Research Progress on Traditional Chinese Medicine Regulating the NLRP3/Caspase-1 Signaling Pathway in the Treatment of Coronary Heart Disease

Tian Peng; Zhang Qiuyan

doi:10.23977/medcm.2026.080112

Research Progress on Traditional Chinese Medicine Regulating the NLRP3/Caspase-1 Signaling Pathway in the Treatment of Coronary Heart Disease

Download as PDF

DOI: 10.23977/medcm.2026.080112 | Downloads: 0 | Views: 15

Author(s)

Tian Peng ¹, Zhang Qiuyan ¹

Affiliation(s)

¹ Hunan University of Chinese Medicine, Changsha, China

Corresponding Author

Zhang Qiuyan

ABSTRACT

Coronary Heart Disease (CHD) is a cardiovascular disease with a high global prevalence. Its pathophysiological mechanisms are complex, with inflammatory responses and pyroptosis mediated by the NLRP3/Caspase-1 signaling pathway serving as critical factors driving CHD progression. Upon activation, the NLRP3 inflammasome recruits and activates Caspase-1, which subsequently induces the cleavage of GSDMD and the maturation and release of inflammatory cytokines. This process triggers pyroptosis and exacerbates myocardial injury.Traditional Chinese Medicine (TCM), characterized by its holistic regulatory advantages of multi-component, multi-target, and multi-pathway action, has demonstrated unique potential in the prevention and treatment of CHD. This paper aims to elucidate the role of the NLRP3/Caspase-1 pathway in the pathological progression of CHD and systematically reviews the research progress of TCM monomers and compound formulas in intervening with CHD by regulating this signaling pathway. The goal is to provide a theoretical basis and new perspectives for the modernization and clinical application of TCM research.

KEYWORDS

NLRP3/Caspase-1, Coronary Heart Disease, Traditional Chinese Medicine

CITE THIS PAPER

Tian Peng, Zhang Qiuyan. Research Progress on Traditional Chinese Medicine Regulating the NLRP3/Caspase-1 Signaling Pathway in the Treatment of Coronary Heart Disease. MEDS Chinese Medicine (2026). Vol. 8, No. 1, 103-111. DOI: http://dx.doi.org/10.23977/medcm.2026.080112.

