<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="research-article" dtd-version="2.3" xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Pharmacol.</journal-id>
<journal-title>Frontiers in Pharmacology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Pharmacol.</abbrev-journal-title>
<issn pub-type="epub">1663-9812</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">741623</article-id>
<article-id pub-id-type="doi">10.3389/fphar.2021.741623</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Pharmacology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>
<italic>Parkia speciosa</italic> Hassk. Empty Pod Extract Alleviates Angiotensin II-Induced Cardiomyocyte Hypertrophy in H9c2 Cells by Modulating the Ang II/ROS/NO Axis and MAPK Pathway</article-title>
<alt-title alt-title-type="left-running-head">Siti et&#x20;al.</alt-title>
<alt-title alt-title-type="right-running-head">
<italic>Parkia speciosa</italic> and Cardiomyocyte Hypertrophy</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Siti</surname>
<given-names>Hawa Nordin</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1506535/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jalil</surname>
<given-names>Juriyati</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/421717/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Asmadi</surname>
<given-names>Ahmad Yusof</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1506465/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Kamisah</surname>
<given-names>Yusof</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1028636/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<label>
<sup>1</sup>
</label>Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, <addr-line>Kuala Lumpur</addr-line>, <country>Malaysia</country>
</aff>
<aff id="aff2">
<label>
<sup>2</sup>
</label>Unit of Pharmacology, Department of Basic Medical Sciences, Faculty of Medicine, Universiti Sultan Zainal Abidin, <addr-line>Kuala Terengganu</addr-line>, <country>Malaysia</country>
</aff>
<aff id="aff3">
<label>
<sup>3</sup>
</label>Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, <addr-line>Kuala Lumpur</addr-line>, <country>Malaysia</country>
</aff>
<aff id="aff4">
<label>
<sup>4</sup>
</label>Unit of Pharmacology, Faculty of Medicine and Defense Health, Universiti Pertahanan Nasional Malaysia, <addr-line>Kuala Lumpur</addr-line>, <country>Malaysia</country>
</aff>
<aff id="aff5">
<label>
<sup>5</sup>
</label>Cardiovacular Health Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, <addr-line>Kuala Lumpur</addr-line>, <country>Malaysia</country> </aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/445036/overview">Uraiwan Panich</ext-link>, Mahidol University, Thailand</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1208012/overview">Raquel Bridi</ext-link>, Pontificia Universidad Cat&#xf3;lica de Chile, Chile</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/421367/overview">Lei Chen</ext-link>, Guangdong Ocean University, China</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Yusof Kamisah, <email>kamisah_y@yahoo.com</email>
</corresp>
<fn fn-type="other">
<p>This article was submitted to Ethnopharmacology, a section of the journal Frontiers in Pharmacology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>14</day>
<month>10</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>12</volume>
<elocation-id>741623</elocation-id>
<history>
<date date-type="received">
<day>15</day>
<month>07</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>28</day>
<month>09</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2021 Siti, Jalil, Asmadi and Kamisah.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Siti, Jalil, Asmadi and Kamisah</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these&#x20;terms.</p>
</license>
</permissions>
<abstract>
<p>Cardiac hypertrophy is characteristic of heart failure in patients who have experienced cardiac remodeling. Many medicinal plants, including <italic>Parkia speciosa</italic> Hassk., have documented cardioprotective effects against such pathologies. This study investigated the activity of <italic>P. speciosa</italic> empty pod extract against cardiomyocyte hypertrophy in H9c2 cardiomyocytes exposed to angiotensin II (Ang II). In particular, its role in modulating the Ang II/reactive oxygen species/nitric oxide (Ang II/ROS/NO) axis and mitogen-activated protein kinase (MAPK) pathway was examined. Treatment with the extract (12.5, 25, and 50&#xa0;&#x3bc;g/ml) prevented Ang II-induced increases in cell size, NADPH oxidase activity, B-type natriuretic peptide levels, and reactive oxygen species and reductions in superoxide dismutase activity. These were comparable to the effects of the valsartan positive control. However, the extract did not significantly ameliorate the effects of Ang II on inducible nitric oxide synthase activity and nitric oxide levels, while valsartan did confer such protection. Although the extract decreased the levels of phosphorylated extracellular signal-related kinase, p38, and c-Jun N-terminal kinase, valsartan only decreased phosphorylated c-Jun N-terminal kinase expression. Phytochemical screening identified the flavonoids rutin (<bold>1</bold>) and quercetin (<bold>2</bold>) in the extract. These findings suggest that <italic>P. speciosa</italic> empty pod extract protects against Ang II-induced cardiomyocyte hypertrophy, possibly by modulating the Ang II/ROS/NO axis and MAPK signaling pathway via a mechanism distinct from valsartan.</p>
</abstract>
<kwd-group>
<kwd>
<italic>Parkia speciosa</italic>
</kwd>
<kwd>angiotensin II</kwd>
<kwd>NADPH oxidase</kwd>
<kwd>iNOS</kwd>
<kwd>ERK</kwd>
<kwd>p38</kwd>
<kwd>JNK</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>Cardiac hypertrophy initially develops as an adaptive response to compensate for reduced cardiac function (<xref ref-type="bibr" rid="B3">Bernardo and McMullen, 2016</xref>). Unfortunately, the sustained effects of pathological stimuli promote pathophysiological changes that lead to cardiac remodeling and, ultimately, heart failure (<xref ref-type="bibr" rid="B48">Wang et&#x20;al., 2016</xref>). Angiotensin II (Ang II), a potent stimulus of cardiac myocyte growth factors, has been found to be elevated in cardiac failure (<xref ref-type="bibr" rid="B61">Zucker et&#x20;al., 2015</xref>). Ang II can be used to mimic pressure-overload-induced cardiac hypertrophy (<xref ref-type="bibr" rid="B53">Ying et&#x20;al., 2014</xref>) and has been widely employed as a hypertrophic stimulus in various <italic>in&#x20;vitro</italic> cardiac disease models (<xref ref-type="bibr" rid="B13">Ding et&#x20;al., 2019</xref>).</p>
<p>Exposure to Ang II stimulates the development of cardiac hypertrophy by activating G-protein-coupled receptors, which, in turn, activate several cascades, including the Ang II/reactive oxygen species/nitric oxide (Ang II/ROS/NO) axis as well as signaling kinases and phosphatases (<xref ref-type="bibr" rid="B43">Takano et&#x20;al., 2003</xref>). Substantial evidence has linked Ang II-stimulated pathways to the activation of NADPH oxidase (NOX), which is a significant source of ROS in cardiovascular cells (<xref ref-type="bibr" rid="B33">Nguyen Dinh Cat et&#x20;al., 2013</xref>). ROS have been implicated in the activation of mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-&#x3ba;B) pathways in Ang II-induced cardiac hypertrophy (<xref ref-type="bibr" rid="B7">Chen et&#x20;al., 2020</xref>; <xref ref-type="bibr" rid="B59">Zhu et&#x20;al., 2020</xref>). MAPK has three subfamilies&#x2014;extracellular signal-related kinase (ERK1/2), c-Jun N-terminal kinase (JNK), and p38 kinase (p38)&#x2014;that have been reported to play a role in cardiac hypertrophy (<xref ref-type="bibr" rid="B58">Zhang et&#x20;al., 2003</xref>; <xref ref-type="bibr" rid="B29">Muslin, 2008</xref>; <xref ref-type="bibr" rid="B8">Cheng et&#x20;al., 2017</xref>). Ang II also causes cardiac inflammation by promoting inducible nitric oxide synthase (iNOS) activity (<xref ref-type="bibr" rid="B19">Huang et&#x20;al., 2017</xref>). These overlapping pathways eventually lead to cardiac remodeling and hypertrophy.</p>
<p>A potential therapeutic target for halting the progression of cardiac failure involves the prevention of pathological cardiac hypertrophy, for which numerous studies have attempted to identify novel therapies. While no drugs directly or specifically targeting pathological cardiac hypertrophy have been identified (<xref ref-type="bibr" rid="B45">Tran et&#x20;al., 2016</xref>), neurohormonal blockers have been found to reduce cardiac hypertrophy indirectly. Ethnopharmacology is a promising screening tool in drug discovery, and many medicinal plants, including <italic>Eriobotrya japonica</italic> (Thunb.) Lindl (<xref ref-type="bibr" rid="B9">Chiang et&#x20;al., 2018</xref>) and <italic>Nelumbo nucifera</italic> Gaertn. (<xref ref-type="bibr" rid="B10">Cho et&#x20;al., 2019</xref>), have been shown to display cardioprotective activity against Ang II-induced cardiomyocyte hypertrophy.</p>
<p>
<italic>Parkia speciosa</italic> Hassk., a leguminous plant in the family Fabaceae, grows indigenously in Southeast Asia and has traditionally been used to manage hypertension (<xref ref-type="bibr" rid="B2">Azliza et&#x20;al., 2012</xref>) and heart problems (<xref ref-type="bibr" rid="B55">Yullia, 2008</xref>). The plant&#x2019;s empty pods have been reported to display various pharmacological activities, including anti-inflammatory (<xref ref-type="bibr" rid="B30">Mustafa et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B16">Gui et&#x20;al., 2019a</xref>), antioxidant (<xref ref-type="bibr" rid="B17">Gui et&#x20;al., 2019b</xref>), and &#x3b1;-glucosidase-inhibiting (<xref ref-type="bibr" rid="B36">Saleh et&#x20;al., 2021</xref>) properties. Extracts from its pods contain a higher antioxidant capacity than its seeds (<xref ref-type="bibr" rid="B22">Kamisah et&#x20;al., 2013</xref>), likely associated with the pod&#x2019;s flavonoid and phenolic components, including gallic acid, quercetin, gossypetin, and catechin (<xref ref-type="bibr" rid="B24">Ko et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B36">Saleh et&#x20;al., 2021</xref>). Experiments in hypertensive rats support the pods&#x2019; hypotensive and cardioprotective properties (<xref ref-type="bibr" rid="B23">Kamisah et&#x20;al., 2017</xref>). However, their effects on cardiomyocyte hypertrophy have yet to be investigated. As plant extracts with high flavonoid content have been shown to protect against cardiomyocyte hypertrophy (<xref ref-type="bibr" rid="B42">Sun et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B10">Cho et&#x20;al., 2019</xref>), this study aimed to investigate the effects of <italic>P. speciosa</italic> empty pod extract on the Ang II/ROS/NO axis and MAPK signaling pathway in Ang II-treated cardiomyocytes.</p>
</sec>
<sec sec-type="materials|methods" id="s2">
<title>Materials and Methods</title>
<sec id="s2-1">
<title>Materials</title>
<p>
<italic>P. speciosa</italic> pods (<xref ref-type="fig" rid="F1">Figure&#x20;1</xref>) were purchased from a local trader at Slim River, Perak, Malaysia (3&#xb0;49&#x2032;31.0&#x2ba;N 101&#xb0;29&#x2032;12.1&#x2ba;E) in January 2018. A voucher specimen (UKMB40383) was deposited at the Universiti Kebangsaan Malaysia Herbarium. H9c2 cardiomyocytes were obtained commercially (American Type Culture Collection, Rockville, MD, United&#x20;States). All chemicals were purchased from Sigma-Aldrich (St. Louis, MO, United&#x20;States), and all antibodies for Western blotting were purchased from Cell Signaling Technology (Danvers, MA, United&#x20;States) unless otherwise&#x20;noted.</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>
