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Few studies were devoted to investigating cerebral functional changes after acute cerebellar infarction (CI). The purpose of this study was to examine the brain functional dynamics of CI using electroencephalographic (EEG) microstate analysis. And the possible heterogenicity in neural dynamics between CI with vertigo and CI with dizziness was explored. Thirty-four CI patients and 37 age- and gender-matched healthy controls(HC) were included in the study. Each included subject underwent a 19-channel video EEG examination. Five 10-s resting-state EEG epochs were extracted after data preprocessing. Then, microstate analysis and source localization were performed using the LORETA-KEY tool. Microstate parameters such as duration, coverage, occurrence, and transition probability are all extracted. The current study showed that the duration, coverage, and occurrence of microstate(Ms) B significantly increased in CI patients, but the duration and coverage of MsA and MsD decreased. Compared CI with vertigo to dizziness, finding a decreased trend in the coverage of MsD and the transition from MsA and MsB to MsD. Taken together, our study sheds new light on the dynamics of cerebral function after CI, mainly reflecting increased activity in functional networks involved in MsB and decreased activity in functional networks involved in MsA and MsD. Vertigo and dizziness post-CI may be suggested by cerebral functional dynamics. Further longitudinal studies are needed to validate and explore the alterations in brain dynamics to what extent depict the clinical traits and their potential applications in the recovery of CI.
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Mapeo Encefálico , Mareo , Humanos , Mareo/etiología , Encéfalo , Electroencefalografía , Vértigo , InfartoRESUMEN
Adhesion of monocytes to the vascular endothelium is crucial in atherosclerosis development. Connexins (Cxs) which form hemichannels or gap junctions, modulate monocyte-endothelium interaction. We previously found that rutaecarpine, an active ingredient of the Chinese herbal medicine Evodia, reversed the altered Cx expression induced by oxidized low-density lipoprotein (ox-LDL) in human umbilical vein endothelial cells, and consequently decreases the adhesive properties of endothelial cells to monocytes. This study further investigated the effect of rutaecarpine on Cx expression in monocytes exposed to ox-LDL. In cultured human monocytic cell line THP-1, ox-LDL rapidly reduced the level of atheroprotective Cx37 but enhanced that of atherogenic Cx43, thereby inhibiting adenosine triphosphate release through hemichannels. Pretreatment with rutaecarpine recovered the expression of Cx37 but inhibited the upregulation of Cx43 induced by ox-LDL, thereby improving adenosine triphosphate-dependent hemichannel activity and preventing monocyte adhesion. These effects of rutaecarpine were attenuated by capsazepine, an antagonist of transient receptor potential vanilloid subtype 1. The antiadhesive effects of rutaecarpine were also attenuated by hemichannel blocker 18α-GA. This study provides additional evidence that rutaecarpine can modulate Cx expression through transient receptor potential vanilloid subtype 1 activation in monocytes, which contributes to the antiadhesive properties of rutaecarpine.
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Conexinas/efectos de los fármacos , Endotelio Vascular/metabolismo , Alcaloides Indólicos/farmacología , Lipoproteínas LDL/metabolismo , Monocitos/metabolismo , Quinazolinas/farmacología , Adenosina Trifosfato/metabolismo , Aterosclerosis/fisiopatología , Células Cultivadas , Relación Dosis-Respuesta a Droga , Humanos , Factores de TiempoRESUMEN
Pulmonary hypertension (PH) is a malignant pulmonary vascular disease with a poor prognosis. Although the development of targeted drugs for this disease has made some breakthroughs in recent decades, PH remains incurable. Therefore, innovative clinical treatment methods and drugs for PH are still urgently needed. DYZY01 is a new drug whose main ingredient is high-purity cannabidiol, a non-psychoactive constituent of cannabinoids that was demonstrated to have anti-inflammatory and anti-pyroptosis properties. Several recent studies have found cannabidiol could improve experimental PH, whereas the mechanistic effect of it warrants further investigation. Thus, this study aimed to investigate whether DYZY01 can treat PH by inhibiting inflammation and pyroptosis and to reveal its underlying mechanism. We established hypoxia and monocrotaline (MCT)-induced PH rat models in vivo and treated them with either DYZY01 (10,50 mg/kg/d) or Riociguat (10 mg/kg/d) by oral administration. The mean pulmonary arterial pressure (mPAP), right ventricular hypertrophy index (RVHI), and extent of vascular remodeling were measured. Meanwhile, the effect of DYZY01 on human pulmonary arterial endothelial cells (HPAECs) was assessed in vitro. The results indicated that DYZY01 significantly reduced mPAP and RVHI in PH rats and reversed the extent of pulmonary vascular remodeling. This improvement may have been achieved by reducing endothelial cell pyroptosis via inhibiting the NF-κB/NLRP3/Caspase-1 pathway. Furthermore, DYZY01 could improve endothelial vascular function, possibly by regulating the secretion of vasodilator factors and inhibiting the proliferation and migration of pulmonary endothelial cells.