REFERENCES

[1] Libby P, Theroux P. Pathophysiology of coronary artery disease. Circulation. 2005. 111(25): 3481-3488.
[2] Collaborators GBoCDaR2. Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023. J Am Coll Cardiol. 2025. 86(22): 2167-2243.
[3] Liu M, He X, Yang X, Wang Z. 2024 annual report on cardiovascular health and diseases in China: Data and trend. Chin Med J (Engl). 2025. 138(23): 3037-3049.
[4] Tao S, Tang X, Yu L, et al. Prognosis of coronary heart disease after percutaneous coronary intervention: a bibliometric analysis over the period 2004-2022. Eur J Med Res. 2023. 28(1): 311.
[5] RASHEDI S, KEYKHAEI M, SATO A, et al. Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease: Meta-Analysis of Randomized Trials[J]. J Am Coll Cardiol, 2025,85(11):1189-1203.
[6] Zhang Yu, Li Yuqi, Ding Qi, et al. Research progress on the treatment of unstable angina pectoris with coronary heart disease using traditional Chinese medicine [J]. Journal of Modern Integrated Traditional Chinese and Western Medicine, 2025,34(07):1013-1017.
[7] ATTIQ A, AFZAL S, AHMAD W, et al. Hegemony of inflammation in atherosclerosis and coronary artery disease[J]. Eur J Pharmacol, 2024,966:176338.
[8] LIBBY P, SOEHNLEIN O. Inflammation in atherosclerosis: Lessons and therapeutic implications[J]. Immunity, 2025,58(10):2383-2401.
[9] XING Y, LIN X. Challenges and advances in the management of inflammation in atherosclerosis[J]. J Adv Res, 2025, 71:317-335.
[10] AJOOLABADY A, PRATICO D, LIN L,et al. Inflammation in atherosclerosis: pathophysiology and mechanisms[J]. Cell Death Dis, 2024,15(11):817.
[11] GUO X, FENG X, YANG Y, et al. Spermidine attenuates chondrocyte inflammation and cellular pyroptosis through the AhR/NF-κB axis and the NLRP3/caspase-1/GSDMD pathway[J]. Front Immunol, 2024,15:1462777.
[12] Pan Xubiao, Li Xiangyu, Wang Zhixin, et al. Research progress on the NLRP3-(Caspase-1)/IL-1β signaling pathway [J]. China Medical Guide, 2019,16(01):41-44.
[13] STARK K, MASSBERG S. Interplay between inflammation and thrombosis in cardiovascular pathology[J]. Nat Rev Cardiol, 2021,18(9):666-682.
[14] CHEN Y, YE X, ESCAMES G, et al. The NLRP3 inflammasome: contributions to inflammation-related diseases[J]. Cell Mol Biol Lett, 2023,28(1):51.
[15] WU Q, YANG H, ZHANG H, et al. IP3R2-mediated Ca2+ release promotes LPS-induced cardiomyocyte pyroptosis via the activation of NLRP3/Caspase-1/GSDMD pathway[J]. Cell Death Discov, 2024,10(1):91.
[16] JIA Z, ZHANG X, LI Z, et al. Hydrogen sulfide mitigates ox‑LDL‑induced NLRP3/caspase‑1/GSDMD dependent macrophage pyroptosis by S‑sulfhydrating caspase‑1[J]. Mol Med Rep, 2024,30(2)
[17] KODI T, SANKHE R, GOPINATHAN A, et al. New Insights on NLRP3 Inflammasome: Mechanisms of Activation, Inhibition, and Epigenetic Regulation[J]. J Neuroimmune Pharmacol, 2024,19(1):7.
[18] LV J, MUHAMMAD F, WANG Z, et al. Defective RuO(2) Nanospheres Attenuate Osteoarthritis Progression via Suppressing the ROS/NLRP3/Caspase-1 Signaling Pathway[J]. ACS Nano, 2025,19(25):23080-23095.
[19] Cui Xinyu, Li Haolin, Li Weiqing, et al. Effects of Yiqi Juanbi Formula on pyroptosis of chondrocytes in collagen-induced arthritis rats via NF-κB/NLRP3/Caspase-1 signaling pathway[J]. Chinese Patent Medicine, 2025,47(09):2880-2887.
[20] Cai M, Zhang YN. Effects of Panax notoginseng total saponins on pyroptosis of chondrocytes in osteoarthritis rats through regulation of TLR4/NLRP3/Caspase-1 signaling pathway [J]. Chinese Journal of Traditional Medicine Information, 2023,40(02):11-17.
[21] LIU S, SONG X, SUN Y, et al. Kai-Xin-San ameliorates mild cognitive impairment in SAMP8 mice by inhibiting neuroinflammation and pyroptosis via NLRP3/Caspase-1 pathway modulation[J]. Front Pharmacol, 2025,16:1528011.
[22] SHUAIHUI Q, QIQI Y, JUN Y, et al. Effects of Huayu Tongluo moxibustion on learning and memory ability and neuronal injury in the hippocampal CA1 region in vascular dementia rats via the NLRP3/Caspase-1/GSDMD signaling pathway[J]. Chinese Acupuncture and Moxibustion, 2025,45(11):1591-1599.