<bold>(A)</bold> <italic>Parkia speciosa</italic> pods and <bold>(B)</bold> its slived deseeded pod.</p>
</caption>
<graphic xlink:href="fphar-12-741623-g001.tif"/>
</fig>
</sec>
<sec id="s2-2">
<title>Empty Pod Extraction</title>
<p>The pods were cleaned, deseeded, and dried at room temperature. The dried, empty pods were ground and extracted in 95% ethanol in a 100&#xa0;g:1&#xa0;L ratio at room temperature for 9&#xa0;days (<xref ref-type="bibr" rid="B24">Ko et&#x20;al., 2014</xref>), with the ethanol changed every 3&#xa0;days to improve yield. The extract was then filtered through cotton wool, and the filtrate was concentrated with a rotary vacuum evaporator (Buchi Rotavapor R-200 System, Marshall Scientific, Hampton, NH, United&#x20;States). After freeze-drying (Labconco, Kansas City, MO, United&#x20;States) for 5&#xa0;days, the powder was stored at 4&#xb0;C.</p>
</sec>
<sec id="s2-3">
<title>Phytochemical Screening</title>
<p>Phytochemical screening was conducted using high-performance liquid chromatography (HPLC) following the method of <xref ref-type="bibr" rid="B46">Tuszy&#x144;ska (2014)</xref> with some modifications. Briefly, <italic>P. speciosa</italic> extract powder was dissolved in 100% aqueous methanol (10&#xa0;mg/ml) before filtering through a nylon membrane (0.45&#xa0;&#xb5;m) (&#x23;PP013045; Membrane Solutions, Auburn, WA, United&#x20;States). Since hydrolyzed glycosides are not applicable for <italic>in&#x20;vitro</italic> experiments, the extract was not subjected to acid hydrolysis. HPLC was performed on a C<sub>18</sub> column (150 &#xd7; 4.6&#xa0;mm, 5&#xa0;&#x3bc;m; Phenomenex, Torrance, CA) using a Waters Series 600 (Waters, Milford, MA) fitted with a photodiode array detector and an autosampler with an injection volume of 20&#xa0;&#x3bc;l. The samples were isocratically eluted using 0.2% orthophosphoric acid in methanol/water (60/40) at 0.75&#xa0;ml/min with detection at 370&#xa0;nm. This procedure was repeated on three separate days (interday) with at least three replicates/day (intraday) to determine precision.</p>
<p>Peaks in the extract samples were compared to catechin (K4512), rutin (R5143), quercetin (Q4951), kaempferol (K0133), ellagic acid (E2250), gallic acid (27,645), and caffeic acid (C0625) standards. The area under the curve (AUC) was calculated for five concentrations (62.5&#x2013;1,000&#xa0;&#x3bc;g/ml) of each standard run in triplicate and was used to prepare calibration curves. Fitted equations for the calibration curves were used to calculate the concentration of the compounds in <italic>P. speciosa</italic> extract.</p>
</sec>
<sec id="s2-4">
<title>H9c2 Cell Culture</title>
<p>H9c2 cells were cultured in Dulbecco&#x2019;s Modified Eagle Medium (DMEM; Gibco BRL Life Technologies, Grand Island, NY, United&#x20;States) supplemented with 10% fetal bovine serum (FBS), 100 U/ml penicillin G, and 100&#xa0;&#x3bc;g/ml streptomycin at 37&#xb0;C in a humidified atmosphere containing 5% CO<sub>2</sub>. The medium was changed every 2&#xa0;d. The cells were grown to 60&#x2013;70% confluency and serum-starved for 24&#xa0;h prior to the experiment (<xref ref-type="bibr" rid="B51">Yan et&#x20;al., 2013</xref>). Cells passaged 5&#x2013;7&#x20;times and grown to a density of 1.6 &#xd7; 10<sup>4</sup>&#xa0;cells/ml were used for the experiments.</p>
</sec>
<sec id="s2-5">
<title>Cytotoxicity Study</title>
<p>Cells were seeded in a 96-well plate and incubated with various concentrations of <italic>P. speciosa</italic> extract (3.125&#x2013;400&#xa0;&#x3bc;g/ml) for 24&#xa0;h. Cell viability was assayed using 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS; Cat No: 197010, Abcam, Cambridge, United&#x20;Kingdom) with detection at 490&#xa0;nm. Dimethyl sulfoxide (DMSO) (&#x3c;0.1%) was used as the vehicle for <italic>P. speciosa</italic> extract. A minimum of three biological replicates was performed in triplicate (<italic>n</italic>&#x20;&#x3d;&#x20;3).</p>
</sec>
<sec id="s2-6">
<title>Concentration-Response Study of <italic>P. speciosa</italic> Extract on H9c2 Cell Size</title>
<p>Cells were treated concurrently with Ang II (600&#xa0;nM) (<xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>) and various concentrations of <italic>P. speciosa</italic> extract (3.125&#x2013;100&#xa0;&#x3bc;g/ml) for 24&#xa0;h in eight-well chamber slides. Cell size was measured using immunofluorescence staining. The best three extract concentrations for protecting against Ang II-induced cardiomyocyte hypertrophy were selected for further study. At least three biological replicates were performed in triplicate (<italic>n</italic>&#x20;&#x3d;&#x20;3).</p>
</sec>
<sec id="s2-7">
<title>Experimental Groups</title>
<p>H9c2 cells were randomly assigned to seven groups: 1) control (vehicle), 2) 50&#xa0;&#x3bc;g/ml <italic>P. speciosa</italic> extract, 3) Ang II (600&#xa0;nM; <xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>), 4) Ang II and 12.5&#xa0;&#x3bc;g/ml extract, 5) Ang II and 25&#xa0;&#x3bc;g/ml extract, 6) Ang II and 50&#xa0;&#x3bc;g/ml extract, and 7) Ang II and 20&#xa0;&#x3bc;M valsartan (<xref ref-type="bibr" rid="B1">Al-Mazroua et&#x20;al., 2013</xref>). Valsartan served as the positive control. Cells were treated concurrently with the extract and Ang II for 24&#xa0;h.</p>
</sec>
<sec id="s2-8">
<title>Cell Size Quantification</title>
<p>Cell size was measured following the method of <xref ref-type="bibr" rid="B21">Jeong et&#x20;al. (2015)</xref> with slight modifications described by <xref ref-type="bibr" rid="B37">Siti et&#x20;al. (2021)</xref>. Cells were stained with a primary antibody against &#x3b1;-actinin (1:200 dilution; ab9465, Abcam, Cambridge, MA, United&#x20;States) followed by an Alexa Fluor 488-conjugated anti-mouse secondary antibody (1:200 dilution; A-11059, Invitrogen, Waltham, MA, United&#x20;States) and visualized via fluorescence microscopy (Olympus Optical, Tokyo, Japan). A blinded assessor quantified the cardiomyocytes&#x2019; surface areas (&#x3e;60 cells) using ImageJ software (U. S. National Institutes of Health, Bethesda, MD, United&#x20;States) and compared them to control cells. A minimum of three biological replicates was performed in triplicate (<italic>n</italic>&#x20;&#x3d;&#x20;3).</p>
</sec>
<sec id="s2-9">
<title>Cellular B-Type Natriuretic Peptide and iNOS Levels</title>
<p>The cellular levels of B-type natriuretic peptide (BNP) and iNOS were estimated from cell lysates using commercial kits (Elabscience, Houston, TX, United&#x20;States). Briefly, the biotinylated detection antibody and samples were incubated in micro-ELISA wells precoated with BNP or rat NOS2/iNOS antibodies, excess conjugates were removed, and an avidin-horseradish peroxidase (HRP) conjugate was added to develop a blue color. Upon addition of a stop solution, a yellow color change occurred, which was measured at 450&#xa0;nm. BNP and iNOS levels were estimated against standard curves. A minimum of three biological replicates was performed in triplicate (<italic>n</italic>&#x20;&#x3d;&#x20;3).</p>
</sec>
<sec id="s2-10">
<title>Cellular Nitrite and Intracellular ROS Detection</title>
<p>Nitrite, a stable metabolite of NO, was measured following the method described by <xref ref-type="bibr" rid="B38">Siti et&#x20;al. (2019)</xref>. Cardiomyocytes were seeded in 96-well plates. Sample cell lysate (50&#xa0;&#x3bc;l) was reacted with an equal volume of modified Griess reagent for 15&#xa0;min at room temperature in the dark. The absorbance was measured at 540&#xa0;nm (EnSpire<sup>&#xae;</sup> Multimode Plate Reader, PerkinElmer, Inc., MA, United&#x20;States) and compared to a sodium nitrite standard curve to determine nitrite concentrations.</p>
<p>Global levels of ROS, including peroxynitrite and superoxide, were assessed in living cells using a commercial kit (ROS-ID<sup>&#xae;</sup> Total ROS/Superoxide Detection Kit, ENZ-51010, Enzo, NY, United&#x20;States) according to the manufacturer&#x2019;s protocol. Fluorescence signals were measured at 488&#xa0;nm using a microplate reader (EnSpire<sup>&#xae;</sup> Multimode Plate Reader, PerkinElmer, Inc., MA, United&#x20;States).</p>
<p>At least three biological replicates were performed in triplicate (<italic>n</italic>&#x20;&#x3d; 3) for all experiments.</p>
</sec>
<sec id="s2-11">
<title>NOX and Superoxide Dismutase Activities</title>
<p>NOX activity was measured according to the method described by <xref ref-type="bibr" rid="B31">Mustapha et&#x20;al. (2010)</xref>. Briefly, cell lysate (50&#xa0;&#x3bc;g protein/sample), cytochrome <italic>c</italic> (250&#xa0;&#x3bc;g/L), and NADPH (100&#xa0;&#x3bc;M) were incubated at 37&#xb0;C for 2&#xa0;h with or without diphenyleneiodonium (DPI, 100&#xa0;&#x3bc;M). The absorbance of the mixture was quantified at 550&#xa0;nm. NOX activity was calculated using an extinction coefficient of 21&#xa0;mMcm<sup>&#x2212;1</sup>.</p>
<p>Superoxide dismutase (SOD) activity (U/mg of protein) was measured according to the procedure of <xref ref-type="bibr" rid="B4">Beyer and Fridovich (1987)</xref>. Sample cell lysate (20&#xa0;&#x3bc;l) and riboflavin (10&#xa0;&#x3bc;l, 50&#xa0;&#x3bc;M) were added into an assay mixture containing 27&#xa0;ml of phosphate buffer (pH 7.8, 50&#xa0;mM), EDTA (50&#xa0;&#x3bc;M), 1.5&#xa0;ml of L-methionine (20&#xa0;mM), and 1&#xa0;ml of nitroblue tetrazolium (1.5&#xa0;mM). The mixture was illuminated for 7&#xa0;min in an aluminum foil-coated box equipped with a 40&#xa0;W fluorescent bulb, and absorbance was measured at 550&#xa0;nm.</p>
<p>At least three biological replicates were performed in triplicate (<italic>n</italic>&#x20;&#x3d; 3) for all experiments.</p>
</sec>
<sec id="s2-12">
<title>Western Blot Analysis</title>
<p>Protein expression was measured by Western blot as previously described (<xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>). Anti-phospho-ERK1/2 rabbit polyclonal (1:1,000) (&#x23;4377), anti-phospho-JNK1/2 rabbit monoclonal (1:1,000) (&#x23;4668), and anti-phospho-p38 mouse monoclonal (1:500) (sc-166182; Santa Cruz Biotechnology, Dallas, TX, United&#x20;States) were the primary antibodies used in this study. &#x3b2;-Actin mouse monoclonal antibodies (1:500) (sc-47778; Santa Cruz Biotechnology, Dallas, TX, United&#x20;States) served as the loading control. HRP-conjugated IgG anti-mouse (1:2000) (sc-516102; Santa Cruz Biotechnology, Dallas, TX, United&#x20;States) was used as the secondary antibody. Blots were visualized on a gel doc system and analyzed with ImageJ software (U. S. National Institutes of Health, Bethesda, MD, United&#x20;States). A minimum of three biological replicates was performed in triplicate (<italic>n</italic>&#x20;&#x3d;&#x20;3).</p>
</sec>
<sec id="s2-13">
<title>Statistical Analysis</title>
<p>All data are reported as mean&#x20;&#xb1; standard error of the mean (SEM) from a minimum of three biological replicates performed in triplicate. The Shapiro-Wilk test was used to test for normality. Results were analyzed using one-way analysis of variance (ANOVA) followed by Tukey&#x2019;s post hoc test in SPSS version 24.0 software (IBM Corp., Armonk, NY, United&#x20;States), with <italic>p</italic>&#x20;&#x3c; 0.05 considered significant.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec id="s3-1">