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Células Endoteliales , Hipertensión Pulmonar , Piroptosis , Ratas Sprague-Dawley , Animales , Piroptosis/efectos de los fármacos , Hipertensión Pulmonar/tratamiento farmacológico , Hipertensión Pulmonar/fisiopatología , Hipertensión Pulmonar/patología , Ratas , Masculino , Células Endoteliales/efectos de los fármacos , Células Endoteliales/metabolismo , Humanos , FN-kappa B/metabolismo , Remodelación Vascular/efectos de los fármacos , Cannabidiol/farmacología , Cannabidiol/uso terapéutico , Modelos Animales de Enfermedad , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/metabolismo , Endotelio Vascular/patología , Arteria Pulmonar/efectos de los fármacos , Arteria Pulmonar/patología , Transducción de Señal/efectos de los fármacosRESUMEN
BACKGROUND: Pulmonary hypertension (PH) is a fatal progressive disease characterized by pulmonary endothelial injury and occlusive pulmonary vascular remodeling. Lysosomal protease cathepsin L degrades essential molecules to participate in the human pathophysiological process. BMPR2 (bone morphogenetic protein type II receptor) deficiency, an important cause of PH, results from mutational inactivation or excessive lysosomal degradation and induces caspase-3-mediated cell death. Given recent evidence that pyroptosis, as a new form of programmed cell death, is induced by caspase-3-dependent GSDME (gasdermin E) cleavage, we hypothesized that cathepsin L might promote PH through BMPR2/caspase-3/GSDME axis-mediated pyroptosis. METHODS: Cathepsin L expression was evaluated in the lungs and plasma of patients with pulmonary arterial hypertension. The role of cathepsin L in the progression of PH and vascular remodeling was assessed in vivo. Small interfering RNA, specific inhibitors, and lentiviruses were used to explore the mechanisms of cathepsin L on human pulmonary arterial endothelial cell dysfunction. RESULTS: Cathepsin L expression is elevated in pulmonary artery endothelium from patients with idiopathic pulmonary arterial hypertension and experimental PH models. Genetic ablation of cathepsin L in PH rats relieved right ventricular systolic pressure, pulmonary vascular remodeling, and right ventricular hypertrophy, also restoring endothelial integrity. Mechanistically, cathepsin L promotes caspase-3/GSDME-mediated endothelial cell pyroptosis and represses BMPR2 signaling activity. Cathepsin L degrades BMPR2 via the lysosomal pathway, and restoring BMPR2 signaling prevents the pro-pyroptotic role of cathepsin L in PAECs and experimental PH models. CONCLUSIONS: These results show for the first time that cathepsin L promotes the development of PH by degrading BMPR2 to induce caspase-3/GSDME-mediated endothelial pyroptosis.