[23] Xie Xiaofang, Zhao Zhanqing, Fu Meichui. Effect of ligustrazine on pyroptosis in sepsis-induced lung injury rats by regulating NLRP3/Caspase-1 signaling pathway [J]. China Journal of Pharmacy, 2023,58(19):1744-1751.
[24] Zhao Guanyu, Xin Ruihua, Qiu Zhengying, et al. Mechanism of Wumei Pill-induced pyroptosis in colonic epithelial cells of ulcerative colitis mice based on NLRP3/Caspase-1/GSDMD signaling pathway[J]. Chinese Herbal Medicine, 2023,54(24):8086-8093.
[25] Zhao Zhuo. Effects of Banxia Xiexin Decoction on inflammatory responses in ulcerative colitis rats via the NLRP3/Caspase-1 pyroptosis signaling pathway [D]. Shenyang: Liaoning University of Traditional Chinese Medicine, 2024.
[26] MA X, YANG Y, LI H, et al. Periplogenin inhibits pyroptosis of fibroblastic synoviocytes in rheumatoid arthritis through the NLRP3/Caspase-1/GSDMD signaling pathway[J]. Int Immunopharmacol, 2024,133:112041.
[27] LI H, LI X, XU G, et al. Minocycline alleviates lipopolysaccharide-induced cardiotoxicity by suppressing the NLRP3/Caspase-1 signaling pathway[J]. Sci Rep, 2024,14(1):21180.
[28] MA X, ZHAO X, YANG Y, et al. Paeonol inhibits NETs-mediated foam cell inflammation through the CitH3/NLRP3/caspase-1 signaling pathway in atherosclerosis[J]. Int Immunopharmacol, 2025,151:114340.
[29] HOU C, JIANG X, SHENG W, et al. Xinmaikang (XMK) tablets alleviate atherosclerosis by regulating the SREBP2-mediated NLRP3/ASC/Caspase-1 signaling pathway[J]. J Ethnopharmacol, 2024,319(Pt 2):117240.
[30] WANG L H, GU Z W, LI J, et al. Isorhynchophylline inhibits inflammatory responses in endothelial cells and macrophages through the NF-κB/NLRP3 signaling pathway[J]. BMC Complement Med Ther, 2023,23(1):80.
[31] Tan Yu, Chai Hua, Ma Xiaojuan. Effect of Lingbao Huxindan on the pyroptosis signaling pathway of NLRP3/Caspase-1 in myocardial tissue of myocardial infarction rats [J]. China Journal of Integrated Traditional and Western Medicine, 2023,43(01):90-96.
[32] XUAN W, YUN-LONG H, TONG-XING W, et al. Tongxinluo alleviates myocardial ischemia-reperfusion injury by inhibiting the pyroptosis of endothelial cells via the NLRP3/Caspase-1/GSDMD signaling pathway[J]. J Mol Histol, 2025,56(5):302.
[33] CHAI R, YE Z, XUE W, et al. Tanshinone IIA inhibits cardiomyocyte pyroptosis through TLR4/NF-κB p65 pathway after acute myocardial infarction[J]. Front Cell Dev Biol, 2023,11:1252942.
[34] Ji Chengfeng, Wang Chen, Zhang Hexiang, et al. Protective effect of dihydrodanshenone on myocardial ischemia-reperfusion injury in cardiomyocytes [J]. Northwest Journal of Pharmacy, 2023,38(06):77-82.
[35] XU S, ILYAS I, LITTLE P J, et al. Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies[J]. Pharmacol Rev, 2021,73(3):924-967.
[36] He Tingting, Zhang Xulin, Jia Zhenli, et al. Hydrogen sulfide inhibits pyroptosis of vascular endothelial cells induced by oxidized low-density lipoprotein by downregulating the NLRP3/caspase-1 signaling pathway [J]. China Journal of Pathophysiology, 2021,37(10):1738-1746.
[37] Yang Jiale, Shen Xiangchun. Luteolin improves LPS+ATP-induced inflammatory response and pyroptosis in endothelial cells by inhibiting the NLRP3/caspase-1 signaling pathway [J]. China Pharmacological Bulletin, 2022, 38(08):1196-1201.
[38] GAO J, GAO Z. The regulatory role and mechanism of USP14 in endothelial cell pyroptosis induced by coronary heart disease[J]. Clin Hemorheol Microcirc, 2024,86(4):495-508.
[39] WU J, HE S, SONG Z, et al. Macrophage polarization states in atherosclerosis[J]. Front Immunol, 2023,14: 1185587.
[40] Song Luxia. Mechanistic study on Qingxin Jieyu Formula regulating macrophage polarization to stabilize atherosclerotic vulnerable plaques [D]. Beijing: Beijing University of Chinese Medicine, 2024.
[41] LIU Z, LV L, WEI J, et al. Cordycepin attenuates NLRP3/Caspase-1/GSDMD-mediated LPS-induced macrophage pyroptosis[J]. Front Pharmacol, 2025,16:1526616.
[42] Xiao Min, Xiang Jingjing, Wang Wei, et al. Jinxiangdan inhibits the NLRP3/IL-1β/Caspase-1 signaling pathway to alleviate myocardial ischemia-reperfusion injury in rats [J]. China Journal of Experimental Formulary Science, 2021,27(20):87-94.