<title>Phytochemical Screening of the Extract</title>
<p>There were 11 peaks detected in the sample extract chromatogram (<xref ref-type="fig" rid="F2">Figure&#x20;2A</xref>). Two peaks were identified as rutin (<bold>1</bold>) and quercetin (<bold>2</bold>) (<xref ref-type="fig" rid="F3">Figure&#x20;3</xref>) when compared against the peaks of the standards (<xref ref-type="fig" rid="F2">Figure&#x20;2B</xref>). The remaining compounds could not be unequivocally identified owing to peak shape (blunted or multiple peaks). The retention time (t<sub>R</sub>) for rutin (1) and quercetin (2) in the extract resembled that of the standards (<xref ref-type="table" rid="T1">Table&#x20;1</xref>). Based on the rutin and quercetin calibration curves (<xref ref-type="fig" rid="F4">Figure&#x20;4</xref>), the <italic>P. speciosa</italic> empty pod crude ethanolic extract contained 15.5&#xa0;&#x3bc;g rutin/mg extract (<bold>1</bold>) and 0.11&#xa0;&#x3bc;g quercetin/mg extract (<bold>2</bold>) (<xref ref-type="table" rid="T2">Table&#x20;2</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Chromatographic analysis of <bold>(A)</bold> <italic>Parkia speciosa</italic> empty pod crude extract with detected rutin (<bold>1</bold>) and quercetin (<bold>2</bold>), and <bold>(B)</bold> the standard known compounds.</p>
</caption>
<graphic xlink:href="fphar-12-741623-g002.tif"/>
</fig>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>The structure of <bold>(A)</bold> rutin (<bold>1</bold>) and <bold>(B)</bold> quercetin (<bold>2</bold>).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g003.tif"/>
</fig>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Retention time (t<sub>R</sub>) of quercetin and rutin in 10&#xa0;mg <italic>Parkia speciosa</italic> crude extract compared to standard compounds.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th colspan="2" align="center">Retention time, t<sub>R</sub> (min)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Sample</td>
<td align="center">Quercetin</td>
<td align="center">Rutin</td>
</tr>
<tr>
<td align="left">Standard</td>
<td align="char" char="plusmn">6.168&#x20;&#xb1; 0.070</td>
<td align="char" char="plusmn">3.348&#x20;&#xb1; 0.025</td>
</tr>
<tr>
<td align="left">
<italic>P. speciosa</italic> extract</td>
<td align="char" char="plusmn">6.461&#x20;&#xb1; 0.171</td>
<td align="char" char="plusmn">3.551&#x20;&#xb1; 0.064</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Values reported as mean&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3). Each sample was measured at least three times on three different&#x20;days.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>Calibration curves for <bold>(A)</bold> rutin and <bold>(B)</bold> quercetin.</p>
</caption>
<graphic xlink:href="fphar-12-741623-g004.tif"/>
</fig>
<table-wrap id="T2" position="float">
<label>TABLE 2</label>
<caption>
<p>Concentration of quercetin and rutin in 10&#xa0;mg <italic>Parkia speciosa</italic> crude extract.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th align="left"/>
<th align="center">Area under the curve</th>
<th align="center">Concentration (&#xb5;g/ml)</th>
<th align="center">Percentage (%)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Rutin</td>
<td align="char" char="plusmn">4,603,554&#x20;&#xb1; 250,,072</td>
<td align="char" char="plusmn">158.35&#x20;&#xb1; 7.02</td>
<td align="char" char=".">1.58</td>
</tr>
<tr>
<td align="left">Quercetin</td>
<td align="char" char="plusmn">1,168,863&#x20;&#xb1; 86,994</td>
<td align="char" char="plusmn">20.60&#x20;&#xb1; 1.53</td>
<td align="char" char=".">0.21</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Values reported as mean&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3). Each sample was measured at least three times on three different&#x20;days.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="s3-2">
<title>Extract Cytotoxicity</title>
<p>Treatment with 0.1% DMSO alone had no effect on cell viability as compared to the control (data not shown), indicating that its use as a vehicle for <italic>P. speciosa</italic> extract did not contribute to cytotoxicity. The median inhibitory concentration (IC<sub>50</sub>) of the extract was approximately 108.35&#xa0;&#x3bc;g/ml (<xref ref-type="fig" rid="F5">Figure&#x20;5</xref>). Subsequent experiments used sub-IC<sub>50</sub> extract concentrations.</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>Cell viability of H9c2 cells after 24&#xa0;h exposure to <italic>Parkia speciosa</italic> empty pod extract at increasing concentrations. &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control. Results are presented as the mean&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g005.tif"/>
</fig>
</sec>
<sec id="s3-3">
<title>Optimizing Extract Concentration for Antihypertrophic Activity</title>
<p>Ang II-induced cardiomyocyte hypertrophy was significantly alleviated with 6.25, 12.5, 25, and 50&#xa0;&#x3bc;g/ml extract (<xref ref-type="fig" rid="F6">Figure&#x20;6</xref>). Cell size was significantly reduced at 100&#xa0;&#x3bc;g/ml extract compared to both the control and Ang II treatments (<italic>p</italic>&#x20;&#x3c; 0.05). Based on these findings, 12.5, 25, and 50&#xa0;&#x3bc;g/ml extract were used in the subsequent experiments.</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Effect of various concentrations of <italic>Parkia speciosa</italic> empty pod extract on cell size in H9c2 cells exposed to Ang II (600&#xa0;nM) for 24&#xa0;h. <bold>(A)</bold> Representative immunofluorescent image (magnification &#xd7; 100) and <bold>(B)</bold> quantitative analysis of immunofluorescent cells. &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control (no treatment) group. &#x23;<italic>p</italic>&#x20;&#x3c; 0.05 vs. Ang II group. Bars represent the mean&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g006.tif"/>
</fig>
</sec>
<sec id="s3-4">
<title>Cell Size and BNP Levels</title>
<p>Ang II-treated cells showed a significant increase in cell size (1.52&#x20;&#xb1; 0.04 times) and cellular BNP levels (50.49&#x20;&#xb1; 1.16&#xa0;ng/mg protein) compared to the control (27.29&#x20;&#xb1; 2.08&#xa0;ng/mg protein) (<xref ref-type="fig" rid="F7">Figure&#x20;7</xref>). Treatment with valsartan or the selected extract concentrations significantly reduced Ang II-induced changes in cell size and BNP levels (<italic>p</italic>&#x20;&#x3c; 0.05). There were no significant differences in these effects across the three extract concentrations or valsartan treatments. Treatment with 50&#xa0;&#x3bc;g/ml extract alone did not significantly affect cell size or BNP levels.</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>Effect of <italic>Parkia speciosa</italic> empty pod extract (&#x3bc;g/ml) or valsartan (20&#xa0;&#x3bc;M, positive control) co-incubation on Ang II (600&#xa0;nM)-induced H9c2 cell hypertrophy seen in <bold>(A)</bold> representative immunofluorescent-stained cells (magnification &#xd7; 100), <bold>(B)</bold> cell surface area, and <bold>(C)</bold> B-type natriuretic peptide (BNP) after 24&#xa0;h &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control (no treatment) group. &#x23;<italic>p</italic>&#x20;&#x3c; 0.05 vs. Ang II group. Results are presented as the mean&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g007.tif"/>
</fig>
</sec>
<sec id="s3-5">
<title>Intracellular ROS Levels and NOX and SOD Activities</title>
<p>While Ang II significantly increased the intracellular ROS levels and NOX activity and decreased the SOD activity in H9c2 cells compared to the control (<xref ref-type="fig" rid="F8">Figures 8A&#x2013;C</xref>), co-treatment with valsartan or the selected extract concentrations prevented these effects. There were no significant differences in intracellular ROS levels across the three extract concentrations. SOD activity was rescued similarly across all treatments. Treatment with 50&#xa0;&#x3bc;g/ml extract alone did not significantly affect these parameters.</p>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption>
<p>
<bold>(A)</bold> Cellular reactive oxygen species (ROS) level, <bold>(B)</bold> NADPH oxidase (NOX) activities, and <bold>(C)</bold> superoxide dismutase (SOD) activities in cells co-treated with Ang II (600&#xa0;nM) and three concentrations of <italic>Parkia speciosa</italic> extract (&#x3bc;g/ml) or valsartan (20&#xa0;&#x3bc;M, positive control) for 24&#xa0;h &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control (no treatment) group. &#x23;<italic>p</italic>&#x20;&#x3c; 0.05 vs. Ang II group. Bars represent means&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g008.tif"/>
</fig>
</sec>
<sec id="s3-6">
<title>Cellular iNOS and Nitrite Levels</title>
<p>Ang II significantly increased H9c2 cellular iNOS levels (0.016&#x20;&#xb1; 0.002&#xa0;pg/mg protein, <italic>p</italic>&#x20;&#x3c; 0.05) compared to the control (0.008&#x20;&#xb1; 0.001&#xa0;pg/mg protein) (<xref ref-type="fig" rid="F9">Figure&#x20;9A</xref>). While co-treatment with <italic>P. speciosa</italic> empty pod extract did not prevent this change, iNOS levels were rescued with valsartan (<italic>p</italic>&#x20;&#x3c; 0.05). Exposure to Ang II significantly reduced H9c2 cellular nitrite levels (18.96&#x20;&#xb1; 3.49&#xa0;mM/mg protein, <italic>p</italic>&#x20;&#x3c; 0.05) compared to the control (31.79&#x20;&#xb1; 4.29&#xa0;mM/mg protein) (<xref ref-type="fig" rid="F9">Figure&#x20;9B</xref>). Neither valsartan nor the selected extract concentrations significantly prevented this change (<italic>p</italic>&#x20;&#x3e; 0.05). Treatment with 50&#xa0;&#x3bc;g/ml extract alone did not significantly affect these parameters.</p>
<fig id="F9" position="float">
<label>FIGURE 9</label>
<caption>
<p>Cellular <bold>(A)</bold> inducible nitric oxide synthase (iNOS) activity and <bold>(B)</bold> nitrite level in groups co-treated with Ang II (600&#xa0;nM) and three concentrations of <italic>Parkia speciosa</italic> empty pod extract or valsartan (20&#xa0;&#x3bc;M, positive control) for 24&#xa0;h &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control (no treatment) group. &#x23;<italic>p</italic>&#x20;&#x3c; 0.05 vs. Ang II cells. Bars represent means&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g009.tif"/>
</fig>
</sec>
<sec id="s3-7">
<title>MAPK Protein Expression</title>
<p>After 24&#xa0;h, Ang II-treated H9c2 cells expressed elevated levels of phosphorylated ERK1/2, p38, and JNK (<italic>p</italic>&#x20;&#x3c; 0.05) (<xref ref-type="fig" rid="F10">Figure&#x20;10</xref>). Co-treatment with all three selected extract concentrations prevented these elevated levels to a similar extent, while valsartan only rescued <italic>p</italic>-JNK expression. Treatment with 50&#xa0;&#x3bc;g/ml extract alone did not significantly affect MAPK protein expression.</p>
<fig id="F10" position="float">
<label>FIGURE 10</label>
<caption>