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Understanding the factors driving ecosystem service (ES) change is essential for maintaining ES functions and achieving sustainable development. Although research on the spatial variations in the effects of driving forces on ESs provides guidance for regional ecological management, the responses of driving forces to environmental conditions have not been adequately investigated, especially in regions with high spatial heterogeneity. By using remote sensing images and socioeconomic data, this paper aims to fill this gap by estimating the spatial distribution characteristics of the effects of driving forces on ESs and their responses to different environmental conditions in Sichuan Province, China. First, the biophysical values of soil conservation (SC) and water yield (WY) were evaluated using ecological simulation models. Second, the spatial distribution of the effects of four driving forces on two services was explored using the geographically weighted regression (GWR) model. Finally, the responses of driving forces to environmental conditions were quantified by using scatter plots. The results revealed that the spatial patterns of SC and WY showed spatial heterogeneity. The effects of driving forces on ESs varied with space. Both positive and negative effects of driving forces were observed in Sichuan Province. Under different biophysical and socioeconomic conditions, the effects of driving forces on ESs showed different change trends, characterized by fluctuating trends and obvious thresholds. In our study area, urban sprawl, impervious surfaces, agricultural expansion, intensive human activities, and complex topographic features contributed to the variations in the effects of driving forces. Our results suggest that the responses of driving forces to different land-use coverage, topographical, NDVI, and socioeconomic conditions should be considered in ecological decision-making. Such research results are expected to manage the driving forces of ESs and serve as a practical reference for local management in order to maintain the functions of ESs and attain sustainable development.
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Conservación de los Recursos Naturales , Ecosistema , Agricultura , China , Conservación de los Recursos Naturales/métodos , Humanos , Suelo , AguaRESUMEN
Aortic aneurysms are prevalent and severe vascular diseases with high mortality from unpredicted ruptures, while the only treatment option is surgical correction of large aneurysms with considerable risk. We have shown that folic acid (FA) is highly effective in alleviating development of aneurysms although not sufficient to completely attenuate aneurysm formation. Here, we examined therapeutic effects on aneurysms of combining FA with Nifedipine as novel and potentially more effective oral medication. Oral administration with FA (15 mg/kg/day) significantly reduced incidence of AAA from 85.71% to 18.75% in Ang II-infused apolipoprotein E (apoE) null mice, while combination of FA with Nifedipine (1.5, 5.0 or 20 mg/kg/day) substantially and completely further reduced incidence of AAA to 12.5%, 11.76% and 0.00% respectively in a dose-dependent manner. The combinatory therapy substantially and completely further alleviated enlargement of abdominal aortas defined by ultrasound, vascular remodeling characterized by elastin degradation and adventitial hypertrophy, as well as aortic superoxide production and eNOS uncoupling activity also in a dose-dependent manner, with combination of FA with 20 mg/kg/day Nifedipine attenuating all of these features by 100% to control levels. Aortic NO and H4B bioavailabilities were also dose-dependently further improved by combining FA with Nifedipine. These data establish entirely innovative and robust therapeutic regime of FA combined with Nifedipine for the treatment of aortic aneurysms. The comminatory therapy can serve as a first-in-class and most effective oral medication for aortic aneurysms, which can be rapidly translated into clinical practice to revolutionize management of the devastating vascular diseases of aortic aneurysms known as silent killers.
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Aneurisma de la Aorta Abdominal , Aneurisma de la Aorta , Animales , Ratones , Angiotensina II/metabolismo , Aneurisma de la Aorta/tratamiento farmacológico , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta Abdominal/etiología , Modelos Animales de Enfermedad , Ácido Fólico , Ratones Endogámicos C57BL , Nifedipino/farmacología , Nifedipino/uso terapéutico , Ratones Noqueados para ApoERESUMEN
Passive daytime radiative cooling (PDRC) is an emerging sustainable technology that can spontaneously radiate heat to outer space through an atmospheric transparency window to achieve self-cooling. PDRC has attracted considerable attention and shows great potential for personal thermal management (PTM). However, PDRC polymers are limited to polyethylene, polyvinylidene fluoride, and their derivatives. In this study, a series of polymer films based on thermoplastic polyurethane (TPU) and their composite films with silica aerogels (aerogel-functionalized TPU (AFTPU)) are prepared using a simple and scalable non-solvent-phase-separation strategy. The TPU and AFTPU films are freestanding, mechanically strong, show high solar reflection up to 94%, and emit strongly in the atmospheric transparency window, thereby achieving subambient cooling of 10.0 and 7.7 °C on a hot summer day for the TPU and AFTPU film (10 wt%), respectively. The AFTPU films can be used as waterproof and moisture permeable coatings for traditional textiles, such as cotton, polyester, and nylon, and the highest temperature drop of 17.6 °C is achieved with respect to pristine nylon fabric, in which both the cooling performance and waterproof properties are highly desirable for the PTM applications. This study opens up a promising route for designing common polymers for highly efficient PDRC.
