms remain unclear. This study aimed to elucidate how SFI regulates macrophage-cardiac fibroblasts (CFs) communication - specifically via exosomal miR-155-5p from M1 macrophages.

methodsAn isoproterenol (ISO)-induced mouse model of HF was established to assess the effects of SFI on cardiac function, inflammatory cytokines, myocardial fibrosis, and the expression and localisation of miR-155-5p. In vitro, an M1 macrophage model was generated using lipopolysaccharide (LPS)-stimulated RAW264.7 cells, which were then treated with SFI or an miR-155-5p inhibitor. Exosomes from these cells were isolated and co-cultured with CFs to evaluate the miR-155-5p/SOCS1 pathway and fibrosis markers.

resultsmiR-155-5p expression was markedly upregulated and localized to infiltrating cardiac macrophages in mice. SFI treatment reduced levels of TNF-α, IL-6, and miR-155-5p, along with improved fibrosis and cardiac function. In vitro, SFI significantly decreased miR-155-5p levels in exosomes derived from M1 macrophages. Co-culture with exosomes from macrophages that were either SFI-treated or miR-155-5p-inhibited suppressed CFs activation. This was demonstrated by reduced expression of fibrosis markers (α-SMA, Col I, Col III), as well as decreased miR-155-5p levels and restored SOCS1 expression.

conclusionThis study demonstrates that SFI alleviates myocardial fibrosis by suppressing macrophage-derived exosomal miR-155-5p and restoring SOCS1 in CFs, thereby providing a mechanistic basis for its established clinical efficacy in HF. Our findings highlight the potential of targeting the macrophage-fibroblast miR-155-5p/SOCS1 axis as a therapeutic strategy.

Indexed as

Cardiac fibrosisExosomeM1 macrophagemiR-155-5pShenfu Injection

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.