<p>Effects of <italic>Parkia speciosa</italic> empty pod extract and valsartan (20&#xa0;&#x3bc;M, positive control) on <bold>(A)</bold> representative immunoblots via Western blot analysis, quantitative analysis of phosphorylated <bold>(B)</bold> extracellular signal-related kinases (P-ERK1/2), <bold>(C)</bold> p38 kinase (P-p38), and <bold>(D)</bold> c-Jun N-terminal kinases (P-JNK) protein expressions in H9c2 cells that were exposed to Ang II (600&#xa0;nM) for 24&#xa0;h &#x2a;<italic>p</italic>&#x20;&#x3c; 0.05 vs. control (no treatment) group. &#x23;<italic>p</italic>&#x20;&#x3c; 0.05 vs. Ang II cells. Bars represent means&#x20;&#xb1; SEM (<italic>n</italic>&#x20;&#x3d; 3).</p>
</caption>
<graphic xlink:href="fphar-12-741623-g010.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>Exposure to Ang II induced an ROS/NO axis imbalance, apparent in augmented intracellular superoxide/ROS (O<sub>2</sub>
<sup>&#x2212;&#x2022;</sup>/ROS) levels, increased NOX and iNOS activities, and decreased SOD activity. This imbalance led to cardiomyocyte hypertrophy, which manifested in increased cell size and elevated BNP levels, indicative of ventricular dysfunction. Ang II is reported to promote cardiac hypertrophy by stimulating growth factors (<xref ref-type="bibr" rid="B13">Ding et&#x20;al., 2019</xref>). The findings of this study confirm previous reports regarding the involvement of oxidative stress in the development of Ang II-induced cardiomyocyte hypertrophy (<xref ref-type="bibr" rid="B15">Guan et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B18">Hong et&#x20;al., 2019</xref>). Binding of Ang II to the Ang II type 1 receptor (AT<sub>1</sub>R) enhances the activation of NOX (<xref ref-type="bibr" rid="B27">Masi et&#x20;al., 2019</xref>), which is a substantial producer of ROS, including O<sub>2</sub>
<sup>&#x2212;&#x2022;</sup> (<xref ref-type="bibr" rid="B49">Wen et&#x20;al., 2019</xref>). The elevated levels of O<sub>2</sub>
<sup>&#x2212;&#x2022;</sup> detected in the H9c2 cells depleted the antioxidant SOD, which functions as a first line of defense against cardiomyocyte hypertrophy by converting the radical anion into water and hydrogen peroxide (<xref ref-type="bibr" rid="B5">Campos-Shimada et&#x20;al., 2020</xref>).</p>
<p>The detrimental effects of Ang II on the ROS/NO axis were prevented by co-treating with <italic>P. speciosa</italic> empty pod extract. Notably, the cardioprotective effects of the extract were not concentration-dependent. These findings highlight the extract&#x2019;s antioxidant properties, in agreement with previous work (<xref ref-type="bibr" rid="B23">Kamisah et&#x20;al., 2017</xref>; <xref ref-type="bibr" rid="B17">Gui et&#x20;al., 2019b</xref>). The empty pod extract was employed in this study as it is reported to contain a higher antioxidant capacity than the seed extract (<xref ref-type="bibr" rid="B22">Kamisah et&#x20;al., 2013</xref>; <xref ref-type="bibr" rid="B56">Zaini and Mustaffa 2017</xref>). The cardioprotective effects of the extract are likely associated with its flavonoid content, with rutin (<bold>1</bold>) and quercetin (<bold>2</bold>) identified among its primary metabolites in this work. Studies have reported the presence of other flavonoids (<xref ref-type="bibr" rid="B24">Ko et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B14">Ghasemzadeh et&#x20;al., 2018</xref>) not detected in this work, likely due to differences in chromatographic analysis. HPLC analysis in this study was unable to identify the remaining contents in the extract unambiguously, which may have included other flavonoids and phenolic acids. As these other metabolites could play a role in the cardioprotective effects of <italic>P. speciosa</italic> extract, additional studies should focus on their identification. The purpose of identifying the metabolites in this study was to aid in understanding how the extract could provide its cardioprotective effects. To determine the specific mechanisms by which the extract prevents cardiomyocyte hypertrophy, studies should investigate the activity of the individual extract components. For example, previous work using commercial quercetin and rutin demonstrated their antioxidant and antihypertrophic activities in Ang II-treated cardiomyocytes (<xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>). Flavonoids, such as quercetin and rutin, can exert their antioxidant effects by binding SOD and increasing its activity (<xref ref-type="bibr" rid="B12">Cos et&#x20;al., 1998</xref>; <xref ref-type="bibr" rid="B60">Zhuang et&#x20;al., 2016</xref>). Metabolites in the extract may also directly prevent the prooxidant effects of Ang II itself.</p>
<p>Another source of cellular ROS is iNOS, which is upregulated in response to increased microenvironmental inflammation (<xref ref-type="bibr" rid="B11">Cinelli et&#x20;al., 2020</xref>). Ang II was found to activate iNOS activity in this work, consistent with previous findings (<xref ref-type="bibr" rid="B35">Restini et&#x20;al., 2017</xref>). Ang II promotes inflammation via activation of the NF-&#x3ba;B signaling pathway and the release of tumor necrosis factor-&#x3b1; (TNF&#x3b1;) and interleukin 6 (<xref ref-type="bibr" rid="B19">Huang et&#x20;al., 2017</xref>). However, this study found that despite increasing iNOS activity, exposure to Ang II decreased NO levels. NO can react with O<sub>2</sub>
<sup>&#x2212;&#x2022;</sup> to generate peroxynitrite radicals (<xref ref-type="bibr" rid="B34">Radi, 2018</xref>), reducing its own level. Co-treatment with the extract did not prevent the harmful effects of Ang II on iNOS activity or NO levels. However, ethyl acetate fractions of the extract have been reported to reduce both parameters in cardiomyocytes and human umbilical vein endothelial cells exposed to TNF&#x3b1; (<xref ref-type="bibr" rid="B30">Mustafa et&#x20;al., 2018</xref>; <xref ref-type="bibr" rid="B16">Gui JS. et&#x20;al., 2019</xref>). The discrepancy between these findings could stem from differences in the models and the type of fraction used. Rutin (50&#xa0;&#xb5;M) and quercetin (331&#xa0;&#xb5;M) have been reported to reverse the effects of Ang II on iNOS activity and NO levels (<xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>). The highest concentration of extract used in this work (50&#xa0;&#x3bc;g/ml) contained much lower concentrations of the flavonoids [0.790&#xa0;&#x3bc;g/ml rutin (<bold>1</bold>) and 0.105&#xa0;&#x3bc;g/ml quercetin (<bold>2</bold>)], possibly rationalizing the poor protection.</p>
<p>Valsartan was used as the positive control in this work due to its ability to reduce cardiomyocyte hypertrophy and BNP levels (<xref ref-type="bibr" rid="B50">Xu et&#x20;al., 2015</xref>; Wu et&#x20;al., 2017), as well as its use in the clinical management of heart failure (<xref ref-type="bibr" rid="B47">Vaduganathan et&#x20;al., 2020</xref>). The antioxidant activity of valsartan has manifested in suppressed ROS levels (<xref ref-type="bibr" rid="B6">Chen et&#x20;al., 2014</xref>; <xref ref-type="bibr" rid="B44">Tian et&#x20;al., 2018</xref>). Valsartan displayed similar protective effects against Ang II-induced cardiomyocyte hypertrophy and oxidative stress in this study. It acts as an AT<sub>1</sub>R blocker to prevent Ang II receptor activation and downstream pathological events. Valsartan demonstrated better anti-inflammatory properties than the extract in suppressing the negative effects of Ang II. Previous work reported similar beneficial effects of valsartan on iNOS expression (<xref ref-type="bibr" rid="B28">Mohammed et&#x20;al., 2015</xref>).</p>
<p>Ang II treatment was found to increase the levels of phosphorylated ERK1/2, JNK1/2, and p38, consistent with previous studies (<xref ref-type="bibr" rid="B41">Sriramula and Francis, 2015</xref>; <xref ref-type="bibr" rid="B54">Yokota and Wang, 2016</xref>; <xref ref-type="bibr" rid="B26">Lu et&#x20;al., 2020</xref>). Exposure to Ang II triggers signal transduction, which activates the MAPK cascade via phosphorylation of ERK1/2, JNK, and p38 prior to nuclear translocation. This leads to the activation of numerous transcription factors (<xref ref-type="bibr" rid="B58">Zhang et&#x20;al., 2003</xref>), some of which regulate the expression of hypertrophic gene products, such as BNP (<xref ref-type="bibr" rid="B32">Nayer et&#x20;al., 2014</xref>).</p>
<p>Treatment with <italic>P. speciosa</italic> extract reduced the expression of P-ERK, P-p38, and P-JNK, suggesting that its antihypertrophic activity may function via modulation of the MAPK signaling pathway. The extract may prevent Ang II from binding AT<sub>1</sub>R, suppressing downstream events leading to hypertrophy, although this requires further investigation. Quercetin (<bold>2</bold>) has been shown to block activation of the MAPK signaling pathway. As rutin (<bold>1</bold>) lacks this property (<xref ref-type="bibr" rid="B37">Siti et&#x20;al., 2021</xref>), the inhibitory effects of the extract on the MAPK signaling pathway are most likely due to quercetin and/or other unidentified phytochemical contents. Nevertheless, both rutin and quercetin have been reported to ameliorate cardiac hypertrophy via multiple routes, including apoptosis, autophagy, and prohypertrophic pathways (<xref ref-type="bibr" rid="B40">Siti et&#x20;al., 2020a</xref>; <xref ref-type="bibr" rid="B39">Siti et&#x20;al., 2020b</xref>). Therefore, rutin may confer protection via mechanisms other than inhibition of MAPK signaling.</p>
<p>Apart from reducing P-JNK levels, valsartan had no effect on MAPK signaling. Similar effects have been reported for losartan, another AT<sub>1</sub>R blocker, in a study on myocardial hypertrophy in hypertensive rats (<xref ref-type="bibr" rid="B20">Izumi et&#x20;al., 2000</xref>). Valsartan has been shown to mitigate the Ang II-induced activation of p38, ERK1/2, and JNK in HL-1 cardiomyocytes (<xref ref-type="bibr" rid="B25">Liu et&#x20;al., 2015</xref>). These contradictory findings could derive from differences in the types of cells or models used. The findings in this work suggest that the cardioprotective effect of valsartan on cardiomyocyte hypertrophy occurs via modulation of the Ang II/ROS/NO axis rather than regulation of the MAPK pathway.</p>
<p>Few studies apart from this one have investigated the cardioprotective potential of <italic>P. speciosa</italic> extract. This study demonstrated the protective effects of <italic>P. speciosa</italic> empty pod extract against Ang II-induced cardiomyocyte hypertrophy in H9c2 cells (<xref ref-type="fig" rid="F11">Figure&#x20;11</xref>), and may support the traditional use of the plant in ameliorating cardiac problems. The antihypertrophic properties of the extract were investigated by cotreating cardiomyocytes with extract and Ang II. While this study presents promising findings, the antihypertrophic effects of the extract should be investigated as a post-treatment in future investigations. Results from this work suggest that the extract could be used as a supplement to ameliorate cardiac remodeling, although further studies are required before clinical use. Future research should also explore other possible mechanisms of action, such as the extract&#x2019;s effects on calcium regulatory proteins or other pathways, including the specificity protein-1/GATA binding protein-4 (Sp1/GATA4) or phosphatidylinositol 3-kinase/protein kinase B/glycogen synthase kinase-3&#x3b2; (PI3K/Akt/GSK-3&#x3b2;) signaling pathways in hypertrophied cardiomyocytes.</p>
<fig id="F11" position="float">
<label>FIGURE 11</label>
<caption>