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BACKGROUND: Endothelial dysfunction enhances vascular inflammation, which initiates pulmonary arterial hypertension (PAH) pathogenesis, further induces vascular remodeling and right ventricular failure. Activation of inflammatory caspases is an important initial event at the onset of pyroptosis. Studies have shown that caspase-1-mediated pyroptosis has played a crucial role in the pathogenesis of PAH. However, the role of caspase-11, another inflammatory caspase, remains to be elucidated. Therefore, the purpose of this study was to clarify the role of caspase-11 in the development of PAH and its mechanism on endothelial cell function. METHODS: The role of caspase-11 in the progression of PAH and vascular remodeling was assessed in vivo. In vitro, the effect of caspase-4 silencing on the human pulmonary arterial endothelial cells pyroptosis was determined. RESULTS: We confirmed that caspase-11 and its human homolog caspase-4 were activated in PAH animal models and TNF (tumor necrosis factor)-α-induced human pulmonary arterial endothelial cells. Caspase-11-/- relieved right ventricular systolic pressure, right ventricle hypertrophy, and vascular remodeling in Sugen-5416 combined with chronic hypoxia mice model. Meanwhile, pharmacological inhibition of caspase-11 with wedelolactone exhibited alleviated development of PAH on the monocrotaline-induced rat model. Moreover, knockdown of caspase-4 repressed the onset of TNF-α-induced pyroptosis in human pulmonary arterial endothelial cells and inhibited the activation of pyroptosis effector GSDMD (gasdermin D) and GSDME (gasdermin E). CONCLUSIONS: These observations identified the critical role of caspase-4/11 in the pyroptosis pathway to modulate pulmonary vascular dysfunction and accelerate the progression of PAH. Our findings provide a potential diagnostic and therapeutic target in PAH.
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Caspasas Iniciadoras/metabolismo , Células Endoteliales/metabolismo , Hipertensión Arterial Pulmonar/metabolismo , Arteria Pulmonar/metabolismo , Piroptosis/fisiología , Animales , Caspasas Iniciadoras/genética , Línea Celular , Modelos Animales de Enfermedad , Humanos , Hipoxia , Masculino , Ratones , Ratones Noqueados , Ratas , Ratas Sprague-Dawley , Remodelación VascularRESUMEN
Nerve regeneration and repair still remain a huge challenge for both central nervous and peripheral nervous system. Although some therapeutic substances, including neuroprotective agents, clinical drugs and stem cells, as well as various growth factors, are found to be effective to promote nerve repair, a carrier system that possesses a sustainable release behavior, in order to ensure high on-site concentration during the whole repair and regeneration process, and high bioavailability is still highly desirable. Hydrogel, as an ideal delivery system, has an excellent loading capacity and sustainable release behavior, as well as tunable physical and chemical properties to adapt to various biomedical scenarios; thus, it is thought to be a suitable carrier system for nerve repair. This paper reviews the structure and classification of hydrogels and summarizes the fabrication and processing methods that can prepare a suitable hydrogel carrier with specific physical and chemical properties. Furthermore, the modulation of the physical and chemical properties of hydrogels is also discussed in detail in order to obtain a better therapeutic effect to promote nerve repair. Finally, the future perspectives of hydrogel microsphere carriers for stroke rehabilitation are highlighted.
