Exploring the mechanism of TLR4/NF-κB signaling pathway in hypoxic myocardial injury: Implications for traditional Chinese medicine therapy

Fitoterapia. 2025 Jun 30:185:106721. doi: 10.1016/j.fitote.2025.106721. Online ahead of print.

Abstract

Hypoxic myocardial injury is the core mechanism of many cardiovascular diseases and poses a serious threat to global public health. Its pathogenesis involves energy metabolism disorder, oxidative stress, inflammatory response, apoptosis regulation imbalance, and other links, resulting in myocardial dysfunction and damage. In recent years, a large number of studies have confirmed that the Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling network can regulate hypoxic myocardial injury by mediating HMGB1, MyD88, Caspase-3, HIF-1α, TNF-α, NLRP3, HSP70, etc. Traditional Chinese Medicine (TCM) and its active components have obvious advantages in the treatment of complex diseases such as hypoxic myocardial injury, and inhibiting the key target of TLR4/NF-κB signaling network is one of the mechanisms of myocardial protection. However, there are few systematic reviews and summaries in this field. Based on this, this review summarizes the regulatory mechanism of TLR4/NF-κB signaling pathway involved in hypoxic myocardial injury and the intervention effect of TCM in recent years, to provide a theoretical basis for basic research and new drug development of hypoxic myocardial injury.

Keywords: Hypoxic myocardial injury; TLR4/NF-κB signaling pathway; Traditional Chinese medicine (TCM) agents.

Publication types

  • Review