<p>Schematic summary of the possible site of cardioprotective effects of <italic>Parkia speciosa</italic> empty pod extract. AT<sub>1</sub>R, angiotensin II type 1 receptor; BNP, B-type natriuretic peptide; cGMP, cyclic guanosine monophosphate; eNOS, endothelial nitric oxide synthase; ERK1/2, extracellular signal-related kinase; iNOS, inducible nitric oxide synthase; JNK, c-Jun N-terminal kinase; MEF2, myocyte enhancer factor-2; NFAT, nuclear factor of activated T-cells; NF-&#x3ba;B, nuclear factor kappa B; NO, nitric oxide; PKG, protein kinase G; p38, p38 kinase; P-ERK1/2, phosphorylated extracellular signal-related kinase (ERK1/2), P-JNK, phosphorylated c-Jun N-terminal kinase; P-p38, phosphorylated p38 kinase; SOD, superoxide dismutase; SRF, serum response factor; &#x22a5;, inhibition.</p>
</caption>
<graphic xlink:href="fphar-12-741623-g011.tif"/>
</fig>
</sec>
<sec sec-type="conclusion" id="s5">
<title>Conclusion</title>
<p>
<italic>P. speciosa</italic> empty pod extract afforded protection against Ang II-induced cardiomyocyte hypertrophy by mitigating oxidative stress and modulating the MAPK signaling pathway. These effects may be attributed to its rich rutin (<bold>1</bold>) and quercetin (<bold>2</bold>) content. Notably, the protective effects of the extract appear to occur via mechanisms distinct from valsartan.</p>
</sec>
</body>
<back>
<sec id="s6">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="s7">
<title>Author Contributions</title>
<p>HS performed the experiments, as well as wrote the article. JJ supervised the extraction and phytochemical screening. AA and YK supervised the study. All authors designed the study, revised the article and approved its submission.</p>
</sec>
<sec id="s8">
<title>Funding</title>
<p>This study received a funding from the Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2019-021).</p>
</sec>
<sec sec-type="COI-statement" id="s9">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s10">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ack>
<p>The authors would like to acknowledge technical assistance given by En Fadhlullah Zuhair Japar Sidik and Puan Juliana Abdul Hamid.</p>
</ack>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Al-Mazroua</surname>
<given-names>H. A.</given-names>
</name>
<name>
<surname>Al-Rasheed</surname>
<given-names>N. M.</given-names>
</name>
<name>
<surname>Korashy</surname>
<given-names>H. M.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Downregulation of the Cardiotrophin-1 Gene Expression by Valsartan and Spironolactone in Hypertrophied Heart Rats <italic>In Vivo</italic> and Rat Cardiomyocyte H9c2 Cell Line <italic>In Vitro</italic>: A Novel Mechanism of Cardioprotection</article-title>. <source>J.&#x20;Cardiovasc. Pharmacol.</source> <volume>61</volume> (<issue>4</issue>), <fpage>337</fpage>&#x2013;<lpage>344</lpage>. <pub-id pub-id-type="doi">10.1097/FJC.0b013e318283a565</pub-id> </citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Azliza</surname>
<given-names>M. A.</given-names>
</name>
<name>
<surname>Ong</surname>
<given-names>H. C.</given-names>
</name>
<name>
<surname>Vikineswary</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Noorlidah</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Haron</surname>
<given-names>N. W.</given-names>
</name>
</person-group> (<year>2012</year>). <article-title>Ethno-medicinal Resources Used by the Temuan in Ulu Kuang Village</article-title>. <source>Stud. Ethno-Medicine</source> <volume>6</volume> (<issue>1</issue>), <fpage>17</fpage>&#x2013;<lpage>22</lpage>. <pub-id pub-id-type="doi">10.1080/09735070.2012.11886415</pub-id> </citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bernardo</surname>
<given-names>B. C.</given-names>
</name>
<name>
<surname>McMullen</surname>
<given-names>J.&#x20;R.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Molecular Aspects of Exercise-Induced Cardiac Remodeling</article-title>. <source>Cardiol. Clin.</source> <volume>34</volume> (<issue>4</issue>), <fpage>515</fpage>&#x2013;<lpage>530</lpage>. <pub-id pub-id-type="doi">10.1016/j.ccl.2016.06.002</pub-id> </citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Beyer</surname>
<given-names>W. F.</given-names>
</name>
<name>
<surname>Fridovich</surname>
<given-names>I.</given-names>
</name>
</person-group> (<year>1987</year>). <article-title>Assaying for Superoxide Dismutase Activity: Some Large Consequences of Minor Changes in Conditions</article-title>. <source>Anal. Biochem.</source> <volume>161</volume> (<issue>2</issue>), <fpage>559</fpage>&#x2013;<lpage>566</lpage>. <pub-id pub-id-type="doi">10.1016/0003-2697(87)90489-1</pub-id> </citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Campos-Shimada</surname>
<given-names>L. B.</given-names>
</name>
<name>
<surname>Hideo Gilglioni</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Fernandes Garcia</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Rizato Martins-Maciel</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Luiza Ishii-Iwamoto</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Luzia Salgueiro-Pagadigorria</surname>
<given-names>C.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Superoxide Dismutase: a Review and a Modified Protocol for Activities Measurements in Rat Livers</article-title>. <source>Arch. Physiol. Biochem.</source> <volume>126</volume> (<issue>4</issue>), <fpage>292</fpage>&#x2013;<lpage>299</lpage>. <pub-id pub-id-type="doi">10.1080/13813455.2018.1520891</pub-id> </citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Pan</surname>
<given-names>S. Q.</given-names>
</name>
<name>
<surname>Shen</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Pan</surname>
<given-names>S. F.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>X. M.</given-names>
</name>
<name>
<surname>He</surname>
<given-names>Q. Y.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Puerarin Inhibits Angiotensin II-Induced Cardiac Hypertrophy via the Redox-Sensitive ERK1/2, P38 and NF-&#x39a;b Pathways</article-title>. <source>Acta Pharmacol. Sin.</source> <volume>35</volume> (<issue>4</issue>), <fpage>463</fpage>&#x2013;<lpage>475</lpage>. <pub-id pub-id-type="doi">10.1038/aps.2013.185</pub-id> </citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Ge</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhai</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>Y.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>Delphinidin Attenuates Pathological Cardiac Hypertrophy via the AMPK/NOX/MAPK Signaling Pathway</article-title>. <source>Aging (Albany NY)</source> <volume>12</volume> (<issue>6</issue>), <fpage>5362</fpage>&#x2013;<lpage>5383</lpage>. <pub-id pub-id-type="doi">10.18632/aging.102956</pub-id> </citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cheng</surname>
<given-names>C. I.</given-names>
</name>
<name>
<surname>Lee</surname>
<given-names>Y. H.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>P. H.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>Y. C.</given-names>
</name>
<name>
<surname>Chou</surname>
<given-names>M. H.</given-names>
</name>
<name>
<surname>Kao</surname>
<given-names>Y. H.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Cobalt Chloride Induces RhoA/ROCK Activation and Remodeling Effect in H9c2 Cardiomyoblasts: Involvement of PI3K/Akt and MAPK Pathways</article-title>. <source>Cell Signal</source> <volume>36</volume>, <fpage>25</fpage>&#x2013;<lpage>33</lpage>. <pub-id pub-id-type="doi">10.1016/j.cellsig.2017.04.013</pub-id> </citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chiang</surname>
<given-names>J.&#x20;T.</given-names>
</name>
<name>
<surname>Badrealam</surname>
<given-names>K. F.</given-names>
</name>
<name>
<surname>Shibu</surname>
<given-names>M. A.</given-names>
</name>
<name>
<surname>Kuo</surname>
<given-names>C. H.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>C. Y.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>B. C.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>
<italic>Eriobotrya Japonica</italic> Ameliorates Cardiac Hypertrophy in H9c2 Cardiomyoblast and in Spontaneously Hypertensive Rats</article-title>. <source>Environ. Toxicol.</source> <volume>33</volume> (<issue>11</issue>), <fpage>1113</fpage>&#x2013;<lpage>1122</lpage>. <pub-id pub-id-type="doi">10.1002/tox.22589</pub-id> </citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cho</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Cho</surname>
<given-names>H. W.</given-names>
</name>
<name>
<surname>Woo</surname>
<given-names>K. W.</given-names>
</name>
<name>
<surname>Jeong</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Lim</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Park</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>
<italic>Nelumbo nucifera</italic> Receptaculum Extract Suppresses Angiotensin II-Induced Cardiomyocyte Hypertrophy</article-title>. <source>Molecules</source> <volume>24</volume> (<issue>9</issue>), <fpage>1647</fpage>. <pub-id pub-id-type="doi">10.3390/molecules24091647</pub-id> </citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cinelli</surname>
<given-names>M. A.</given-names>
</name>
<name>
<surname>Do</surname>
<given-names>H. T.</given-names>
</name>
<name>
<surname>Miley</surname>
<given-names>G. P.</given-names>
</name>
<name>
<surname>Silverman</surname>
<given-names>R. B.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>Inducible Nitric Oxide Synthase: Regulation, Structure, and Inhibition</article-title>. <source>Med. Res. Rev.</source> <volume>40</volume> (<issue>1</issue>), <fpage>158</fpage>&#x2013;<lpage>189</lpage>. <pub-id pub-id-type="doi">10.1002/med.21599</pub-id> </citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cos</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Ying</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Calomme</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Hu</surname>
<given-names>J.&#x20;P.</given-names>
</name>
<name>
<surname>Cimanga</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Van Poel</surname>
<given-names>B.</given-names>
</name>
<etal/>
</person-group> (<year>1998</year>). <article-title>Structure-activity Relationship and Classification of Flavonoids as Inhibitors of Xanthine Oxidase and Superoxide Scavengers</article-title>. <source>J.&#x20;Nat. Prod.</source> <volume>61</volume> (<issue>1</issue>), <fpage>71</fpage>&#x2013;<lpage>76</lpage>. <pub-id pub-id-type="doi">10.1021/np970237h</pub-id> </citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ding</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Luo</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Han</surname>
<given-names>L.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Klotho Inhibits Angiotensin II-Induced Cardiac Hypertrophy, Fibrosis, and Dysfunction in Mice through Suppression of Transforming Growth Factor-&#x392;1 Signaling Pathway</article-title>. <source>Eur. J.&#x20;Pharmacol.</source> <volume>859</volume>, <fpage>172549</fpage>. <pub-id pub-id-type="doi">10.1016/j.ejphar.2019.172549</pub-id> </citation>
</ref>
<ref id="B14">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ghasemzadeh</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Jaafar</surname>
<given-names>H. Z. E.</given-names>
</name>
<name>
<surname>Bukhori</surname>
<given-names>M. F. M.</given-names>
</name>
<name>
<surname>Rahmat</surname>
<given-names>M. H.</given-names>
</name>
<name>