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The outbreak of COVID-19 has remained uncontained with urgent need for robust therapeutics. We have previously reported sex difference of COVID-19 for the first time indicating male predisposition. Males are more susceptible than females, and more often to develop into severe cases with higher mortality. This predisposition is potentially linked to higher prevalence of cigarette smoking. Nonetheless, we found for the first time that cigarette smoking extract (CSE) had no effect on angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) expression in endothelial cells. The otherwise observed worse outcomes in smokers is likely linked to baseline respiratory diseases associated with chronic smoking. Instead, we hypothesized that estrogen mediated protection might underlie lower morbidity, severity and mortality of COVID-19 in females. Of note, endothelial inflammation and barrier dysfunction are major mediators of disease progression, and development of acute respiratory distress syndrome (ARDS) and multi-organ failure in patients with COVID-19. Therefore, we investigated potential protective effects of estrogen on endothelial cells against oxidative stress induced by interleukin-6 (IL-6) and SARS-CoV-2 spike protein (S protein). Indeed, 17ß-estradiol completely reversed S protein-induced selective activation of NADPH oxidase isoform 2 (NOX2) and reactive oxygen species (ROS) production that are ACE2-dependent, as well as ACE2 upregulation and induction of pro-inflammatory gene monocyte chemoattractant protein-1 (MCP-1) in endothelial cells to effectively attenuate endothelial dysfunction. Effects of IL-6 on activating NOX2-dependent ROS production and upregulation of MCP-1 were also completely attenuated by 17ß-estradiol. Of note, co-treatment with CSE had no additional effects on S protein stimulated endothelial oxidative stress, confirming that current smoking status is likely unrelated to more severe disease in chronic smokers. These data indicate that estrogen can serve as a novel therapy for patients with COVID-19 via inhibition of initial viral responses and attenuation of cytokine storm induced endothelial dysfunction, to substantially alleviate morbidity, severity and mortality of the disease, especially in men and post-menopause women. Short-term administration of estrogen can therefore be readily applied to the clinical management of COVID-19 as a robust therapeutic option.
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Tratamiento Farmacológico de COVID-19 , COVID-19 , Estrógenos/uso terapéutico , Glicoproteína de la Espiga del Coronavirus , Enzima Convertidora de Angiotensina 2/genética , COVID-19/metabolismo , Quimiocina CCL2/genética , Células Endoteliales/metabolismo , Femenino , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Masculino , NADPH Oxidasa 2 , Especies Reactivas de Oxígeno/metabolismo , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus/genética , Glicoproteína de la Espiga del Coronavirus/metabolismo , Regulación hacia ArribaRESUMEN
OBJECTIVE: To compare the efficiency of transcutaneous electrical acupoint stimulation (TEAS) with those of conventional and TCM herb on bone marrow suppression in small cell lung cancer (SCLC) patients after initial chemotherapy. METHODS: We recruited 139 participants with pathologically confirmed SCLC who had not received chemotherapy. The conventional group (n = 37) received gemcitabine and cisplatin chemotherapy and routine care. The TCM herb group (n = 35) received 3 Diyushengbai tablets thrice a day for one day prior to chemotherapy and maintained during the trial. The TEAS group (n = 42) received TEAS at a frequency of 65-100 Hz with a pulse width of 100-200 µsec. Acupoints were selected from Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4) and were treated on days 1, 2, 3, 5, 8, 14, 21, and 28 of chemotherapy for 30 min each day. All three groups underwent a 28-day treatment for a total of one treatment course. Changes in the white blood cell, neutrophil, platelet, and hemoglobin indices on day 1 before chemotherapy and days 5, 8, 11, 14, 21, and 28 days after chemotherapy were compared among the groups. Comfort levels of patients on day 1 before chemotherapy and days 5, 11, and 21 after chemotherapy were observed. RESULTS: Compared with