When there is damage to cardiac tissue, enzymes such as CK-MB, AST, and LDH, along with proteins, are released into the bloodstream, resulting in an increase in their serum levels. Therefore, measuring the levels of these enzymes and proteins in the blood can be used as a diagnostic tool for detecting heart dysfunction (
31). Administration of D-Gal increases these cardiac markers in serum, while co-administration of OLE with D-Gal reduces these disturbances. It is worth mentioning that normalization of serum levels of these markers via OLE indicates protection of cardiac cells (
32).
The role of oxidative stress in causing heart damage has been well demonstrated (
33). If the body is unable to neutralize oxidative stress, an imbalance is created, leading to cardiovascular diseases. Oxidative stress can also promote inflammation and contribute to the development of hypertension, heart failure, and other cardiovascular disorders. Additionally, oxidative stress can cause damage to cardiac cells, leading to cell death and the release of enzymes and proteins into the bloodstream, which can be used as markers of heart dysfunction. Therefore, reducing oxidative stress has become a vital target for the prevention and treatment of these diseases (
33,
34).
Mammalian bodies have multiple antioxidant defense mechanisms (such as SOD, GPx, and CAT) that help manage free radicals, maintaining equilibrium between oxidants and antioxidants, and preventing oxidative stress (
35,
36). Current studies have provided insight into the disease-protective mechanism of OLE and elucidated many of its effects through oxidative stress modulation and antioxidant action (
37). Oleuropein has demonstrated the capability to inhibit the production of reactive oxygen and nitrogen species (ROS and NOS, respectively) in vitro biochemical tests, as well as in human cells, where it prevented excessive ROS generation. It was also shown to reduce oxidative stress by modulating the ERK/Nrf2 pathway-mediated signaling, with downstream effects on a variety of cellular processes (
38).
Increasing biomarkers such as MDA and PC, and decreasing antioxidant enzymes such as SOD, GPx, and CAT, in some ways indicate oxidative damage (
39). Our findings showed that aging in the D-Gal group was associated with an elevation in both MDA and PC content and a reduction in GSH, CAT, SOD, and GPx activities. These findings indicated that intraperitoneal administration of D-Gal for 8 weeks increased oxidative stress in the heart tissue of rats. These findings are consistent with other studies. In a similar study, Yang et al. (
40) showed that the administration of 150 mg/kg of D-Gal for 8 weeks increased oxidative stress, evidenced by decreased GSH and other enzymatic antioxidants such as SOD. Studies conducted by Fu et al. in 2018 (
41), Yang et al. in 2016 (
40), and Coban et al. in 2015 (
42) also showed that subcutaneous administration of D-Gal for 8 weeks increased oxidative stress in different tissues. Another study conducted by Bo-Htay et al. revealed that D-Gal administration could cause cardiac damage through upregulation of the expression of senescence markers. They suggested that increased oxidative stress, decreased antioxidant levels, and heightened apoptosis are some of the mechanisms involved in promoting aging induced by D-Gal (
43).
Simultaneous administration of OLE by gavage for 8 weeks led to remarkable alterations in the tissue antioxidant status of the heart, resulting in increased GSH, CAT, SOD, and GPx activities and reduced MDA and PC levels in treated groups compared to the group that received D-Gal alone. These findings suggest that the reduction in oxidative stress is likely due to an increase in antioxidant defense mechanisms. These effects obtained from the present study are comparable to another study conducted by Coban et al. in 2014 (
44). They evaluated the positive effect of olive leaf extract on oxidative stress in vital tissues of elderly rats. The findings showed that the consumption of this extract can decrease oxidative stress in organs such as the liver, heart, and brain of rats (
44).
Some studies have shown that SIRT1 has a protective role against apoptosis and plays a role in the survival of cardiac myocytes and neurons under stress in vitro. Overexpression of SIRT1 (2.5-fold to moderate 7.5-fold) in the hearts of transgenic mice reduces age-related effects, including cardiac hypertrophy, apoptosis, fibrosis, cardiac dysfunction, and expression of aging-related markers (
45,
46). Our findings showed that D-Gal administration resulted in downregulation of SIRT1 gene expression in cardiac tissue. Oleuropein administration resulted in significant expression of the SIRT1 gene in cardiac tissue, as shown by the current study. Our findings are consistent with those of a study conducted by Alcendor et al. They reported that a moderate increase in SIRT1 expression can provide protection for heart tissue against oxidative stress while also promoting the expression of antioxidant enzymes (
47).
A limitation of D-Gal is that, as a sugar, it can be consumed by cells, potentially reducing its inducing effect. The difference between D-Gal in inducing aging and the natural aging process is that natural aging requires time, whereas D-Gal can induce aging in a short period (
48). The PGC-1α is highly expressed in tissues with high energy demands, such as the heart, skeletal muscle, and liver. It is activated by various stimuli, including exercise, cold exposure, and fasting, and can induce the expression of genes involved in energy metabolism. The PGC-1α has been shown to play a role in the pathogenesis of metabolic disorders such as obesity, type 2 diabetes, and cardiovascular disease. Therefore, it has become an attractive target for the development of therapeutic interventions (
49-
51).
The results of the present study indicated that administration of D-Gal caused downregulation of PGC-1α in heart tissue. This reduction was significant compared to the control (healthy) group. Co-administration of OLE with D-Gal for 8 weeks by gavage increased PGC-1α gene expression, showing a reduction in the effect of D-Gal. Notably, this effect was more prominent and higher at a dose of 80 mg/kg OLE. Histopathological results of heart tissue also confirmed the findings of antioxidant tests and gene expression, showing that D-Gal consumption led to severe damage to heart tissue, while OLE administration reduced the severity of heart tissue damage. In histopathological studies of heart tissue, performed using conventional H&E staining, signs of D-Gal toxicity in the form of hemorrhage, myocardial irregularity, myofibrillar loss, and inflammatory cell infiltration were clearly evident. The histopathological results of heart tissue in the present study align with studies conducted by Wang et al. in 2012 and He et al. in 2009 (
52,
53).
Practically, the effect of OLE has been shown to prevent heart aging. Thus, including olives (the source of OLE) in the human diet could be beneficial. Overall, the results of the present study and other reports indicate the role of OLE in improving cardiac function and reducing oxidative stress. Therefore, this issue should be confirmed with further studies and its use in humans, which requires additional investigation.
The limitations of this study include the use of D-Gal to induce aging instead of naturally aged rats, which were not available. Additionally, given the complexity of the antioxidant-oxidative stress system, the lack of measurement of DNA damage indices and total antioxidant capacity is another limitation. Considering the wide range of mechanisms for improving telomere function in heart tissue, the lack of measurement of key proteins in nuclear transcription, such as NRFs and PPARs, is also a limitation.
5.1. Conclusions
Our findings showed that OLE dose-dependently reduced heart lesions caused by D-Gal. The findings suggest that the protective effect of OLE is through the reduction of oxidative damage. The expression of genes involved in the aging process increased, and oxidative stress factors, such as MDA, were effectively suppressed. In fact, the oxidative phase decreased while the antioxidant phase increased, with an increase in PGC1. This indicates that PGC1 functions to increase the number of heart mitochondria, thereby improving heart function. Based on the results obtained in this study, we can explore the effect of this substance on other factors affecting aging. Considering our study, the findings showed that OLE administration increased the levels of SOD and GPx enzymes, as well as PGC1-α and SIRT1 gene expression, while decreasing MDA and PC levels in the heart tissue of rats. It is suggested that future studies evaluate the effect of this substance on mitochondrial biogenesis and the improvement of telomere and telomerase enzyme function.