<surname>Rahmat</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Assessment and Comparison of Phytochemical Constituents and Biological Activities of Bitter Bean (Parkia Speciosa Hassk.) Collected from Different Locations in Malaysia</article-title>. <source>Chem. Cent. J.</source> <volume>12</volume> (<issue>1</issue>), <fpage>12</fpage>. <pub-id pub-id-type="doi">10.1186/s13065-018-0377-6</pub-id> </citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Guan</surname>
<given-names>X. H.</given-names>
</name>
<name>
<surname>Hong</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>X. H.</given-names>
</name>
<name>
<surname>Xiao</surname>
<given-names>Y. F.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>T. T.</given-names>
</name>
<etal/>
</person-group> (<year>2017</year>). <article-title>CD38 Promotes Angiotensin II-Induced Cardiac Hypertrophy</article-title>. <source>J.&#x20;Cel. Mol. Med.</source> <volume>21</volume> (<issue>8</issue>), <fpage>1492</fpage>&#x2013;<lpage>1502</lpage>. <pub-id pub-id-type="doi">10.1111/jcmm.13076</pub-id> </citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gui</surname>
<given-names>J.&#x20;S.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Jubri</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2019a</year>). <article-title>Parkia Speciosa Empty Pod Extract Exerts Anti-inflammatory Properties by Modulating NF&#x3ba;B and MAPK Pathways in Cardiomyocytes Exposed to Tumor Necrosis Factor-&#x3b1;</article-title>. <source>Cytotechnology</source> <volume>71</volume>, <fpage>79</fpage>&#x2013;<lpage>89</lpage>. <pub-id pub-id-type="doi">10.1007/s10616-018-0267-8</pub-id> </citation>
</ref>
<ref id="B17">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gui</surname>
<given-names>J.&#x20;S.</given-names>
</name>
<name>
<surname>Mustafa</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Jubri</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2019b</year>). <article-title>Modulation of NOX4 and MAPK Signalling Pathways by <italic>Parkia Speciosa</italic> Empty Pods in H9c2 Cardiomyocytes Exposed to H<sub>2</sub>O<sub>2</sub>
</article-title>. <source>Indian J.&#x20;Pharm. Sci.</source> <volume>81</volume>, <fpage>1029</fpage>&#x2013;<lpage>1035</lpage>. <pub-id pub-id-type="doi">10.36468/pharmaceutical-sciences.600</pub-id> </citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hong</surname>
<given-names>E. Y.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>T. Y.</given-names>
</name>
<name>
<surname>Hong</surname>
<given-names>G. U.</given-names>
</name>
<name>
<surname>Kang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Lee</surname>
<given-names>J.&#x20;Y.</given-names>
</name>
<name>
<surname>Park</surname>
<given-names>J.&#x20;Y.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Inhibitory Effects of Roseoside and Icariside E4 Isolated from a Natural Product Mixture (No-Ap) on the Expression of Angiotensin Ii Receptor 1 and Oxidative Stress in Angiotensin II-Stimulated H9C2 Cells</article-title>. <source>Molecules</source> <volume>24</volume> (<issue>3</issue>), <fpage>414</fpage>. <pub-id pub-id-type="doi">10.3390/molecules24030414</pub-id> </citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Huang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y.</given-names>
</name>
<etal/>
</person-group> (<year>2017</year>). <article-title>Ophiopogonin D and EETs Ameliorate Ang II-Induced Inflammatory Responses via Activating PPAR&#x3b1; in HUVECs</article-title>. <source>Biochem. Biophys. Res. Commun.</source> <volume>490</volume> (<issue>2</issue>), <fpage>123</fpage>&#x2013;<lpage>133</lpage>. <pub-id pub-id-type="doi">10.1016/j.bbrc.2017.06.007</pub-id> </citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Izumi</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Zhan</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Namba</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Yasumoto</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Iwao</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>2000</year>). <article-title>Important Role of Angiotensin II-Mediated C-Jun NH(2)-terminal Kinase Activation in Cardiac Hypertrophy in Hypertensive Rats</article-title>. <source>Hypertension</source> <volume>36</volume> (<issue>4</issue>), <fpage>511</fpage>&#x2013;<lpage>516</lpage>. <pub-id pub-id-type="doi">10.1161/01.hyp.36.4.511</pub-id> </citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jeong</surname>
<given-names>M. H.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>S. J.</given-names>
</name>
<name>
<surname>Kang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Park</surname>
<given-names>K. W.</given-names>
</name>
<name>
<surname>Park</surname>
<given-names>W. J.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>S. Y.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Cucurbitacin I Attenuates Cardiomyocyte Hypertrophy via Inhibition of Connective Tissue Growth Factor (CCN2) and TGF- &#x3b2;/Smads Signalings</article-title>. <source>PLoS One</source> <volume>10</volume>, <fpage>e0136236</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0136236</pub-id> </citation>
</ref>
<ref id="B22">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Othman</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Qodriyah</surname>
<given-names>H. M.</given-names>
</name>
<name>
<surname>Jaarin</surname>
<given-names>K.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Parkia Speciosa Hassk.: A Potential Phytomedicine</article-title>. <source>Evid. Based Complement. Alternat Med.</source> <volume>2013</volume>, <fpage>709028</fpage>. <pub-id pub-id-type="doi">10.1155/2013/709028</pub-id> </citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zuhair</surname>
<given-names>J.&#x20;S. F.</given-names>
</name>
<name>
<surname>Juliana</surname>
<given-names>A. H.</given-names>
</name>
<name>
<surname>Jaarin</surname>
<given-names>K.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>
<italic>Parkia Speciosa</italic> Empty Pod Prevents Hypertension and Cardiac Damage in Rats Given N(G)-nitro-L-arginine Methyl Ester</article-title>. <source>Biomed. Pharmacother.</source> <volume>96</volume>, <fpage>291</fpage>&#x2013;<lpage>298</lpage>. <pub-id pub-id-type="doi">10.1016/j.biopha.2017.09.095</pub-id> </citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ko</surname>
<given-names>H.-J.</given-names>
</name>
<name>
<surname>Ang</surname>
<given-names>L.-H.</given-names>
</name>
<name>
<surname>Ng</surname>
<given-names>L.-T.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Antioxidant Activities and Polyphenolic Constituents of Bitter BeanParkia Speciosa</article-title>. <source>Int. J.&#x20;Food Properties</source> <volume>17</volume> (<issue>9</issue>), <fpage>1977</fpage>&#x2013;<lpage>1986</lpage>. <pub-id pub-id-type="doi">10.1080/10942912.2013.775152</pub-id> </citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Geng</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Yun</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Yan</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Valsartan Reduced Atrial Fibrillation Susceptibility by Inhibiting Atrial Parasympathetic Remodeling through MAPKs/Neurturin Pathway</article-title>. <source>Cell. Physiol. Biochem.</source> <volume>36</volume> (<issue>5</issue>), <fpage>2039</fpage>&#x2013;<lpage>2050</lpage>. <pub-id pub-id-type="doi">10.1159/000430171</pub-id> </citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lu</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Sun</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Peng</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Jiang</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Yuan</surname>
<given-names>H.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>Angiotensin II-Induced Vascular Remodeling and Hypertension Involves Cathepsin L/V- MEK/ERK Mediated Mechanism</article-title>. <source>Int. J.&#x20;Cardiol.</source> <volume>298</volume>, <fpage>98</fpage>&#x2013;<lpage>106</lpage>. <pub-id pub-id-type="doi">10.1016/j.ijcard.2019.09.070</pub-id> </citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Masi</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Uliana</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Virdis</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Angiotensin II and Vascular Damage in Hypertension: Role of Oxidative Stress and Sympathetic Activation</article-title>. <source>Vascul Pharmacol.</source> <volume>115</volume>, <fpage>13</fpage>&#x2013;<lpage>17</lpage>. <pub-id pub-id-type="doi">10.1016/j.vph.2019.01.004</pub-id> </citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mohammed</surname>
<given-names>H. E.</given-names>
</name>
<name>
<surname>Askar</surname>
<given-names>M. E.</given-names>
</name>
<name>
<surname>Ali</surname>
<given-names>S. I.</given-names>
</name>
<name>
<surname>Fathy</surname>
<given-names>O. M.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Effect of Rennin Inhibitors and Sngiotensin II Receptor Antagonists on Left Ventricular Hypertrophy in Renovascular Hypertensive Rats</article-title>. <source>Int. J.&#x20;Pharm. Pharm. Sci.</source> <volume>7</volume> (<issue>9</issue>), <fpage>292</fpage>&#x2013;<lpage>298</lpage>. </citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Muslin</surname>
<given-names>A. J.</given-names>
</name>
</person-group> (<year>2008</year>). <article-title>MAPK Signalling in Cardiovascular Health and Disease: Molecular Mechanisms and Therapeutic Targets</article-title>. <source>Clin. Sci. (Lond)</source> <volume>115</volume> (<issue>7</issue>), <fpage>203</fpage>&#x2013;<lpage>218</lpage>. <pub-id pub-id-type="doi">10.1042/CS20070430</pub-id> </citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mustafa</surname>
<given-names>N. H.</given-names>
</name>
<name>
<surname>Ugusman</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Anti-inflammatory Property of <italic>Parkia Speciosa</italic> Empty Pod Extract in Human Umbilical Vein Endothelial Cells</article-title>. <source>J.&#x20;App Pharm. Sci.</source> <volume>8</volume>, <fpage>152</fpage>&#x2013;<lpage>158</lpage>. <pub-id pub-id-type="doi">10.7324/JAPS.2018.8123</pub-id> </citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mustapha</surname>
<given-names>N. M.</given-names>
</name>
<name>
<surname>Tarr</surname>
<given-names>J.&#x20;M.</given-names>
</name>
<name>
<surname>Kohner</surname>
<given-names>E. M.</given-names>
</name>
<name>
<surname>Chibber</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>NADPH Oxidase versus Mitochondria-Derived ROS in Glucose-Induced Apoptosis of Pericytes in Early Diabetic Retinopathy</article-title>. <source>J.&#x20;Ophthalmol.</source> <volume>2010</volume>, <fpage>746978</fpage>. <pub-id pub-id-type="doi">10.1155/2010/746978</pub-id> </citation>
</ref>
<ref id="B32">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nayer</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Aggarwal</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Galwankar</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Utility of point-of-care Testing of Natriuretic Peptides (Brain Natriuretic Peptide and N-Terminal Pro-brain Natriuretic Peptide) in the Emergency Department</article-title>. <source>Int. J.&#x20;Crit. Illn. Inj.&#x20;Sci.</source> <volume>4</volume> (<issue>3</issue>), <fpage>209</fpage>&#x2013;<lpage>215</lpage>. <pub-id pub-id-type="doi">10.4103/2229-5151.141406</pub-id> </citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nguyen Dinh Cat</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Montezano</surname>