the conventional group, the white blood cell counts in the TEAS group on days 8 (7.07 ± 2.11 vs. 5.97 ± 2.10 × 109/L) and 14 (6.14 ± 1.51 vs. 5.07 ± 2.41 × 109/L) of chemotherapy and that in the TCM herb group on day 14 (6.63 ± 3.44 vs. 5.07 ± 2.41 × 109/L) of chemotherapy were increased (P < 0.05). Compared with the conventional group, the neutrophil count in the TEAS group on days 5 (4.28 ± 1.54 vs. 3.01 ± 1.41 × 109/L), 8 (3.75 ± 1.21 vs. 2.77 ± 1.17 × 109/L), 11 (3.46 ± 1.31 vs. 2.31 ± 1.24 × 109/L), 14 (3.18 ± 1.29 vs. 2.07 ± 1.14 × 109/L), and 21 (4.67 ± 1.31 vs. 3.58 ± 1.23 × 109/L) of chemotherapy and that in the TCM herb group on day 5 (3.88 ± 1.05 vs. 3.01 ± 1.41 × 109/L) of chemotherapy were increased (P < 0.05). Compared with the conventional group, the platelet count of patients in the TEAS group increased on days 5 (264.7 ± 64.1 vs. 201.0 ± 55.7 × 109/L), 8 (251.3 ± 74.9 vs. 188.2 ± 65.8 × 109/L), 11 (236.7 ± 74.9 vs. 181.3 ± 84.3 × 109/L), and 14 (238.3 ± 75.9 vs. 192.8 ± 95.8 × 109/L) of chemotherapy (P < 0.05). Compared with the TCM herb group, the platelet count in the TEAS group increased on days 5 (264.7 ± 64.1 vs. 216.3 ± 57.9 × 109/L), 8 (251.3 ± 74.9 vs. 213.7 ± 70.3 × 109/L), 11 (236.7 ± 74.9 vs. 181.3 ± 84.3 × 109/L), and 21 (254.8 ± 81.8 vs. 213.9 ± 82.6 × 109/L) of chemotherapy (P < 0.05). Compared with the conventional group, the hemoglobin level in the TCM herb group increased on day 14 (135.03 ± 28.06 vs. 122.09 ± 12.63 g/L) of chemotherapy (P < 0.05). Compared with the conventional group, the comfort score of the TEAS group increased on days 5 (78.31 ± 10.21 vs. 70.18 ± 9.34 score) and 11 (80.07 ± 10.44 vs. 72.11 ± 9.47 score) of chemotherapy (P < 0.05). CONCLUSION: TEAS is an effective and safe treatment modality for improving bone marrow suppression in SCLC patients after initial chemotherapy. TEAS improved comfort levels more effectively than did conventional and TCM herb.
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[Figure: see text].
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Aorta/metabolismo , Aneurisma de la Aorta Abdominal/metabolismo , Endotelio Vascular/metabolismo , MicroARNs/metabolismo , NADPH Oxidasas/metabolismo , Tetrahidrofolato Deshidrogenasa/metabolismo , Anciano , Anciano de 80 o más Años , Aorta/efectos de los fármacos , Aneurisma de la Aorta Abdominal/genética , Regulación hacia Abajo/efectos de los fármacos , Células Endoteliales/efectos de los fármacos , Células Endoteliales/metabolismo , Endotelio Vascular/efectos de los fármacos , Femenino , Humanos , Peróxido de Hidrógeno/farmacología , Masculino , MicroARNs/genética , Persona de Mediana Edad , Óxido Nítrico/metabolismo , Óxido Nítrico Sintasa de Tipo III/metabolismoRESUMEN
Overexpression of connexin 43 (Cx43) was related to dysfunction of vascular smooth muscle cells (VSMCs). Our previous study reported that rutaecarpine, an active ingredient of herbal medicine Evodia, modulated connexins expression in human umbilical vein endothelial cells. This study aims to explore the effects of rutaecarpine on Cx43 expression and VSMCs dysfunction induced by oxidized low-density lipoprotein (ox-LDL). In cultured rat thoracic aortic VSMCs, ox-LDL upregulated the level of Cx43 in a time- and dose-dependent manner, which were abolished by the NF-κB inhibitor BAY11-7082 and PDTC. Furthermore, exposure to ox-LDL for 4â¯h induced the nuclear translocation of the NF-κB p65 in VMSCs. Ox-LDL (50â¯mg/l,48â¯h) induced dysfunction of VSMCs, demonstrated as excessive proliferation, migration, and phenotype switch of cells, which were attenuated by treatment with Cx43 gap junction blocker Gap26(100⯵M)) or rutaecarpine (1, 3, and 10⯵M). Rutaecarpine inhibited ox-LDL-induced upregulation of Cx43, prevented nuclear translocation of the NF-κB p65, and increased intracellular calcium level in VSMCs. These effects were abolished by pretreatment with transient receptor potential vanilloid subtype 1 (TRPV1) antagonist capsazepine, intracellular calcium chelator BAPTA-AM or CaM antagonist W-7. In conclusion, this study demonstrated that rutaecarpine inhibited Cx43 overexpression through TRPV1/[Ca2+]i/CaM/NF-κB signal pathway, thereby preventing VSMCs dysfunction induced by ox-LDL. Our study provides a novel mechanism by which rutaecarpine modulate Cx43 expression and VSMC function.