[43] Li SH, Li QJ, Zhou C, et al. Resveratrol regulates pyroptosis of vascular smooth muscle cells mediated by NLRP3 inflammasome to combat atherosclerosis [J]. Drug Evaluation Research, 2022,45(10):1972-1979.
[44] QIN J, YANG Q, WANG Y, et al. The role of pyroptosis in heart failure and related traditional chinese medicine treatments[J]. Front Pharmacol, 2024,15:1377359.
[45] Fan Xingyu, Liao Xiaoqian, Huang Shumin, et al. Exploring the regulation of cellular pyroptosis by Shenfu Injection on chronic heart failure based on the NLRP3/caspase-1 pathway [J]. China Journal of Traditional Chinese Medicine, 2023,48(23):6475-6482.
[46] Liang Guoqing, Xia Ran, Wang Yinyan, et al. Effects of Shenqi Jianxin Formula on pyroptosis in cardiomyocytes of chronic heart failure model rats based on the NLRP3/Caspase-1 signaling pathway[J]. Chinese Journal of Traditional Chinese Medicine, 2024,65(01):94-102.
[47] ZHANG L, LI Y, FAN C D, et al. Chinese medicinal formula Fu Xin decoction against chronic heart failure by inhibiting the NLRP3/caspase-1/GSDMD pyroptotic pathway[J]. Biomed Pharmacother, 2024,174:116548.
[48] ZHANG J, XUE S, CHEN H, et al. Exploring the Mechanism of Si-miao-yong-an Decoction in the Treatment of Coronary Heart Disease based on Network Pharmacology and Experimental Verification[J]. Comb Chem High Throughput Screen, 2024,27(1):57-68.
[49] ZHAO J, WANG Z, YUAN Z, et al. Baicalin ameliorates atherosclerosis by inhibiting NLRP3 inflammasome in apolipoprotein E-deficient mice[J]. Diab Vasc Dis Res, 2020,17(6):1479164120977441.
[50] YUAN Y, LIU H, MENG Q. The Cardioprotective Effects and Mechanisms of Astragalus-Safflower Herb Pairs on Coronary Heart Disease Identified by Network Pharmacology and Experimental Verification[J]. Front Biosci (Landmark Ed), 2023,28(5):94.
[51] WEN J, CHANG Y, HUO S, et al. Tanshinone IIA attenuates atherosclerosis via inhibiting NLRP3 inflammasome activation[J]. Aging (Albany NY), 2020,13(1):910-932.
[52] SILVIS M J M, FIOLET A T L, OPSTAL T S J, et al. Colchicine reduces extracellular vesicle NLRP3 inflammasome protein levels in chronic coronary disease: A LoDoCo2 biomarker substudy[J]. Atherosclerosis, 2021, 334: 93-100.
[53] Chen Yulin, He Yingying, Hu Kai, et al. Effects and mechanisms of Trichosanthes seed exosome vesicles in preventing and treating atherosclerosis [J]. China Tissue Engineering Research, 2026,30(07):1768-1781.
[54] Zhao D, Huang Y, Chen Wenxuan, et al. Exploring the mechanism of Danzhuanshuan Tea on coronary heart disease complicated with depression in mice based on network pharmacology and NLRP3 inflammatory pathway[J]. Chinese Journal of New Drugs and Clinical Pharmacology, 2024,35(10):1552-1561.
[55] Chang Yanbin, Li Yan, Zhang Lili, et al. Study on the mechanism of modified Wenden Decoction inhibiting NLRP3-mediated pyroptosis of endothelial cells in preventing coronary heart disease with phlegm-stasis syndrome [J]. Journal of Modern Integrated Traditional Chinese and Western Medicine, 2022,31(20):2808-2812+2905.
[56] GAO S, HE Y, LIU Y, et al. Dan-Lou tablets reduce inflammatory response by inhibiting the activation of NLRP3 inflammasome for coronary heart disease[J]. Phytomedicine, 2024,131:155773.
[57] WANG J, LI T L, CHANG P F, et al. Clinical effects and mechanisms of a Chinese patent medicine, Tongxinluo capsule, as an adjuvant treatment in coronary heart disease[J]. Heliyon, 2024,10(6):e27460.
[58] ZHAO X, DING H, MA Y, et al. Ling-Gui-Zhu-Gan decoction inhibits cardiomyocyte pyroptosis via the NLRP3/Caspase-1 signaling pathway[J]. Tissue Cell, 2024,91:102588.

Subscription

E-Mail Alert

Downloads:	10176
Visits:	760362

Research Progress on Traditional Chinese Medicine Regulating the NLRP3/Caspase-1 Signaling Pathway in the Treatment of Coronary Heart Disease

Author(s)

Affiliation(s)

Corresponding Author

ABSTRACT

KEYWORDS

CITE THIS PAPER

REFERENCES

RESOURCES

JOIN US

PUBLICATION SERVICES

CONTACT US