<given-names>A. C.</given-names>
</name>
<name>
<surname>Burger</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Touyz</surname>
<given-names>R. M.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Angiotensin II, NADPH Oxidase, and Redox Signaling in the Vasculature</article-title>. <source>Antioxid. Redox Signal.</source> <volume>19</volume> (<issue>10</issue>), <fpage>1110</fpage>&#x2013;<lpage>1120</lpage>. <pub-id pub-id-type="doi">10.1089/ars.2012.4641</pub-id> </citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Radi</surname>
<given-names>R.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Oxygen Radicals, Nitric Oxide, and Peroxynitrite: Redox Pathways in Molecular Medicine</article-title>. <source>Proc. Natl. Acad. Sci. U S A.</source> <volume>115</volume>, <fpage>5839</fpage>&#x2013;<lpage>5848</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.1804932115</pub-id> </citation>
</ref>
<ref id="B35">
<citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname>Restini</surname>
<given-names>C. B. A.</given-names>
</name>
<name>
<surname>Garcia</surname>
<given-names>A. F. E.</given-names>
</name>
<name>
<surname>Natalin</surname>
<given-names>H. M.</given-names>
</name>
<name>
<surname>Natalin</surname>
<given-names>G. M.</given-names>
</name>
<name>
<surname>Rizzi</surname>
<given-names>E.</given-names>
</name>
</person-group> (<year>2017</year>). &#x201c;<article-title>Signaling Pathways of Cardiac Remodeling Related to Angiotensin II</article-title>,&#x201d; in <source>Renin-Angiotensin System: Past, Present and Future</source>. Editor <person-group person-group-type="editor">
<name>
<surname>Tolekova</surname>
<given-names>A. N.</given-names>
</name>
</person-group>. <publisher-loc>Rijeka, Croatia</publisher-loc> <publisher-name>IntechOpen</publisher-name>, <fpage>51</fpage>&#x2013;<lpage>68</lpage>. <pub-id pub-id-type="doi">10.5772/66076</pub-id> </citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Saleh</surname>
<given-names>M. S. M.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Mustafa</surname>
<given-names>N. H.</given-names>
</name>
<name>
<surname>Ramli</surname>
<given-names>F. F.</given-names>
</name>
<name>
<surname>Asmadi</surname>
<given-names>A. Y.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>UPLC-MS-Based Metabolomics Profiling for &#x3b1;-Glucosidase Inhibiting Property of Parkia Speciosa Pods</article-title>. <source>Life</source> <volume>11</volume> (<issue>2</issue>), <fpage>78</fpage>. <pub-id pub-id-type="doi">10.3390/life11020078</pub-id> </citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Siti</surname>
<given-names>H. N.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Asmadi</surname>
<given-names>A. Y.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Rutin Modulates MAPK Pathway Differently from Quercetin in Angiotensin II-Induced H9c2 Cardiomyocyte Hypertrophy</article-title>. <source>Int. J.&#x20;Mol. Sci.</source> <volume>22</volume> (<issue>10</issue>), <fpage>5063</fpage>. <pub-id pub-id-type="doi">10.3390/ijms22105063</pub-id> </citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Siti</surname>
<given-names>H. N.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Mohamed</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Jaarin</surname>
<given-names>K.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Effects of Citrus Leaf Extract on Aortic Vascular Reactivity in Hypertensive Rats Fed Repeatedly Heated Vegetable Oil</article-title>. <source>Appl. Physiol. Nutr. Metab.</source> <volume>44</volume> (<issue>4</issue>), <fpage>373</fpage>&#x2013;<lpage>380</lpage>. <pub-id pub-id-type="doi">10.1139/apnm-2018-0175</pub-id> </citation>
</ref>
<ref id="B39">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Siti</surname>
<given-names>H. N.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Asmadi</surname>
<given-names>A. Y.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2020b</year>). <article-title>Effects of Quercetin on Cardiac Function in Pressure Overload and Postischemic Cardiac Injury in Rodents: a Systematic Review and Meta-Analysis</article-title>. <source>Cardiovasc. Drugs Ther</source> <pub-id pub-id-type="doi">10.1007/s10557-020-07100-y</pub-id> </citation>
</ref>
<ref id="B40">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Siti</surname>
<given-names>H. N.</given-names>
</name>
<name>
<surname>Jalil</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Asmadi</surname>
<given-names>A. Y.</given-names>
</name>
<name>
<surname>Kamisah</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2020a</year>). <article-title>Roles of Rutin in Cardiac Remodeling</article-title>. <source>J.&#x20;Funct. Foods</source> <volume>64</volume>, <fpage>103606</fpage>. <pub-id pub-id-type="doi">10.1016/j.jff.2019.103606</pub-id> </citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sriramula</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Francis</surname>
<given-names>J.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Tumor Necrosis Factor - Alpha Is Essential for Angiotensin II-Induced Ventricular Remodeling: Role for Oxidative Stress</article-title>. <source>PLoS One</source> <volume>10</volume> (<issue>9</issue>), <fpage>e0138372</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0138372</pub-id> </citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sun</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Jin</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Piao</surname>
<given-names>Z. H.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Ryu</surname>
<given-names>Y.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>
<italic>Dendropanax Morbifera</italic> Prevents Cardiomyocyte Hypertrophy by Inhibiting the Sp1/GATA4 Pathway</article-title>. <source>Am. J.&#x20;Chin. Med.</source> <volume>46</volume> (<issue>5</issue>), <fpage>1021</fpage>&#x2013;<lpage>1044</lpage>. <pub-id pub-id-type="doi">10.1142/S0192415X18500532</pub-id> </citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Takano</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Zou</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Hasegawa</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Akazawa</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Nagai</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Komuro</surname>
<given-names>I.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Oxidative Stress-Induced Signal Transduction Pathways in Cardiac Myocytes: Involvement of ROS in Heart Diseases</article-title>. <source>Antioxid. Redox Signal.</source> <volume>5</volume> (<issue>6</issue>), <fpage>789</fpage>&#x2013;<lpage>794</lpage>. <pub-id pub-id-type="doi">10.1089/152308603770380098</pub-id> </citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tian</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Yu</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Hu</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>P.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Hu</surname>
<given-names>Q.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>Angiotensin II Upregulates Cyclophilin A by Enhancing ROS Production in Rat Cardiomyocytes</article-title>. <source>Mol. Med. Rep.</source> <volume>18</volume> (<issue>5</issue>), <fpage>4349</fpage>&#x2013;<lpage>4355</lpage>. <pub-id pub-id-type="doi">10.3892/mmr.2018.9448</pub-id> </citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tran</surname>
<given-names>H. A.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Greenberg</surname>
<given-names>B. H.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Potential New Drug Treatments for Congestive Heart Failure</article-title>. <source>Expert Opin. Investig. Drugs</source> <volume>25</volume> (<issue>7</issue>), <fpage>811</fpage>&#x2013;<lpage>826</lpage>. <pub-id pub-id-type="doi">10.1080/13543784.2016.1181749</pub-id> </citation>
</ref>
<ref id="B46">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tuszy&#x144;ska</surname>
<given-names>M.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Validation of the Analytical Method for the Determination of Flavonoids in Broccoli</article-title>. <source>J.&#x20;Hortic. Res.</source> <volume>22</volume> (<issue>1</issue>), <fpage>131</fpage>&#x2013;<lpage>140</lpage>. <pub-id pub-id-type="doi">10.2478/johr-2014-0016</pub-id> </citation>
</ref>
<ref id="B47">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vaduganathan</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Claggett</surname>
<given-names>B. L.</given-names>
</name>
<name>
<surname>Desai</surname>
<given-names>A. S.</given-names>
</name>
<name>
<surname>Anker</surname>
<given-names>S. D.</given-names>
</name>
<name>
<surname>Perrone</surname>
<given-names>S. V.</given-names>
</name>
<name>
<surname>Janssens</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>Prior Heart Failure Hospitalization, Clinical Outcomes, and Response to Sacubitril/valsartan Compared with Valsartan in HFpEF</article-title>. <source>J.&#x20;Am. Coll. Cardiol.</source> <volume>75</volume> (<issue>3</issue>), <fpage>245</fpage>&#x2013;<lpage>254</lpage>. <pub-id pub-id-type="doi">10.1016/j.jacc.2019.11.003</pub-id> </citation>
</ref>
<ref id="B48">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wang</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Long</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>J.&#x20;X.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>C. Y.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>B.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>A Circular RNA Protects the Heart from Pathological Hypertrophy and Heart Failure by Targeting miR-223</article-title>. <source>Eur. Heart J.</source> <volume>37</volume> (<issue>33</issue>), <fpage>2602</fpage>&#x2013;<lpage>2611</lpage>. <pub-id pub-id-type="doi">10.1093/eurheartj/ehv713</pub-id> </citation>
</ref>
<ref id="B49">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wen</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Luo</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>Q.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>NADPH Oxidase Hyperactivity Contributes to Cardiac Dysfunction and Apoptosis in Rats with Severe Experimental Pancreatitis through ROS-Mediated MAPK Signaling Pathway</article-title>. <source>Oxid. Med. Cel. Longev.</source> <volume>2019</volume>, <fpage>4578175</fpage>. <pub-id pub-id-type="doi">10.1155/2019/4578175</pub-id> </citation>
</ref>
<ref id="B50">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Xu</surname>
<given-names>W. P.</given-names>
</name>
<name>
<surname>Yao</surname>
<given-names>T. Q.</given-names>
</name>
<name>
<surname>Jiang</surname>
<given-names>Y. B.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>M. Z.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y. P.</given-names>
</name>
<name>
<surname>Yu</surname>
<given-names>Y.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Effect of the Angiotensin II Receptor Blocker Valsartan on Cardiac Hypertrophy and Myocardial Histone Deacetylase Expression in Rats with Aortic Constriction</article-title>. <source>Exp. Ther. Med.</source> <volume>9</volume> (<issue>6</issue>), <fpage>2225</fpage>&#x2013;<lpage>2228</lpage>. <pub-id pub-id-type="doi">10.3892/etm.2015.2374</pub-id> </citation>
</ref>
<ref id="B51">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yan</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J.&#x20;D.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Lv</surname>
<given-names>Y. J.</given-names>
</name>
<name>
<surname>Jiang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>G. L.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Quercetin Inhibits Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats and Inhibits Angiotensin II-Induced H9C2 Cells Hypertrophy by Enhancing PPAR-&#x3b3; Expression and Suppressing AP-1 Activity</article-title>. <source>PLoS One</source> <volume>8</volume> (<issue>9</issue>), <fpage>e72548</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0072548</pub-id> </citation>
</ref>
<ref id="B53">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ying</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Xu</surname>
<given-names>M. C.</given-names>
</name>
<name>
<surname>Tan</surname>
<given-names>J.&#x20;H.</given-names>
</name>
<name>
<surname>Shen</surname>
<given-names>J.&#x20;H.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>D. F.</given-names>
</name>
</person-group> (<year>2014</year>). <article-title>Pressure Overload-Induced Cardiac Hypertrophy Response Requires Janus Kinase 2-histone Deacetylase 2 Signaling</article-title>. <source>Int. J.&#x20;Mol. Sci.</source> <volume>15</volume> (<issue>11</issue>), <fpage>20240</fpage>&#x2013;<lpage>20253</lpage>. <pub-id pub-id-type="doi">10.3390/ijms151120240</pub-id> </citation>
</ref>
<ref id="B54">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yokota</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Y.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>p38 MAP Kinases in the Heart</article-title>. <source>Gene</source> <volume>575</volume> (<issue>2 Pt 2</issue>), <fpage>369</fpage>&#x2013;<lpage>376</lpage>. <pub-id pub-id-type="doi">10.1016/j.gene.2015.09.030</pub-id> </citation>
</ref>
<ref id="B55">
<citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname>Yullia</surname>
<given-names>T.</given-names>
</name>
</person-group> (<year>2008</year>). &#x201c;<article-title>Prakata</article-title>,&#x201d; in <source>Variasi Masakan Petai &#x26; Jengkol, Tim Dapur DeMedia (Jakarta Selatan, DeMedia Pustaka)</source>. <publisher-name>Jakarta Selatan and DeMedia</publisher-name>, <volume>2</volume>. </citation>
</ref>
<ref id="B56">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zaini</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Mustaffa</surname>
<given-names>F.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Review: Parkia Speciosa as Valuable, Miracle of Nature</article-title>. <source>Ajmah</source> <volume>2</volume> (<issue>3</issue>), <fpage>1</fpage>&#x2013;<lpage>9</lpage>. <pub-id pub-id-type="doi">10.9734/AJMAH/2017/30997</pub-id> </citation>
</ref>
<ref id="B58">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Elimban</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Nijjar</surname>
<given-names>M. S.</given-names>
</name>
<name>
<surname>Gupta</surname>
<given-names>S. K.</given-names>
</name>
<name>
<surname>Dhalla</surname>
<given-names>N. S.</given-names>
</name>
</person-group> (<year>2003</year>). <article-title>Role of Mitogen-Activated Protein Kinase in Cardiac Hypertrophy and Heart Failure</article-title>. <source>Exp. Clin. Cardiol.</source> <volume>8</volume> (<issue>4</issue>), <fpage>173</fpage>&#x2013;<lpage>183</lpage>. </citation>
</ref>
<ref id="B59">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhu</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>R. D.</given-names>
</name>
<name>
<surname>Lv</surname>
<given-names>Y. G.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>Y. M.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Xu</surname>
<given-names>J.&#x20;Q.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>BRD4 Blockage Alleviates Pathological Cardiac Hypertrophy through the Suppression of Fibrosis and Inflammation via Reducing ROS Generation</article-title>. <source>Biomed. Pharmacother.</source> <volume>121</volume>, <fpage>109368</fpage>. <pub-id pub-id-type="doi">10.1016/j.biopha.2019.109368</pub-id> </citation>
</ref>
<ref id="B60">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhuang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Song</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Cui</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Liu</surname>
<given-names>Z.</given-names>
</name>
<etal/>
</person-group> (<year>2016</year>). <article-title>Noncovalent Interactions between Superoxide Dismutase and Flavonoids Studied by Native Mass Spectrometry Combined with Molecular Simulations</article-title>. <source>Anal. Chem.</source> <volume>88</volume> (<issue>23</issue>), <fpage>11720</fpage>&#x2013;<lpage>11726</lpage>. <pub-id pub-id-type="doi">10.1021/acs.analchem.6b03359</pub-id> </citation>
</ref>
<ref id="B61">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zucker</surname>
<given-names>I. H.</given-names>
</name>
<name>
<surname>Schultz</surname>
<given-names>H. D.</given-names>
</name>
<name>
<surname>Patel</surname>
<given-names>K. P.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>Modulation of Angiotensin II Signaling Following Exercise Training in Heart Failure</article-title>. <source>Am. J.&#x20;Physiol. Heart Circ. Physiol.</source> <volume>308</volume> (<issue>8</issue>), <fpage>H781</fpage>&#x2013;<lpage>H791</lpage>. <pub-id pub-id-type="doi">10.1152/ajpheart.00026.2015</pub-id> </citation>
</ref>
</ref-list>
<sec id="s11">
<title>Glossary</title>
<def-list>
<def-item>
<term id="G1-fphar.2021.741623">
<bold>Ang II</bold>
</term>
<def>
<p>angiotensin&#x20;II</p>
</def>
</def-item>
<def-item>
<term id="G2-fphar.2021.741623">
<bold>ANOVA</bold>
</term>
<def>
<p>one-way analysis of variance</p>
</def>
</def-item>
<def-item>
<term id="G3-fphar.2021.741623">
<bold>AT<sub>1</sub>R</bold>
</term>
<def>
<p>Ang II type 1 receptor</p>
</def>
</def-item>
<def-item>
<term id="G4-fphar.2021.741623">
<bold>AUC</bold>
</term>
<def>
<p>area under the&#x20;curve</p>
</def>
</def-item>
<def-item>
<term id="G5-fphar.2021.741623">
<bold>BNP</bold>
</term>
<def>
<p>B-type natriuretic peptide</p>
</def>
</def-item>
<def-item>
<term id="G6-fphar.2021.741623">
<bold>cGMP</bold>
</term>
<def>
<p>cyclic guanosine monophosphate</p>
</def>
</def-item>
<def-item>
<term id="G7-fphar.2021.741623">
<bold>DMEM</bold>
</term>
<def>
<p>Dulbecco&#x2019;s Modified Eagle Medium</p>
</def>
</def-item>
<def-item>
<term id="G8-fphar.2021.741623">
<bold>DMSO</bold>
</term>
<def>
<p>dimethyl sulfoxide</p>
</def>
</def-item>
<def-item>
<term id="G9-fphar.2021.741623">
<bold>DPI</bold>
</term>
<def>
<p>diphenyleneiodonium</p>
</def>
</def-item>
<def-item>
<term id="G10-fphar.2021.741623">
<bold>EDTA</bold>
</term>
<def>
<p>ethylenediaminetetraacetic&#x20;acid</p>
</def>
</def-item>
<def-item>
<term id="G11-fphar.2021.741623">
<bold>ELISA</bold>
</term>
<def>
<p>enzyme-linked immunosorbent&#x20;assay</p>
</def>
</def-item>
<def-item>
<term id="G12-fphar.2021.741623">
<bold>eNOS</bold>
</term>
<def>
<p>endothelial nitric oxide synthase</p>
</def>
</def-item>
<def-item>
<term id="G13-fphar.2021.741623">
<bold>ERK1/2</bold>
</term>
<def>
<p>extracellular signal-related kinase</p>
</def>
</def-item>
<def-item>
<term id="G14-fphar.2021.741623">
<bold>FBS</bold>
</term>
<def>
<p>fetal bovine&#x20;serum</p>
</def>
</def-item>
<def-item>
<term id="G15-fphar.2021.741623">
<bold>HPLC</bold>
</term>
<def>
<p>high-performance liquid chromatography</p>
</def>
</def-item>
<def-item>
<term id="G16-fphar.2021.741623">
<bold>HRP</bold>
</term>
<def>
<p>horseradish peroxidase</p>
</def>
</def-item>
<def-item>
<term id="G17-fphar.2021.741623">
<bold>IC<italic>50</italic>
</bold>
</term>
<def>
<p>median inhibitory concentration</p>
</def>
</def-item>
<def-item>
<term id="G18-fphar.2021.741623">
<bold>iNOS</bold>
</term>
<def>
<p>inducible nitric oxide synthase</p>
</def>
</def-item>
<def-item>
<term id="G19-fphar.2021.741623">
<bold>JNK</bold>
</term>
<def>
<p>c-Jun N-terminal kinase</p>
</def>
</def-item>
<def-item>
<term id="G20-fphar.2021.741623">
<bold>MAPK</bold>
</term>
<def>
<p>mitogen-activated protein kinase</p>
</def>
</def-item>
<def-item>
<term id="G21-fphar.2021.741623">
<bold>MEF2</bold>
</term>
<def>
<p>myocyte enhancer factor-2</p>
</def>
</def-item>
<def-item>
<term id="G22-fphar.2021.741623">
<bold>MTS</bold>
</term>
<def>
<p>3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium</p>
</def>
</def-item>
<def-item>
<term id="G23-fphar.2021.741623">
<bold>NADPH</bold>
</term>
<def>
<p>nicotinamide adenine dinucleotide phosphate</p>
</def>
</def-item>
<def-item>
<term id="G24-fphar.2021.741623">
<bold>NF-&#x3ba;B</bold>
</term>
<def>
<p>nuclear factor kappa-B</p>
</def>
</def-item>
<def-item>
<term id="G25-fphar.2021.741623">
<bold>NO</bold>
</term>
<def>
<p>nitric&#x20;oxide</p>
</def>
</def-item>
<def-item>
<term id="G26-fphar.2021.741623">
<bold>NOX</bold>
</term>
<def>
<p>NADPH oxidase</p>
</def>
</def-item>
<def-item>
<term id="G27-fphar.2021.741623">
<bold>NFAT</bold>
</term>
<def>
<p>nuclear factor of activated T-cells</p>
</def>
</def-item>
<def-item>
<term id="G28-fphar.2021.741623">
<bold>NOS2</bold>
</term>
<def>
<p>nitric oxide synthase&#x20;2</p>
</def>
</def-item>
<def-item>
<term id="G29-fphar.2021.741623">
<bold>O<sub>2</sub>
<sup>&#x2212;&#x2022;</sup>
</bold>
</term>
<def>
<p>superoxide&#x20;anion</p>
</def>
</def-item>
<def-item>
<term id="G30-fphar.2021.741623">
<bold>P-ERK1/2</bold>
</term>
<def>
<p>phosphorylated ERK1/2</p>
</def>
</def-item>
<def-item>
<term id="G31-fphar.2021.741623">
<bold>p38</bold>
</term>
<def>
<p>p38 kinase</p>
</def>
</def-item>
<def-item>
<term id="G32-fphar.2021.741623">
<bold>PI3K/Akt/GSK-3&#x3b2;</bold>
</term>
<def>
<p>phosphatidylinositol 3-kinase/protein kinase B/glycogen synthase kinase-3&#x3b2;</p>
</def>
</def-item>
<def-item>
<term id="G33-fphar.2021.741623">
<bold>P-p38</bold>
</term>
<def>
<p>phosphorylated&#x20;p38</p>
</def>
</def-item>
<def-item>
<term id="G34-fphar.2021.741623">
<bold>P-JNK</bold>
</term>
<def>
<p>phosphorylated JNK</p>
</def>
</def-item>
<def-item>
<term id="G35-fphar.2021.741623">
<bold>PKG</bold>
</term>
<def>
<p>protein kinase G</p>
</def>
</def-item>
<def-item>
<term id="G36-fphar.2021.741623">
<bold>ROS</bold>
</term>
<def>
<p>reactive oxygen species</p>
</def>
</def-item>
<def-item>
<term id="G37-fphar.2021.741623">
<bold>SEM</bold>
</term>
<def>
<p>standard error of the&#x20;mean</p>
</def>
</def-item>
<def-item>
<term id="G38-fphar.2021.741623">
<bold>SOD</bold>
</term>
<def>
<p>superoxide dismutase</p>
</def>
</def-item>
<def-item>
<term id="G39-fphar.2021.741623">
<bold>Sp1/GATA4</bold>
</term>
<def>
<p>specificity protein-1/GATA binding protein-4</p>
</def>
</def-item>
<def-item>
<term id="G40-fphar.2021.741623">
<bold>SPSS</bold>
</term>
<def>
<p>Statistical Product and Service Solutions</p>
</def>
</def-item>
<def-item>
<term id="G41-fphar.2021.741623">
<bold>SRF</bold>
</term>
<def>
<p>serum response factor</p>
</def>
</def-item>
<def-item>
<term id="G42-fphar.2021.741623">
<bold>TNF&#x3b1;</bold>
</term>
<def>
<p>tumor necrosis factor-&#x3b1;</p>
</def>
</def-item>
<def-item>
<term id="G43-fphar.2021.741623">
<bold>t<sub>R</sub>
</bold>
</term>
<def>
<p>retention&#x20;time</p>
</def>
</def-item>
</def-list>
</sec>
</back>
</article>